Masaki Nakagaichi

Effects of Exercise Program Requiring Attention, Memory and Imitation on Cognitive Function in Elderly Persons: A Non-Randomized Pilot Study

Background: Square-Stepping Exercise (SSE) was developed as a novel exercise form that combines physical and cognitive training. Participants watch, recognize, memorize and follow step patterns which an instructor demonstrates on a 4 by 10 square-patterned SSE mat without viewing printed pattern diagrams. The purpose of this study was to examine the effects of SSE on cognitive function. Methods: Community-dwelling, healthy elderly persons were non-randomly divided into a weekly session group (WG) (26 participants) and a fortnightly session group (FG) (32 participants) for a six month intervention. SSE sessions lasted 50-60 minutes, and an SSE mat was provided to participants for home use. We asked participants to review printed pattern diagrams at home, then practice the SSE and record this in a log. Five cognitive tests were given preand post-intervention: cued recall, character position referencing, animal name listing, clock drawing and an analogy test. Results: Both groups significantly improved in the cued recall test (memory): 2.7 points [95% confidence interval (CI): 1.1-4.4] in the WG and 2.4 points [95%CI: 0.9-4.0] in the FG. Furthermore, the WG significantly improved in the character position referencing test (executive function) (5.6 points [95%CI: 2.8-8.3]). The three other cognitive function tests did not significantly improve. On the cued recall test, the rate of session participation and the rate of SSE performance for all designated days positively correlated in the WG/FG combined data. On the character position referencing test, the total SSE time and the number of days SSE was performed at home and in session were significant in the WG/FG combined data. Conclusion: The results of this pilot study indicate that SSE be could use as an intervention to promote cognitive function, especially memory and executive function. The amount and/or frequency of exposure to SSE would affect its impact on various types of cognitive function.

Accuracy of two simple methods for the assessment of health-related physical fitness.

We have developed a useful equation for estimating health-related physical fitness age. This version of health-related fitness age was developed as an extension of the biological age index and is useful for evaluation of individual differences in functional abilities of middle-aged and older adults. This measure consists of 4 independent variables fitness (V̇O2 max, standing trunk flexibility, %fat, and grip strength). However, direct measurement of maximal oxygen uptake (V̇O2 max) is an invasive clinical procedure and not practical for large scale work. In the current study, we attempted to assess the fitness age more feasibly. We selected a questionnaire method and a 12-min. submaximal treadmill walk test as substitutes for the V̇O2 max test. The three fitness ages were computed for 23 Japanese men [Mage 54.1 ± 10.7 yr.), using actual V̇O2 max (actual fitness age), questionnaire V̇O2 max (predicted questionnaire fitness age), and treadmill V̇O2 max (predicted treadmill fitness age). Predicted questionnaire fitness age (61.0 ± 10.5 yr.) and predicted treadmill fitness age (60.0 ± 12.4 yr.) were significantly correlated with actual fitness age (60.1 ± 12.4 yr.) (r = .96 and .97, respectively). There were no significant differences among the three indices, but there was a significant difference between actual fitness age and chronological age (p<.05). For V̇O2 max substituting the questionnaire for the treadmill estimate is acceptable in assessing fitness age and reducing the clinical risk for middle-aged and older Japanese men.

Validation of the functional fitness age (FFA) index in older Japanese women.

Functional fitness age (FFA), which we previously described, is a measure of functional age that reflects a person’s overall physical ability to complete daily tasks such as preparing meals and performing various household chores. The purpose of this study was to validate FFA in two elderly populations: 1) older subjects from different communities, and 2) older subjects participating in an exercise intervention program. FFA was calculated from 4 performance tests: performing arm curls; moving beans with chopsticks; demonstrating functional reach; and sitting and walking around two cones. The first study group was selected from 4 different communities (N=127), and was subdivided into a less active group (N=87) and an active group (N=40). The results of the 4 tests for the less active group were not significantly different from those for the original validation group used in developing the FFA equation. The FFA of the less active group (71.1±7.7 yrs) was not different from their chronological age (70.4±6.6 yrs). In the active group, except for the arm curls, test scores were significantly higher than those of the original validation group. The FFA of the active group (66.2±5.1 yrs) was significantly younger than their chronological age (70.9±4.2 yrs). Another group of 14 older women (79.5±3.9 yrs) was recruited for pre- and post-training testing. After the 3-month exercise program, they showed significant improvements in sitting and walking around two cones and functional reach; their FFA decreased significantly from 81.5±5.0 yrs to 78.3±4.5 yrs. The control group selected from the same community (N=16, 79.8±5.3 yrs) showed no significant changes in the 4 performance tests, and their FFA remained unchanged. These results indicate that our FFA is highly cross- validated for different Japanese communities, and is sensitive to changes associated with participation in an exercise intervention program.