Mitsuo Kanagae

Associations of vertebral deformities and osteoarthritis with back pain among Japanese women: the Hizen-Oshima study

SummaryWe examined the spinal distribution of the types of vertebral deformities and the associations of vertebral deformities and osteoarthritis with back pain in Japanese women. Midthoracic and upper lumbar vertebrae were more susceptible to deformity. Vertebral deformity and osteoarthritis were frequent and were associated with back pain.IntroductionVertebral fractures due to osteoporosis and osteoarthritis are both common and significant health problems in aged people. However, little is known about the descriptive epidemiology of the individual deformity types and the relative clinical impact in women in Japan.MethodsLateral radiographs were obtained from 584 Japanese women ages 40 to 89 years old. Deformities were defined as vertebral heights of more than 3 standard deviations (SDs) below the normal mean. Osteoarthritis was defined as Kellgren–Lawrence (KL) grade 2 or higher. Information on upper or low back pain during the previous month was collected by questionnaire. We compared the spinal distribution of the three types of vertebral deformities (wedge, endplate, and crush) typical of fractures and examined the associations of number and type of vertebral deformities and osteoarthritis with back pain.ResultsFifteen percent of women had at least one vertebral deformity and 74% had vertebral osteoarthritis. The prevalence of upper or low back pain was 30.1%. Deformities were most common in the midthoracic and upper lumbar regions and wedge was the frequent type, followed by endplate and crush. Multiple logistic regression analysis showed that the odds of back pain was 3.0 (95% CI 1.5–6.3) times higher for women with a single wedge deformity and 3.2 (95% CI 1.0-–0.6) times higher for women with two or more wedge deformities, compared to women with no wedge deformity. Vertebral osteoarthritis was associated with back pain (OR 1.8, 95% CI 1.1–2.9), independent of other covariates including age and deformities.ConclusionOur results in this group of Japanese women are similar to and consistent with results reported previously in other populations of Japanese and Caucasians.

Factors Predicting Health-related Quality of Life in Knee Osteoarthritis Among Community-dwelling Women in Japan: The Hizen-Oshima Study

Knee osteoarthritis is the most common chronic joint disorder in elderly people. However, a population-based, longitudinal study on health-related quality of life in knee osteoarthritis has not been conducted in Japan. We studied 333 women aged 50 years and older at baseline, with 8 to 9 years of follow-up. Anteroposterior weight-bearing knee radiographs were obtained at baseline and graded according to the Kellgren-Lawrence criteria. Definite osteoarthritis was defined as Kellgren-Lawrence grade 2 or higher in at least 1 joint. At baseline, all participants were asked if they had knee pain and comorbidities (heart disease, lung disease, stroke, or diabetes mellitus). Height (m), weight (kg), and chair stand time were measured. At follow-up, quality of life in knee osteoarthritis was evaluated using the Japanese Knee Osteoarthritis Measure score. Multiple linear regression analysis showed that age, knee osteoarthritis, knee pain, comorbidity, and increasing chair stand time were independently related to subsequent health-related quality of life. These findings suggest that treating knee osteoarthritis and comorbidities, managing pain, and optimizing lower extremity muscle strength may be effective targets for intervention.

Association of Physical Performance and Pain With Fear of Falling Among Community-Dwelling Japanese Women Aged 65 Years and Older.

AbstractOur aim was to explore the association of physical performance and pain with fear of falling among community-dwelling Japanese women.The subjects were 278 women aged 65 years and over. We collected information on fear of falling, painful joints, comorbidities, falls in the previous year, and cataracts. Walking time (distance of 6 m), chair stand time (5 times), grip strength, the timed up and go test (TUG), and functional reach were measured.The prevalence of fear of falling was 36.3%, and it increased with age, but it was not significant (P = 0.081). Multivariate logistic regression analysis showed that poor physical performance (longer walking time, longer chair stand time, weaker grip strength, and longer TUG) and pain (low back, and upper and lower extremity pain) were significantly associated with fear of falling after adjusting for age, body mass index, comorbidities, falls in the previous year, and cataracts.Maintaining physical functioning and managing pain may be important for elderly women with fear of falling.

Association of spinal inclination with physical performance measures among community‐dwelling Japanese women aged 40 years and older

Spinal inclination assesses spinal posture as a whole. However, the association between spinal inclination and physical performance has not yet been fully elucidated. Therefore, this study aimed to explore the association of spinal inclination with physical performance measures.

Age-specific risk factors for incident disability in activities of daily living among middle-aged and elderly community-dwelling Japanese women during an 8–9-year follow up: The Hizen-Oshima study

The purposes of the present study were to investigate risk factors for incident disability in activities of daily living (ADL) among middle‐aged and older women, and to determine whether there are differences in risk factors according to age groups.

Usefulness of chair stand time as a surrogate of gait speed in diagnosing sarcopenia

Determining gait speed as a measure of physical performance is recommended in diagnosing sarcopenia. Gait speed measurements require a certain amount of space (e.g. a 6‐m course), and might not be feasible in clinical settings or heath checkup examination sites. We developed a formula to estimate chair stand time based on gait speed, and examined the validity (sensitivity and specificity) of using the estimated chair stand time cut‐off point as a surrogate for the recommended gait speed cut‐off point.

Evaluation of high sensitive C-reactive protein and 5-10 methylenetetrahydrofolate reductase genotype in japanese young adults.

Primary objective: To carry out a preliminary evaluation of subclinical inflammation and its genetic background in young adults. Research design: Fifty-five healthy Japanese young adults aged 19–27 years (37 males and 18 females, mean age: 22.3 years), and 58 healthy Japanese adults aged 40 to 60 years (21 males and 37 females, mean age: 51.5 years) were included in this study. Methods and procedures: We measured plasma high-sensitive C-reactive protein (hs-CRP) levels and screened for the C677T polymorphism of the 5-10 methylenetetrahydrofolate reductase gene (MTHFR), which is considered a genetic risk factor for atherosclerosis, by HinfI digestion. Main outcomes and results: Hs-CRP levels of the young adult group were significantly lower than the levels of the middle aged group (0.014±0.030 mg/dl vs. 0.031±0.040 mg/dl, p=0.005). The levels were significantly higher in males than in females (0.028±0.019 mg/dl vs. 0.013±0.010 mg/dl, p=0.008) among young adults. Furthermore, we evaluated the relationship of the C677T genotype and hs-CRP values, but found no association between them. Conclusions: Although the sample size is limited, our preliminary study demonstrated the profiles of hs-CRP in Japanese young adults. Further investigation will be needed to establish the guidelines for customized school health education using sensitive laboratory and genetic markers.

Exercise intervention implemented by trained volunteers improves health-related quality of life among Japanese community-dwelling older females: an intervention study

[Purpose] This study aimed to evaluate the sustainability and efficacy of exercise intervention, as implemented by professionally trained volunteers, on the health-related quality of life among Japanese community-dwelling older females. [Subjects and Methods] We conducted a non-randomized observational prospective study of a six-month exercise intervention delivered by volunteers or health professionals. Health-related quality of life was scored using the Short Form 36 Health Survey before and after the intervention. Participants were classified into three groups, comprising those with improved health, maintained health, and reduced health. [Results] Among 127 Japanese community-dwelling females aged >65 years, 50 of 62 (80.6%) females involved in the intervention conducted by volunteers, and 55 of 65 (84.6%) females involved in the intervention conducted by health professionals, completed the six-month intervention program. Scoring revealed that interventions by both volunteers and health professionals had a maintaining or improving effect on scores in >70% of participants instead of an expected six-month aging decline. [Conclusion] Exercise intervention by trained volunteers was sustainable and effective for improving the health-related quality of life among Japanese community-dwelling older females. Professionally trained volunteers could benefit communities in helping older persons avoid the need for daily nursing care through promoting health activities.

Usefulness of chair stand time as a surrogate of gait speed in diagnosing sarcopenia: Letter to the Editor

conform to the definitions of the European Working Group on Sarcopenia in Older People and the Asian Working Group for Sarcopenia, because the purpose of the research is consideration of its usefulness in sarcopenia diagnosis. Fourth, there were mistakes in the description of the height of both sexes, and the weight and BMI of women in Table 1 of reference 1. Female participants could be presumed to be the same as the participants of the Oshima Health Study, which was presented as a reference. We want to ensure that the authors’ interpretation is correct. In addition, the descriptions of the eligibility criteria and the registration methods of the male participants were insufficient. Even if 87 male participants were actually analyzed, the authors should describe the eligibility criteria, and the sources and methods of participant selection. Finally, the height of the chair used for the measurement of chair stand timewas not reported. Thedescription of the chair was only “a standard chair.” The height of the seat surface and the presence or absence of a backrest and armrests were unclear. Chair stand time might change depending on the height of the seat or thematerial of the seat surface. Therefore, to increase the reproducibility of this research, the nature of the chair should be described as in previous research, “A standard chair (with a seat height of 40cm) without a backrest but with armrests was used.” We hope that the authors can address these concerns in order to clarify their findings.

Relationship Between Urinary Cross-Linked N-Telopeptide of Type-I Collagen and Heel Stiffness Index Measured by Quantitative Ultrasound in Middle-Aged and Elderly Men.

AbstractThe aim of the present study was to investigate the age-related patterns and the relationship between levels of urinary cross-linked N-telopeptide of type-I collagen (NTx) and heel stiffness index measured by quantitative ultrasound (QUS) in men with a special reference to age groups of aged 40 to 59 years and ≥60 years.A total of 379 men participated in this study. Heel stiffness index (bone mass) was measured by QUS. Spot urine samples were collected, and urinary NTx was measured. The values were corrected for creatinine (Cre) concentration.Stiffness index was significantly lower in men aged ≥60 years compared with men aged 40 to 59 years (P < 0.0001). There was no significant difference of Log (NTx/Cre) by 10-year age groups. Multiple regression analysis showed that higher level of urinary NTx/Cre was significantly correlated with lower stiffness index after adjusting for age and body mass index in men aged ≥60 years, but not in men aged 40 to 59 years.Higher rates of bone resorption were associated with lower stiffness index only in elderly men. Our results may indicate a different mechanism of low bone mass among different age groups.