Motonaga Kojima

The effects of short-term exercise intervention on falls self-efficacy and the relationship between changes in physical function and falls self-efficacy in Japanese older people: a randomized controlled trial.

Arai T, Obuchi S, Inaba Y, Nagasawa H, Shiba Y, Watanabe S, Kimura K, Kojima M: The effects of short-term exercise intervention on falls self-efficacy and the relationship between changes in physical function and falls self-efficacy in Japanese older people: a randomized controlled trial. Am J Phys Med Rehabil 2007;86:133–141. Objective:To evaluate the effects of short-term exercise intervention on falls self-efficacy and to evaluate the relationships between baseline falls self-efficacy and changes in physical function in older people. Design:Single-blinded randomized controlled trial. The participants were 171 subjects aged 65 and older. They were randomly assigned into an exercise intervention group or a health education group. The subjects in the exercise intervention group performed an exercise program for 3 mos. Falls self-efficacy was measured using the falls efficacy scale (FES). The measurements of physical function included static and dynamic balance, walking velocity, flexibility, and strength. Results:There was no significant improvement of FES in either group. But there were significant negative correlations between baseline FES score and the change in maximum walking velocity (r = −0.29, P < 0.018) and knee extensor strength (r = −0.25, P < 0.040. Linear regression analysis showed that the change in static balance was related to baseline FES. Conclusions:The results suggest that a short-term exercise intervention had no effect, possibly because of the high baseline FES scores of the participants, on the confidence of community-dwelling older persons. However, the negative association between FES score and increases in some measures of function suggest that short-term exercise may be beneficial to a subset of older persons with lower FES scores.

Classification of frailty using the Kihon checklist: A cluster analysis of older adults in urban areas.

Frailty is an important predictor of the need for long‐term care and hospitalization. Our aim was to categorize frailty in community‐dwelling older adults.

Physical and Sociopsychological Characteristics of Older Community Residents With Mild Cognitive Impairment as Assessed by the Japanese Version of the Montreal Cognitive Assessment

Background: Although mild cognitive impairment (MCI) criteria are disputable, characterizing various aspects of operational MCI (O-MCI) may lead to a better understanding of potential modulators of cognitive decline and contribute to more effective public health strategies. The aim of the study is to examine characteristics of community-dwelling elderly people with MCI assessed using Japanese version of Montreal Cognitive Assessment (MoCA-J). Methods: A total of 913 community-dwelling Japanese (65-84 years) participated in health examinations in Tokyo, 2011. The MoCA-J, Mini-Mental State Examination (MMSE), and other physical and mental tests were conducted. Excluded were those with <24 MMSE scores. Those with <26 in MoCA-J were divided into 2 subgroups, (A) participants independent of instrumental activities of daily living (IADL) and no memory complaints and (B) participants independent of IADL with memory complaints or partially dependent on IADL with/without memory complaints. Those with ≥26 in MoCA-J and subgroup (A) of MCI were the normal controls (NCs, 57.4%), and subgroup (B) of MCI was O-MCI, 36.5%. We compared each variable between NC and O-MCI, using logistic regression analysis, adjusted for gender and age. Results: The majority of all the groups were independent of IADL. The O-MCI characteristics were increased depressive symptom, worse self-rated health, lower systolic blood pressure, poorer intellectual activities, no hobbies, weaker grip strength, and slower than usual walking speed compared to the NC group. Conclusions: Older persons with O-MCI defined by MoCA-J have partially decreased cognition and physical and sociopsychological functions.

The validity of an assessment of maximum angular velocity of knee extension (KE) using a gyroscope.

Although it is more important to assess the muscular power of the lower extremities than the strength, no simplified method for doing so has been found. The aim of this study was to assess the validity of the assessment of the angular velocity of KE using a gyroscope. Participants included 105 community-dwelling older people (55 women, 50 men, age ± standard deviation (SD) 75±5.3). Pearson correlation coefficients and Spearman rank-correlation coefficients were used to examine the relationships between the angular velocity of KE and functional performance measurements, a self-efficacy scale and health-related quality of life (HRQOL). The data from the gyroscope were significantly correlated with some physical functions such as muscle strength (r=0.304, p<0.01), and walking velocity (r=0.543, p<0.001). In addition, the joint angular velocity was significantly correlated with self-efficacy (r=0.219-0.329, p<0.01-0.05) and HRQOL (r=0.207-0.359, p<0.01-0.05). The absolute value of the correlation coefficient of angular velocity tended to be greater than that of the muscle strength for mobility functions such as walking velocity and the timed-up-and-go (TUG) test. In conclusion, it was found that the assessment of the angular velocity of the knee joint using a gyroscope could be a feasible and meaningful measurement in the geriatrics field.

Relationship between sensory perception and frailty in a community-dwelling elderly population

BackgroundAging anorexia, defined as loss of appetite and/or reduced food intake, has been postulated as a risk factor for frailty. Impairments of taste and smell perception in elderly people can lead to reduced enjoyment of food and contribute to the anorexia of aging.ObjectiveTo evaluate the relationship between frailty and taste and smell perception in elderly people living in urban areas.DesignData from the baseline evaluation of 768 residents aged ≥ 65 years who enrolled in a comprehensive geriatric health examination survey was analyzed. Fourteen out of 29-items of Appetite, Hunger, Sensory Perception questionnaire (AHSP), frailty, age, sex, BMI, chronic conditions and IADL were evaluated. AHSP was analyzed as the total score of 8 taste items (T) and 6 smell items (S). Frailty was diagnosed using a modified Fried’s frailty criteria.ResultsThe area under the receiver operator curves for detection of frailty demonstrated that T (0.715) had moderate accuracy, but S (0.657) had low accuracy. The cutoffs, sensitivity, specificity and Youden Index (YI) values for each perception were T: Cutoff 26.5 (YI: 0.350, sensitivity: 0.639, specificity: 0.711) and S: Cutoff 18.5 (YI: 0.246, sensitivity: 0.690, specificity: 0.556). Results from multiple logistic regression models, after adjusting for age, sex, IADL and chronic conditions showed that participants under the T cutoff were associated with exhaustion and those below the S cutoff were associated with slow walking speed. The adjusted logistic models for age, sex, IADL and chronic conditions showed significant association between T and frailty (OR 2.81, 95% CI 1.29-6.12), but not between S and frailty (OR 1.73, 95% CI 0.83-3.63).ConclusionsTaste and smell perception, particularly taste perception, were associated with a greater risk of frailty in community-dwelling elderly people. These results suggest that lower taste and smell perception may be an indicator of frailty in old age.

Exome-wide Association Study Identifies CLEC3B Missense Variant p.S106G as Being Associated With Extreme Longevity in East Asian Populations

Abstract Life span is a complex trait regulated by multiple genetic and environmental factors; however, the genetic determinants of extreme longevity have been largely unknown. To identify the functional coding variants associated with extreme longevity, we performed an exome-wide association study (EWAS) on a Japanese population by using an Illumina HumanExome Beadchip and a focused replication study on a Chinese population. The EWAS on two independent Japanese cohorts consisting of 530 nonagenarians/centenarians demonstrated that the G allele of CLEC3B missense variant p.S106G was associated with extreme longevity at the exome-wide level of significance (p = 2.33×10–7, odds ratio [OR] = 1.50). The CLEC3B gene encodes tetranectin, a protein implicated in the mineralization process in osteogenesis as well as in the prognosis and metastasis of cancer. The replication study consisting of 448 Chinese nonagenarians/centenarians showed that the G allele of CLEC3B p.S106G was also associated with extreme longevity (p = .027, OR = 1.51), and the p value of this variant reached 1.87×10–8 in the meta-analysis of Japanese and Chinese populations. In conclusion, the present study identified the CLEC3B p.S106G as a novel longevity-associated variant, raising the novel hypothesis that tetranectin, encoded by CLEC3B, plays a role in human longevity and aging.

Construct validity of posture as a measure of physical function in elderly individuals: Use of a digitalized inclinometer to assess trunk inclination

The first aim of the present study was to determine the construct validity of evaluating posture as a measure of physical function in elderly individuals. The second aim was to determine reference values for sternum inclination in elderly individuals when measured using a digitalized inclinometer.

Inverse Association Between Height-Increasing Alleles and Extreme Longevity in Japanese Women

Growth hormone (GH)/insulin-like growth factor-1 (IGF-1)/insulin signaling is one of the most plausible biological pathways regulating aging and longevity. Previous studies have demonstrated that several single nucleotide polymorphisms (SNPs) in the GH/IGF-1/insulin signaling-associated genes influence both longevity and adult height, suggesting the possibility of a shared genetic architecture between longevity and height. We therefore examined the relationship between 30 height-associated SNPs and extreme longevity in a Japanese population consisting of 428 centenarians and 4,026 younger controls. We confirmed that height-increasing genetic scores (HGSs) constructed based on 30 SNPs were significantly associated with height in the controls (p = 6.95 × 10-23). HGS was significantly and inversely associated with extreme longevity in women (p = .011), but not in men, although no SNPs were significantly associated with extreme longevity after Bonferroni correction. The odds ratio for extreme longevity in the lowest HGS group (≤27) and the second lowest HGS group (28-30) relative to the highest HGS group (≥37) was 1.71 (p = .056) and 1.69 (p = .034), respectively, for women. In conclusion, the present study demonstrated an inverse association between height-increasing alleles with extreme longevity in Japanese women, providing novel insight into the genetic architecture of longevity and aging.

Morphological and qualitative characteristics of the quadriceps muscle of community-dwelling older adults based on ultrasound imaging: classification using latent class analysis

BackgroundMuscle thickness and echo intensity measured using ultrasound imaging represent both increased muscle volume and connective tissue accumulation. In combination, these ultrasound measurements can be utilized for assessing sarcopenia in community-dwelling older adults.AimsThis study aimed to determine whether morphological and qualitative characteristics classified by quadriceps muscle thickness and echo intensity measured using ultrasound are associated with muscle strength, physical function, and sarcopenia in community-dwelling older adults.MethodsQuadriceps muscle thickness and echo intensity were measured using ultrasound imaging in 1239 community-dwelling older adults. Latent class analyses were conducted to classify participants based on similarity in the subcutaneous fat thickness (FT), quadriceps muscle thickness (MT), subcutaneous fat echo intensity (FEI), and muscle echo intensity (MEI), which were assessed using ultrasound imaging.Results and discussionMorphological and qualitative characteristics were classified into four types as follows: (A) normal, (B) sarcopenic obesity, (C) obesity, and (D) sarcopenia type. Knee extension strength was significantly greater in A than in B and D. FT and percent body fat were greater in C than in the other types. The correlation between the ultrasound measures and knee extension strength differed among the classification types. The classification types were significantly associated with sarcopenia prevalence.ConclusionsClassification of the morphological and qualitative characteristics obtained from ultrasound imaging may be useful for assessing sarcopenia in community-dwelling older adults.

Relationships between serum brain-derived neurotrophic factor concentration and parameters for health scores in community-dwelling older adults

Brain‐derived neurotrophic factor (BDNF) have been implicated in the progression of neuronal survival, phenotyping differentiation and maintenance of various neurons, as well as neurogenesis. We studied how BDNF affects health parameters of older adults by carrying out a health examination of community‐dwelling older adults.