Shouzoh Ueki

Effect of exercise, aging and functional capacity on acute secretory immunoglobulin A response in elderly people over 75 years of age.

Background:  Age‐associated decline in immune function and regulation, referred to as immunosenescence, brings about an increased incidence of infectious diseases in the aged; however, there are few data on the effect of aging and exercise on mucosal immune function in elderly people. Moreover, there is no evidence on whether the change in functional capacity affects mucosal immunity in elderly people. Therefore, the aim of the present study was to examine the effects of exercise, aging and functional capacity on mucosal immune function in elderly people over 75 years of age.

The development of a Tai Chi exercise regimen for the prevention of conditions requiring long-term care in Japan

This study was to examine an effect of such an exercise program on preventing conditions requiring long-term care in the Japanese frail elderly who participated in a Tai Chi Yuttari-exercise program. The first-intervention group underwent an intervention program by participating in a Tai Chi Yuttari-exercise session once a week for 3 months. Each session lasted 90 min including a break time. Moreover, the subjects received a video recording of the exercise, and instructions to carry out the exercise at home. The same program was administered to the second-intervention group. Physical function improved significantly in the first-intervention group, with single-leg balance (SLB) increasing, and trunk anteflexion increasing after the intervention program. Furthermore, the total score of the Motor Fitness Scale (MFS) improved significantly. On the other hand, mono- and multi-variate analyses showed no significant differences observed in the second-intervention group during the study period. A careful interpretation of the results suggests that Tai Chi Yuttari-exercise improves physical function and ability for frail elderly individuals and could reduce the need for long-term care.

Comparison of characteristics and care-needs certification proportion between participants and non-participants in a geriatric health examination over a 3-year follow-up

The purpose of this study was to compare the care-needs certification proportion of participants and non-participants in a geriatric health examination targeting community-dwelling seniors aged 70 years and older over 3 years. We implemented a geriatric health examination for 1347 community-dwelling adults aged 70 years and older in a local region of Japan in 2004. We followed the occurrence of new care-needs certification for 3 years in 443 subjects who participated in the health examination and in the 395 non-participants. Among the 838 subjects, there were 94 new certifications (11%) during the observation period. Non-participants had a significantly higher proportion of dependent, required assistance with walking and bathing, a history of stroke, poor self-reported health, tendency for depression and outdoors less than once a week than participants. Non-participants had a significantly lower average score of the motor fitness scale (MFS), their standing time from a long sitting position on the floor and the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG Index of Competence). The proportion of care-needs certification over 3 years was significantly higher for non-participants (63/395, 16%) than for participants (31/443, 7%, p<0.05). Non-participants have a higher risk of care-needs certification. It is necessary to investigate current data gathering methods for seniors who do not undergo these examinations.

Effect of time standing up on orthostatic blood pressure change in the elderly: The J‐SHIPP Study

Background:  Orthostatic dysregulation of blood pressure (BP) has been shown to be associated with an increased incidence of future cardiovascular disease, stroke and even mortality. To make a meaningful assessment of this association, we evaluated the effect of time elapsed after standing on any change in orthostatic BP.

The predictive power of physical function assessed by questionnaire and physical performance measures for subsequent disability

Background and aims: To compare the predictive power of physical function assessed by questionnaire and physical performance measures for subsequent disability in community-dwelling elderly persons. Methods: Prospective cohort study. Participants were 813 aged 70 years and older, elderly Japanese residing in the community, included in the Tsurugaya Project, who were not disabled at the baseline in 2003. Physical function was assessed by the questionnaire of “Motor Fitness Scale”. Physical performance measures consisted of maximum walking velocity, timed up and go test (TUG), leg extension power, and functional reach test. The area under the curve (AUC) of the receiver operating characteristic curve for disability was used to compare screening accuracy between Motor Fitness Scale and physical performance measures. Incident disability, defined as certification for long-term care insurance, was used as the endpoint. Results: We observed 135 cases of incident disability during follow-up. The third or fourth quartile for each measure was associated with a significantly increased risk of disability in comparison with the highest quartile. The AUC was 0.70, 0.72, 0.70, 0.68, 0.69 and 0.74, for Motor Fitness Scale, maximum walking velocity, TUG, leg extension power, functional reach test, and total performance score, respectively. Conclusions: The predictive power of physical function assessed by the Motor Fitness Scale was equivalent to that assessed by physical performance measures. Since Motor Fitness Scale can evaluate physical function safely and simply in comparison with physical performance tests, it would be a practical tool for screening persons at high risk of disability.