Taiki Yukutake

Arterial stiffness is associated with low skeletal muscle mass in Japanese community-dwelling older adults.

To examine whether arterial stiffness, measured by the cardio‐ankle vascular index (CAVI), is associated with skeletal muscle mass index (SMI) in Japanese community‐dwelling older adults.

A survey examining the correlations between Japanese little league baseball coaches' knowledge of and compliance with pitch count recommendations and player elbow pain.

Background: With the incidence of Little League elbow increasing, pitch limit recommendations for preventing throwing injuries have been developed in both the United States and Japan. However, levels of knowledge of and compliance with these recommendations among coaches of young baseball teams in Japan remain unknown. The relationship between these levels and elbow pain among players has not been adequately studied. Hypothesis: Knowledge of and compliance with these recommendations is similar in the United States and Japan. Greater knowledge and higher levels of compliance have a significant correlation with reduced elbow pain in Little League baseball players. Study Design: Cross-sectional study. Methods: Coaches of youth baseball teams in Kyoto, Japan, completed a questionnaire assessing knowledge of and compliance with recommendations. Team variables and coach-related factors concerning elbow pain among young baseball players were surveyed, and the questionnaire investigated demographic data and elbow pain history in the previous 12 months. Results: In total, 123 baseball coaches and 654 baseball players aged 6 to 12 years participated in this study; data were analyzed for 113 coaches and 339 players. Among coaches, 39.8% had accurate knowledge of the recommendations (similar to the US data) and 28.3% complied with them (lower than the US data). There was no correlation between elbow pain and knowledge of and compliance with the recommendations, but coaches’ opinions on the number of games were indicated as a significant risk factor for elbow pain; the more coaches considered the number of games played, the fewer the number of players who experienced elbow pain. Conclusion: The level of knowledge of recommendations in Japan was similar to that in the United States, but compliance levels were far lower. There was no correlation between elbow pain and knowledge and compliance. Clinical Relevance: The Little League elbow problem should be addressed at global and national levels.

Chronic kidney disease (CKD) is an independent risk factor for long-term care insurance (LTCI) need certification among older Japanese adults: A two-year prospective cohort study

CKD is associated with impairments in health status, physical function, and frailty. The aim of the current prospective cohort study was to determine whether CKD predicted new LTCI need certification among community-dwelling older Japanese adults. This was a prospective cohort study. We analyzed the cohort data from a prospective study, The Japan Multicenter Aging Cohort for Care Prevention (J-MACC). We followed 8063 elderly adults for 2 years, and we analyzed the relationship between CKD and LTCI need. The outcome studied was new certification for LTCI service need during a 2-year period. We measured serum creatinine (the estimated glomerular filtration rate; eGFR), serum albumin, frailty checklist scores, and body mass index. During the 2-year follow-up, 536 subjects (6.6%) were newly certified as needing LTCI services. We stratified the cohort according to eGFR quartile and performed multivariate analyses using an eGFR value of 71.4-83.6 ml/min/1.73 m(2) as a reference. We found that subjects with eGFR values <60.0 ml/min/1.73 m(2) had a significantly elevated risk of LTCI service need (adjusted hazard ratio: 1.44 [95% CI 1.12-1.86]). Our results indicate that CKD is independently associated with new LTCI service need certification and is an important marker of frailty in older adults.

Efficacy of an Exercise Game Based on Kinect in Improving Physical Performances of Fall Risk Factors in Community-Dwelling Older Adults

OBJECTIVE The purpose of this study was to demonstrate whether a 12-week program of training with dual-task Tai Chi (DTTC), which is a new concept game we developed using Kinect (Microsoft, Redmond, WA), would be effective in improving physical functions of fall risk factors. MATERIALS AND METHODS This study examined balance, muscle strength, locomotive ability, and dual-task ability in community-dwelling older adults (75.4±6.3 years) before and after 12 weeks of DTTC training (training group [TG]; n=32) or standardized training (control group [CG]; n=41). Primary end points were based on the difference in physical functions between the TG and the CG. RESULTS Significant differences were observed between the two groups with significant group×time interaction for the following physical function measures: timed up-and-go (TUG) (P<0.01), one-leg standing (OLS) (P<0.05), and 5 chair stand (5-CS) (P<0.05). There were no significant differences among the other measures: 10-m walking time under standard conditions, manual-task conditions, and cognitive-task conditions, 10-m maximal walking time, and Functional Reach test scores. Thus, the scores of TUG, OLS, and 5-CS in the TG improved significantly with DTTC training compared with the CG. CONCLUSIONS The results suggest that the DTTC training is effective in improving balance ability and mobility, which are risk factors for falls.

Cognitive decline predicts long-term care insurance requirement certification in community-dwelling older Japanese adults: a prospective cohort study.

Aim: The purpose of this prospective cohort study is to examine whether cognitive decline is an independent predictor of new long-term care insurance (LTCI) requirement certifications in Japan. Methods: A total of 5,765 community-dwelling older Japanese adults who, at baseline, were independent in terms of their activities of daily living participated in this study and were followed up for 18 months. The outcome measure was the number of new LTCI requirement certifications during the 18-month period of the study. We collected demographic information through questionnaires and assessed cognitive skills with the Cognitive Performance Scale (CPS). The participants were divided into 3 groups according to CPS scores (0, 1, and 2 or greater). Results: During the 18-month period, 399 subjects (6.9%) became newly certified for LTCI services. In a multivariate Cox proportional hazards model, older participants with a CPS score of 1 (adjusted HR: 1.39, 95% CI: 1.08-1.77) and 2 or greater (adjusted HR: 2.27, 95% CI: 1.74-2.96) were significantly more likely to receive an LTCI certification compared to those with a CPS score of 0. Conclusions: Cognitive decline is an independent predictor of new LTCI requirement certifications and the severity of cognitive decline in elderly adults is positively associated with receiving an LTCI requirement certification in Japan.

A Preseason Checklist for Predicting Elbow Injury in Little League Baseball Players

Background: Despite pitch count limits, the incidence of Little League elbow is increasing. A risk-evaluation tool capable of predicting which players are predisposed to throwing injury could potentially prevent injuries. Purpose: To investigate the effectiveness of a risk factor checklist for predicting elbow injury in Little League baseball players during 1 season. The hypothesis was that a preseason risk-evaluation checklist could predict which players were predisposed to elbow injury. Study Design: Case-control study; Level of evidence, 3. Methods: A preseason risk-evaluation checklist was distributed to Little League baseball teams in Japan. Six months later, a follow-up questionnaire was mailed to determine injuries sustained during the season. Logistic regression analysis was performed, assigning presence or absence of elbow injury during the season as the dependent variable, and an injury risk score (IRS) was developed based on the statistically significant variables. Receiver operating characteristic (ROC) curve analysis was conducted to determine the predictive validity of the checklist and the optimal cutoff IRS. Results: Data from 389 Little League players were analyzed. Among them, 53 players experienced an elbow injury requiring medical treatment during the season. Six checklist items associated with a medical history of throwing injury, pitch volume, and arm fatigue were found to be significant. Responses to the items could predict the players who were susceptible to injury during the season, with a two-thirds cutoff value for a 6-item checklist (area under the curve, 0.810; sensitivity, 0.717; specificity, 0.771). Conclusion: Results from a 6-item preseason checklist can predict which Little League players are to sustain an elbow injury by the end of the season. Clinical Relevance: The ability to predict which Little League baseball players are predisposed to elbow injury allows parents and coaches to initiate preventive measures in those players prior to and during the baseball season, which could lead to fewer elbow injuries.

Arterial Stiffness Predicts Cognitive Decline in Japanese Community-dwelling Elderly Subjects: A One-year Follow-up Study

AIM The purpose of this study was to determine whether arterial stiffness can be used to predict one-year changes in the cognitive function in Japanese community-dwelling elderly subjects. METHODS A total of 103 Japanese community-dwelling elderly patients joined this study. Information regarding the age, height, weight, gender and past medical history of each participant was obtained. Additionally, arterial stiffness was determined according to the cardio-ankle vascular index (CAVI), and the cognitive function was assessed with the Mini-Mental State Examination (MMSE). One year later, we performed the MMSE in the same subjects. After dividing the cohort according to the 80th percentile of the CAVI (normal and arterial stiffness [AS] groups), we examined whether the degree of cognitive decline, as determined using the pre- and post-MMSE, was significantly different based on the severity of arterial stiffness, adjusted for age, BMI, gender and the pre-MMSE scores. RESULTS Of the 103 subjects who participated in the pre-data collection, 74 (38 men and 36 women, 73.4±4.0 years) joined the post-data collection. We found a significant difference in the change in the post-MMSE scores between the normal and AS groups (pre-MMSE: normal group [27.4±2.1] and AS group [26.9±2.4] and post-MMSE: normal group [27.2±2.1] and AS group [25.5±2.3], F=5.95, p=0.02). For each domain of the MMSE, the changes in MMSE-attention-and-calculation (F=5.11, p=0.03) and MMSE-language (F=4.32, p=0.04) were significantly different according to an ANCOVA. CONCLUSIONS We found that arterial stiffness predicts cognitive decline in Japanese community-dwelling elderly subjects regardless of the initial level of the global cognitive function. This finding indicates the potential use of the degree of arterial stiffness as an indicator for preventing or delaying the onset of dementia in the elderly.

Shoe-fit is correlated with exercise tolerance in community-dwelling elderly people

Purpose: Maintenance of physical activity significantly affects quality of life, and the frequency of physical activity depends upon exercise tolerance. However, there is minimal information on the external factors that contribute to exercise tolerance. The aim of this study was to examine the association between exercise tolerance and shoe-fit in community-dwelling elderly people. Methods: Subjects were 155 elderly, healthy, community-dwelling Japanese volunteers. Exercise tolerance (Shuttle Walk Test [SWT]), 10-m walking time (10mWT), and forced expiratory volume in 1 second (FEV1) were measured. Shoe-fit was assessed and participants were divided into three groups according to the heel-fit of their shoes (Too Loose, Loose, Fit). Group scores in the above variables were compared. Further, a multivariate logistic regression model using a stepwise method was performed to investigate which shoe-fit factors were independently associated with SWT. Results: No significant differences in age, gender, body mass index, 10mWT, FEV1, or presence or absence of pain sites were observed between the three groups. The Fit (p = 0.001) and Loose (p = 0.008) groups had significantly higher SWT score than the Too Loose group. Multivariate logistic regression analysis showed that poor heel-fit was significantly correlated with a low SWT score, even following adjustments for age, gender, 10mWT and FEV1 (odds ratio: 0.25, 95% confidence interval: 0.07–0.95, p = 0.04). Conclusions: This study demonstrates that heel-fit is associated with exercise tolerance in community-dwelling elderly people. It is important for elderly people to wear adequate fit shoes in order to enhance physical functions and prevent declining physical functions.