Takanori Honda

Identifying associations between sedentary time and cardio-metabolic risk factors in working adults using objective and subjective measures: a cross-sectional analysis

BackgroundSedentary behavior has been reported to be associated with metabolic and vascular health independent of moderate-to-vigorous physical activity (MVPA). In order to select appropriate options to measure sedentary behavior in practice and research settings, it is worthwhile to characterize the extent to which objective and subjective measures of sedentary behavior quantify adverse health risks in the same population. This cross-sectional analysis compared accelerometer-derived and self-reported sedentary time to identify their association with cardio-metabolic risk factors.MethodsCross-sectional analysis was conducted using data from 661 Japanese workers (145 women) aged 20–64 years. Participants wore a tri-axial accelerometer device for 10 consecutive days and completed the Japan Atherosclerosis Longitudinal Study Physical Activity Questionnaire. Data on body mass index, waist circumference, resting blood pressure, triglycerides, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, total:HDL cholesterol ratio, blood glucose, and glycosylated hemoglobin (HbA1c) were obtained from annual health examinations.ResultsBoth accelerometer-derived and self-reported sedentary time were deleteriously associated with triglycerides, HDL-cholesterol, total:HDL ratio, and HbA1c after adjustment for potential confounders including MVPA. There were no significant differences in regression coefficients between the two measures. Thus, the magnitude of the associations of both measures with cardio-metabolic risk factors was similar, despite poor agreement between them. Occupational sedentary time was correlated with both measures of total sedentary time, and more consistently associated with cardio-metabolic risk factors than sedentary leisure time.ConclusionsBoth accelerometer and self-report measurements are similarly associated with cardio-metabolic risk factors in a Japanese working adult population. Subjective and objective measures of sedentary behaviors appear to capture different aspects of behaviors. Further efforts to establish data processing methods integrating objective and subjective measures are needed to more effectively assess sedentary time’s relationship to health outcomes.

Screening for frailty phenotype with objectively-measured physical activity in a west Japanese suburban community: evidence from the Sasaguri Genkimon Study

BackgroundThe low physical activity domain of the frailty phenotype has been assessed with various self-reported questionnaires, which are prone to possible recall bias and a lack of diagnostic accuracy. The primary purpose of this study was to define the low physical activity domain of the frailty phenotype using accelerometer-based measurement and to evaluate the internal construct validity among older community-dwellers. Secondly, we examined potential correlates of frailty in this population.MethodsWe conducted a cross-sectional study of 1,527 community-dwelling older men and women aged 65 and over. Data were drawn from the baseline survey of the Sasaguri Genkimon Study, a cohort study carried out in a west Japanese suburban community. Frailty phenotypes were defined by the following five components: unintentional weight loss, low grip strength, exhaustion, slow gait speed, and low physical activity. Of these criteria, physical activity was objectively measured with a tri-axial accelerometer. To confirm our measure’s internal validity, we performed a latent class analysis (LCA) to assess whether the five components could aggregate statistically into a syndrome. We examined the correlates of frailty using multiple stepwise logistic regression models.ResultsThe estimated prevalence of frailty was 9.3% (95% confidence intervals, CI, 8.4-11.2); 43.9% were pre-frail (95% CI, 41.5-46.4). The percentage of low physical activity was 19.5%. Objectively-assessed physical activity and other components aggregated statistically into a syndrome. Overall, increased age, poorer self-perceived health, depressive and anxiety symptoms, not consuming alcohol, no engagement in social activities, and cognitive impairment were associated with increased odds of frailty status, independent of co-morbidities.ConclusionsThis study confirmed the internal construct validity of the frailty phenotype that defined the low energy expenditure domain with the objective measurement of physical activity. Accelerometry may potentially standardize the measurement of low physical activity and improve the diagnostic accuracy of the frailty phenotype criteria in primary care setting. The potential role of factors associated with frailty merits further studies to explore their clinical application.

Associations of sedentary time and breaks in sedentary time with disability in instrumental activities of daily living in community-dwelling older adults

BACKGROUND This cross-sectional study was performed to examine associations of objectively measured sedentary time (ST) and breaks in sedentary time (BST) with instrumental activities of daily living (IADL) disability in Japanese community-dwelling older adults. METHODS The sample comprised 1634 older adults (mean age: 73.3 y, men: 38.4%). Sedentary behavior was measured using a triaxial accelerometer. Disability was defined as inability in at least 1 of the IADL tasks using the Tokyo Metropolitan Institute of Gerontology Index of Competence. RESULTS After adjusting for potential confounders and moderate-to-vigorous physical activity (MVPA), longer ST was significantly associated with higher likelihood of IADL disability, whereas a greater number of BST was associated with lower likelihood of IADL disability. ST and BST remained statistically significant after mutual adjustment with odds ratio of 1.30 (95% confidence interval [CI)], 1.00-1.70) and 0.80 (95% CI, 0.65-0.99), respectively. CONCLUSIONS This study first demonstrated that shorter ST and more BST were associated with lower risk of IADL disability independent of MVPA and that the association for ST was independent of BST and vice versa. These findings suggest not only total ST but also the manner in which it is accumulated may contribute to the maintenance of functional independence in older adults.

The Impact of Sleep Timing, Sleep Duration, and Sleep Quality on Depressive Symptoms and Suicidal Ideation amongst Japanese Freshmen: The EQUSITE Study

Aim. The aim of this study was to identify the impact of bedtime, wake time, sleep duration, sleep-onset latency, and sleep quality on depressive symptoms and suicidal ideation amongst Japanese freshmen. Methods. This cross-sectional data was derived from the baseline survey of the Enhancement of Q-University Students Intelligence (EQUSITE) study conducted from May to June, 2010. A total of 2,631 participants were recruited and completed the following self-reported questionnaires: the Pittsburgh Sleep Quality Index (PSQI), the Center for Epidemiologic Studies Depression Scale (CES-D), and the original Health Support Questionnaires developed by the EQUSITE study research team. Results. Of 1,992 participants eligible for analysis, 25.5% (n = 507) reported depressive symptoms (CES-D total score ≥ 16), and 5.8% (n = 115) reported suicidal ideation. The present study showed that late bedtime (later than 01:30), sleep-onset latency (≥30 minutes), and poor sleep quality showed a marginally significant association with depressive symptoms. Poor sleep quality was seen to predict suicidal ideation even after adjusting for depressive symptoms. Conclusion. The current study has important implications for the role of bedtime in the prevention of depressive symptoms. Improving sleep quality may prevent the development of depressive symptoms and reduce the likelihood of suicidal ideation.

Global cognitive performance and frailty in non-demented community-dwelling older adults: Findings from the Sasaguri Genkimon Study.

To investigate the associations of global cognitive performance with frailty and pre‐frailty in non‐demented community‐dwelling older adults.

Association Between Daily Sleep Duration and Risk of Dementia and Mortality in a Japanese Community: SLEEP AND RISK OF DEMENTIA AND DEATH

To investigate the association between daily sleep duration and risk of dementia and death in a Japanese elderly population.

Patterns and Levels of Sedentary Behavior and Physical Activity in a General Japanese Population: The Hisayama Study

Background The purpose of this cross-sectional study was to describe the patterns and levels of sedentary time and physical activity (PA) in a general Japanese population. Methods A total of 1,740 community-dwelling Japanese adults aged ≥40 years participated in this study. Sedentary time and PA were assessed for 7 consecutive days using a tri-axial accelerometer. Daily patterns and levels of sedentary time and PA were calculated by sex, age group (40–64, 65–74, and ≥75 years), and body mass index (BMI; <25 and ≥25 kg/m2). Results Participants spent half of their waking time being sedentary, 32.7% of which was accumulated in prolonged bouts ≥30 minutes, versus only 54.4 minutes/day (7% of waking time) as moderate-to-vigorous PA (MVPA) (11.8 minutes/day in bouts ≥10 minutes). In addition to total sedentary time, men had longer prolonged sedentary bouts and fewer breaks per sedentary hour than women. Similar trends were observed in participants aged ≥75 years and those with a higher BMI (≥25 kg/m2) compared to those with a younger age and lower BMI. Moreover, participants aged ≥75 years and those with a higher BMI accumulated fewer MVPA minutes in bouts ≥10 minutes. Only 34.8% of the population met the recommended level of ≥150 minutes/week MVPA in bouts ≥10 minutes. Conclusion Japanese adults accumulated a large proportion of total sedentary time in prolonged bouts but few minutes in sustained bouts of MVPA, and few of them met the current PA guideline.

Physical Frailty is Associated with Longitudinal Decline in Global Cognitive Function in Non-Demented Older Adults: A Prospective Study

ObjectivesTo assess the relationship between physical frailty and subsequent decline in global cognitive function in the non-demented elderly.Design and settingA prospective population-based study in a west Japanese suburban town, with two-year follow-up.ParticipantsCommunity-dwellers aged 65 and older without placement in long-term care, and not having a history of dementia, Parkinson’s disease and depression at baseline, who participated in the cohort of the Sasaguri Genkimon Study and underwent follow-up assessments two years later (N = 1,045).MeasurementsGlobal cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). Physical frailty was identified according to the following five components: weight loss, low grip strength, exhaustion, slow gait speed and low physical activities. Linear regression models were used to examine associations between baseline frailty status and the MoCA scores at follow-up. Logistic regression models were used to estimate the risk of cognitive decline (defined as at least two points decrease of MoCA score) according to baseline frailty status.ResultsSeven hundred and eight non-demented older adults were included in the final analyses (mean age: 72.6 ± 5.5 years, male 40.3%); 5.8% were frail, and 40.8% were prefrail at baseline. One hundred and fifty nine (22.5%) participants experienced cognitive decline over two years. After adjustment for baseline MoCA scores and all confounders, being frail at baseline was significantly associated with a decline of 1.48 points (95% confidence interval [CI], -2.37 to -0.59) in MoCA scores, as compared with non-frailty. Frail persons were over two times more likely to experience cognitive decline (adjusted odds ratio 2.28; 95% CI, 1.02 to 5.08), compared to non-frail persons.ConclusionPhysical frailty is associated with longitudinal decline in global cognitive function in the non-demented older adults over a period of two years. Physically frail older community-dwellers should be closely monitored for cognitive decline that can be sensitively captured by using the MoCA.

A potential novel pathological implication of serum soluble triggering receptor expressed on myeloid cell 2 in insulin resistance in a general Japanese population: the Hisayama Study

AIMS No cohort study has examined the pathological significance of triggering receptor expressed on myeloid cell 2 (TREM2), a cell surface receptor expressed on myeloid lineage cells, and its soluble form, sTREM2, in insulin resistance in a general population. METHODS A total of 2742 community-dwelling Japanese individuals aged ≥40 years were divided into 4 groups according to the serum sTREM2 concentration quartiles. We examined the cross-sectional association of sTREM2 levels with anthropometric parameters and the homeostasis model assessment of insulin resistance (HOMA-IR). RESULTS The median sTREM2 concentrations was 255.6 (interquartile range, 162.5-419.2) pg/mL. In multivariate analyses, waist circumference and fat mass index increased with elevating sTREM2 levels (P for trend: <0.001 and 0.02, respectively), but there was no significant association between sTREM2 levels and body mass index and fat-free mass index. Among the subjects without taking antidiabetic medications (n = 2610), greater sTREM2 levels were associated with higher HOMA-IR (P for trend <0.001) even after adjusting for waist circumference, fat mass index, and high-sensitivity C-reactive protein. CONCLUSIONS Our findings suggest that serum sTREM2 had novel pathological roles in insulin resistance, while obesity and inflammation had no substantial effects on the relationship between sTREM2 and insulin resistance in this cohort.

Development and validation of modified risk prediction models for cardiovascular disease and its subtypes: The Hisayama Study

BACKGROUND AND AIMS Predicting cardiovascular events is of practical benefit for disease prevention. The aim of this study was to develop and evaluate an updated risk prediction model for cardiovascular diseases and its subtypes. METHODS A total of 2462 community residents aged 40-84 years were followed up for 24 years. A Cox proportional hazards regression model was used to develop risk prediction models for cardiovascular diseases, and separately for stroke and coronary heart diseases. The risk assessment ability of the developed model was evaluated, and a bootstrapping method was used for internal validation. The predicted risk was translated into a simplified scoring system. A decision curve analysis was used to evaluate clinical usefulness. RESULTS The multivariable model for cardiovascular diseases included age, sex, systolic blood pressure, hemoglobin A1c, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, smoking habits, and regular exercise as predictors. The models for stroke and coronary heart diseases incorporated both shared and unique variables. The developed models showed good discrimination with little evidence of overfitting (optimism-corrected Harrells C statistics 0.726-0.777) and calibrations (Hosmer-Lemeshow test, p = 0.44-0.90). The decision curve analysis revealed that the predicted risk-based decision-making would have higher net benefit than either a CVD intervention strategy for all individuals or no individuals. CONCLUSIONS The developed risk prediction models showed a good performance and satisfactory internal validity, which may help understand individual risk and setting personalized goals, and promote risk stratification in public health strategies for CVD prevention.