Takashi Jindo

Relationship between built environment attributes and physical function in Japanese community-dwelling older adults

To explore the relationships between the built environment and older adults’ physical function.

Pedometers Affect Changes in Lower-Extremity Physical Function During a Square-Stepping Exercise Program in Older Japanese Adults.

Background and Purpose:Pedometers are often used as motivational tools to increase physical activity. Hence, providing a pedometer during an exercise intervention may enhance the benefit of exercise on lower-extremity physical function (LEPF) by maintaining or increasing daily physical activity. The purpose of this study was to compare the effect on LEPF between an exercise intervention with and without the use of a pedometer. Methods:The subjects of this study were 68 community-dwelling older adults (mean age: 70.0 ± 3.6 years) in Kasama City, rural Japan. All subjects participated in a fall-prevention exercise program called square-stepping exercise (SSE) conducted once a week for 11 weeks. Participants were allocated to 2 groups: SSE with pedometer group (n = 34) and SSE without pedometer group (n = 34). We matched the participants of both groups by their standardized score of physical function tests. To ascertain the LEPF benefits induced by the exercise intervention, we measured 5 physical function tests: single-leg balance with eyes open, 5-repetition sit-to-stand, timed up and go, 5-m habitual walk, and choice stepping reaction time. We used a 2-way analysis of variance to confirm the interaction between the 2 groups. Results:Significant group-by-time interactions were observed on timed up and go (P < .01) and 5-m habitual walk (P = .02); participants in the SSE with pedometer group enhanced their physical function more than the SSE without pedometer group participants. Conclusions:This study suggests that providing a pedometer during an exercise intervention is an effective addition to an exercise program to improve LEPF.

Change in hand dexterity and habitual gait speed reflects cognitive decline over time in healthy older adults: a longitudinal study

[Purpose] There is a relationship between physical and cognitive functions; therefore, impairment of physical function would mean cognitive decline. This study aimed to investigate the association between change in physical and cognitive functions. [Subjects and Methods] Participants were 169 healthy community-dwelling older adults who attend the survey after three years from baseline (mean age, 72.4 ± 4.8 years). Grip strength, one-leg standing balance, five-times-sit-to-stand test, timed up and go, 5-m habitual walk, and a peg-moving task were used to evaluate physical performance. Five cognitive function tests were used to assess attention, memory, visuospatial function, verbal fluency, and reasoning. Cognitive function was defined as the cumulative score of these tests. [Results] At baseline, five-times-sit-to-stand test, timed up and go, and hand dexterity were independently associated with cognitive function. In longitudinal analyses, changes in habitual walking speed and hand dexterity were significantly associated with change in cognitive function. [Conclusion] Deterioration of specific physical function, such as hand dexterity and walking ability, may be associated with progression of cognitive decline. Decreasing extent of daily functions, such as hand dexterity and walking ability, can be useful indices to grasp changes in cognitive function.

Daily Life Physical Activity Modulates the Effects of an Exercise Program on Lower-extremity Physical Function in Japanese Older Adults

Background and Purpose: Decreasing daily life physical activity (PA) outside an exercise program might hinder the benefit of that program on lower-extremity physical function (LEPF) in older adults. The purpose of this study was to investigate how daily life PA modulates the effects of an exercise program on LEPF. Methods: The participants were 46 community-dwelling older adults (mean age, 70.1 ± 3.5 years) in Kasama City, a rural area in Japan. All participated in a fall-prevention program called square-stepping exercise once a week for 11 weeks. We evaluated their daily life PA outside the exercise program with pedometers and calculated the average daily step counts during the early and late periods of the program. We divided participants into 2 groups on the basis of whether or not they decreased PA by more than 1000 steps per day between the early and late periods. To ascertain the LEPF benefits induced by participating in the exercise program, we measured 5 physical performance tests before and after the intervention: 1-leg stand, 5-time sit-to-stand, Timed Up and Go (TUG), habitual walking speed, and choice-stepping reaction time (CSRT). We used a 2-way analysis of variance to confirm the interaction between the 2 groups and the time effect before and after the intervention. Results: During the exercise program, 8 participants decreased their daily life PA (early period, 6971 ± 2771; late period, 5175 ± 2132) and 38 participants maintained PA (early period, 6326 ± 2477; late period, 6628 ± 2636). Both groups significantly improved their performance in TUG and CSRT at the posttest compared with the baseline. A significant group-by-time interaction on the walking speed (P = .038) was observed: participants who maintained PA improved their performance more than those who decreased their PA. Discussion: Square-stepping exercise requires and strengthens dynamic balance and agility, which contributed to the improved time effects that occurred in TUG and CSRT. On the contrary, because PA is positively associated with walking speed, maintaining daily life PA outside an exercise program may have a stronger influence on walking speed. To enhance the effectiveness of an exercise program for young-old adults, researchers and instructors should try to maintain the participants daily life PA outside the program. Conclusion: Regardless of decreasing or maintaining daily life PA, the square-stepping exercise program could improve aspects of LEPF that require complex physical performance. However, a greater effect can be expected when participants maintain their daily life PA outside the exercise program.

PHYSICAL SIGN FOR DETECTING COGNITIVE DECLINE IN COMMUNITY-DWELLING OLDER ADULTS

PHYSICAL SIGN FOR DETECTING COGNITIVE DECLINE IN COMMUNITY-DWELLING OLDER ADULTS T. Abe1, Y. Soma3, N. Kitano4, T. Jindo4, A. Sato1, K. Tsunoda5, T. Tsuji6, T. Okura1, 1. University of Tsukuba, Ibaraki, Japan, 3. Hirosaki University, Aomori, Japan, 4. Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, Tokyo, Japan, 5. Yamaguchi Prefectural University, Yamaguchi, Japan, 6. Chiba University, Chiba, Japan Previous cohort studies that investigated the association between physical and cognitive function conducted only either physical or cognitive assessment in their follow up survey. Therefore, the relationship between changes in physical and cognitive functions is unclear. The study aimed to investigate whether change in physical functions is associated with change in cognitive function. In this study, the data was obtained from the Kasama study, a cohort study in Japan; and the follow up period was 3 years. Only older adults without cognitive impairment at baseline were included and 131 participants (72.2 ± 4.7 yrs.) were eligible. We used 6 physical performance tests: grip strength, one-leg standing balance, 5 times sit-to-stand, timed up and go, 5-m habitual walk, and peg moving task to measure physical function. To measure cognitive function, five tests were administered including tests of attention, memory, visuospatial function, verbal fluency, and reasoning. The total score was defined as cognitive function. Multiple regression analyses were conducted. We entered change in cognitive function as dependent variable and each of the change in physical function as independent variables, and age, sex, education, body mass index, medical history of hypertension and heart disease, depressive mood, intake medicine, knee pain, and upperextremity pain as covariates. Changes in 5-m habitual walk (β = -0.207, P = 0.026) and peg moving task (β = 0.178, P = 0.042) showed significant association with change in cognitive function. These results suggest that deterioration of gait speed and hand dexterity is a useful sign for detecting cognitive decline.