Yoshimi Tanimoto

Association of sarcopenia with functional decline in community-dwelling elderly subjects in Japan.

The present study aimed to determine the association of sarcopenia, defined by muscle mass, muscle strength and physical performance, with functional disability from a 2‐year cohort study of community‐dwelling elderly Japanese people.

Association between the Trail Making Test and physical performance in elderly Japanese.

Aim:  The Trail Making Test (TMT) is used in Western countries as an indicator of executive function, but there is little information regarding its use in Japan. Our previous initial study showed that the TMT was significantly associated with mobility‐related functions among elderly Japanese living in the community and in this study, we increased the number of participants to clarify that result.

An Overview of Boron, Lithium, and Strontium in Human Health and Profiles of These Elements in Urine of Japanese

The biological, medical and environmental roles of trace elements have attracted considerable attention over the years. In spite of their relevance in nutritional, occupational and toxicological aspects, there is still a lack of consistent and reliable measurement techniques and reliable information on reference values. In this review our understandings of the urinary profilings of boron, lithium and strontium are summarized and fundamental results obtained in our laboratory are discussed.Over the past decade we have successfully used inductively coupled plasma emission spectrometry for the determination of reference values for urinary concentrations of boron, lithium and strontium. Taking into account the short biological half-life of these elements and the fact that their major excretion route is via the kidney, urine was considered to be a suitable material for monitoring of exposure to these elements. We confirmed that urinary concentrations of boron, lithium and strontium follow a lognormal distribution. The geometric mean reference values and 95% confidence intervals were 798 μg/l (398–1599 μg/l) for boron, 23.5 μg/l (11.0–50.5 μg/l) for lithium and 143.9 μg/l (40.9–505.8 μg/l) for strontium. There were no discrepancies between our values and those previously reported. Our reference values and confidential intervals can be used as guidelines for the health screening of Japanese individuals to evaluate environmental or occupational exposure to these elements.

Correlation between muscle strength and muscle mass, and their association with walking speed, in community-dwelling elderly Japanese individuals.

Objectives We aimed to assess the correlation between muscle strength and muscle mass based on sex and age, and their association with walking speed, which is a health predictor for independent living, in elderly Japanese individuals. Methods The participants included 318 (111 men, 207 women) community-dwelling elderly Japanese individuals aged ≥65 years. Knee extension strength was assessed as an indicator of muscle strength, and bioelectrical impedance analysis was used to measure muscle mass. The maximum walking speed of participants was recorded. All measurements were categorized based on sex and age groups as follows: young-old (age, 65–74 years) and old-old (age, ≥75 years). Results Appendicular muscle mass and knee extension strength decreased with age in both men and women. In men, knee extension strength showed significant positive correlations with leg and appendicular muscle mass in both young-old and old-old age groups. However, in women, only the old-old age group showed significant positive correlations between knee extension strength and leg and appendicular muscle mass. Muscle strength was significantly positively correlated with maximum walking speed in all groups, whereas muscle mass was not significantly correlated with maximum walking speed in men and women. Conclusions Muscle strength was significantly correlated with muscle mass in both age groups in men. However, in women, the correlation between muscle strength and muscle mass differed according to age. This finding suggests that the relationship between muscle strength and muscle mass differs according to sex and age. Muscle strength showed significant correlation with walking speed in both men and women in both age groups. These findings suggest that it is necessary to recognize that muscle strength is different from muscle mass, and that an individualized approach to prevent decline of muscle strength and muscle mass is necessary for health promotion in elderly.

Quality of life (QOL) of the community-dwelling elderly and associated factors: A population-based study in urban areas of China

OBJECTIVE China has the most elderly people. Maintaining and improving the QOL of the elderly has emerged as a particularly important issue. This population-based study aimed to examine the QOL of the urban elderly and to clarify the associated factors. METHODS A cross-sectional study was performed in Liaoning Province. The elderly people without senile dementia composed our study population and were interviewed from March to November, 2012 with questionnaires pertaining to QOL (SF-36), cognitive ability, demographic characteristics, health status, behavioral factors, and social-psychological factors. 4067 effective responses were received (effective response rate: 86.0%). After further cognitive screening, 3714 participants were included as the subjects. RESULTS The mean scores of physical component summary (PCS) and mental component summary (MCS) were 53.7±21.5 (mean±SD) and 58.9±18.9, respectively. With adjustment for age and sex, general linear model analysis showed that, in standardized estimate (β) sequence, PCS was significantly associated with chronic disease, taking a walk, visual ability, sleeping quality, marital status, alcohol consumption, hearing ability, smoking, neighborhood relationships, filial piety, ethnicity, and regular diet, and MCS was associated with chronic disease, sleeping quality, taking a walk, visual ability, marital status, ethnicity, filial piety, regular diet, alcohol consumption, smoking, and hearing ability. CONCLUSIONS The community-dwelling elderly in urban areas had a low level of QOL. To improve QOL, the maintenance of health conditions was crucial. Efforts to encourage the elderly to perform feasible exercise and develop good lifestyles should be focused on. Also, childrens filial duty to their parents should be enhanced.

Assessment of the best gait parameter in relation to bone status in community-dwelling young–old and old–old women in Japan

Even if physical exercise contributes to bone health of the elderly, intense activities have the potential to worsen the risk of osteoporosis. This fact and the inevitable decrease of mobility with age increase the likelihood that the mobility parameter that best benefits bone health differs with age. The aim of this study was to objectively assess the gait parameter that most strongly influences bone health of young-old and old-old women. Subjects comprised 200 community-dwelling elderly women (132 young-old, 68 old-old) registered at welfare centers for the aged. Bone status was examined in the right heel by quantitative ultrasound (QUS) and indicated as stiffness index (SI). Gait parameters including usual and maximum walking speed (UWS and MWS, respectively), daily walking steps (DWS), obstacle-negotiating gait, and stair-climbing were examined objectively. Other bone-related physical factors (body components, handgrip strength, and masticatory function) were measured and adjusted while performing assessment. After adjustment for covariates, multiple linear regression analysis showed that MWS had the strongest association with SI in young-old women and DWS had the strongest association with SI in old-old women. To prevent osteoporosis, brisk walking exercise and engaging in movement in everyday life, respectively, should be advocated for young-old women and old-old women in Japan.

Systemic effects and skin injury after experimental dermal exposure to monochloroacetic acid

There have been many fatal occupational accidents of skin exposure to monochloroacetic acid (MCA). However, there have been no reports of dermatological findings and the lethal consequences have not yet been demonstrated. Therefore, harmful local and systemic effects were investigated after dermal exposure to MCA. A 0.5 mL aliquot of MCA solution (40% w/w) was applied to the abdominal skin of ten 10-week-old male SD rats under anesthesia. The exposure area (25 × 25 mm2) was 1.6% of the total surface area. The dose of MCA per area was 34.1 mg/cm2. Saline was similarly administered to 10 control rats. Histopathological findings after 10 min were observed by light microscopy. Blood samples were collected by exsanguinations from the carotid arteries after 4 h. Skin samples were collected 10 min after the initial exposure. Histological findings showed severe degeneration of collagen bundles in the epidermis and subcutaneous tissues. PCO2, HCO3 −, TCO2, BE and glucose levels were decreased in the MCA group. AST, m-AST, ALT, BUN, Cr, NH3, lactic acid, pyruvic acid, RBC, Hb, Hct, total protein and albumin were increased in the MCA group. The burn was determined to be a third-degree burn on the basis of the histopathological findings. The severe toxicity was probably a consequence of the rapid permeability. Biochemical parameters were a consequence of hepatocellular injuries, renal dysfunction, dysglyconeogenesis and dysfunction of ammonia metabolism. MCA reportedly enters the TCA cycle and inhibits aconitase. MCA metabolites also inhibit pyruvate carboxylase in the gluconeogenesis pathway. Therefore, the important serum biochemical abnormalities such as hypoglycemia and lactic acidosis should be monitored to find the acute systemic disorders.

Obstacle-negotiating gait and related physical measurement indicators for the community-dwelling elderly in Japan

The aim of this study is to assess obstacle-negotiating gait (ONG) and explore its related physical factors. Subjects comprised 571 community-dwelling persons (195 men and 376 women) age>or=65 years and without cognitive impairment. ONG, timed up and go (TUG), and stair-climbing were measured and their relations were assessed. Walking ability (usual walking speed=UWS and daily walking steps=DWS), balance deficiency, and musculoskeletal function (handgrip strength and bone health) were examined objectively to explore ONG related physical factors. Logistic regression and general linear model analysis were performed with adjustment for age and body mass index (BMI). Time of ONG was 7.72s in men and 8.93s in women. Logistic regression analysis showed that the fast tertiles of ONG corresponding to the fast levels of TUG and stair-climbing had the highest odds ratio values. General linear model analysis showed that ONG was significantly associated with UWS and balance deficiency (no) in men, and with UWS, handgrip strength, DWS and balance deficiency (no) in women. Overall, ONG was considerably associated with falls screening tools and its determinants were also the main causes of falls. Training in ONG could be an attractive strategy for the prevention of falls among the elderly.

Occlusal support including that from artificial teeth as an indicator for health promotion among community-dwelling elderly in Japan.

Aim:  The Eichner index (EI) is used to evaluate occlusal support. However, this index is based on existing natural tooth contact. This study aimed to establish whether a modified EI that included artificial teeth reflected individual oral condition of elderly people, and to clarify the relationship between this index and: (i) mental condition; (ii) physical condition; and (iii) physical function.

Ultrasound parameters of bone health and related physical measurement indicators for the community‐dwelling elderly in Japan

Deteriorated bone strength, which approaches osteoporosis, increases the likelihood that an elderly person will not able to live independently. However, few data are available pertaining to bone health and various physical objective indicators. The aim of the present study was to objectively assess bone health by quantitative ultrasound (QUS) and identify related physical measurement indicators among the elderly to aid the health promotion strategies in Japan. A cross‐sectional study was performed at five welfare centers for the aged in the suburban area of Takatsuki city, Japan. Subjects comprised community‐dwelling persons (134 men, 240 women) aged ≥60 years and registered at welfare centers. QUS of the right‐heel was conducted and recorded as stiffness index (SI). Physical factors including body components (fat and muscle mass), handgrip strength, daily physical activity, daily walking steps, maximum and usual walking speed and maximum bite force were examined objectively during the period May–June 2005. SI in women was lower than that in men (P < 0.01) and decreased significantly with age (P < 0.01). The SI correlated with six physical items in men and with all items in women. Multiple linear regression analysis showed that muscle mass, usual walking speed and maximum bite force were the strongest physical indicators of male SI; and muscle mass, maximum walking speed and maximum bite force were the strongest indicators of female SI. Muscle training, daily walking exercise and oral health care should be included in health promotion programs for the bone health of elderly women and men in Japan.