Yosuke Kusano

Relationship between falls and physical performance measures among community-dwelling elderly women in Japan

Background and aims: The relationship between falls and physical performance has focused on the frail elderly who have several health problems, particularly those in nursing homes or care facilities. It is important to clarify the relationship between falls and physical performance among the community-dwelling elderly. Methods: We examined the relationship between falls and physical performance measures (grip strength, chair stand time, functional reach, usual walking speed) among 402 community-dwelling Japanese elderly women aged 60 years and over. Results: Overall prevalence of falls was 21.1%, and increased with age. In univariate analysis, grip strength and functional reach were not significantly different between women who did and did not fall. Chair stand time of women who fell was longer than that of women who did not (p=0.05), and the usual walking speed of women who fell was significantly slower than that of women who did not fall (p<0.0001). Physical functioning significantly decreased with age; grip strength, functional reach and usual walking speed decreased, and chair stand time increased. Logistic regression analysis, adjusting for age and other covariates, showed that slower usual walking speed was significantly associated with falls, but grip strength and functional reach were not. Increased chair stand time had a borderline association (p=0.1). Conclusions: Our findings indicate that poor lower extremity function, especially walking ability, is an important risk factor for falls in elderly Japanese community-dwelling women.

Evaluation of clinical markers of atherosclerosis in young and elderly Japanese adults.

Abstract Background: In order to be able to take preventative measures early in life against the development of atherosclerosis, it is important to evaluate profiles of subclinical atherosclerosis, especially among young adults. Methods: We screened plasma homocysteine levels, highly sensitive C-reactive protein levels and carotid intima-media thickness in young and elderly adults. Results: Among both young and elderly adults, plasma homocysteine and highly sensitive C-reactive protein were significantly lower in females than in males. Highly sensitive C-reactive protein was significantly lower in young adults than in elderly adults, and homocysteine was lower (but not significantly) in young adults than in elderly adults. Among young adults, mean carotid intima-media thickness was lower (but not significantly) in females than in males. Among elderly adults, mean carotid intima-media thickness was significantly lower in females than in males. Among both males and females, mean carotid intima-media thickness was significantly higher in elderly adults than in young adults. Conclusions: These results demonstrate basic profiles of atherosclerosis markers in young and elderly Japanese adults. Further study is needed to evaluate measures developed for application in early adulthood to prevent atherosclerosis. Clin Chem Lab Med 2006;44:824–9.

Associations of vertebral deformities and osteoarthritis with back pain among Japanese women: the Hizen-Oshima study

SummaryWe examined the spinal distribution of the types of vertebral deformities and the associations of vertebral deformities and osteoarthritis with back pain in Japanese women. Midthoracic and upper lumbar vertebrae were more susceptible to deformity. Vertebral deformity and osteoarthritis were frequent and were associated with back pain.IntroductionVertebral fractures due to osteoporosis and osteoarthritis are both common and significant health problems in aged people. However, little is known about the descriptive epidemiology of the individual deformity types and the relative clinical impact in women in Japan.MethodsLateral radiographs were obtained from 584 Japanese women ages 40 to 89 years old. Deformities were defined as vertebral heights of more than 3 standard deviations (SDs) below the normal mean. Osteoarthritis was defined as Kellgren–Lawrence (KL) grade 2 or higher. Information on upper or low back pain during the previous month was collected by questionnaire. We compared the spinal distribution of the three types of vertebral deformities (wedge, endplate, and crush) typical of fractures and examined the associations of number and type of vertebral deformities and osteoarthritis with back pain.ResultsFifteen percent of women had at least one vertebral deformity and 74% had vertebral osteoarthritis. The prevalence of upper or low back pain was 30.1%. Deformities were most common in the midthoracic and upper lumbar regions and wedge was the frequent type, followed by endplate and crush. Multiple logistic regression analysis showed that the odds of back pain was 3.0 (95% CI 1.5–6.3) times higher for women with a single wedge deformity and 3.2 (95% CI 1.0-–0.6) times higher for women with two or more wedge deformities, compared to women with no wedge deformity. Vertebral osteoarthritis was associated with back pain (OR 1.8, 95% CI 1.1–2.9), independent of other covariates including age and deformities.ConclusionOur results in this group of Japanese women are similar to and consistent with results reported previously in other populations of Japanese and Caucasians.

Association between alkaline phosphatase and hypertension in a rural Japanese population: The Nagasaki Islands study

BackgroundAlthough serum alkaline phosphatase (ALP) levels have been associated with hypertension, and ALP is known as an enzyme affected by alcohol consumption, no study has been published on the associations between ALP and the risk of hypertension in relation to drinking status.MethodsWe conducted a cross-sectional study of 2,681 participants (837 men and 1,846 women) aged 30 to 89 years undergoing a general health check-up to investigate the associations between ALP and hypertension in relation to drinking status.ResultsOf the 2,681 participants, 1,549 (514 men and 1,035 women) were diagnosed with hypertension. A sex difference was observed for the relationship between ALP and hypertension. While no significant association was observed for men, the association was significantly positive for women. The multivariable adjusted odds ratio and 95% coincidence interval (CI) of hypertension per increment of 1-log ALP were 0.95 (95% CI: 0.56 to 1.59) for men and 1.57 (95% CI: 1.07 to 2.33) for women. When this analysis was restricted to nondrinkers, a significantly elevated risk of hypertension was observed for men and remained significant for women; that is, 3.32 (95% CI: 1.38 to 8.02) for men and 1.68 (95% CI: 1.11 to 2.55) for women.ConclusionALP is associated with hypertension for both male and female nondrinkers, but not for drinkers. For analyses of associations between ALP and blood pressure, alcohol consumption should thus be considered a potential confounder.

Factors Predicting Health-related Quality of Life in Knee Osteoarthritis Among Community-dwelling Women in Japan: The Hizen-Oshima Study

Knee osteoarthritis is the most common chronic joint disorder in elderly people. However, a population-based, longitudinal study on health-related quality of life in knee osteoarthritis has not been conducted in Japan. We studied 333 women aged 50 years and older at baseline, with 8 to 9 years of follow-up. Anteroposterior weight-bearing knee radiographs were obtained at baseline and graded according to the Kellgren-Lawrence criteria. Definite osteoarthritis was defined as Kellgren-Lawrence grade 2 or higher in at least 1 joint. At baseline, all participants were asked if they had knee pain and comorbidities (heart disease, lung disease, stroke, or diabetes mellitus). Height (m), weight (kg), and chair stand time were measured. At follow-up, quality of life in knee osteoarthritis was evaluated using the Japanese Knee Osteoarthritis Measure score. Multiple linear regression analysis showed that age, knee osteoarthritis, knee pain, comorbidity, and increasing chair stand time were independently related to subsequent health-related quality of life. These findings suggest that treating knee osteoarthritis and comorbidities, managing pain, and optimizing lower extremity muscle strength may be effective targets for intervention.

Allostatic load differs by sex and diet, but not age in older Japanese from the Goto Islands.

Abstract Background: Lifelong exposure to stressors promotes physiological dysregulation and produces an allostatic load (AL). In European-derived samples, AL associates significantly with sex, age and health. Aim: To assess associations of AL with age, sex, socio-demographic differences and self-reports of diet and ability to complete activities of daily living in older Japanese residing in rural Nagasaki Prefecture. Subjects and methods: In 2011, 96 older residents of Nagasaki Prefecture, Japan, were assessed for components of AL. They also self-reported their age, principal life-long occupational activity, educational attainments, marital status, dietary choices and abilities to complete daily living activities. Results: Average age was 67.9 years (range = 55–89; SD = 8.65). Among these 48 men and 48 women, AL was not related significantly to age, although women showed lower AL than men. AL did not differ significantly between respondents by occupation, marital status, education or abilities to complete daily activities. Women who reported eating more green/yellow vegetables or consuming more meat had lower AL than their counterparts. Men who reported drinking more alcohol spirits had higher AL. Conclusions: Among older Japanese residing outside a major urban area, AL varies significantly by sex, but not age, while being associated with dietary choices. Although lack of association with life ways was not expected, AL apparently assesses physiological dysregulation cross-culturally.

Altered expression of a novel cellular gene as a consequence of integration of human T cell lymphotropic virus type 1

By analysing a genomic DNA clone derived from the human T cell lymphotropic virus type 1 (HTLV-1)-infected cell line, TL-Su, we found that an integrated HTLV-1 provirus interrupted the poly(A) signal-containing exon of a novel gene, RY-1. Nucleotide sequence analysis of a cDNA derived from Jurkat cells revealed that the normal RY-1 mRNA could encode a novel protein that has an unique primary structure, suggesting that a nucleic acid binding property was involved. Proviral integration led to an accumulation of aberrant RY-1 mRNA species in the cells. All the aberrant RY-1 cDNAs derived from TL-Su cells terminated at the poly(A) site of the R region of the HTLV-1 long terminal repeat and initiated in the intron, approx. 800 bp upstream from the putative second exon. Furthermore, another intron, downstream from this position, remained unspliced in some of the cDNAs. In addition to the activation by the integrated viral elements of cryptic promoters located upstream, mechanisms involving altered rates of degradation or transport from the nucleus to the cytoplasm of intron-containing RNA were suggested.

A pilot study of allostatic load among elderly Japanese living on Hizen-Oshima Island.

BackgroundBetween July and September 2005, a preliminary sampling of the elderly population of Hizen-Oshima Island, Nagasaki Prefecture, Japan was conducted by the local hospital’s nursing staff.ResultsReported here are preliminary results from this sample of 27 individuals with an average age of 71 years. Their ages ranged from 51 to 82 years, with a standard deviation (sd) of 7.4 years. In total, 33 aspects of physical and physiological variation were assessed on these 15 women and 12 men. As expected from previous studies of Japanese elders, our sample shows slightly elevated average blood pressure (142/81 mmHg, sd 16/10), but they are relatively lean (waist/hip = .9: sd 0.06) when compared to European or American standards. However, their average total cholesterol (TC = 210 mg/dl, sd = 42.8) is high compared to standards, as is their high-density lipoprotein cholesterol (HDLc = 55.4 mg/dl, sd = 15.1). Means, standard deviations (sd), ranges and upper bounds for quartile cut-points for all 10 variables used in the calculation of allostatic load (AL) were assessed. The overall average estimate for AL in this sample is 3.1 (sd = 1.58) and ranges from 1 to 7.ConclusionAL shows variability across men and women, has little correlation with age, and is associated with physiological variation in blood glucose, dopamine and uric acid.

Association of spinal inclination with physical performance measures among community‐dwelling Japanese women aged 40 years and older

Spinal inclination assesses spinal posture as a whole. However, the association between spinal inclination and physical performance has not yet been fully elucidated. Therefore, this study aimed to explore the association of spinal inclination with physical performance measures.

Quantitative ultrasound and radiographic absorptiometry are associated with vertebral deformity in Japanese Women: the Hizen-Oshima study.

SummaryWe evaluated the ability of heel quantitative ultrasound (QUS) and metacarpal radiographic absorptiometry (RA) to identify subjects with vertebral deformities in Japanese women aged ≥40. Both QUS and RA were associated with vertebral deformities, and the estimated prevalence at each T-score widely varied with age.IntroductionHeel QUS and metacarpal RA have been used for screening patients to evaluate risk of osteoporotic fractures. The aim of this study was to evaluate the ability of QUS and RA to identify women with vertebral deformities in 570 Japanese women aged ≥40, and to estimate the prevalence of vertebral deformity at each T-score.MethodsCalcaneal QUS and metacarpal RA were performed. Radiographic vertebral deformities were assessed by quantitative morphometry, defined as vertebral heights more than 3 SD below the normal mean.ResultsThe receiver operating characteristic analysis showed that both calcaneal stiffness index (SI) and metacarpal bone mineral density (BMD) were associated with vertebral deformities. Using the T-score of −2.5 as a cutoff value, the specificity and sensitivity for identifying individuals with vertebral deformities was 65% and 83% for calcaneal SI, and 40% and 88% for metacarpal BMD, respectively. The prevalence of vertebral deformity was estimated using age-adjusted logistic regression models. Women with calcaneal SI T-score of −2.5 had a 2% estimated probability of vertebral deformity at age 40, and 22% at age 80. For metacarpal BMD T-score of −2.5, estimated probability was less than 1% at age 40, and 27% at age 80.ConclusionBoth calcaneal SI and metacarpal BMD were associated with prevalence of vertebral deformity. Furthermore, the prevalence widely varied with age at any given bone value.