Yu Nofuji

Decreased serum brain-derived neurotrophic factor in trained men

The purpose of this study was to clarify the effect of physical activity on the level of serum brain-derived neurotrophic factor (BDNF). The serum BDNF level in trained men who have participated in regular sport activity (n=12) was compared to that in sedentary subjects (n=14). The physical activity levels expressed as total energy expenditure, move-related energy expenditure and walking count in the trained were significantly higher than those in the sedentary. The serum BDNF level in the trained men was found to be lower than that in the sedentary (19.54+/-4.53 ng/ml vs. 23.63+/-2.94 ng/ml, respectively, P<0.01). The serum BDNF level showed a significant negative correlation with daily total energy expenditure (r=-0.507, P<0.05), movement-related energy expenditure (r=-0.503, P<0.05), and walking count (r=-0.480, P<0.05). These results may suggest that vigorous habitual physical activity decrease the serum BDNF level.

Do bonding and bridging social capital affect self-rated health, depressive mood and cognitive decline in older Japanese? A prospective cohort study.

Little is known regarding the longitudinal effects of bonding and bridging social capital on health. This study examined the longitudinal associations of bonding and bridging social capital with self-rated health, depressive mood, and cognitive decline in community-dwelling older Japanese. Data analyzed in this study were from the 2010 (baseline) and 2012 (follow-up) Hatoyama Cohort Study. Bonding social capital was assessed by individual perception of homogeneity of the neighborhood (the level of homogeneity among neighbors) and of networks (the amount of homogeneous personal networks) in relation to age, gender, and socioeconomic status. Bridging social capital was assessed by individual perception of heterogeneity of networks (the amount of heterogeneous personal networks) in relation to age, gender, and socioeconomic status. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to evaluate the effects of baseline social capital on poor health outcome at follow-up by logistic regression analysis. In total, 681 people completed baseline and follow-up surveys. The mean age of participants was 71.8 ± 5.1 years, and 57.9% were male. After adjusting for sociodemographics, lifestyle factors, comorbidity, functional capacity, baseline score of each outcome, and other bonding/bridging social capital, stronger perceived neighborhood homogeneity was inversely associated with poor self-rated health (OR = 0.55, 95% CI = 0.30-1.00) and depressive mood assessed by the Geriatric Depression Scale (OR = 0.58, 95% CI = 0.34-0.99). When participants who reported a depressive mood at baseline were excluded, stronger perceived heterogeneous network was inversely associated with depressive mood (OR = 0.40, 95% CI = 0.19-0.87). Neither bonding nor bridging social capital was significantly associated with cognitive decline assessed by the Mini-Mental State Examination. In conclusion, bonding and bridging social capital affect health in different ways, but they both have beneficial effects on the health of older Japanese. Our findings suggest that intervention focusing on bonding and bridging social capital may improve various health outcomes in old age.

Nutritional Biomarkers and Subsequent Cognitive Decline Among Community-Dwelling Older Japanese: A Prospective Study

BACKGROUND Micronutrients are associated with dementia and cognitive decline among older adults. However, nutritional biomarkers of such decline have not been identified. We attempted to identify nutritional biomarkers that were independent risk markers of cognitive decline in a population of older Japanese. METHODS Among 873 cognitively intact adults aged 70 years or older at baseline, 682 (mean age [standard deviation], 75.5 [4.4] years; women 59.7%) were followed for a period of up to 4 years, and nutritional biomarkers in a blood panel were assessed, namely, red blood cell count, hematocrit, mean corpuscular volume, hemoglobin, total cholesterol, high-density lipoprotein cholesterol, hemoglobin A1c, creatinine, albumin, blood glucose, γ-glutamyl transpeptidase, triglyceride, and white blood cell count. Cognition was assessed by the Mini-Mental State Examination, and cognitive decline was defined as a decrease of at least three points on the Mini-Mental State Examination. RESULTS During an average follow-up of 2.7 years, 115 adults (16.9%) developed cognitive decline. After controlling for important confounders, the odds ratios for cognitive decline in the lowest and middle tertiles of red blood cell count were 2.62 (95% confidence interval: 1.44-4.74) and 2.18 (1.20-3.96), respectively, as compared with the highest tertile. The corresponding odds ratios were 1.81 (1.05-3.22) and 1.03 (0.58-1.83), respectively, for high-density lipoprotein cholesterol and 2.06 (1.14-3.77) and 1.02 (0.54-1.94) for albumin. CONCLUSIONS Low red blood cell count, high-density lipoprotein cholesterol, and albumin were independent risk markers for subsequent cognitive decline in a general population of older adults and may be useful in early clinical screening.

Public health approach to preventing frailty in the community and its effect on healthy aging in Japan

Effective methods to prevent or delay the onset of frailty are urgently required in aging societies, such as Japan. As a public health approach, we carried out a 10‐year community intervention for frailty prevention, and examined its impact on healthy aging among older adults. The target population was all residents aged 65 years or older in the town of Kusatsu, Gunma Prefecture, Japan. For community empowerment, we organized a community forum, and discussed how to address the frailty issue in the community. For primary prevention, we attempted to promote physical activity, nutrition and social participation by means of a health education program to motivate older residents. For secondary prevention, we added a comprehensive geriatric assessment to routine annual health check‐ups, which helped older participants improve self‐care ability of functional health. High‐risk persons were screened and encouraged to participate in a frailty prevention class with a multicomponent program. The attendance rate at annual health check‐ups has remained constant at 30–40% of the target population; however, over 80% of the population appeared at least once during the 10 year‐period. For evaluation, we carried out biennial health monitoring surveys, and reviewed the records of the local Long‐Term Care Insurance system. The functional health of older residents was significantly improved as a result of the interventions; the incidence rate of Long‐Term Care Insurance system certification in the old‐old population (age ≥75 years) was decreased by one second, and healthy life expectancy at age 70 years was extended by 1.2 years for women and 0.5 years for men. Such trends greatly contrasted with those in the reference area, and Japan as a whole. In summary, the present public health approach to frailty prevention appears to promote healthy aging among older adults. Geriatr Gerontol Int 2016; 16 (Suppl. 1): 87–97.

Are neighborhood bonding and bridging social capital protective against depressive mood in old age? A multilevel analysis in Japan

While the importance of distinguishing between bonding and bridging social capital is now understood, evidence remains sparse on their contextual effects on health. We examined the associations of neighborhood bonding and bridging social capital with depressive mood among older Japanese. A questionnaire survey of all community residents aged 65 and older in the city of Yabu, Hyogo Prefecture, Japan was conducted in July and August 2012. Bonding and bridging social capital were assessed by evaluating individual homogeneous and heterogeneous social networks in relation to age, gender, and socioeconomic status. Individual responses in each neighborhood were aggregated to create an index of neighborhood-level bonding/bridging social capital. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to evaluate the associations of such social capital with depressive mood using multilevel binomial logistic regression analysis. Of the 7271 questionnaires distributed, 6416 were analyzed (covering 152 administrative neighborhoods). Approximately 56.8% of respondents were women, and the mean age was 76.2 ± 7.1 years. Neighborhood-level bonding social capital was inversely associated with depressive mood (OR = 0.84, 95% CI = 0.75-0.94), but neighborhood-level bridging social capital was not. Gender-stratified analysis revealed that neighborhood-level bonding social capital was inversely associated with depressive mood in both genders (OR = 0.83, 95% CI = 0.72-0.96 for men; OR = 0.85, 95% CI = 0.72-0.99 for women), while neighborhood-level bridging social capital was positively associated with depressive mood in women (OR = 1.15, 95% CI = 1.00-1.34). There was also a significant interaction between individual- and neighborhood-level bonding social capital, indicating that people with a weaker homogeneous network and living in a neighborhood with weaker bonding social capital were more likely to have depressive mood. Our results suggest that neighborhood social capital does not necessarily benefit mental health in old age. These findings might stimulate further discussion on the relationship of bonding and bridging social capital with mental health.

Prospective Study of Arterial Stiffness and Subsequent Cognitive Decline Among Community-Dwelling Older Japanese

Background Brachial-ankle pulse wave velocity (baPWV) is inversely associated with cognitive function. However, it is not known whether baPWV predicts cognitive decline (CD) in later life. We examined whether or not baPWV is an independent risk marker of subsequent CD in a population of older Japanese. Methods Among 982 adults aged 65 years or older who participated in a baseline survey, 526 cognitively intact adults (Mini-Mental State Examination [MMSE] score ≥24; mean [SD] age, 71.7 [5.6] years; women, 57.8%) were followed for a period of up to 5 years. Pulse wave velocity was determined using an automated waveform analyser. Cognition was assessed by the MMSE, and CD was defined as a decrease of two points or more on the MMSE. Results During an average follow-up of 3.4 years, 85 participants (16.2%) developed CD. After controlling for important confounders, the odds ratios for CD in the highest and middle tertiles of baPWV, as compared with the lowest tertile, were 2.95 (95% confidence interval, 1.29–6.74) and 2.39 (95% confidence interval, 1.11–5.15), respectively. Conclusions High baPWV was an independent predictor of CD in a general population of older adults and may be useful in the clinical evaluation of elders.

Association of dietary variety with body composition and physical function in community-dwelling elderly Japanese

ObjectivesTo examine the associations of dietary variety with body composition and physical function in community-dwelling elderly JapaneseDesignCross-sectional study.SettingCommunity-based.ParticipantsA total of 1184 community-dwelling elderly adults aged 65 and over.MeasurementsDietary variety was assessed with a food frequency questionnaire (maximum, 10 points) that encompassed the 10 main food components of Japanese meals (meat, fish/shellfish, eggs, milk, soybean products, green/yellow vegetables, potatoes, fruit, seaweed, and fats/oils). Body composition was determined by multifrequency bioelectrical impedance analysis. Physical function was assessed by measuring grip strength and usual walking speed. Multiple linear regression analysis was used to examine the associations of dietary variety with body composition and physical function.ResultsAfter adjusting for potential confounders, higher dietary variety scores were independently associated with higher lean mass (β (SE): 0.176 (0.049), p<0.001) and appendicular lean mass (β (SE): 0.114 (0.027), p<0.001) but not with body fat mass. Elders with a higher dietary variety score had greater grip strength and faster usual walking speed (β (SE): 0.204 (0.071), p=0.004, and β (SE): 0.008 (0.003), p=0.012, respectively).ConclusionGreater dietary variety was significantly associated with greater lean mass and better physical function in Japanese elders. The causal relationship warrants investigation in a prospective study.

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.

Dietary variety and decline in lean mass and physical performance in community-dwelling older Japanese: A 4-year follow-up study

ObjectivesTo examine associations of dietary variety with changes in lean mass and physical performance during a 4-year period in an elderly Japanese population. Design: Four-year prospective study.SettingThe Hatoyama Cohort Study and Kusatsu Longitudinal Study, Japan.Participants935 community-dwelling Japanese aged 65 years or older.MeasurementsDietary variety was assessed using a 10-item food frequency questionnaire. Body composition was determined by multifrequency bioelectrical impedance analysis, and physical performance (grip strength and usual gait speed) was measured in surveys at baseline and 4 years later. Longitudinal analysis included only participants who were originally in the upper three quartiles of lean body mass, appendicular lean mass, grip strength, and usual gait speed. The outcome measures were decline in lean body mass, appendicular lean mass, grip strength, and usual gait speed, defined as a decrease to the lowest baseline quartile level at the 4-year follow-up survey. Associations of dietary variety with the outcome measures were examined by logistic regression analysis adjusted for potential confounders.ResultsIn the fully adjusted model, the odds ratios for decline in grip strength and usual gait speed were 0.43 (95% confidence interval, 0.19–0.99) and 0.43 (confidence interval, 0.19–0.99), respectively, for participants in the highest category of dietary variety score as compared with those in the lowest category. Dietary variety was not significantly associated with changes in lean body mass or appendicular lean mass.ConclusionAmong older adults, greater dietary variety may help maintain physical performance, such as grip strength and usual gait speed, but not lean mass.

Effects of a multifactorial intervention comprising resistance exercise, nutritional and psychosocial programs on frailty and functional health in community‐dwelling older adults: A randomized, controlled, cross‐over trial

To examine the effects of a multifactorial intervention on frailty and functional health among community‐dwelling older adults, a 6‐month randomized, controlled, cross‐over trial was carried out within the Hatoyama Cohort Study.