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Hirose T, Sawaya Y, Ishizaka M, Hashimoto N, Kubo A, Urano T. How the prevalence of frailty shifted from 2022 to 2023 as the COVID-19 pandemic calmed down in Japan: second report. J Nutr Health Aging 2024; 28:100254. [PMID: 38688117 DOI: 10.1016/j.jnha.2024.100254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Accepted: 04/21/2024] [Indexed: 05/02/2024]
Affiliation(s)
- Tamaki Hirose
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Tochigi, Japan
| | - Yohei Sawaya
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Tochigi, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Tochigi, Japan
| | - Naori Hashimoto
- Senior Services Division of Otawara, Otawara, Tochigi, Japan
| | - Akira Kubo
- Department of Physical Therapy, School of Health Sciences at Odawara, International University of Health and Welfare, Odawara, Kanagawa, Japan
| | - Tomohiko Urano
- Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, Narita, Chiba, Japan.
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Urano T, Kuroda T, Shiraki M. Nutritional and inflammation factors associated with current frailty level and effect of co-morbidities on the progression of frailty. Geriatr Gerontol Int 2024. [PMID: 38618879 DOI: 10.1111/ggi.14873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 03/27/2024] [Accepted: 03/29/2024] [Indexed: 04/16/2024]
Abstract
AIM Frailty is defined as extreme vulnerability, a syndrome that exposes the individual to a higher risk of disability. While risk factors for frailty have been gradually uncovered, the full identification of biochemical factors and co-morbidities influencing frailty remains incomplete. METHODS Cross-sectional and longitudinal analyses were performed to elucidate the risk factors for the prevalence and progression of frailty. The study included 1035 Japanese female outpatients. At baseline, biochemical markers were measured. Co-morbidities included diabetes mellitus, dyslipidemia, hypertension, vertebral osteoarthritis, and osteoporosis. Frailty levels were assessed using frailty scores ranging from 0 to 5. Prevalence of frailty was judged by a score of 3 or above, and progression was judged by an increase in the frailty score during the observation period. Multiple regression analysis was used for the cross-sectional analysis, and the Cox hazard model was used for the longitudinal analysis. RESULTS Of the 1035 selected participants, 212 were diagnosed with frailty. Advanced age and log IL-6 and branched-chain amino acids (BCAA) levels were significant independent risk factors for frailty. Subjects were followed for 7.7 ± 5.9 years and progression was observed in 130 subjects. Older age, the absence of hyperlipidemia, the presence of osteoporosis, and lower frailty scores were identified as significant risk factors for frailty progression. CONCLUSIONS Inflammatory and nutritional markers exhibited significant associations with the current frailty status, whereas co-morbidities such as osteoporosis or hyperlipidemia emerged as independent risk or protective factors of future frailty progression. Geriatr Gerontol Int 2024; ••: ••-••.
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Affiliation(s)
- Tomohiko Urano
- Department of Geriatric Medicine, International University of Health and Welfare School of Medicine, Chiba, Japan
| | | | - Masataka Shiraki
- Research Institute and Practice for Involutional Diseases, Nagano, Japan
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Kuroda T, Shiraki M, Saito M, Urano T. Spinal osteoarthritis is a risk of vertebral fractures in postmenopausal women. Sci Rep 2024; 14:3528. [PMID: 38347047 PMCID: PMC10861596 DOI: 10.1038/s41598-024-53994-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 02/07/2024] [Indexed: 02/15/2024] Open
Abstract
Recent studies have revealed that despite high bone mineral density (BMD), osteoarthritis (OA) is a risk factor for osteoporotic fractures. However, the relationship between spinal OA and vertebral fractures has not yet been fully investigated. This longitudinal analysis used a subset of ongoing cohort study consist with Japanese postmenopausal women. The prevalence of spinal OA was determined using Kellgren-Lawrence grading method. The incidence of vertebral fractures were determined by semiquantitative analysis of spinal X-ray films. The relationship between the presence of spinal OA and incidence of vertebral fractures was evaluated using the Cox regression analysis. In total, 1480 women were followed up for 8.1 ± 6.4 years. Among them, 923 were diagnosed with spinal OA, and incident vertebral fractures were observed in 473 participants. After adjusting for confounding variables, the spinal OA (≥ grade 2) was a significant predictor of incident vertebral fractures (hazard ratio, 1.52; 95% confidence interval: 1.19-1.93, p = 0.001). Using ROC analysis, the thresholds of lumbar BMD for incident vertebral fractures were 0.952 g/cm2 for patients with spinal OA and 0.753 g/cm2 for patients without spinal OA. The presence of spinal OA is a risk factor for incident vertebral fractures despite high lumbar BMD.
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Affiliation(s)
| | - Masataka Shiraki
- Research Institute and Practice for Involutional Diseases, Azumino City, Nagano, Japan
| | - Mitsuru Saito
- Department of Orthopedic Surgery, Tokyo Jikei University, School of Medicine, Minato-ku, Tokyo, Japan
| | - Tomohiko Urano
- Department of Geriatric Medicine, International University of Health and Welfare School of Medicine, 4-3, Kozunomori, Narita City, Chiba, 286-8686, Japan.
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Sato R, Sawaya Y, Ishizaka M, Yin L, Shiba T, Hirose T, Urano T. Neck circumference is a highly reliable anthropometric measure in older adults requiring long-term care. PeerJ 2024; 12:e16816. [PMID: 38313007 PMCID: PMC10838066 DOI: 10.7717/peerj.16816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 12/29/2023] [Indexed: 02/06/2024] Open
Abstract
The reliability of neck circumference measurement as an assessment tool for older adults requiring long-term care remains unknown. This study aimed to evaluate the reliability of neck circumference measurement in older adults requiring long-term care, and the effect of edema on measurement error. Two physical therapists measured the neck circumference. Intraclass correlation coefficient (ICC) and Bland-Altman analyses were performed to examine the reliability of neck circumference measurement. Correlation analysis was used to evaluate the relationship between edema values (extracellular water/total body water) and neck circumference measurement difference. For inter-rater reliability of neck circumference measurement, the overall ICC (2,1) was 0.98. The upper and lower limits of the difference between examiners ranged from -0.9 to 1.2 cm. There was no association between edema values and neck circumference measurement error. Thus, measurement of the neck circumference in older adults requiring long-term care is a reliable assessment tool, with a low error rate, even in older adults with edema.
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Affiliation(s)
- Ryo Sato
- Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Nishinasuno General Home Care Center, Nasushiobara, Tochigi, Japan
| | - Yohei Sawaya
- Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Nishinasuno General Home Care Center, Nasushiobara, Tochigi, Japan
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Tochigi, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Tochigi, Japan
| | - Lu Yin
- Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Nishinasuno General Home Care Center, Nasushiobara, Tochigi, Japan
| | - Takahiro Shiba
- Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Nishinasuno General Home Care Center, Nasushiobara, Tochigi, Japan
| | - Tamaki Hirose
- Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Nishinasuno General Home Care Center, Nasushiobara, Tochigi, Japan
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Tochigi, Japan
| | - Tomohiko Urano
- Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Nishinasuno General Home Care Center, Nasushiobara, Tochigi, Japan
- Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, Narita, Chiba, Japan
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Sato R, Sawaya Y, Hirose T, Shiba T, Yin L, Ishizaka M, Urano T. Screening for sarcopenia using calf muscle circumference in older adults requiring long-term care. J Nutr Health Aging 2024; 28:100006. [PMID: 38267159 DOI: 10.1016/j.jnha.2023.100006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 12/02/2023] [Indexed: 01/26/2024]
Affiliation(s)
- Ryo Sato
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
| | - Yohei Sawaya
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Tochigi, Japan; Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Tochigi, Japan
| | - Tamaki Hirose
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Tochigi, Japan; Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Tochigi, Japan
| | - Takahiro Shiba
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
| | - Lu Yin
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Tochigi, Japan
| | - Tomohiko Urano
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Tochigi, Japan; Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, Chiba, Japan.
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Hirose T, Sawaya Y, Ishizaka M, Hashimoto N, Kubo A, Urano T. Prevalence and factors associated with changes in frailty among community-dwelling older adults in Japan during the COVID-19 pandemic: A prospective cohort study from 2020 to 2022. Geriatr Gerontol Int 2024; 24:40-47. [PMID: 38009433 DOI: 10.1111/ggi.14748] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 10/25/2023] [Accepted: 11/09/2023] [Indexed: 11/28/2023]
Abstract
AIM This study aimed to ascertain the prevalence of frailty during the pandemic and to determine factors associated with changes in frailty status. METHODS In May-June of 2020-2022, we assessed the frailty of 549 participants using the Kihon Checklist. Furthermore, we classified participant residences as urban, suburban, and rural and investigated participants' engagement in hobbies and community activities in 2020 and 2022. Cochran's Q test was used to analyze the proportions of frailty status. Subsequently, we conducted a binomial logistic regression analysis with the improvement/deterioration of frailty status from 2020 to 2022 as the dependent variable, and engagement in hobbies and community activities as the independent variables. RESULTS Significant changes were observed among participants in urban areas, where an increase in pre-frailty and a decrease in robust individuals from 2020 to 2021 were noted. Focusing on item no. 17 (going out), the decreasing frequency had recovered by 2022 in the group of all groups. Continued engagement in only hobbies or only community activities, and continued engagement in both were associated with remained robust/frailty-status improvement. Moreover, not engaging in either hobbies or community activities was associated with remained frail/frailty-status deterioration. CONCLUSIONS During the early stages, the COVID-19 pandemic impacted the frailty of older adults in densely populated areas. The results also suggest an attenuation in the decline in older adult activity in 2022. Continuous engagement in hobbies and community activities was crucial for improving and preventing deterioration in frailty status during the COVID-19 pandemic. Geriatr Gerontol Int 2024; 24: 40-47.
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Affiliation(s)
- Tamaki Hirose
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Japan
| | - Yohei Sawaya
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Japan
| | | | - Akira Kubo
- Department of Physical Therapy, School of Health Sciences at Odawara, International University of Health and Welfare, Odawara, Japan
| | - Tomohiko Urano
- Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, Narita, Japan
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Sato R, Sawaya Y, Ishizaka M, Shiba T, Hirose T, Yin L, Urano T. Association between decreased neck circumference and impaired activities of daily living among older adults in long-term care. Geriatr Gerontol Int 2023; 23:906-911. [PMID: 37861100 DOI: 10.1111/ggi.14704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 09/25/2023] [Accepted: 09/29/2023] [Indexed: 10/21/2023]
Abstract
AIM Assessment interventions for the decline of activities of daily living (ADLs) in older adults are crucial, as ADL decline increases hospitalization duration and mortality risk. Decreased neck circumference may result in various physical dysfunctions, including malnutrition. However, the association between neck circumference and ADLs has not been fully clarified. This study aimed to determine the association between decreased neck circumference and ADLs in older adults requiring long-term care. METHODS The study included 152 older adults deemed to require support or care under Japan's long-term care insurance system. Neck circumference was measured just below the thyroid cartilage with a measuring tape. The Barthel index was used to evaluate ADLs, and skeletal muscle mass and nutritional status were assessed by bioelectrical impedance analysis instruments. A multivariate analysis was conducted to investigate the association between neck circumference and ADLs. RESULTS Neck circumference demonstrated a significant inverse correlation with age and a significant positive correlation with body mass index, skeletal muscle mass index, phase angle, and Barthel index. In the multivariate analysis, ADLs was significantly associated with neck circumference (odds ratio [OR] = 0.51, P = 0.002) and phase angle (OR = 0.04, P < 0.001). CONCLUSIONS Neck circumference is associated with age, skeletal muscle mass, and nutritional status. Furthermore, a decrease in neck circumference is suggested as an independent risk factor for ADL decline in older adults requiring long-term care. Geriatr Gerontol Int 2023; 23: 906-911.
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Affiliation(s)
- Ryo Sato
- Department of Day Rehabilitation, Nishinasuno General Home Care Center, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
| | - Yohei Sawaya
- Department of Day Rehabilitation, Nishinasuno General Home Care Center, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Tochigi, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Tochigi, Japan
| | - Takahiro Shiba
- Department of Day Rehabilitation, Nishinasuno General Home Care Center, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
| | - Tamaki Hirose
- Department of Day Rehabilitation, Nishinasuno General Home Care Center, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Tochigi, Japan
| | - Lu Yin
- Department of Day Rehabilitation, Nishinasuno General Home Care Center, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
| | - Tomohiko Urano
- Department of Day Rehabilitation, Nishinasuno General Home Care Center, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
- Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, Chiba, Japan
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Taguchi A, Urano T, Nakamura Y, Shiraki M. Increased Risk of Tooth Loss in Postmenopausal Women With Prevalent Vertebral Fractures: An Observational Study. JBMR Plus 2023; 7:e10822. [PMID: 38130772 PMCID: PMC10731137 DOI: 10.1002/jbm4.10822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/22/2023] [Accepted: 09/07/2023] [Indexed: 12/23/2023] Open
Abstract
The association between prevalent fractures and tooth loss in postmenopausal women remains unclear. Herein, we investigated the association between prevalent vertebral and nonvertebral fractures, the number of teeth present at baseline, and the number of teeth lost during follow-up in postmenopausal Japanese women. This cross-sectional study enrolled 843 participants (mean age 68.3 years). The number of teeth at follow-up was evaluated in 655 women in this longitudinal study. The participants were divided into four groups according to their prevalent fracture status: no fractures, vertebral fractures alone, nonvertebral fractures alone, and both fracture types. After adjusting for covariates, Poisson regression analyses were performed to investigate differences in the number of teeth at baseline and that lost during the follow-up period among the four groups. Participants with prevalent vertebral fractures alone had significantly fewer teeth at baseline than those in participants without fractures or nonvertebral fractures alone (p < 0.001 for both). Furthermore, they lost more teeth during the follow-up period than did those with no fractures (p = 0.021) and tended to lose more teeth than did those with nonvertebral fractures alone or both prevalent fracture types. We observed no significant difference in the number of teeth lost between the participants with nonvertebral fractures alone and those with no fractures. Postmenopausal women with prevalent vertebral fractures may be at a higher risk of tooth loss. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Akira Taguchi
- Department of Oral and Maxillofacial RadiologyMatsumoto Dental UniversityShiojiriJapan
| | - Tomohiko Urano
- Department of Geriatric MedicineInternational University of Health and Welfare School of MedicineNaritaJapan
| | - Yukio Nakamura
- Department of Orthopaedic SurgeryShinshu University School of MedicineMatsumotoJapan
| | - Masataka Shiraki
- Department of Internal MedicineResearch Institute and Practice for Involutional DiseasesAzuminoJapan
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Yin L, Sawaya Y, Sato R, Shiba T, Hirose T, Onoda K, Urano T. Minimal Detectable Changes in the Five Times Sit-to-Stand Test in Older Japanese Adults with Sarcopenia Requiring Long-Term Care. Medicina (Kaunas) 2023; 59:2019. [PMID: 38004068 PMCID: PMC10673437 DOI: 10.3390/medicina59112019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/06/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: Although the importance of sarcopenia control has been suggested, there are no minimal detectable change (MDC) studies of older adults with sarcopenia, to our knowledge, and the criteria for determining the effectiveness of interventions are unknown. The purpose of this study was to calculate the MDC in the five times sit-to-stand test (FTSST) in older Japanese adults with sarcopenia and use it as an index to determine the effectiveness of future interventions. Materials and Methods: This was a cross-sectional study conducted in January and February 2023. The participants of this study were older Japanese adults using daycare rehabilitation. Thirty-eight participants performed the FTSST twice a week. Grip strength, walking speed, and skeletal muscle mass were measured to determine the presence of sarcopenia. The diagnosis of sarcopenia was defined as low skeletal muscle mass and low muscle strength and/or low physical function, based on the Asian Working Group for Sarcopenia 2019 diagnostic criteria. Participants were further classified as sarcopenic or non-sarcopenic. Intraclass correlation coefficients (ICCs) and MDCs were calculated for the overall, sarcopenia, and non-sarcopenia groups using the two FTSST measures. The average and difference of the two variables were used to calculate the MDC. Results: Overall, the ICC (1,1) was 0.94, MDC was 2.87 s, and MDC% was 23.3%. The sarcopenia group had an ICC (1,1) of 0.93, MDC of 3.12 s, and MDC% of 24.0%. The non-sarcopenia group had an ICC (1,1) of 0.95, MDC of 2.25 s, and MDC% of 19.2%. Conclusions: Despite the limitation of the data being only from this study population, we found that a change of ≥3.12 s or ≥24.0% in the FTSST of older adults with sarcopenia was clinically meaningful and may help to determine the effectiveness of sarcopenia treatment. The improvement or decline in older Japanese adults with sarcopenia should be determined by changes in the FTSST over a longer period of time than that for other conditions.
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Affiliation(s)
- Lu Yin
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly “Maronie-en”, 533-11, Iguchi, Nasushiobara 329-2763, Tochigi, Japan; (L.Y.); (Y.S.); (R.S.); (T.S.); (T.H.)
| | - Yohei Sawaya
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly “Maronie-en”, 533-11, Iguchi, Nasushiobara 329-2763, Tochigi, Japan; (L.Y.); (Y.S.); (R.S.); (T.S.); (T.H.)
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara 324-8501, Tochigi, Japan;
| | - Ryo Sato
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly “Maronie-en”, 533-11, Iguchi, Nasushiobara 329-2763, Tochigi, Japan; (L.Y.); (Y.S.); (R.S.); (T.S.); (T.H.)
| | - Takahiro Shiba
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly “Maronie-en”, 533-11, Iguchi, Nasushiobara 329-2763, Tochigi, Japan; (L.Y.); (Y.S.); (R.S.); (T.S.); (T.H.)
| | - Tamaki Hirose
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly “Maronie-en”, 533-11, Iguchi, Nasushiobara 329-2763, Tochigi, Japan; (L.Y.); (Y.S.); (R.S.); (T.S.); (T.H.)
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara 324-8501, Tochigi, Japan;
| | - Ko Onoda
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara 324-8501, Tochigi, Japan;
| | - Tomohiko Urano
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly “Maronie-en”, 533-11, Iguchi, Nasushiobara 329-2763, Tochigi, Japan; (L.Y.); (Y.S.); (R.S.); (T.S.); (T.H.)
- Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, 4-3 Kozunomori, Narita 286-8686, Chiba, Japan
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Yamaguchi Y, Okochi J, Urano T, Ebihara T, Kadono T, Arai H, Iijima K, Ishii S, Kuzuya M, Rakugi H, Akishita M, Higashi K, Kozaki K. Survey on the health status within two weeks after mRNA vaccination for SARS-CoV-2 in geriatric health service facilities in Japan. Geriatr Gerontol Int 2023; 23:892-893. [PMID: 37818862 DOI: 10.1111/ggi.14700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/23/2023] [Accepted: 09/27/2023] [Indexed: 10/13/2023]
Affiliation(s)
- Yasuhiro Yamaguchi
- Department of Pulmonary Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Jiro Okochi
- Geriatric Health Services Faculty Tatsumanosato, Daito, Japan
| | - Tomohiko Urano
- Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, Chiba, Japan
| | - Takae Ebihara
- Department of Geriatric Medicine, Graduate School of Medicine, Kyorin University, Tokyo, Japan
| | - Takafumi Kadono
- Department of Dermatology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Japan
| | - Katsuya Iijima
- Institute of Gerontology, Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
| | - Shinya Ishii
- Department of Medicine for Integrated Approach to Social Inclusion, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | | | | | - Masahiro Akishita
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kentaro Higashi
- Japan Association of Geriatric Health Services Facilities, Tokyo, Japan
| | - Koichi Kozaki
- Department of Geriatric Medicine, Graduate School of Medicine, Kyorin University, Tokyo, Japan
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Sawaya Y, Hirose T, Ishizaka M, Hashimoto N, Shiba T, Sato R, Yin L, Watanabe M, Itokazu M, Kubo A, Urano T. A question about opening polyethylene terephthalate bottle caps enables high-precision determination of handgrip strength in older Japanese adults. Geriatr Gerontol Int 2023; 23:764-765. [PMID: 37697446 DOI: 10.1111/ggi.14666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/16/2023] [Accepted: 08/29/2023] [Indexed: 09/13/2023]
Affiliation(s)
- Yohei Sawaya
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Japan
- Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Nishinasuno General Home Care Center, Nasushiobara, Japan
| | - Tamaki Hirose
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Japan
- Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Nishinasuno General Home Care Center, Nasushiobara, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Japan
| | | | - Takahiro Shiba
- Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Nishinasuno General Home Care Center, Nasushiobara, Japan
| | - Ryo Sato
- Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Nishinasuno General Home Care Center, Nasushiobara, Japan
| | - Lu Yin
- Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Nishinasuno General Home Care Center, Nasushiobara, Japan
| | - Miyoko Watanabe
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Japan
| | - Masafumi Itokazu
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Japan
| | - Akira Kubo
- Department of Physical Therapy, School of Health Sciences at Odawara, International University of Health and Welfare, Odawara, Japan
| | - Tomohiko Urano
- Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Nishinasuno General Home Care Center, Nasushiobara, Japan
- Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, Narita, Japan
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12
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Shiba T, Sato R, Sawaya Y, Hirose T, Ishizaka M, Kubo A, Urano T. Sarcopenia with Depression Presents a More Severe Disability Than Only Sarcopenia among Japanese Older Adults in Need of Long-Term Care. Medicina (Kaunas) 2023; 59:1095. [PMID: 37374299 DOI: 10.3390/medicina59061095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/30/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023]
Abstract
Background and objectives: The combination of depression and sarcopenia, a condition prevalent worldwide, may cause dis-tinct problems that should not be underestimated. However, to the best of our knowledge, no reports have investigated the combined effects of depression and sarcopenia. In this study, we compared physical function, nutritional status, and daily functioning among older adults with only depression (OD), those with only sarcopenia (OS), and those with sarcopenia with depression (SD) to examine the effects of the combination of depression and sarcopenia. Materials and Methods: The participants were 186 communi-ty-dwelling older individuals who required support or care. The participants were classified into four groups based on the presence or absence of sarcopenia and depression: Control, OD, OS, and SD. The following parameters were evaluated in the four groups: grip strength, walking speed, skeletal muscle mass index (SMI), Mini Nutritional Assessment Short-Form (MNA-sf), and long-term care certification level. In addition, univariate and multivariate analyses of the survey results were performed to identify risk factors leading from OS to SD. Results: We found that 31.2% of older participants who needed support or nursing care had SD, which had more pronounced adverse effects on grip strength, walking speed, SMI, MNA-sf, and level of nursing care than OD or OS. Furthermore, multivariate analysis of SD vs. OS showed that decreased grip strength and worsening MNA-sf were independent risk factors. Conclusions: SD is common among older individuals living in the community. Patients with SD require support and care, and the condition has a greater impact on physical function, nutritional status, and decline in life function compared to OD and OS. Therefore, it is desirable to elucidate the process leading to SD and investigate the risk factors and prognosis. It is expected that sarcopenia with depression will be investigated worldwide in the future.
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Affiliation(s)
- Takahiro Shiba
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en," 533-11 Iguchi, Nasushiobara 329-2763, Tochigi, Japan
| | - Ryo Sato
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en," 533-11 Iguchi, Nasushiobara 329-2763, Tochigi, Japan
| | - Yohei Sawaya
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en," 533-11 Iguchi, Nasushiobara 329-2763, Tochigi, Japan
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara 324-8501, Tochigi, Japan
| | - Tamaki Hirose
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en," 533-11 Iguchi, Nasushiobara 329-2763, Tochigi, Japan
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara 324-8501, Tochigi, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara 324-8501, Tochigi, Japan
| | - Akira Kubo
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara 324-8501, Tochigi, Japan
| | - Tomohiko Urano
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en," 533-11 Iguchi, Nasushiobara 329-2763, Tochigi, Japan
- Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, 4-3 Kozunomori, Narita 286-8686, Chiba, Japan
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13
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Sato R, Sawaya Y, Ishizaka M, Shiba T, Hirose T, Urano T. Leg skeletal muscle mass asymmetry is independently associated with gait speed in older adults requiring long-term care. Geriatr Gerontol Int 2023; 23:371-375. [PMID: 37039131 DOI: 10.1111/ggi.14583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 03/23/2023] [Accepted: 03/27/2023] [Indexed: 04/12/2023]
Abstract
AIM Decreased gait speed in older adults has been associated with incident disability, cognitive impairment, institutionalization, falls, deterioration in level of care, and mortality. Gait speed has been reported to be related to leg asymmetry. However, the relationship between gait speed and leg skeletal muscle mass asymmetry in older adults requiring long-term care has not been clarified. In this study, we examined the association between gait speed and leg skeletal muscle mass asymmetry and the cutoff values of leg skeletal muscle mass asymmetry that may affect gait speed. METHODS The asymmetry index of leg skeletal muscle mass was measured in 230 older adults under the Japanese long-term care insurance system using bioelectrical impedance analysis. This cross-sectional study used multiple regression analysis and receiver operating characteristic (ROC) curve analysis to determine the relationship between gait speed and the asymmetry index of leg skeletal muscle mass. RESULTS Multiple regression analysis revealed that the asymmetry index of leg skeletal muscle mass (β = -0.19, P = 0.002, R2 = 0.261) was independently and significantly associated with gait speed. Furthermore, ROC analysis showed that the cutoff value of the asymmetry index of leg skeletal muscle mass that identified reduced gait speed (<1.0 m/s) was 3.02% (Area under the curve = 0.62, sensitivity 47.3%, specificity 81.0%, P = 0.014). CONCLUSIONS The asymmetry index of leg skeletal muscle mass was associated with gait speed in older adults requiring long-term care. Future assessment and interventions directed towards symmetry of leg skeletal muscle mass may help to improve gait speed in older adults. Geriatr Gerontol Int 2023; ••: ••-••.
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Affiliation(s)
- Ryo Sato
- Division of Physical Therapy, Doctoral Program in Health Sciences, Graduate School of Health and Welfare Sciences, International University of Health and Welfare, Tochigi, Japan
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
| | - Yohei Sawaya
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Tochigi, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Tochigi, Japan
| | - Takahiro Shiba
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
| | - Tamaki Hirose
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Tochigi, Japan
| | - Tomohiko Urano
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
- Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, Chiba, Japan
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14
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Sato R, Sawaya Y, Shiba T, Hirose T, Ishizaka M, Urano T. Indicators predicting the development and improvement of sarcopenia in older adults requiring long-term care. J Phys Ther Sci 2023; 35:242-246. [PMID: 36866017 PMCID: PMC9974322 DOI: 10.1589/jpts.35.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 12/14/2022] [Indexed: 03/04/2023] Open
Abstract
[Purpose] This study aimed to identify factors associated with sarcopenia development and improvement among older adults requiring long-term care. [Participants and Methods] This prospective observational study included 118 older adults requiring long-term care in a single facility. Sarcopenia was assessed according to the 2019 diagnostic criteria of the Asian Working Group for Sarcopenia at baseline and after 6 months. Nutritional status was measured using calf circumference and the Mini Nutritional Assessment-Short Form to examine the association between sarcopenia onset and improvement. [Results] Risk of malnutrition and lower calf circumference at baseline were significantly associated with sarcopenia development. The study also showed that a non-risk of malnutrition, higher calf circumference, and higher skeletal muscle mass index were significantly associated with improved sarcopenia. [Conclusion] The Mini Nutritional Assessment-Short Form and calf circumference were able to predict sarcopenia development and improvement in older adults requiring long-term care.
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Affiliation(s)
- Ryo Sato
- Division of Physical Therapy, Doctoral Program in Health
Sciences, Graduate School of Health and Welfare Sciences, International University of
Health and Welfare, Japan
| | - Yohei Sawaya
- Department of Physical Therapy, School of Health Sciences,
International University of Health and Welfare, Japan
| | - Takahiro Shiba
- Nishinasuno General Home Care Center, Department of Day
Rehabilitation, Care Facility for the Elderly “Maronie-en”, Japan
| | - Tamaki Hirose
- Department of Physical Therapy, School of Health Sciences,
International University of Health and Welfare, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences,
International University of Health and Welfare, Japan
| | - Tomohiko Urano
- Department of Geriatric Medicine, School of Medicine,
International University of Health and Welfare: 4-3 Kozunomori, Narita-shi, Chiba
286-8686, Japan,Corresponding author. Tomohiko Urano (E-mail: )
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15
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Takahashi K, Amano H, Urano T, Li M, Oki M, Aoki K, Amizuka N, Nakayama KI, Nakayama K, Udagawa N, Higashi N. p57Kip2 is an essential regulator of vitamin D receptor-dependent mechanisms. PLoS One 2023; 18:e0276838. [PMID: 36791055 PMCID: PMC9931147 DOI: 10.1371/journal.pone.0276838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 10/14/2022] [Indexed: 02/16/2023] Open
Abstract
A cyclin-dependent kinase (CDK) inhibitor, p57Kip2, is an important molecule involved in bone development; p57Kip2-deficient (p57-/-) mice display neonatal lethality resulting from abnormal bone formation and cleft palate. The modulator 1α,25-dihydroxyvitamin D3 (l,25-(OH)2VD3) has shown the potential to suppress the proliferation and induce the differentiation of normal and tumor cells. The current study assessed the role of p57Kip2 in the 1,25-(OH)2VD3-regulated differentiation of osteoblasts because p57Kip2 is associated with the vitamin D receptor (VDR). Additionally, 1,25-(OH)2VD3 treatment increased p57KIP2 expression and induced the colocalization of p57KIP2 with VDR in the osteoblast nucleus. Primary p57-/- osteoblasts exhibited higher proliferation rates with Cdk activation than p57+/+ cells. A lower level of nodule mineralization was observed in p57-/- osteoblasts than in p57+/+ cells. In p57+/+ osteoblasts, 1,25-(OH)2VD3 upregulated the p57Kip2 and opn mRNA expression levels, while the opn expression levels were significantly decreased in p57-/- cells. The osteoclastogenesis assay performed using bone marrow cocultured with 1,25-(OH)2VD3-treated osteoblasts revealed a decreased efficiency of 1,25-(OH)2VD3-stimulated osteoclastogenesis in p57-/- cells. Based on these results, p57Kip2 might function as a mediator of 1,25-(OH)2VD3 signaling, thereby enabling sufficient VDR activation for osteoblast maturation.
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Affiliation(s)
- Katsuhiko Takahashi
- Department of Biochemistry, Hoshi University, Ebara, Shinagawa-ku, Tokyo
- Department of Anatomy, School of Medicine, Showa University Hatanodai, Shinagawa-ku, Tokyo
| | - Hitoshi Amano
- Department of Biochemistry, Hoshi University, Ebara, Shinagawa-ku, Tokyo
- Department of Basic Oral Health Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Yushima, Bunkyo-ku, Tokyo, Japan
- Department of Biochemistry, Matsumoto Dental University, Shiojiri, Japan
- * E-mail:
| | - Tomohiko Urano
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, Chiba, Japan
| | - Minqi Li
- Stomatology Department of Jining Medical University, Jining, and Department of Bone Metabolism, School of Stomatology Shandong University, Shandong Provincial Key Laboratory of Oral Tissue Regeneration, Jinan, China
| | - Meiko Oki
- Department of Basic Oral Health Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Yushima, Bunkyo-ku, Tokyo, Japan
| | - Kazuhiro Aoki
- Department of Basic Oral Health Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Yushima, Bunkyo-ku, Tokyo, Japan
| | - Norio Amizuka
- Developmental Biology and Hard Tissue, Graduate School of Dental Medicine and Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Keiichi I. Nakayama
- Department of Molecular and Cellular Biology, Medical Institute of Bioregulation, Kyushu University, Maidashi, Higashi-ku, Fukuoka, Japan
| | - Keiko Nakayama
- Division of Cell Proliferation, ART, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
| | - Nobuyuki Udagawa
- Department of Biochemistry, Matsumoto Dental University, Shiojiri, Japan
| | - Nobuaki Higashi
- Department of Biochemistry, Hoshi University, Ebara, Shinagawa-ku, Tokyo
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16
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Shiraki M, Kuroda T, Nakano M, Nakamura Y, Saito M, Urano T. Nitric oxide is associated with fracture risk in Japanese women. PLoS One 2023; 18:e0280854. [PMID: 36749766 PMCID: PMC9904477 DOI: 10.1371/journal.pone.0280854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 01/09/2023] [Indexed: 02/08/2023] Open
Abstract
Although nitric oxide (NO) is a known factor that regulates the bone physiology, few and discordant results have been obtained in human studies evaluating the effect of nitrates on bone health. We investigated for the relationship between serum NOx level and incident osteoporotic fracture rate prospectively in a cohort consisting of Japanese women. A total of 871 subjects (67.5 ± 10.8 y/o) were analyzed. During the observation period (8.8 ± 7.2 yrs), incident osteoporotic fractures occurred in 267 participants (209 vertebral fractures, 57 long-bone fractures, and 1 both types). Hazard ratio, by the Cox proportional hazards model, of serum NOx for incident fracture was 0.64 (95% confidence interval 0.53-0.78, p < 0.001) after adjustment for baseline age (1.13, 1.06-1.21, p < 0.001), lumbar bone mineral density (L-BMD; 0.85, 0.78-0.92, p < 0.001), presence of prevalent fracture (3.27, 2.49-4.32, p < 0.001), and treatment of osteoporosis (0.70, 0.53-0.92, p = 0.010). The relationships between serum level of NOx and bone-related parameters were examined by multiple regression analysis; body mass index (p < 0.001) and L-BMD (p = 0.011) were significantly associated with serum NOx level. These results suggest that the low circulating NOx is one of the independent predictors for osteoporotic fracture occurrence in postmenopausal women.
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Affiliation(s)
- Masataka Shiraki
- Research Institute and Practice for Involutional Diseases, Azumino City, Nagano, Japan
| | | | - Masaki Nakano
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto City, Nagano, Japan
| | - Yukio Nakamura
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto City, Nagano, Japan
- * E-mail:
| | - Mitsuru Saito
- Department of Orthopaedic Surgery, Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Tomohiko Urano
- Department of Geriatric Medicine, International University of Health and Welfare School of Medicine, Narita City, Chiba, Japan
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17
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Hirose T, Sawaya Y, Ishizaka M, Hashimoto N, Kubo A, Urano T. Frailty under COVID-19 pandemic in Japan: Changes in prevalence of frailty from 2017 to 2021. J Am Geriatr Soc 2023; 71:1603-1609. [PMID: 36647923 DOI: 10.1111/jgs.18237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 11/24/2022] [Accepted: 12/23/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND After the outbreak of the coronavirus disease 2019 (COVID-19), "pandemic-associated-frailty" or profound health deterioration, in older adults has been considered a health concern. In this study, we sought to demonstrate whether pandemic-associated-frailty is occurring in Japan, where the population is aging, by showing the prevalence of frailty before and during the COVID-19 outbreak, using the same method. METHODS A total of 5222 older adults in Otawara City, Tochigi Prefecture, aged 70 and 75 were surveyed annually using a complete survey, excluding those who were certified as requiring long-term care. Frailty during 2017-2019 before the COVID-19 outbreak and during 2020-2021 during the COVID-19 outbreak was determined using the Kihon Checklist (KCL). Statistical analysis was performed using the χ2 test to compare annual frailty status and Kruskal-Wallis test to compare the scores. RESULTS The frailty statuses over the five-year period showed a significant decrease in Robust and a significant increase in Pre-frailty and Frailty (p < 0.001). Frailty increased markedly during the second year of the pandemic. Based on the category, the scores deteriorated significantly for activities of daily living (p < 0.001), physical function (p = 0.003), oral function (p < 0.001), outdoor activity (p < 0.001), and depression (p < 0.001). Moreover, there was a significant deterioration in the total score for 25 items (p < 0.001). In addition, a significant deterioration was observed in the total score of 23 items, excluding the social withdrawal affected by self-restraint life (p < 0.001). CONCLUSIONS The population prevalence of frailty in older adults increased steadily from the pre-pandemic year through the first and second years of the pandemic. Based on the 25 questions of the KCL, two aspects including visiting friends and going out less stood out. This suggests that pandemic-associated-frailty occurred in Japan.
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Affiliation(s)
- Tamaki Hirose
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Tochigi, Japan
| | - Yohei Sawaya
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Tochigi, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Tochigi, Japan
| | - Naori Hashimoto
- Senior Services Division of Otawara, Otawara, Tochigi, Japan
| | - Akira Kubo
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Tochigi, Japan
| | - Tomohiko Urano
- Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, Narita, Chiba, Japan
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18
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Sawaya Y, Hirose T, Ishizaka M, Shiba T, Sato R, Kubo A, Urano T. Patterns of Changes in Respiratory Muscle Strength over 1 Year in Non-Sarcopenia, Sarcopenia, and Severe Sarcopenia. Int J Environ Res Public Health 2022; 19:16571. [PMID: 36554450 PMCID: PMC9779222 DOI: 10.3390/ijerph192416571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/27/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
In this prospective longitudinal cohort study, we explored the characteristics of older people with lower respiratory muscle strength, according to sarcopenia severity, over the course of 1 year. The maximum expiratory pressure (MEP), grip strength, walking speed, and skeletal muscle mass index of 58 participants (28 men, 30 women; mean age, 76.9 ± 7.7 years) were measured at baseline and at the 1-year follow-up. Participants were classified into a decreased MEP group (n = 29; MEP decreased by ≥10% after 1 year) and a non-decreased MEP group (n = 29; MEP decreased by <10%). Sarcopenia status in the mild direction at baseline was significantly associated with MEP decline after one year. Repeated two-way analysis of variance showed significant main effects of measurement time (p < 0.001) and severity of sarcopenia (p = 0.026), as well as a significant interaction effect (p = 0.006). Surprisingly, MEP decreased significantly in the non-sarcopenia and sarcopenia groups, but not in the severe sarcopenia group. Thus, individuals without sarcopenia and those with moderate sarcopenia at baseline are predisposed to MEP decline and should be closely monitored for signs of such decline and associated adverse events.
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Affiliation(s)
- Yohei Sawaya
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara 324-8501, Tochigi, Japan
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly “Maronie-en,” 533-11 Iguchi, Nasushiobara 329-2763, Tochigi, Japan
| | - Tamaki Hirose
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara 324-8501, Tochigi, Japan
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly “Maronie-en,” 533-11 Iguchi, Nasushiobara 329-2763, Tochigi, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara 324-8501, Tochigi, Japan
| | - Takahiro Shiba
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly “Maronie-en,” 533-11 Iguchi, Nasushiobara 329-2763, Tochigi, Japan
| | - Ryo Sato
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly “Maronie-en,” 533-11 Iguchi, Nasushiobara 329-2763, Tochigi, Japan
| | - Akira Kubo
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara 324-8501, Tochigi, Japan
| | - Tomohiko Urano
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly “Maronie-en,” 533-11 Iguchi, Nasushiobara 329-2763, Tochigi, Japan
- Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, 4-3 Kozunomori, Narita 286-8686, Chiba, Japan
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19
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Itokazu M, Ishizaka M, Uchikawa Y, Takahashi Y, Niida T, Hirose T, Ito A, Yakabi A, Endo Y, Sawaya Y, Igawa T, Kobayashi K, Hara T, Watanabe M, Kubo A, Urano T. Relationship between Eye Frailty and Physical, Social, and Psychological/Cognitive Weaknesses among Community-Dwelling Older Adults in Japan. Int J Environ Res Public Health 2022; 19:13011. [PMID: 36293591 PMCID: PMC9602133 DOI: 10.3390/ijerph192013011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/07/2022] [Accepted: 10/08/2022] [Indexed: 06/16/2023]
Abstract
This study investigated the relationship between eye frailty and physical, social, and psychological/cognitive weaknesses among older adults in Japan. The participants were 192 community-dwelling older adult women. We measured handgrip strength, walking speed, and skeletal muscle mass; additionally, their physical, social, and psychological/cognitive frailties were surveyed using questionnaires. Eye frailty self-checks were used to assess eye frailty. Exploratory and confirmatory factor analyses were employed to verify the validity of the eye frailty self-checks. Eye frailty prevalence and related factors were investigated by conducting a binomial logistic regression analysis, with eye frailty as the dependent variable. The factor analysis results showed that a model could be constructed with the two factors of visual acuity or contrast and visual field. The model's goodness of fit was acceptable, supporting the validity of the self-checking construct. The Kihon checklist was the only variable with a significant relationship to eye frailty. Regarding the relationship between eye frailty and subordinate items of the Kihon checklist, social withdrawal [odds ratio (OR) 2.437, 95% confidence interval 1.145-5.188], cognitive function (OR 2.047, 95%CI 1.051-3.984), and depressed mood (OR 1.820, 95%CI 1.163-2.848) were significant. Eye frailty can be considered a factor reflecting the existence of social and psychological/cognitive frailties.
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Affiliation(s)
- Masafumi Itokazu
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Yoshikazu Uchikawa
- Department of Orthoptics and Visual Sciences, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Yoshiaki Takahashi
- Department of Ophthalmology, Dokkyo Medical University Nikko Medical Center, Nikko 321-2593, Tochigi, Japan
| | - Takahiro Niida
- Department of Orthoptics and Visual Sciences, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Tamaki Hirose
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Akihiro Ito
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Akihiro Yakabi
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Yoshiaki Endo
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Yohei Sawaya
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Tatsuya Igawa
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Kaoru Kobayashi
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Tsuyoshi Hara
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Miyoko Watanabe
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Akira Kubo
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara 324-8501, Tochigi, Japan
| | - Tomohiko Urano
- Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, Narita 286-8686, Chiba, Japan
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20
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Sato R, Sawaya Y, Ishizaka M, Shiba T, Hirose T, Urano T. Assessing nutritional status in older adults requiring long-term care: Interchangeability of bioelectrical impedance analysis and manual methods for upper arm anthropometric measurements. Geriatr Gerontol Int 2022; 22:938-942. [PMID: 36151781 DOI: 10.1111/ggi.14486] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/22/2022] [Accepted: 08/30/2022] [Indexed: 11/30/2022]
Abstract
AIM In older adults, arm circumference and arm muscle circumference are common nutritional assessment tools. Bioelectrical impedance analysis devices can automatically measure arm circumference and arm muscle circumference. However, the interchangeability of the measurements made by bioelectrical impedance analysis with the actual manual measurements has not been clarified. This study examined the interchangeability of these two measurements and their relationship with sarcopenia. METHODS The interchangeability between bioelectrical impedance analysis and manual arm circumference and arm muscle circumference measurements was calculated using Bland-Altman analysis in 112 older adults certified to require long-term care in the Japanese system. Furthermore, multivariate analysis was used to investigate the association between arm circumference and arm muscle circumference obtained using the bioelectrical impedance analysis method and sarcopenia. RESULTS The bioelectrical impedance analysis and manual methods were interchangeable, with a percentage error of <15% (arm circumference 13.54% and arm muscle circumference 13.54%) for the upper arm anthropometric measurement. In multivariate analysis, decreased arm muscle circumference was significantly associated with sarcopenia risk. CONCLUSIONS Values obtained using the bioelectrical impedance analysis method were interchangeable with the values obtained using manual measurement. This shows that upper arm anthropometric measurement using bioelectrical impedance analysis might be useful as a nutritional assessment tool for older adults requiring long-term care. Geriatr Gerontol Int 2022; ••: ••-••.
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Affiliation(s)
- Ryo Sato
- Division of Physical Therapy, Doctoral Program in Health Sciences, Graduate School of Health and Welfare Sciences, International University of Health and Welfare, Tochigi, Japan.,Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en,", Tochigi, Japan
| | - Yohei Sawaya
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en,", Tochigi, Japan.,Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Tochigi, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Tochigi, Japan
| | - Takahiro Shiba
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en,", Tochigi, Japan
| | - Tamaki Hirose
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en,", Tochigi, Japan.,Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Tochigi, Japan
| | - Tomohiko Urano
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en,", Tochigi, Japan.,Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, Chiba, Japan
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21
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Hirose T, Sawaya Y, Ishizaka M, Hashimoto N, Ito A, Endo Y, Kobayashi K, Yakabi A, Onoda K, Hara T, Watanabe M, Itokazu M, Kubo A, Urano T. Characteristics of Japanese Older Adults Whose Trunk Muscle Mass Decreased during the COVID-19 Pandemic. Int J Environ Res Public Health 2022; 19:11438. [PMID: 36141711 PMCID: PMC9517623 DOI: 10.3390/ijerph191811438] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/07/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
The coronavirus (COVID-19) pandemic significantly affected the physical and mental functions in older adults, resulting in "corona-frailty". This 2-year prospective study characterized changes in quantitative measures and corona-frailty among a cohort of community-dwelling older women. Changes were evaluated using face-to-face interactions with 39 Japanese women (mean age: 76.1 ± 5.9) in 2019 (pre-pandemic baseline) and 2021 (follow-up during the pandemic). Quantitative measurements of handgrip strength, walking speed, calf circumference, body composition, and background factors were evaluated. Body weight and trunk muscle mass significantly decreased at follow-up. Multiple regression analysis, using change in trunk muscle mass as the dependent variable and background factors as independent variables, identified that decrease in trunk muscle mass was associated with "being robust at baseline" and answering "Yes" to the question of "Do you go out less frequently compared with last year"? The 2-year trunk muscle mass change for each baseline frailty stage showed a significant decrease only in the robust group (-8.0%). The decrease in trunk muscle mass might be related to pandemic-induced lifestyle restraint, suggesting that robust older adults who are healthy and active should take measures that focus on trunk muscles to avoid "corona-frailty".
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Affiliation(s)
- Tamaki Hirose
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara 324-8501, Tochigi, Japan
| | - Yohei Sawaya
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara 324-8501, Tochigi, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara 324-8501, Tochigi, Japan
| | - Naori Hashimoto
- Senior Services Division of Otawara, 1-4-1 Honcho, Otawara 324-8641, Tochigi, Japan
| | - Akihiro Ito
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara 324-8501, Tochigi, Japan
| | - Yoshiaki Endo
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara 324-8501, Tochigi, Japan
| | - Kaoru Kobayashi
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara 324-8501, Tochigi, Japan
| | - Akihiro Yakabi
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara 324-8501, Tochigi, Japan
| | - Ko Onoda
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara 324-8501, Tochigi, Japan
| | - Tsuyoshi Hara
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara 324-8501, Tochigi, Japan
| | - Miyoko Watanabe
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara 324-8501, Tochigi, Japan
| | - Masafumi Itokazu
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara 324-8501, Tochigi, Japan
| | - Akira Kubo
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara 324-8501, Tochigi, Japan
| | - Tomohiko Urano
- Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, 4-3 Kozunomori, Narita 286-8686, Chiba, Japan
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22
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Kojima G, Taniguchi Y, Iwasaki M, Aoyama R, Urano T. Associations between self-reported masticatory dysfunction and frailty: A systematic review and meta-analysis. PLoS One 2022; 17:e0273812. [PMID: 36084116 PMCID: PMC9462797 DOI: 10.1371/journal.pone.0273812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 08/12/2022] [Indexed: 11/18/2022] Open
Abstract
Background Oral health is a key factor of overall health and closely associated with well-being and quality of life. Mastication is one the most important oral functions and may deteriorate with aging. Evidence on association between masticatory dysfunction and frailty in the literature is scarce and not coherent. Methods A search strategy was developed to conduct a systematic review of the literature in PubMed, CINAHL, and AMED in accordance with the PRISMA 2020 guidelines. We searched for studies published in 2000 or later that examined associations between self-reported masticatory dysfunction and frailty risk. The reference lists of the relevant articles were reviewed for additional studies. We calculated pooled odds ratios (OR) of association between self-reported masticatory dysfunction and the risk of frailty by fixed-effects meta-analysis. The Joanna Briggs Institute Critical Appraisal Checklist was used to assess risk of bias. Publication bias was assessed by visually inspecting a funnel plot. Results A total of 285 studies were identified by the literature search. Among 5 studies selected for this review, 4 cross-sectional studies including a total of 7425 individuals were used for meta-analysis. The pooled results by a fixed-effects model showed that there was a significant association between self-reported masticatory dysfunction and frailty risk (pooled OR = 1.83, 95%CI = 1.55–2.18, p<0.00001). There was no evidence of publication bias observed. Conclusions This systematic review and meta-analysis highlighted pooled cross-sectional evidence that community-dwelling older people who report masticatory dysfunction are significantly more likely to be frail than those who do not. The limitations of this study are: inclusion of only cross-sectional studies, no gold standard to measure masticatory functions, self-reported information on masticatory function, and the limited number of included studies. More longitudinal studies are warranted for further understanding of the causal pathways and elucidate underlying mechanisms. Registration: PROSPERO CRD42021277173
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Affiliation(s)
- Gotaro Kojima
- Department of Research, Dr. AGA Clinic, Tokyo, Japan
| | - Yu Taniguchi
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan
| | | | - Reijiro Aoyama
- Department of Japanese Studies, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Tomohiko Urano
- Department of Geriatric Medicine, International University of Health and Welfare, Chiba, Japan
- * E-mail:
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23
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Hirose T, Sawaya Y, Ishizaka M, Hashimoto N, Kubo A, Urano T. Kihon Checklist items associated with the development of frailty and recovery to robust status during the COVID-19 pandemic. Geriatr Gerontol Int 2022; 22:745-752. [PMID: 35929095 PMCID: PMC9538351 DOI: 10.1111/ggi.14447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 06/10/2022] [Accepted: 07/06/2022] [Indexed: 12/11/2022]
Abstract
AIM The Kihon Checklist (KCL) is used to assess frailty in daily life. We aimed to identify KCL items associated with the development of frailty and recovery to robust status during the COVID-19 pandemic. METHODS We conducted a 1-year prospective cohort study of community-dwelling adults aged 70 and 75 years in Otawara City, Tochigi Prefecture, Japan. Information regarding age, sex, presence of disease and KCL items was collected in May 2020 (baseline) and June 2021 (follow-up) using a mailed questionnaire. Changes in frailty status as determined by the KCL at baseline and follow-up were evaluated. To clarify factors related to changes in the frailty status, we conducted two sets of binomial logistic regression analyses with the presence/absence of development of frailty and presence/absence of recovery to robust status at follow-up as the dependent variables and the KCL items as the independent variables. RESULTS The analysis included 716 participants who provided complete responses to both questionnaires. The KCL Items 6, 10, 20, 23 and 24 were related to the development of frailty, and the KCL Items 6, 15, 21 and 23 were associated with the recovery to robust status. CONCLUSIONS The baseline KCL items regarding physical function and associated mental aspects were related to both development of frailty and recovery to robust status during the COVID-19 pandemic. Cognitive and depressive declines were associated with the development of frailty, while good oral environment and sense of fulfillment in life were associated with the recovery to robust status. Geriatr Gerontol Int ••; ••: ••-•• Geriatr Gerontol Int 2022; ••: ••-••.
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Affiliation(s)
- Tamaki Hirose
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Japan
| | - Yohei Sawaya
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Japan
| | | | - Akira Kubo
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Japan
| | - Tomohiko Urano
- Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, Chiba, Japan
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24
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Kojima G, Taniguchi Y, Ogawa K, Aoyama R, Urano T. Age at menopause is negatively associated with frailty: A systematic review and meta-analysis. Maturitas 2022; 165:94-99. [PMID: 35940027 DOI: 10.1016/j.maturitas.2022.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 06/27/2022] [Accepted: 07/16/2022] [Indexed: 11/30/2022]
Abstract
Menopause and related changes may be associated with frailty and contribute to higher frailty risk. This systematic review of the literature on the association between menopause and frailty combines the findings from studies of community-dwelling women. PubMed was systematically searched in March 2021 with a time frame from 2000 to March 2021 without language restriction. Potentially eligible studies were those that provided cross-sectional or prospective observational data on associations between menopause and frailty in community-dwelling women. Reference lists of relevant articles and the included studies were reviewed for additional studies. The same effect sizes were combined using a meta-analysis using the generic inverse variance method. From 131 studies identified, cross-sectional data on age at menopause from 3 studies and longitudinal data on surgical menopause from 2 studies were used for meta-analysis. Each one-year increase in age at menopause was significantly associated with a 2 % decreased risk of prevalent frailty (pooled odds ratio = 0.98, 95%CI (confidence interval) = 0.96-0.99, p < 0.001). Surgical menopause did not predict incident frailty (pooled OR = 1.02, 95%CI = 0.82-1.28, p = 0.23). This systematic review and meta-analysis showed that later age at menopause was significantly associated with a lower risk of prevalent frailty. In a clinical setting, age at menopause can be useful information to help clinicians to evaluate and stratify frailty risk in postmenopausal women. Hormonal changes after menopause may be related to the link between age at menopause and frailty and thus warrant further investigation.
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Affiliation(s)
- Gotaro Kojima
- Department of Research, Dr. AGA Clinic, Tokyo, Japan
| | - Yu Taniguchi
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan
| | - Kohei Ogawa
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Reijiro Aoyama
- Department of Japanese Studies, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Tomohiko Urano
- Department of Geriatric Medicine, International University of Health and Welfare, Chiba, Japan.
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25
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Sato R, Sawaya Y, Ishizaka M, Shiba T, Hirose T, Urano T. Neck circumference may predict sarcopenia in Japanese older adults requiring long-term care. Geriatr Nurs 2022; 47:159-163. [PMID: 35914493 DOI: 10.1016/j.gerinurse.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/05/2022] [Accepted: 07/05/2022] [Indexed: 11/27/2022]
Abstract
Several studies have established the advantage of using anthropometric measurements as indicators of sarcopenia. Nevertheless, no study has explored the association between sarcopenia and neck circumference. In this cross-sectional study, we examined the data of 90 older adults requiring long-term care to evaluate this association and establish cut-off points for individuals at risk of sarcopenia as defined by the Asian Working Group for Sarcopenia (AWGS) 2019. A significant association was found between sarcopenia and neck circumference using binomial logistic regression and receiver operating characteristic analyses. The optimal cut-off value for neck circumference associated with increased risk for sarcopenia among older adults was 32.8 cm for females and 38.0 cm for males. Given the potential of declining neck circumference as an anthropometric marker of sarcopenia, it has clinical applications in screening for sarcopenia in older adults requiring long-term care.
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Affiliation(s)
- Ryo Sato
- Division of Physical Therapy, Graduate School of Health and Welfare Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara, Tochigi 324-8501, Japan; Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", 537-3, Iguchi, Nasushiobara, Tochigi 329-2763, Japan
| | - Yohei Sawaya
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", 537-3, Iguchi, Nasushiobara, Tochigi 329-2763, Japan; Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara, Tochigi 324-8501, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara, Tochigi 324-8501, Japan
| | - Takahiro Shiba
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", 537-3, Iguchi, Nasushiobara, Tochigi 329-2763, Japan
| | - Tamaki Hirose
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", 537-3, Iguchi, Nasushiobara, Tochigi 329-2763, Japan; Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara, Tochigi 324-8501, Japan
| | - Tomohiko Urano
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", 537-3, Iguchi, Nasushiobara, Tochigi 329-2763, Japan; Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, 4-3, Kozunomori, Narita, Chiba 286-8686, Japan.
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26
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Sawaya Y, Hirose T, Ishizaka M, Shiba T, Sato R, Kubo A, Urano T. The inability to open a polyethylene terephthalate bottle cap can predict sarcopenia. Geriatr Gerontol Int 2022; 22:682-684. [PMID: 35765204 DOI: 10.1111/ggi.14425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/25/2022] [Accepted: 06/01/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Yohei Sawaya
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Tochigi, Japan.,Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en," Tochigi, Japan
| | - Tamaki Hirose
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Tochigi, Japan.,Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en," Tochigi, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Tochigi, Japan
| | - Takahiro Shiba
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en," Tochigi, Japan
| | - Ryo Sato
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en," Tochigi, Japan
| | - Akira Kubo
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Tochigi, Japan
| | - Tomohiko Urano
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en," Tochigi, Japan.,Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, Chiba, Japan
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27
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Kojima G, Taniguchi Y, Aoyama R, Urano T. Earlier menopause is associated with higher risk of incident frailty in community-dwelling older women in England. J Am Geriatr Soc 2022; 70:2602-2609. [PMID: 35546044 DOI: 10.1111/jgs.17838] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 03/29/2022] [Accepted: 04/13/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Although it is well known that women have higher risk of frailty, mechanisms are not clear. Reproductive history may be related to the sex difference in frailty. METHODS A total of 1249 community-dwelling women aged ≥60 in England were examined for associations between age at menopause and risk of developing frailty. Frailty defined by the frailty phenotype was measured at baseline and 4 years later. Age at menopause was used as a continuous variable and categorical groups: premature/early (10-45 years), normal (46-55 years), and late (56 years or older). Men with comparable conditions from the same cohort were also used as a comparison. RESULTS Earlier age at menopause was significantly associated with higher risk of incident frailty. One year later menopause age was associated with a 3% decrease in incident frailty risk (Odds ratio [OR] = 0.97, 95%CI = 0.95-1.00, p = 0.02). Women with premature or early menopause had a significantly higher risk of developing frailty compared with those with normal menopause (OR = 1.90, 95%CI = 1.28-2.81, p = 0.001), while those with late menopause did not. In a supplementary analysis with older men, older women with premature or early menopause were more likely to develop frailty compared with older men (OR = 2.29, 95%CI = 151-3.48, p < 0.001), however, there was no significant difference between women with normal or late menopause. CONCLUSIONS Earlier menopause was significantly associated with higher risk of developing frailty. Our findings suggest that menopause or its related factors, such as decline in estrogen after menopause, potentially play an important role in the sex difference in frailty.
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Affiliation(s)
- Gotaro Kojima
- Department of Research, Dr. AGA Clinic, Tokyo, Japan
| | - Yu Taniguchi
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan
| | - Reijiro Aoyama
- Department of Chinese and Bilingual Studies, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Tomohiko Urano
- Department of Geriatric Medicine, International University of Health and Welfare, Chiba, Japan
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28
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Sawaya Y, Sato M, Ishizaka M, Shiba T, Kubo A, Urano T. Maximum Phonation Time is a Useful Assessment for Older Adults Requiring Long-term Care/support. Phys Ther Res 2022; 25:35-40. [PMID: 35582117 PMCID: PMC9095422 DOI: 10.1298/ptr.e10152] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 02/17/2022] [Indexed: 11/19/2023]
Abstract
OBJECTIVE The maximum phonation time (MPT) is used to assess simple respiratory functions and can be performed anywhere without special instruments. We investigated the association between MPT and respiration, considering the future utilization of simple respiratory assessments during home-based physical therapy. METHOD This cross-sectional study included 140 older adults enrolled in Japanese long-term care insurance (77 men, 63 women; mean age, 77.9±8.0 years). The participants performed the MPT, followed by spirometry. We analyzed the MPT of the three age groups, relative reliability of the MPT values, and the association between MPT and respiratory function. RESULTS We found that the MPT of older men requiring long-term care or support was related to age. The intraclass correlation coefficient of MPT was >0.8 for all groups. Only forced vital capacity was associated with MPT in the partial correlation and multiple regression analyses. CONCLUSION MPT could be an alternative assessment of respiratory function in home-based physical therapy for older adults requiring long-term care or support.
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Affiliation(s)
- Yohei Sawaya
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Japan
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Japan
| | - Miho Sato
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Japan
| | - Takahiro Shiba
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Japan
| | - Akira Kubo
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Japan
| | - Tomohiko Urano
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Japan
- Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, Japan
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29
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Sawaya Y, Shiba T, Ishizaka M, Hirose T, Sato R, Kubo A, Urano T. Sarcopenia is not associated with inspiratory muscle strength but with expiratory muscle strength among older adults requiring long-term care/support. PeerJ 2022; 10:e12958. [PMID: 35194529 PMCID: PMC8858577 DOI: 10.7717/peerj.12958] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/27/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Recently, the concept of respiratory sarcopenia has been advocated, but evidence is lacking regarding which respiratory parameters are appropriate indicators. Therefore, we investigated the association between sarcopenia, respiratory function, and respiratory muscle strength to identify the most appropriate parameters for respiratory sarcopenia. METHODS We included 124 older adults (67 men, 57 women; average age 77.2 ± 8.3 years) requiring long-term care/support who underwent Day Care for rehabilitation. Handgrip strength, usual gait speed, and skeletal muscle mass were measured using bioelectrical impedance analysis. Participants were then diagnosed with sarcopenia using the algorithm of the Asian Working Group for Sarcopenia 2019. Parameters of respiratory function (forced vital capacity, forced expiratory volume in one second [FEV1.0], FEV1.0%, and peak expiratory flow rate) and respiratory muscle strength (maximal expiratory pressure [MEP] and maximal inspiratory pressure) were also measured according to American Thoracic Society guidelines. Respiratory parameters significantly related to sarcopenia were identified using binomial logistic regression and receiver operating characteristic analyses. RESULTS Seventy-seven participants were classified as having sarcopenia. Binomial logistic regression analysis showed that MEP was the only respiratory parameter significantly associated with sarcopenia. The cut-off MEP value for predicting sarcopenia was 47.0 cmH20 for men and 40.9 cmH20 for women. CONCLUSIONS The most appropriate parameter for assessing respiratory sarcopenia may be MEP, which is an indicator of expiratory muscle strength, rather than FVC, MIP, or PEFR, as suggested in previous studies. Measuring MEP is simpler than measuring respiratory function parameters. Moreover, it is expected to have clinical applications such as respiratory sarcopenia screening.
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Affiliation(s)
- Yohei Sawaya
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Tochigi, Japan,Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly “Maronie-en”, Nasushiobara, Tochigi, Japan
| | - Takahiro Shiba
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly “Maronie-en”, Nasushiobara, Tochigi, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Tochigi, Japan
| | - Tamaki Hirose
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Tochigi, Japan,Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly “Maronie-en”, Nasushiobara, Tochigi, Japan
| | - Ryo Sato
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly “Maronie-en”, Nasushiobara, Tochigi, Japan
| | - Akira Kubo
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Tochigi, Japan
| | - Tomohiko Urano
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly “Maronie-en”, Nasushiobara, Tochigi, Japan,Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, Narita, Chiba, Japan
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Sato M, Shiba T, Jinushi C, Sawaya Y, Kiryu S, Abe M, Urano T. [An improved driving ability after attention function training for safe driving via use of a day rehabilitation service in a patient with cerebral infarction]. Nihon Ronen Igakkai Zasshi 2022; 59:102-109. [PMID: 35264524 DOI: 10.3143/geriatrics.59.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
In recent years, the assessment of and support for the safety of driving for people with higher brain dysfunction to allow them to resume car driving have become issues to be addressed in Japan. It is difficult to determine whether or not people with higher brain dysfunction may safely resume car driving; in addition, methods of supporting this resumption have not been established. To support people with higher brain dysfunction and allow them to live at home in areas where public means of transportation may be insufficient, initiatives promoting the resumption of car driving are necessary in healthcare sectors, including day rehabilitation facilities. We provided support to a patient with an attention disorder due to left thalamic infarction, with the aim of achieving sufficient independence to drive a car, in a day rehabilitation facility. We herein report this case from the perspective of a speech-language-hearing therapist. The patient was a right-handed man in his 60s who had higher brain dysfunction with attention disorder as the main symptom. No marked motor paralysis of the extremities was observed. Use of a day rehabilitation service was started approximately two months after the onset of symptoms. Rehabilitation and support aimed at the resumption of car driving were provided approximately one month after the start of the day rehabilitation service use. To determine whether or not the patient was fit to drive a car, higher brain function tests for the intellectual function, attention function, and frontal function, as well as a theoretical evaluation based on the Stroke Drivers' Screening Assessment Japanese Version (J-SDSA) and monitoring of daily behaviors were performed. In addition, after the patient was given permission from an attending physician to drive a car on the condition that the patient did not drive fast and the patient's wife always accompanied him while driving, a safety assessment was also performed. As a result, approximately 10 months later, the J-SDSA theoretical evaluation score showed a passing grade, in contrast to the failing grade he had previously earned. Furthermore, errors in performing household activities due to a decreased attention function became unremarkable with respect to daily behaviors; therefore, we determined, together with the attending physician, that the patient now had sufficient independence to drive a car. In our day rehabilitation facility, the number of requests for advice on car driving from people with higher brain dysfunction living in the community had been increasing. Multisectoral assessments, training, and instruction should be continued in collaboration with attending physicians, other facilities located within the community, and driving schools in order to support people with higher brain dysfunction and help them once again be able to drive a car.
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Affiliation(s)
- Miho Sato
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en"
| | - Takahiro Shiba
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en"
| | - Chihiro Jinushi
- Department of Speech and Hearing Sciences, School of Health Science, International University of Health and Welfare
| | - Yohei Sawaya
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en"
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare
| | - Shigeru Kiryu
- Department of Radiology, School of Medicine, International University of Health and Welfare
| | - Masako Abe
- Department of Speech and Hearing Sciences, School of Health Science, International University of Health and Welfare
| | - Tomohiko Urano
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en"
- Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare
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Shiba T, Sawaya Y, Hirose T, Sato R, Ishizaka M, Kubo A, Urano T. Features of older community-dwelling adults with osteosarcopenia requiring support or care. J Phys Ther Sci 2022; 34:341-346. [PMID: 35527844 PMCID: PMC9057679 DOI: 10.1589/jpts.34.341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 02/01/2022] [Indexed: 11/30/2022] Open
Abstract
[Purpose] This study aimed to investigate the problems associated with osteosarcopenia
and its effect on physical performance, nutritional status, and support or care required
by older community-dwelling adults. [Participants and Methods] This study investigated 141
older community-dwelling adults requiring support or care using an ambulatory
rehabilitation service. The patients were divided into a control, osteopenia only,
sarcopenia only, and osteosarcopenia group. We investigated the associations of each
condition with the baseline information, grip strength, gait speed, Mini Nutritional
Assessment-Short Form score, and support or care level required. [Results] The
osteosarcopenia group consisted of 43.3% of the total study participants. Osteosarcopenia
was more closely associated with body mass index, support or care level, grip strength,
gait speed, skeletal muscle mass index, and Mini Nutritional Assessment-Short Form score
than osteopenia or sarcopenia alone. [Conclusion] Osteosarcopenia is highly prevalent in
older community-dwelling adults requiring support or care, which may suggest a greater
effect on physical performance, nutritional status, and support or care required than that
exerted by osteopenia or sarcopenia alone.
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Affiliation(s)
- Takahiro Shiba
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly “Maronie-en”: 533-4 Iguchi, Nasushiobara-shi, Tochigi 329-2763, Japan
| | - Yohei Sawaya
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Japan
| | - Tamaki Hirose
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Japan
| | - Ryo Sato
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly “Maronie-en”: 533-4 Iguchi, Nasushiobara-shi, Tochigi 329-2763, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Japan
| | - Akira Kubo
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Japan
| | - Tomohiko Urano
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly “Maronie-en”: 533-4 Iguchi, Nasushiobara-shi, Tochigi 329-2763, Japan
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Sugita Y, Hara T, Ohnuma T, Kogure E, Urano T. [Factors related to regional differences among home-visit rehabilitation users]. Nihon Ronen Igakkai Zasshi 2022; 59:49-57. [PMID: 35264534 DOI: 10.3143/geriatrics.59.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
AIM The present study investigated the relationship between the type of residential area and each factor of the International Classification of Functioning, Disability and Health (ICF) framework among elderly subjects receiving home-visit rehabilitation. METHODS This was a cross-sectional study conducted at two institutions. A total 84 participants (46 men and 38 women, age: 79.1±7.8 years old) who were receiving home-visit rehabilitation in urban and rural areas were examined. The parameters measured included the modified Gait Efficacy Scale (mGES), grip strength, 30-seconds chair stand test (CS-30), Functional Independence Measure (FIM), Life-Space Assessment (LSA), Frenchay Activities Index (FAI), Ikigai-9, and Home and Community Environment (HACE), which is based on the ICF concepts of health status, physical structure, physical and mental functions, activities, participation, personal factors, and environmental factors respectively; these points were evaluated by physical or occupational therapists. The health status was based on the diagnosis obtained from the clinical record. RESULTS Receiving home-visit rehabilitation in a rural area was significantly associated with the LSA (odds ratio [OR]=1.075, p=0.028), optimistic and positive feelings for life (OR=0.698, p=0.040), and community mobility scores (OR=5.755, p=0.001). CONCLUSIONS Environmental factors, activities, and personal factors differed depending on the region where the elderly subject received home-visit rehabilitation. Thus, intervention methods concerning home-visit rehabilitation may need to be adjusted according to the region where the patient lives.
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Affiliation(s)
- Yuta Sugita
- Division of Physical Therapy, Doctoral Program in Health Science Graduate School of Medicine, International University of Health and Welfare
- Nishinasuno General Home Care Center
- Division of Rehabilitation, International University of Health and Welfare Hospital
| | - Tsuyoshi Hara
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare
| | | | | | - Tomohiko Urano
- Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en"
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Nakano M, Nakamura Y, Urano T, Miyazaki A, Suzuki T, Watanabe K, Takahashi J, Shiraki M. Associations of Homocysteine Metabolism With the Risk of Spinal Osteoarthritis Progression in Postmenopausal Women. J Clin Endocrinol Metab 2021; 106:3428-3438. [PMID: 34375425 DOI: 10.1210/clinem/dgab591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Indexed: 02/07/2023]
Abstract
CONTEXT Although homocysteine accumulation is a reported risk factor for several age-related disorders, little is known about its relationship with osteoarthritis (OA). OBJECTIVE We investigated for associations of homocysteine and C677T polymorphism in methylenetetrahydrofolate reductase (MTHFR), which is involved in homocysteine clearance, with the development and progression of spinal OA through a combined cross-sectional and longitudinal cohort study. METHODS A total of 1306 Japanese postmenopausal outpatients participating in the Nagano Cohort Study were followed for a mean 9.7-year period. Cross-sectional multiple logistic regression for spinal OA prevalence at registration by serum homocysteine level was performed with adjustment for confounders. In addition to Kaplan-Meier analysis, multivariate Cox regression was employed to examine the independent risk of MTHFR C677T variant for spinal OA progression. RESULTS Multivariate regression analysis revealed a significant association between homocysteine and spinal OA prevalence (odds ratio 1.38; 95% CI 1.14-1.68). Kaplan-Meier curves showed a gene dosage effect of the T allele in MTHFR C677T polymorphism on the accelerated progression of spinal OA severity (P = 0.003). A statistically significant independent risk of the T allele for spinal OA advancement was validated by Cox regression analysis. Respective adjusted hazard ratios for the CT/TT and TT genotypes were 1.68 (95% CI, 1.16-2.42) and 1.67 (95% CI, 1.23-2.28). CONCLUSION Circulating homocysteine and C677T variant in MTHFR are associated with the prevalence rate and ensuing progression, respectively, of spinal OA. These factors may represent potential interventional targets to prevent OA development and improve clinical outcomes.
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Affiliation(s)
- Masaki Nakano
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Yukio Nakamura
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Tomohiko Urano
- Department of Geriatric Medicine, International University of Health and Welfare School of Medicine, 4-3 Kozunomori, Narita, Chiba 286-8686, Japan
| | - Akiko Miyazaki
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Takako Suzuki
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
- Department of Human Nutrition, Faculty of Human Nutrition, Tokyo Kasei Gakuin University, 22 Sanban-cho, Chiyoda-ku, Tokyo 102-8341, Japan
| | - Kazuki Watanabe
- Department of Biology, College of Liberal Arts and Sciences, Tokyo Medical and Dental University, 2-8-30 Kohnodai, Ichikawa, Chiba 272-0827, Japan
| | - Jun Takahashi
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Masataka Shiraki
- Research Institute and Practice for Involutional Diseases, 1610-1 Meisei, Misato, Azumino, Nagano 399-8101, Japan
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Watanabe M, Ishizaka M, Yakabi A, Itokazu M, Kubo A, Urano T. Rejuvenation of standing and gait balance in community-dwelling older individuals: A comparative study between 2006 and 2019. Geriatr Gerontol Int 2021; 21:975-980. [PMID: 34490713 DOI: 10.1111/ggi.14271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 08/16/2021] [Accepted: 08/19/2021] [Indexed: 11/30/2022]
Abstract
AIM The present study investigated the rejuvenation of physical function in terms of walking speed and grip strength. Specifically, it examined the rejuvenation of physical functions in community-dwelling older individuals between 2006 and 2019. The study is novel, because it analyzes this by focusing on gait balance. METHODS Data were collected from 339 participants (52 men, 287 women) in 2006, and 382 participants (83 men, 299 women) in 2019. They were categorized according to age: early-stage and late-stage groups for men, and early-stage, late-stage and latest-stage groups for women. These groups were analyzed by participants' walking speed, grip strength, Timed Up and Go test, Functional Reach test and One-Leg Standing test. The results were compared based on two factors: time (2006 to 2019) and age group. RESULTS The scores for the Timed Up and Go and One-Leg Standing tests were better in 2019 than in 2006 for all age groups in both older men and women. However, improvement in walking speed was observed only in women. Additionally, the decline in physical function with age was slower for walking speed among men, and Functional Reach and One-Leg Standing tests among women. CONCLUSIONS The changes over this 13-year period showed that the physical function of community-dwelling older individuals was rejuvenated in terms of improved standing and walking balance. These rejuvenations will aid in preventing falls among community-dwelling older individuals. Geriatr Gerontol Int 2021; 21: 975-980.
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Affiliation(s)
- Miyoko Watanabe
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara City, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara City, Japan
| | - Akihiro Yakabi
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara City, Japan
| | - Masafumi Itokazu
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara City, Japan
| | - Akira Kubo
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara City, Japan
| | - Tomohiko Urano
- Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, Narita City, Japan
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Shiba T, Sato M, Akisawa N, Sawaya Y, Murai H, Kiryu S, Otsuka M, Urano T. [A patient with mesenteric lymphoma who developed amyotrophic lateral sclerosis and sepsis]. Nihon Ronen Igakkai Zasshi 2021; 58:476-481. [PMID: 34483176 DOI: 10.3143/geriatrics.58.476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
We treated a patient with mesenteric lymphoma who concomitantly developed amyotrophic lateral sclerosis (ALS). The patient died of urinary tract infection nine months after the onset of ALS. We herein report the changes in the patient's condition and the sequence of events until death from the viewpoint of a physiotherapist. The patient was a 69-year-old woman who developed mesenteric lymphoma in September of X year and perceived weakness in the toes in November of X year. She showed signs of upper and lower motor neuron disorders, and electrophysiologic testing revealed denervation in three areas of the spinal cord. In March of X+1 year, she was diagnosed with definite ALS based on the Awaji criteria. In April of X+1 year, she began to receive continuous home healthcare, specifically outpatient rehabilitation. No remarkable bulbar palsy was observed soon after the initiation of rehabilitation; however, manual muscle testing revealed strengths in the lower and upper limbs of 1 and 3-5, respectively, indicating muscle weakness and muscle atrophy. She developed exacerbation of neurological symptoms in the upper limbs, bulbar palsy, and respiratory muscle paralysis during rehabilitation. The ALS Functional Rating Scale-Revised indicated a decreased tendency to X [please define X]. In July of X+1 year, the mesenteric lymphoma had enlarged, resulting in the development of ureteric obstruction and ultimately causing hydronephrosis. Urinary tract infection and sepsis were diagnosed, and she was hospitalized. Although her fever temporarily subsided following ceftriaxone administration, she ultimately died due to a systemic inflammatory response syndrome three days after hospitalization. The mean period between the ALS onset and death is reportedly 40.6±33.1 months. The rate of ALS progression differs among individuals. Malignant tumors and paraneoplastic neurological syndrome may be involved in rapidly worsening neurological symptoms. Patients who concomitantly develop motor neuron disorders and malignant tumors are likely to have a higher risk of developing serious conditions associated with the exacerbation of neurological symptoms and complications. Our patient had several diseases that affected her survival prognosis; however, the sharing of information regarding her condition among healthcare professionals may have been insufficient. The primary physician responsible for treating each disease should cooperate with physiotherapists and other paramedical staff who have frequent opportunities to talk to patients in daily clinical practice. In geriatric patients in particular, such an environment is essential.
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Affiliation(s)
- Takahiro Shiba
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en"
| | - Miho Sato
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en"
| | - Naomi Akisawa
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en"
| | - Yohei Sawaya
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en".,Department of Physical Therapy, School of Health Science, International University of Health and Welfare
| | - Hiroyuki Murai
- Department of Neurology, School of Medicine, International University of Health and Welfare
| | - Shigeru Kiryu
- Department of Radiology, School of Medicine, International University of Health and Welfare
| | - Mieko Otsuka
- Department of Neurology, International University of Health and Welfare Hospital
| | - Tomohiko Urano
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en".,Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare
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Sawaya Y, Ishizaka M, Hirose T, Shiba T, Onoda K, Kubo A, Maruyama H, Urano T. Minimal detectable change in handgrip strength and usual and maximum gait speed scores in community-dwelling Japanese older adults requiring long-term care/support. Geriatr Nurs 2021; 42:1184-1189. [PMID: 34419871 DOI: 10.1016/j.gerinurse.2021.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 10/20/2022]
Abstract
Aging is an important issue in Japan that has led to a large number of older adults requiring long-term care/support. Therefore, we determined the range of measurement error in the measurement of handgrip strength and gait speed which are representative tests. This cross-sectional study included 111 community-dwelling Japanese older adults aged ≥65 years who required long-term care/support and underwent ambulatory rehabilitation. Handgrip strength and usual and maximum gait speed were measured on two days in one single week. Minimal detectable change (MDC) was calculated. The MDC in handgrip strength was 2.9 kg for the overall population, 3.2 kg for the male participants, and 2.4 kg for the female participants. For the overall population, the MDC in usual gait speed was 0.18 m/s and that in maximum gait speed was 0.23 m/s. These MDCs are expected to be suitable for judging clinical changes because this study considered gender and typical tests.
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Affiliation(s)
- Yohei Sawaya
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara-city, Tochigi, 324-8501, Japan; Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en," 537-3, Iguchi, Nasushiobara-city, Tochigi, 329-2763, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara-city, Tochigi, 324-8501, Japan
| | - Tamaki Hirose
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara-city, Tochigi, 324-8501, Japan; Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en," 537-3, Iguchi, Nasushiobara-city, Tochigi, 329-2763, Japan
| | - Takahiro Shiba
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en," 537-3, Iguchi, Nasushiobara-city, Tochigi, 329-2763, Japan
| | - Ko Onoda
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara-city, Tochigi, 324-8501, Japan
| | - Akira Kubo
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara-city, Tochigi, 324-8501, Japan
| | - Hitoshi Maruyama
- Department of Physical Therapy, Faculty of Medical Science, Fukuoka International University of Health and Welfare, 3-6-40 Momochihama, Sawaraku, Fukuoka-city, Fukuoka, 814-0001, Japan
| | - Tomohiko Urano
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en," 537-3, Iguchi, Nasushiobara-city, Tochigi, 329-2763, Japan; Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, 4-3, Kozunomori, Narita-city, Chiba, 286-8686, Japan.
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Urano T, Shiraki M, Imai T, Iinuma N, Kuroda T, Tanaka S, Saito M. Association of advanced glycation end-products levels with vascular events in postmenopausal women. Geriatr Gerontol Int 2021; 21:651-656. [PMID: 34151495 DOI: 10.1111/ggi.14218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 04/26/2021] [Accepted: 05/30/2021] [Indexed: 11/28/2022]
Abstract
AIM Advanced glycation end-products (AGEs) are a known factor that accelerates vascular complications. AGEs (e.g. pentosidine or N-ε-carboxy-methyl-lysine [CML]) have been particularly investigated in patients with diabetes or chronic kidney disease and have been associated not only with arteriosclerosis, but also with novel vascular events. On the contrary, the correlation of vascular events with AGEs has not been sufficiently investigated in groups excluding those with diabetes or chronic kidney disease. The present study aimed to evaluate the impact of AGEs on the history of vascular events in postmenopausal women excluding those with diabetes or renal insufficiency. METHODS Japanese postmenopausal women were registered to the study after obtaining informed consent. Patients with critical illness, including diabetes mellitus and renal insufficiency, were excluded from the study. Participants were asked about their medical histories during the registration for the Nagano Cohort Study. Non-fasting serum and urine samples were collected to measure biochemical markers, including urinary pentosidine and serum CML levels. RESULTS Among 357 postmenopausal women, 32 had a history of vascular events. After adjusting age and other variables known to be associated with the presence of vascular event history, positive correlations between AGEs and vascular event history were observed (standardized odds ratio of log[pentosidine] 1.38, 95% CI 0.96-2.00, P = 0.086; standardized odds ratio of log[CML] 1.73, 95% CI 1.10-2.74, P = 0.019). DISCUSSION The present results showed a significant association between serum CML and the presence of vascular event history, suggesting that serum CML might play a role in vascular events. Geriatr Gerontol Int 2021; 21: 651-656.
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Affiliation(s)
- Tomohiko Urano
- Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, Chiba, Japan.,Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masataka Shiraki
- Research Institute and Practice for Involutional Diseases, Nagano, Japan
| | - Takumi Imai
- Department of Medical Statistics, Osaka City University Graduate School of Medicine, Osaka, Japan
| | | | | | - Shiro Tanaka
- Department of Clinical Biostatistics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Mitsuru Saito
- Department of Orthopedic Surgery, Jikei University School of Medicine, Tokyo, Japan
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Sugita K, Suzuki N, Nogaki F, Washida N, Urano T. [An 89-year-old man who underwent percutaneous peritoneal dialysis catheter placement and had peritoneal dialysis introduced]. Nihon Ronen Igakkai Zasshi 2021; 58:303-308. [PMID: 34039808 DOI: 10.3143/geriatrics.58.303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The number of elderly patients requiring dialysis is continuously increasing. In Japan, many patients undergo hemodialysis; however, it has been associated with huge stress-mainly on the cardiovascular system-and requires frequent hospital visits. Conversely, peritoneal dialysis is much less invasive with a much lower frequency of hospital visits than that of hemodialysis; therefore, it is suitable for elderly patients. In addition, peritoneal dialysis, which originally had a high affinity for home care, has become more useful for elderly patients with renal failure thanks to the recent introduction of a cloud-based remote monitoring system at home. We performed percutaneous placement of a peritoneal dialysis catheter to reduce physical invasiveness and initiate peritoneal dialysis. The Barthel Index before hospitalization was 0 but increased to 65 at discharge. Further technology advancements in peritoneal dialysis are expected in the future. The cloud-based remote monitoring system is also expected to maintain or increase activities of daily living and the quality of life in elderly patients with renal failure with decreased activities of daily living.
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Affiliation(s)
- Kazuya Sugita
- Division of Nephrology, Shimada Municipal Hospital.,Division of Nephrology, School of Medicine, International University of Health and Welfare.,Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare
| | | | | | - Naoki Washida
- Division of Nephrology, School of Medicine, International University of Health and Welfare
| | - Tomohiko Urano
- Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare
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Hirose T, Sawaya Y, Shiba T, Ishizaka M, Onoda K, Kubo A, Urano T. Characteristics of patients discontinuing outpatient services under long-term care insurance and its effect on frailty during COVID-19. PeerJ 2021; 9:e11160. [PMID: 33868818 PMCID: PMC8029655 DOI: 10.7717/peerj.11160] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/04/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Among community-dwelling older adults who require long-term care and use outpatient rehabilitation services, we aimed to examine the characteristics of patients who discontinued using outpatient rehabilitation services to prevent exposure to COVID-19 and the effects of this discontinuation on patient frailty. METHODS Participants were 119 older adults (69 males, 50 females; average age 77.3 ± 8.3 years) requiring long-term care who used outpatient rehabilitation services. Our outpatient rehabilitation service involved day care for older adults undergoing rehabilitation including pick-up and drop-off services under the long-term care insurance system. They were divided into two groups: participants who discontinued using outpatient rehabilitation services and participants who continued their use. To find the factors associated with this discontinuation, binomial logistic regression analysis was performed, in which the following independent variables were used: gender, age, height, weight, long-term care level, grip strength, and normal walking speed. Frailty status was investigated in April 2020 and again in September 2020 through interviews and telephone surveys utilizing the Frailty Screening Index. RESULTS Women and normal walking speed were independent factors associated with the discontinuation of outpatient rehabilitation due to COVID-19. According to the results of the Frailty Screening Index, similar tendencies were exhibited in both April and September. The discontinued group indicated that they were getting less exercise and having stronger feelings of fatigue than the continuing group. CONCLUSIONS The findings are in accordance with other studies indicating that women are more likely to employ prevention measures against COVID-19, as seen among the community-dwelling older adults requiring long-term care who used outpatient rehabilitation services. People with higher levels of physical function were also likely to refrain from using outpatient rehabilitation services. Results further suggested that the discontinued group had more frailty-related factors (i.e., low physical activity and strong exhaustion) than the continuing group.
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Affiliation(s)
- Tamaki Hirose
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Tochigi, Japan
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly “Maronie-en”, Nasushiobara, Tochigi, Japan
| | - Yohei Sawaya
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Tochigi, Japan
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly “Maronie-en”, Nasushiobara, Tochigi, Japan
| | - Takahiro Shiba
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly “Maronie-en”, Nasushiobara, Tochigi, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Tochigi, Japan
| | - Ko Onoda
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Tochigi, Japan
| | - Akira Kubo
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Tochigi, Japan
| | - Tomohiko Urano
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly “Maronie-en”, Nasushiobara, Tochigi, Japan
- Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, Narita, Chiba, Japan
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Hirata A, Ishizaka M, Sawaya Y, Shiba T, Urano T. [Relationship between the swallowing function, nutritional status, and sarcopenia in elderly outpatients]. Nihon Ronen Igakkai Zasshi 2021; 58:134-142. [PMID: 33627550 DOI: 10.3143/geriatrics.58.134] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE It is important to prevent sarcopenia in community-dwelling elderly adults. Thus, we investigated the relationship between the swallowing function, nutritional status, and physical function in elderly outpatients. METHODS A total of 90 elderly outpatients (77.2±8.3 years) participated in the study. The investigation items included the Seirei dysphagia screening questionnaire, 20 masticable foods questionnaire, tongue pressure, grip strength, the skeletal muscle mass index (SMI), the questionnaire for sarcopenia screening (SARC-F), and the Mini Nutritional Assessment-Short Form (MNA-SF). The odds ratio for the swallowing function and six items was determined by a logistic regression analysis. RESULTS About 83.3% of the participants were at risk of dysphagia. The questions that detected the symptom in ≥30% of the participants were, "Do you cough during a meal?", "Have you become slower at eating?", and "Has it become more difficult to eat hard food?". The 20 masticable foods questionnaire, SARC-F, and MNA-SF were correlated with the Seirei dysphagia screening questionnaire. The results of the logistic regression analysis indicated that SARC-F was a significant predictor for a loss of the swallowing function. CONCLUSION Because elderly outpatients have a decreased oral function, including chewing, they are at an increased risk of dysphagia. This study suggested that the swallowing function in elderly outpatients is related to the chewing ability, nutritional status, and sarcopenia. The swallowing function can thus be used to detect sarcopenia in elderly outpatients at an early stage and is important for preventing dysphagia.
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Affiliation(s)
- Aya Hirata
- Department of Speech and Hearing Sciences, School of Health Science, International University of Health and Welfare
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare
| | - Yohei Sawaya
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare.,Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for Elderly "Maronie-en"
| | - Takahiro Shiba
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for Elderly "Maronie-en"
| | - Tomohiko Urano
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for Elderly "Maronie-en".,Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare
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Kojima G, Taniguchi Y, Urano T. Fruit and Vegetable Consumption and Incident Frailty in Older Adults: A Systematic Review and Meta-Analysis. J Frailty Aging 2021; 11:45-50. [DOI: 10.14283/jfa.2021.32] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background: There is limited evidence regarding associations between fruit and vegetable consumption and incident frailty risk among older people. Objectives: The objective of this study was to conduct a systematic review and meta-analysis regarding the association between fruit and vegetable consumption and incident frailty risk among older adults. Methods: A systematic search of the literature was conducted according to the PRISMA guidelines using PubMed in January 2021 for studies that prospectively examined risk of incident frailty in relation to fruit and vegetable consumption in older adults aged 60 and older. Methodological quality and heterogeneity were assessed. Odds ratios (OR) were pooled using random-effects or fixed-effects meta-analysis, depending on the presence of heterogeneity. Results: Among three studies included in this review, data of four cohorts were provided by two studies and used in meta-analysis. The highest fruit and vegetable consumption was significantly associated with lower risk of incident frailty compared with the lowest consumption (pooled OR=0.38, 95%CI=0.24-0.59, p=<0.001). Conclusions: This study provided the pooled evidence that high fruit and vegetable consumption may be beneficial for preventing the development of frailty in older adults. Increasing fruit and vegetable consumption can be a relevant strategy to prevent frailty.
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Kameyama YU, Kameyama M, Kojima T, Ishii M, Kidana K, Yakabe M, Ishii S, Urano T, Ogawa S, Akishita M. Cognitive function has a stronger correlation with “perceived age” than “chronological age,” especially in females. Alzheimers Dement 2020. [DOI: 10.1002/alz.037133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
| | - Masashi Kameyama
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology Tokyo Japan
| | | | | | | | | | | | - Tomohiko Urano
- The University of Tokyo Tokyo Japan
- International University of Health and Welfare Narita Japan
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Sawaya Y, Ishizaka M, Kubo A, Shiba T, Hirose T, Onoda K, Maruyama H, Urano T. The Asian working group for sarcopenia's new criteria updated in 2019 causing a change in sarcopenia prevalence in Japanese older adults requiring long-term care/support. J Phys Ther Sci 2020; 32:742-747. [PMID: 33281290 PMCID: PMC7708002 DOI: 10.1589/jpts.32.742] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 08/22/2020] [Indexed: 12/25/2022] Open
Abstract
[Purpose] The Asian Working Group for Sarcopenia (AWGS) criteria were recently updated. However, whether these changes would result in a difference in sarcopenia prevalence was unclear. We therefore focused on Japanese older adults who required long-term care/support and determined the differences in sarcopenia prevalence between the new and old criteria. [Participants and Methods] This cross-sectional study included 161 Japanese older adults aged ≥65 years who required long-term care/support along with ongoing daycare. Handgrip strength, usual gait speed, and skeletal muscle mass index were measured. We analyzed the difference in sarcopenia prevalence between the 2019 and 2014 AWGS criteria using the McNemar test. [Results] The overall sarcopenia prevalence rates were 60.2% and 53.4%, and the prevalence rates of sex-specific sarcopenia were 63.6% and 55.7% among males and 56.2% and 50.7% among females when the 2019 and 2014 AWGS criteria were used, respectively. Overall, males exhibited a significantly higher prevalence with the new than criteria than with the old. [Conclusion] With the 2019 AWGS criteria, more older males who required long-term care/support were diagnosed as having sarcopenia. Conversely, the sarcopenia diagnosis in females statistically remained unchanged. Thus, a mismatch might exist between the two criteria regarding sarcopenia prevalence in males.
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Affiliation(s)
- Yohei Sawaya
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare: 2600-1 Kitakanemaru, Ohtawara-city, Tochigi 324-8501, Japan.,Division of Physical Therapy, Doctoral Program in Health Sciences, Graduate School of Health and Welfare Sciences, International University of Health and Welfare, Japan.,Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare: 2600-1 Kitakanemaru, Ohtawara-city, Tochigi 324-8501, Japan
| | - Akira Kubo
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare: 2600-1 Kitakanemaru, Ohtawara-city, Tochigi 324-8501, Japan
| | - Takahiro Shiba
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Japan
| | - Tamaki Hirose
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare: 2600-1 Kitakanemaru, Ohtawara-city, Tochigi 324-8501, Japan.,Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Japan
| | - Ko Onoda
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare: 2600-1 Kitakanemaru, Ohtawara-city, Tochigi 324-8501, Japan
| | - Hitoshi Maruyama
- Division of Physical Therapy, Doctoral Program in Health Sciences, Graduate School of Health and Welfare Sciences, International University of Health and Welfare, Japan
| | - Tomohiko Urano
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Japan.,Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, Japan
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Sawaya Y, Ishizaka M, Kubo A, Shiba T, Hirose T, Onoda K, Maruyama H, Urano T. Association between skeletal muscle mass index and lung function/respiratory muscle strength in older adults requiring long-term care or support. J Phys Ther Sci 2020; 32:754-759. [PMID: 33281292 PMCID: PMC7708015 DOI: 10.1589/jpts.32.754] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 08/22/2020] [Indexed: 12/25/2022] Open
Abstract
[Purpose] We focused on skeletal muscle mass index, one of the biomarkers of sarcopenia, and investigated the association between skeletal muscle mass index and the parameters of lung function and respiratory muscle strength. [Participants and Methods] After applying the exclusion criteria, we included, in this cross-sectional study, 120 community-dwelling older adults aged ≥65 years who required long-term care/support and underwent ambulatory rehabilitation under the long-term care insurance system in Japan. We measured the skeletal muscle mass index, forced vital capacity, forced expiratory volume in 1 second, peak expiratory flow rate, maximum expiratory pressure, and maximum inspiratory pressure. The data were analyzed using Pearson correlation coefficient and multiple regression analysis. [Results] The skeletal muscle mass index was positively correlated with only maximum expiratory pressure for both male and female participants by Pearson's correlation coefficient. With the skeletal muscle mass index as a dependent variable, only the maximum expiratory pressure was significant for both male and female participants by the multiple regression analysis. [Conclusion] Therefore, the findings of this study suggested that compared with lung function tests, maximum expiratory pressure, which is an indicator of respiratory muscle strength, is related to muscle mass. Maximum expiratory pressure might be the most useful indicator for sarcopenia.
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Affiliation(s)
- Yohei Sawaya
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare: 2600-1 Kitakanemaru, Ohtawara-city, Tochigi 324-8501, Japan.,Division of Physical Therapy, Doctoral Program in Health Sciences, Graduate School of Health and Welfare Sciences, International University of Health and Welfare, Japan.,Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare: 2600-1 Kitakanemaru, Ohtawara-city, Tochigi 324-8501, Japan
| | - Akira Kubo
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare: 2600-1 Kitakanemaru, Ohtawara-city, Tochigi 324-8501, Japan
| | - Takahiro Shiba
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Japan
| | - Tamaki Hirose
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare: 2600-1 Kitakanemaru, Ohtawara-city, Tochigi 324-8501, Japan.,Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Japan
| | - Ko Onoda
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare: 2600-1 Kitakanemaru, Ohtawara-city, Tochigi 324-8501, Japan
| | - Hitoshi Maruyama
- Division of Physical Therapy, Doctoral Program in Health Sciences, Graduate School of Health and Welfare Sciences, International University of Health and Welfare, Japan
| | - Tomohiko Urano
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Japan.,Department of Geriatric Medicine, School of medicine, International University of Health and Welfare, Japan
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Umeda-Kameyama Y, Kameyama M, Kojima T, Ishii M, Kidana K, Yakabe M, Ishii S, Urano T, Ogawa S, Akishita M. Cognitive function has a stronger correlation with perceived age than with chronological age. Geriatr Gerontol Int 2020; 20:779-784. [PMID: 32618098 PMCID: PMC7496800 DOI: 10.1111/ggi.13972] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 05/22/2020] [Accepted: 05/31/2020] [Indexed: 11/30/2022]
Abstract
Aim The perceived age of older adults, as measured by their facial appearance, has been shown to be a robust biomarker of aging predictive of survival, telomere length and DNA methylation, and reportedly correlates with carotid atherosclerosis and bone status. This study aimed to determine whether metrics of dementia, including general cognition, vitality, depressive state and self‐supportability, have stronger correlations with perceived age than with chronological age. Methods This study included 124 patients who were admitted to the Department of Geriatric Medicine, The University of Tokyo Hospital, on account of being suspected of cognitive decline. The Mini‐Mental State Examination, Vitality Index, Geriatric Depression Scale‐15, instrumental activities of daily living and Barthel Index were carried out. Five experienced geriatricians and five experienced clinical psychologists determined the perceived age of participants based on photographs. Results The average values of the 10 raters showed excellent reliability (intraclass correlation coefficient (3, 10) = 0.941). Steiger's test revealed that perceived age showed a significantly better correlation with the Mini‐Mental State Examination (female) and Vitality Index (total, female) than did chronological age, but not with Geriatric Depression Scale‐15, instrumental activities of daily living or the Barthel Index. Conclusions Perceived age was shown to be a reliable biomarker for cognitive assessment. Geriatr Gerontol Int 2020; 20: 779–784.
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Affiliation(s)
- Yumi Umeda-Kameyama
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masashi Kameyama
- Department of Diagnostic Radiology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Taro Kojima
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masaki Ishii
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kiwami Kidana
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Home Care Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mitsutaka Yakabe
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shinya Ishii
- Department of Medicine for Integrated Approach to Social Inclusion, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tomohiko Urano
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, Narita, Japan
| | - Sumito Ogawa
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masahiro Akishita
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Sawaya Y, Ishizaka M, Kubo A, Shiba T, Sato T, Onoda K, Maruyama H, Urano T. Absolute reliability of tongue pressure measurement in young healthy adults and elderly patients with certification of needing long-term care or support. Geriatr Gerontol Int 2020; 20:488-493. [PMID: 32176436 DOI: 10.1111/ggi.13902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 01/26/2020] [Accepted: 02/19/2020] [Indexed: 11/29/2022]
Abstract
AIM We aimed to determine systematic bias and the range of random error in tongue pressure measurements among young healthy adults and elderly patients with certification of requiring long-term care or support, considering sex, and to establish a measurement method. METHODS Subjects were 226 adults (88 young healthy adults and 138 elderly patients with certification of requiring long-term care or support). Tongue pressure was measured thrice. Bland-Altman analysis was performed for the first and second trials, and second and third trials. RESULTS Fixed bias was revealed for the first and second trials among young healthy adults. Systematic bias was not found for the second and third trials. Fixed bias was revealed for the first and second trials among elderly patients, with a proportional bias with a negative slope for the second and third trials. For young healthy adults, the minimal detectable change was 6.0 and 5.4 kPa in males and females, respectively. For elderly patients, the limit of agreement ranged from -5.9 to 8.6 and from -5.4 to 8.8 kPa in males and females, respectively. CONCLUSIONS There was a difference in systematic bias in tongue pressure measurement between young healthy adults and elderly patients with certification of needing long-term care or support. In young healthy adults, the third trial results showed stability, whereas they decreased in elderly patients. In elderly patients, it was suggested that the number of measurements reduced from three to two when a maximum value was adopted. No differences were observed among sexes in either young or elderly patients. Geriatr Gerontol Int 2020; 20: 488-493.
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Affiliation(s)
- Yohei Sawaya
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Japan.,Division of Physical Therapy, Doctoral Program in Health Sciences, Graduate School of Health and Welfare Sciences, International University of Health and Welfare, Otawara, Japan.,Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Japan
| | - Akira Kubo
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Japan
| | - Takahiro Shiba
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
| | - Tamae Sato
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Japan.,Division of Physical Therapy, Doctoral Program in Health Sciences, Graduate School of Health and Welfare Sciences, International University of Health and Welfare, Otawara, Japan
| | - Ko Onoda
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Otawara, Japan
| | - Hitoshi Maruyama
- Division of Physical Therapy, Doctoral Program in Health Sciences, Graduate School of Health and Welfare Sciences, International University of Health and Welfare, Otawara, Japan
| | - Tomohiko Urano
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
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Shiba T, Sawaya Y, Hirose T, Ishizaka M, Kubo A, Urano T. [Prevalence and risk factors of sarcopenia in commuting rehabilitation service users]. Nihon Ronen Igakkai Zasshi 2020; 57:149-154. [PMID: 32475942 DOI: 10.3143/geriatrics.57.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE To clarify the prevalence and risk factors of sarcopenia in commuting rehabilitation service users. TARGET The 104 participants of the plant [Sorry, the English is unclear: please clarify the meaning of the highlighted text] (56 men, 48 women; average age 78.6±7.7 years). METHODS The diagnosis of sarcopenia was classified based on the AWGS diagnostic algorithm. The following 10 items were investigated for their causal relationship with sarcopenia as risk factors: risk factor survey (1) cerebrovascular disease, (2) hypertension, (3) respiratory disease, (4) cardiovascular disease, (5) orthopedic disease, (6) fracture, (7) cancer, (8) intractable diseases, (9) diabetes mellitus, and (10) fall history in the past year. RESULTS The prevalence of sarcopenia was 51.9%. Significant differences were observed in the items of "cancer" and "fall history in the past year" as risk factors for sarcopenia. CONCLUSION Elderly people needing support or care (especially those with cancer and a history of falling) have a very high risk of sarcopenia and are expected to require early intervention.
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Affiliation(s)
- Takahiro Shiba
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en"
| | - Yohei Sawaya
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en"
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare
| | - Tamaki Hirose
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en"
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare
| | - Akira Kubo
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare
| | - Tomohiko Urano
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly "Maronie-en"
- Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare
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Urano T. [Introduction to Nursing Care Facilities for the Elderly]. Nihon Ronen Igakkai Zasshi 2020; 57:200-203. [PMID: 32475948 DOI: 10.3143/geriatrics.57.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
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Kojima G, Taniguchi Y, Iliffe S, Urano T, Walters K. Factors Associated With Improvement in Frailty Status Defined Using the Frailty Phenotype: A Systematic Review and Meta-analysis. J Am Med Dir Assoc 2019; 20:1647-1649.e2. [PMID: 31301987 DOI: 10.1016/j.jamda.2019.05.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 05/18/2019] [Accepted: 05/21/2019] [Indexed: 12/31/2022]
Affiliation(s)
- Gotaro Kojima
- Department of Primary Care and Population Health, University College London, London, United Kingdom; Videbimus Toranomon Clinic, Tokyo, Japan
| | - Yu Taniguchi
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan
| | - Steve Iliffe
- Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Tomohiko Urano
- Department of Geriatric Medicine, International University of Health and Welfare, Chiba, Japan
| | - Kate Walters
- Department of Primary Care and Population Health, University College London, London, United Kingdom
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Sato W, Ikeda K, Urano T, Abe Y, Nakasato N, Horie-Inoue K, Takeda S, Inoue S. Efp promotes in vitro and in vivo growth of endometrial cancer cells along with the activation of nuclear factor-κB signaling. PLoS One 2018; 13:e0208351. [PMID: 30586414 PMCID: PMC6306158 DOI: 10.1371/journal.pone.0208351] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 11/15/2018] [Indexed: 01/05/2023] Open
Abstract
Endometrial cancer is common among postmenopausal women and its incidence is increasing in developed countries. Considering that >80% of endometrial cancers are assumed to be estrogen-related, higher estrogen exposure will be relevant to tumorigenesis. Therefore, the roles of estrogen target genes will be important to understand the pathophysiological mechanisms. We previously revealed that estrogen-responsive RING finger protein Efp contributes to breast cancer progression through the protein degradation of cell cycle checkpoint 14-3-3σ. We and others also proposed that Efp has tumor-promoting activities in estrogen receptor (ER)-negative cancer cells. In addition, Efp plays a role in type I interferon production by activating antiviral signaling, which provokes nuclear factor-κB (NF-κB) signaling. In the present study, we investigate whether Efp plays a critical role in endometrial cancer biology. We show that siRNA-mediated Efp knockdown represses the proliferation and migration of endometrial cancer ER-positive Ishikawa and ER-negative HEC-1A cells. Efp knockdown increases 14-3-3σ protein levels and decreases the rates proliferative stage cells. Efp siRNA significantly inhibits the in vivo tumor growth of endometrial cancer cells in both subcutaneous and orthotopic xenograft models. Intriguingly, Efp knockdown represses NF-κB-dependent transactivation and transcription of target genes, such as IL6ST and IL18, in endometrial cancer cells. Overall, Efp would exert a tumor-promoting role through modulating NF-κB pathway and 14-3-3σ protein degradation in endometrial cancer regardless of its estrogen receptor status. Our results indicate that Efp could be a potential diagnostic and therapeutic target for endometrial cancer.
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Affiliation(s)
- Wataru Sato
- Division of Gene Regulation and Signal Transduction, Research Center for Genomic Medicine, Saitama Medical University, Hidaka-shi, Saitama, Japan
| | - Kazuhiro Ikeda
- Division of Gene Regulation and Signal Transduction, Research Center for Genomic Medicine, Saitama Medical University, Hidaka-shi, Saitama, Japan
| | - Tomohiko Urano
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan
| | - Yayoi Abe
- Division of Gene Regulation and Signal Transduction, Research Center for Genomic Medicine, Saitama Medical University, Hidaka-shi, Saitama, Japan
- Department of Obstetrics and Gynecology, School of Medicine, Juntendo University, Bunkyo-ku, Tokyo, Japan
| | - Norie Nakasato
- Division of Gene Regulation and Signal Transduction, Research Center for Genomic Medicine, Saitama Medical University, Hidaka-shi, Saitama, Japan
- Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, Kawagoe-shi, Saitama, Japan
| | - Kuniko Horie-Inoue
- Division of Gene Regulation and Signal Transduction, Research Center for Genomic Medicine, Saitama Medical University, Hidaka-shi, Saitama, Japan
| | - Satoru Takeda
- Department of Obstetrics and Gynecology, School of Medicine, Juntendo University, Bunkyo-ku, Tokyo, Japan
- Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, Kawagoe-shi, Saitama, Japan
| | - Satoshi Inoue
- Division of Gene Regulation and Signal Transduction, Research Center for Genomic Medicine, Saitama Medical University, Hidaka-shi, Saitama, Japan
- Functional Biogerontology, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, Japan
- * E-mail:
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