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Background: The association between subjective cognitive decline and falls has not been clearly determined.Aims: Our aim was to explore the effect of subjective cognitive decline on falls in community-dwelling older adults with or without objective cognitive decline.Methods: We included 470 older adults (mean age 73.6 ± 5.2; 329 women) living in the community and obtained data on fall history directly from the participants. Subjective cognitive decline was assessed using a self-administered question. Objective cognitive function was measured using the Mini-Mental State Examination. Statistical analyses were carried out separately for participants with objective cognitive decline and those without.Results: A multiple logistic regression analysis showed that, among participants without objective cognitive decline, subjective cognitive decline was positively associated with falls [OR 1.91; 95% confidence interval (CI) 1.17-3.12; p = 0.01). Conversely, among participants with objective cognitive decline, subjective cognitive decline was negatively associated with falls (OR 0.07; 95% CI 0.01-0.85, p = 0.04).Discussion: The result suggests that the objective-subjective disparity may affect falls in community-dwelling older adults.Conclusions: The presence of subjective cognitive decline was significantly positively associated with falls among cognitively intact older adults. However, among their cognitively impaired peers, the absence of subjective cognitive decline was positively associated with falls. [ABSTRACT FROM AUTHOR]

Objective: To examine the clinical impact of coexisting lateral osteoarthritis (OA) in knees with mild medial OA.Design: In patients with Kellgren/Lawrence (K/L) grade 2 OA in the medial compartment (n = 100; age: 56-89 years; 80.0% female), anteroposterior knee radiography was used to assess the presence of lateral OA, using grading systems from the Osteoarthritis Research Society International (OARSI) atlas and the K/L classification. The Japanese Knee Osteoarthritis Measure (JKOM), knee range of motion (ROM), and performance-based functional measures (10 m walk, timed up and go and five repetition chair stand maneuvers) were evaluated. The outcomes were compared between patients with and without lateral OA using an analysis of covariance (ANCOVA) or nonparametric rank ANCOVA. Furthermore, ordinal logistic regression analysis was performed, with responses on individual JKOM pain questionnaires as the outcomes and lateral OA as the predictor.Results: Knees with coexisting lateral OA had a significantly worse score of JKOM pain question compared with those without, after adjusting for covariates. The presence of lateral OA was significantly associated with knee pain while ascending/descending stairs and standing. These results were consistent between different definitions of the K/L and OARSI grading systems. The knee ROM and performance-based functional measures were not significantly different between patients with and without lateral OA.Conclusion: Knees with concomitant lateral and mild medial OA may be more symptomatic compared to those without lateral OA. These findings might help to define a clinically distinct subgroup based on a simple radiographic finding in mild knee OA. [ABSTRACT FROM AUTHOR]

Background: The shuttle walking test (SWT) is a simple, widely used method for assessing endurance performance in the elderly. Despite widespread community use, its associated factors are unclear. Aims: We aim to identify previously undefined SWT association factors in community-dwelling elderly people. Methods: Herein, 149 healthy elderly Japanese subjects performed the SWT, and were assessed for height, weight, smoking history, 10-m walk time, Timed Up and Go (TUG) scores, handgrip strength, skeletal mass index (SMI), forced vital capacity (FVC), forced expiratory volume in 1 s (FEV), cardio-ankle vascular index, and ankle brachial index. We divided men and women into higher and lower SWT score groups, compared between-group parameters, and performed stepwise multivariate logistic regression analysis to identify factors independently associated with SWT scores. Results: Age, BMI, 10-m walk time, TUG score, SMI, FVC (L; %-predicted), and FEV (L; %-predicted) were significantly different between SWT score groups for men, while in women, significant differences were observed in age, TUG score, handgrip strength, FVC (L; %-predicted), and FEV (L; %-predicted) ( p < 0.05). In the multivariate logistic regression model, 10-m walk time, and FEV showed significant associations with SWT results in men; among women, age was the only significantly associated factor ( p < 0.05). Conclusions: Results indicate that better lung function and shorter walk time independently associate with SWT results in community-dwelling men; in women, age is the only association. Our findings may offer insight when considering the focus of community exercise programs among the elderly. [ABSTRACT FROM AUTHOR]

Background Dementia is currently one of the most common conditions in older adults, and early detection of cognitive decline is crucial for identifying dementia. We developed a new type of short-term memory and attention test that uses a spot-the-difference task: Spot the Difference for Cognitive Decline (SDCD). The purpose of the present study was to examine the accuracy of the SDCD test for the identification of cognitive impairment in community-dwelling older adults. Methods The participants were 443 Japanese community-dwelling older adults. The SDCD test uses two scenery pictures. Participants were instructed to memorize the details of the first picture for 30 seconds, after which the first picture was taken away and the second picture was shown. Next, the participants were asked to identify as many differences as possible between the first and second pictures, which were presented sequentially. The number of correct responses comprises the SDCD score (scores: 0–10). The Mini-Mental State Examination and Scenery Picture Memory Test were used to measure the participants' cognitive function. We used receiver-operating characteristic analysis to examine the power of the SDCD test and identify the optimal cutoff value of the SDCD score. Results Of the 443 participants, 30 (6.77%) had some cognitive impairment based on the Mini-Mental State Examination scores. Participants without cognitive impairment had higher SDCD scores than those with cognitive impairment ( p < 0.001). The SDCD scores were significantly associated with the Mini-Mental State Examination ( r = 0.333) and Scenery Picture Memory Test ( r = 0.402) results. The receiver-operating characteristic curve used for the identification of cognitive impairment had a comparatively high area under the curve (0.798) for the SDCD score with a cutoff value of 1/2 (with >1 being normal; sensitivity: 70.5%; and specificity: 80.0%). Conclusion The present study found that the SDCD test could be an effective clinical tool for the identification of cognitive impairment in older adults. [ABSTRACT FROM AUTHOR]

Background and aims: The aim of this study was to investigate the physiological characteristics of community-dwelling elderly subjects, aged ≥65 years, with airflow limitation in the Japanese community. Methods: Subjects were recruited through local press advertisement, and 180 individuals were enrolled. Data on age, body mass index (BMI), gender, smoking history, and past medical history were obtained, as were pulmonary function parameters, skeletal muscle mass index, and physical activity. Results: The final study population comprised 161 participants from whom we obtained valid spirometry results. The mean age of this population was 73.4 ± 4.4 years, and 78 participants (48.4 %) were men. The prevalence of airflow limitation was 29.2 % ( n = 47). Subjects with airflow limitation were significantly older ( P = 0.01) and had poorer pulmonary function ( P < 0.01), lower BMI ( P < 0.01), and lower skeletal muscle mass index ( P = 0.03) than healthy elderly subjects. Furthermore, skeletal muscle mass index was significantly correlated with the percentage of predicted forced vital capacity ( r = 0.45, P < 0.05) and forced expiratory volume in 1 s ( r = 0.50, P < 0.05) only in men with airflow limitation. Conclusions: We found that the skeletal muscle mass index was significantly reduced in community-dwelling elderly with airflow limitation, and the skeletal muscle mass index was correlated with pulmonary function only in men with airflow limitation. [ABSTRACT FROM AUTHOR]

Objective To examine the association between pedometer-based ambulatory physical activity (PA) and physical function in patients with knee osteoarthritis (OA). Design Cross-sectional observational study. Setting Institutional practice. Participants Participants in orthopedic clinics (N=207; age, 56–90y; 71.5% women) with diagnosed radiographic knee OA (Kellgren/Lawrence [K/L] grade ≥1). Interventions Not applicable. Main Outcome Measures Ambulatory PA was objectively measured as steps per day. Physical function was assessed using the Japanese Knee Osteoarthritis Measure (JKOM) functional subcategory, 10-m walk, Timed Up and Go (TUG), and 5-repetition chair stand (5CS) tests. Results Patients walking <2500 steps/d had a low level of physical function with a slower gait speed, longer TUG time, and worse JKOM functional score compared with those who walk 2500 to 4999, 5000 to 7499, and ≥7500 steps/d adjusted for age, sex, body mass index [BMI], and K/L grade. Ordinal logistic regression analysis revealed that steps per day (continuous) was associated with better physical function adjusted for age, sex, BMI, and K/L grade. These relationships were still robust in sensitivity analyses that included patients with K/L grades ≥2 (n=140). Conclusions Although increased ambulatory PA had a positive relationship with better physical function, walking <2500 steps/d may be a simple indicator for a decrease in physical function in patients with knee OA among standard PA categories. Our findings might be a basis for counseling patients with knee OA about their ambulatory PA and for developing better strategies for improving physical function in sedentary patients with knee OA. [ABSTRACT FROM AUTHOR]