Search

Background: A decline in cognitive function is associated with inflammatory processes. However, the association between high-sensitivity C-reactive protein (hs-CRP) levels and cognitive decline in the Japanese population remains inconclusive. Thus, this study aimed to determine whether hs-CRP is associated with low cognitive function in 70- and 80-year-old community-dwelling Japanese individuals., Methods: The participants in this cross-sectional study were 872 Japanese residents aged 70 and 80 years who voluntarily participated in the Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians (SONIC) study between 2010 and 2011. Blood sample collection, cognitive assessment, and other measurements were performed at the venue. Low cognitive function was defined as a score of 25 points or lower on the Japanese version of the Montreal Cognitive Assessment. The odds ratio (OR) and 95% confidence interval (95% CI) for each hs-CRP quartile were calculated using logistic regression analysis., Results: A total of 288 (69.9%) parsons in the 70-year-old group and 372 (80.9%) in the 80-year-old group exhibited low cognitive function. The association between hs-CRP levels and low cognitive function was significant among 70- and 80-year-old Japanese community-dwelling adults. In particular, the fourth quartile of hs-CRP (0.727-7.420 mg/L) in the 70-year-old group and the second and fourth quartiles (0.214-0.404 and 0.911-9.890 mg/L) in the 80-year-old group were associated with low cognitive function. Furthermore, the third quartile (0.409-0.892 mg/L) in the 80-year-old group was closely associated with low cognitive function., Conclusions: High hs-CRP levels were associated with lower cognitive function in 70- and 80-year-old Japanese community-dwelling individuals, suggesting that high hs-CRP levels may influence cognitive function., (© 2024. The Author(s).)

This study aimed to evaluate cognitively stimulating environments throughout life and to examine direct and indirect associations between these environments and late-life cognition. Early-life education, three domains of work complexity (data, people, and things) based on the longest-held occupation, and engagement in late-life leisure activities (LAs) were assessed. A structural equation model was developed using cross-sectional data of 1721 Japanese older adults in 70 ± 1 and 80 ± 1 years. The model confirmed significant direct effects of work complexity with data and late-life LAs on late-life cognitive performance. The associations of education and work complexity with late-life cognition were mediated through the subsequent environment(s). However, the total effects of work complexity with people and things on late-life cognition were insignificant. The findings suggest that cognitively stimulating activities in adulthood and beyond may lead to individual differences in late-life global cognition. In addition, antecedent complex environments might make subsequent life environments more cognitively stimulating. The results are discussed from the perspectives of cognitive plasticity and environmental complexity., Competing Interests: Declaration of competing interest All authors acknowledge there are no competing interests with the publication of this article. All authors have agreed to the published version of the manuscript., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: The relationship between moderate alcohol drinking or other alcohol drinking patterns such as frequency, beverage type, and situation of drinking and cognitive function is not sufficiently clear in older people. The purpose of this study was to investigate the association between alcohol drinking patterns and cognitive function in community-dwelling Japanese people aged 75 and over., Methods: This study was a cross-sectional design based on a prospective cohort study called the SONIC study. Subjects were older people aged 75-77 or 85-87 who voluntarily participated in 2016-2017. Drinking information was collected for daily drinking frequency, daily drinking intake, beverage type, and non-daily drinking opportunity. Cognitive function was measured using the Japanese version of the Montreal Cognitive Assessment (MoCA-J). Other potential confounding factors evaluated were age, sex, medical factors, and psychosocial factors. An analysis of covariance was performed to evaluate the MoCA-J score relative to drinking frequency or alcohol intake. Multiple regression analysis was performed to investigate the association between beverage type or non-daily drinking opportunity and the MoCA-J score., Results: The final number of participants analyzed was 1,226. The MoCA-J score for participants who reported drinking alcohol 1-6 days/week was significantly higher than that for those who reported drinking none or every day. No significant difference in the MoCA-J score was observed relative to daily alcohol intake. In terms of beverage type, wine was associated positively with the MoCA-J score. Non-daily drinking opportunity was also associated positively with the MoCA-J score., Conclusions: Moderate-frequency drinking, wine consumption, and non-daily drinking opportunities were associated with higher cognitive function in community-dwelling Japanese aged 75 and over. Further longitudinal studies are needed to clarify the causal relationships., (© 2022. The Author(s).)

We investigated the association of systolic blood pressure (SBP) level with physical frailty and cognitive function in community-dwelling older Japanese. Using the 'Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians' survey as the baseline, we performed a cross-sectional analysis of people aged 70 ± 1 (n = 1000), 80 ± 1 (n = 978), and 90 ± 1 (n = 272) years. Medical histories and medications were collected via interviews conducted by medical professionals. Blood pressure (BP), grip strength, gait speed, and cognitive function were examined on site. Trend analysis and multiple regression analysis were used to determine the association of the SBP level with physical frailty and cognitive function. The principal finding was that the association of SBP with physical frailty and cognitive function varied depending on characteristics such as age, physical and cognitive function, and antihypertensive medication use. A lower SBP level was associated with a higher prevalence of physical frailty only among 80-year-olds who were on antihypertensive medication. A significant association was found between higher SBP and lower cognitive function among 70-year-olds, while among 90-year-olds, the opposite was found. No association was found among participants who were 80 years old or among participants of all ages without antihypertensive medication. Our finding that an inverted association between SBP and geriatric syndrome exists suggests that the treatment of older patients must be individualized to prevent geriatric syndrome.

Although high blood pressure (BP) and BP variability have been reported to be associated with cognitive impairment, few studies have investigated the association between home BP (HBP) and cognitive function in the oldest-old. The aim of this study was to evaluate whether the value of and the day-to-day variability in HBP was associated with cognitive function in a Japanese community-dwelling oldest-old population. Among 111 participants aged 85-87 years, cognitive function was assessed using the Japanese version of the Montreal Cognitive Assessment (MoCA-J). HBP was measured two times every morning for a median of 30 days. The value of and variability in HBP were calculated as the average and coefficient of variation (CV) of the measurements, respectively. The associations of HBP variability with MoCA-J were examined using multiple linear regression models. Of 111 participants, 47.7% were men, and 64.0% were taking medications for hypertension. The mean HBP was 141.9 ± 14.8/72.2 ± 8.4 mmHg, and the mean CV of HBP was 6.7 ± 1.9/6.8 ± 2.4. The mean total MoCA-J score was 22.9 ± 3.5. The MoCA-J score was significantly lower with increasing CVs of both systolic BP (b = -0.36, p = 0.034) and diastolic BP (b = -0.26, p = 0.046) after adjustment for possible confounding factors. The value of HBP was not associated with MoCA-J. In the community-dwelling oldest-old population, higher day-to-day HBP variability, but not the value of HBP, was associated with cognitive impairment. When measuring HBP, attention should be paid not only to the values but also to their variations.

Engagement in leisure activities has been claimed to be highly beneficial in the elderly. Practicing such activities is supposed to help older adults to preserve cognitive function, physical function, and mental health, and thus to contribute to successful aging. We used structural equation modeling (SEM) to analyze the impact of leisure activities on these constructs in a large sample of Japanese older adults (N = 809; age range 72-74). The model exhibited an excellent fit (CFI = 1); engaging in leisure activities was positively associated with all the three successful aging indicators. These findings corroborate previous research carried out in Western countries and extend its validity to the population of Eastern older adults. Albeit correlational in nature, these results suggest that active engagement in leisure activities can help older adults to maintain cognitive, physical, and mental health. Future research will clarify whether there is a causal relationship between engagement in leisure activities and successful aging., Competing Interests: The authors have declared that no competing interests exist.

Aim: The objective of this study was to clarify the relationship between cognitive function and the serum albumin/globulin ratio (A/G ratio) in community-dwelling Japanese older adults., Methods: Randomly extracted residents in both urban and rural parts of Japan were enrolled in this study. A total of 1827 participants with a mean age of 70 or 80 years were recruited. A venue survey method was carried out with comprehensive studies, including interviews, blood collection, physical examination and cognitive function tests., Results: Univariate analysis showed a significant positive correlation between the total Japanese version of the Montreal Cognitive Assessment score and the serum A/G ratio at the age of 70 and 80 years, in which better cognitive function was associated with a high serum A/G ratio. Multiple regression analysis with the total Japanese version of the Montreal Cognitive Assessment score as the dependent variable showed that the serum albumin level, serum globulin level, serum A/G ratio, C-reactive protein, years of formal education and sex were related to the Japanese version of the Montreal Cognitive Assessment total score at the age of 70 years, and that the serum albumin level, serum globulin level, serum A/G ratio, C-reactive protein, years of formal education and stroke were related at the age of 80 years. The serum A/G ratio showed a better correlation than the serum globulin levels at the age of 70 and 80 years (70 years: β = 0.131 vs -0.111, 80 years: β = 0.108 vs -0.071)., Conclusions: We found a correlation between cognitive function and the serum A/G ratio in community-dwelling older people, suggesting that nutritional status and chronic inflammation might influence cognitive function. Geriatr Gerontol Int 2019; 19: 967-971., (© 2019 Japan Geriatrics Society.)

ABSTRACTObjectives:Centenarians have survived into very late life, but whether they reach very old age in good health remains unclear. The purpose of this study was to compare the cardiovascular health status and cognitive functioning of centenarians in the United States with centenarians in Japan., Design, Setting, and Participants: This cross-national design compared centenarians from the United States and Japan. The sample of U.S. centenarians was recruited from the Georgia Centenarian Study and included 287 centenarians. The sample of Japanese centenarians was recruited from the Tokyo Centenarian Study and included 304 centenarians., Measurements: Cognitive functioning was assessed with a mental status questionnaire, and cardiovascular disease by a health history assessment, blood pressure, and selected blood parameters., Results: The results suggest that Tokyo centenarians had lower disease experiences and BMI values, when compared to Georgia centenarians, but blood pressure was higher among Japanese centenarians. Lower levels of hemoglobin in Japanese centenarians and higher levels of C-reactive protein in Georgia were also found. The positive association of hypertension and albumin levels with cognitive functioning and the negative association of stroke occurrence with cognitive functioning were replicated in both countries. Differential effects were obtained for heart problems, BMI, and C-reactive protein (with positive effects for Tokyo centenarians, except for C-reactive protein)., Conclusion: For extremely old individuals, some markers of cardiovascular disease are replicable across countries, whereas differential effects for cardiovascular health also need to be considered in cardiovascular health.

Background: There is increasing evidence of causal links between poor mastication and cognitive impairment, but possible effects of dietary hardness, which clearly affects mastication, on cognitive function are unknown., Objective: We investigated the hypothesis that hardness of the habitual diet would be associated with cognitive function among older Japanese adults., Methods: The subjects of this cross-sectional study were 635 Japanese community-dwelling people aged 69-71 years. The masticatory muscle activity required for the habitual diet was used to determine dietary hardness. Consumption of 38 foods was assessed by a validated, brief-type, self-administered diet history questionnaire. A published database was then used to estimate the masticatory muscle activity involved in the ingestion of these foods. The Japanese version of the Montreal Cognitive Assessment (MoCA-J) was used for the measurement of cognitive function., Results: The principal contributors to dietary hardness were cooked rice (28.0%), green leafy vegetables (5.1%), dried fish (4.9%), and pork and beef (4.6%). There was a positive association between dietary hardness and MoCA-J score that was robust to adjustment for potential confounders (MoCA-J score per 100-unit increase in dietary hardness: β = 0.83 [95% CI: 0.08, 1.59], P = 0.03). These results did not change materially even after exclusion of subjects who reported substantial changes in their diet for any reason (β = 0.94 [95% CI: 0.02, 1.86], P = 0.04)., Conclusion: This preliminary cross-sectional study suggests that dietary hardness might have a beneficial effect on cognitive function in older Japanese people. Further prospective studies with more accurate measurements are needed to confirm this finding., (© 2018 John Wiley & Sons Ltd.)

Objectives: Oral tactile perception is important for better mastication, appetite, and enjoyment of food. However, previous investigations have not utilized comprehensible variables thought to have negative effect on oral perception, including aging, denture wearing, and cognitive function. The aim of this study was to elucidate the impact of cognitive function on oral perception in independently living older individuals., Materials and Methods: The study sample was comprised of 987 participants (466 males, 521 females; age 69-71 years). Oral examinations, assessments of cognitive function in preclinical level by Montreal Cognitive Assessment (MoCA)-J, and determination of oral stereognostic ability as an indicator of oral perception were performed. Related variables were selected by univariate analyses; then, multivariate logistic regression model analysis was conducted., Results: Univariate analyses revealed that number of teeth, removable dentures usage, and cognitive function respectively had a significant relationship with stereognostic score. Next, the subjects were classified into good and poor perception groups (lowest 17.4%) according to oral stereognostic ability. Logistic regression analysis revealed that lower cognitive function was significantly associated with poor oral perception (OR = 0.934, p = 0.017) after controlling for other variables., Conclusions: Cognitive decline even in preclinical stage was associated with reduced oral perception after controlling for gender, tooth number and denture use in independent living older people., Clinical Relevance: This study suggested that preclinical level of change in cognitive function affected oral perception. Dental practitioners and caregivers may need to pay attention to reduced oral perception among older people even if they do not have trouble in daily life.

Aim: To assess the burdens of polypharmacy and the drug burden index in community-dwelling elder people., Methods: The survey was conducted on 396 participants who participated in The Kawasaki Wellbeing Project from March to December 2017. We investigated the associations between the drug burden and the physical/cognitive/mental outcomes. The drug burden was determined by calculating the number of medications and the drug burden index (DBI) based on the use of anticholinergic and sedative drugs. A multivariate regression analysis was conducted for the outcome measures ADL, IADL, MMSE, J-CHS, and EQ5D5L after adjusting for the sex, age, number of diseases, education level, smoking history, and alcohol history., Results: A total of 389 subjects were analyzed, the mean age of the population was 86 years old, and 187 people (48%) were male. Polypharmacy was reported in 243 people (62%), and DBI exposure was reported for 142 people (36.5%). We found that this population was physically healthy, with a median ADL of 100, and had high quality of life, with a median EQ5D5L of 0.895. Polypharmacy was found to be related to the J-CHS (β: 0.04) and EQ5D5L (-0.01). The DBI was also related to the EQ5D5L (-0.04)., Conclusion: These results showed that even though this population was healthier than the general Japanese elderly population, the drug burden of polypharmacy and high dosages of anticholinergic/sedative drugs exerted significant negative effects on frailty and the quality of life. Additional research should be conducted to investigate the long-term effects of polypharmacy and anticholinergic/sedative drugs on elderly people.

Purpose: The purpose of this study was to compare centenarians in the United States and Japan on sensory, cognitive, and physical functioning and to evaluate a model that tests the interrelationship between physical function, cognition, and sensory impairment in these two unique samples of the oldest old., Methods: The sample of U. S. centenarians included 245 centenarians, the sample of Japanese centenarians included 304 centenarians. Sensory impairment was assessed by general assessments of vision and hearing, and physical function was assessed with six physical activities of daily living (i.e., eating, grooming, dressing, transporting, bathing, and walking)., Results: The results suggest that centenarians from the Georgia study showed higher levels of functioning in all domains when compared to the Tokyo sample. A structural equation model yielded stronger associations between cognitive and sensory function with physical function for the Tokyo sample., Conclusions: Functional differences may be due, in part, to different care patterns for the oldest old in the United States when compared to Japan.

Background: Despite a steady increase in life expectancy, a few studies have investigated cross-sectional correlates and longitudinal predictors of cognitive function, a core domain of the successful aging, among socio-clinico-demographic factors in the oldest-old exclusively., Objectives: The aims of this study were to examine socio-clinico-demographic characteristics associated with global cognition and its changes in the oldest-old., Methods: We reanalyzed a dataset of cognitively preserved community-dwelling subjects aged 85 years and older in the Tokyo Oldest Old Survey on Total Health, a 6-year longitudinal observational study. This study consisted of (1) baseline cross-sectional analyses examining correlates of global cognition (n = 248) among socio-clinico-demographic factors and (2) longitudinal analyses examining baseline predictors for changes of global cognition in 3-year follow-up (n = 195). The Mini-Mental State Examination was used as a screening test to assess global cognition., Results: At baseline, higher weights were related to higher cognitive function in the oldest-old. The baseline predictors of global cognitive decline in 3-year follow-up were higher global cognition, shorter education period, and lower sociocultural activities and lower instrumental activity of daily living, in this order., Conclusions: The present study suggests that it is crucial to attain higher education during early life and avoid leanness or obesity, participate in sociocultural cognitive activities during late life, and maintain instrumental activity of daily living to preserve optimal cognitive function in the oldest-old, which will facilitate developing prevention strategies for cognitive decline and promoting successful aging in this increasing population., (Copyright © 2018 John Wiley & Sons, Ltd.)

Background: Growing evidence suggests that oral health may be an important factor associated with cognitive function in aged populations. However, many previous studies on this topic used insensitive oral indicators or did not include certain essential covariates. Thus, we examined the association between occlusal force and cognitive function in a large sample of older adults, controlling for dietary intake, vascular risk factors, inflammatory biomarkers, depression, and genetic factors., Methods: In this cross-sectional study of older community-dwelling Japanese adults, we examined data collected from 994 persons aged 70 years and 968 persons aged 80 years. Cognitive function was measured using the Japanese version of the Montreal Cognitive Assessment (MoCA-J). Oral status and function were evaluated according to the number of remaining teeth, periodontal pocket depth, and maximal occlusal force. Associations between MoCA-J scores and occlusal force were investigated via bivariate and multivariate analyses., Results: Education level, financial status, depression score, and intake of green and yellow vegetables, as well as number of teeth and occlusal force, were significantly correlated with MoCA-J scores in both age groups. Among individuals aged 80 years, CRP and periodontal status were weakly but significantly associated with MoCA-J score. After controlling for all significant variables via bivariate analyses, the correlation between maximal occlusal force and cognitive function persisted. A path analysis confirmed the hypothesis that cognitive function is associated with occlusal force directly as well as indirectly via food intake., Conclusions: After controlling for possible factors, maximal occlusal force was positively associated with cognitive function directly as well as indirectly through dietary intake.

Background: An increasing number of studies in Western countries have shown that healthy dietary patterns may have a protective effect against cognitive decline and dementia. However, information on this relationship among non-Western populations with different cultural settings is extremely limited. We aim to examine the relationship between dietary patterns and cognitive function among older Japanese people., Methods: This cross-sectional study included 635 community-dwelling people aged 69-71 years who participated in the prospective cohort study titled Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians (SONIC). Diet was assessed over a one-month period with a validated, brief-type, self-administered diet history questionnaire. Dietary patterns from thirty-three predefined food groups [energy-adjusted food (g/d)] were extracted by factor analysis. Cognitive function was assessed using the Japanese version of the Montreal Cognitive Assessment (MoCA-J). Multivariate regression analysis was performed to examine the relationship between dietary patterns and cognitive function., Results: Three dietary patterns were identified: the 'Plant foods and fish', 'Rice and miso soup', and 'Animal food' patterns. The 'Plant foods and fish' pattern, characterized by high intakes of green and other vegetables, soy products, seaweeds, mushrooms, potatoes, fruit, fish, and green tea, was significantly associated with a higher MoCA-J score [MoCA-J score per one-quartile increase in dietary pattern: β = 0.56 (95% CI: 0.33, 0.79), P for trend <0.001]. This association was still evident after adjustment for potential confounding factors [β = 0.41 (95% CI: 0.17, 0.65), P for trend <0.001]. In contrast, neither the 'Rice and miso soup' nor the 'Animal food' pattern was related to cognitive function. To confirm the possibility of reverse causation we also conducted a sensitivity analysis excluding 186 subjects who reported substantial changes in their diet for any reason, but the results did not change materially., Conclusion: This preliminary cross-sectional study suggests that a diet with high intakes of vegetables, soy products, fruit, and fish may have a beneficial effect on cognitive function in older Japanese people. Further prospective studies are needed to confirm this finding.

The scope and purpose of this review was to summarize the aims, methods, findings, and future of centenarian and (semi)-supercentenarian studies in Japan, particularly those from our own interdisciplinary laboratory. Medically, approximately 97% of centenarians contract chronic diseases including hypertension and gastrointestinal disease; however, they present with few cardiovascular risk factors. The low prevalence of diabetes mellitus and carotid atherosclerotic plaques is peculiarities of centenarians, which could be associated with high adiponectin levels. While conducting the Tokyo centenarian study (TCS), we found that only 20% of centenarians enjoyed physical and cognitive independence at the age of 100 years, although most remained independent in daily living until into their 90s. Those who maintained physical independence at 100 years of age were highly likely to become semi-supercentenarians (over 105 years) or even supercentenarians (beyond 110 years). We also describe parts of results of the Japan Semi-supercentenarian Study (JSS), which showed that the suppression of chronic inflammation is an important driver of successful aging at extreme old age. Telomere maintenance and an extremely low frequency of APOE-ε4 alleles are genetic peculiarities of (semi)-supercentenarians. The available data confirm our conviction that semi-supercentenarians are a more appropriate model for the study of human longevity., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Apolipoprotein E (APOE) ε4 allele and education have been reported to affect the cognitive function in young-old adults. However, the effects and interactions of the ε4 allele and education on cognitive function in very old age, particularly in centenarians, are not well known. We studied 542 Japanese centenarians. Using the data in total of 452 participants (74 men and 378 women, mean age 103.6 ± 3.2 years) who were genotyped and assessed cognitive function with the Mini-Mental States Examination (MMSE), we examined the effects and interactions of the ε4 allele and education on the MMSE score. First, we coded education as three levels: low, middle, and high based on the formal educational levels (analysis 1). Second, to clarify the modifying effect of education, we adopted a new coding for education into two levels, considering a periodical background (around 1900) of gender differences in educational attainments (analysis 2). In analysis 1, the main effects of the ε4 allele and education on the MMSE score were significant after adjusting for age. Further, there was a significant three-way interaction effect between the ε4 allele, education, and gender on the MMSE. Analysis 2 showed that the modifying effect of the ε4 allele by education was observed only in women with the ε4 allele. These findings suggest that both the APOE ε4 allele and education appear to be associated with cognitive function even in centenarians, but the interaction between the ε4 allele and education might depend on gender in this cohort., Competing Interests: Compliance with ethical standards For participation in any of the studies, written informed consent was obtained either from the participants or by proxy when individuals lacked the capacity to consent. TCS and JSS were approved by the Ethical Committee of the Keio University School of Medicine and Tokyo Metropolitan Institute of Gerontology.

High blood pressure in middle age (up to 64 years) has been proposed as a predictive indicator of dementia. However, the association between hypertension and the cognitive functioning is controversial in older age groups. The aim of this study was to investigate this association in 70-80-year-old participants in the Japanese study of Septuagenarians, Octogenarians and Nonagenarians Investigation with Centenarians (SONIC). Participants aged 70 (±1) and 80 (±1) years (n=1000 and 973, respectively) were randomly recruited from the general population in Japan. Cognitive functioning was measured by the Montreal Cognitive Assessment. Blood pressure and other medical and social variables were analyzed by multiple regression analyses. High systolic blood pressure (SBP) was significantly correlated with a reduced cognitive functioning only in participants aged 70 years. Additionally, this correlation became more marked in participants with uncontrolled blood pressure at age 70 years. In contrast, SBP was not significantly correlated with the cognitive functioning at age 80 years. Nutritional status indicators such as serum albumin and frequency of going outdoors were significantly associated with cognitive functioning at age 80 years. Our findings indicate that high SBP has a significant role in cognitive functioning at age 70 years; however, blood pressure is less important as a risk factor for cognitive decline at age 80 years.

Background: Prevention of disability is a major challenge in aging populations; however, the extent to which physical independence can be maintained toward the limit of human life span remains to be determined., Methods: We examined the health and functional status of 642 centenarians: 207 younger centenarians (age: 100-104 years), 351 semi-supercentenarians (age: 105-109 years), and 84 supercentenarians (age: >110 years). All-cause mortality was followed by means of an annual telephone or mailed survey., Results: Age-specific disability patterns revealed that the older the age group, the higher the proportion of those manifesting independence in activities of daily living at any given age of entry. Multiple logistic regression analysis identified male gender and better cognitive function as consistent determinants of physical independence across all age categories. In a longitudinal analysis, better physical function was significantly associated with survival advantage until the age of 110. However, mortality beyond that age was predicted neither by functional status nor biomedical measurements, indicating alternative trajectories of mortality at the highest ages., Conclusions: These findings suggest that maintaining physical independence is a key feature of survival into extreme old age. Future studies illuminating genetic and environmental underpinnings of supercentenarians' phenotypes will provide invaluable opportunities not only to improve preventive strategies but also to test the central hypotheses of human aging.

Background/aims: We examined the effect of aging on cognitive function at the limit of human life expectancy by characterizing state of cognition in centenarians without clinical cognitive impairment., Methods: Participants were 68 centenarians without cognitive impairment (Clinical Dementia Rating (CDR) 0), 96 controls 60 to 74 years old, and 46 controls 75 to 89 years old. We visited the places where centenarians were living and administered the Mini-Mental State Examination (MMSE) individually. Control subjects came to the assembly hall within their dwelling area, to be administered the MMSE., Results: Mean total scores of centenarians (22.3) were lower than for either 60-74 (27.2) or 75-89 (26.2). Comparison of scores in each of five cognitive domains measured by MMSE showed a significant age-group effect upon orientation, memory, and attention. Centenarians' scores were lower than for younger groups in every domain except for the language and praxis, concentration, and for repetition., Conclusion: The centenarians' scores in memory and orientation declined as in earlier studies of normal aging. Centenarians' scores for attention and concentration differed from those in previous studies. The present result suggests that even primary memory is influenced by advanced age in centenarians, while ability to store information declines, ability to process is maintained., (Copyright 2009 S. Karger AG, Basel.)

Objectives: To compare the acceptability and feasibility of computerized and pencil-and-paper tests of cognitive function in 85-year-old people., Design: Group comparison of participants randomly allocated to pencil-and-paper (Wechsler Adult Intelligence and Memory Scales) or computerized (Cognitive Drug Research) tests of verbal memory and attention., Setting: The Newcastle 85+ Pilot Study was the precursor to the Newcastle 85+ Study a United Kingdom Medical Research Council/Biotechnology and Biological Sciences Research Council cohort study of health and aging in the oldest-old age group., Participants: Eighty-one community-dwelling individuals aged 85., Measurements: Participant and researcher acceptability, completion rates, time taken, validity as cognitive measures, and psychometric utility., Results: Participants randomized to computerized tests were less likely to rate the cognitive function tests as difficult (odds ratio (OR)=0.16, 95% confidence interval (CI)=0.07-0.39), stressful (OR=0.18, 95% CI=0.07-0.45), or unacceptable (OR=0.18, 95% CI=0.08-0.48) than those randomized to pencil-and-paper tests. Researchers were also less likely to rate participants as being distressed in the computer test group (OR=0.19, 95% CI=0.07-0.46). Pencil-and-paper tasks took participants less time to complete (mean+/-standard deviation 18+/-4 minutes vs 26+/-4 minutes) but had fewer participants who could complete all tasks (91% vs 100%). Both types of task were equally good measures of cognitive function., Conclusion: Computerized and pencil-and-paper tests are both feasible and useful means of assessing cognitive function in the oldest-old age group. Computerized tests are more acceptable to participants and administrators.

Background: Research in Western countries has shown most centenarians to be survivors with multiple comorbidities. However, Japanese centenarians' morbidity and its relationship to functional status has yet to be elucidated. The aim of this study is to clarify the association of morbidity with the physical and cognitive function of centenarians. We examined Tokyo-area centenarians to determine their kinds of morbidity profiles and how such morbidity related to their functional status., Methods: We studied 302 centenarians living in Tokyo (101.2+/-1.8 years; 65 men, 237 women), and assessed their physical status, morbidity, and use of medication. Activities of daily living and cognitive function were also assessed using the Barthel Index and the Clinical Dementia Rating., Results: More than 95% of the centenarians had chronic diseases. Both the physical and cognitive functions were significantly higher in men. The present and previous illnesses most frequently included hypertension, heart disease, stroke, fractures, and cataracts. Fractures were observed significantly more frequently in women. Diabetes mellitus was uncommon. The physical and cognitive function of centenarians with a history of stroke or fracture were particularly poor, whereas those centenarians with hypertension tended to show a high level of physical and cognitive function., Conclusions: Almost all centenarians had chronic diseases. Stroke and fracture were correlated with poorer function; therefore, we hypothesize that prevention of stroke and fracture might improve functional status in the oldest-old.

The associations among cognitive function, hypertension, and dyslipidemia in older adults are controversial. Therefore, we investigated the associations among cognitive decline, hypertension, dyslipidemia, and their combination in community-dwelling older people in their 70s, 80s, and 90s in the long-term observational Septuagenarians, Octogenarians, Nonagenarians, Investigation with Centenarians (SONIC) study. We administered the Montreal Cognitive Assessment Japanese version (MoCA-J) by trained geriatricians and psychologists, and conducted blood testing and blood pressure (BP) measuring by medical staff involving 1186 participants. We performed multiple regression analysis to assess the relationships among hypertension, dyslipidemia, their combination, and lipid and BP levels with cognitive function at the 3-year follow-up after adjusting for covariate factors. At the baseline, the percentage of the combination of hypertension and dyslipidemia was 46.6% (n = 553), hypertension was 25.6% (n = 304), dyslipidemia was 15.0% (n = 178), and that without hypertension or dyslipidemia was 12.7% (n = 151). Conducting multiple regression analysis, no significant correlation was found between the combination of hypertension and dyslipidemia and MoCA-J score. In the group with the combination, high high-density lipoprotein cholesterol (HDL) levels resulted in higher MoCA-J scores at the follow-up (β = 0.06; P

Objective To determine the physical and mental health of very old people (aged 80+) with anaemia. Methods Individual level meta-analysis from five cohorts of octogenarians (n = 2,392): LiLACS NZ Māori, LiLACS NZ non-Māori, Leiden 85-plus Study, Newcastle 85+ Study, and TOOTH. Mixed models of change in functional ability, cognitive function, depressive symptoms, and self-rated health over time were separately fitted for each cohort. We combined individual cohort estimates of differences according to the presence of anaemia at baseline, adjusting for age at entry, sex, and time elapsed. Combined estimates are presented as differences in standard deviation units (i.e. standardised mean differences–SMDs). Results The combined prevalence of anaemia was 30.2%. Throughout follow-up, participants with anaemia, on average, had: worse functional ability (SMD −0.42 of a standard deviation across cohorts; CI -0.59,-0.25); worse cognitive scores (SMD -0.27; CI -0.39,-0.15); worse depression scores (SMD -0.20; CI -0.31,-0.08); and lower ratings of their own health (SMD -0.36; CI -0.47,-0.25). Differential rates of change observed were: larger declines in functional ability for those with anaemia (SMD −0.12 over five years; CI -0.21,-0.03) and smaller mean difference in depression scores over time between those with and without anaemia (SMD 0.18 over five years; CI 0.05,0.30). Conclusion Anaemia in the very old is a common condition associated with worse functional ability, cognitive function, depressive symptoms, and self-rated health, and a more rapid decline in functional ability over time. The question remains as to whether anaemia itself contributes to worse outcomes or is simply a marker of chronic diseases and nutrient deficiencies. [ABSTRACT FROM AUTHOR]

The Montreal Cognitive Assessment (MoCA) is a test assessing global cognition in older adults which is often used by researchers and clinicians worldwide, although some of its psychometric properties have yet to be established. We focus on three fundamental aspects: the factorial structure of the MoCA, its general factor saturation, and the measurement invariance of the test. We administered the MoCA to a large sample of Japanese older adults clustered in three cohorts (69–71-year-olds, 79–81-year-olds, and 89–91-year-olds; N = 2,408). Our results show that the test has an overall stable hierarchical factorial structure with a general factor at its apex and satisfactory general-factor saturation. We also found measurement invariance across participants of different ages, educational levels, economic status, and sex. This comprehensive investigation thus supports the idea that the MoCA is a valid tool to assess global cognition in older adults of different socioeconomic status and age ranges. [ABSTRACT FROM AUTHOR]

We studied the significance for further survival of heart rate variability and other variables in the very elderly. In 1992, we assessed activities of daily living, cognitive function, and nutritional status in 27 centenarians with no disease, in addition to the power of the heart rate variability in the ultralow, very low, low (LF), and high frequency (HF) bands. In 1996, we assessed survival in these centenarians; 17 had died and 10 were still living. Logistic regression analysis using backward elimination detected three factors, dementia, LF/HF, and age, that independently influenced mortality. Mortality risk increased with greater age in 1992, more severe dementia, or lower LF/HE Sympathetic nerve activity, represented as LF/HF, may be associated with prognosis for survival in centenarians. [ABSTRACT FROM AUTHOR]

Background: It is well documented that serum insulin-like growth factor 1 (IGF-1) levels as well as growth hormone secretion decline with advancing age. Low levels of IGF-1 are shown to be associated with low activity of growth hormone, low lean mass, and high body fat mass; however, in the elderly, the relationship has not been confirmed.Methods: We studied serum IGF-1 levels in 49 centenarians, who are at the ultimate stage of physiological senescence, and investigated the possible relationship between IGF-1 and body mass index, lipid parameters, nutritional indices, physical and cognitive function, and frequency of hip fracture. As nutritional indices, serum levels of albumin, prealbumin, transferrin, and retinol binding protein were measured. Cognitive function of the centenarians was assessed by clinical dementia rating.Results: In the centenarians, the mean levels of IGF-1 were relatively low, indicating that there is an age-associated decline in IGF-1 even in the extremely old age. We demonstrated a strong association of IGF-1 with prealbumin and retinol binding protein (r2 = .192, .195, respectively); however, there was no association with albumin, transferrin, or body mass index. Interestingly, centenarians with lower IGF-1 levels had a higher prevalence of definitive dementia.Conclusions: These data suggest that serum IGF-1 levels in the centenarians appeared to reflect their short-term nutritional status as a rapid turnover protein. It is also suggested that low levels of serum IGF-1 may be involved in the progression of dementia in the oldest old. [ABSTRACT FROM AUTHOR]