Search

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]

Aim The purpose of the present study was to explore the association between cognitive function and fear of falling in frail/non-frail older adults in a community setting. Methods We recruited 483 community-dwelling older adults aged 65 years and older (mean age 73.3 ± 5.1 years, 68.3% women). Fear of falling was assessed using a yes/no question, 'Are you afraid of falling?' Cognitive function was measured using the Mini- Mental State Examination. The five subscores of the examination were also recorded. We used the frailty criteria developed by the Cardiovascular Health Study, and divided the participants into non-frail and frail groups according to the number of affected domains. The statistical analyses were carried out separately for these two groups. Results A multiple logistic regression analysis showed that, in frail older adults, cognitive impairment was significantly associated with the absence of fear of falling ( OR 0.04, 95% CI 0.00-0.50, P = 0.012). In addition, a stepwise multivariate logistic regression analysis showed that the score on the attention and calculation subsection of the Mini- Mental State Examination was positively associated with the presence of fear of falling in frail older adults ( OR 1.83, 95% CI 1.08-3.12, P = 0.026). In contrast, cognitive impairment was not associated with fear of falling in non-frail older adults. Conclusions The results suggest that cognitive impairment, especially that in executive function, is associated with the absence of fear of falling in community-dwelling frail older adults. Geriatr Gerontol Int 2017; 17: 232-238. [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]

Objective. To investigate the association between knee pain during gait and 4 clinical phenotypes based on static varus alignment and varus thrust in patients with medial knee osteoarthritis (OA). Methods. Patients in an orthopedic clinic (n5266) diagnosed as having knee OA (Kellgren/Lawrence [K/L] grade ≥1) were divided into 4 phenotype groups according to the presence or absence of static varus alignment and varus thrust (dynamic varus): no varus (n5173), dynamic varus (n517), static varus (n550), and static varus1dynamic varus (n526).The knee range of motion, spatiotemporal gait parameters, visual analog scale scores for knee pain, and scores on the Japanese Knee Osteoarthritis Measure were used to assess clinical outcomes. Multiple logistic regression analyses identified the relationship between knee pain during gait and the 4 phenotypes, adjusted for possible risk factors, including age, sex, body mass index, K/L grade, and gait velocity. Results. Multiple logistic regression analysis showed that varus thrust without varus alignment was associated with knee pain during gait (odds ratio [OR] 3.30, 95% confidence interval [95% CI] 1.08-12.4), and that varus thrust combined with varus alignment was strongly associated with knee pain during gait (OR 17.1, 95% CI 3.19- 320.0). Sensitivity analyses applying alternative cutoff values for defining static varus alignment showed comparable results. Conclusion. Varus thrust with or without static varus alignment was associated with the occurrence of knee pain during gait. Tailored interventions based on individual malalignment phenotypes may improve clinical outcomes in patients with knee OA. [ABSTRACT FROM AUTHOR]

Objectives Frailty in older adults is a serious problem because of various adverse health outcomes in many countries with aging populations, such as Japan. The purpose of this study was to determine whether frailty and pre-frailty are associated with cognitive decline and sarcopenia in community-dwelling older adults. Design This is a cross-sectional study. Setting Japan. Participants The participants were 273 Japanese community-dwelling older women aged 65 years and older. Measurements We used the frailty criteria developed by the Cardiovascular Health Study to define physical frailty. We divided the cohort into nonfrail, prefrail, and frail according to frailty scores. Cognitive decline and memory decline were defined by using the Mini-Mental State Examination and Scenery Picture Memory Test, respectively. Sarcopenia was defined according to the diagnostic algorithm recommended by the Asian Working Group for Sarcopenia. Results In the multivariate logistic regression analysis by using non-frail participants as the reference, pre-frail elderly individuals were significantly more likely to have sarcopenia than non-frail elderly individuals [odds ratio (OR): 2.77, 95% confidence interval (CI): 1.05–9.26], but not cognitive decline or memory decline. Frail elderly individuals were significantly more likely to have cognitive decline (OR: 5.76, 95% CI: 1.20–27.6), memory decline (OR: 5.53, 95% CI: 1.64–18.7) and sarcopenia (OR: 19.1, 95% CI: 3.73–98.0) than non-frail elderly individuals. Conclusions Sarcopenia was associated with pre-frailty and frailty, whereas cognitive decline was associated only with frailty. [ABSTRACT FROM AUTHOR]

Objective: We investigated the association between telework frequency and the presence of non-COVID-19–related physical symptoms during the COVID-19 emergency declaration among workers in Japan. Methods: Data were collected from 1648 workers via web-based self-reported questionnaires. Multivariate logistic regression models were used to investigate the association between telework frequency per week (0, 1–2, 3–4, and ≥5 days/week) and the presence of stiff shoulders, eyestrain, and low back pain. Results: Among 917 participants, telework frequency was significantly associated with stiff shoulders (≥5 days: adjusted odds ratio [aOR] 3.02, 95% confidence interval [CI] 1.37–7.06), eyestrain (≥5 days: aOR 5.31, 95% CI 2.09–13.44), and low back pain (≥5 days: aOR 5.57, 95% CI 2.22–14.00), compared with non-teleworkers. Conclusions: Workers who abruptly began telework experienced more physical symptoms than non-teleworkers during the emergency declaration. [ABSTRACT FROM AUTHOR]

Objective The purpose of this 1-year prospective study was to determine whether sarcopenia is an independent risk factor of cognitive deterioration in community-dwelling older adults. Study Design One-year prospective study. Setting Japanese community. Participants A total of 131 community-dwelling older adults aged 65 years and older participated in this study. Measurements We defined sarcopenia using the diagnostic algorithm recommended by the Asian Working Group for Sarcopenia, and the participants were classified into the sarcopenia and normal groups according to this definition. The participants' cognitive functions were assessed using the Mini-Mental State Examination (MMSE) during pre- and postdata collection (after 1 year). Results The rate of change in pre- and post-MMSE scores during the follow-up term was significantly different between the 2 groups (normal group, −0.32 ± 8.39%; sarcopenia group, −5.86 ± 5.16%; P = .002). The analysis of covariance, adjusted for demographic data and the pre-MMSE scores, showed a significant change in the MMSE scores between the normal and sarcopenia group (F = 9.30, P = .003). Furthermore, in the multivariate logistic regression analysis, the cognitive function was significantly more likely to deteriorate (defined as a loss of at least 2 points of MMSE) in the sarcopenia group during the follow-up term (odds ratio: 7.86, 95% confidence interval: 1.53–40.5). Conclusions Sarcopenia was identified as an independent risk factor of cognitive deterioration in community-dwelling older adults during the 1-year study period. [ABSTRACT FROM AUTHOR]