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Previous studies have reported opposite effects of occupational or non-occupational physical activity (PA) and sedentary behavior (SB) on health outcomes. However, no study has investigated the relationship between domain-specific movement behaviors and cardiometabolic health (CMH) among office workers, considering the compositional nature of time-use data. We investigated the associations of accelerometer-measured PA and SB for each domain (working time, non-working time on workday, and non-workday) with CMH indicators among office workers, using compositional data analysis.This cross-sectional study included 1258 Japanese office workers. The time spent on SB, light-intensity PA (LPA), and moderate- to vigorous-intensity PA (MVPA) were assessed using an accelerometer. CMH indicators were retrieved from the annual health check-up data.Compositional multiple linear regression indicated that PA and SB during non-working time on workdays, but not working time or non-workdays, were significantly associated with CMH. In particular, during non-working time, time reallocations from SB to LPA and from SB to MVPA were associated with favorable changes in cardiometabolic risk score and lipid metabolism, respectively. Paradoxically, a greater proportion of LPA during non-working time was associated with favorable diastolic blood pressure (β = 1.61; 95% confidence interval [CI] = 0.02, 3.19), whereas occupational LPA was detrimental (β = -2.48; 95% CI = -4.87, -0.09).Our results suggested that reducing SB and increasing PA during non-working time on workdays may be effective for managing CMH among office workers. Future longitudinal studies using compositional data analysis are required to confirm our results.

Objective: This study aimed to determine whether the timing of exercise influenced the effects of home-based low-intensity stepping exercises on the sleep parameters of older adults. Method: For 8 weeks, 60 healthy older adults participated in a randomized controlled trial, performing low-intensity aerobic exercise (70-80 bpm) for about 30 minutes every day at home, either in the morning (from waking until 12:00) or evening (18:00 to bedtime). Results: In the evening exercise group, both subjectively and objectively measured sleep latency significantly improved throughout the intervention. Further, postintervention subjective sleep satisfaction was significantly higher in the evening group (6.2 ± 1.3 points) than in the morning group (5.2 ± 1.4 points; P = .006). Additionally, sleep variables related to evening exercise had larger effect sizes (Cohen d) than those performed in the morning. Conclusion: Engaging in low-intensity stepping exercises during the evening is potentially a useful nonpharmacological approach to improving sleep quality among older adults.

OBJECTIVE Ergonomic office redesigning possibly improves physical activity (PA) and sedentary behavior (SB); however, its impact on cardiometabolic risk has not yet been determined. This study aimed to examine the effect of office relocation on cardiometabolic risk factors. METHODS Annual health check-up data of 95 office workers from four offices in Tokyo, Japan, who relocated to an office with activity-based working (ABW) and height-adjustable desk (HAD) and a propensity-score matched control-cohort were analyzed. PA and SB on weekdays were measured only in the relocation group before and 10 months after relocation. RESULTS Significant interactions were observed for waist circumference, high-density lipoprotein cholesterol, and glycosylated hemoglobin (HbA1c). HbA1c changes showed a significant negative association with moderate-to-vigorous-intensity PA. CONCLUSION An ABW office with HAD improves cardiometabolic risk factors in office workers, possibly through changes in PA and SB.

We clarified the effect of exercising with others on the risks of incident functional disability and all-cause mortality among community-dwelling adults. We used an inventory mail survey with a five-year follow-up for 1520 independently living older adults (mean age: 73.4 &plusmn, 6.3 years) in Kasama City, Japan. Subjects responded to a self-reported questionnaire in June 2014. Exercise habits and the presence of exercise partners were assessed. Subjects were classified into three groups: Non-exercise, exercising alone, and exercising with others. Follow-up information and date of incident functional disability and death during the five-year follow-up were collected from the database. To compare the association between exercise habits and functional disability and mortality, Cox regression analysis was conducted. Compared with the non-exercise group, exercising with others had significantly lower hazard ratios (HRs) for functional disability (0.59, 95% confidence interval (CI) 0.40&ndash, 0.88) and mortality (0.40, 95% CI 0.24&ndash, 0.66) in the covariate models. Compared with exercising alone, exercising with others decreased the HRs for incident functional disability (0.53, 95% CI: 0.36&ndash, 0.80) and mortality (0.50, 95% CI 0.29&ndash, 0.85) rates in the unadjusted model, these associations were not significant in the covariate models. Exercising with others can contribute to functional disability prevention and longevity.

This study aimed to examine the factors related to participation in volunteer-managed preventive care exercises by focusing on the distance to exercise facilities and interpersonal social networks. A postal mail survey was conducted in 2013 in Kasama City in a rural region of Japan. Older adults (aged ≥ 65 years) who were living independently (n = 16,870) were targeted. Potential participants who were aware of silver-rehabili taisou exercise (SRTE) and/or square-stepping exercise (SSE) were included in the analysis (n = 4005). A multiple logistic regression analysis revealed that social and environmental factors were associated with participation in SRTE and SSE. After adjusting for confounding variables, exercise participation was negatively associated with an extensive distance from an exercise facility in both sexes for SRTE and SSE. Among women, participation in SRTE was negatively associated with weak interpersonal social networks (odds ratio (OR) = 0.57), and participation in SRTE and SSE was negatively associated with being a car passenger (SRTE, OR = 0.76, SSE, OR = 0.60). However, there were no significant interactions between sex and social and environmental factors. Our findings suggest the importance of considering location and transportation to promote participation in preventive care exercise.

The aim of this study was to clarify the effect of living alone on the cognitive function of older people and the mediating effect of instrumental activities of daily living (IADL) ability. The data for a final sample of 3276 participants aged 65 years and above who did not require long-term care at the baseline were used from a 4-year prospective cohort study conducted in Kasama City, Japan. Demographic data including age, sex, and depression at baseline were used as covariates. The Kihon checklist evaluated the IADL ability at baseline and cognitive function at follow-up. The characteristics of those living alone and with others were compared using the student t test and χ2 test. The effect of living alone on cognitive function was analyzed using logistic regression analysis. Mediation analyses determined the mediating effects of IADL. A total of 325 participants were living alone; they were significantly older than those living with others, more likely to be female, not provide emotional support, and have low physical function, more severe depression, and lower IADL disability. Living alone had a significantly lower risk of cognitive decline at follow-up than living with others. The mediation analysis revealed that IADL disability at follow-up was significantly associated with cognitive decline. Thus, greater IADL ability decreased cognitive decline risk. Older people living alone had a significantly lower risk of cognitive decline, and cognitive function significantly mediated IADL ability. Health support for enhancing IADL abilities may help older people living alone maintain good cognitive function.

Decreasing daily life physical activity (PA) outside an exercise program might hinder the benefit of that program on lower-extremity physical function (LEPF) in older adults. The purpose of this study was to investigate how daily life PA modulates the effects of an exercise program on LEPF. The participants were 46 community-dwelling older adults (mean age, 70.1 ± 3.5 years) in Kasama City, a rural area in Japan. All participated in a fall-prevention program called square-stepping exercise once a week for 11 weeks. We evaluated their daily life PA outside the exercise program with pedometers and calculated the average daily step counts during the early and late periods of the program. We divided participants into 2 groups on the basis of whether or not they decreased PA by more than 1000 steps per day between the early and late periods. To ascertain the LEPF benefits induced by participating in the exercise program, we measured 5 physical performance tests before and after the intervention: 1-leg stand, 5-time sit-to-stand, Timed Up and Go (TUG), habitual walking speed, and choice-stepping reaction time (CSRT). We used a 2-way analysis of variance to confirm the interaction between the 2 groups and the time effect before and after the intervention. During the exercise program, 8 participants decreased their daily life PA (early period, 6971 ± 2771; late period, 5175 ± 2132) and 38 participants maintained PA (early period, 6326 ± 2477; late period, 6628 ± 2636). Both groups significantly improved their performance in TUG and CSRT at the posttest compared with the baseline. A significant group-by-time interaction on the walking speed (P = .038) was observed: participants who maintained PA improved their performance more than those who decreased their PA. Square-stepping exercise requires and strengthens dynamic balance and agility, which contributed to the improved time effects that occurred in TUG and CSRT. On the contrary, because PA is positively associated with walking speed, maintaining daily life PA outside an exercise program may have a stronger influence on walking speed. To enhance the effectiveness of an exercise program for young-old adults, researchers and instructors should try to maintain the participant's daily life PA outside the program. Regardless of decreasing or maintaining daily life PA, the square-stepping exercise program could improve aspects of LEPF that require complex physical performance. However, a greater effect can be expected when participants maintain their daily life PA outside the exercise program.

Preventing nonalcoholic simple fatty liver (NASFL) from progressing to nonalcoholic steatohepatitis (NASH) is a key to avoiding cirrhosis. Physical activity (PA) may help manage fatty liver; however, there is a lack of prospective studies showing an association between PA and NASH. Our current prospective study investigated whether PA prevents NASFL from progressing to NASH. Study data were obtained from the health check-up program of Meiji Yasuda Shinjuku Medical Center in Tokyo, Japan. From a baseline survey between 2005 and 2007, 1149 people with NASFL met eligibility criteria including low alcohol consumption. We followed participants until 2014 assessing liver status via ultrasound and liver enzyme levels, including alanine aminotransferase (ALT) and aspartate aminotransferase (AST). We classified participants with fatty liver and higher levels of either ALT or AST as having NASH. Through a self-reported questionnaire, we classified PA into three intensities: moderate low-intensity PA (MLPA, 3-5 METs), moderate high-intensity PA (MHPA, 5-7 METs), and vigorous-intensity PA (VPA, ≥7 METs). During a mean follow-up of 4.2years (4804person-years), 318 of the 1149 participants (27.7%) progressed from NASFL to NASH. A multivariate-adjusted Cox model showed a significant preventive effect of VPA on progression to NASH (HR=0.55, 95% CI=0.32-0.94) and no significant associations between MLPA (HR=1.01, 95% CI=0.79-1.30) or MHPA (HR=0.97, 95% CI=0.66-1.42) and progression to NASH. Only VPA prevented NASFL from progressing to NASH; MLPA and MHPA had no preventive effect on NASH. Higher intensity PA may be needed to manage NASH.

BACKGROUND AND PURPOSE Pedometers are often used as motivational tools to increase physical activity. Hence, providing a pedometer during an exercise intervention may enhance the benefit of exercise on lower-extremity physical function (LEPF) by maintaining or increasing daily physical activity. The purpose of this study was to compare the effect on LEPF between an exercise intervention with and without the use of a pedometer. METHODS The subjects of this study were 68 community-dwelling older adults (mean age: 70.0 ± 3.6 years) in Kasama City, rural Japan. All subjects participated in a fall-prevention exercise program called square-stepping exercise (SSE) conducted once a week for 11 weeks. Participants were allocated to 2 groups: SSE with pedometer group (n = 34) and SSE without pedometer group (n = 34). We matched the participants of both groups by their standardized score of physical function tests. To ascertain the LEPF benefits induced by the exercise intervention, we measured 5 physical function tests: single-leg balance with eyes open, 5-repetition sit-to-stand, timed up and go, 5-m habitual walk, and choice stepping reaction time. We used a 2-way analysis of variance to confirm the interaction between the 2 groups. RESULTS Significant group-by-time interactions were observed on timed up and go (P < .01) and 5-m habitual walk (P = .02); participants in the SSE with pedometer group enhanced their physical function more than the SSE without pedometer group participants. CONCLUSIONS This study suggests that providing a pedometer during an exercise intervention is an effective addition to an exercise program to improve LEPF.

There was no evidence of satisfying the standard to decide the efficacies of glucosamine and chondroitin in middle-aged and older Japanese adults with knee pain and/or stiffness. To investigate the effects of 24 week oral N-acetyl glucosamine and chondroitin sulfate supplementation on knee pain, self-reported knee function, physical activity, and physical performance. We randomly assigned 11 men and 39 women (aged 52–87 years) to receive 100 mg of N-acetyl glucosamine and 180 mg of chondroitin sulfate daily (Glu/Cho group) or a placebo (control, C group) for 24 weeks. The primary outcomes were a 100 mm visual analog pain scale (VAS) and the Japanese Knee Osteoarthritis Measure (JKOM) score. The secondary outcomes were physical activity and physical performance. We observed a significant group × time interaction on the JKOM score. According to the post hoc test, it significantly decreased (i.e., improved knee function) from the 4- to 12-week follow-up in the Glu/Cho group and the Glu/Cho group score was significantly lower than the C group at the 12-week follow-up. We found a significant interaction on household physical activity. There was no significant interaction on VAS or physical performance tests. The results of the present study were consistent with previous studies mainly conducted in European and American countries. These results suggest that consumption of N-acetyl glucosamine and chondroitin sulfate for 12 weeks or longer has a positive effect on self-reported knee function and household physical activity in middle-aged and older Japanese adults with knee pain and/or stiffness.

Few prospective cohort studies have examined the association between physical activity (PA) and insomnia prevention, and the effective PA intensity remains unclear. This prospective study explores how PA intensity prevents incident short sleep duration and subjective insufficient sleep in middle-aged and older adults.A self-reported questionnaire gathered data on sleep and PA variables, including moderate low-intensity PA (MLPA); moderate high-intensity PA (MHPA); and vigorous-intensity PA (VPA), during health checkups conducted in Meiji Yasuda Shinjuku Medical Center in Tokyo. This study followed two cohorts from a 2008 baseline survey: (1) participants free of short sleep duration (n=7,061) and (2) participants free of insufficient sleep (n=7,385). They were divided into middle-aged (60 years; 45.7 [8.8] years for sleep duration and 45.5 [8.8] years for sleep sufficiency) and older adults (both groups aged 65.3 [4.7] years) and followed for a mean 3.4 years until 2013. Data were analyzed in 2014.Engaging in MHPA (hazard ratio [HR]=0.81, 95% CI=0.67, 0.98) and VPA (HR=0.83, 95% CI=0.71, 0.97) had a significant preventive effect on incident subjective insufficient sleep among middle-aged adults. For older adults, only MLPA (HR=0.58, 95% CI=0.42, 0.81) had a significant preventive effect on incident insufficient sleep, and PA did not significantly affect incident short sleep duration.Middle-aged adults engaging in MHPA and VPA and older adults engaging in MLPA can effectively maintain sleep sufficiency. When providing an effective PA program to prevent insomnia, the intensity of PA should correspond to the participant's age.

Aim The purpose of this study was to investigate whether the degree of improvement in cognitive function achieved with an exercise intervention in community-dwelling older Japanese women is affected by the participant's baseline cognitive function and age. Methods Eighty-eight women (mean age: 70.5±4.2 years) participated in a prevention program for long-term care. They completed the Square-Stepping Exercise (SSE) program once a week, 120 minutes/session, for 11 weeks. We assessed participants' cognitive function using 5 cognitive tests (5-Cog) before and after the intervention. We defined cognitive function as the 5-Cog total score and defined the change in cognitive function as the 5-cog post-score minus the pre-score. We divided participants into four groups based on age (≤69 years or ≥70 years) and baseline cognitive function level (above vs. below the median cognitive function level). We conducted two-way analysis of variance. Results All 4 groups improved significantly in cognitive function after the intervention. There were no baseline cognitive function level×age interactions and no significant main effects of age, although significant main effects of baseline cognitive function level (P=0.004, η(2)=0.09) were observed. Conclusion Square-Stepping Exercise is an effective exercise for improving cognitive function. These results suggest that older adults with cognitive decline are more likely to improve their cognitive function with exercise than if they start the intervention with high cognitive function. Furthermore, during an exercise intervention, baseline cognitive function level may have more of an effect than a participant's age on the degree of cognitive improvement.

Aim To investigate the validity and reliability of a novel performance test, called the "Trail Making Peg" (TMP) test, for evaluating the cognitive function. Methods We recruited 632 community-dwelling older adults (mean age: 73.3±5.2 years) as subjects for the assessment of the validity of the test and 319 adults (mean age: 73.1±5.2 years) as subjects for the assessment of reliability. Five cognitive tests (5-Cog) were used to evaluate the cognitive function, and the degree of cognitive decline was delineated for subjects scoring below 1 SD from the mean 5-Cog score. A receiver operating characteristic analysis was employed to calculate the cut-off point. Results There were no sex differences in the TMP scores (P=0.951), and the TMP and 5-Cog scores were found to correlate significantly (r=-0.63) with each other. The Trail Making Peg test demonstrated an area under the curve of 0.855 for discriminating between non-cognitive decline and cognitive decline. At this cutoff point, the sensitivity was 85% and the specificity was 69%. The intraclass correlation coefficient of the TMP was 0.746. Conclusions The TMP exhibits sufficient validity and reliability. Our results suggest that TMP is a useful screening test for detecting cognitive decline.

Fortified milk and resistance training (RT) increase muscle mass, muscle strength, and physical performance in older adults, but it remains unclear whether RT combined with aerobic training (AT) would have stronger effects on these outcomes. The purpose of this study was to examine the effects of aerobic and resistance training (ART) combined with fortified milk consumption on muscle mass, muscle strength, and physical performance in older adults. Open-labeled randomized controlled trial. Setting: University of Tsukuba. Fifty-six older adults aged 65-79. Participants were randomly allocated into resistance training (RT + fortified milk, n = 28) and aerobic and resistance training (ART + fortified milk, n = 28) groups. All participants attended supervised exercise programs twice a week at University of Tsukuba and ingested fortified milk every day for 12 weeks. Skeletal muscle index ([SMI]: appendicular lean mass/ height2) was assessed using dual-energy X-ray absorptiometry as a muscle mass measure. One-repetition maximum strength was measured using four kinds of resistance training machines (chest press, leg extension, leg curl, and leg press) as muscle strength measures. Sit-to-stand and arm curl tests were also assessed as physical performance measures. The primary measurements were muscle mass and strength. The secondary outcomes were physical performance, blood samples, habitual diet, habitual physical activity, and medication use. Although the muscle strength and physical performance measures significantly improved in both groups, SMI significantly improved in only the RT group. There was no significant difference in the change in SMI and muscle strength measures between the two groups. However, the change in sit-to-stand and arm curl measures in the ART group were significantly higher than those in the RT group. These results suggest that AT before RT combined with fortified milk consumption has similar effects on skeletal muscle mass and strength compared with RT alone, but it may be a more useful strategy to improve physical performance in older adults. Although the mechanism of our intervention is uncertain, our program would be an effective prevention for sarcopenia in older adults.

Background and purpose Whole-body vibration (WBV) training is a relatively new approach for enhancing muscle strength, physical performance, and flexibility. The aim of this study was to examine whether short-term WBV training by using the triple-plane vertical vibration device (ie, acceleration training [AT]) improves functional mobility and flexibility in healthy, older adults. Methods Eighteen healthy, older adults (9 men and 9 women; mean age 69.1 years; standard deviation, 2.5 years) participated in this randomized, crossover study. Two static stretching positions, half-squatting and hamstrings stretching, were performed with (AT) and without (control [Con]) vibration stimulus (frequency, 40 Hz; amplitude, 2-4 mm). The intervention consisted of stretching for 30 seconds per set × 3 sets per position, alternating between the 2 stretching positions. The Timed Up and Go (TUG) test was measured to determine functional mobility, which is closely linked to lower extremity muscle function. Sit-and-Reach and Functional Reach tests were performed to evaluate flexibility. Results Only the TUG test demonstrated a significant time × intervention interaction: TUG test results improved significantly immediately and 30 minutes after the AT but not after the Con intervention. We found significant main effects of time on the Sit-and-Reach and Functional Reach results. Furthermore, the improvement rates after the AT intervention were greater than the improvement rates after the Con intervention at the immediate and 30-minute posttests. Conclusion Short-term WBV training by using the triple-plane vertical vibration device elicited a significantly larger improvement in functional mobility than training without WBV. The effect on flexibility was similar with and without vibration stimulus, but there was a greater tendency to improve with WBV training in healthy, older adults. In addition, these short-term effects were maintained for about 30 minutes.

Objective We investigated associations of walking and other leisure-time physical activity (LTPA) with environmental characteristics and transportation modes in older Japanese adults. Methods This cross-sectional study in 2010–2011 used data from 421 community-dwelling older adults aged 65–85 years living in Kasama City, rural Japan. We used the Physical Activity Scale for the Elderly to assess walking and other LTPAs, and the International Physical Activity Questionnaire Environment Module for neighborhood environments. Results After adjusting for confounders, we found that good traffic safety and aesthetics were positively associated with high levels of walking (ORs = 1.64–2.12); whereas, good access to public transportation was negatively associated with walking (OR = 0.64, 95% CI = 0.42–0.98). Good access to recreational facilities, presence of sidewalks, absence of hills, seeing people exercise, and aesthetically pleasing surroundings were positively associated with high levels of LTPA except walking (ORs = 1.61–2.13). Individuals who rode bicycles more than once per week were more likely to engage in a LTPA except walking (1–3 days: OR = 1.72, 95% CI = 1.03–2.87; ≥ 4 days: OR = 2.90, 95% CI = 1.71–4.93). Conclusion This study adds information on correlates of physical activity among older Japanese adults; the positive association between LTPA except walking and the frequency of bicycle travel is an especially new and intriguing finding.

The present study examines factors affecting individuals' awareness of certain types of preventive care exercises, particularly the distance from their home to an exercise facility and their social networks.Participants were 3206 men (age, 73.0±6.2 years) and 3395 women (age, 73.2±6.4 years) aged ≥65 years who had not been certified as persons with care needs and who had responded to an inventory survey conducted in Kasama City, Japan, in 2013. We performed multiple logistic regression analysis to assess the characteristics associated with participants' awareness of two types of exercises for preventive care: "silver rehabili taisou" (SRT) and "square-stepping exercise" (SSE). Independent variables were distance from home to the exercise facility, social networks, transportation availability, physical function, cognitive function, and neighborhood population density.Older adults who were aware of the exercises lived significantly closer to an exercise facility (SRT, aware: 1,148.5±961.3 m vs. unaware: 1,284.2±1,027.4 m; SSE, aware: 1,415.9±1104.1 m vs. unaware: 1,615.7±1,172.2 m). Multiple logistic regression analysis showed that participation in community activities (men, SRT-odds ratio [OR]=2.54 and SSE-OR=2.19; women, SRT-OR=4.14 and SSE-OR=3.34] and visiting friends (men, SRT-OR=1.45 and SSE-OR=1.49; women SRT-OR=1.44 and SSE-OR=1.73) were promoting factors for awareness of both types of exercises. In men and women, low physical function (SRT-OR=0.73 and SSE-OR=0.56) and dependence on another person to drive them to the destination (SRT-OR=0.79 and SSE-OR=0.78) were inhibiting factors, respectively. A distance of500 m between their home and the facility tended to be an inhibiting factor.A shorter distance from home to an exercise facility and better social networks increased awareness of preventive care exercises in both sexes and for both types of exercise. Establishing exercise centers and devising effective methods of imparting information to individuals (e.g., via community magazines and home visits) may promote participation in preventive care exercises.

To explore the relationships between the built environment and older adults' physical function.The present cross-sectional study carried out in 2010-2012 used data drawn from 509 community-dwelling older adults aged 65-86 years living in Kasama City, a Japanese rural region. We evaluated physical function with the following performance tests: grip strength, sit-to-stand, timed upgo and walking speed. Using geographic information systems, we measured population density and the number of destinations related to daily life, community centers, medical facilities and recreational facilities within participants' neighborhoods.After adjusting for potential confounders, we found lower population density was related to poor performance of sit-to-stand and walking speed in both sexes, and grip strength in women (trend P 0.05). A lower number of daily life-related destinations was related to poor performance of sit-to-stand and walking speed in men, and grip strength and sit-to-stand in women. Similarly, the number of community centers was related to walking speed in both sexes. The number of medical and recreational facilities was also related to some physical performance in both sexes. A lower land use mix score, calculated by principal component analysis, was related to lower performance of sit-to-stand and walking speed in men, and grip strength and sit-to-stand in women.The present study suggests that, although there are some sex differences, low population density, land use mix, and fewer daily life-related destinations, community centers, medical facilities and recreational facilities are negative determinants of physical function. Geriatr Gerontol Int 2017; 17: 382-390.

AIM The purpose of this study was to investigate determinants of changes in physical fitness after a fall-prevention exercise program in older females. METHODS The study subjects included 83 community-dwelling females 65 years of age or older (mean age: 70.4±4.0 years) living in Kasama City, rural Japan. All subjects participated in a fall-prevention exercise program called square-stepping exercise (SSE) conducted once a week for 11 weeks. In order to assess the physical fitness benefits of by the exercise program, we measured the results of five physical performance tests: grip strength, one leg stand, sit and reach, timed up and go and the choice-stepping reaction time. In addition, we evaluated comprehensive physical fitness scores based on the standardized total score of the five physical performance tests. The changes in the comprehensive physical fitness score between baseline and after the program was used as the dependent variable, while the baseline values of age, education, clinical history, physical activity, Lubben social network scale, geriatric depression scale, five cognitive function test result, comprehensive physical fitness score and percentage of attendance were treated as independent variables. RESULTS A stepwise multiple regression analysis revealed that the change in comprehensive physical fitness score correlated significantly with the baseline values of age (β=-0.273), the five cognitive function test result (β=0.293) and comprehensive physical fitness score (β=-0.607). CONCLUSIONS These results suggest that older females with a low level of physical fitness at baseline are more likely to improve their physical fitness with a period of exercise training. However, the improvements in physical fitness are lower in older females with a low level of cognitive function than in those with a high level of cognitive function.

Background: Research has shown that engaging in leisure-time physical activity (LTPA) and consuming dairy foods can lead to better sleep. Combining these two non-invasive prescriptions may be more effective for helping people fall asleep. This study investigates whether participating in LTPA in conjunction with consuming milk and milk products has a beneficial association with difficulty initiating sleep (DIS) among older adults. Methods: The present study looked at 421 community-dwelling older people aged 65 years and older living in Ibaraki prefecture, Japan (mean age 74.9 ± 5.5 years, male 43.7%). We measured LTPA and sleep latency with the Physical Activity Scale for the Elderly and the Pittsburgh Sleep Quality Index, respectively. Participants who needed 30 minutes or more to fall asleep were defined as having DIS. We assessed dairy consumption as participants’ habitual intake of milk, yogurt and cheese. Results: After adjusting for covariates, participants who engaged in sufficient levels of LTPA as well as consumed milk (OR = 0.27, 95% CI = 0.10-0.73) or cheese (OR = 0.34, 95% CI = 0.14-0.85) were less likely to complain of DIS compared with people who neither engaged in LTPA nor ingested milk or cheese. Conclusions: Our findings suggest that the combination of engaging in LTPA and consuming milk or cheese is necessary as a prescription to improve falling asleep for older adults suffering from DIS. Additionally, engaging in LTPA along with dairy consumption may effectively improve a problem with falling asleep. peerReviewed

This study aimed to compare relationships of leisure-time, household, and work-related physical activity (PA) with physical performance by age and gender in older Japanese adults.This cross-sectional study included 525 community-dwelling older adults (73.3 ± 5.2 years) recruited in 2009-2011 in Kasama City, rural Japan. We used the Physical Activity Scale for the Elderly to assess PA variables. Physical performance was evaluated by 11 performance tests: grip strength, single-leg balance, functional reach, sit-and-reach, standing time from long sitting position, sit-to-stand, timed up and go, habitual walk, hand working, and simple and choice reaction times.After adjusting for potential confounders, leisure-time PA in young-old (≤ 74 years) men correlated significantly with eight performance tests (absolute value of Spearman's partial rank correlation coefficient: r = 0.18-0.39), whereas in old-old (≥ 75 years) men it correlated with three performance tests (r = 0.20-0.23). Although leisure-time PA correlated with six performance tests (r = 0.19-0.22) in young-old women, there were no significant correlations between leisure-time PA and performance tests in old-old women. Household PA of young-old men (r = 0.20-0.23) and old-old women (r = 0.26-0.34) correlated with four performance tests. In old-old men and young-old women, no significant correlation was found between household PA and performance tests. Work-related PA did not relate significantly to any performance tests in any groups.This study showed that leisure-time PA is related to physical performance, especially in young-old men and women, and household PA is especially related in young-old men and old-old women. Our findings suggest that supporting strategies for maintaining physical functions would differ by gender and age.