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The physical function of older patients with heart failure (HF) is likely to decline, and the Short Physical Performance Battery (SPPB) is widely used for its evaluation. No study has analyzed the SPPB by using Rasch model in these patients. The aim of this study was to examine the structural validity and item response of the SPPB in older inpatients with HF. In this multicenter cross-sectional study, we investigated 106 older inpatients with HF. We evaluated the SPPB's rating scale structure, unidimensionality, and measurement accuracy (0 = poor performance to 4 = normal performance). The SPPB rating scale fulfilled the category functioning criteria. All items fit the underlying scale construct. The SPPB demonstrated adequate reliability (person reliability = 0.81) and separated persons into four strata: those with very low, low, moderate, and high physical performance. Item-difficulty measures were −0.59 to 0.96 logits, and regarding the person ability-item difficulty matching for the SPPB, the item was somewhat easy (the mean of person ability = 0.89 logits; mean of item difficulty = 0.00). The SPPB has strong measurement properties and is an appropriate scale for quantitatively evaluating physical function in older patients with HF. For older adults with heart failure (HF), the Short Physical Performance Battery (SPPB) is often used to measure physical performance. Rasch analysis revealed that SPPB had strong measurement properties in older adults with HF. This result may help rehabilitation professionals use the SPPB as a physical performance scale in clinical practice to aid decision-making in intervention planning. [ABSTRACT FROM AUTHOR]

In the assessment of skeletal muscle strength, rate of force development (RFD) is clinically identified as a functional index that reflects the effects of aging, but there are few reports on RFD of the tongue. The purpose of this study was to examine the relationship between RFD of tongue pressure (RFD-TP) and oral and whole-body physical performance in older adults, and to clarify its characteristics. We enrolled adults aged ≥65 years with pathological occlusal contact in premolar and molar regions of teeth in the Tamba-Sasayama area, Japan, from 2017 to 2018. Maximum tongue pressure (MTP) and the speed to reach the maximum tongue pressure (RFD-TP) were evaluated as measures of tongue function. Oral functions related to objective measures of tongue function, such as repetitive saliva swallowing test, oral diadochokinesis, and physical status or performance, such as mini mental state examination, body mass index, skeletal mass index, knee extension force, one-leg standing time, grip strength, walking speed, timed up-and-go test, and five-time chair stand speed was evaluated. No significant correlation was found between MTP and age, but RFD-TP had a significant negative correlation with age. Neither RFD-TP nor MTP showed a significant correlation with oral function. RFD-TP was associated with physical performance, such as knee extension force and one-leg standing time. RFD-TP is more sensitive to aging than MTP. In addition, RFD-TP is related to physical performance and may be useful for the early detection of frailty. [ABSTRACT FROM AUTHOR]

Osteoporosis, vertebral fractures, and spinal degenerative diseases are common conditions that often coexist in older adults. This study aimed to determine the factors influencing low back pain and its impact on activities of daily living (ADL) and physical performance in older individuals with multiple comorbidities. This cross-sectional study was part of a large-scale population-based cohort study in Japan, involving 1009 participants who underwent spinal magnetic resonance imaging (MRI) to assess cervical cord compression, radiographic lumbar spinal stenosis, and lumbar disc degeneration. Vertebral fractures in the thoracolumbar spine were evaluated using sagittal MRI with a semi-quantitative method. Bone mineral density was measured using dual-energy X-ray absorptiometry. Low back pain, Oswestry Disability Index (ODI), and physical performance tests, such as one-leg standing time, five times chair-stand time, maximum walking speed, and maximum step length, were assessed. Using clinical conditions as objective variables and image evaluation parameters as explanatory variables, multiple regression analysis showed that vertebral fractures were significantly associated with low back pain and ODI. Vertebral fractures and osteoporosis significantly impacted physical performance, whereas osteoporosis alone did not affect low back pain or ODI. Our findings contribute to new insights into low back pain and its impact on ADL and physical performance., (© 2024. The Author(s).)

Background: While gait speed, one-leg standing balance, and handgrip strength have been shown to be independent predictors for functional disability, it is unclear whether such simple measures of physical function contribute to improved risk prediction of functional disability in older adults.Methods: A total of 1,591 adults aged ≥ 65 years and without functional disability at baseline were followed up for up to 7.9 years. Functional disability was identified using the database of Japan's Long-term Care Insurance System. Maximum gait speed, one-leg standing time, and handgrip strength were measured at baseline. Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95 % confidence intervals (CIs) for the association of physical function and functional disability incidence. The incremental predictive value of each physical function measure for risk prediction was quantified using the difference in overall C-statistic, category-free net reclassification improvement (NRI), and integrated discrimination improvement (IDI) index.Results: During follow-up (median: 7.8 years), functional disability was identified in 384 participants. All of the physical function measures were inversely associated with the risk of functional disability, independent of potential confounding factors. The multivariable adjusted HRs (95 % CIs) for functional disability per one standard deviation increment of maximum gait speed, one-leg-standing time, and hand grip strength were 0.73 (0.65-0.83), 0.68 (0.59-0.79), and 0.72 (0.59-0.86), respectively. Incorporation of each of maximum gait speed, one-leg-stand time, and hand grip strength into a basic model with other risk factors significantly improved C-statistic from 0.770 (95 % CIs, 0.751-0.794) to 0.778 (0.759-0.803), 0.782 (0.760-0.805), and 0.775 (0.756-0.800), respectively (all p < 0.05). A model including all three measures had the highest C-statistic of 0.787 (0.765-0.810). The improvements in risk prediction were also confirmed by category-free NRI and IDI index.Conclusions: Adding any of the three measures to a basic model with other known risk factors significantly improved the prediction of functional disability and addition of all three measures provided further improvement of the prediction in older Japanese adults. These data provide robust evidence to support the practical utility of incorporating these simple physical function measures into functional disability risk prediction tools. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to examine whether long-term ingestion of low-dose milk protein supplementation causes a greater increase in muscle mass and strength of older adults during low-to-moderate intensity exercise training intervention than isocaloric carbohydrate. Methods: In a randomized, double-blind, and placebo-controlled design, 122 healthy older adults (60–84 year) received either an acidified milk protein drink containing 10 g of milk protein (MILK; n = 61) or an isocaloric placebo drink (PLA; n = 61) daily throughout 6 months of body weight and medicine ball exercise training. Measurements before and after the intervention included body composition, physical performance and blood biochemistry. Results: Lean body mass significantly increased in the MILK group (+ 0.54 kg, p < 0.001), but did not change in the PLA group (− 0.10 kg, p = 0.534). The increases in the MILK group were significantly greater than in the PLA group (p = 0.004). Fat mass (− 0.77 kg) and plasma uric acid levels (− 0.3 mg/dL) significantly decreased only in the MILK group (p < 0.001), with a significant group difference (p = 0.002 and p < 0.001, respectively). Most of the physical performance tests significantly improved in both groups, but no group differences were found. Conclusion: We conclude that low-dose milk protein supplementation (10 g of protein/day) combined with low-to-moderate intensity exercise training is associated with increased muscle mass, but not improved physical performance compared to carbohydrate combined with exercise in healthy older adults. This study was registered in the UMIN Clinical Trials Registry (UMIN000032189). [ABSTRACT FROM AUTHOR]

Aging of society has increased the incidence of physical disability. The goal of this study was to examine the physical ability of elderly people classified as having sarcopenia, presarcopenia, or dynapenia (a low muscle function without low muscle mass) in a community in Japan. The subjects were volunteers aged >60 years who were participants in a health checkup in Yakumo, Hokkaido and were in good general health. Demographic data were collected and physical performance tests were performed to measure grip strength, walking speed, back muscle strength, maximum stride length, and 3-m timed-up-and-go (3m TUG) time. A measurement of skeletal muscle mass was used as a basis for calculating the appendicular skeletal muscle index (aSMI). The rates of sarcopenia, presarcopenia, and dynapenia were 10%, 22%, and 8% in males (n=101, age 69.7±5.4 years), and 19%, 23%, and 13% in females (n=112, 68.5±5.9 years). Body mass index in subjects with dynapenia was significantly higher compared to that in subjects with sarcopenia and presarcopenia (p<0.01). Back muscle strength, maximum stride length and 3m TUG were similar in dynapenia and sarcopenia, but differed significantly with those in presarcopenia in both males and females without the influence of age (p<0.05). Further studies are needed to evaluate the benefits of dynapenia intervention programs and to explore the underlying pathophysiology of dynapenia. [ABSTRACT FROM AUTHOR]

BACKGROUND: Age- and lifestyle-related changes in respiratory and physical function affect cough strength. However, in older adults, the main factors that relate to cough strength remain unclear. This study was a preliminary investigation of factors that contribute to cough strength and the relationships between cough strength and respiratory function, physical performance, physical activity, and sedentary behavior in community-dwelling older adults. METHODS: By using accelerometers and other tools, we assessed cough peak flow (CPF), FVC, maximum inspiratory pressure (PImax), maximum expiratory pressure (PEmax), chest and abdominal wall mobility (breathing movement scale), physical performance (Timed Up and Go test and 30-s chair stand test), physical activity (steps, and locomotive and non-locomotive moderate-to-vigorous physical activity), and sedentary behavior (sedentary time) in 65 community-dwelling older adults (25 males and 40 females) without air-flow limitation. RESULTS: Twenty-six percent of the subjects (17/65) had reduced CPF (<240 L/min). The subjects with reduced CPF had significantly lower FVC, PImax, PEmax, chest and abdominal wall mobility, physical performance, and locomotive moderate-to-vigorous physical activity compared with those with non-reduced CPF. Significant correlations between CPF and variables of respiratory function (FVC, PImax, PEmax, and breathing movement scale) and physical performance were weak to moderate. FVC and PImax were independently associated with CPF during the multiple regression analysis adjusted for sex, age, and height. The receiver operating characteristic analysis showed that FVC and PImax had fair-to-good sensitivity for detecting reduced CPF. CONCLUSIONS: Analysis of our results indicated that FVC and PImax were related to CPF and provided preliminary evidence that supported strategies for preserving and improving cough strength in community-dwelling older adults. [ABSTRACT FROM AUTHOR]

Objectives: To investigate whether supplementation with low-dose dairy protein plus micronutrients augments the effects of resistance exercise (RE) on muscle mass and physical performance compared with RE alone among older adults.Design: Randomized controlled trial.Setting: Tokyo, Japan.Participants: Eighty-two community-dwelling older adults (mean age, 73.5 years) were randomly allocated to an RE plus dairy protein and micronutrient supplementation group or an RE only group (n = 41 each).Intervention: The RE plus supplementation group participants ingested supplements with dairy protein (10.5 g/day) and micronutrients (8.0 mg zinc, 12 μg vitamin B12, 200 μg folic acid, 200 IU vitamin D, and others/day). Both groups performed the same twice-weekly RE program for 12 weeks.Measurements: Whole-body, appendicular, and leg lean soft-tissue mass (WBLM, ALM, and LLM, respectively) with dual-energy X-ray absorptiometry, physical performance, biochemical characteristics, nutritional intake, and physical activity were measured before and after the intervention. Data were analyzed by using linear mixed-effects models.Results: The groups exhibited similar significant improvements in maximum gait speed, Timed Up-and-Go, and 5-repetition and 30-s chair stand tests. As compared with RE only, RE plus supplementation significantly increased WBLM (0.63 kg, 95% confidence interval [CI]: 0.31-0.95), ALM (0.37 kg, 95% CI: 0.16-0.58), LLM (0.27 kg, 95% CI: 0.10-0.46), and serum concentrations of 25-hydroxyvitamin D (4.7 ng/mL, 95% CI: 1.6-7.9), vitamin B12 (72.4 pg/mL, 95% CI: 12.9-131.9), and folic acid (12.9 ng/mL, 95% CI: 10.3-15.5) (all P < 0.05 for group-by-time interactions). Changes over time in physical activity and nutritional intake excluding the supplemented nutrients were similar between groups.Conclusion: Low-dose dairy protein plus micronutrient supplementation during RE significantly increased muscle mass in older adults but did not further improve physical performance. [ABSTRACT FROM AUTHOR]

Background: Numerous reported studies have shown that vertebral compression fractures are associated with impaired function or disability; however, few examined their association with objective measures of physical performance or functioning.Methods: We examined the association of vertebral compression fractures with physical performance measures in 556 Japanese women aged 40-89 years. Lateral spine radiographs were obtained and radiographic vertebral compression fractures were assessed by quantitative morphometry, defined as vertebral heights more than 3 SD below the normal mean. Measures of physical performance included walking speed, chair stand time and functional reach. Adjusted means of performance-based measures according to the number and severity of vertebral compression fractures were calculated using general linear modeling methods.Results: After adjusting for age, body mass index, back pain, number of painful joints, number of comorbidities and regular physical activities, the walking speed of women with two or more compression fractures (1.17 m/s) was significantly slower than that of women without compression fracture (1.24 m/s) (p = 0.03). Compared with women without compression fracture, chair stand time was longer in women with two or more compression fractures (p = 0.01), and functional reach was shorter (p = 0.01). No significant differences were observed in walking speed, chair stand time, or functional reach between women with one compression fracture and those without compression fracture.Conclusions: Having multiple vertebral compression fractures affects physical performance in community-dwelling Japanese women. Poor physical functioning may lead to functional dependence, accelerated bone loss, and increased risk for falls, injuries, and fractures. Preventing vertebral compression fracture is considered important for preserving the independence of older adults. [ABSTRACT FROM AUTHOR]

Aim: Recent meta-analyses of the literature confirmed the association between the RR+RX genotype of theACTN3R577X polymorphism and elite sprint/power athletic status in Europeans but not in Asians and Africans, while the association between the R577X genotype and elite endurance athlete status is less convincing. The aim of the present study was to investigate the association between theACTN3R577X genotype and elite athlete status in a large Asian (Japanese) cohort of track and field athletes. Methods: One-thousand fifty-seven Japanese track and field athletes (627 sprint/power athletes and 430 endurance athletes) and 810 Japanese controls were genotyped for theACTN3R577X polymorphism (rs1815739) by using the TaqMan® SNP Genotyping Assay. Results: Elite sprint/power athletes had a higher frequency of the RR+RX genotype than the controls (OR: 1.59, 95% CI: 1.16–2.18;P = .003). A significant linear correlation was found between the RR + RX genotype and athlete status (i.e. regional < national < international) in sprint/power athletes (regional: 71%, national: 81%, international: 84%;P = .001 for trend) and long-distance runners (regional: 65%, national: 72%, international: 82%;P = .030 for trend). Conclusions: The data obtained for this large Asian (Japanese) cohort of track and field athletes served to confirm the association between the RR + RX genotype of theACTN3R577X polymorphism and elite sprint/power athlete status and also the association between theACTN3RR + RX genotype and long-distance running athletic status. [ABSTRACT FROM PUBLISHER]

Background: Poor physical ability and skeletal muscle wasting are common in chronic kidney disease (CKD) patients, who may experience a decline in daily activity and, in turn, increased mortality. The purpose of this study was to evaluate the effectiveness and safety of modest exercise in patients with stable CKD. Methods: Forty-seven CKD patients were enrolled in a 6-month group program for aerobic and resistance exercise by self-training. Parameters of physical function and clinical laboratory markers, including renal function, were measured. Results: The International Physical Activity Questionnaire score improved from a baseline of 36.6 ± 13.8 to 40.1 ± 14.8 after the exercise program ( P < 0.001). The number of daily steps increased from 6141 ± 2620 to 7679 ± 3026 ( P < 0.001). We detected significant changes in the 30-s chair stand test (from 20.7 ± 5.3 to 26.0 ± 5.9 repetitions; P < 0.001), single-foot standing test (from 53.0 ± 44.3 to 68.4 ± 43.0 s; P = 0.001) and 6-min walk (from 501.6 ± 63.8 to 528.7 ± 71.8 m; P = 0.02). Moreover, body weight, waist circumference, and blood pressure were significantly reduced. No significant deterioration was observed in the estimated glomerular filtration rate. Proteinuria significantly decreased in 21 patients. Conclusion: Our modest exercise program improved the physical performance of CKD patients without deterioration of renal function. These results suggest that exercise rather than excess rest should be recommended for CKD patients to avoid muscle wasting. [ABSTRACT FROM AUTHOR]

Background: 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. Aim: 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. Methods: 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. Results: 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. Discussion: The results of the present study were consistent with previous studies mainly conducted in European and American countries. Conclusion: 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. [ABSTRACT FROM AUTHOR]

Background and aims: Little is known about differences in the risk of poor nutritional status as assessed by the Geriatric Nutritional Risk Index (GNRI) in relation to physical performance in elderly female cardiac inpatients. The present study aimed to determine both differences in physical performance based on the GNRI and physical performance cut-off values according to the GNRI in elderly female cardiac inpatients. Methods: We enrolled 105 consecutive female Japanese inpatients aged ≥65 years (mean age, 74.6 years) with cardiac disease in this cross-sectional study. We divided the patients into two groups according to GNRI: high-GNRI group (≥92 points) ( n = 71) and low-GNRI group (<92 points) ( n = 34). Handgrip strength (HG), knee extensor muscle strength (KEMS), gait speed (GS), and one-leg standing time (OLST) were assessed as indices of hospital physical performance and compared between the two groups to determine cut-off values of physical performance. Results: After adjustment for age and left ventricular ejection fraction, HG, KEMS, GS, and OLST were significantly lower in the low-GNRI versus high-GNRI group. Cut-off values by ROC curve analysis were 16.2 kgf (AUC = 0.66; p < 0.001) for HG, 34.3 % of body weight (AUC = 0.62; p = 0.04) for KEMS, 1.24 m/s (AUC = 0.72; p < 0.01) for GS, and 8.28 s (AUC = 0.62; p = 0.04) for OLST. Conclusion: The risk of poor nutrition, as indicated by a low GNRI, might be a predictor of lower physical performance. Cut-off values determined in this study might be minimum target goals for physical performance that can be attained by elderly female cardiac inpatients. [ABSTRACT FROM AUTHOR]

Objective The purpose of this study was to determine whether frailty is an important and independent predictor of incident depressive symptoms in elderly people without depressive symptoms at baseline. Design Fifteen-month prospective study. Setting General community in Japan. Participants A total of 3025 community-dwelling elderly people aged 65 years or over without depressive symptoms at baseline. Measurements The self-rated 15-item Geriatric Depression Scale was used to assess symptoms of depression with a score of 6 or more at baseline and 15-month follow-up. Participants underwent a structural interview designed to obtain demographic factors and frailty status, and completed cognitive testing with the Mini-Mental State Examination and physical performance testing with the Short Physical Performance Battery as potential predictors. Results At a 15-month follow-up survey, 226 participants (7.5%) reported the development of depressive symptoms. We found that frailty and poor self-rated general health (adjusted odds ratio 1.86, 95% confidence interval 1.30–2.66, P < .01) were independent predictors of incident depressive symptoms. The odds ratio for depressive symptoms in participants with frailty compared with robust participants was 1.86 (95% confidence interval 1.05–3.28, P = .03) after adjusting for demographic factors, self-rated general health, behavior, living arrangements, Mini-Mental State Examination, Short Physical Performance Battery, and Geriatric Depression Scale scores at baseline. Conclusions Our findings suggested that frailty and poor self-rated general health were independent predictors of depressive symptoms in community-dwelling elderly people. [ABSTRACT FROM AUTHOR]

Aim Nutrition is the focus of a new treatment target in older hospitalized cardiac patients. However, little is known about the differences in nutritional status in relation to physical performance in these inpatients. We determined the differences in physical performance based on the Geriatric Nutritional Risk Index ( GNRI) and physical performance cut-off values according to the GNRI in older male cardiac inpatients. Methods We enrolled 251 Japanese male inpatients aged ≥65 years (mean age 74.7 years) with cardiac disease in the present cross-sectional study. We divided the patients into two groups according to GNRI: high- GNRI group (≥92 points; n = 178) and low- GNRI group (<92 points; n = 73). In-hospital physical performance as measured by handgrip strength ( HG), knee extensor muscle strength ( KEMS), gait speed ( GS), and one-leg standing time ( OLST) was assessed and compared between the two groups to determine cut-off values of physical performance. Results After adjustment for age, HG, KEMS, GS and OLST were significantly lower in the low- GNRI versus high- GNRI group. Cut-off values by receiver operating characteristic curve analysis were 25.75 kgf (area under the curve [ AUC] = 0.740; P < 0.001) for HG strength, 46.1% for bodyweight ( AUC = 0.742; P < 0.01) for KEMS, 1.45 m/s ( AUC = 0.782; P < 0.01) for GS and 11.32 s ( AUC = 0.705; P < 0.01) for OLST. Conclusion The risk of poor nutrition, as shown by a low GNRI, could be a useful predictor of physical performance. The cut-off values determined in the present study might be expected minimum target values that can be attained by Japanese older male cardiac inpatients. Geriatr Gerontol Int 2015; 15 189-195. [ABSTRACT FROM AUTHOR]

Aim It is very important to maintain cognitive function in patients with mild cognitive disorder. The aim of the present study was to determine whether the amount of physical activity is associated with memory function in older adults with mild cognitive disorder. Methods A total of 47 older adults with mild cognitive disorder were studied; 30 were diagnosed with mild Alzheimer's disease and 17 with mild cognitive impairment. The global cognitive function, memory function, physical performance and amount of physical activity were measured in these patients. We divided these patients according to their walking speed (<1 m/s or >1 m/s). A total of 26 elderly patients were classified as the slow walking group, whereas 21 were classified as the normal walking group. Results The normal walking group was younger and had significantly better scores than the slow walking group in physical performance. Stepwise multiple linear regression analysis showed that only the daily step counts were associated with the Scenery Picture Memory Test in patients of the slow walking group (β = 0.471, P = 0.031), but not other variables. No variable was significantly associated with the Scenery Picture Memory Test in the normal walking group. Conclusions Memory function was strongly associated with the amount of physical activity in patients with mild cognitive disorder who showed slow walking speed. The results show that lower physical activities could be a risk factor for cognitive decline, and that cognitive function in the elderly whose motor function and cognitive function are declining can be improved by increasing the amount of physical activity. Geriatr Gerontol Int 2014; 14: 758-762. [ABSTRACT FROM AUTHOR]

This study assessed the association between sarcopenia (using the definition of the European Working Group on Sarcopenia in Older People) and fall in the past year among community-dwelling Japanese elderly. Subjects were 1110 community-dwelling Japanese aged 65 or older. We used bioelectrical impedance analysis (BIA) to measure muscle mass, grip strength to measure muscle strength, and usual walking speed to measure physical performance in a baseline study. "Sarcopenia" was characterized by low muscle mass and low muscle strength or low physical performance. "Presarcopenia" was characterized only by low muscle mass. Subjects who did not have any of these deficiencies were classified as "normal." We then administered a questionnaire assessing age, sex, household status, chronic illness, lifestyle-related habits, and fall. This study showed the prevalence of fall was 16.9% and 21.3% in men and women, respectively, while that of sarcopenia was 13.4% and 14.9% in men and women, respectively. In men and women, the prevalence of sarcopenia was higher among those who had fallen. A logistic regression analysis using age, body fat, current drinker status, and physical inactivity for men, and age, body fat, smoking, and diabetes for women as covariate variables revealed that sarcopenia was significantly associated with a history of fall. The odds ratio for fall in the sarcopenia group relative to the normal group was 4.42 (95%CI 2.08-9.39) in men and 2.34 (95%CI 1.39-3.94) in women. This study revealed sarcopenia to be associated with falling in elderly Japanese. Sarcopenia prevention interventions may help prevent falls among elderly individuals. [ABSTRACT FROM AUTHOR]

Summary: The present cross-sectional study investigated the prevalence of sarcopenia and clarified its associated factors in 1,000 elderly participants of Japanese population-based cohorts. Exercise habit in middle age was associated with low prevalence of sarcopenia in older age, suggesting that it is a protective factor against sarcopenia in older age. Introduction: The present study investigated the prevalence of sarcopenia using the European Working Group on Sarcopenia in Older People (EWGSOP) definition, and clarified the association of sarcopenia with physical performance in the elderly participants of Japanese population-based cohorts of the Research on Osteoarthritis/osteoporosis Against Disability (ROAD) study. Methods: We enrolled 1,000 participants (aged ≥65 years) from the second visit of the ROAD study who had completed assessment of handgrip strength, gait speed, and skeletal muscle mass measured by bioimpedance analysis. Presence of sarcopenia was determined according to the EWGSOP algorithm. Information collected included exercise habits in middle age. Results: Prevalence of sarcopenia was 13.8 % in men and 12.4 % in women, and tended to be significantly higher according to increasing age in both sexes. Factors associated with sarcopenia, as determined by logistic regression analysis, were chair stand time (odds ratio [OR], 1.09; 95 % confidence interval [CI], 1.04-1.14), one-leg standing time (OR, 0.97; 95 % CI, 0.96-0.99), and exercise habit in middle age (OR, 0.53; 95 % CI, 0.31-0.90). Exercise habit in middle age was associated with low prevalence of sarcopenia in older age. Furthermore, linear regression analysis revealed that exercise habits in middle age were significantly associated with grip strength ( P < .001), gait speed ( P < .001), and one-leg standing time ( P = .005) in older age. Conclusions: This cross-sectional study suggests that exercise habit in middle age is a protective factor against sarcopenia in older age and effective in maintaining muscle strength and physical performance in older age. [ABSTRACT FROM AUTHOR]

The article presents information on a study conducted to evaluate the effects of high-velocity resistance training on muscle function, muscle properties, and physical performance in patients suffering from hip osteoarthritis. In the study, women with hip osteoarthritis underwent home-based resistance training programme by using an elastic band. The study concluded that high-velocity training has a greater effect on muscle properties and physical performance.

Aim The present study aimed to determine the association of sarcopenia, defined by muscle mass, muscle strength and physical performance, with functional disability from a 2-year cohort study of community-dwelling elderly Japanese people. Method Participants were 743 community-dwelling elderly Japanese people aged 65 years or older. We used bioelectrical impedance analysis ( BIA) to measure muscle mass, grip strength to measure muscle strength, and usual walking speed to measure physical performance in a baseline study. Functional disability was defined using an activities of daily living ( ADL) scale and instrumental activities of daily living ( IADL) scale at baseline and during follow-up examinations 2 years later. Logistic regression analysis, adjusted for age and body mass index, was used to examine the association between sarcopenia and the occurrence of functional disability. Results In the present study, 7.8% of men and 10.2% of women were classified as having sarcopenia. Among sarcopenia patients in the baseline study, 36.8% of men and 18.8% of women became dependent in ADL at 2-year follow up. From the logistic regression analysis adjusted by age and body mass index, sarcopenia was significantly associated with the occurrences of physical disability compared with normal subjects in both men and women. Conclusions Sarcopenia, defined by muscle mass, muscle strength and physical performance, was associated with functional decline over a 2-year period in elderly Japanese. Interventions to prevent sarcopenia are very important to prevent functional decline among elderly individuals. Geriatr Gerontol Int 2013; 13: 958-963. [ABSTRACT FROM AUTHOR]

Aim To identify whether individual physical performance measures or a combination of measures is a better indicator of multiple geriatric syndromes ( MGS) defined as the concomitant presence of more than one geriatric syndrome in an individual. Methods We carried out cross-sectional analyses on data from 340 community-dwelling women aged 75 years and older (mean 80.0 years). We examined the following geriatric syndromes: urinary incontinence, falls, underweight, depression and functional decline. Trained testers measured usual gait speed ( UGS), hand-grip strength and lower extremity performance ( LEP) score derived from four LEP measures: tandem stance, chair stand test, alternate step and timed up-and-go ( TUG). We categorized UGS to distinguish high- and low-performing participants using the established 1.0 m/s cut-off point. Applying the same population percentile (35.8%), we determined cut-off points for all individual measures and the LEP score. Results The UGS, TUG and LEP score had similar discriminating powers for MGS (each with area under receiver-operator curves [ AUC] of 0.80), which were more significant than the discriminating powers of other individual measures ( AUC = 0.69-0.76) when considered as continuous variables. A slow UGS, especially less than 1.0 m/s, was more strongly associated with MGS (odds ratio [ OR] = 7.6, 95% confidence interval [ CI] = 3.6-15.9) than the same percentiles for TUG ( OR = 3.9, 95% CI = 1.9-7.8) and LEP score ( OR = 5.2, 95% CI = 2.5-10.6). Conclusion The UGS test alone might be sufficient in detecting MGS in women aged 75 years and older compared with a more comprehensive test battery. Geriatr Gerontol Int 2013; 13: 901-910. [ABSTRACT FROM AUTHOR]

The control region of mitochondrial DNA ( mtDNA) contains the main regulatory elements for mtDNA replication and transcription. Certain polymorphisms in this region would, therefore, contribute to elite athletic performance, because mitochondrial function is one of determinants of physical performance. The present study was undertaken to examine the effect of polymorphisms in this region on elite athlete status by sequencing the mtDNA control region. Subjects comprised 185 elite Japanese athletes who had represented Japan at international competitions (i.e., 100 endurance/middle-power athletes: EMA; 85 sprint/power athletes: SPA), and 672 Japanese controls ( CON). The mtDNA control region was analyzed by direct sequencing. Frequency differences of polymorphisms (minor allele frequency ≥ 0.05) in the mtDNA control region between EMA, SPA, and CON were examined. EMA displayed excess of three polymorphisms [m. 152T> C, m.514( CA)n repeat ( n ≥ 5), and poly- C stretch at m.568-573 ( C ≥ 7)] compared with CON. On the other hand, SPA showed greater frequency of the m.204T> C polymorphism compared with CON. In addition, none of the SPA had m.16278 C> T polymorphism, whereas the frequencies of this polymorphism in CON and EMA were 8.3% and 10.0%, respectively. These findings imply that several polymorphisms detected in the control region of mtDNA may influence physical performance probably in a functional manner. [ABSTRACT FROM AUTHOR]

The article reports on research which was conducted to investigate whether true or apparent leg length discrepancy was a better predictor of short term functional outcomes after total hip arthroplasty. Researchers evaluated leg length discrepancy in 53 arthroplasty patients. They found that apparent leg length discrepancy was a better predictor of outcome.

Our study aimed to investigate the physical performance and quality of life (QOL) as associated factors with self-rated health (SRH). Japanese community-dwelling women aged 65 years or more ( n = 51; mean age = 75.3 ± 6.0) answered a questionnaire regarding socio-demographic information, SRH, QOL by the Short Form-8, and performed the physical tests, such as Timed Up and Go, Functional Reach (FR), One Leg Stand (OLS), Five Chair Stands (CS), and hand grip strength (HGS). Smoking ( p = 0.04), more medical consultations ( p = 0.03), and more number of medications ( p = 0.001) were significantly associated with poor self-assessment of their health. Moreover, those who assessed their health condition as not so good to bad condition had lower performance in FR ( p = 0.02), HGS ( p = 0.04), OLS ( p = 0.05), and CS ( p = 0.02), and poorer QOL condition in general health ( p < 0.01), bodily pain ( p = 0.02), and vitality ( p = 0.03) in comparison with the other SRH groups (good and/or normal). Therefore, we encouraged the use of the SRH assessment and the interpretation of its results based on the present findings such as associating the SRH of older women with their physical performance and QOL. [ABSTRACT FROM AUTHOR]

Background: The oldest old, defined as those aged 90 or over, is now the fastest-growing population sector. This study aimed to determine reference values for several physical performance measures (PPMs) among 90-year-olds using internationally standardized measurements and to clarify the characteristics of these indices by comparing their results for 90-year-olds with those for older people 70 and 80., Methods: We used the Septuagenarians, Octogenarians, and Nonagenarians Investigation with Centenarians (SONIC) study data from 2010 to 2018. The study subjects were 70, 80, and 90-year-olds in the target area eligible to participate in the venue. Excluding those certified for long-term care, the final number of eligible persons is 70s cohort 1000 (2010), 80s cohort 973 (2011), and 90s cohort 690. 90s cohort only consisted of three survey waves: 2012, 2015, and 2018. We used hand grip strength and score on the Short Physical Performance Battery (SPPB) for our physical performance measurements. In addition, we statistically analyzed sex and age differences., Result: The simple mean ± standard deviation (SD) for the 90-year-old respondents were in men, 24.1 ± 5.4 kg in hand grip strength, 0.80 ± 0.22 m/s in usual gait speed, 17.2 ± 6.73 s in 5times chair stand, 5.89 ± 4.42 s in tandem balance, and 8.3 ± 2.2 in SPPB respectively and in women, 14.4 ± 4.0 kg in hand grip strength, 0.72 ± 0.20 m/s in usual gait speed, 17.8 ± 7.89 s in 5times chair stand, 4.72 ± 4.35 s in tandem balance, and 7.5 ± 2.4 in SPPB, respectively. For all PPMs, the age 90 cohort was statistically significantly different from the age 70 and 80 cohorts (all trends P <  0.001). Hand grip strength decreased with a similar gradient with age cohort increase of 10 years for both sexes. In contrast, SPPB lower limb score showed a larger drop between the age 80 and 90 cohorts than between the age 70 and 80 cohorts. We also constructed sex-specific appraisal standards according to quintiles., Conclusions: Our study yielded inclusive sex-specific reference values and appraisal standards for major physical performance measures not certified as requiring long-term care, community-dwelling, oldest old Japanese. The characteristics of age-related decline in physical performance differed between the upper and lower extremity assessments., (© 2022. The Author(s).)

The article presents a study on the prevalence of cervical cord compression (CCC) and the link between CCC and physical performance measures in a population-based cohort in Japan. The researchers evaluated images of the cervical spine of subjects who underwent magnetic resonance imaging (MRI) examinations. It was found that the prevalence of CCC was higher in men. The correlation of CCC with physical performance measures from an early stage of the disease before the myelopathic signs is noted.

Osteoarthritis (OA) is the most common chronic joint disorder. Relationships between knee OA and physical performance have been examined, but mainly in patients with knee OA. Clarifying the relationship between knee OA and physical performance among community-dwelling individuals is thus important. Subjects comprised 563 community-dwelling Japanese women. Radiographic knee OA was defined as Kellgren-Lawrence criteria grade 2 or higher. Painful knee OA was defined as radiographic OA combined with knee pain. We evaluated performance-based measures of physical functioning. Student's t tests were used to compare continuous variables. Adjusted means of performance-based measures were compared between groups using general linear modeling methods. Mean age was 64.3 years. Women with radiographic OA were older than those without OA ( P < 0.0001). BMI was greater in women with radiographic OA than in women without OA ( P < 0.0001). In univariate analysis, women with radiographic OA displayed worse physical functioning than women without OA, with longer chair stand time, longer walking time, and shorter functional reach. Performance-based measurements with painful OA resembled those with radiographic OA. Age- and BMI-adjusted means of chair stand time and walking time were longer in women with radiographic or painful knee OA than in women without OA ( P < 0.0001 each). Furthermore, chair stand and walking took longer for women with painful knee OA than for women with radiographic knee OA. Women with knee OA showed deteriorated performance of chair stand and walking. Painful knee OA was associated with poorer performance than radiographic knee OA. [ABSTRACT FROM AUTHOR]

Background and aims: Poor physical performance is known to be inversely related to mortality. The purpose of the present study was to determine whether an association between physical performance and 10-year mortality could be extended to a Japanese 70-year-old community-dwelling population, and to compare findings with those found in an octogenarian population. Methods: Seventy-year-old subjects residing in Niigata city, Japan, participated. Baseline examinations, including a physical performance test of four tests of muscle strength, one test of balance, and one test of agility, were carried out in June 1998 for 600 participants, and these individuals were then followed for 10 years. Results: During the 10-year follow up, 80 subjects died. Cox regression analysis with adjustment for confounding factors showed that high scores in muscle strength tests for lower extremities, such as single-leg and double-leg extensor strength and isokinetic leg extensor power, were found to be related to decreases in total cause mortality. Conclusions: In an elderly 70-year-old Japanese community-dwelling population, poor muscle strength was found to be an independent predictor of total mortality. Together with our previous findings in an 80-year-old population, the association between poor strength and high mortality may have effects at 70 but not 80 years of age. (Aging Clin Exp Res 2012; 24: 257-264) [ABSTRACT FROM AUTHOR]

Physical activity (PA) is known to be inversely associated with medical care costs. The amount of PA is strongly associated with the level of physical performance among the elderly population. Therefore, it is possible that known relation between PA and medical care merely shows the relation between physical performance and medical care. To know whether PA itself relates to medical care, considering physical performance is necessary. The aim of this study was to ascertain the impact of PA on medical care expenditure by considering the physical performance in an elderly community-dwelling population. We investigated 483 subjects who did not have any history of diseases relating to limited PA and who completed both a self-administered questionnaire including questions on PA and underwent a physical performance measurement. We ascertained the total medical care costs through a computerized linkage with claims lodged between August 2002 and March 2008 with the Miyagi National Health Insurance Association. The physical performance was positively associated with their level of PA. After multivariate adjustment for covariables including the levels of physical performance, the per capita medical care costs were found to be $US 827.3 (598.0-1056.7) (mean, 95% confidence interval), $US 711.1 (476.4-945.8) and $US 702.0 (461.6-942.4) ( P for linear trend = 0.02) per month for those who had the lowest, average and the highest level of PA, respectively. This prospective study indicates that a higher level of PA is associated with lower medical care costs among the Japanese elderly irrespective of physical performance. [ABSTRACT FROM AUTHOR]

Abstract: Inflammatory cytokines may contribute to lower physical function in elderly. The purpose of this study was to clarify the relation between circulating level of C-reactive protein (CRP) and physical performance among the community-dwelling elderly in Japan. Participants were 803 (329 men and 474 women) aged 65 years and over. Four physical performances were assessed using hand-grip strength, length of time standing on one leg, and walking speed (usual and maximal). Low physical performance was defined as the lowest 25% of study sample in each sex. Multiple logistic regression analysis showed that CRP was negatively associated with physical performance in hand-grip strength (odds ratio=OR=1.86, 95% confidence interval=95% CI=1.32–3.05, OR=2.92, 95% CI=1.53–5.58, for the middle and highest, respectively), time of one leg standing (OR=1.96, 95% CI=1.28–3.00, OR=2.16, 95% CI=1.19–3.92, for the middle and highest, respectively) and maximal walking speed (OR=2.46, 95% CI=1.23–4.93, for the highest) when adjusted for the confounding factors. The results showed the negatively associated between CRP level and physical performance when adjusted for the confounding factors. CRP level may be a useful indicator for detecting the lower physical performance in elderly. [ABSTRACT FROM AUTHOR]

Deteriorating sleep quality and physical or mental fatigue in older adults leads to decreased quality of life and increased mortality rates. This study investigated the effects of the time-dependent intake of nicotinamide mononucleotide (NMN) on sleep quality, fatigue, and physical performance in older adults. This randomized, double-blind placebo-controlled study evaluated 108 participants divided into four groups (NMN&#95;AM; antemeridian, NMN&#95;PM; post meridian, Placebo&#95;AM, Placebo&#95;PM). NMN (250 mg) or placebo was administered once a day for 12 weeks. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index. Fatigue was evaluated using the "Jikaku-sho shirabe" questionnaire. Grip strength, 5-times sit-to-stand (5-STS), timed up and go, and 5-m habitual walk were evaluated to assess the physical performance. Significant interactions were observed between 5-STS and drowsiness. 5-STS of all groups on post-intervention and drowsiness of the NMN&#95;PM and Placebo&#95;PM groups on mid- and post-intervention showed significant improvement compared with those in pre-intervention. The NMN&#95;PM group demonstrated the largest effect size for 5-STS (d = 0.72) and drowsiness (d = 0.64). Overall, NMN intake in the afternoon effectively improved lower limb function and reduced drowsiness in older adults. These findings suggest the potential of NMN in preventing loss of physical performance and improving fatigue in older adults.

Background: The Asian Working Group for Sarcopenia 2019 (AWGS 2019) is the gold standard diagnostic criteria for sarcopenia in Asian populations. The calf circumference (CalF), the strength, assistance in walking, rising from a chair, climbing stairs, and falls (SARC-F) and the SARC-CalF questionnaires for sarcopenia screening have been used by AWGS 2019. The aim of this study was to assess accuracy of these three sarcopenia screening tools in patients with interstitial lung disease., Methods: In this cross-sectional study, stable patients with interstitial lung disease were enrolled. The SARC-F, SARC-CalF, and CalF, used in patients with interstitial lung disease, were compared to the diagnostic criteria proposed by AWGS 2019. The accuracy of screening tools was compared using sensitivity and specificity. Moreover, areas under the receiver operating characteristic curves (AUC) were computed., Results: Seventy eight patients were analyzed, and sarcopenia was identified in 25 (32.1%) patients with interstitial lung disease by the AWGS 2019 criteria. The sensitivity of the CalF was highest (96%) of the three screening tools, while the specificity was 60%. The sensitivity of SARC-F and SARC-CalF were 24% and 68%, while the specificity were 92% and 66%, respectively. The AUCs of CalF, SARC-F, and SARC-CalF in all patients were 0.78, 0.58, and 0.67, respectively., Conclusions: The CalF is most suitable for screening sarcopenia in patients with interstitial lung disease, while SARC-F and SARC-CalF are not., (© 2022. The Author(s).)

Background: Several studies have examined the association between physical performance and fracture in women, but few such studies have targeted elderly men. This study aimed to determine whether the combined results of several physical performance tests can predict the subsequent incidence of fractures in elderly men after adjusting for confounding factors., Methods: Of the 2174 elderly men who participated in this study, 2012 completed the baseline study visit, including physical performance tests (walking speed, hand grip strength, and one-leg standing) and measurement of bone mineral density by dual-energy X-ray absorptiometry. Follow-up study visits were conducted five and ten years later, during which incident fractures were identified by detailed interviews. We excluded 140 men with diseases or who took medications known to affect bone metabolism at baseline, 185 with missing values for predictors and potential confounding factors, and one who did not participate in any of the follow-up study visits. The remaining 1686 men were analyzed. Each physical performance test was analyzed by quartiles. Poor performance was defined as belonging to the worst quartile of performance. The association between physical performance and fracture was assessed using Cox proportional hazards models., Results: We identified 175 clinical fractures (osteoporotic fracture: 77, major osteoporotic fracture: 48) in 1686 men during a mean follow-up period of 8.4 years. After adjusting for potential confounding factors including bone mineral density, men who performed poorly on all three physical performance tests had a 3.7-fold higher risk of osteoporotic fracture and a 6.6-fold higher risk of major osteoporotic fracture than men who did not perform poorly on any of the tests., Conclusions: Japanese elderly men who performed poorly on all three physical performance tests had a significantly higher risk of incident osteoporotic fracture independently of bone mineral density. The combined results of several physical performance tests may be useful for predicting incident fractures in elderly men., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: The Japanese Orthopaedic Association (JOA) proposed the concept of locomotive syndrome (LS) in 2007 for detecting high-risk individuals with mobility limitation. In 2020, the JOA revised the clinical decision limits and introduced LS stage 3, which carried the highest-risk for LS compared to the conventional stages, 1 and 2. The purpose of this study was to characterize the prevalence, comorbidities, and physical characteristics in each LS stage, as per the LS criteria 2020., Methods: We analyzed 2077 participants (64.9% women; mean age, 68.3 ± 5.4 years) from the Nagahama Study aged ≥60 years. Participants were classified into 4 groups, non-LS and LS stages 1, 2, and 3, based on a 25-question Geriatric Locomotive Function Scale. The prevalence of comorbidities (sarcopenia, osteoporosis, diabetes mellitus, low back pain [LBP], and knee pain) were investigated. Physical characteristics were measured based on the physical performance tests including gait speed, five-times chair-stand, single-leg stand, and short physical performance battery; muscle strength tests including grip, knee extension, hip flexion, and abduction; and body-composition analysis including muscle quantity and quality. Differences in the prevalence of comorbidities between LS stages were tested using the chi-square test. The general linear model was performed for univariate and multivariate analyses with post-hoc test to compare the differences in physical characteristics among the LS stages., Results: The prevalence of LS increased with age, and the mean prevalence of LS stages 1, 2, and 3 were 24.4, 5.5, and 6.5%, respectively. The prevalence of comorbidities, including sarcopenia, osteoporosis, LBP, and knee pain, increased with worsening LS stage. Physical performance tests were significantly different between LS stages 2 and 3; and muscle strength differed significantly between LS stages 1 and 2. Additionally, in terms of body composition analysis, muscle quality but not muscle quantity showed significant differences among all the LS stages., Conclusions: Our findings suggest that muscle strengthening and dynamic training, including balance training in LS stage 1 and 2, respectively, were needed for preventing the LS progression. Individuals with LS stage 3 should perform dynamic training and muscle strengthening exercises while receiving treatment for comorbidities., (© 2021. The Author(s).)

Objectives: Improvement of life expectancy is increasingly important with the aging of society. The aim of the study was to compare physical performance in elderly people in two 3-year periods (2001-2003) and (2016-2018)., Methods: The participants were healthy Japanese elderly adults who attended public health check-ups in Yakumo. Results for 10 m gait time, two-step test, back muscle strength, and grip strength were examined prospectively for participants in 2001-2003 (Group A: n  = 488) and 2016-2018 (Group B: n  = 309) by gender and age (65-74 and 75-84 years)., Results: There were significant differences between Groups A and B for 10 m gait time (age 65-74: male: 5.6 vs. 5.2 s, female: 6.3 vs. 5.5 s; age 75-84: male: 6.1 vs. 5.5 s, female: 6.7 vs. 5.8 s; all p  < .05) and two-step test (age 65-74: male: 1.41 vs. 1.48, female: 1.35 vs. 1.44; age 75-84: male: 1.32 vs. 1.41, female: 1.30 vs. 1.38; all p  < .05), but not for back muscle strength or grip strength., Conclusion: Our results suggest a phenomenon of 'overcoming locomotive syndrome', in which physical performance changed by aging, including motor functions such as 10 m gait time and two-step test, has improved in the current population compared with a similar population from 15 years ago.

Physical fitness is one of the key factors in healthy aging. Although physical fitness is widely recognized to decline with age, age-related decreases in the individual dimensions of physical fitness in later life are less clear. Purpose : The purpose of the present study was to describe the age-related changes in six fitness components covering a variety of motor dimensions in men and women through a 12-year longitudinal epidemiological study. Method : Participants were randomly selected community-living men (n = 1,139) and women (n = 1,128) aged 40 to 79 years at baseline who were repeatedly tested over a mean (standard deviation) follow-up period of 9.8 (3.4) years with a mean of 4.9 (2.3) examinations. The six physical fitness tests were sit-and-reach, grip strength, sit-ups, one-leg standing, reaction time and leg extension power. The effect of age on each physical fitness task was analyzed using a mixed-effects model controlling for habitual physical activity level. Results : The fixed effect of the interaction of age and time in all fitness tests was significant in men. Higher age at baseline was significantly associated with a greater decrease over time except in one-leg standing. In women, no significant interaction effect of age and time was found in grip strength or reaction time. Age-related changes in grip strength and reaction time were constant with increasing age. Conclusion : Twelve-year longitudinal data showed that the age-related decrease in physical fitness over time, especially musculoskeletal fitness in men, was pronounced, whereas in women, the decrease was less pronounced.

Aging of society has increased the incidence of physical disability. The goal of this study was to examine the physical ability of elderly people classified as having sarcopenia, presarcopenia, or dynapenia (a low muscle function without low muscle mass) in a community in Japan. The subjects were volunteers aged >60 years who were participants in a health checkup in Yakumo, Hokkaido and were in good general health. Demographic data were collected and physical performance tests were performed to measure grip strength, walking speed, back muscle strength, maximum stride length, and 3-m timed-up-and-go (3m TUG) time. A measurement of skeletal muscle mass was used as a basis for calculating the appendicular skeletal muscle index (aSMI). The rates of sarcopenia, presarcopenia, and dynapenia were 10%, 22%, and 8% in males (n=101, age 69.7±5.4 years), and 19%, 23%, and 13% in females (n=112, 68.5±5.9 years). Body mass index in subjects with dynapenia was significantly higher compared to that in subjects with sarcopenia and presarcopenia (p<0.01). Back muscle strength, maximum stride length and 3m TUG were similar in dynapenia and sarcopenia, but differed significantly with those in presarcopenia in both males and females without the influence of age (p<0.05). Further studies are needed to evaluate the benefits of dynapenia intervention programs and to explore the underlying pathophysiology of dynapenia., Competing Interests: None of the authors have a conflict of interest regarding the work in the manuscript.

Purpose: Japan is one of few countries with a male life expectancy over 80 years. The gap between the healthy life span and the total life expectancy is large, highlighting the importance of maintaining physical performance. The present study aims to establish reference values for multiple physical performance measures among high-functioning oldest-old Japanese men and to investigate the correlations among these measurements to understand how these variables are related., Methods: This study was conducted with 120 Japanese males aged 80 years or older who were able to walk independently. Seven measures of physical performance were assessed: handgrip strength, quadriceps strength, static balance ability (one-legged stance), dynamic balance ability (Functional Reach Test; FRT), walking ability (5-m walking time test), combined movement ability (Timed Up & Go test), and bone quality. Cognitive function was also measured (Mini-Mental State Examination; MMSE)., Results: Specific reference values are reported for each physical performance measurement explored in this study. Only six participants were classified as cognitively impaired, and 16 had mild cognitive impairment. There were significant correlations of varying levels among all of the measures of physical performance. Age was significantly correlated with all performance measures except FRT, and there was no correlation between age and MMSE. MMSE was weakly correlated with FRT and unrelated to the other performance measures., Conclusions: The reference ranges can be used by older men who have not yet reached 80 years and their health care providers as physical performance targets to facilitate the maintenance of independent mobility in later life.

Introduction: Age-related functional decline elevates the risk of car accidents. Whether specific cognitive impairments and physical frailty increase the risk of car accidents is still unclarified., Objective: This study examines the association between car accidents, frailty, and cognitive function, owing to an increase in car accidents related to older adults., Methods: Data were collected from 12,013 older adults (45.4% women, mean age: 71.7 years [min: 60, max: 96]) enrolled in the National Center for Geriatrics and Gerontology (NCGG) - Study of Geriatric Syndromes. A 2-year self-reported history of car accidents was assessed. The Japanese cardiovascular health study index was used as the criterion and included the following components of frailty: shrinking, weakness, exhaustion, low activity, and slowness. "Frailty" was assigned a value of 1 or more based on these components. Cognitive function was assessed using the NCGG Functional Assessment Tool, and cognitive impairment was assessed using a standardized value., Results: Of the participants, 1,117 (9.3%) had a car accident history. The proportions of the frailty components' applicability were observed in the car accidents group compared to the non-car accidents group: shrinking (p = 0.006), exhaustion (p = 0.031), low activity (p = 0.034), and slowness (p = 0.030), but not weakness (p = 0.452). The proportion of cognitive impairment in executive function was also higher in the car accidents group (p = 0.011). A logistic regression analysis showed that both frailty (OR 1.26, 95% CI 1.11-1.43; p < 0.001) and cognitive impairment (OR 1.26, 95% CI 1.11-1.43, p < 0.001) are associated with car accidents., Discussion: This study's findings contribute to enhancing the utility of risk assessments for older drivers. Further study is required to clarify the risk of car accidents., (© 2020 S. Karger AG, Basel.)

• We described multimorbidity prevalence in Japanese adults aged ≥60 years. • Multimorbidity was observed in over two-fifths of the survey sample. • Hypertension, low back pain, and cataracts were highly prevalent. • Poor grip strength, but not slow walking speed, was associated with multimorbidity. • Poor self-rated health was associated with multimorbidity. To examine the association of physical performance measures and self-rated health with multimorbidity among older Japanese adults aged ≥60 years using cross-sectional data from a nationwide longitudinal survey. Using respondents' self-reported data from the 2012 National Survey of the Japanese Elderly, we analyzed multimorbidity involving nine major chronic diseases (heart disease, arthralgia, hypertension, diabetes, stroke, cataract, cancer, respiratory disease, and low back pain). Respondents who reported having two or more of these diseases were identified as having multimorbidity. Multivariate logistic regression analysis was used to examine if physical performance (grip strength and walking speed) and self-rated health were independently associated with multimorbidity after adjusting for potential confounders (e.g., demographic, physiological, and lifestyle-related variables). The responses of 2525 participants who responded to the survey by themselves (i.e., without proxies) were analyzed (response rate: 57.9%). Among the chronic diseases examined, hypertension had the highest prevalence (44.1%), followed by low back pain (25.7%) and cataract (24.7%). Approximately 44.4% of the respondents had multimorbidity. The regression analysis revealed that multimorbidity was significantly associated with both poor grip strength (P = 0.006) and self-rated health (P < 0.001), but not with walking speed (P = 0.479). Multimorbidity is prevalent in older Japanese adults, and poor grip strength and self-rated health were independently and significantly associated with multimorbidity. Health assessments that include these indicators may provide insight into the health status patterns of older adults with multimorbidity and inform the development of health management strategies. [ABSTRACT FROM AUTHOR]

Background: Fall-related efficacy has been found to be associated with both falls and fall risk factors such as physical performance. The aim of the present study was to clarify whether fall-related efficacy is, independent of physical performance and other potential risk factors, associated with future falls in community-dwelling older people., Methods: The study participants were 237 Japanese older people aged 65 years and over who were living independently in their community. Fall-related efficacy and physical performance were assessed at baseline using the short version of the Falls Efficacy Scale-International (short FES-I) and 5-m walking time, the Timed Up and Go Test, the 5 Times Sit to Stand Test, and grip strength. Physical performance was then again assessed at 1-year follow-up. The number of falls was obtained every 6 months for 1 year after the baseline survey. Instrumental activities of daily living (IADL), depression, fall history, current medications, medical history, and pain were also investigated as potential confounding factors that have possible associations with falls. The associations between the short FES-I, physical performance, and number of falls were analyzed using Poisson regression analysis adjusted for physical performance and potential confounding factors., Results: The mean age of the participants (75.9% women) was 71.1 ± 4.6 years, and 92.8% could perform IADL independently. The total numbers of falls and fallers during the 1-year follow-up period were 70 and 42, respectively. On Poisson regression analysis adjusted for walking time and potential confounding factors, independent of physical performance, the short FES-I was found to be significantly associated with number of falls (relative risk = 1.09, p < 0.05). On the other hand, physical performance was not significantly associated with the number of falls., Conclusions: The findings of the present study suggest that the short FES-I, independent of physical performance and other potential risk factors, is a useful index to detect fall risk in community-dwelling older people, and that fall-related efficacy is an important factor in terms of fall prevention.

The usefulness of performing physical function assessments for evaluating clinical outcomes after all cardiac surgeries has been reported. However, no studies have evaluated the relationship between physical function and prognosis in patients undergoing cardiac open surgery with mitral valve regurgitation (MR). This study investigated whether physical assessment, such as the short physical performance battery (SPPB), could predict unplanned readmission events in patients undergoing mitral valve surgery due to MR. SPPB could predict unplanned admission events in patients undergoing mitral valve surgery due to MR. This retrospective study included 168 patients who underwent mitral valve surgery. SPPB was performed 1.6 ± 1.1 days before surgery. The primary endpoint was unplanned readmission. The mean follow-up period was 762 ± 480 days, mean age was 73.8 ± 6.3 years, and 43% of the patients were women. Of the study patients, 46 required unplanned readmissions; 29 of these patients required readmissions within 1 year. Multivariate Cox regression analysis demonstrated that SPPB was independently associated with the primary endpoint. Receiver-operating characteristic analysis showed that SPPB had an area under the curve of 0.71, with an optimal cutoff of 11. The study patients were stratified into SPPB 12 or SPPB ≤ 11 groups. Kaplan-Meier analysis showed that the event-free rate was significantly lower in the SPPB ≤ 11 group (hazard ratio 3.8, 95% confidence interval 2.1-7.0; p < 0.001). SPPB was a useful tool for predicting unplanned readmission in patients undergoing mitral valve surgery due to MR.

Background: Age- and lifestyle-related changes in respiratory and physical function affect cough strength. However, in older adults, the main factors that relate to cough strength remain unclear. This study was a preliminary investigation of factors that contribute to cough strength and the relationships between cough strength and respiratory function, physical performance, physical activity, and sedentary behavior in community-dwelling older adults., Methods: By using accelerometers and other tools, we assessed cough peak flow (CPF), FVC, maximum inspiratory pressure (P Imax ), maximum expiratory pressure (P Emax ), chest and abdominal wall mobility (breathing movement scale), physical performance (Timed Up and Go test and 30-s chair stand test), physical activity (steps, and locomotive and non-locomotive moderate-to-vigorous physical activity), and sedentary behavior (sedentary time) in 65 community-dwelling older adults (25 males and 40 females) without air-flow limitation., Results: Twenty-six percent of the subjects (17/65) had reduced CPF (<240 L/min). The subjects with reduced CPF had significantly lower FVC, P Imax , P Emax , chest and abdominal wall mobility, physical performance, and locomotive moderate-to-vigorous physical activity compared with those with non-reduced CPF. Significant correlations between CPF and variables of respiratory function (FVC, P Imax , P Emax , and breathing movement scale) and physical performance were weak to moderate. FVC and P Imax were independently associated with CPF during the multiple regression analysis adjusted for sex, age, and height. The receiver operating characteristic analysis showed that FVC and P Imax had fair-to-good sensitivity for detecting reduced CPF., Conclusions: Analysis of our results indicated that FVC and P Imax were related to CPF and provided preliminary evidence that supported strategies for preserving and improving cough strength in community-dwelling older adults., Competing Interests: The authors have disclosed no conflicts of interest., (Copyright © 2019 by Daedalus Enterprises.)

Objective: To investigate the association between posterior occlusal support by residual teeth and the reduction in walking speed in 80-year-old Japanese adults using propensity score matching., Background Data Discussing the Present Status of the Field: Previous studies have demonstrated an association between oral status and motor function; however, most of these studies had a cross-sectional design., Material and Method: This study included 353 community-dwelling Japanese people aged 79-81 years. Low walking speed was defined as ≤0.8 m/s, and participants with a low walking speed at baseline were excluded. The participants were divided into two groups: with or without posterior occlusal support by residual teeth at baseline. Propensity score matching was used to reduce the effects of bias by matching participants with and without posterior occlusal support according to similar background factors at baseline. Conditional logistic regression was conducted to determine low walking speed at the 3-year follow-up, which included posterior occlusal support as an independent variable with matching data., Results: Before matching for posterior occlusal support, significant differences existed between the groups in terms of sex, years of education, height, weight and grip strength. However, after matching, there was no significant difference between the groups in any characteristic. Logistic regression analysis showed that posterior occlusal support is a significant variable (odds ratio = 1.88; P = 0.04) associated with reduced walking speed., Conclusion: Lack of posterior occlusal support at baseline independently predicted the incidence of reduced walking speed over 3 years., (© 2019 Gerodontology Association and John Wiley & Sons Ltd.)

Introduction: Resistance training (RT) and nutritional supplementation seem to have beneficial effects on muscle properties and physical performance in older adults. However, the reported effects of specific RT programmes and supplementation prescriptions vary among studies. The present study aims to examine the acute and residual effects of RT and/or beta-hydroxy-beta-methylbutyrate (HMB) supplementation on muscle mass, muscle strength and physical performance in older women with reduced muscle mass., Methods and Analysis: This is a randomised, double-blind, placebo-controlled trial. Older women fitting the eligibility criteria were recruited in February 2018 from a population-based sample identified via screening conducted in October 2017. In March 2018, 156 participants were randomly allocated to undergo one of four interventions (RT + HMB, RT + placebo, education + HMB and education + placebo) for 12 weeks. Supervised RT consisted of body weight, elastic band, ankle weight and machine-based exercises two times per week at the Tokyo Metropolitan Institute of Gerontology (TMIG). Each participant ingested HMB (1200 mg) or placebo supplements once daily. Sessions of education not associated with sarcopenia treatment were conducted every 2 weeks. Post-intervention follow-up will be conducted for 12 weeks, until September 2018. The study includes assessments conducted in March (baseline), June (post-intervention) and September 2018 (follow-up). The primary outcome is the longitudinal change in muscle mass. Secondary outcomes include the longitudinal changes in muscle strength, physical performance, muscle thickness, muscle quality, blood counts, blood biochemistry, calf circumference, skin viscoelasticity, habitual dietary intake, habitual physical activity levels, functional capacity and health-related quality of life. Intention-to-treat analyses will be conducted., Ethics and Dissemination: The study protocol was approved by the Ethics Committee of the TMIG, Japan. The study is being conducted according to the principles of the Declaration of Helsinki. The findings will be presented at international academic congresses and published in peer-reviewed international journals., Trial Registration Number: UMIN000028560; Post-results., Competing Interests: Competing interests: The intervention products (HMB and placebo supplements) were provided by Kyowa Co., Ltd. DM is employed by Kyowa Co., Ltd. The funder is not involved in subject recruitment, intervention, data collection, data analysis or preparation of the manuscript., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: The detection of impaired physical performance in older adults with cardiovascular disease is essential for clinical management and therapeutic decision-making. There is a requirement for an assessment tool that can be used conveniently, rapidly, and securely in clinical practice for screening decreased physical performance., Objective: The present study was performed to evaluate the association of office-based physical assessments with decreased physical performance and to compare the prognostic capability of these assessments in older adults with cardiovascular disease., Methods: A total of 1,040 patients aged 75 years and older with cardiovascular disease were included in this analysis. One-leg standing time (OLST) and handgrip strength were measured as office-based physical assessment tools, and short physical performance battery (SPPB), 6-min walk distance, and usual gait speed were also measured at hospital discharge as measurements of physical performance. All-cause mortality was assessed by death registry at the hospital. We examined the association of office-based measures with physical performance and all-cause mortality., Results: The areas under the curve of OLST for SPPB < 10, 6-min walk distance < 300 m, and usual gait speed < 1.0 m/s were 0.87 (95% CI 0.83-0.91), 0.83 (95% CI 0.80-0.86), and 0.81 (95% CI 0.78-0.85), respectively. The discrimination abilities of OLST for decreased physical performance were significantly higher than those of handgrip strength. After adjusting for the effects of patient characteristics, the hazard ratio for all-cause mortality in the < 3 s group for OLST was 1.68 (95% CI 1.06-2.67, p = 0.03). Handgrip strength, however, was not significantly associated with mortality risk in these participants., Conclusion: Short OLST, in particular < 3 s, is associated with decreased physical performance and elevated mortality risk in elderly patients with cardiovascular disease. OLST can be conveniently measured in the clinician's office as a screening tool for impaired physical performance., (© 2019 S. Karger AG, Basel.)

Background: Numerous reported studies have shown that vertebral compression fractures are associated with impaired function or disability; however, few examined their association with objective measures of physical performance or functioning., Methods: We examined the association of vertebral compression fractures with physical performance measures in 556 Japanese women aged 40-89 years. Lateral spine radiographs were obtained and radiographic vertebral compression fractures were assessed by quantitative morphometry, defined as vertebral heights more than 3 SD below the normal mean. Measures of physical performance included walking speed, chair stand time and functional reach. Adjusted means of performance-based measures according to the number and severity of vertebral compression fractures were calculated using general linear modeling methods., Results: After adjusting for age, body mass index, back pain, number of painful joints, number of comorbidities and regular physical activities, the walking speed of women with two or more compression fractures (1.17 m/s) was significantly slower than that of women without compression fracture (1.24 m/s) (p = 0.03). Compared with women without compression fracture, chair stand time was longer in women with two or more compression fractures (p = 0.01), and functional reach was shorter (p = 0.01). No significant differences were observed in walking speed, chair stand time, or functional reach between women with one compression fracture and those without compression fracture., Conclusions: Having multiple vertebral compression fractures affects physical performance in community-dwelling Japanese women. Poor physical functioning may lead to functional dependence, accelerated bone loss, and increased risk for falls, injuries, and fractures. Preventing vertebral compression fracture is considered important for preserving the independence of older adults.

Objective: To identify the differences of incidence of disability between frail older persons with and without slow walking speed., Design: Prospective cohort study., Setting: Japanese community., Participants: A total of l4,081 older adults aged ≥65 years living in the community, participated in a baseline assessment and were followed for incidence of disability for 29.5 months., Measurements: Care-needs certification in the national long-term care insurance system of Japan, physical frailty (slow walking speed, muscle weakness, exhaustion, low activity, weight loss), adjusted for several potential confounders such as demographic characteristics; Kaplan-Meier survival curves for incident disability by physical frailty with and without slow walking speed., Results: During the follow-up period, 198 participants (4.9%) were certified as requiring long-term care insurance in accordance with incident disability. Participants who had prefrailty without slow walking speed (hazard ratio 1.86, 95% confidence interval 1.19-2.92), prefrailty with slow walking speed (3.62, 2.19-5.96), frailty without slow walking speed (4.33, 2.00-9.39), and frailty with slow walking speed (4.68, 2.72-8.05) at the baseline assessment had an increased risk of incident disability compared with nonfrail participants. In stratified analyses, frail older men and frail participants with low cognitive performance had the highest risk of incidence of disability., Conclusion: The presence of frailty or even prefrailty when older adults showed slow walking speed increased the risk of future disability in community-dwelling older adults., (Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.)

Abstract: This study aimed to determine the association between sarcopenia, defined by muscle mass, muscle strength, and physical performance, and higher-level functional capacity in community-dwelling Japanese elderly people. Subjects were 1158 elderly, community-dwelling Japanese people aged 65 or older. We used bioelectrical impedance analysis to measure muscle mass, grip strength to measure muscle strength, and usual walking speed to measure physical performance. Sarcopenia was characterized by low muscle mass, plus low muscle strength or low physical performance. Subjects without low muscle mass, low muscle strength, and low physical performance were classified as “normal.” Examination of higher-level functional capacity was performed using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC). The TMIG-IC is a 13-item questionnaire completed by the subject; it contains five questions on self-maintenance and four questions each on intellectual activity and social role. Sarcopenia was identified in 11.3% and 10.7% of men and women, respectively. The percentage of disability for instrumental activities of daily living (IADL) was 39.0% in men with sarcopenia and 30.6% in women with sarcopenia. After adjustment for age, in men, sarcopenia was significantly associated with IADL disability compared with intermediate and normal subjects. In women, sarcopenia was significantly associated with every subscale of the TMIG-IC disability compared with intermediate and normal subjects. This study revealed that sarcopenia, defined by muscle mass, muscle strength, and physical performance, had a significant association with disability in higher-level functional capacity in elderly Japanese subjects. Interventions to prevent sarcopenia may prevent higher-level functional disability among elderly people. [Copyright &y& Elsevier]

Purpose . To prepare a Japanese-language version of the Physical Performance Test (PPT) Battery and assess its reliability and validity. Method . Activity limitations by pain were evaluated by means of the Japanese-language version of the PPT Battery in 82 patients with chronic pain in the limbs and trunk. Two self-report questionnaires, one related to sensory evaluation of pain, and the other related to affective evaluation of pain, and the Functional Independence Measure (FIM), which evaluates activities of daily living, were simultaneously administered to the subjects. Results . The results for reliability showed that the ICC values for inter-rater reliability and intra-rater reliability were 0.91 or more for every item. The results for validity showed significant associations between the scores for all of the items on the Japanese-language version of the PPT Battery and the total scores on the FIM ( p < 0.01). Significant associations were found between 5 of the 8 items on the Japanese-language version of the PPT Battery and affective state due to the pain. Conclusions. The Japanese-language version of the PPT Battery was shown to possess adequate reliability and validity as a scale for evaluating the activity limitations of patients with chronic limb or trunk pain. The results also suggested that it might be possible to improve the activity limitations of patients with chronic pain by improving their affective state in response to the pain. [ABSTRACT FROM AUTHOR]