Search

To determine the association between physical activity and apathy in community-dwelling older adults.This was a cross-sectional study. Apathy was assessed using three sub-items from the Geriatric Depression Scale 15 (GDS-3A) on apathy syndrome. Physical activity was measured using a wrist-worn accelerometer. Exercise intensity was classified as sedentary behavior, light-intensity physical activity, or moderate-to-vigorous-intensity physical activity. A logistic regression analysis was used to examine the association between apathy and physical activity for each exercise intensity level.Seven-hundred and eighty-four participants (age 72.7±5.9 years old) were included. Of those, 103 (13.1%) were in the apathy group. A multivariate analysis adjusted for demographic factors revealed that decreased total physical activity (odds ratio [OR] = 0.947, 95% confidence interval [CI] = 0.912-0.984, p = 0.005), light-intensity physical activity (OR = 0.941, 95% CI = 0.899-0.985, p = 0.009), and increased sedentary behavior (OR = 1.002, 95% CI = 1.001-1.003, p = 0.007) were associated with a greater OR of apathy, although moderate-to-vigorous-intensity physical activity was not significant (OR = 0.916, 95% CI = 1.826-1.017, p = 0.100). However, in the final model adjusted for depressive symptoms and functional factors, the association was not found to be significant, and a strong association was observed between depressive symptoms and apathy.Physical activity in older adults with apathy symptoms was decreased in this study. However, the associations seemed to be strongly affected by depressive symptoms, and physical activity was not independently associated with apathy.

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.

We aimed to clarify the factors that contribute to the improvement or progression of frailty in rural Japanese community-dwelling older adults.Of the 840 participants in the cohort study of independent older adults aged 65 years and older living in the Tamba-Sasayama area of Hyogo Prefecture (FESTA study) from September 2016 to December 2017, 551 participated in the 2-year follow-up survey from September 2018 to December 2019.We evaluated clinical background, physical and cognitive function, total physical activity, daily protein intake, quality of life (QOL) using the WHOQOL-BREF (WHOQOL-26), and frailty status diagnosed using the Japanese version of the Cardiovascular Health Study. We compared the frailty status at the initial and follow-up examinations and classified the participants into three groups: improvement, unchanged, and worsening. Each parameter was compared among the three groups and the factors contributing to the improvement or worsening of frailty status were analyzed using a modified Poisson regression analysis.The median age at the first survey was 72 years (range: 68-76); 190 men and 361 women were enrolled. The improvement group consisted of individuals with a change in status from frail to prefrail/robust and from prefrail to robust (n = 114); the worsening group consisted of individuals with a change in status from robust to prefrail/frail and from prefrail to frail (n = 92). The physical domain of QOL was significantly associated with an improvement in frailty status independent of the frailty status at baseline. Contrastingly, any domains of QOL were not significantly associated with a worsening frailty status.This study demonstrated for the first time that QOL has a significant impact on the future improvement and progression of frailty status and that QOL conditions and frailty status affect older adults bidirectionally.

Background Sarcopenia is prevalent in patients with chronic kidney disease (CKD). The indices of physical function, such as grip power and gait speed, decreased according to the decline in the estimated glomerular filtration rate (eGFR). Methods We examined the relationships between cystatin C-based GFR (eGFRcys), creatinine-based GFR (eGFRcre), their ratio (eGFRcys/eGFRcre) and sarcopenia in community-dwelling older adults in Japan. This cross-sectional study included 302 men aged 73.9 ± 6.2 years and 647 women aged 72.9 ± 5.8 years from a rural area in Hyogo Prefecture, Japan. eGFRcys and eGFRcre were simultaneously measured, and sarcopenia based on the Asia Working Group for Sarcopenia (AWGS) 2019 criteria was evaluated. Results eGFRcys and the eGFRcys/eGFRcre ratio were significantly correlated with grip power and gait speed (p p p p p p Conclusion In conclusion, CKDcys but not CKDcre is associated with sarcopenia. A lower eGFRcys/eGFRcre ratio may be a practical screening marker of sarcopenia in community-dwelling older adults.

Background It has not been clarified whether physical frailty symptoms predict social. frailty. The purpose of this study was to elucidate the effect of physical frailty on social frailty, and to determine which domains of physical frailty predict the development of social frailty. Methods We employed a two-year prospective cohort study. A total of 342 socially robust community-dwelling older adults were recruited. We used a modified social frailty screening index consisting of four social domains including financial difficulties, living alone, social activity, and contact with neighbors. Physical frailty status was also assessed at baseline. At the two-year follow-up, we assessed the development of social frailty. Social status was assessed using four social subdomains for the primary analysis. Social status was assessed using the two social subdomains of social activity and contact with neighbors, which would be affected by the physical frailty component, for the secondary analysis. The risk ratios (RR) of physical frailty for the development of social frailty were estimated. Results Although physical frailty symptoms were not a significant risk factor for future development of social frailty as assessed by four social subdomains (adjusted RR 1.39, 95% CI 0.95–2.15), it became significant when development of social frailty was assessed by the two social subdomains (adjusted RR 1.78, 95% CI 1.10–2.88). An analysis using the physical frailty subdomain showed that slow gait speed (adjusted RR 3.41, 95% CI 1.10–10.53) and weakness (adjusted RR 1.06, 95% CI 1.01–1.12) were independent risk factors for development of social frailty as assessed by two social subdomains. Conclusions Physical frailty symptoms predict the development of social frailty. Among physical frailty subdomains, gait speed and muscle strength are critical independent risk factors for future decline in the social aspect. The prevention of physical frailty, especially by maintaining gait ability and muscle strength, may be effective for avoiding social frailty.

Fabb (2004) made a distinction between linguistic forms and literary forms. Linguistic forms hold of a text by virtue of being generated by a linguistic representation of the text, while literary forms hold of a text by virtue of being the content of thought about the text. The present article discusses whether the observed emphatic construction in Old Japanese texts is a linguistic form or implied literary form. The emphatic construction is [p-koso q-e], concordance of the emphatic particle koso with the sentence ending form -e (conjunctive subordinator), which is found primarily in literary contexts. Ohno (1993) argued that koso -e shifted its uses over the period of Old to Early Middle Japanese. The process of shift involves three stages: i) the contrastive uses, ii) the concessive uses, and iii) the simple emphatic uses. In Ohno’s analysis, the shift from (i) to (ii) is non-distinctive, but (ii) is aesthetically more complex. I argue that the shift of koso -e from (i) to (ii) is a semantic change from literal form to linguistic form, and that linguistic form may appear less distinct due to the literary form associated with the emphatic construction.

Objectives Sarcopenia is defined as a combination of low skeletal muscle mass index (SMI), weak muscle strength, and reduced physical function. Recently, many studies have reported that the creatinine/cystatin C ratio (Cr/CysC) is useful for evaluating muscle mass. We designed a cross-sectional study with separate model development and validation groups to develop a prediction equation to estimate bioimpedance analysis (BIA)-measured SMI with Cr/CysC. Design The current study was a retrospective cross-sectional study. Setting and Participants The model development group included 908 subjects (288 men and 620 women) from the Frail Elderly in the Sasayama-Tamba Area (FESTA) study, and the validation group included 263 subjects (112 men and 151 women) from participants in the medical checkup program at the Anti-Aging Center in Ehime Prefecture. Measures Multivariate regression analysis indicated that age, hemoglobin (Hb), body weight (BW), and Cr/CysC were independently associated with SMI in both men and women. The SMI prediction equation was developed as follows: Men: 4.17 − 0.012 × Age + 1.24 × ( Cr / CysC ) − 0.0513 × Hb + 0.0598 × BW Women: 3.55 − 0.00765 × Age + 0.852 × ( Cr / CysC ) − 0.0627 × Hb + 0.0614 × BW Results The SMI prediction equation was applied to the validation group and strong correlations were observed between the BIA-measured and predicted SMI (pSMI) in men and women. According to the receiver operator characteristic (ROC) analysis, the areas under the curve were 0.93 (specificity 89.0%, sensitivity 87.2%) among men and 0.88 (specificity 83.6%, sensitivity 79.6%) among women for using pSMI to identify low SMI in the model development group. The pSMI also indicated high accuracy in ROC analysis for low SMI in the validation group. The Bland-Altman plot regression showed good agreement between BIA-measured and pSMI. Conclusions and Implications Our new prediction equation to estimate SMI is easy to calculate in daily clinical practice and would be useful for diagnosing sarcopenia.

AIM We speculated that low back pain, which is the most common ailment in older adults, is associated with frailty and/or sarcopenia and contributes to the progression of either condition. Our objective was to evaluate the relationship between low back pain, sarcopenia and frailty in rural Japanese community-dwelling older adults. METHODS We recruited 730 participants aged ≥65 years who underwent a comprehensive health examination between November 2016 and December 2018. The Oswestry Disability Index (ODI) was used to assess low back pain quantitatively, and scores were compared for the frail groups determined by the Japanese version of Cardiovascular Health Study, and the sarcopenia groups as determined by the Asian Working Group for Sarcopenia 2019. RESULTS Among 730 participants, the prevalence of low back pain was 57.8%. There were significant differences in the ODI scores between the robust, prefrail and frail groups (P

Koutatsu Nagai,1 Kayoko Tamaki,2 Hiroshi Kusunoki,2 Yosuke Wada,3 Shotaro Tsuji,4 Masako Ito,5 Kyoko Sano,5 Manabu Amano,6 Soji Shimomura,7 Ken Shinmura2 1Department of Physical Therapy, School of Rehabilitation, Hyogo University of Health Sciences, Kobe, Japan; 2Department of General Medicine, Hyogo College of Medicine, Nishinomiya, Japan; 3Department of Rehabilitation, Hyogo College of Medicine Sasayama Medical Center, Sasayama, Japan; 4Department of Orthopaedic Surgery, Hyogo College of Medicine Sasayama Medical Center, Sasayama, Japan; 5Department of Occupational Therapy, School of Rehabilitation, Hyogo University of Health Sciences, Kobe, Japan; 6School of Pharmacy, Hyogo University of Health Sciences, Kobe, Japan; 7Department of General Medicine and Community Health Science, Hyogo College of Medicine Sasayama Medical Center, Sasayama, Japan Objectives: Recently, isotemporal substitution has been developed to substitute activity time for an equivalent amount of another activity. This study employed this method to demonstrate the effects of replacing sedentary behavior (SB) time with an equivalent amount of light-intensity physical activity (LPA) and moderate-to-vigorous intensity physical activity (MVPA) on the risk for different severities of frailty.Methods: A total of 886 older adults (average age 73.6 years, female 70%) participated in this cross-sectional study. Frailty status was assessed according to the cardiovascular health study criteria.Main outcome measures: Wrist-worn accelerometers were used to measure SB, LPA, and MVPA. Isotemporal substitution models were applied to show the estimated effects of substituting 30 min of SB with an equal amount of time spent in LPA or MVPA on the risk for pre-frailty and frailty.Results: The physical activity level and SB were not associated with the incidence of pre-frailty. However, a 16% (OR: 0.84; 95% CI: 0.78–0.90) and 42% (OR: 0.58; 95% CI: 0.37–0.92) decrease in frailty risk was noted when SB was substituted with LPA and MVPA, respectively, in the crude model. In the adjusted model, the significant effect was sustained for LPA (OR: 0.86; 95% CI: 0.80–0.92) but not for MVPA (OR: 0.74; 95% CI: 0.47–1.17).Conclusions: This study indicates that replacing 30 min of SB with an equivalent amount of LPA decreases the risk for frailty in older adults. Moreover, increasing LPA seems more feasible than increasing MVPA in older adults, with substantial benefit. Keywords: isotemporal substitution, frailty, physical activity, sedentary behavior

Background: Sarcopenia, the age-related decline in skeletal muscle volume and function, is associated with negative clinical and socioeconomic outcomes in elderly people. Clinical biomarkers to diagnose sarcopenia that can be quantified in a reliable, and cost- effective manner, are needed. We investigated whether the creatinine (Cr) /cystatin C (CysC) ratio is correlated with muscle volume and physical function in Japanese community-dwelling elderly subjects. Methods: The present study included 213 men aged 73.2±6.2 years and 464 women aged 72.4±5.5 years from a rural area in the Hyogo prefecture of Japan. To evaluate whether the Cr/CysC ratio is correlated with sarcopenia criteria in elderly individuals with preserved kidney function, we excluded subjects with estimate glomerular filtration rate (eGFR)

Background Sarcopenia is prevalent in patients with chronic kidney disease (CKD). Sarcopenia is prevalent in patients with chronic kidney disease (CKD). The indices of physical function, such as grip power and gait speed, decreased according to the decline in estimated glomerular filtration rate (eGFR). Methods We examined the relationships between cystatin C-based GFR (eGFRcys), and creatinine-based GFR (eGFRcre), and their ratio (eGFRcys/eGFRcre) and low skeletal muscle mass index (SMI) in community-dwelling older adults in Japan. This cross-sectional study included 286 men aged 73.3±6.2 years and 606 women aged 72.9±5.8 years from a rural area in Hyogo Prefecture, Japan. eGFRcys and eGFRcre were simultaneously measured, whereas low SMI based on the AWGS criteria was evaluated. Results eGFRcys and the eGFRcys/eGFRcre were significantly correlated with grip power and gait speed. The eGFRcys/eGFRcre was also correlated with SMI. In the multivariate logistic regression analysis, when the eGFRcys/eGFRcre was added as a covariate to the basic model, it was significantly associated with low SMI, both in all subjects. Moreover, CKDcys with a low eGFRcys/eGFRcre ratio (

To develop effective nutritional interventions for preventing frailty, the specific problems associated with the dietary habits of individuals based on sex differences must be identified. The purpose of this study was to evaluate the association between dietary habits and frailty in rural Japanese community-dwelling older adults. We recruited 800 participants, aged 65 and older, who underwent a comprehensive health examination between November 2015 and December 2017. Dietary habits were assessed by a brief self-administered dietary history questionnaire. Frailty was determined using either the Kihon Checklist (KCL) or the Japanese version of the Cardiovascular Health Study (J-CHS). The percentage of frail older adults was 8.4% according to KCL and 4.0% according to J-CHS. Various kinds of nutrient intakes, including three major nutrients, minerals, and vitamins in frail men, according to KCL, were the lowest. By contrast, there were no differences in nutrient intake between the robust, prefrail, and frail female groups according to KCL. We found significant associations of the intakes of soluble dietary fiber, potassium, folate, and vitamin C with a frail status in men (p = 0.035, 0.023. 0.012, and 0.007, respectively), and an association of the intake of vitamin C with a frail status in women (p = 0.027) according to J-CHS. Attention should be paid to the diagnostic criteria of frailty and to sex differences, when nutritional interventions for the prevention of frailty are planned.

The behavior of frugivorous birds during the removal of fruit from Swida controversa was investigated to compare the relationships between measures of fruit maturation and quantitative fruit removal behavior of birds. Bird exclusion devices were used on some branches to allow comparison of the traits of removed and un-removed fruits. Nine bird species visited S. controversa, but only four removed fruit, and each bird species removed a different number of fruits per visit. Only 11.5% of a branch's fruits were removed by birds. Birds removed only larger, blacker, more mature fruits, suggesting birds were effective seed dispersers.

The present study was conducted to clarify hydrarch community structure on the Nobeyama Plateau and characterize plant succession characteristics over a period of three years. The aim of the study was to develop plant conservation strategies for habitats that support the threatened Primula sieboldii communities. The results of TWINSPAN analysis showed that the study area contained four community types and that identified species could be classified into five species groups. Two community types contained valuable species group that have Primula sieboldii and Viola hirtipes. Sasa nipponica, a species characteristic of dry environments, and Phamnus davurica var. nipponica, a species characteristic of Phamno nipponicae-Alnetumjaponicae ass. nov., increased, and the degree of succession increased particularly well defined in these two communities. In general, while an increase in succession decreases the levels of Therophytes (Th) and Helophytes and Hydrophytes (HH), the degree of the decrease in Th and HH wasn't marked; this observation appears to be a characteristic feature of succession in this community. Although the rate of succession in this community was low relative to other mesic communities, given the marked increase in shrubs over a short period of time, any vegetation management strategy may need employ mowing to remove potential competitors.

Objective: Examination of effectiveness of different sites of constraint-induced movement therapy (CI therapy) for upper-extremity impairment of patients after stroke. Subjects: Patients exhibiting moderate to slight upper-extremity impairment after stroke. Methods: The patients received a modified version of CI therapy for a cumulative total of 5 h daily for 10 days. Using Fugl-Meyer scores, shoulder/elbow/forearm, wrist and hand functions were separately assessed before and after treatment. To assess the site-specific effects of CI therapy, before and after scores were statistically compared at each site using Wilcoxon signed-rank tests. Relative effects were evaluated by paired comparison of the results at each site with, in turn, the results at every other site. Instances of single-score increments were, using standard chi-square tests, statistically isolated and compared. Results: Nineteen patients, 12-169 (median 31) months after stroke, were enrolled in this study and completed the protocol. Age range was 40-81 (median 65) years old and pretreatment Fugl-Meyer total scores spanned 31-64 (median 48). Analyses detected statistically significant improvements for wrist, hand and coordination but not for shoulder/elbow/forearm subcomponents. For the hand, at least single-point increments were observed in 74% of the population, while only 47% showed similar increments for the shoulder/elbow/forearm, and 53% for the wrist. Statistical analysis revealed that a higher proportion had increments in hand scores. Conclusions: Statistical analysis shows that CI therapy is most beneficial for treating hand function, suggesting an efficient application of this treatment.

A unique O-glycan structure, Xylalpha1-3Xylalpha1-3Glcbeta1-O-Ser is found on the consensus sequence C-X-S-X-P-C (X denotes any amino acid) in epidermal growth factor (EGF)-like domains of plasma proteins such as clotting factor VII and IX. One of the enzymes involved in the biosynthesis of this trisaccharide, UDP-d-xylose:beta-d-glucoside 1,3-d-xylosyltransferase has been identified in HepG2 cells (Omichi, K., Aoki, K., Minamida, S., and Hase, S. Eur. J. Biochem. 245, 143-146 [1997]). Here, we report that this enzyme activity can be detected in bovine liver and that the enzyme has been purified from the microsomal fraction. The enzyme was purified 6200-fold in terms of specific activity and ran as a single band on native-PAGE and isoelectric focusing gel electrophoresis. The best acceptor substrate of those tested was the EGF-like domain of bovine factor IX carrying beta-glucoside at Ser53. The Km value for this substrate was 34 muM. Comparison of initial velocity with various acceptor substrates shows that this xylosyltransferase recognizes not only the glucose moiety to which xylose is transferred but also the tertiary structure of the EGF-like domain. With regard to the donor substrate, the enzyme does not recognize UDP-d-glucose but does recognize UDP-d-xylose.

Uridine 5′-diphospho-α- d -xylopyranose, which donates d -xylose during glycoconjugate biosynthesis, was chemically synthesized from α- d -xylose 1-phosphate and uridine 5′-monophosphoimidazolide.

A unique O-glycan structure, Xylalpha1-3Xylalpha1-3Glcbeta1-O-Ser is found on the consensus sequence C-X-S-X-P-C (X denotes any amino acid) in epidermal growth factor (EGF)-like domains of plasma proteins such as clotting factor VII and IX. One of the enzymes involved in the biosynthesis of this trisaccharide, UDP-d-xylose:beta-d-glucoside 1,3-d-xylosyltransferase has been identified in HepG2 cells (Omichi, K., Aoki, K., Minamida, S., and Hase, S. Eur. J. Biochem. 245, 143-146 [1997]). Here, we report that this enzyme activity can be detected in bovine liver and that the enzyme has been purified from the microsomal fraction. The enzyme was purified 6200-fold in terms of specific activity and ran as a single band on native-PAGE and isoelectric focusing gel electrophoresis. The best acceptor substrate of those tested was the EGF-like domain of bovine factor IX carrying beta-glucoside at Ser53. The Km value for this substrate was 34 muM. Comparison of initial velocity with various acceptor substrates shows that this xylosyltransferase recognizes not only the glucose moiety to which xylose is transferred but also the tertiary structure of the EGF-like domain. With regard to the donor substrate, the enzyme does not recognize UDP-d-glucose but does recognize UDP-d-xylose.