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

BACKGROUND Although a few studies have confirmed the association of accelerometer-measured sedentary behaviour (SB) and physical activity (PA) with non-alcoholic fatty liver disease (NAFLD), PA intensity and co-dependent daily time-use of movement behaviours are yet to be studied. AIMS To cross-sectionally examine the dose-response relationship between accelerometer-measured SB or PA and NAFLD using cubic spline analysis and the interdependence of movement behaviours over 24 hours with compositional data analysis. METHODS Data were obtained between May 2017 and February 2020 from 1914 people who were not heavy alcohol drinkers using health check-ups at the Meiji Yasuda Shinjuku Medical Center, Tokyo. SB, light-intensity PA (LPA) and moderate- to vigorous-intensity PA (MVPA) were evaluated using a triaxial accelerometer. Fatty liver was diagnosed by ultrasonography. RESULTS A multivariable-adjusted logistic model showed an inverse association between MVPA and NAFLD (odds ratio [OR] per 600 metabolic equivalents [MET]-min/week = 0.85, 95% confidence interval [CI] = 0.76-0.96). MVPA showed rapidly decreasing odds of NAFLD to approximately 1800 MET-min/week in cubic spline analysis and then a moderate decline. Although SB was significantly associated with NAFLD in a body mass index (BMI)-unadjusted model, it was not significant in a BMI-adjusted model. In the compositional isotemporal substitution, reallocating 60 min/day of SB to MVPA decreased the odds of NAFLD by 22% (OR = 0.78, 95% CI: 0.65-0.93), whereas reallocating 60 min/day of MVPA to SB increased it by 69% (OR = 1.69, 95% CI: 1.12-2.38). CONCLUSIONS The inverse dose-response association between MVPA and NAFLD confirms increased MVPA as a target for the prevention of NAFLD.

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

This study investigated acceptable walking and cycling distances and their correlates. Cross-sectional data were obtained in 2013 from 8227 people aged ≥65 years in Kasama City, Japan. Acceptable walking distance was assessed by asking “What distance would you walk to a destination from your house?” (responses: ≤ 300 m, ≤ 500 m, ≤ 1 km, ≤ 2 km, ≤ 3 km, and > 3 km). Acceptable cycling distance was assessed using a similar question, with seven response options, including “cannot ride a bicycle.” The most frequently selected acceptable walking distance was ≤1 km. Those who could ride a bicycle most frequently selected ≤2 km as an acceptable cycling distance. Accessibility to various destinations around the participants’ homes was assessed using a geographic information system; these variables for accessibility were integrated using principal component (PC) analysis. Multivariable-adjusted logistic models showed significant positive or negative associations of acceptable walking/cycling distances with age, education, social relationships, frequency of going out, depressive mood, history of falls, and main travel mode. For PC scores for accessibility to various destinations, middle (OR = 0.83, 0.72–0.96) and highest (OR = 0.85, 0.74–0.99) tertile were inversely associated with accepting short cycling distances. Only the middle level PC score (OR = 0.74, 0.64–0.86) was associated with lower odds of accepting a short cycling distance. Older adults may accept active travel options if their destinations are within 1 km for walking or 2 km for cycling. Various internal and external factors determine acceptable travel distances.

Background; Many studies have demonstrated an association between diabetes and breast cancer risk. Purpose; We examined whether fasting glucose and hemoglobin A1c (HbA1c) are associated with mammographic breast density in Japanese women. Methods; Study consisted of 6,203 women who attend breast cancer screening with the medical health check-up (2014-2019). We used mammographic breast density assessed at the first breast screening. Fasting serum glucose and HbA1c were examined at the same day on the breast cancer screening. The association between breast density and fasting serum glucose and HbA1c were analyzed by logistic regression adjusted for potential confounding factors. Serum glucose and HbA1c levels were calculated with continuous variables. BI-RADS c and d were defined as dense breast tissue. Results; Of 6,203 women with mean age of 51 years, dense breast tissue was present in 60.0 % of participants. 960 (15.1%) had hyper-glycemia (≥100) and 2,830 (45.62%) had hyper-HbA1c (>5.5%). As table 1 illustrates, hyper-glycemia and hyper-HbA1c were significantly inversely associated with dense breast tissue, (serum glucose: odds ratio; 0.987 confidence interval: 0.982-0.992, p Table 1 The relations of glucose intolerance and mammographic breast density.odds ratioconfidence intervalp valueFasting serum glucose0.9870.982-0.992 Citation Format: Ken Uchida, Naruki Kitano, Daisuke Yamaguchi, Hiroko Nogi, Makiko Kamio, Hiroshi Takeyama. Impaired glucose tolerance decreases mammographic breast density in Japanese women [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P5-08-24.

We prospectively investigated the association between acceptable travel distances (i.e., walking and cycling) and the incidence of functional disability and mortality among older Japanese adults. A baseline survey was conducted in 2013 among 7618 individuals aged ≥65 years in Kasama City, Japan, and they were tracked through the city's database until 2021. Acceptable travel distances were assessed using a questionnaire. Outcomes (i.e., functional disability and mortality) were gathered as binary (incident or not) with survival time. A multivariable-adjusted Cox proportional-hazards model indicated that shorter acceptable walking and cycling distances were markedly linked with higher risks of functional disability and mortality. In conclusion, acceptable distances of ≤500 m for walking and ≤1 km for cycling were associated with higher risks of functional disability and mortality among older adults.

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

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

[Purpose] Exercise effects on executive functioning depend on exercise mode. We tested the effects of three acute exercises in the sitting position-stepping, stretching, and finger movement-on older adults' executive functioning in comparison to a resting state (i.e., control condition). [Subjects and Methods] Participants were 26 healthy older adults (mean age, 71.8 ± 4.7 years). All participants performed the three sitting exercises for 10 minutes; resting for an equal amount of time was used as a control condition. These four conditions were presented in random order. The color-word matching Stroop task was used to evaluate executive function before and after the sitting exercises and control condition. [Results] All three sitting exercises significantly reduced Stroop interference scores, while the control condition did not. There was a significant difference between the finger movement exercise and the control condition in pre-to-post-intervention changes in Stroop interference scores. [Conclusion] The acute finger movement exercise was especially beneficial for executive function as evaluated by the color-word matching Stroop task.

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

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

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

[Purpose] There is a relationship between physical and cognitive functions; therefore, impairment of physical function would mean cognitive decline. This study aimed to investigate the association between change in physical and cognitive functions. [Subjects and Methods] Participants were 169 healthy community-dwelling older adults who attend the survey after three years from baseline (mean age, 72.4 ± 4.8 years). Grip strength, one-leg standing balance, five-times-sit-to-stand test, timed up and go, 5-m habitual walk, and a peg-moving task were used to evaluate physical performance. Five cognitive function tests were used to assess attention, memory, visuospatial function, verbal fluency, and reasoning. Cognitive function was defined as the cumulative score of these tests. [Results] At baseline, five-times-sit-to-stand test, timed up and go, and hand dexterity were independently associated with cognitive function. In longitudinal analyses, changes in habitual walking speed and hand dexterity were significantly associated with change in cognitive function. [Conclusion] Deterioration of specific physical function, such as hand dexterity and walking ability, may be associated with progression of cognitive decline. Decreasing extent of daily functions, such as hand dexterity and walking ability, can be useful indices to grasp changes in cognitive function.

This study protocol introduces the Kasama Study, a mid-sized longitudinal study of health, fitness, and physical activity in older people. The study is a challenging research project that discusses the future of the system for preventive nursing care and for supporting successful aging in Japan. In May 2008, we began the Kasama Study with an exercise program of preventive nursing care for community-dwelling older adults. As of March 2016, we have conducted six study projects: 1) the Kasama health checkup for longevity, 2) an all-round exercise class, 3) the volunteer and the circle, 4) an exercise class for men only, 5) an exercise class for improving cognitive and physical function, and 6) the Kasama Iki-iki checklist survey. We describe each project in detail in the present study protocol.

Highlights • Practice of workplace exercise was positively related to work engagement. • Relationship of workplace exercise with work engagement was independent of physical activity and sedentary behavior. • Workplace exercise, however, might not improve psychological distress., We investigated the relationship between workplace exercise and psychological distress, and work engagement, both of which are factors related to the mental health and work productivity of employees. Data from the Meiji Yasuda Lifestyle study, collected from July 2017 through December 2017, were used. Data from an annual health checkup and questionnaire were collected from the Meiji Yasuda Shinjuku Medical Center in Tokyo, Japan. The 1321 participants (mean age: 50.8 ± 9.5 years, rate of female: 68.2%, rate of white-collar workers: 64.7%) were divided into three groups based on the frequency of performing workplace exercise: less than once, once or twice, and three or more times a week. Vigor of work engagement and psychological distress were assessed using the Utrecht Work Engagement Scale and Kessler Psychological Distress Scale (K6). Logistic regression analyses were performed to examine relationships between workplace exercise frequencies and work engagement or psychological distress. Demographic variables, health behaviors, health status, work characteristics, and objectively measured physical activity and sedentary behavior were adjusted for odds ratio (OR) and 95% confidence interval (95% CI). Participants who performed workplace exercise once or twice and three or more times a week showed a significantly higher OR (OR = 1.93, 95% CI = 1.00–3.71, p = 0.049, OR = 1.63, 95% CI = 1.23–2.15, p = 0.001, respectively) for vigor of work engagement. Neither groups of workplace exercise showed a significant OR for psychological distress even when adjusted for covariates. The practice of workplace exercise is positively and independently related to vigor of work engagements of physical activity and sedentary behavior, and the association was observed regardless of the frequency of once or twice, or three or more times a week. Workplace exercise, however, does not correlate with psychological distress. Our findings indicated that workplace exercise at least once or twice a week could have practical implications for the enhancement of vigor of work engagement, especially among white-collar workers.

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

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

Aim To explore the relationships between the built environment and older adults’ physical function. Methods The present cross-sectional study carried out in 2010–2012 used data drawn from 509 community-dwelling older adults aged 65–86 years living in Kasama City, a Japanese rural region. We evaluated physical function with the following performance tests: grip strength, sit-to-stand, timed up & go and walking speed. Using geographic information systems, we measured population density and the number of destinations related to daily life, community centers, medical facilities and recreational facilities within participants’ neighborhoods. Results After adjusting for potential confounders, we found lower population density was related to poor performance of sit-to-stand and walking speed in both sexes, and grip strength in women (trend P

Highlights • Time in sleep was favorably associated with mental distress and work engagement. • Sedentary behavior (SB) was negatively correlated with distress and work engagement. • Light-intensity physical activity (LPA) was negatively correlated with distress. • Reallocating time in SB or LPA to sleep was associated with better mental health., This cross-sectional study investigated the relationship between 24-hour movement behaviors and mental health among Japanese workers, accounting for the co-dependence of time spent in different behaviors during a single day. This research is part of a prospective cohort study called the Meiji Yasuda LifeStyle study. Participants were 1095 workers in Tokyo, Japan, who underwent annual health check-ups between 2017 and 2018. Time use during workdays and non-workdays was separately evaluated. Behaviors included sleep (self-reported duration), sedentary behavior (SB), light-intensity physical activity (LPA), and moderate- to vigorous-intensity physical activity (assessed with a tri-axial accelerometer). We used the six-item Kessler Psychological Distress scale to evaluate psychological distress and the Utrecht Work Engagement Scale to assess work engagement as indicators for negative and positive mental health, respectively. We performed compositional logistic regression and compositional isotemporal substitution to examine associations between 24-hour movement behaviors and mental health. After controlling for potential confounders, time spent in workdays was significantly associated with higher psychological distress and lower work engagement (p

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

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

Objective The purpose of this study was to cross-sectionally examine associations between frequencies of bicycle and motor vehicle travel, physical and mental statuses and social networks. Methods This study was conducted from 2009 to 2012 with 629 community-dwelling older adults (73.3±5.2 years old, female 53.7%) in Kasama City, Rural Japan. Travel status, physical activity scale for the elderly, Lubben social network scale and geriatric depression scale were collected via a self-administrated questionnaire. We also calculated a standardized physical function score through physical performance tests. Results After adjusting for age, gender, education, living arrangement, body mass index and clinical history, we found a positive association between frequency of bicycle and motor vehicle travel and physical activity, social networks and mental status (Trend P P P Conclusion Extending the travel area through use of transportation modes might provide health benefits. Assessing transportation mode usage could improve screening and assistance strategies for people who are physically or mentally frail or lonely.

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

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

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

Previous cohort studies that investigated the association between physical and cognitive function conducted only either physical or cognitive assessment in their follow up survey. Therefore, the relationship between changes in physical and cognitive functions is unclear. The study aimed to investigate whether change in physical functions is associated with change in cognitive function. In this study, the data was obtained from the Kasama study, a cohort study in Japan; and the follow up period was 3 years. Only older adults without cognitive impairment at baseline were included and 131 participants (72.2 ± 4.7 yrs.) were eligible. We used 6 physical performance tests: grip strength, one-leg standing balance, 5 times sit-to-stand, timed up and go, 5-m habitual walk, and peg moving task to measure physical function. To measure cognitive function, five tests were administered including tests of attention, memory, visuospatial function, verbal fluency, and reasoning. The total score was defined as cognitive function. Multiple regression analyses were conducted. We entered change in cognitive function as dependent variable and each of the change in physical function as independent variables, and age, sex, education, body mass index, medical history of hypertension and heart disease, depressive mood, intake medicine, knee pain, and upper-extremity pain as covariates. Changes in 5-m habitual walk (β = -0.207, P = 0.026) and peg moving task (β = 0.178, P = 0.042) showed significant association with change in cognitive function. These results suggest that deterioration of gait speed and hand dexterity is a useful sign for detecting cognitive decline.

[Purpose] Although some studies suggest the importance of getting adequate sleep for enhancing mood, there is not yet sufficient evidence on the relationship between sleep and mood states in athletes, especially for athletes with physical disability. The purpose of this study is to reveal relationships between sleep and psychological mood states in female wheelchair basketball players. [Subjects and Methods] Seventeen female wheelchair basketball players (30.9 ± 9.4 years old) on a Japanese national team participated. Sleep states were assessed with the Pittsburgh Sleep Quality Index (PSQI), and mood states with the Japanese version of the Profile of Mood States short form (POMS-SF). Spearman's rank correlations were computed. [Results] The mean PSQI score was 5.4 ± 2.6 points, and 9 athletes (52.9%) exceeded the cutoff point (5.5) for insomnia. Higher sleep efficiency (rS=0.58), fewer sleep disturbances (rS=-0.58), and lower total PSQI score (rS=-0.51) were significantly correlated with higher vigor. Lower likelihood of daytime dysfunction was also significantly correlated with lower tension (rS=0.50). [Conclusion] Vigor was the mood state most frequently correlated with sleep variables. Because vigor is a known key psychological factor in optimal performance, the findings are valuable for wheelchair basketball players.

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

Aim This study aimed to compare relationships of leisure-time, household, and work-related physical activity (PA) with physical performance by age and gender in older Japanese adults. Methods This cross-sectional study included 525 community-dwelling older adults (73.3 ± 5.2 years) recruited in 2009–2011 in Kasama City, rural Japan. We used the Physical Activity Scale for the Elderly to assess PA variables. Physical performance was evaluated by 11 performance tests: grip strength, single-leg balance, functional reach, sit-and-reach, standing time from long sitting position, sit-to-stand, timed up and go, habitual walk, hand working, and simple and choice reaction times. Results After adjusting for potential confounders, leisure-time PA in young-old (≤74 years) men correlated significantly with eight performance tests (absolute value of Spearman's partial rank correlation coefficient: r = 0.18–0.39), whereas in old-old (≥75 years) men it correlated with three performance tests (r = 0.20–0.23). Although leisure-time PA correlated with six performance tests (r = 0.19–0.22) in young-old women, there were no significant correlations between leisure-time PA and performance tests in old-old women. Household PA of young-old men (r = 0.20–0.23) and old-old women (r = 0.26–0.34) correlated with four performance tests. In old-old men and young-old women, no significant correlation was found between household PA and performance tests. Work-related PA did not relate significantly to any performance tests in any groups. Conclusion This study showed that leisure-time PA is related to physical performance, especially in young-old men and women, and household PA is especially related in young-old men and old-old women. Our findings suggest that supporting strategies for maintaining physical functions would differ by gender and age. Geriatr Gerontol Int 2013; 13: 919–927.

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