JAR life最新文献

Background: Studies show that centenarians' physical function and activities of daily living (ADL) levels improved recently. However, it is unclear whether this positive impact has been altered due to COVID-19, causing reduced ADL. This study had two objectives: 1) to investigate whether the physical function of Japanese centenarians has improved over time, and 2) to examine the impact of COVID-19 on centenarians.

Method: The data were collected from research conducted in Kyotango City from 2014 to the present. Kyotango City Hall collected data, including the functional status of all centenarians who reached 100 years of age every year. In this study, we divided nine-year cohort into three periods: 2014-2016 (P1), 2017-2019 (P2), and 2020-2022 (P3). The participation rates were 89 % (n = 100), 78 % (n = 90), and 74 % (n = 114), respectively.

Results: The centenarians' ADL declined as the cohort aged. For basic activities of daily living (BADL), independent participants and female centenarians exhibited a proportional increase from P1 to P2 and a proportional decrease from P2 to P3, whereas male centenarians did not experience this trend. Concerning mobility, only the proportion of bedridden centenarians decreased over the three periods. Statistically significant differences in the trends of female centenarians with robust mobility and those with weak mobility were obtained in the three periods.

Conclusion: The proportion of independent female centenarians declined with cohort aged in both BADL and Mobility. The opposite is true for male centenarians. This phenomenon was not affected by COVID-19.

Background: Web-based approach is considered helpful for the research focused on screening and early detection of individuals with preclinical Alzheimer's disease (AD); obtaining sufficient responses is critical to the success of such online study.

Objectives: This study examined factors influencing response rates to an online survey about disease-modifying drugs for AD among participants in the Japanese Trial-Ready Cohort (J-TRC) webstudy.

Design: This was a retrospective observational study.

Settings: Online survey in Japan using Google Forms.

Participants: We enrolled the eligible J-TRC webstudy participants who had registered before September 2023. We sent them an invitation e-mail including a questionnaire web address on November-December 2023, in order to conduct an online survey regarding their perceptions of disease-modifying therapy drug that was approved in July 2023, Japan.

Measurements: We analyzed the impact of mailed day of the week (DOW), participant gender, age, employment status, and educational background with/without response to the invitation, quantified by the odds ratio of response.

Results: Among approximately 10,400 J-TRC web study participants who sent invitation emails, the overall response rate was approximately 20 %, without significant influence depending on the DOW when the survey invitation was sent. Individuals who were older (50s-70s), retired, or had higher education levels were significantly more likely to respond, regardless of the DOW. Differences in response rates by sex/gender were observed, but were largely influenced by the employment status.

Conclusions: In order to improve response rates and enhance data quality, these findings provide valuable insights for optimizing the design of future online studies/surveys in the field of AD and dementia, particularly for targeting cognitively unimpaired middle-aged and older populations.

Background: Older females have higher Alzheimer's Disease (AD) risk and tau burden, especially in early disease stages, compared to males. Overlapping cardiovascular disease (CVD) and dementia risk factors, like the apolipoprotein (APOE)-ε4 allele, show mixed sex-specific results. We previously found that late-life CVD risk related more strongly to tau at a single timepoint in cognitively normal, older female APOE-ε4 carriers than in males.

Objectives: Do composite and component CVD risk factors explain sex differences in tau accumulation in older adults with mild cognitive impairment (MCI) and underlying amyloid-beta (Aβ) pathology?

Design: Longitudinal analysis in the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort.

Setting: ADNI is a multi-site longitudinal study across the United States and Canada.

Participants: n = 52 older adults (aged 60-90), designated as both Aβ-positive and MCI.

Measurements: CVD risk was measured by body mass index (BMI) and FRS, which includes age, systolic blood pressure (BP), high-density lipoprotein (HDL), total cholesterol, hypertension treatment, smoking, and diabetes. Regional standardized uptake value ratios (SUVRs) were extracted at each tau-PET timepoint. Composite SUVRs for Braak34 and Braak56 were calculated. Statistical models examined the separate and interactive effects of sex and APOE-ε4 on tau accumulation, and moderating effects of FRS, its components, or BMI, on tau accumulation.

Results: Females accumulated more tau than males in bilateral Braak34 and right Braak56, while APOE-ε4 carriers trended toward more tau accumulation in left Braak56. FRS and its components did not relate to tau accumulation, nor influence sex effects, although they attenuated APOE-ε4 effects. In left Braak56, higher baseline BMI in males showed a trend toward greater tau accumulation.

Conclusions: In MCI and Aβ-positive older adults, females accumulated more tau than males, and late-life vascular risk did not explain this relationship. Higher BMI related to more tau accumulation in males only, suggesting sex-specific vulnerability to BMI on brain health. Although replication in larger and more representative cohorts is needed, these findings corroborate accelerated tau progression in older females, independent of CVD risk, and suggest that vascular health has limited influence on tau progression once AD pathology is established in the brain.

Introduction: Postoperative changes in body composition and nutritional challenges are significant concerns for older patients undergoing gastrointestinal (GI) cancer surgery. This study compared body composition changes and nutritional outcomes between patients with upper gastrointestinal (UGI) and lower gastrointestinal (LGI) cancers over 12 months to identify tailored postoperative care needs.

Methods: This retrospective study included 55 Japanese patients (≥65 years) who underwent curative GI cancer surgery at the National Center for Geriatrics and Gerontology between 2018 and 2022. Patients were categorized as UGI (n = 17) or LGI (n = 38). Body composition parameters, including body mass index (BMI), fat-free mass (FFM), and body fat mass (BFM), were measured preoperatively and at 1, 3, 6, and 12 months postoperatively using bioelectrical impedance analysis. Two-way repeated-measures ANOVA was conducted, adjusting for age, sex, surgical method, operation time, blood loss, infection rates, and MMSE scores to minimize bias.

Results: UGI patients showed significant reductions in weight, BMI, FFM, and BFM postoperatively, indicating a higher risk of malnutrition and muscle loss. In contrast, LGI patients exhibited stable or increasing trends in these parameters. Significant time and interaction effects were observed for FFM and BFM (p<0.05), underscoring differential recovery patterns between groups.

Conclusions: UGI patients face a higher risk of postoperative malnutrition and muscle loss compared to LGI patients, who showed more favorable recovery trajectories. Early, intensive nutritional interventions and personalized rehabilitation strategies are essential for mitigating muscle wasting and improving outcomes in UGI patients.

Some patients undergoing surgical procedures display long-term post-surgery cognitive impairment (post-operative cognitive dysfunction; POCD), which may precipitate progression to dementia. We investigated whether preoperative cognitive impairment defined using specific cognitive tests (Paired-Associates Learning and Spatial-Span from the Cambridge Neuropsychological Test Automated Battery, (CANTAB) was associated with increased risk of POCD. N = 590 patients >65years and a matched control group n=114 comprised the final sample. Patients were classified as impaired if a composite memory-score derived from two tests from the CANTAB test battery (spatial working memory and paired-associate learning) scored 1 SD below norms derived from a normative database. Risk of developing POCD 3 months post-surgery was higher [odds ratio 2.048 (95% CI 1.027 - 4.087)] for those with pre-surgical cognitive impairment compared to those with no impairment. This suggests that impairment on hippocampus-based tasks spatial-span memory and paired-associates learning is associated with increased risk for POCD in older surgical patients.

Background: Intervention adherence is crucial to ensure cognitive benefits in trials designed to prevent cognitive decline. During the coronavirus disease 2019 (COVID-19) pandemic, the Japan-Multimodal Intervention Trial for the Prevention of Dementia offered live online exercise sessions to older adults with mild cognitive impairment (MCI).

Objectives: To assess adherence and aerobic exercise intensity through live online exercise sessions in older adults with MCI.

Design: Posthoc analysis of the 18-month, multi-center, randomized controlled trial.

Setting: The study was conducted across five institutions in Japan.

Participants: Older adults aged 65-85 years who were assigned to the intervention group and completed the intervention. Participants were stratified by region (Aichi and Tokyo), where the state of emergency duration due to COVID-19 varied.

Interventions: The intervention group participated in multidomain interventions, including 90-minute group-based physical exercise sessions held weekly for 78 sessions. During the state of emergency, live online sessions were conducted via video conferencing.

Measurements: Attendance rates and aerobic exercise intensity (based on heart rates) during online and onsite sessions were compared using the Wilcoxon signed-rank test.

Results: A total of 207 participants were analyzed. Over 18 months, 78 exercise sessions were conducted, including live online sessions. In the Aichi region, 2 online sessions were held, while in the Tokyo region, 24 online sessions were conducted. In the Tokyo region, adherence was higher in online sessions compared to onsite sessions (92 % vs. 86 %, p = 0.046), while exercise intensity showed no significant difference (49 % vs. 52 %, p = 0.279). No adverse events were reported.

Conclusions: Live online exercise sessions were safe, feasible, and demonstrated adherence and intensity comparable to onsite sessions.

Trial registration: The trial was registered at the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) on November 24, 2019 (UMIN000038671) (https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000044075).

Background: Within-country studies show that physical activity is associated with better intrinsic capacity.

Objectives: To examine whether the contribution of physical activity to intrinsic capacity varies between countries due to varying social determinants, and whether physical activity associates differently with only certain domains of intrinsic capacity.

Design: Prospective cohort studies.

Setting: Populations of the USA, UK, Europe, and China.

Participants: Nationally representative samples of middle-aged and older adults who were interviewed every two or three years.

Measurements: Intrinsic capacity was assessed according to the following domains: locomotor, vitality, cognition, vision and hearing, and psychological health. Physical activity was defined as taking part in vigorous or moderate physical activity was more than weekly.

Results: Physical activity was associated with better intrinsic capacity in both genders in USA, UK, and Europe, but not in China. In these developed countries, physical activity was associated with all domains of intrinsic capacity, except for cognition in men in the UK. The largest effect sizes were observed in the domains of locomotion, psychological health, and vitality. In China, physical activity was significantly and positively associated with two domains of intrinsic capacity (vitality and locomotion) for men and women only in rural areas.

Conclusions: Physical activity may contribute differently to intrinsic capacity, perhaps as a result of cultural and economic differences between countries.

Objective: To examine the incremental value of intrinsic capacity (IC) and environmental characteristics in the risk prediction of disability.

Method: Secondary analysis was performed on a longitudinal sample of individuals aged 50 years or above. The selected subsample was ambulant and cognitively intact, and did not have any disabilities in instrumental activities of daily living (IADL) at baseline. A set of 18 indicators were first used to assess conditions associated with declines in IC and environmental characteristics. Participants were then followed up for approximately one year, and the IADL status (i.e., disabled or not) was treated as the outcome variable in the logistic regression models. The incremental predictive value of IC was examined by comparing the baseline model that only included traditional risk factors (e.g., health conditions and lifestyle factors), against the full model that also included the aforementioned 18 indicators. The comparison was performed using the change in area under the receiver operating characteristic curve (ROCAUC) and the continuous net reclassification index (NRI).

Results: Among 10,993 participants (mean age = 73.3, 82.1 % women), 680 (6.2 %) developed disability during the concerned period. The full model significantly outperformed the baseline model, with the ROCAUC improving from 0.707 to 0.729 (change = 0.021; 95 % CI: 0.013-0.030). The continuous NRI was 0.361 (95 % bootstrap CI: 0.280-0.450).

Conclusions: Measurements of IC and environmental characteristics have a significant incremental value in predicting disability. In practice, the full model can be implemented as a calculator for identifying older populations at risk of disability in the community settings.

Background: Dementia disproportionately affects Hispanic communities, which may be partially attributable to disparities in resources to address modifiable risk factors. Addressing risk factors at younger ages would likely confer greater benefit than at older ages. Interest among Hispanic and younger persons participating in a dementia prevention program is unknown.

Objectives: To understand knowledge of dementia risk factors and attitudes toward prevention program participation among Arizona residents.

Design: Cross-sectional study.

Setting: Online survey conducted of Arizona residents in either English or Spanish between July 13, 2021 and August 2, 2021.

Participants: 1,303 persons age 35 and older; 332 (25.5%) were Hispanic.

Measurements: Survey questions about knowledge of dementia risk factors and dementia prevention program interest. Comparisons between Hispanic and non-Hispanic White and younger and older respondents were made using chi-squared tests.

Results: Overall, 30.7% of respondents were aware of any risk factors that increased risk for dementia with no differences between Hispanic and non-Hispanic White respondents. 76.4% of all respondents were "very" or "somewhat" interested in a dementia prevention program, interest was significantly higher in Hispanic (83.0% vs 73.3% "very" or "somewhat interested," X2 (3, N=1226) = 14.8, p=0.002) and younger respondents (82.2% vs 72.1% "very" or "somewhat" interested X2 (1, N=1302) = 20.0, p<0.001).

Conclusion: General knowledge of risk factors for dementia is low, contrasting with high interest in a prevention program. Interest is higher in Hispanic and younger persons compared with older or non-Hispanic White persons. A dementia prevention program accessible to younger and Hispanic populations could help narrow dementia outcome disparities.