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BACKGROUND/OBJECTIVES To clarify the effects of intake of legumes and isoflavones on all-cause mortality in middle-aged and older Japanese. SUBJECT/METHODS The subjects were 2136 randomly chosen community-dwelling Japanese men and women aged 40-79 years who participated in a first-wave survey (1997-2000; baseline). The subjects were followed from baseline to December 31, 2017 (mean period of 16.6 ± 4.2 years). Intake of legumes, soybeans, and isoflavones at baseline was assessed using a 3-day dietary record with photographs. The relationships of intake amounts of legumes and isoflavones to mortality were assessed using Cox proportional hazards regression controlling for age, sex, education, employment, body mass index, smoking habits, medical histories, drinking, and energy intake. RESULTS There were 491 deaths during the follow-up period. We found inverse associations of the intake of total soy products and intake of each of the isoflavones with all-cause mortality (p for trend

Background/Objectives Dietary habits are known to affect health, including the rate of brain ageing and susceptibility to diseases. This study examines the longitudinal relationship between dietary diversity and hippocampal volume, which is a key structure of memory processing and is known to be impaired in dementia. Subjects/Methods Subjects were aged 40–89 years (n = 1683, men: 50.6%) and participated in a 2-year follow-up study of the National Institute for Longevity Sciences-Longitudinal Study of Aging. Dietary intake was calculated from 3-day dietary records, and dietary diversity was determined using the Quantitative Index for Dietary Diversity at baseline. Longitudinal changes in hippocampal and total grey matter volumes were estimated by T1-weighted brain magnetic resonance imaging and FreeSurfer software. Estimated mean brain volume change in relation to dietary diversity score quintiles was assessed by the general linear model, adjusted for age, sex, education, smoking status, alcohol intake, physical activity, and comorbidities. Results The mean (± standard deviation) % decreases in hippocampal and total grey matter volume during the 2-year follow-up were 1.00% (±2.27%) and 0.78% (±1.83%), respectively. Multivariate-adjusted decreases in total grey matter volume were associated with dietary diversity score (p = 0.065, p for trend = 0.017), and the % decrease in hippocampal volume was more strongly associated with the dietary diversity score: the estimated mean (± standard error) values were 1.31% (±0.12%), 1.07% (±0.12%), 0.98% (±0.12%), 0.81% (±0.12%), and 0.85% (±0.12%), according to dietary diversity quintiles in ascending order (p = 0.030, p for trend = 0.003). Conclusions Among community dwellers, increased dietary diversity may be a new nutritional strategy to prevent hippocampal atrophy.

Background: Frailty is a dynamic process, with frequent transitions between frailty, prefrailty, and robust statuses over time. The effect of dietary intake on frailty transitions is unknown. Objective: To examine the association between dietary intake and frailty transitions. Design: Survey-based retrospective analysis of the National Institute for Longevity Sciences-Longitudinal Study of Aging data. Setting: Areas neighboring the National Center for Geriatrics and Gerontology in Aichi Prefecture, Japan. Participants: We included 469 prefrail community dwellers aged 60–87 years who participated both in the baseline (2008–2010) and 2-year follow-up (2010–2012) surveys of the National Institute for Longevity Sciences-Longitudinal Study of Aging. Measurements: Transitions of frailty were categorized by changes in status from baseline to follow-up: “deterioration (prefrail to frail),” “persistence (persistent prefrail),” and “reversal (prefrail to robust).” Estimated dietary (nutrients and food) intakes assessed by 3-day dietary records in each frailty transition were analyzed with a multivariate-adjusted general linear model after adjusting for sex, age, education, family income, smoking, and chronic disease. Results: At the 2-year follow-up, 28%, 7%, and 65% of participants had robust, frail, and pre-frail status, respectively. Among 13 food groups, only milk and dairy product intake was positively associated with frailty reversal even after adjusting for all frailty criteria at baseline. Despite insignificant differences in the estimated mean intakes, the baseline intake of saturated fatty acids, potassium, and vitamin B1 tended to be the highest in the reversal group. The estimated mean (standard error) for milk and dairy product intake (g/day) was 79.1 (28.6), 129.3 (19.9), and 161.7 (21.7) for the deterioration, persistence, and reversal groups, respectively (P=0.0036, P-trend=0.0019). Conclusions: Daily consumption of dairy products may contribute to frailty reversal and frailty prevention among older community dwellers who consume small amounts of dairy products. Other food groups showed no association with frailty status transitions.

We investigated the associations between hearing aids (HA) and the maintenance of cognitive function among community-dwelling older adults with moderate hearing loss. A total of 407 participants aged 60 years or older with moderate hearing loss were recruited from the National Institute for Longevity Sciences, Longitudinal Study for Aging (NILS-LSA). Moderate hearing loss was defined as a pure-tone average of 40–69 dB at 500, 1000, 2000, and 4000 Hz of the better ear, according to the definition proposed by the Japan Audiological Society. Cognitive function was evaluated using the four subtests of the Japanese version of the Wechsler Adult Intelligence Scale-Revised Short Forms (WAIS-R-SF): Information, Similarities, Picture completion, and Digit Symbol Substitution (DSST). A longitudinal analysis of 1192 observations with a mean follow-up period of 4.5 ± 3.9 years was performed. The HA use rate at any time during the follow-up period was 31.4%, and HA users were significantly younger (t-test, p = 0.001), had worse hearing (p < .0001) and higher education (p = 0.001), participated more frequently in the survey (p < .0001), and were less depressed (χ2 test, p = 0.003) than the older adults not using HA. General linear mixed models consisted of the fixed effects of HA use, follow-up time, and an HA use × time interaction term adjusted for age and pure-tone average thresholds at baseline, sex, education, and other possible confounders. HA use showed significant main effects on the scores for Picture completion and DSST after adjustment; scores were better in the HA use group than in the no HA use group. The HA use × time interaction was significant for the Information score (p = 0.040). The model-predicted 12-year slope with centralizing age indicated that the no HA use group showed greater decline over time on Information scores than did HA use group. The slopes did not differ between HA users and non-users for the Similarities, Picture completion and DSST. In conclusion, HA use may have a protective effect on the decline in general knowledge in older adults with moderate hearing loss.

Objective:To examine the association between green tea and coffee intake and cognitive decline in older adults.Design:A prospective cohort study. The average intake of green tea and coffee in the previous year was assessed through a dietitian interview using a dietary questionnaire. A Mini-Mental State Examination (MMSE) was conducted up to six times biennially. Cognitive decline was screened using the MMSE; its incidence was defined as the first time a score of Setting:The National Institute for Longevity Sciences, Longitudinal Study of Aging (NILS-LSA) in Japan.Participants:Men (n 620) and women (n 685), aged 60–85 years, from the NILS-LSA.Results:During a mean of 5·3 (sd 2·9) years of follow-up, 432 incident cases of cognitive decline were observed. Compared with participants who consumed green tea Ptrend < 0·05). No significant association was found between coffee intake and cognitive decline.Conclusions:The intake of green tea, but not coffee, was shown to reduce the risk of cognitive decline in older adults.

This study examined the association between frailty development and physical activity including the number of steps, the time of light-intensity physical activity (LPA) with3.0 metabolic equivalents (METs), and the time of moderate- to vigorous-intensity physical activity (MVPA) with ≥3.0 METs in community-dwelling older Japanese adults.Study subjects were 401 older adults at the baseline examination (April 2000-May 2002) who participated at least once in the follow-up examination of the longitudinal study of aging. Their 1787 cumulative data points (mean number of repeat visits, 3.5) were used for analysis.The number of steps, time of LPA, and time of MVPA were recorded at baseline using a uniaxial accelerometer. Frailty was defined according to 5 frailty criteria: shrinking, exhaustion, low physical activity, low grip strength, and slow gait speed.The fully adjusted odds ratio for frailty among subjects walking5000 steps was 1.85 [95% confidence interval (CI), 1.10-3.11]. The fully adjusted odds ratio for frailty among subjects with MVPA for7.5 minutes was 1.80 (95% CI, 1.05-3.09). No significant association was observed between frailty and LPA.The risk for developing frailty was substantially lower in older people walking ≥5000 steps/d or exercising for at least 7.5 minutes/d at an intensity3.0 METs. These data could be applicable to the community interventions that aim to prevent frailty.

Background Hyperglycemia is believed to be a risk factor for cognitive decline, but the longitudinal relationship between hyperglycemia and cognitive decline in the Japanese population is unclear. The present study aimed to clarify the association between blood glucose levels and information processing ability in middle-aged and older adults. Methods The subjects were 866 men and 815 women aged 40–79 years not taking medication for diabetes who participated in the first study wave (1997–2000) and then participated at least once in the subsequent six study waves (2000–2012) of the National Institute for Longevity Sciences—Longitudinal Study of Aging, Japan. Hemoglobin A1c (HbA1c) levels were categorized into four groups (

Background To investigate the association between green tea consumption and the annual rate of change of gray matter (GM), white matter (WM), and hippocampal volumes in middle-aged and older Japanese community-dwellers. Methods A prospective cohort study with two years of follow-up was conducted with 1693 participants (aged 40–89 years). Green tea consumption (mL/day) data were collected with a 3-day dietary record. Volumes of GM, WM, and the hippocampus were estimated by T1-weighted brain magnetic resonance imaging and FreeSurfer software. The GM ratio, WM ratio, and hippocampal ratio (HR) were calculated as the percentages of total intracranial volume, respectively. Results The mean (SD) annual rate of change of hippocampal volume [(HR at baseline - HR at follow-up)/HR at baseline/follow-up years×100%] was 0.499 (1.128) (%). In the multivariable-adjusted general linear model, green tea consumption at baseline was negatively associated only with the annual rate of change of hippocampal volume (%) [β (95% CI) for each 1 mL/day increase in green tea consumption = -20.2E-5 (-35.0E-5 to -5.3E-5); P-value = 0.008]. No associations were observed for the annual rate of change of GM or WM volumes. The results remained significant when the analysis was limited to those with stable green tea consumption and were especially evident among individuals aged 65 years and older and among women. Conclusions In this study, each additional 100 mL/day of green tea intake was related to a reduction of approximately 5% in annual hippocampal atrophy. This association was especially evident among older individuals and among women. Key messages A negative association between green tea consumption and brain atrophy has been suggested; however, this relationship has not yet been investigated in humans. In this study, for the first time, a negative association between green tea consumption and annual hippocampal atrophy was observed in community-dwelling middle-aged and older individuals.

Background There is a growing interest in the significance of adopting a variety of lifestyle habits for maintaining cognitive function among older adults. A lifestyle that is easy to modify, simple, and less burdensome for older people is ideal. We investigated the longitudinal association between global cognitive decline and cognitive leisure activities (CLAs) combined with long-chain polyunsaturated fatty acids (LCPUFAs) intake. Methods The National Institute for Longevity Sciences-Longitudinal Study of Aging (NILS-LSA) enrolled community-dwelling middle-aged and older men and women who were randomly selected from Obu-City and Higashiura Town, Aichi, Japan. Baseline data (2006–2008), including CLAs and dietary intake, were obtained from 517 participants (aged 60–84 years) with normal cognition. Global cognitive decline, defined as the Mini-Mental State Examination (MMSE) score ≤ 27, was assessed at baseline and four years later. Interaction between CLAs and LCPUFAs on cognitive decline was investigated using a multiple logistic analysis with adjustment for confounders. CLA engagement and LCPUFA intake were divided into high and low groups according to the frequency at which each participant engaged in the activity and the median intake level according to sex, respectively. Results A significant interaction was detected for the combination of CLA engagement and LCPUFA intake. Logistic regression coefficients revealed significant interactions when participants engaged in more than five CLA varieties. One of the CLAs, art appreciation, produced a significant main effect against cognitive decline and a significant interaction in combination with LCPUFA intake. The major LCPUFAs—docosahexaenoic acid and arachidonic acid—also exhibited a significant interaction. The combination of high LCPUFA intake and high art appreciation frequency yielded a lower adjusted odds ratio for cognitive decline than the combination of low LCPUFA and low art appreciation [0.25 (95 % confidence intervals, 0.11–0.56)]. Conclusions Preserving cognitive function might be associated with a combination of varied and high-frequency engagement in CLAs combined with high LCPUFA intake.

Positive affect contributes to health and longevity. While most research has been conducted in individualistic societies where the experience and expression of positive emotions are highly valued, evidence remains scarce in collectivistic societies that de-emphasize the importance thereof. Employing 19-year longitudinal data of Japanese adults (age range 40‒79; N = 2,033), we examined whether positive affect predicted mortality and morbidity. Health outcomes were all-cause and cause-specific mortality as well as the onset of morbidity (heart disease, stroke, hypertension, diabetes, and cancer). After adjusting for relevant covariates, the Cox proportional hazards models revealed that positive affect predicted none of the outcomes. Our results did not replicate the health−benefits of positive affect. We discussed potential reasons for the null results.

Background To investigate the association between green tea consumption and the annual rate of change of gray matter (GM), white matter (WM), and hippocampal volumes in community-dwelling middle-aged and older Japanese individuals. Methods A prospective cohort study with two years of follow-up was conducted as part of the National Institute for Longevity Sciences-Longitudinal Study of Aging (NILS-LSA) project. A total of 1693 participants (862 men and 831 women, aged 40–89 years) were included. Green tea consumption (mL/day) data were collected with a 3-day dietary record. Volumes of GM, WM, and the hippocampus were estimated by T1-weighted brain magnetic resonance imaging and FreeSurfer software. The GM ratio, WM ratio, and hippocampal ratio (HR) were calculated as the percentages of total intracranial volume, respectively. Results The mean (SD) annual rate of change of hippocampal volume [(HR at baseline - HR at follow-up)/HR at baseline/follow-up years×100%] was 0.499 (1.128) (%). In the multivariable-adjusted general linear model, green tea consumption was negatively associated only with the annual rate of change of hippocampal volume (%) [β (95% CI) for each 1 mL/day increase in green tea consumption = -20.2E-5 (-35.0E-5 to -5.3E-5); P-value = 0.008]. No associations were observed for the annual rate of change of GM or WM volumes. The results remained significant when the analysis was limited to those with stable green tea consumption and were especially evident among individuals aged 65 years and older and among women. Conclusions In this study, higher green tea consumption was associated with less annual hippocampal atrophy, and each additional 100 mL/day of green tea intake was related to a reduction of approximately 5% in annual hippocampal atrophy. This association was especially evident among older individuals and among women. Further study in different settings is needed to confirm this association.

Hearing loss is a risk factor for cognitive impairment, and the use of a hearing aid (HA) may prevent cognitive decline alongside hearing loss. We aimed to elucidate the prevalence of self-reported HA usage in Japanese community-dwelling elders with hearing loss, and the effect of hearing and HA on cognitive impairment.A total of 1193 participants, who had audiometric defined hearing loss and were aged 60 years or over, had their cumulative 3260 observations followed up for 10 years from a large cohort of a Japanese study. Association between hearing (pure-tone average threshold level at 500, 1000, 2000, and 4000 Hz from the better hearing ear: PTABHE) and HA usage with cognitive impairment (total score of Mini-Mental State Estimation was under 27 or diagnosed as dementia) was analyzed using generalized estimating equations.The HA usage rate of the 1193 community-dwelling elders with hearing loss was 6% during the first involvement. The majority (59.2%) of HA users always used an HA. HA usage rate was 0.7% for the mild hearing loss group and 32.4% for the moderate or greater hearing loss group in the latest participating wave. PTABHE was significantly associated with cognitive impairment (odds ratio for every 10 dB 1.36; 95% CI 1.21-1.53, p0.0001) after adjusting for age, sex, education, depressed mood, smoking status, alcohol intake, income, activity, obesity, histories of hypertension, dyslipidemia, ischemic heart disease, diabetes, stroke, ear disease, and occupational noise exposure. PTABHE was also significantly associated with cognitive impairment in the mild hearing loss group (odds ratio for every 10 dB 1.34; 95% CI 1.05-1.72, p = 0.020) and moderate hearing loss group (odds ratio for every 10 dB 1.82; 95% CI 1.27-2.61, p = 0.001). HA use showed a significant suppressive effect on cognitive impairment in those with moderate hearing loss who always use an HA (odds ratio 0.54; 95% CI 0.30-1.00, p = 0.049).The prevalence of HA usage among Japanese community-dwelling elders with hearing loss is consistent, at around 10%. The hearing level remained a primary risk factor for cognitive impairment among elders with hearing loss after adjusting for several confounding factors. Regular HA use may have a protective effect on cognitive impairment in those with moderate hearing loss.

Background: Muscle mass is often mentioned not to reflect muscle strength. For muscle mass assessment skeletal muscle index (SMI) is often used. We have reported that dual-energy X-ray absorptiometry (DXA)-derived SMI does not change with age in women, whereas the cross-sectional muscle area (CSMA) derived from computed tomography (CT) does. Objectives: The present study aimed to compare CT and DXA for the assessment of muscle tissue. Design & Setting: Cross-sectional study in the local residents. Participants: A total of 1818 subjects (age 40-89 years) randomly selected from community dwellers underwent CT examination of the right mid-thigh to measure the cross-sectional muscle area (CSMA). Skeletal muscle mass (SMM) was measured by DXA. The subjects performed physical function tests such as grip strength, knee extension strength, leg extension strength, and gait speed. The correlation between CT-derived CSMA and DXA-derived SMM along with their association with physical function was examined. Results: After controlling for related factors, the partial correlation coefficient of muscle cross-sectional area (CSA) with physical function was larger than that of DXA-derived SMM for gait speed in men (p=0.002) and knee extension strength in women (p=0.03). The partial correlation coefficient of quadriceps (Qc) CSA with physical function was larger than that of DXA-derived SMM for leg extension power in both sexes (p=0.01), gait speed in men (p

We examined associations between dietary diversity and all-cause and cause-specific mortality in 386 men and 413 women (age range, 60&ndash, 79 years at baseline) who took part in the National Institute for Longevity Sciences-Longitudinal Study of Aging study from 1997 to 2000. Dietary intake was assessed using three-day dietary records and photographs. The Quantitative Index for Dietary Diversity was used to determine the dietary diversity among thirteen food groups. Dietary diversity score and each food intake were examined by sex-stratified tertiles, and hazard ratios (HR) were calculated to compare the risk for all-cause and cause-specific deaths across tertiles, after controlling for age, sex, body mass index, alcohol intake, smoking status, education, physical activity, and disease history. During a mean follow-up of 15.7 years, 289 subjects (36.2%) died. Compared to the subjects in the lowest tertile, the multivariate-adjusted HR for all-cause and cancer mortality was 0.69 (95% confidence interval (CI): 0.51&ndash, 0.94) and 0.57 (95% CI: 0.33&ndash, 0.98), respectively (trend p &lt, 0.05), in subjects in the highest tertile of dietary diversity. There were no significant associations between dietary diversity score and death from cardiovascular or cerebrovascular disease. Eating a variety of foods might contribute to longevity in older Japanese community dwellers.

Nutrition plays an important role in the development of frailty, and the present study examined the association between energy, macronutrient, and food intake and the development of physical frailty. Prospective cohort study. The National Institute for Longevity Sciences — Longitudinal Study of Aging (NILS-LSA), a community-based study. Participants included 166 men and 117 women aged 65–86 years without frailty components at baseline who participated in both the sixth (2008–2010) and seventh (2010–2012) waves of the NILS-LSA. Physical frailty was assessed using the modified criteria established by the Cardiovascular Health Study (2001). All participants were classified as “robust (number of frailty components: 0),” “prefrail (1–2),” or “frail (3–5).” Energy, macronutrient, and food intake was calculated based on 3-day dietary records during the sixth wave. Associations between dietary intake per day and the development of frailty 2 years later (from robust at the sixth wave to prefrail/frail at the seventh wave) were examined using multiple logistic regression analysis after adjusting for sex, baseline age, and other covariables. Among the participants included, 36% were classified as prefrail/frail 2 years later. Higher energy [1 standard deviation (SD), odds ratio (95% confidence interval): 362 kcal, 0.68 (0.49–0.94)], protein [16 g, 0.72 (0.53–0.97)], and fat [15 g, 0.69 (0.52–0.92)] intake was negatively associated with frailty development. Higher meat [38 g, 0.68 (0.51–0.92)] and dairy [114 g, 0.73 (0.55–0.96)] intake was negatively associated with frailty development. Higher energy intake was negatively associated with the development of weakness (low grip strength) and low activity, while higher protein intake was negatively associated with the development of low activity. Increased consumption of meat and dairy products may provide sufficient protein and fat necessary for achieving higher energy intake, thereby effectively preventing physical frailty among older Japanese individuals.

Aim The association between polypharmacy and the development of frailty is unknown. The present study assessed the longitudinal relationship between polypharmacy and frailty risk in Japanese community-dwelling older adults. Methods Participants included 299 non-frail older Japanese adults aged 65-81 years who participated in both baseline and follow-up examinations of a longitudinal study of aging (mean duration 6.2 years). At baseline examination, all prescribed and non-prescribed medications used during the previous 2 weeks were confirmed and coded by physicians. Frailty was diagnosed according to frailty criteria, and included shrinking, exhaustion, low activity, low grip strength and low gait speed. The relationship between frailty and the number of medications was assessed using multiple logistic regression analysis. The logistic regression model was used to control for potential confounders, including age at baseline, sex, body fat, total physical activity, education, employment, current smoking and number of comorbidities. Results The percentage of participants who developed frailty during follow up was 5.1% in those taking five or fewer medications, and 22.5% in those taking six or more medications. The fully adjusted odds ratio for frailty among participants taking six or more medications was 5.55 (95% confidence interval 2.17-14.22). Conclusions Polypharmacy appears to be a significant risk factor for the development of frailty in older Japanese adults. Geriatr Gerontol Int 2018; 18: 1497-1500.

Objectives The pathology of sudden sensorineural hearing loss, which is known as sudden deafness (SD), remains unknown. The purpose of this study was to investigate the association between mitochondrial uncoupling protein 2 (UCP2) polymorphism and SD risk. Materials and methods We compared 83 patients suffering from SD and 2048 controls who participated in the Longitudinal Study of Aging at the National Institute for Longevity Sciences. Multiple logistic regression was used to calculate the odds ratios (ORs) for SD with a polymorphism of the UCP2 (rs660339) gene. Results Under the additive model of inheritance, UCP2 polymorphisms showed significant association with a SD risk. The OR was 1.468 (95% confidence interval, 1.056-2.040) with an adjustment for any past history, such as diabetes, dyslipidemia, or hypertension, and for age and sex. Conclusion Our results imply that the UCP2 (rs660339) polymorphism has a significant association with the risk of developing SD.

Objective This study aimed to assess the relationship between weight gain from early adulthood and visceral fat accumulation. Methods The participants were 549 men aged 42 to 64 years who were randomly selected from the local resident registry for the National Institute for Longevity Sciences' neighbourhood. They were asked to recall their weight at 18 years of age, and then, post-18 weight-change values were calculated for each participant (their current weight minus their weight at 18). The participants were divided according to their median body mass index (BMI) at 18 years of age (initial BMI) (

AIM The association between frailty and increased mortality risk is unknown. The present study assessed the longitudinal relationship between frailty and mortality risk in Japanese community-dwelling older adults. METHODS Participants included 841 randomly chosen community-dwelling Japanese individuals, including 175 older adults aged 65-88 years with incomplete data at the baseline examination (July 2006-July 2008). Participants were followed from baseline to 31 December 2015 (mean 7.9 years). Frailty was diagnosed according to frailty criteria, including unintentional weight loss (shrinking), exhaustion, low activity, low grip strength and low gait speed. Information on deaths was obtained from a population dynamics survey. The relationship between frailty and mortality was assessed using Kaplan-Meier survival curves and Cox proportional hazards regression. The Cox proportional hazards model was used to control for potential confounders, including age at baseline, body fat, education, the Mini-Mental State Examination score, the Center for Epidemiologic Studies Depression Scale score, total physical activity, total caloric intake, alcohol intake, current smoking, household income and the number of current diseases. RESULTS The fully adjusted hazard ratio for all-cause mortality in the frailty group was 2.63 (95% confidence interval, 1.28-5.39; P for trend

Data were derived from the National Institute for Longevity Sciences-Longitudinal Study of Aging. Subjects comprised 403 men and 373 women aged 60-81 years at baseline who participated in the follow-up study at least once. Bean, soy product and soy isoflavone intake was assessed using a 3-day dietary record at baseline. Cognitive function was assessed by the Mini-Mental State Examination (MMSE). MMSE scores of ≤23 were used to define cognitive impairment. The relationship between bean, soy product and soy isoflavone intake and cognitive impairment was assessed using a generalized estimating equation. Multivariate-adjusted odds ratios (95% confidence intervals) for cognitive impairment with a 1 s.d. increase in total bean, total soybean and total soy isoflavone intakes were 0.48 (0.28-0.81; p = 0.006), 0.51 (0.32-0.83; p = 0.007), and 0.55 (0.32-0.93; p = 0.026), respectively, in women. Total soybean and soy isoflavone intake might decrease the risk of cognitive impairment in elderly Japanese women.

Background Age-related declines in skeletal muscle mass and strength, representing “sarcopenia,” are a growing concern in aging societies. However, the prevalence of low muscle mass based on the height2-adjustment has been shown to be extremely low, and a more appropriate definition of low muscle mass is needed, particularly for Asian women. The aim of this study was to explore the most appropriate adjustment of appendicular lean mass (ALM) for predicting mortality or disability risk using ALM or any of 5 adjustments of ALM among community-dwelling Japanese. Methods Subjects comprised 1026 men and 952 women between 40 and 79 years old at baseline (1997–2000) who participated in the National Institute for Longevity Sciences - Longitudinal Study of Aging, Japan. ALM (kg) and 5 adjusted indices of ALM (ALM/leg length, ALM/height, ALM/height2, ALM/weight, and ALM/body mass index [BMI]) were assessed at baseline. Disability was defined by long-term care insurance certification based on responses to a survey mailed in 2013, and death records were obtained as vital statistics until December 2014. Crude and adjusted Cox proportional hazard models were used to estimate hazard ratios for mortality or disability by sex-stratified quintiles of each ALM index (ALM and adjusted ALM) or sarcopenia-related indices. The area under the curve (AUC) was calculated with the multivariate-adjusted logistic regression model. Additionally, mixed-effects analyses were used to clarify the age-related ALM indices decline over 12 years (n = 1838). Results Crude Cox proportional hazard models and multivariate-adjusted logistic model (AUC) indicated that higher ALM and ALM/BMI in women, and higher ALM, ALM/leg length, ALM/height, and ALM/BMI in men were associated with lower risks for mortality or disability than ALM/height2. The mixed effect model indicated all ALM indices in men, and ALM, ALM/leg length, and ALM/height in women could better predict age-related lean muscle mass decline. Conclusions Unadjusted ALM in women, and ALM/leg length, ALM/height, ALM/BMI, and ALM in men may be more appropriate for predicting future mortality or disability than ALM/height2. Considering the age-related muscle mass decline, unadjusted ALM would be the first variable to assess, regardless of sex, in this Japanese cohort study. Electronic supplementary material The online version of this article (10.1186/s12877-017-0699-6) contains supplementary material, which is available to authorized users.

Inhibition of angiotensin-converting enzyme (ACE) is a strategy used worldwide for managing hypertension. In addition to converting angiotensin I to angiotensin II, ACE also converts neurotoxic β-amyloid protein 42 (Aβ42) to Aβ40. Because of its neurotoxicity, Aβ42 is believed to play a causative role in the development of Alzheimer's disease (AD), whereas Aβ40 has neuroprotective effects against Aβ42 aggregation and also against metal-induced oxidative damage. Whether ACE inhibition enhances Aβ42 aggregation or impairs human cognitive ability are very important issues for preventing AD onset and for optimal hypertension management. In an 8-year longitudinal study, we found here that the mean intelligence quotient of male, but not female, hypertensive patients taking ACE inhibitors declined more rapidly than that of others taking no ACE inhibitors. Moreover, the sera of all AD patients exhibited a decrease in Aβ42-to-Aβ40–converting activity compared with sera from age-matched healthy individuals. Using human amyloid precursor protein transgenic mice, we found that a clinical dose of an ACE inhibitor was sufficient to increase brain amyloid deposition. We also generated human amyloid precursor protein/ACE(+/−) mice and found that a decrease in ACE levels promoted Aβ42 deposition and increased the number of apoptotic neurons. These results suggest that inhibition of ACE activity is a risk factor for impaired human cognition and for triggering AD onset.

Aim To clarify the effectiveness of dietary diversity, calculated by dietary records, on cognitive decline. Methods Data were derived from the National Institute for Longevity Sciences – Longitudinal Study of Aging. Participants comprised 298 men and 272 women aged 60–81 years at baseline (second wave) who participated in the follow-up study (third to seventh wave) at least once. Cognitive function was assessed with the Mini-Mental State Examination in all study waves. Dietary diversity was determined using the Quantitative Index for Dietary Diversity based on a 3-day dietary record in the second wave. Cumulative data among participants with a Mini-Mental State Examination score >27 in the second wave were analyzed using a generalized estimating equation. Multivariate adjusted odds ratios and 95% confidence intervals for Mini-Mental State Examination scores ≤27 in each study wave according to a 1 standard deviation (increase), or quartiles of the Quantitative Index for Dietary Diversity at baseline, were adjusted for sex, age, follow-up time, baseline Mini-Mental State Examination score, education, body mass index, annual household income, current smoking status, energy intake and disease history. Results Multivariate adjusted odds ratio for a decline in Mini-Mental State Examination score was 0.79 (95% CI 0.70–0.89; P

Objectives This study aimed to clarify the effects of dietary diversity on a decline in higher-level functional capacity among middle-aged and elderly subjects in Japan. Methods Data were derived from the National Institute for Longevity Sciences - Longitudinal Study of Aging. Subjects comprised 1317 men and women aged 40 to 79 at baseline (1997–2000) who participated in a follow-up postal survey (2013). Higher-level functional capacity was measured using the Tokyo Metropolitan Institute of Gerontology index of competence (total score and 3 subscales). Dietary intake was assessed using a 3-d dietary record, and dietary diversity was determined using the Quantitative Index for Dietary Diversity (QUANTIDD). The odds ratios and 95% confidence intervals (CI) for a decline in higher-level functional capacity in the follow-up study according to quartiles of QUANTIDD at baseline were estimated, controlling for age, sex, higher-level functional capacity scores at baseline, body mass index, alcohol consumption, physical activity, depressive score, household income, education, smoking, and disease history. Results A total of 214 (16%), 145 (11%), 70 (5%), and 136 (10%) subjects showed a decline in total score for higher-level functional capacity (≥2), instrumental self-maintenance (≥1), intellectual activity (≥2), and social role (≥2), respectively. Multivariate-adjusted odds ratios (95% confidence intervals) for the score for intellectual activity decline according to the lowest through highest quartiles of QUANTIDD were 1.00 (reference), 0.47 (0.23–0.95), 0.44 (0.22–0.90), and 0.41 (0.20–0.83), respectively (P for trend = 0.06). Conclusions Daily intake of various foods may protect against a decline in intellectual activity among middle-aged and elderly community dwellers in Japan.

Background: Whether smokers and former smokers have worse lipid profiles or glucose levels than non-smokers remains unclear. Methods: The subjects were 1152 Japanese males aged 42 to 81 years. The subjects were divided according to their smoking habits (nonsmokers, former smokers, and current smokers) and their visceral fat area (VFA) (

Background and objectives Hearing impairment (HI) is a major global health concern. In addition, social networks are important for healthy aging. This study aimed to examine the association between HI and social relationships. Research design and methods This study was conducted by the National Institute for Longevity Sciences as part of its Longitudinal Study of Aging with 1176 Japanese participants aged 60 years or older (mean age 71.0 ± 7.4). The convoy model was used to evaluate participants’ network size. A pure-tone average hearing level (HL) of 0.5, 1, 2, and 4 kHz in the better ear >25 dB HL was defined as HI. Multivariate analysis was performed to assess the relationship between HI and the network size, adjusting for age, gender, years of education, presence of depressive symptoms, and higher-level functional capacity score. Results The mean network sizes across the three circles of the convoy model differed significantly by HI status (18.7 ± 0.4 in the no-HI group vs 17.0 ± 0.5 in the HI group, p = 0.003). In particular, the number of non-kin in the outer circle was significantly less in the HI group (4.1 ± 0.2 vs 3.3 ± 0.3, p = 0.004). Discussion and implications The social network size was significantly smaller in the HI group. The outer circle of people to whom the individual feels less close and the number of non-kin were related to the presence of HI. Therefore, HI may be associated with elderly people’s social relationships.

This study describes trends in dietary diversity and food intake over 12 years according to age at first participation in the study. Prospective cohort study. The National Institute for Longevity Sciences-Longitudinal Study of Aging, a community-based study. Participants included 922 men and 879 women who participated in the first study-wave (age, 40-79 years) and also participated in at least one study-wave from the second to seventh study-wave. Study-waves were conducted biennially. Dietary intake was calculated from 3-day dietary records with photographs. Dietary diversity was determined using the Quantitative Index for Dietary Diversity based on food intake. A mixed-effects model was used to estimate linear changes in dietary diversity and food intake over 12 years according to age at first study-wave. Mean (standard deviation (SD)) follow-up time and number of study-wave visits were 9.5 (3.7) years and 5.4 (1.8), respectively. Mean (SD, range) dietary diversity score was 0.86 (0.06, 0.52-0.96) in men and 0.88 (0.04, 0.66-0.96) in women, respectively. Fixed effects for interactions of age and time with dietary diversity score were statistically significant (p

The purpose of this study was to estimate sex differences in age-related grip strength decline and describe the course of decline in grip strength from age 40 to 89 years by a longitudinal epidemiological study. Participants were randomly selected community-living men (n = 648) and women (n = 598) aged 40 to 79 years at baseline. Grip strength was measured with standard techniques every other year over a 10-year period. The preservation rate of grip strength was calculated as the 10-year follow-up value divided by the baseline value. The relationship between the preservation rates of grip strength and age group (by decade) at baseline by sex was analyzed using Two-Way Analysis of Variance and the Tukey-Kramer method. The trajectories of grip strength over 10 years were plotted for both men and women. The mean grip strength preservation rates of participants in their 40s, 50s, 60s and 70s over 10 years was 0.90, 0.88, 0.84 and 0.79 in men, and 0.89, 0.89, 0.89 and 0.88 in women, respectively. There were significant differences in sex and age group at baseline in the preservation rate of grip strength. Among men, the preservation rate of grip strength for the 70s group was significantly lower than that of younger groups (p < 0.05); however, no significant difference was observed among age groups in women. The trajectories of grip strength decline year by year were steep in men, but even in women. Age-related decline in grip strength markedly increased in older men, but remained constant throughout middle and late adulthood in women.

A healthy elderly person may require nursing care after becoming frail, a condition characterized by slowness, weakness, exhaustion, low activity, and shrinking. Because few cohort studies have examined frailty in detail, the prevalence of frailty among the elderly in Japan is unclear. We examined the prevalence of frailty based on the frailty phenotype established by Fried using a large-scale cohort of randomly selected community-dwelling elderly in Japan. Participants included 871 elderly (446 men and 425 women) aged 65-91 years who participated in the sixth wave examination (July 2008 to July 2010) and seventh wave examination (July 2010 to July 2012) of the National Institute for Longevity Sciences - Longitudinal Study of Aging. The prevalence of shrinking, exhaustion, low activity, slowness, and weakness among the elderly participants was 10.2%, 38.6%, 21.1%, 11.4%, and 15.5%, respectively. The prevalence of frailty characterized by the limitations in 3 or more of these 5 domains was 8.5%. The prevalence of pre-frailty, characterized by limitations in 1 or 2 of 5 domains was 52.2%. Elderly who were diagnosed with frailty and pre-frailty included 3,086,000 people and 17,950,000 people, respectively. These data could contribute to the promotion of prevention and treatment strategies for frailty in Japan.

The effect ofn-3 long-chain PUFA (n-3 LCPUFA) on depression in healthy subjects is unclear, and most of the previous studies have focused on populations eating Western diets with lower fish intake. The present study investigated the association between blood levels ofn-3 LCPUFA and depressive symptoms in Japanese community dwellers with highern-3 LCPUFA blood levels. A cross-sectional study was conducted from 2006 to 2008, including 1050 men and 1073 women aged 40 years or older from the National Institute for Longevity Sciences – the Longitudinal Study of Aging. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to assess depressive symptoms. Multiple logistic regression analysis was performed to estimate the OR and 95 % CI for a CES-D score ≥16. Serum concentrations ofn-3 PUFA, but notn-6 PUFA, were inversely associated with depressive symptoms. Compared with the lowest quintile, the adjusted OR for serum EPA at the fourth and fifth quintiles were 0·55 (95 % CI 0·35, 0·85) and 0·64 (95 % CI 0·42, 0·98), respectively, and at the fifth quintile for DHA it was 0·58 (95 % CI 0·37, 0·92), for the presence of depressive symptoms (Pfor trend=0·013 and 0·011, respectively). Serum levels of EPA and DHA were inversely associated with depressive symptoms in Japanese community dwellers with higher blood levels ofn-3 LCPUFA, suggesting thatn-3 LCPUFA intakes corresponding to higher levels in a Japanese population may have implications for a lower prevalence of depression.

The aims of this study were to determine the prevalence of MRI abnormalities which were suspected as sinusitis in community-dwelling middle-aged and elderly Japanese and to identify risk factors for the MRI abnormality. Brain magnetic resonance imaging (MRI) data from the National Institute for Longevity Sciences, Longitudinal Study of Aging (NILS-LSA) were used for the analysis. Among the 2330 subjects in the NILS-LSA, 1933 participants were categorized as having no MRI abnormality or MRI abnormality using the Lund-Mackay (LM) score. The mean LM score of the participants was 0.88±1.92, and 144 (7.4%) participants had MRI abnormalities which were suspected as sinusitis when it was classified as an LM score greater than or equal to 4. The prevalence of MRI abnormality was significantly higher in participants of older age and the male sex, in participants with obesity, hypertension, bronchial asthma, chronic bronchitis, gout, or hyperuricemia and in ex- or current smokers. A multivariate logistic regression revealed that older age (odds ratio [OR] = 1.17), obesity (OR = 1.54), a smoking habit (OR = 1.71), history of asthma (OR = 3.77), and chronic bronchitis (OR = 2.66) were significant risk factors for MRI abnormality.

Although high circulation adiponectin levels have been reported to disturb physical performance, the association between adiponectin and sarcopenia has not been reported. The aim of this study is to clarify the effects of adiponectin on muscle mass and risk of sarcopenia in a community living population. Data were derived from the National Institute for Longevity Sciences - Longitudinal Study of Aging. Subjects comprised 2023 men and women aged 40 to 88 who participated in the 5th wave (2006–2008) examination without sarcopenia and also participated in the 6th (2008–2010) and/or 7th wave examination (2010–2012). Muscle mass was accessed by dual-energy x-ray absorptiometry and skeletal mass index (SMI) was calculated by total muscle mass of arms and legs / square of height (kg/m2). Sarcopenia was determined by the algorithm of the Asian Working Group of Sarcopenia. Serum adiponectin was significantly higher in sarcopenia comparing with normal subjects (9.72 ± 0.57 vs 6.21 ± 0.09µg/dL). Age and sex- adjusted odds ratio of developing sarcopenia by 1SD increase in adiponectin was 1.273 (95%CI: 1.047–1.550) by generalized estimation equation. However, the odds ratio was not significant after controlling for SMI at the baseline. Adiponectin level was significantly different by CDH13 rs3865188 genotype (TT: 7.36 ± 0.15, TA: 5.90 ± 0.16, AA: 4.18 ± 0.34µg/dL in the subjects), but prevalence of sarcopenia did not differ by the genotype. From these results, it is suspected that decrease in muscle mass causes increase in adiponectin, and adiponectin does not reduce muscle mass.

Relationship between ApoE-ε4 allele and longitudinal changes of cognitive abilities were examined in middle-aged and elderly community-dwelling Japanese. The participants were 2088 men and women (age: 40–79, excluding history of dementia) who participated in the National Institute for Longevity Sciences- Longitudinal Study of Aging. They were tested in up to eight times, for approximately 15 years. Cognitive abilities including general knowledge and processing speed were assessed using Information and Digit Symbol Test, components of Wechsler Adult Intelligence Scale-Revised. Participants with 1 or 2 ApoE-ε4 allele were considered ε4 carriers (n=406, 19.4%). General linear mixed models were comprised of fixed effects of ApoE-ε4 (carriers/non-carriers), baseline age, follow-up years, their interactions and covariates (sex, education, BMI, alcohol intake, marital status, occupation, current smoking, past and present illness and retest effect). Individual variance (intercept and slope) assigned as random effects. Results indicated that main effects of Apoe-ε4 were not significant for both test scores. However, the interaction terms, ApoE-ε4×age×follow-up years were significant for general knowledge and processing speed (p=.016; p=.004), suggesting the effect of ApoE-ε4 on cognitive changes differed depending on baseline age. Predicted trajectory substituting baseline age and ApoE-ε4 status indicated that differences in slopes between ApoE-ε4 carriers and non-carriers were significant after 55 years of age for general knowledge, and 57 years of age for processing speed, with rate of decline in ApoE-ε4 carriers being larger than that in non-carriers. In conclusion, APOE-ε4 might affect the decline in general knowledge and processing speed from the latter half of their 50s.

Aim Sex- and age-related differences in mid-thigh composition and muscle quality remain unclear. The present study aimed to clarify these differences using computed tomography in middle-aged and elderly Japanese. Methods A total of 2310 participants (age 40–89 years), who were randomly selected from the local residents, underwent computed tomography examination of the right mid-thigh. Thigh circumference and cross-sectional areas of the thigh, muscle, quadriceps, non-quadriceps, fat, and bone were measured. Knee extension strength and muscle quality index (knee extension strength/quadriceps cross-sectional area) were also assessed. Sex- and age-related differences in these indices were analyzed. Results The thigh cross-sectional area in men and women decreased by 0.6% and 0.5%/year, respectively, because of a decrease in muscle cross-sectional area (men 75.2%, women 40.6%), fat cross-sectional area (men 24.4%, women 59.6%) and bone cross-sectional area (men 0.5%, women −0.2%). Muscle cross-sectional area in men and women decreased by 0.6% and 0.4%/year, respectively, because of a decrease in quadriceps cross-sectional area (men 65.6%, women 81.6%) and non-quadriceps cross-sectional area (men 34.4%, women 18.4%). Muscle quality in men and women decreased by 0.4% and 0.3%/year, respectively. Conclusion Thigh cross-sectional area decreased with age mainly because of a decrease in muscle cross-sectional area in men and fat cross-sectional area in women. The rate of decrease in muscle cross-sectional area was 1.5-fold higher in men than in women. Muscle cross-sectional area decreased with age mainly because of a decrease in quadriceps cross-sectional area, especially in women. Decrease in muscle quality with age was similar in both sexes. Geriatr Gerontol Int 2015; 15: 700–706.

Objectives The relationship between physical frailty and regional gray matter volume in the brain was investigated among community-dwelling older Japanese people. Methods Participants (N = 835; age range 65–89 years) were community-dwelling older adults in Obu City and Higashiura Town in Aichi Prefecture, Japan. Physical frailty was determined by the modified criteria of the Cardiovascular Health Study, which included weight loss, slowness, weakness, exhaustion, and low physical activity. Regional gray matter volumes were evaluated from 3-dimensional T1-weighted magnetic resonance images by statistical parametric mapping. The relationship between physical frailty and regional gray matter volume was analyzed with an analysis of covariance design using statistical parametric mapping adjusting for age, sex, and education level. Results The voxel-based analyses showed that physical frailty per se was not significantly associated with any brain region. However, weakness was associated with reduced gray matter volumes in the hippocampus, amygdala, and fusiform gyrus, and slowness was associated with reduced gray matter volumes in the hippocampus, amygdala, fusiform gyrus, medial prefrontal and orbitofrontal cortex, inferior frontal gyrus, primary somatosensory cortex, insula, superior temporal sulcus, and cerebellum. Other components of physical frailty were not associated with the gray matter volumes in any regions. Conclusions and implications The weakness and slowness components of physical frailty were linked to reduced gray matter volume in brain regions associated with not only physical mobility but also cognitive functions and social processes. This study addressed the underlying mechanisms in the progression of physical, cognitive, and social frailty, from the perspective of brain structures that are associated with frailty.

The associations between meat/fish consumption, docosahexaenoic acid (DHA)/eicosapentaenoic acid (EPA) intakes, and blood DHA/EPA levels, and mortality in Japan were examined as part of the National Institute for Longevity Sciences-Longitudinal Study of Aging: 520 men and 534 women (60&ndash, 79 years at baseline) were followed from 1997&ndash, 2017. Nutritional intakes were assessed using a 3-day dietary record and fasting venous blood samples were collected. Serum EPA/DHA concentrations, the EPA/arachidonic acid (ARA) ratio, EPA/DHA intakes, and fish/meat intakes were examined in tertiles as indicator variables, and hazard ratios (HR) were calculated to compare the risk of death across tertiles controlling for sex, age, body mass index, smoking status, alcohol drinking, physical activity, education, employment, and history of diseases. During follow-up (mean 11.7 years), 422 subjects (40.4%) died. The multivariate-adjusted HR for all-cause mortality in subjects in the highest tertile of serum DHA and EPA/ARA ratio was 0.73 (95% confidence intervals (CI): 0.53&ndash, 0.99) and 0.71 (95% CI: 0.53&ndash, 0.96) compared with subjects in the lowest tertile, respectively (trend p &lt, 0.05). There were no significant associations between mortality and serum EPA/ARA and DHA/EPA intakes. An increased serum DHA level or EPA/ARA ratio might be recommended for longevity to Japanese community dwellers.

Aim Sarcopenia accelerates frailty syndrome, and adversely affects activities of daily living and quality of life. The aim of the present study was to assess longitudinal relationships between baseline androgen and muscle mass changes in Japanese women. Methods Data were collected from 539 community-dwelling, Japanese women aged 40–79 years at baseline who participated in both baseline and follow-up examinations of a longitudinal study of aging (mean duration 8.3 years). Appendicular skeletal muscle mass was measured with dual-energy X-ray absorptiometry at baseline and follow-up examinations. The cut-off point for sarcopenia was a skeletal muscle index (appendicular skeletal muscle mass/height2)

Aim The present study aimed to evaluate age-related changes in skeletal muscle mass among community-dwelling middle-aged and elderly Japanese. Methods This 12-year longitudinal study of a community-dwelling population in Japan included 15 948 examinations of 1962 men and 1990 women. We assessed appendicular muscle mass (AMM) using dual X-ray absorptiometry and calculated the skeletal muscle index (SMI) using the AMM divided by height squared (kg/m2). Low muscle mass was defined as muscle mass minus two standard deviations below the mean for young healthy adults. Leg extension power (watts) was measured as an index of muscle function. Longitudinal data of skeletal muscle mass were analyzed using a general linear mixed-effect model. Results The prevalence of low muscle mass at the first wave of examinations was 27.1% in men and 16.4% in women. Longitudinal analysis showed that skeletal muscle mass decreased with aging during the 12-year study period except in middle-aged men, and to a greater extent in elderly men (P for trend

Background/Objectives: To clarify the association of serum docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) levels with cognitive decline over 10 years. Subjects/Methods: This study was part of the National Institute for Longevity Sciences - Longitudinal Study of Aging, and was conducted with 232 male and 198 female Japanese community-dwelling subjects aged 60–79 years in the second wave (2000–2002). Cognitive function was assessed with the Mini-Mental State Examination (MMSE) in both the second and seventh (2010–2012) waves. Fasting venous blood samples were collected in the morning, and serum DHA and EPA levels were measured. Multiple logistic regression analysis was performed among participants with an MMSE score ⩾24 in the second wave (n=430) to estimate the odds ratio (OR) and 95% confidence interval (CI) for MMSE score ⩽23 or MMSE score decline ⩾4 10 years later. These estimates were based on baseline tertiles of serum DHA or EPA levels, and controlled for age, sex, education, MMSE score at baseline, alcohol consumption, current smoking, body mass index and disease history. Results: Fifteen (3.5%) subjects whose MMSE score was ⩽23 and 36 (8.3%) subjects whose MMSE score declined to ⩾4 showed cognitive decline. Multivariate-adjusted OR (95% CI) for the lowest through highest tertiles of serum DHA to MMSE score ⩽23 or decline⩾4 were 1.00 (reference), 0.11 (0.02–0.58) and 0.17 (0.04–0.74), or 1.00 (reference), 0.22 (0.08–0.61) and 0.31 (0.12–0.75), respectively (P for trend=0.01 or 0.04). Serum EPA was not associated with cognitive decline. Conclusions: The study gives some indication that a moderately high level of serum DHA might prevent cognitive decline among community-dwelling elderly Japanese individuals.

BACKGROUND: If cognitive decline can be prevented through changes in daily diet with no medical intervention, it will be highly significant for dementia prevention. OBJECTIVES: This longitudinal study examined the associations of different food intakes on cognitive decline among Japanese subjects. DESIGN: Prospective cohort study. SETTING: The National Institute for Longevity Sciences - Longitudinal Study of Aging, a community-based study. PARTICIPANTS: Participants included 298 males and 272 females aged 60 to 81 years at baseline who participated in the follow-up study (third to seventh wave) at least one time. MEASUREMENTS: Cognitive function was assessed with the Mini-Mental State Examination (MMSE) in all study waves. Nutritional intake was assessed using a 3-day dietary record in the second wave. Cumulative data among participants with an MMSE >27 in the second wave were analyzed using a generalized estimating equation. Multivariate adjusted odds ratios (OR) and 95% confidence intervals (CI) for an MMSE score ≤27 in each study wave according to a 1 standard deviation (SD) increase of each food intake at baseline were estimated, after adjusting for age, follow-up time, MMSE score at baseline, education, body mass index, annual household income, current smoking status, energy intake, and history of diseases. RESULTS: In men, after adjusting for age, and follow-up period, MMSE score at baseline, the adjusted OR for a decline in MMSE score was 1.20 (95% CI, 1.02-1.42; p=0.032) with a 1-SD increase in cereal intake. After adjusting for education and other confounding variables, the OR for a decrease in MMSE score did not reach statistical significance for this variable. In women, multivariate adjusted OR for MMSE decline was 1.43 (95% CI, 1.15-1.77; p=0.001) with a 1-SD increase in cereal intake and 0.80 (95% CI, 0.65-0.98; p=0.034) with a 1-SD increase in milk and dairy product intake. CONCLUSIONS: This study indicates that a 1-SD (108 g/day) decrease in cereal intake and a 1-SD (128 g/day) increase in milk and dairy product intake may have an influence of cognitive decline in community-dwelling Japanese women aged 60 years and older. Further studies are needed in order to explore the potential causal relationship.

The association of knee extensor muscle strength with bone mineral density (BMD) has been reported in cross-sectional epidemiological studies, but it remains unclear whether or not this is the case with longitudinal change. Thus, we investigated whether or not the knee extension strength can predict the incidence of osteopenia or osteoporosis after 6 years, then compared the difference between sexes. Subjects were 1255 community-dwelling Japanese men and menopaused women, aged 40–81 years. BMD of lumbar spine and femoral neck was assessed by dual-energy X-ray absorptiometry twice at 6-year intervals. Subjects were divided into three groups, normal, osteopenia, and osteoporosis, depending on their young adult mean BMD % value. In the cross-sectional analysis the correlations between the knee extension strength and BMD of the two regions were examined, using Pearson’s correlation coefficient. Longitudinal analyses were then conducted to determine the odds ratio, controlled for age and BMI, given that those who were normal in the initial stage developed osteopenia or osteoporosis after 6 years, for every 1 SD decrease in knee extension strength, as well as those who first had normal or osteopenia and then developed osteoporosis. Cross-sectional analysis showed a statistically significant relation between knee extensor muscle strength and BMD at both the lumbar spine (p = 0.02) and the femoral neck (p

This study examined the relation between educational level and intellectual change in Japanese older adults. Participants (age = 65–79 years, n = 593) comprised the first-wave participants of the National Institute for Longevity Sciences-Longitudinal Study of Aging (NILS-LSA). They were followed for 10 years and were tested six times. Educational levels were divided into two groups (low-educated or high-educated), and intellectual changes for the 10 years were assessed using the Japanese Wechsler Adult Intelligence Scale-Revised Short Forms (JWAIS-R-SF); subtests included Information, Similarities, Picture Completion, and Digit Symbol. General linear mixed-model analyses revealed that education had not affected 10-year changes of the Information, Similarities, and Picture Completion subtest scores. In contrast, education was significantly associated with a change in the Digit Symbol subtest score; individuals with higher levels of education showed greater decline than those with less education, although they had higher ability at every time point. These findings suggest that higher education does not protect against intellectual decline in late life, although it is associated with long-term individual differences in intelligence.

Aim Little is known about longitudinal changes of body composition measured by dual-energy X-ray absorptiometry (DXA) in middle-aged and elderly individuals. We evaluated longitudinal changes of body composition, and age and sex differences in appendicular skeletal muscle mass. Methods Participants were 1454 community-dwelling Japanese men and women aged 40–79 years. Body composition at baseline and 6-year follow up was measured by DXA. Results Fat increased significantly in men of all ages, and in women aged in their 40s and 50s. Among men, arm lean tissue mass (LTM) changed by 0.9%, −0.5%, −1.4% and −3.7%, respectively, for the 40s to the 70s, and decreased significantly in the 60s and 70s. Leg LTM in men changed by −0.4%, −1.3%, −1.7% and −3.9%, respectively, and decreased significantly from the 50s to the 70s. Compared with the preceding age groups, significant differences were observed between the 60s and 70s in arm and leg LTM change in men. Among women, arm LTM changed by 0.7%, 0.2%, 1.6% and −1.5%, respectively, which was significant in the 60s and 70s. Leg LTM decreased significantly in all age groups of women by −2.0%, −2.8%, −2.4% and −3.9%, respectively. With respect to sex differences, leg LTM loss rates were significantly higher in women than men at the 40s and 50s. Conclusions Longitudinal data suggest that arm and leg LTM decreased markedly in men in their 70s, and leg LTM had already decreased in women in their 40s. Geriatr Gerontol Int 2014; 14: 354–361.

Aim The association between sarcopenia diagnosed according to the criteria of the Asian Working Group for Sarcopenia and increased mortality risk is currently unknown. The present study assessed the longitudinal relationship between sarcopenia and mortality risk in an elderly Japanese population. Methods Participants were 720 community-dwelling Japanese individuals aged 65–79 years at baseline (November 1997 to April 2000). The participants were followed from baseline to 31 December 2014 (mean duration 11.0 years). Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia criteria, using extremity muscle mass assessed by dual-energy X-ray absorptiometry, grip strength and gait speed. A population dynamics survey was used to obtain information on deaths. The relationship between sarcopenia and mortality was assessed using Kaplan–Meier survival curves and Cox proportional hazards regression. The Cox proportional hazards model was used to control for potential confounders, including age at baseline, body mass index, total caloric intake, alcohol intake, current smoking habits, leisure-time physical activity and the number of current diseases. Results The fully adjusted hazard ratio for all-cause mortality among men in the sarcopenia group was 1.95 (95% confidence interval 1.04–3.67) compared with that in the normal group. No significant association between sarcopenia and all-cause mortality was observed among women. Conclusion The complications of sarcopenia, including low muscle mass, low grip strength and low gait speed, appear to be significant risks for mortality in older Japanese men. Geriatr Gerontol Int 2017; 17: 1642–1647.

Aims To estimate the prevalence of lower urinary tract symptoms (LUTS) in Japanese people, and the relationships to aging and sex, we carried out the present population-based study. Methods The present study included 1198 men aged 60.7 ± 12.5 years and 1218 women aged 60.8 ± 12.7 years who participated in a study of aging carried out at the National Center for Geriatrics and Gerontology between 2006 and 2008, using linguistically validated versions of the International Prostate Symptom Score (I-PSS) and International Consultation on Incontinence Questionnaire Short-form (ICIQ-SF). Results The prevalence of I-PSS ≥8 was 25.2% in men and 11.8% in women, that of two or more a week urinary incontinence was 3.3% and 6.6%, respectively, and that of I-PSS ≥8 and/or two or more a week urinary incontinence was 25.8% and 16.0%, respectively. The prevalence of the seven symptoms in I-PSS increased with aging. Just 9.1% of men and 4.6% of women who reported LUTS were medicated for LUTS. Conclusions The results showed that the severity of LUTS in Japan was related to aging. The prevalence of LUTS with I-PSS ≥8 in Japan is similar to that in other countries. Geriatr Gerontol Int 2013; 13: 1010–1017.

Folate metabolism is essential for cellular functioning. Despite extensive research on the roles of folate-metabolism-related gene polymorphisms in the pathophysiology of many diseases, such as cardiovascular disease, cancers, and sudden sensorineural hearing loss, little is known about their association with Ménière's disease (MD). The aim of this study was to investigate the effect of methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms (C677T and A1298C) on the risk of MD in a Japanese population. We examined the C677T and A1298C (rs1801133 and rs1801131) polymorphisms in the MTHFR gene and compared them between 1946 adults (986 men and 960 women) participating in the National Institute for Longevity Sciences Longitudinal Study of Aging and 86 cases of MD. A multiple logistic regression was performed to obtain odds ratios (ORs) for the risk of MD regarding the MTHFR polymorphisms before (model 1) and after (model 2) adjustment for age and sex factors. The OR of MTHFR C677T for the risk of MD was 0.669 (95% confidence interval [CI], 0.479-0.934) in model 1 and 0.680 (95% CI, 0.484-0.954) in model 2. In contrast, the OR of MTHFR A1298C for the risk of MD was 1.503 (95% CI, 1.064-2.123) in model 1 and 1.505 (95% CI, 1.045-2.167) in model 2. Our results imply that the MTHFR C677T and A1298C polymorphisms are associated with the risk of MD.