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• Exercise alone or combined with nutrition significantly improved walking parameters. • Those with unchanged/reduced walking speed had weaker lower extremities. • Those with unchanged/reduced walking speed were likely to have knee osteoarthritis. • Additive effects of milk fat globule membrane were not observed. To investigate the effects of exercise and milk fat globule membrane (MFGM) supplementation on walking ability and walking parameters in community-dwelling elderly Japanese women with declined walking ability. A randomized placebo controlled trial was performed on 126 elderly community-dwelling women over 79 years old. Participants were randomly assigned to one of four three-month interventions: exercise and MFGM (Ex + MFGM), exercise and placebo (Ex + P), MFGM, and placebo interventions. The exercise intervention group performed one-hour progressive exercise classes twice a week. The MFGM supplementation included ingesting 1 g of MFGM per day. Medical history, physical function measurements included grip strength, knee extension strength, walking speed, as well as walking parameters, and blood components were analyzed. Significant group × time interactions were observed in usual walking speed, stride, and foot progression angle between the groups. Walking speed improved in both exercise groups (P < 0.001). Similarly, stride significantly increased in the exercise groups compared to the MFGM and placebo groups (P < 0.001). Foot progression angle decreased in the exercise groups (P = 0.023) but not in MFGM or placebo groups. Participants with decreased or unchanged walking speed had significantly lower knee extension strength at baseline (P = 0.016), and a higher prevalence of knee OA (P = 0.033, P = 0.010, respectively). The exercise interventions alone or combined with nutrition were effective in improving walking speed as well as other walking parameters. Improvement in stride and foot progression angle may have contributed to the increase in walking speed. However, augmented effects of MFGM with exercise could not be confirmed. [ABSTRACT FROM AUTHOR]

Aim: To investigate the prevalence and associated factors of cognitive frailty and cognitive frailty‐related falls in community‐dwelling older people. Methods: A total of 25 out of 1192 community‐dwelling older people aged >70 years with cognitive frailty participated in the present cross‐sectional study. Cognitive function was assessed using the Mini‐Mental State Examination. Physical function measures included calf circumference, Timed Up and Go (TUG) and usual walking speed. Interviews were carried out to assess Council on Nutrition Appetite Questionnaire (CNAQ); chronic diseases including hypertension, diabetes and falls; as well as physical frailty, defined as having three of five criteria: muscle weakness, slowness, exhaustion, low activity and weight loss. Results: The prevalence of cognitive frailty was 2.1%. Participants with cognitive frailty had significantly reduced Mini‐Mental State Examination and calf circumference; and higher instrumental activities of daily living disability and falls. Old age (OR 1.151, 95% CI 1.053–1.257), fall history (OR 3.577, 95% CI 1.381–9.263), having four or more chronic diseases (OR 7.419, 95% CI 2.117–26.005) and slower TUG (OR 1.234, 95% CI 1.041–1.462) were significantly associated with cognitive frailty, whereas greater calf circumference (OR 0.748, 95% CI 0.625–0.895) and CNAQ (OR 0.736, 95% CI 0.628–0.8631) had protective effects. Old age (OR 1.132, 95% CI 1.002–1.280), hospitalization (OR 10.090, 95% CI 2.554–39.854), having four or more chronic diseases (OR 5.120, 95% CI 1.113–23.557) and slower TUG (OR 1.394, 95% CI 1.167–1.665) were significantly associated with cognitive frailty‐related falls, whereas CNAQ (OR 0.704, 0.571–0.868) had protective effects. Conclusions: Age, chronic disease, TUG and CNAQ were significantly associated with cognitive frailty and cognitive frailty‐related falls. The TUG and CNAQ have the greatest potential for improvement by intervention or lifestyle change. Further research is necessary to determine the efficacy of positive changes in these factors for symptomatic improvements. Geriatr Gerontol Int 2019; 19: 647–653. [ABSTRACT FROM AUTHOR]

Background: Exercise may reduce the risk of disability for activities of daily living (ADL), but the degree of associations between specific exercise types and such a risk remains unclear. This study aimed to examine the longitudinal associations between exercise types and the incidence of ADL disability in older women. Methods: This 8‐year population‐based prospective cohort study enrolled 1003 community‐dwelling older Japanese women without ADL disability in the baseline surveys. In the baseline surveys, all participants were asked whether or not they participated in any of 16 exercise types through a face‐to‐face interview. ADL were assessed using a modified form of the Katz index that comprised five ADL tasks. ADL disability was defined as dependence in at least one ADL task during the 8‐year follow‐up period. Binary logistic regression analyses were applied to obtain adjusted odds ratios (ORs) and 95% confident intervals (CIs) for the incidence of ADL disability based on participation or non‐participation in each exercise type. Results: Activities of daily living disability was noted in 130 participants (13.0%) over the 8‐year follow‐up period. After adjustment for confounders and other exercise types, participation in dancing, compared to non‐participation, was associated with a significantly lower OR (0.27; 95% CI: 0.09‐0.75) for incident ADL disability. There were no significant associations between other exercise types and incident ADL disability. Conclusion: Dancing was significantly and independently associated with a lower incidence of ADL disability. Thus, dancing may solely contribute to a reduced risk of ADL disability in older women. [ABSTRACT FROM AUTHOR]

Objectives To investigate whether higher serum β2-microglobulin (B2M) levels, a kidney function marker, are associated with prevalent and incident frailty in community-dwelling older women. Design Cross-sectional and longitudinal analyses of a prospective cohort. Setting Population-based cohort study in Tokyo, Japan. Participants Community-dwelling women aged 75 and older with adequate data for assessing frailty status (N = 1,191) and a subset of participants without baseline frailty but with repeated frailty assessment at 2 and 4 years of follow-up. Measurements The primary predictor was B2M level. Outcomes were prevalent and incident frailty during the 4-year follow-up period. Frailty was defined as presence of three of the five Fried criteria: weight loss, exhaustion, weakness, slowness, and low physical activity. Adjusted odds ratios for the main confounders were obtained using logistic regression. Discrete-time Cox proportional hazards models were used to determine the risk of developing frailty. Results The study included 241 (20.2%) women with prevalent frailty at baseline and 139 (21.1%) with incident frailty during the 4-year follow-up. On multivariate analysis adjusted for multiple potential confounders, the odds of prevalent frailty were 2.5 times as great with B2M levels of 1.9 to 2.1 mg/L as with levels less than 1.6 mg/L and 2.0 times as great with B2M levels of 2.2 mg/L or more. In the unadjusted model, B2M levels of 1.9 to 2.1 mg/L were associated with a greater incidence of frailty than B2M levels of less than 1.6 mg/L (hazard ratio = 1.72, 95% confidence interval = 1.04-2.86). In the multivariate analysis adjusted for potential confounders, no significant association was noted between the highest B2M quartile and incident frailty. Conclusion Higher B2M levels were independently associated with greater frailty at baseline in older adults but only slightly associated with greater risk of incident frailty over 4 years of follow-up. [ABSTRACT FROM AUTHOR]

To investigate the effects of mold-fermented cheese (MFC) on brain-derived neurotrophic factor (BDNF) in community-dwelling older Japanese women with mild cognitive impairment (MCI). Randomized controlled crossover trial. Participants were randomly assigned to 2 groups. The MFC group was provided with 33.4 g MFC (camembert cheese) daily for 3 months, and the non-MFC group was provided with the same amount of non-MFC (processed cheese made from mozzarella cheese and cream cheese) for 3 months. After the post-intervention analysis (primary analysis), there was a 3-month washout period, followed by a crossover period (secondary analysis). Urban community in Tokyo, Japan. A total of 71 older women aged ≥70 years with MCI based on selected criteria in 689 community-dwelling women. Face-to-face interviews were conducted to administer the Geriatric Depression Scale (GDS) and Mini-Mental State Examination (MMSE) and collect data on medical history. Physical function measures included grip strength, knee extension strength, and usual walking speed. Blood samples were obtained to determine the levels of albumin, vitamin D, high-sensitivity C-reactive protein, and BDNF. Significant interactions were observed in BDNF after intervention of MFC intake in the secondary (F = 5.368, P =.024) and combined analyses (F = 4.354, P =.039) but not the primary analysis. There were no significant changes in the 3 categories of MMSE score (normal, MCI, moderate or severe cognitive impairment), GDS score, physical function, and blood indicators. Three months of MFC ingestion had beneficial effects on BDNF levels in community-dwelling older women with MCI; however, the BDNF increases did not translate into MMSE scores. Further study into the effects of interventions on cognitive function and depression in older people with MCI is necessary. [ABSTRACT FROM AUTHOR]