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Background/Objective: Although there are many reports on the association between cognitive and physical functions in older adults, little information is available on those aged ≥75 years. Therefore, this study aimed to determine whether mild cognitive impairment (MCI) in older adults over 75 years who live in independent senior housing is associated with physical function. Methods: In this study, 271 participants (174 women and 97 men) with a mean age of 85.4 ± 4.7 years were included. Cognitive function was assessed using the Japanese version of the Montreal Cognitive Assessment; a score < 26 confirmed MCI. MCI was an objective variable in univariate and multivariable logistic regression analyses. Physical function was measured using hand grip strength, normal and maximum gait speeds, and the 30 s chair stand test. Physical function was an explanatory variable adjusted for age and divided into tertiles (high, middle, and low) based on sex. The significance level was set at 5%. Results: There were 170 participants (63%) with MCI. Compared to the non-MCI group, the MCI group had significantly higher age and significantly lower normal and maximum gait speeds and 30 s chair stand test values Age-adjusted univariate analyses in women showed higher MCI rates in the low-fitness group than in the high-fitness group for maximum gait speed and 30 s chair stand test values. No variables were associated with MCI in men. Conclusions: MCI may be associated with physical function in women and older adults over 75 years who live in independent senior housing. [ABSTRACT FROM AUTHOR]

The purpose of this study was to conduct a cross-sectional analysis of the association between hearing aid use and cognitive decline in community-dwelling older adults with hearing impairment, stratified by cardiovascular risk level. This cross-sectional study covers 1857 hearing-impaired individuals selected among 10,674 community-dwelling older adults (≥65 years of age) in Japan. We investigate the association between hearing aid use and cognitive decline stratified by cardiovascular risk level, by assessing self-reported hearing impairment and hearing aid use, absolute cardiovascular risk, cognitive function, and potential confounding factors. The association between hearing impairment severity and increased cardiovascular risk, and the benefit of hearing aid use in preventing cognitive decline, were examined in a binomial logistic regression analysis, with the presence of cognitive decline as the objective variable. In the low cardiovascular risk group, hearing aid users had a lower odds ratio for decline in executive function than non-users (odds ratio = 0.61, 95% confidence interval: 0.39–0.98). However, there was no significant association between hearing aid use and cognitive decline in the high cardiovascular risk group (p > 0.05). Among older adults with hearing impairment, hearing aid use was associated with the maintenance of executive function in individuals of low cardiovascular risk. [ABSTRACT FROM AUTHOR]

Exercise training integrating physical and cognitive activities is gaining attention because of its potential benefits for brain health. This study focuses on exercise training using a dart game called Wellness Darts. Wellness Darts is a sport involving throwing darts and walking to pull them out of the board, memorizing the score, and subtracting this from the total score, thus requiring the simultaneous performance of two tasks: exercise and calculation. This is expected to maintain and improve cognitive function, and whether this continual darts training affects brain function is of great interest. Before conducting the longitudinal study revealing its effect on brain function, we aimed to cross-sectionally confirm the difference in hemispheric lateralization between expert and non-expert players. Functional near-infrared spectroscopy (fNIRS) was used to measure brain activity for three groups: an expert older group who practiced darts continually, a non-expert older control group, and a non-expert younger control group. Their brain activity patterns were quantified by the lateralization index (LI) and compared between groups. The results showed that the younger and the expert older groups had significantly higher LI values than the non-expert older group, and there was no difference between the expert older and the younger groups. Our results suggest that the Wellness Darts game possibly promotes hemispheric lateralization. [ABSTRACT FROM AUTHOR]

Objectives: Hoarding in older adults can have a detrimental effect on daily life. Repetitive negative thinking (RNT) could result in a greater avoidance of discarding and increased saving behaviors; yet, the unique role of RNT on hoarding in older adults remains understudied. This study aimed to investigate whether the intensity of RNT contributes to hoarding in older adults. Methods: Two hundred and sixty-four older adults in Japan (ages 65–86 years, 132 males and 132 females) participated in an online survey. Hierarchical regression analyses were conducted to examine whether RNT could significantly explain the variance of hoarding after controlling for age, sex, years of education, self-reported cognitive impairment, and depression. Results: As we expected, RNT was significantly associated with greater hoarding behaviors, such as excessive acquisition (β =.27, p =.005) and difficulty in discarding (β =.27, p =.003). On the other hand, reflection, repetitive thinking without negative emotional valence, was significantly associated with higher scores on clutter (β =.36 p <.001). Conclusion: Our findings highlight the importance of addressing RNT in the prevention and treatment of hoarding symptoms among older adults, potentially leading to more effective interventions and improved outcomes in managing hoarding behaviors in this population. [ABSTRACT FROM AUTHOR]

Background: Schizophrenia is a complex mental disorder characterized by significant cognitive and neurobiological alterations. Impairments in cognitive function and eye movement have been known to be promising biomarkers for schizophrenia. However, cognitive assessment methods require specialized expertise. To date, data on simplified measurement tools for assessing both cognitive function and eye movement in patients with schizophrenia are lacking. Objective: This study aims to assess the efficacy of a novel tablet-based platform combining cognitive and eye movement measures for classifying schizophrenia. Methods: Forty-four patients with schizophrenia, 67 healthy controls, and 41 patients with other psychiatric diagnoses participated in this study from 10 sites across Japan. A free-viewing eye movement task and 2 cognitive assessment tools (Codebreaker task from the THINC-integrated tool and the CognitiveFunctionTest app) were used for conducting assessments in a 12.9-inch iPad Pro. We performed comparative group and logistic regression analyses for evaluating the diagnostic efficacy of the 3 measures of interest. Results: Cognitive and eye movement measures differed significantly between patients with schizophrenia and healthy controls (all 3 measures; P<.001). The Codebreaker task showed the highest classification effectiveness in distinguishing schizophrenia with an area under the receiver operating characteristic curve of 0.90. Combining cognitive and eye movement measures further improved accuracy with a maximum area under the receiver operating characteristic curve of 0.94. Cognitive measures were more effective in differentiating patients with schizophrenia from healthy controls, whereas eye movement measures better differentiated schizophrenia from other psychiatric conditions. Conclusions: This multisite study demonstrates the feasibility and effectiveness of a tablet-based app for assessing cognitive functioning and eye movements in patients with schizophrenia. Our results suggest the potential of tablet-based assessments of cognitive function and eye movement as simple and accessible evaluation tools, which may be useful for future clinical implementation. [ABSTRACT FROM AUTHOR]

Background: The amyloid-β1-42 (Aβ42) level is a biomarker that is widely used to evaluate individual cognitive dysfunction early in neurodegenerative diseases, as well as differentiate between normal cognitive function, mild cognitive impairment, Alzheimer's disease, and vascular cognitive impairment. Objective: Our cross-sectional study evaluated the association between daily exercise and physical and cognitive function and Aβ42 levels among a subsample of 325 older adults from the Kasama Study. Methods: Participants (age: 74.5 [range 65–90] years) were classified into three exercise groups: the dual-task (DEG, n = 128), single-task (SEG, n = 122), and non-exercise (NEG, n = 75) groups. The main outcomes were the plasma Aβ42 levels and the scores of the five cognitive (5-COG) tests and five cognition-related physical function (5-PHYS) tests. Results: The Aβ42 levels and 5-COG and 5-PHYS scores were higher in the SEG and DEG than in the NEG. The Aβ42 levels were higher in the DEG than in the NEG (p = 0.008). Conclusions: Physical activities such as regular exercise may benefit older adults, improving their cognitive and physical function. [ABSTRACT FROM AUTHOR]

Objectives Although cognitive decline is a well-known mortality risk, it has not been adequately investigated, whether social relationships modify the relationship between cognitive decline and mortality. We examined the modifying effects of social relationships (household composition, social network [frequency of social contact with individuals outside the household], and social participation) on the association between cognitive decline and all-cause mortality in older Japanese people. Methods In 2015, a baseline questionnaire was distributed to all 132,005 independent community-dwelling individuals aged ≥65 years resident in Adachi Ward of the Tokyo Metropolitan area. The final sample analyzed comprised 74,872 participants (men: 44.9%; mean age: 73.7 ± 6.0 years). Cognitive decline was assessed using a self-administered dementia checklist that was validated using the Clinical Dementia Rating Scale. Results A Cox proportional hazard model with an average follow-up of 1,657 days revealed that cognitive decline was associated with higher mortality (hazard ratio [HR]: 1.37, 95% confidence interval [95% CI]: 1.25–1.50). We identified significant associations among household composition, social networks, and cognitive decline. Stratified analyses indicated that the cognitive decline–mortality association was stronger among participants with low contact frequency (HR = 1.60, 95% CI: 1.39–1.85) than high frequency (HR = 1.24, 95% CI: 1.11–1.39). Conversely, the association was weaker among individuals living alone (HR = 1.13, 95% CI: 0.90–1.40) than among cohabiting individuals (HR = 1.43, 95% CI: 1.29–1.57). Conclusions Although living alone and having a small social network represent an isolated status, their modifying effects were the opposite. These findings indicate that the isolation type should be considered when implementing support strategies for older adults with cognitive decline or dementia. [ABSTRACT FROM AUTHOR]

Introduction: We examined the relationship between previous fluctuations in Mini-Mental State Examination (MMSE) scores, future changes in MMSE scores, and attrition from follow-up surveys, which helps in a more comprehensive interpretation of repeatedly collected MMSE scores. Methods: This 4-year longitudinal study included 2,073 community-dwelling older adults aged ≥65 years in Japan. The MMSE was administered at baseline (T0), 2 years (T1), and 4 years (T2) follow-up. We performed multinomial logistic regression analysis with the dependent variable, indicating the change in MMSE score from T1 to T2 (categorized as increase, no change [reference category], and decrease) and attrition at T2. The independent variables included the change in MMSE scores from T0 to T1 and MMSE scores at T0 and T1. Results: The mean MMSE score was 29 across the three time points. A one-point decrease in MMSE score from T0 to T1 was associated with 79% (95% confidence interval: 1.62, 1.97) higher odds of an increase in MMSE score from T1 to T2 and 28% (1.17, 1.40) higher odds of attrition at T2. A one-point decrement in the MMSE score at T0 and T1 was also associated with an increase in the MMSE score from T1 to T2 and attrition at T2. Conclusion: Focusing on cognitive fluctuation for 2 years, rather than cognitive function at a point in time, would have no remarkable advantage when focusing on future cognitive function and attrition. Our results emphasize the need for further studies to identify factors that distinguish between those who continue to attend follow-up surveys and show improvements in cognitive test scores and those who drop out. [ABSTRACT FROM AUTHOR]

Mild cognitive impairment (MCI), including memory loss, has been attracting attention in Japan. This study assessed the effect of new complete dentures provision alone and with dietary intervention on cognitive functions assessed using the Japanese version of the Montreal Cognitive Assessment (MoCA-J). A randomized controlled trial was conducted with 70 older adults who required new complete dentures. The participants had new complete dentures fabricated and were randomly classified into the intervention or control group. The intervention group received simple dietary advice, and the control group only received denture care advice. Cognitive function was assessed using the MoCA-J before and at 3 and 6 months after treatment. The between-group comparison and within-group comparison were analyzed. No significant differences were reported for comparisons between the intervention and control groups. A significant increase was revealed in the within-group comparisons for the total scores between the 3- and 6-month assessments (p = 0.002) and between the baseline and 6-month assessments (p = 0.012) in the intervention group. In the control group, a significant increase in the total scores was not revealed between any of evaluation period. Complete denture replacement combined with simple dietary intervention may help improve MoCA-J scores in edentulous older adults. [ABSTRACT FROM AUTHOR]

Background: Frailty increases the risk of negative health‐related events, such as falls, disability, hospitalizations, and death. Although the association between oral health and physical frailty is well established, the relationship between oral health and psychological frailty has not yet been investigated. Therefore, we conducted a cross‐sectional study to examine the association between maximal occlusal force and psychological frailty in Japanese community‐dwelling older adults. Methods: Psychological frailty was defined as a World Health Organization‐5 scale (WHO‐5) score of <13, cognitive and functional status was defined as a Japanese version of the Montreal Cognitive Assessment (MoCA‐J) score of <23, and psychological robustness was defined as a WHO‐5 score of ≥13 and a MoCA‐J score of ≥23. We used a cross‐sectional study design to measure maximal occlusal force in 1810 participants, and examined the following factors relevant to psychological frailty: educational level, financial status, living situation, history of chronic diseases, handgrip strength, and instrumental activities of daily living. We used propensity score matching to match the psychological frailty and psychological robustness groups according to demographic and confounding factors. This process, resulted in 344 participants, of whom 172 were in the psychological frailty group and 172 were in the psychological robustness group. In the matched cohort, differences between groups with and without psychological frailty were compared using generalized estimating equations for maximal occlusal force after adjusting for the number of teeth. Results: After controlling for potential confounding factors of frailty, the psychological frailty group showed lower maximal occlusal force compared with the psychological robustness group (unstandardized regression coefficients = −72.7, 95% confidence interval: −126.3 to −19.1). Conclusions: Maximal occlusal force was associated with a reduced prevalence of psychological frailty among Japanese community‐dwelling older adults participating in our study. [ABSTRACT FROM AUTHOR]

Aim: The aging‐related increase in the incidence of anemia potentially affects the mortality risk. Lower cognitive function is common among older adults, and anemia is one of the causes of cognitive decline. However, to the best of our knowledge, no study has investigated whether cognitive decline is a risk factor for anemia in older people. Therefore, in this study, we used a 3‐year longitudinal evaluation to examine the association of cognitive function with anemia in community‐dwelling older adults. Methods: This longitudinal study enrolled participants without anemia (diagnosed based on the World Health Organization's criteria) at baseline. Cognitive function was assessed using the Japanese version of the Montreal Cognitive Assessment. Multiple logistic regression models were used to examine the association between cognitive function at baseline and the presence of anemia 3 years later. Results: Participants were in the 69–71 and 79–81 years age groups, and 974 older people (48.6% men) were enrolled, of whom 126 (12.9%) had anemia after 3 years. After adjusting, cognitive function at baseline was associated with anemia in women, but not in men. Conclusions: Older Japanese women with lower cognitive function have an increased risk for anemia 3 years later. The adoption of a lifestyle that utilizes or improves cognitive function might be important to prevent anemia in older women. Geriatr Gerontol Int 2023; 23: 334–340. [ABSTRACT FROM AUTHOR]

Introduction: Gait disturbance in central nervous system (CNS) demyelinating disorders, including multiple sclerosis (MS) and neuromyelitis optica (NMO) is one of the most troublesome problems that has a direct impact on the quality of life. However, the associations between gait disturbance and other clinical variables of these two diseases have not been fully elucidated. Objective: This study aimed to evaluate gait disturbance using a computerized gait analysis system and its association with various clinical variables in patients with MS and NMO. Methods: A total of 33 patients (14 with MS and 19 with NMO) with minor disabilities, who were able to walk independently and had passed their acute phase, were enrolled in the study. Gait analysis were performed using a computer-based instrumented walkway system. (Walk-way MG-1000, Anima, Japan) Clinical variables, such as disease duration, medication, body mass index (BMI), hand grip power, and muscle mass were recorded. The Montreal Cognitive Assessment (MOCA), Beck Depression Inventory score-II (BDI), and fatigue scale were measured using the Functional Assessment of Chronic Illness Therapy-fatigue scale (FACIT-fatigue) scale. A trained neurologist scored the Expanded Disability Status Scale (EDSS). Results: Gait speed was the single parameter that showed a significant positive correlation with MOCA (p < 0.001). The stance phase time was the single parameter that showed a significant negative correlation with EDSS (p < 0.001). Hand grip strength showed a significant positive correlation with skeletal muscle mass as assessed by bioimpedance analysis (p < 0.05). The FACIT-fatigue scale score showed a significant negative correlation with the BDI (p < 0.001). Conclusion: In our patients with MS/NMO with mild disability, cognitive impairment was significantly correlated with gait speed, and the degree of disability was significantly correlated with stance phase time. Our findings may imply that early detection of a decrease in gait speed and an increase in stance phase time can predict the progression of cognitive impairment in patients with MS/NMO with mild disability. [ABSTRACT FROM AUTHOR]

The amount of aerobic exercise time (AET) is an important factor for improving physical function in patients with stroke. However, there is a lack of evidence regarding the factors for AET during physiotherapy, particularly in stroke patients. To investigate the correlation between AET during physiotherapy and characteristics of patients with subacute stroke. In this cross-sectional study, 61 hospitalized subacute stroke patients (age = 72 (11) years, (median (interquartile range)) were enrolled and their exercise intensity was measured by wearable sensors (Mio Alpha 2) worn during physiotherapy sessions. All patients were divided into two groups, non-ambulatory group (functional ambulation classification (FAC); 0–2) and ambulatory group (FAC; 3–5). The correlations between AET and patient characteristics were assessed in each group. There was no significant difference in AET between the ambulatory and non-ambulatory groups (9 (12) min vs 5 (10) min, p =.27, respectively). There was a significant correlation between AET and the functional independent measures (FIM) motor score in the ambulatory group (r = 0.52, p =.005), and between AET and the FIM cognitive score in the non-ambulatory group (r = 0.44, p =.008). Correlations between AET and patient characteristics were different according to ambulation capacity in patients with subacute stroke. [ABSTRACT FROM AUTHOR]

Aim: This cross‐sectional study aimed to investigate the associations between salivary testosterone concentrations and cognitive function in 70‐year‐old Japanese elderly people without dementia and stroke. Methods: Participants were 197 Japanese community‐dwelling people aged 69–71 years. Their salivary samples were collected, and their cognitive function was assessed using the Japanese version of the Montreal Cognitive Assessment (MoCA‐J). Participants were also administered a 10‐item recall and a 24‐item recognition test. The data for 179 (106 men and 73 women) individuals were analyzed, excluding individuals with a past history of stroke and dementia. Multivariate logistic regression analyses were performed after adjusting for lifestyle factors and analyzing data separately for men and women. Results: MoCA‐J scores showed that men with low testosterone concentrations had a significantly greater risk of low cognitive performance than those with high testosterone concentrations (adjusted odds ratio: 4.72, 95% confidence interval: 1.06–21.00), while no significant association was found in women. The 10‐item recall test scores showed that higher testosterone concentrations were significantly associated with greater recall in the second trial in women (standardized beta = 0.24, P = 0.040), whereas no significant association was found in men. Salivary testosterone concentrations were positively associated with better cognitive performance in older men and women. Conclusions: The associations between salivary testosterone concentrations and cognitive function were shown by different tasks for men and women. Geriatr Gerontol Int 2022; 22: 1040–1046. [ABSTRACT FROM AUTHOR]

This study investigated whether dual tasks comprising cognitive tasks and occupations related to daily living can improve the mental and cognitive function of Japanese community-dwelling older adults. Participants included 30 older adults, equally divided into intervention and control groups. The outcome measures were memory, attention, depression, and health-related quality of life. No adverse effects of the intervention were observed in any participant in the intervention group. Logical memory I, logical memory II, and Center for Epidemiologic Studies Depression Scale scores showed a significant interaction. Dual tasks combining cognitive tasks and occupations may help improve delayed recall and alleviate depression. A novel attempt to integrate cognitive stimulation and activities valued by individuals may help mediate age-related cognitive function decline and reduce depressive symptoms in community-dwelling older adults. [ABSTRACT FROM AUTHOR]

Current medical science has not yet found a cure for dementia. The most important measures to combat dementia are to detect the tendency toward cognitive decline as early as possible and to intervene at an early stage. For this reason, screening for dementia based on language ability has attracted much attention in recent years. However, in most of the previous studies, the cohort of people with dementia has been smaller than the control cohort. In this paper, we use a pre-trained Japanese language model for text analysis and evaluate the effectiveness of text augmentation on a dataset consisting of Japanese-speaking healthy older adults and those with mild cognitive impairment (MCI). We also examined what tasks contributed to the results. This experimental setting can also be used to detect other diseases that may affect the language areas of the brain outside of the hospital. [ABSTRACT FROM AUTHOR]

Aim: To investigate the association of the Japan Science and Technology Agency Index of Competence with physical and cognitive functions in community‐dwelling older adults. Methods: This study used the data of 565 community‐dwelling adults aged ≥65 years (mean age: 74.3 ± 5.2 years) from the Kasama Health Checkup for Longevity survey in Japan. The Japan Science and Technology Agency Index of Competence was used to comprehensively evaluate the higher‐level functional capacity and subscale functional capacity: technology usage, information practice, life management and social engagement. Physical functions were assessed using grip strength, the five‐repetition sit‐to‐stand test, 5‐m habitual walking test, one‐leg standing test and hand working test with a pegboard. Cognitive functions were evaluated using the Five‐Cog test consisting of attention, memory ability, visuospatial function, language ability and reasoning ability. Multiple regression analysis was conducted to examine the associations between total Japan Science and Technology Agency Index of Competence score and physical and cognitive functions. Results: After adjusting for potential confounders, the total Japan Science and Technology Agency Index of Competence score was favorably associated with static balance ability (β = 0.09; B = 0.01; 95% confidence interval: 0.00–0.02), lower limb strength (β = −0.19; B = −0.29; 95% confidence interval: −0.41 to −0.16), walking ability (β = −0.15; B = −0.67; 95% confidence interval: −1.05 to −0.30), hand dexterity (β = −0.13; B = −0.08; 95% confidence interval: −0.14 to −0.03) and overall cognitive function (β = 0.28; B = 0.04; 95% confidence interval: 0.03–0.05). Conclusions: Physical and cognitive functions are important for maintaining higher‐level functional capacity. Geriatr Gerontol Int 2022; 22: 753–758. [ABSTRACT FROM AUTHOR]

Background: The number of people with dementia is increasing in Japan, and establishing evidence for preventing dementia is necessary., Methods: This study was a randomized controlled trial in cognitively normal community-dwelling older adults aged 65 to 85 with diabetes and/or hypertension. Participants were randomly assigned in a 1:1 ratio. The intervention group underwent 90 min of group-based weekly physical exercise, cognitive training, nutritional counseling, and vascular risk management for 18 months. The primary endpoint was the change in a cognitive composite score calculated by averaging the z-scores of seven neuropsychological tests from baseline to 18 months., Results: We randomly assigned 203 participants to two groups, and 178 (87.7%) completed the 18-month follow-up. There was a significant group difference in the cognitive composite score change at 18 months (mean difference 0.16, 95% confidence interval: 0.04 to 0.27; p = 0.009)., Discussion: An 18-month multimodal intervention for older adults at risk of dementia could improve their cognitive function. The trial was registered in the Clinical Trial Registration System (UMIN000041938)., Highlights: Japan-Multimodal Intervention Trial for Prevention of Dementia (J-MINT) PRIME Tamba was a randomized controlled trial to prevent dementia. We provided a multifactorial intervention based on the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) trial methodology. The primary outcome, the cognitive composite score, improved with our intervention. Executive function/processing speed and memory improved in the intervention group. Intervention adherence was high, and no serious adverse events occurred., (© 2024 The Author(s). Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)

Objectives: Studies have examined the association between personality and health behaviour, but research focusing exclusively on regular dental visits has yet to be conducted. This study examined the association between personality traits and regular dental visits among Japanese community‐dwelling older adults. Methods: The participants in this cross‐sectional study included 1,057 community‐dwelling older adults aged 65–74 years from Ranzan and Yoshimi towns; data were collected from October to November 2015 and October to November 2016, respectively. Interviews were conducted to obtain sociodemographic, income, occupation and medical data. The Tokyo Metropolitan Institute of Gerontology Index of Competence was used to assess higher‐level competence; general intelligence was also evaluated. The 'Big Five' personality traits—openness to experience, consciousness, neuroticism, extraversion and agreeableness—were also examined. A multivariable logistic regression analysis was performed to examine the relationship between regular dental visits and personality traits. Results: Among men, the number of natural teeth, current employment status and conscientiousness were associated with dental care utilization. Among women, the number of natural teeth, current annual income, the intellectual activity domain of the Tokyo Metropolitan Institute of Gerontology Index of Competence and openness were significant. Conclusions: The factors associated with regular dental visits differed by gender. Overall, work was associated with men's visits, whereas intellectual activity and economic factors were relevant to women. Factors such as personality traits should be considered when addressing barriers to oral health. Understanding personality traits will help practitioners more effectively encourage older adults to make dental visits. [ABSTRACT FROM AUTHOR]

Objective: Cognitive decline is an important and well-documented health problem. The Mini-Cog, a simple cognitive function test, is recommended as a potential early cognitive screening tool. Kanagawa Prefecture, one of the largest prefectures in Japan, developed this self-testing application on a smartphone to enable a large number of residents to assess their cognitive function. This study aimed to verify the validity and reliability of the Mini-Cog. Results: Twenty men and 20 women aged 65–85 years were enrolled. Criterion-related validity of the method tested by professional staff was found to have an acceptable positive association. The test–retest reliability was lower than the clinically expected intraclass correlation coefficient value because of the inclusion of learning and order effects. If the Mini-Cog score of this application is low, the system is equipped with a function that advises the users on preventing cognitive decline, directing them to the appropriate services, and recommending visits to a medical institution. Therefore, the system can be used continuously as a tool for health behaviors and promotions. [ABSTRACT FROM AUTHOR]

Aims To investigate the effect of mild cognitive impairment (MCI) on unplanned readmission in patients with coronary artery disease (CAD). Methods and results From 2132 CAD patients, MCI was estimated with the Japanese version of the Montreal Cognitive Assessment (MoCA-J) in 243 non-dementia patients who met the study criteria. The primary outcome was unplanned hospital readmission after discharge. The incidence of MCI in this cohort was 33.3%, and 51 patients (21.0%) had unplanned readmission during a mean follow-up period of 418.6 ± 203.5 days. After adjusting for the covariates, MCI (hazard ratio, 2.28; 95% confidence interval: 1.09–4.76; P = 0.03) was independently associated with unplanned readmission in the multivariable Cox proportional hazard regression analysis. In the Kaplan–Meier analysis, the cumulative incidence of unplanned readmission for the MCI group was significantly higher than that for the non-MCI group (log-rank test, P < 0.001). Even after exclusion of the patients readmitted within 30 days of discharge, the main results did not change (log-rank test, P < 0.001). Conclusion Mild cognitive impairment was independently associated with unplanned readmission after adjustment for many independent variables in CAD patients. In addition to its short-term effects, the adverse effects of MCI had a persistent, long-term impact on CAD patients. Assessment of cognitive function should be conducted by health professionals prior to hospital discharge and during follow-up. To prevent readmission of CAD patients, it will be necessary to support solutions to the problems that inhibit secondary prevention behaviours based on the assessment of the patients' cognitive function. [ABSTRACT FROM AUTHOR]

Aim: Identification of modifiable intrinsic factors for occupational falls is required for initiating effective fall prevention strategies for older workers. This study aimed to identify modifiable intrinsic factors related to falls during occupational activities among older workers. Methods: This retrospective study involved 1164 older workers (aged ≥60 years, workdays ≥4/month) sampled from 18 public employment agencies for seniors in Saitama, Japan. Participants were assessed regarding the following 10 modifiable intrinsic factors: multimorbidity, polypharmacy, fall‐risk‐increasing medication use, self‐rated vision and hearing, functional strength, bilateral stepping, standing balance, executive function and visuospatial ability. The number of falls during occupational activities in the past year was also recorded. Results: In total, 111 falls occurred in 73 of the 1164 participants during occupational activities in the past year. A negative binomial regression model showed that use of fall‐risk‐increasing medications (incidence rate ratio [IRR]: 2.23, 95% confidence interval [CI]: 1.08, 4.60, P = 0.031), reduced functional strength (IRR: 1.81, 95% CI: 1.02, 3.21, P = 0.042), poor standing balance (IRR: 1.83, 95% CI: 1.09, 3.09, P = 0.023) and poor visuospatial ability (IRR: 1.56, 95% CI: 1.03, 2.36, P = 0.034) were independently associated with occupational falls. Conclusions: Our findings suggest that the assessment of medication use, functional strength, standing balance and visuospatial ability in regular health checks in the workplace may be useful for screening older workers at risk of occupational falls. Geriatr Gerontol Int 2022; 22: 338–343. [ABSTRACT FROM AUTHOR]

Aim: To clarify prevalence of social frailty among older adults living in a rural Japanese community, and factors associated with social frailty status. Methods: In total, 322 adults aged ≥65 years living in a Japanese rural community took part in the study from 2018 to 2020. Social frailty was defined as deficiencies of: (i) living alone; (ii) talking with someone every day; (iii) feeling helpful to friends or family; (iv) going out less frequently compared with last year; and (v) visiting friends sometimes. Social frail status was categorized as robust (0), social prefrail (1), and social frail (≥2), according to the summated score of Makizako's criteria. Multiple logistic regression analysis was applied to clarify factors associated with social frailty status. Results: Final samples were classified into 68 persons with social frailty, 98 persons with social prefrailty and 147 persons as robust. We observed the prevalence of social frailty (21.7%) and social prefrailty (31.3%) and the GDS‐15 had significantly high scores in the social frail groups. Social frailty was significantly associated with the GDS‐15 score (odds ratio, 1.33; 95% CI, 1.19–1.49) and TMT‐A (odds ratio, 1.04; 95% CI, 1.01–1.08) and GDS‐15 (odds ratio, 1.13; 95% CI, 1.03–1.26) were extracted as independent variables of social prefrail status, with adjustment for demographics, polypharmacy and lifestyle‐related diseases. Conclusions: Our results suggest that social frailty tends to be increasing gradually in a Japanese rural area, and social prefrailty might be potentially associated with attentional function, as well as the GDS‐15 score. Geriatr Gerontol Int 2022; 22: 145–151. [ABSTRACT FROM AUTHOR]

We present data from two studies examining how COVID-19 restrictions affected health behaviours (alcohol consumption, diet, sleep quality, and physical activity levels), mental wellbeing (negative mood) and cognitive function (decision making, attention, learning, working memory, and time perception) in association with sociodemographic factors. Study 1 assessed participants in Scotland and presents cognitive function data for five timepoints. Study 2 is transnational, assessing participants in Scotland and Japan. Data are stored as CSV files. Reuse may involve examining further effects of pandemic enforced social isolation or serve as baseline data when assessing social isolation in expeditions or ageing. [ABSTRACT FROM AUTHOR]

Introduction: Dual-task (DT) exercise can act as a substitute, which can help improve both physical and cognitive functions. Thus, this study investigated the effects of a game-like cognitive DT exercise called "Synapsology" (SYNAP) among the oldest residents of a nursing home. Methods: Participants (aged 85-97 years) were assigned to the intervention group (n = 12) and the control group (n = 12). The intervention group underwent 60-minute sessions, twice a week for 24 weeks. Results: A comparison of the Mini-Mental State Examination scores and six physical function tests, before and after the intervention, shows that the SYNAP had a positive impact on the cognitive and physical functions among the intervention group. Discussion: These findings suggest that SYNAP may help maintain or improve cognitive and physical functions among older adults compared to no interventions. Therefore, SYNAP would act as a beneficial tool amidst a "superaging" society like Japan. [ABSTRACT FROM AUTHOR]

Home adaptations are integral for inpatients with fall-related fractures, especially during discharge. However, it is unclear as to how patient-implemented home evaluations can be prioritized with limited professional rehabilitation resources. This study examines the associations between predisposing, enabling, and needs factors with the implementation of home evaluations in the eastern district of Tokyo. Being a female and lower comprehension in cognitive function was significantly associated with the implementation of home evaluations. It may be necessary to consider patients' cognitive function when deciding who to target for housing evaluations and to seek strategies to best estimate their needs. [ABSTRACT FROM AUTHOR]

This study aimed to examine the effects of a six-month group-based low-intensity resistance exercise program on depression and the cognitive function of hemodialysis patients. We conducted a quasi-cluster randomized, open-label controlled study from October 2017 to December 2018. Forty-two patients undergoing hemodialysis completed the trial over six months; half participated in the resistance exercise group (n = 21, mean = 74.90 years of age, SD = 2.23, 66.67% female) and the other half were in a stretching control group (n = 21, mean = 72.57 years of age, SD = 2.26, 28.57% female). Depressive symptoms and cognitive function were the primary outcome measures. Behavioral and psychological problems associated with cognitive decline (NPI-Q), subjective insomnia, and exercise self-efficacy were secondary outcomes. Outcomes were measured at baseline, three-month (mid-intervention), six-month (end of intervention), and 12-month (six months after intervention) follow-ups. Linear mixed model analyses were used to determine short-term (immediately after intervention) and long-term (six months after intervention) effects. In depression, cognitive function, and the NPI-Q, there were no significant effects. In subjective insomnia, a short-term group-by-time interaction in the intervention group compared to the control group was found (ES =.43). However, the effect had disappeared by the 12-month follow-up. In exercise self-efficacy, short- and long-term group-by-time interactions were found. A significant short-term increase in the resistance exercise and a significant decrease in the stretching control was observed (ES = -.83). However, the effect was weakened in the long term (ES = -.38). The results showed that low-intensity group resistance exercise would reduce subjective insomnia and improve exercise self-efficacy, but the effect was not maintained by six months after the program. Trial registration: This study was registered on the University Hospital Medical Information Network Clinical Trials Registry (UMIN000029372). Trial registration: UMIN Japan identifier: UMIN000029372. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to investigate the association between the number of teeth, food intake, and cognitive function in Japanese community-dwelling older adults., Methods: This 9-year longitudinal study included a total of 293 analyzable participants who participated in baseline and follow-up surveys. Dental status (number of teeth and periodontal pocket depth), dietary assessment using the brief-type self-administered diet history questionnaire, cognitive function, and the following confounding factors were evaluated: educational level, financial satisfaction, living situation, smoking and drinking habits, history of chronic diseases, apolipoprotein E-ε4 carrier, body mass index, handgrip strength, instrumental activities of daily living, and depressive symptomatology. The Japanese version of the Montreal Cognitive Assessment was used to evaluate cognitive function. A multinomial logistic regression analysis for the intake level of each food categorized into three groups (low, moderate, high), and a generalized estimating equation (GEE) for cognitive function over nine years were performed., Results: After controlling for confounding factors, the number of teeth was shown to be associated with the intake of green-yellow vegetables and meat. Furthermore, the GEE indicated that the lowest quartile of intake of green-yellow vegetables significantly associated with lower cognitive function (unstandardized regression coefficient [B] = -0.96, 95 % confidence interval [CI]: -1.72 to -0.20), and the lowest quartile of intake of meat significantly associated with lower cognitive function (B = -1.42, 95 % CI: -2.27 to -0.58)., Conclusions: The intake of green and yellow vegetables and meat, which is influenced by the number of teeth, was associated with cognitive function in Japanese community-dwelling older adults., Clinical Significance: There are few studies that have examined the association between oral health, food intake, and cognitive function. This 9-year longitudinal study suggests that it is important to maintain natural teeth to enable the functional means to consume green-yellow vegetables and meat, and thereby help maintain cognitive function., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Paula Moynihan reports a relationship with GSK Consumer Healthcare that includes: consulting or advisory. Paula Moynihan reports a relationship with Haleon Oral Health Strategic Advisory Council that includes: consulting or advisory. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: The cube‐copying test is used to assess cognitive function. It is one of the methods used to distinguish healthy older individuals from those with cognitive impairment based on its 3 mm vertex criterion and parallel line errors. We sought to assess how: (1) precisely elderly community‐dwelling individuals draw cubes based on two different vertex criteria; and (2) they keep the parallelism of lines. Methods: The cross‐sectional design study population comprised 121 adults ((outlier analysis excluded the results of three, resulting in 118 participants) ≥ 65 years (21 men and 100 women) who participated in an annual physical fitness circuit and who lived independently in their communities. We recorded the participants' ages, years of education, and the scores they obtained in the Japanese version of the Montreal Cognitive Assessment. Participants were instructed to draw the cube as precisely as possible. Cube drawings were assessed based on the correct position of the vertices using 1 and 3 mm criteria and parallel line errors. Results: Eighty‐nine percent of the participants were able to draw vertices within 3 mm distance from the correct position but found it difficult to draw them within 1 mm distance. Using the 3 mm vertex criterion, the mean score for correct vertices was six (out of a maximum of eight). Most of the participants made a maximum of one out of six possible parallel line errors. Conclusions: Almost 90% of the elderly in our study drew the vertices within 3 mm of the correct position, and the parallel line errors were few. The 3 mm vertex and parallel line criteria by cube‐copying seem to be cleared by most community‐dwelling elderly. Further research should determine if participants aged ≥85 years with less than 6 years of education show different results. [ABSTRACT FROM AUTHOR]

Aim: Although poor childhood rearing environment is known to negatively impact late‐life cognitive function, there is a scarcity of evidence on the contribution of positive parenting behaviors. The present study investigates the association between parental involvement in childhood and late‐life cognitive function. Methods: A total of 266 older adults aged between 65 and 88 years living in Wakuya City, Miyagi Prefecture, Japan, without indication of mild cognitive impairment or dementia, participated in a survey. Parental involvement in childhood was assessed by a questionnaire, and late‐life cognitive function was measured by the Japanese version of the Quick Mild Cognitive Impairment (QMCI) screening test (range: 0–100). Multiple regression analysis was performed to investigate the association, adjusting for potential confounders and mediators. Results: After adjusting for age, sex, other child‐rearing environment, and academic performance in grade 6, older adults with a high level of positive parental involvement in childhood scored 6.00 (95% CI: 2.39, 9.61) points higher for the QMCI total score than those without. Parental involvement in childhood showed significant dose–response positive associations with the QMCI total score (P < 0.001), clock‐drawing test score (P < 0.05), and verbal fluency score (P < 0.001). Among the six types of positive parental involvement, book reading showed a significant independent positive association with QMCI total score (P < 0.01) and logical memory score (P < 0.01). Conclusions: Greater parental involvement in childhood, particularly book reading, was associated with better late‐life cognitive function. Geriatr Gerontol Int 2021; 21: 794–801. [ABSTRACT FROM AUTHOR]

Background: Green care farms, which offer care for people with dementia in a farm setting, have been emerging in the Netherlands. The aim of this study was to 1) implement green care farms which use rice farming in Japan, 2) explore the positive experiences of rice farming care, and 3) compare the effect of rice farming care to that of usual care on well-being and cognitive ability.Methods: We developed a new method of green care farm in Japan which uses rice farming, a farming that is practiced all over East Asia. The participants were 15 people with dementia (mean age = 75.6 ± 9.8 years) who participated in a one-hour rice farming care program once a week for 25 weeks. We also collected qualitative data on the positive experiences of study participants after the program. As a reference data, we also collected the corresponding data of the usual care group which included 14 people with dementia (mean age = 79.9 ± 5.8 years) who were attending the near-by day-care.Results: The mean participation rate on the rice farming care group was 72.1%. After the intervention, participants reported experiencing enjoyment and connection during the program. It also changed the staff's view on dementia. The green care farm group showed a significant improvement in well-being but no significant difference in cognitive function compared to the usual care group.Conclusions: Green care farms by using rice farming is promising care method which is evidence-based, empowerment-oriented, strengths-based, community-based dementia service, which also delivers meaningful experience for the people with dementia in East Asia.Trial Registration: UMIN, UMIN000025020 , Registered 1 April 2017. [ABSTRACT FROM AUTHOR]

Background: A cohort of children prenatally exposed to the 1945 atomic bombings in Japan revealed harmful effects of ionizing radiation in a variety of measures of cognitive function, including mental retardation. Here we examined cognitive function in the non-affected, now elderly, cohort.Methods: From 2011-2015, using the Cognitive Abilities Screening Instrument and a maternal uterine radiation dose estimated with the 2002 dosimetry system, we evaluated 303 prenatally exposed subjects and their non-exposed controls from the Adult Health Study of the Radiation Effects Research Foundation, excluding those who had shown marked cognitive effects earlier. About 11% of the subjects were exposed to more than 250 mGy. We examined a self-reported disease history and, using regression analysis, evaluated the relationship between cognitive function and radiation exposures, adjusting for demographic factors.Results: None of the subjects reported a history of dementia. We also did not find a significant radiation effect on cognitive function overall or in any gestational-week group. Education was associated with a significant effect, but educational level was not associated with radiation dose.Conclusion: We found no significant radiation effect on cognitive function among 65- to 70-year-old subjects who were prenatally exposed to the bombings and did not have marked childhood cognitive function deterioration. The limitations of this study include a small sample size and potential bias pertaining to non-participation in the Adult Health Study or refusal of Cognitive Abilities Screening Instrument evaluation. Further investigations using various endpoints in other populations prenatally exposed to radiation are warranted. [ABSTRACT FROM AUTHOR]

Introduction: A prevalence of frailty is gradually increasing with the progress of aging in Japan, and critical challenges regarding early diagnosis and prevention of frailty were necessary in community. Although previous studies have well documented the characteristics of physical disability, there is limited information on frail state differences among older adults in Japanese rural areas. The aim of our cross-sectional observational study was to clarify the association of frail status in northern Japanese community-dwellers aged 65 or more. Methods: 345 participants were recruited from 2018 to 2020, and after getting informed consent from each participant, assessments and outcomes were evaluated according to the ORANGE protocol. We applied the frailty index of Gerontology-the Study of Geriatric Syndromes (NCGG-SGS) to classify frailty status by collecting data of demographics and psychosocial status using the Kihon checklist (KCL) and cognitive domains used by the National Center for Geriatrics and Gerontology-Functional Assessment Tool (NCGG-FAT). Results: Our subjects included 313 older adults divided into 138 robust, 163 prefrail, and 12 frail. For statistical analysis, we found that the frail group had a lower educational duration, worsened KCL items, lower cognitive functions, and a tendency toward depression compared to the other groups. Moreover, physical frailty and cognitive decline were related, and polypharmacy and a lack of joy in daily life were explanatory variables of frail status. Conclusions: We suggest that KCL is important for frail discrimination, and in order to prevent physical frailty, our community should take care of not only exercise and nutrition but also cognitive functioning and depressive tendencies. In particular, polypharmacy and the presence of fun in your life are possible to be related to frailty. [ABSTRACT FROM AUTHOR]

Background: Donepezil has been approved in Japan for the treatment of dementia with Lewy bodies (DLB) based on clinical trials showing its beneficial effects on cognitive impairment. This phase IV study evaluated the efficacy of donepezil by focusing on global clinical status during a 12-week double-blind phase., Methods: Patients with probable DLB were randomly assigned to the placebo (n = 79) or 10 mg donepezil (n = 81) groups. The primary endpoint was changes in global clinical status, assessed using the Clinician's Interview-Based Impression of Change plus Caregiver Input (CIBIC-plus). We also assessed four CIBIC-plus domains (general condition, cognitive function, behaviour, and activities of daily living) and changes in cognitive impairment and behavioural and neuropsychiatric symptoms measured using the Mini-Mental State Examination (MMSE) and the Neuropsychiatric Inventory (NPI), respectively., Results: Although donepezil's superiority was not shown in the global clinical status, a significant favourable effect was detected in the cognitive domain (P = 0.006). MMSE scores improved in the donepezil group after adjustments in post hoc analysis (MMSE mean difference, 1.4 (95% confidence interval (CI), 0.42-2.30), P = 0.004). Improvements in NPIs were similar between the groups (NPI-2: -0.2 (95% CI, -1.48 to 1.01), P = 0.710; NPI-10: 0.1 (95% CI, -3.28 to 3.55), P = 0.937)., Conclusion: The results support the observation that the efficacy of 10 mg donepezil in improving cognitive function is clinically meaningful in DLB patients. The evaluation of global clinical status might be affected by mild to moderate DLB patients enrolled in this study. No new safety concerns were detected., (© 2024 The Authors. Psychogeriatrics published by John Wiley & Sons Australia, Ltd on behalf of Japanese Psychogeriatric Society.)

Aim: To investigate the influence of replacing sedentary time with physical activity on cognitive function using an isotemporal substitution model in a population of community‐dwelling oldest old. Methods: This cross‐sectional study included residents of the Arakawa ward, Tokyo, who were part of a prospective cohort from the Arakawa 85+ study. We measured physical activity in 136 participants using a triaxial actigraph. Cognitive function was measured using the Addenbrooke's Cognitive Examination‐III and participants were divided into a "cognitive decline group" (Addenbrooke's Cognitive Examination‐III ≤88) and "cognitive maintain group" (Addenbrooke's Cognitive Examination‐III ≥89). Physical activity was divided into three categories: sedentary behavior (≤1.5 metabolic equivalents), light physical activity (>1.5 to <3.0 metabolic equivalents), and moderate‐to‐vigorous physical activity (≥3 metabolic equivalents). Using an isotemporal substitution approach, we applied multiple logistic regression analysis to demonstrate the association between cognitive function and replacing 30 min/day of sedentary behavior with an equal period of light physical activity. Covariates included age, education and the Center for Epidemiologic Studies Depression Scale. Results: Our findings showed that in men, replacing 30 min of sedentary behavior per day with light physical activity was associated with a 1.47‐fold increase in the odds of maintaining cognitive function. An association between physical activity and cognitive function was not observed in female participants. Conclusions: Our results indicate that substituting sedentary behavior with light physical activity could be helpful in maintaining cognitive function in community‐dwelling oldest old men. These results highlight the importance of behavioral changes to promote cognition. Geriatr Gerontol Int 2020; 20: 773–778. [ABSTRACT FROM AUTHOR]

Aim: This is a cross-sectional study of relation between metabolic syndrome and cognitive function in community-dwelling non-demented older adults in Japan. We examine the effect of metabolic syndrome and its components on global cognitive function. We also aim to clarify differences of specific cognitive domains between the subjects with and without metabolic syndrome. Methods: We studied 2150 subjects aged between 60 and 90 years whose scores on mini mental state examination (MMSE) were over 23 points. We analyzed difference in MMSE scores between the subjects with and without metabolic syndrome. Logistic regression analysis was performed with MMSE score as the dependent variable and metabolic syndrome components as the independent variable adjusted with age. We also examined differences in attention, logical memory, and verbal and category fluency between the subjects with and without metabolic syndrome. Results: MMSE scores were not significantly different between subjects with and without metabolic syndrome. In logistic regression analysis, the score of MMSE was significantly negatively associated with triglycerides in males and significantly negatively associated with abdominal circumference in females. Subjects with metabolic syndrome showed significantly lower performance of attention tasks compared to subjects without metabolic syndrome. Conclusions: Our results suggest that in community-dwelling non-demented Japanese older adults, attention but not global cognitive function may be impaired by metabolic syndrome. Inverted association between some components of metabolic syndrome and global cognitive function indicate necessity of further studies on the relation between undernutrition and cognitive function. [ABSTRACT FROM AUTHOR]

Supplemental digital content is available in the text. Objective: Cognitive impairments are among the nonmotor symptoms in patients with Parkinson disease. Understanding the cognitive impairments in patients with Parkinson disease may be critical for developing effective rehabilitation interventions. The aims of this study were to assess cognitive function in patients with Parkinson disease using the Wechsler Adult Intelligence Scale Third Edition, and the Wechsler Memory Scale Revised and to investigate how cognitive impairments relate to progression of disease in patients with Parkinson disease according to the Hoehn and Yahr stages. Design: Seventy-eight patients with Parkinson disease participated in the present study. Our study consisted of patients in the following Hoehn and Yahr groups: 1 (no disability, n = 11), 2 (mild, n = 34), 3 (moderate, n = 26), and 4 and 5 (severe, n = 7). Cognitive function was assessed using the Wechsler Adult Intelligence Scale Third Edition, and the Wechsler Memory Scale Revised. Results: The verbal memory was significantly higher in group 1 (106.4 ± 12.0) than in the other groups (2: 90.5 ± 14.0, 3: 89.9 ± 16.9, 4 and 5: 89.6 ± 11.4). Visual memory and delayed recall were similar to the results seen with verbal memory; however, the differences between groups were not statistically significant. The full-scale IQ was not significantly different (1: 107.3 ± 8.1, 2: 96.9 ± 18.2, 3: 96.7 ± 14.8, 4 and 5: 91.7 ± 9.5). Conclusions: These results suggest that a comprehensive assessment focused on memory impairments is important for applying the appropriate interventions in patients with early-stage Parkinson disease. [ABSTRACT FROM AUTHOR]

Background: To identify the clinical factors affecting activities of daily living (ADL) at baseline and after 6 months. Methods: We conducted a single-centre observational study at two time points across 6 months (baseline and after 6 months) from April 2015 to March 2017. in a 270-bed rural recuperation hospital at Hyogo prefecture in Japan. The total number of participants was 131 (male 33, female 98; mean age: 87.0 ± 7.0; mild and moderate dementia, 38; severe dementia, 93). Measurement scales used were Personal Self-Maintenance Scale (PSMS) for assessing ADL, Mini-Mental State Examination and Cognitive Test in Severe Dementia (CTSD) for cognitive function, Neuropsychiatric Inventory- Nursing Home version and Cornell Scale for Depression in Dementia (CSDD) for behavioural/psychological symptoms of dementia, Mini Nutritional Assessment Short form (MNA-SF) for nutritional status, Pain Assessment in Advanced Dementia for pain, and Charlson comorbidity index (CCI) and the number of illness categories based on Cumulative Illness Rating Scale Geriatrics for comorbidities. Multiple regression analyses identified the association between PSMS score as the dependent variable and other variables as independent variables. Results: In participants with severe dementia, the PSMS scores at baseline were significantly associated with CTSD, CCI, MNA-SF, and CSDD scores. In the longitudinal analysis, only CTSD score was significantly associated with PSMS score after 6 months. It is noteworthy that for participants with severe dementia, the only factor associated with ADL after 6 months was cognitive function, as assessed by CTSD score. Conclusions: The most important factor predicting functional decline is cognitive function, even at the severe and profound stage. [ABSTRACT FROM AUTHOR]

Accumulation of advanced glycation end products (AGEs) has been linked with cognitive decline as a risk factor based on the analysis in small populations. We investigated the association between skin autofluorescence of AGEs and global cognitive function in a Japanese older (≥60 years) population (n = 4,041). The AGEs quartiles were inversely associated with the Revised Hasegawa's Dementia Scale score (Q1: reference, Q2: β= -0.011, p = 0.537, Q3: β= -0.043, p = 0.016, Q4: β= -0.064, p < 0.001) independent of major risk factors. Accumulation of AGEs was associated with lower cognitive performance in older adults. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to examine the reliability and construct validity of the Stepping Trail Making Test (S‐TMT) in community‐dwelling older adults. Methods: This study comprised a cross‐sectional study based on a population sample. Participants comprised 1224 community‐dwelling older Japanese women aged 65–81 years without functional disability, dementia, depression, Parkinson's disease, or cognitive and visual impairments. The S‐TMT measured the time taken to step on a sequence of numbers (1–16) positioned on a mat (1 m2). Participants were instructed to step as quickly and accurately as possible. Motor functions were assessed by walking speed and knee extensor strength tests, while cognitive functions were assessed by the Symbol Digit Substitution Task (SDST) test, verbal and logical memory test, and TMT‐A and ‐B. Results: As a result of test–retest reliability over 6 months, the intraclass correlation coefficients of the S‐TMT was 0.82 (95% confidence interval, 0.68–0.90). An adjusted multiple regression model indicated that the S‐TMT was significantly associated with walking speed for motor function, and associated with the SDST, TMT‐A and TMT‐B for cognitive functions (P < 0.001). Conclusions: These results suggest that the S‐TMT is a reliable dual‐task test comprising mobility for motor function and a visual‐dependent execution function for cognitive function in older women. Geriatr Gerontol Int 2020; 20: 291–296. [ABSTRACT FROM AUTHOR]

Aim: The Mini‐Mental State Examination is a widely used cognitive assessment tool. However, it has several limitations, including the learning effect and interrater reliability. Therefore, we developed a Computer‐Based Cognitive Assessment Tool (CompBased‐CAT), which runs on a tablet or personal computer. In this study, we examined the validity and discrimination ability of the CompBased‐CAT. Methods: Participants were recruited from the Otasha‐Kenshin study carried out in 2016. We included 773 community‐dwelling older individuals in Japan (332 men, 441 women, aged 65–97 years). CompBased‐CAT scores were converted to z‐scores, and the correlation with Mini‐Mental State Examination scores was examined using Pearson's correlation coefficient. Furthermore, the ability to discern cognitive impairment was examined using the receiver operating characteristic curve. Results: The Pearson's correlation coefficient for the Mini‐Mental State Examination scores and each task component of the CompBased‐CAT ranged from 0.24 to 0.41 (P < 0.001), and the correlation coefficient of the total z‐scores was 0.51 (P < 0.001). The sensitivity, specificity and area under the receiver operating characteristic curve of the discriminating ability of the CompBased‐CATool for cognitive impairment were 0.81, 0.77 and 0.85, respectively. Conclusions: The CompBased‐CAT certainly possesses validity, discriminating ability and utility as a new cognitive assessment tool in community‐dwelling older individuals. Geriatr Gerontol Int 2020; ••: ••–••. [ABSTRACT FROM AUTHOR]

Background: Rapid eye movement (REM) sleep behavior disorder (RBD) is a male-predominant parasomnia. Earlier clinical RBD patient studies showed gender differences of clinical symptoms and polysomnographic (PSG) findings. However, no previous investigated this issue by means of validated severity scales or by neuropsychological examination related to alpha-synucleinopathy. This study elucidates gender differences in clinical, physiological, and neuropsychological findings in Japanese idiopathic RBD (iRBD) patients.Methods: From 220 patients with complaint of sleep-related vocalization or behaviors who visited Yoyogi Sleep Disorder Center from June 2003 through December 2016, 43 female (68.7 ± 7.3 yr) and 141 male patients (66.7 ± 6.7 yr) diagnosed as having iRBD by video-polysomnography (v-PSG) were selected. All subjects answered the RBD questionnaire (RBDQ-JP) and underwent olfactory function test (Sniffin' Sticks test) and cognitive function test (MoCA-J).Results: Female iRBD patients had later first symptom-witnessed age (sleep-talking 63.2 ± 10.5 yr, behaviors 60.9 ± 8.6 yr) than male patients (sleep-talking 59.1 ± 8.8 yr, behaviors 64.7 ± 8.9 yr). No gender difference was found in age at diagnosis, clinical severity (RBDQ-JP), or olfactory or cognitive function. Regarding electromyogram (EMG) findings during REM sleep, phasic EMG activity was higher in female patients (22.3 ± 17.8% vs. 16.5 ± 16.1%), although no difference was found in tonic EMG activity.Conclusions: Although female iRBD patient symptoms were first recognized later than those of male patients, they showed elevated EMG activity during REM sleep and showed deteriorated olfactory and cognitive function similarly to male patients at the first medical consultation. Results suggest that disease progression in female RBD patients is equivalent to that in male patients. [ABSTRACT FROM AUTHOR]

Background: Recently, many studies have investigated the association between orexin A and Alzheimer's disease (AD). However, it remains to be determined whether the observed changes in orexin A levels are associated with pathological changes underlying AD, or cognitive function. In particular, a direct association between cerebrospinal fluid (CSF) orexin A levels and cognitive function has not been reported to date.Objective: The aim of this study was to identify whether there is a direct association between the orexinergic system and cognitive function in AD.Methods: For this study, we included 22 patients with AD and 25 control subjects who underwent general physical, neurological, and psychiatric examinations, neuroimaging, and CSF collection by lumbar puncture were enrolled. Correlations between CSF orexin A levels and CSF AD biomarker levels (i.e., levels of phosphorylated tau [p-tau], Aβ42, and Aβ42/Aβ40) were assessed to confirm the results of previous studies. Moreover, the correlation between CSF orexin A levels and Mini-Mental State Examination (MMSE) and Japanese version of the Montreal Cognitive Assessment (MoCA-J) scores were analyzed.Results: There was a significant positive correlation between CSF orexin-A levels and cognitive function (MMSE scores: r = 0.591, p = 0.04, MoCA score: r = 0.571, p = 0.006) in AD patients.Conclusion: This is the first study to our knowledge demonstrating an association between cognitive function and CSF orexin A levels in AD. Our results suggest the possibility that orexinergic system overexpression is not always a negative factor for cognitive function In AD. [ABSTRACT FROM AUTHOR]

Aim: The purpose of the present study was to investigate the effect of cognitive decline on household spending. Methods: The panel data covered the years 2007–2009 and were taken from the Japanese Study of Aging and Retirement, with data extracted for 253 participants aged 65 years and over. Sociodemographic characteristics, functional status, depressive symptoms, and monthly household spending excluding spending for shelter (e.g. mortgage) were used in the analysis. Cognitive function was evaluated by delayed recall and serial 7s and represented by the sum of both scores. Changes in spending and cognitive function scores were calculated by subtracting 2007 scores from 2009 scores. Participants were divided into two groups: cognitive decline and no cognitive decline. The effect of cognitive decline on changes in household spending was estimated. Results: Although the cognitive decline group had more severe depressive symptoms than the no cognitive decline group in 2009, cognitive decline was the only factor related to change in household spending. Conclusion: The results imply that cognitive decline may cause a decline in household spending in older people. Focusing on changes in household spending behaviour might help detect cognitive impairment in older people. [ABSTRACT FROM AUTHOR]

Aim: We aimed to examine the association between physical activity (PA) and/or cognitive activity (CA) and cognitive impairment in a sample of older adults from a community‐based cohort in Nagoya, Japan. Methods: A total of 2726 participants (mean age 75.5 ± 3.9 years; 51.8% women) met the study criteria. The time of moderate‐to‐vigorous intensity PA was measured using an accelerometer. CA was subjectively assessed by the frequency of engagement in six activities (reading, writing for pleasure, doing crossword puzzles, playing board games/cards, participating in organized group discussions and playing musical instruments). Participants were categorized into four groups by high or low PA combined with high or low CA. Cognitive impairment was defined by at least one of four neuropsychological tests with a result of at least 1.5 standard deviations below the reference threshold. Results: The prevalence of cognitive impairments differed significantly between the groups (P < 0.001), with 29.5% in the low PA and low CA group, to 14.8% in the high PA and high CA group. Compared with the low PA and low CA group, other groups had significantly lower odds ratio (OR) of cognitive impairment (low PA and high CA: OR 0.54, 95% CI 0.37–0.79; high PA and low CA: OR 0.64, 95% CI 0.45–0.92; high PA and high CA: OR 0.42, 95% CI 0.30–0.58). Conclusions: Both PA and CA showed a protective association with cognitive impairment, even when one or the other is lowly engaged. Therefore, older adults with difficulty engaging in sufficient PA might benefit from CA to prevent cognitive impairment. Geriatr Gerontol Int 2020; 20: 31–35. [ABSTRACT FROM AUTHOR]

Aim: The objective of this study was to clarify the relationship between cognitive function and the serum albumin/globulin ratio (A/G ratio) in community‐dwelling Japanese older adults. Methods: Randomly extracted residents in both urban and rural parts of Japan were enrolled in this study. A total of 1827 participants with a mean age of 70 or 80 years were recruited. A venue survey method was carried out with comprehensive studies, including interviews, blood collection, physical examination and cognitive function tests. Results: Univariate analysis showed a significant positive correlation between the total Japanese version of the Montreal Cognitive Assessment score and the serum A/G ratio at the age of 70 and 80 years, in which better cognitive function was associated with a high serum A/G ratio. Multiple regression analysis with the total Japanese version of the Montreal Cognitive Assessment score as the dependent variable showed that the serum albumin level, serum globulin level, serum A/G ratio, C‐reactive protein, years of formal education and sex were related to the Japanese version of the Montreal Cognitive Assessment total score at the age of 70 years, and that the serum albumin level, serum globulin level, serum A/G ratio, C‐reactive protein, years of formal education and stroke were related at the age of 80 years. The serum A/G ratio showed a better correlation than the serum globulin levels at the age of 70 and 80 years (70 years: β = 0.131 vs –0.111, 80 years: β = 0.108 vs –0.071). Conclusions: We found a correlation between cognitive function and the serum A/G ratio in community‐dwelling older people, suggesting that nutritional status and chronic inflammation might influence cognitive function. Geriatr Gerontol Int 2019; 19: 967–971. [ABSTRACT FROM AUTHOR]

Purpose: Sleep duration is known to affect physiological and circadian metabolites and human homeostasis. However, little is known about the relationship between sleep quality and metabolite and cognitive function during exercise. Therefore, the aim of the present study was to investigate the impact of sleep quality on metabolite level and cognitive function in female volleyball athletes.Methods: Twelve female volleyball athletes participated in this study. Sleep efficiency was measured for 1 week using NemuriSCAN (Paramount Bed Co. Ltd., Japan) as an index of sleep quality. The subjects were divided into better (n = 6) and lesser (n = 6) sleep quality groups by the median value of sleep efficiency. Saliva samples were collected using a Salimetric oral swab cotton and salivary metabolites were analysed using capillary electrophoresis and time-of-flight mass spectrometry. The subjects performed Stroop tasks (simple and difficult tasks) at rest and during aerobic exercise in recumbent cycle ergometer at light and heavy intensity.Results: Increased sleep efficiency was found in the better sleep quality group, whereas total sleep time was similar. There were differences in urea cycle and Krebs cycle metabolites between the two groups; their levels were correlated with sleep efficiency. The difficult-task response time during heavy exercise was faster in the better sleep quality group.Conclusion: We demonstrated that sleep efficiency was associated with urea cycle and Krebs cycle metabolite levels and response time during heavy exercise in volleyball athletes. These results suggested that sleep quality may affect amino acid and energy metabolism and cognitive function during heavy exercise. [ABSTRACT FROM AUTHOR]

Highlights • This study focused on serum miRNAs and cognitive function in the general population. • Low serum miR-20a, -27a, and -103a were associated with lower SMMSE scores. • Serum miR-20a, -27a, and -103a may offer useful biomarkers of cognitive impairment. Abstract Objectives MicroRNAs (miRNAs) dysregulate gene expression by binding to target messenger RNAs, and play an important role in the pathogenesis of various diseases, including cancers, cardiovascular diseases and diabetes. Circulating miRNAs have increasingly been recognized as biomarkers for detecting and diagnosing those diseases. Few studies have investigated the association of circulating miRNA with the early stages of cognitive impairment, such as mild cognitive impairment, in the general population. The purpose of this study was to examine the association between cognitive function and several serum miRNAs levels related to amyloid precursor protein (APP) proteolysis in a Japanese general population who had never been diagnosed with dementia. Methods We conducted a cross-sectional study of 337 Japanese subjects (144 men, 193 women) who attended a health examination. The short form of the Mini-Mental State Examination (SMMSE) was used to assess cognitive function. Serum levels of 6 miRNAs (let-7d, miR-17, miR-20a, miR-27a, miR-34a, miR-103a) were measured by quantitative real-time polymerase chain reaction. Results Multivariable-adjusted odds ratios (ORs) for lower SMMSE score (SMMSE score < 28) were significantly increased in the lowest tertile of serum miR-20a (OR, 2.08; 95% confidence interval (CI), 1.09–4.04) and miR-103a (OR, 1.91; 95%CI, 1.00–3.69) compared to the highest tertile. Moreover, serum levels of miR-20a, -27a, and -103a were linearly and positively associated with SMMSE scores after adjustment for confounding factors. Conclusion Low serum levels of miR-20a, -27a, and -103a are independently associated with cognitive impairment. [ABSTRACT FROM AUTHOR]

Highlights • Oral motor functions were correlated with MMSE as cognitive function. • Tongue pressure and oral diadochokinesis were significantly associated with MMSE. • Diminished tongue pressure and oral diadochokinesis may lead to cognitive decline. Abstract Background Diminished oral motor function is considered to be a factor influencing cognitive decline, but this association has not been clarified. The aim of the present study was to clarify the association between cognitive and oral motor function in older people with either from normal cognitive function or mild cognitive decline. Methods A cross-sectional study was conducted across 1118 older people (445 men, 673 women) aged ≥70 years (mean age, 77.0 ± 4.7 years) who lived in a city of Tokyo Metropolis, Japan. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Older people who had an MMSE score of 23 points or lower were excluded. To investigate the relationship between cognitive and oral motor function, Pearson's correlation, multiple linear regression, and path analysis were performed. Results Pearson's correlation revealed that, among the oral motor functions assessed, masticatory performance, occlusal force, and tongue pressure were correlated with MMSE score. Multiple linear regression showed that tongue pressure and oral diadochokinesis (ODK) were significantly associated with MMSE score. Path analysis revealed that decreases in tongue pressure and in ODK were directly associated with decreases in MMSE score. Decreases in tongue pressure were also indirectly associated with decreases in MMSE score via decreases in ODK. Conclusions Among the oral motor functions assessed, tongue pressure and ODK were associated with cognitive function in older people ranging from those with normal cognitive function to those with mild cognitive decline. Diminished tongue pressure and ODK might thus lead to cognitive decline. [ABSTRACT FROM AUTHOR]

• Cognitive impairment, QoL, and objective cognitive functions were studied. • Subjective cognitive impairment was significantly correlated with measures of QoL. • Subjective and objective cognitive impairment were weakly associated. • Subjective cognitive impairment affects functioning in euthymic bipolar patients. Abstract During the euthymic state in bipolar disorder, cognitive functions often remain affected. Specifically, subjective and objective cognitive impairment might distinctly affect patients' quality of life (QoL); however, this question had not been examined previously in Japanese patients. Therefore, the current study investigated the associations between cognitive complaints, QoL, and objective cognitive functions. Forty patients in remission were recruited from the Hokkaido University Hospital, Sapporo, Japan and assessed with the translated version of the cognitive complaints in bipolar disorder rating assessment (COBRA), medical outcomes study 36-item short-form health survey version 2 (SF-36v2), and Sheehan disability scale (SDS). The Japanese adult reading scale, Wisconsin card sorting test, word fluency, continuous performance test, trail making test (TMT), auditory verbal learning, and Stroop test evaluated objective cognitive functions. Significant correlations were observed between the COBRA, SF-36v2, and SDS results, as well as the TMT scores. Overall, euthymic patients were aware of their cognitive dysfunction, which could be understood in relation to the decrease in satisfaction in their daily life. Therefore, even mild cognitive impairments can have ramifications for patients in the euthymic state of bipolar disorder. [ABSTRACT FROM AUTHOR]