研究者基本情報

• 博士, 札幌医科大学, 2017年03月

• https://researchmap.jp/makinoncgg

• 90775545

• 201801004521215678

• 健康科学
• 疫学
• 公衆衛生学
• 老年学
• 理学療法学

• ライフサイエンス, 衛生学、公衆衛生学分野：実験系を含まない
• ライフサイエンス, 医療薬学, 老年医学
• ライフサイエンス, 医療管理学、医療系社会学
• ライフサイエンス, 栄養学、健康科学

研究活動情報

• 2023年06月, The Geriatrics & Gerontology International Best Reviewer Award
  Keitaro Makino
• 2021年12月, 最優秀賞
  第80回 日本公衆衛生学会総会
  牧野 圭太郎
• 2021年06月, 第10回 日本認知症予防学会学術大会, 浦上賞
  牧野 圭太郎
• 2019年10月, 第9回 日本認知症予防学会学術大会, 浦上賞
  牧野 圭太郎
• 2018年10月, 第5回 日本予防理学療法学会学術大会, 優秀賞
  牧野 圭太郎

• Impact of prenatal manganese and selenium exposure on childhood thyroid hormone parameters up to 4 years of age: Japan environment and children’s study
  Takeshi Yamaguchi; Hiroyoshi Iwata; Sachiko Itoh; Yu Ait Bamai; Atsuko Ikeda; Keitaro Makino; Mariko Itoh; Rahel Mesfin Ketema; Naomi Tamura; Rieko Yamamoto; Maki Tojo; Kensuke Oba; Shuntaro Morikawa; Yasuaki Saijo; Yoshiya Ito; Reiko Kishi
  Environment International, 110353, 110353, Elsevier BV, 2026年06月, ［査読有り］, ［国際誌］
  研究論文（学術雑誌）
• Interaction of moderate-to-vigorous physical activity and brain amyloid accumulation on longitudinal cognitive change
  Keitaro Makino; Takashi Kato; Kengo Ito; Osamu Katayama; Ryo Yamaguchi; Hiroyuki Shimada
  GeroScience, 2026年05月, ［査読有り］, ［筆頭著者, 責任著者］, ［国際誌］
• Prolonged morning wake transitions associated with amyloid beta burden: A cross‐sectional pilot study
  Georg von Fingerhut; Keitaro Makino; Yosuke Osuka; Kengo Ito; Takashi Kato; Shosuke Satake; Hiroyuki Shimada
  Alzheimer's & Dementia, 22, 4, Wiley, 2026年04月06日, ［査読有り］, ［国際誌］
  研究論文（学術雑誌）, Abstract
  
  INTRODUCTION
  
  Sleep quality critically influences amyloid beta (Aβ) clearance, yet the specific role of morning wake transition duration remains unexplored.
  
  METHODS
  
  This hypothesis‐driven secondary analysis examined 97 cognitively unimpaired older adults (mean age ± SD: 74.4 ± 5.8 years) who underwent 14‐day actigraphy and 18F‐florbetapir positron emission tomography (PET). Cognitive function was evaluated using the National Center for Geriatrics and Gerontology‐Functional Assessment Tool (NCGG‐FAT). Time to wake up (TWU) was calculated as the midpoint between initial wake and final rise times.
  
  RESULTS
  
  Binomial logistic regression models adjusted for age, depression, and sleep duration showed that extended TWU (>6.23 min) associated with higher Aβ positivity (27.1% vs 10.2%, odds ratio [OR] = 1.85, 95% confidence interval [CI]: 1.11–3.07, p  = 0.019) and impaired word memory (OR = 2.17, 95% CI: 1.11‐4.24, p  = 0.023). Exploratory analyses of additional cognitive domains showed no significant associations.
  
  DISCUSSION
  
  Prolonged morning wake transitions may represent a behavioral marker associated with Aβ accumulation and memory impairment. The cross‐sectional design and modest sample size warrant cautious interpretation and replication in larger longitudinal cohorts.
• Cognitive domains associated with continued participation in health checkup programs for community-dwelling older adults: A 5-year longitudinal study
  Suguru Shimokihara; Kazuki Yokoyama; Hikaru Ihira; Yuriko Matsuzaki-Kihara; Atsushi Mizumoto; Hideyuki Tashiro; Hidekazu Saito; Keitaro Makino; Shunpei Katsuura; Kiyotaka Shimada; Kosuke Yama; Ryo Miyajima; Takeshi Sasaki; Nozomu Ikeda
  Aging Medicine and Healthcare, 17, 2, 95, 102, Ovid Technologies (Wolters Kluwer Health), 2026年04月, ［査読有り］, ［国際誌］
  研究論文（学術雑誌）, ABSTRACT
  
  Background:
  
  The aging of the global population stresses the importance of health programs that promote cognitive, physical, and social functioning in older adults. Health checkup programs aim to address these needs, yet disengagement remains a significant challenge, particularly among those with mild cognitive impairment (MCI). This study examined the association between baseline cognitive function and continued participation in health checkup programs over 5 years among community-dwelling older adults.
  
  Objectives:
  
  To examine associations between baseline cognitive domains and continued participation in community health check-up programs among older adults.
  
  Methods:
  
  Data collected between 2017 and 2019 in the Widely Hokkaido Individual Training for Elderly study, a longitudinal cohort comprising 428 adults aged 65 years and older, were analyzed. Cognitive function was assessed using the National Center for Geriatrics and Gerontology–Functional Assessment Tool. Cognitive domains assessed included memory, attention, executive function, and processing speed. The relationship between baseline cognitive function and follow-up participation in the health checkup program was evaluated using multinomial logistic regression and comparative analyses.
  
  Results:
  
  Of the 360 participants included, 13.6% had MCI at baseline. Over 5 years, 57% of participants were lost to follow-up, with baseline MCI associated with a significantly high likelihood of disengagement (odds ratio, 3.76; 95% confidence interval, 1.13–12.56; P = 0.03). Among cognitive domains, attention and processing speed showed significant associations with continued follow-up availability.
  
  Conclusion:
  
  Older adults with MCI are more likely to disengage from health checkup programs, with attention and processing speed emerging as critical factors influencing follow-up retention. Targeted interventions, including cognitive support and caregiver involvement, are essential to sustaining participation and promoting better health outcomes among older adults.
• Association between patterns of self-disclosure and depressive symptoms among community-dwelling older females in Japan
  Kazuki Yokoyama; Suguru Shimokihara; Hikaru Ihira; Yuriko Matsuzaki-Kihara; Atsushi Mizumoto; Hideyuki Tashiro; Hidekazu Saito; Keitaro Makino; Shunpei Katsuura; Kiyotaka Shimada; Kosuke Yama; Ryo Miyajima; Takeshi Sasaki; Nozomu Ikeda
  Aging Medicine and Healthcare, 17, 2, 62, 68, Ovid Technologies (Wolters Kluwer Health), 2026年04月, ［査読有り］, ［国際誌］
  研究論文（学術雑誌）, ABSTRACT
  
  Background:
  
  Depressive symptoms are prevalent among older females, and social factors such as self-disclosure may play an important role in early detection and prevention.
  
  Objectives:
  
  This study aimed to determine the association between patterns of self-disclosure and depressive symptoms in community-dwelling older females in Japan.
  
  Methods:
  
  A total of 209 females aged ≥65 in Japan answered a mailed self-administered questionnaire in 2021. Depressive symptoms were assessed using the Geriatric Depression Scale (GDS). Self-disclosure to “family members” and “friends/acquaintances” was assessed using the Self-Disclosure Self-Assessment Scale for Older Adults, which measured 10 contents of self-disclosure.
  
  Results:
  
  Decision tree analysis identified four groups, each indicating a pattern of self-disclosure associated with depressive symptoms. Low self-disclosure about “motivation and strengths in life” and “experiences of work and social activities” was associated with the highest mean GDS score for self-disclosure to family members. Low self-disclosure about “future outlook” and experience of self-disclosure about “concern about cognitive function” were associated with the highest mean GDS score for self-disclosure to friends/acquaintances. Multiple regression analysis showed a significant association between depression and self-disclosure in both groups compared to the self-disclosure pattern of the lowest depressive symptoms, even after adjustment for covariates.
  
  Conclusion:
  
  This study revealed patterns of self-disclosure with high depressive symptoms. Recognizing these self-disclosure features in daily life may contribute to the early detection of and intervention for depressive symptoms in older females.
• The impact of folic acid supplementation in early to mid-pregnancy on the risk of hypertensive disorders of pregnancy: the Japan environment and children's study.
  Akira Oku; Yoshihiro Saito; Hiroyoshi Iwata; Sachiko Itoh; Ami Hosokawa; Takeshi Yamaguchi; Mariko Itoh; Keitaro Makino; Maki Tojo; Hidemichi Watari; Yoshiya Ito; Yasuaki Saijo; Reiko Kishi
  BMC pregnancy and childbirth, 26, 1, 2026年03月06日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, BACKGROUND: Hypertensive disorders of pregnancy (HDP) are potentially life-threatening conditions for both the pregnant woman and fetus with long-term effects on maternal health, and while folic acid supplementation has been suggested to reduce the risk of HDP, current epidemiological evidence remains inconclusive. This study evaluated the impact of the frequency of folic acid supplementation on the risk of HDP and postpartum hypertension in a large-scale prospective cohort study within the Japanese population. METHODS: Data were obtained from the national birth cohort of the Japan Environment and Children's Study (JECS), collected between 2011 and 2014. Maternal folic acid supplementation during pregnancy was categorized into three groups (none, low frequency, and high frequency) based on self-reported intake frequency. Crude and adjusted binomial logistic regression analyses were performed to assess the association between maternal folic acid supplementation during pregnancy and HDP as well as postpartum hypertension. HDP was further classified according to onset timing as early-onset (Eo) or late-onset (Lo), and multinomial logistic regression was applied to examine these subtypes. RESULTS: A total of 91,069 pregnant women were included in the analysis. High frequency folic acid supplementation was associated with a lower risk of HDP compared with no supplementation (adjusted OR 0.86, 95% CI 0.78–0.94), whereas low frequency supplementation showed no significant association. For postpartum hypertension, both low and high frequency folic acid supplementation were associated with reduced risks (adjusted OR 0.88, 95% CI 0.79–0.97 and 0.85, 95% CI 0.79–0.92, respectively). In additional analyses stratified by HDP onset timing, high frequency folic acid supplementation was associated with a lower risk of Lo HDP (adjusted OR 0.86, 95% CI 0.78–0.96), but not Eo HDP. CONCLUSIONS: Folic acid supplementation during pregnancy was inversely associated with the incidence of HDP, particularly Lo HDP. Furthermore, it may contribute to the prevention of postpartum hypertension. In addition to its established role in preventing neural tube defects, continuous folic acid supplementation before conception may be beneficial for maintaining maternal health throughout pregnancy and the postpartum period. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12884-026-08898-5.
• Associations of prenatal exposure to organophosphate pesticides with eczema and allergic rhinoconjunctivitis in 4-year-old children: The Japan Environment and Children's Study
  Megasari Marsela; Hiroyoshi Iwata; Yu Ait Bamai; Mariko Itoh; Rahel Mesfin Ketema; Takeshi Yamaguchi; Yasuaki Saijo; Yoshiya Ito; Sachiko Itoh; Keiko Yamazaki; Naomi Tamura; Keitaro Makino; Maki Tojo; Reiko Kishi; Atsuko Ikeda
  Environmental Research, 123839, 123839, Elsevier BV, 2026年02月, ［査読有り］, ［国際誌］
  研究論文（学術雑誌）
• Usefulness of Step Length for Predicting the Onset of Frailty in Community-Dwelling Healthy Older Adults: A Prospective Cohort Study.
  Daiki Yamagiwa; Osamu Katayama; Ryo Yamaguchi; Takahiro Shimoda; Chika Nakajima; Ayuka Kawakami; Shoma Akaida; Keitaro Makino; Hiroyuki Shimada
  Journal of the American Medical Directors Association, 106090, 106090, 2026年01月24日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, OBJECTIVES: Frailty is a common geriatric syndrome associated with adverse health outcomes. Although gait speed is widely recognized as a predictor of frailty, the contribution of other gait parameters remains unclear, particularly among initially robust older adults. This study aimed to examine the associations between multiple gait variables and incident frailty in community-dwelling older adults who were nonfrail at baseline. DESIGN: A prospective observational study. SETTING AND PARTICIPANTS: A total of 1898 community-dwelling older adults (mean age: 73.0 ± 4.9 years, age range: 65-92 years, 50.9% women) who were determined to be nonfrail by the Kihon Checklist in the baseline survey were included. METHODS: Gait variables, including gait speed, were measured using the Walkway system. Frailty status was reassessed after 3 years via a mailed Kihon Checklist survey. Participants classified as either pre-frail or frail at follow-up were considered to have incident frailty, in order to capture early functional decline. Logistic regression analyses were conducted to evaluate the associations between gait variables and incident frailty. RESULTS: In this study, 611 participants (32.2%) were classified into the incident frailty during follow-up (524 pre-frailty and 87 frailty). Logistic regression analysis showed that gait speed (odds ratio [OR], 0.273; 95% confidence interval [CI], 0.152-0.491), step length (OR, 0.947; 95% CI, 0.924-0.970), and cadence (OR, 0.987; 95% CI, 0.976-0.998) were significantly associated with the onset of frailty. Furthermore, step length was independently associated with the onset of frailty, even in models adjusted for gait speed and covariates (OR, 0.945; 95% CI, 0.909-0.982). CONCLUSIONS AND IMPLICATIONS: Step length was identified as a significant indicator of incident frailty in healthy older adults. For early frailty screening, a comprehensive assessment that includes step length, rather than gait speed alone, may be more informative.
• Replacement of Accelerometer-Measured Sedentary Behavior With Physical Activity Reduces Dementia Risk.
  Ryo Yamaguchi; Osamu Katayama; Daiki Yamagiwa; Shoma Akaida; Keitaro Makino; Kouki Tomida; Yukari Yamashiro; Naoto Takayanagi; Motoki Sudo; Hiroyuki Shimada
  Journal of the American Medical Directors Association, 27, 1, 105972, 105972, 2026年01月, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, OBJECTIVES: The mutual effects of different activity intensities in daily life, such as sedentary behavior (SB) and physical activity (PA), on dementia onset are not yet fully understood. The purpose of this study was to examine the association between replacing SB with PA and the risk of dementia in older adults by using the isotemporal substitution (IS) model. DESIGN: Prospective cohort study. SETTING AND PARTICIPANTS: Community-dwelling older adults living without dementia in Takahama, were enrolled, interviewed, and physically examined. Follow-up data were collected from the Japanese Public Health Insurance and/or Long-Term Care Insurance system databases during follow-up. METHODS: SB and PA data [light-intensity PA (LPA) and moderate-to-vigorous PA (MVPA)] were measured using a triaxial accelerometer for 14 days, and the average daily time for SB and PA was calculated in 10-minute increments. Participants were followed up monthly for new-onset dementia over 5 years. Cox proportional-hazards regression analysis was performed by using IS to estimate the effect of replacing one activity with another on the dementia onset. RESULTS: We included 1664 participants (mean ± standard deviation age, 73.1 ± 5.9 years) in this study. Over 5 years, 128 of 1664 participants developed dementia. Replacing 10 min/d of SB with LPA (hazard ratio, 0.86; 95% CI, 0.75-0.99) or MVPA (0.84; 0.74-0.96) was associated with a lower risk of dementia. CONCLUSIONS AND IMPLICATIONS: Replacing 10 minutes of SB with LPA or MVPA was associated with a lower risk of dementia. Feasible behavioral changes in daily life may lead to a healthy life expectancy.
• Echinococcosis in Japan: Time to Reconsider a Neglected Endemic.
  Hiroyoshi Iwata; Takeshi Yamaguchi; Keitaro Makino; Reiko Kishi
  Internal medicine (Tokyo, Japan), 2025年12月25日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）
• Childhood obesity and DNA methylation in an epigenome-wide association study: findings from the Hokkaido Birth Cohort
  Hiroyoshi Iwata; Chihiro Miyashita; Takeshi Yamaguchi; Atsuko Ikeda; Ryu Miura; Machiko Minatoya; Naomi Tamura; Yu Ait Bamai; Sachiko Itoh; Keiko Yamazaki; Rahel Mesfin Ketema; Mariko Itoh; Maki Tojo; Rieko Yamamoto; Keitaro Makino; Reiko Kishi
  Clinical Epigenetics, Springer Science and Business Media LLC, 2025年12月01日, ［査読有り］, ［国際誌］
  研究論文（学術雑誌）
• The impact of pediatric constipation on appendicitis: a prospective birth cohort in the Japan Environment and Children's Study.
  Hiroyoshi Iwata; Takeshi Yamaguchi; Sachiko Itoh; Yu Ait Bamai; Atsuko Ikeda; Keitaro Makino; Mariko Itoh; Maki Tojo; Rieko Yamamoto; Naomi Tamura; Rahel Mesfin Ketema; Yasuaki Saijo; Yoshiya Ito; Reiko Kishi
  BMC pediatrics, 25, 1, 962, 962, 2025年11月26日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, BACKGROUND: This study aimed to examine the association between constipation and appendicitis in children using data from a nationwide birth cohort, the Japan Environment and Children's Study (JECS). METHODS: Data were obtained from 64,772 children and their mothers participating in JECS, which included over 100,000 pregnancies across 15 regional centres in Japan. Pediatric constipation was assessed at age three using the Rome III criteria, while appendicitis cases were identified between ages three to four. Logistic regression analyses, including univariable and multivariable models, were conducted to evaluate associations. Additional analyses were stratified by sex. RESULTS: Among the 64,772 children analyzed, 156 cases of appendicitis were identified between the ages of 3 and 4 years. Logistic regression suggested a possible association between constipation and an increased risk of appendicitis (univariable odds ratio [OR]: 1.38, 95% confidence interval [CI]: 0.87–2.10; multivariable OR: 1.36, 95% CI: 0.86–2.06). Although the associations did not reach statistical significance, the point estimates consistently indicated a trend toward increased risk. CONCLUSION: Although our analyses of children aged 3–4 years did not yield statistically significant associations, the observed trends may suggest a potential link between constipation and appendicitis. These findings should be interpreted only as exploratory, and further studies in different age groups, including older children and adults, are warranted to confirm or refute this possible association. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12887-025-06263-7.
• Mapping cognitive diversity in older adults through community-based digital screening via mobile devices: a cross-sectional latent class analysis
  Suguru Shimokihara; Kazuki Yokoyama; Keitaro Makino; Nozomu Ikeda; Kiyoji Matsuyama; Tomonori Kashiwagi; Chiaki Kawanishi; Hikaru Ihira
  Frontiers in Digital Health, 7, Frontiers Media SA, 2025年11月25日, ［査読有り］, ［国際誌］
  研究論文（学術雑誌）, Introduction
  
  Early detection of objective cognitive impairment is essential to delay or prevent dementia; however, traditional in-person screening often faces practical barriers, including limited accessibility and substantial personnel demands. Web-based cognitive tools are promising for scalable screening. This study aimed to identify cognitive subgroups among community-dwelling older adults using latent class analysis (LCA) based on data collected through a freely accessible web-based cognitive screening platform that enables convenient participation anytime and anywhere using older adults' own mobile devices.
  
  Methods
  
  Between September and December 2024, adults aged ≥65 from Sapporo and Ebetsu, Japan, were recruited via newspaper insert flyers (92,290 households) and community posters. QR codes linked to the study website were optimized for various devices. After obtaining electronic consent, participants completed web-based demographic surveys and cognitive assessments of memory, attention, and processing speed. Subjective health and memory complaints were recorded. LCA identified cognitive subgroups based on performance, complaints, and sociodemographic factors.
  
  Results
  
  Among the 528 participants (mean age = 71.2; 57% female), most reported good health (86%) and daily conversations (92%). Cognitive function was generally preserved. LCA revealed four clusters: socially isolated females with high subjective memory complaints (SMCs); cohabiting males with high SMCs; cohabiting females with high health perception and preserved cognition; and older adults with cognitive decline.
  
  Discussion
  
  The combination of mass outreach and web-based screening is feasible and effective in identifying diverse cognitive profiles. These findings highlight the mismatch between subjective and objective cognition and the relationship between social context, supporting scalable, tailored approaches and cognitive health.
• Relative Hypothermia and Gray Matter Atrophy in Older Adults: A Cross-Sectional Study.
  Daiki Yamagiwa; Osamu Katayama; Ryo Yamaguchi; Shoma Akaida; Keitaro Makino; Hiroyuki Shimada
  Journal of the American Medical Directors Association, 26, 11, 105855, 105855, 2025年11月, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, OBJECTIVE: Relative hypothermia is associated with tau accumulation. Furthermore, elucidating the association with changes in brain structure may be useful for the early detection and prevention of dementia. In this study, we aimed to investigate the association between relative hypothermia and brain volume, especially gray matter and white matter, and to determine the cutoff point of relative hypothermia associated with brain structure. DESIGN: Cross-sectional. SETTING AND PARTICIPANTS: The study included 101 community-dwelling older adults aged 60 to 90 years. METHODS: Relative hypothermia was defined as the percentage of time during the daytime active phase when body skin temperature, measured by a wearable device, was below the 24-hour average. Brain volume was assessed using magnetic resonance imaging, with gray matter atrophy and total white matter volume quantified. Multiple linear regression analysis examined associations between relative hypothermia and brain volume, while receiver-operating characteristic (ROC) curves determined cutoff points. RESULTS: Among 101 participants (mean age: 73.5 years; 48.5% female), relative hypothermia was significantly associated with gray matter atrophy (P < .05). The ROC analysis identified a significant cutoff point of ≥61.39% (area under the curve 0.763, P < .001). Relative hypothermia above this threshold (≥61.39%) was strongly associated with gray matter atrophy (OR, 3.98; 95% CI, 4.11-4.99; P < .001). CONCLUSIONS AND IMPLICATIONS: Relative hypothermia is a strong marker of gray matter atrophy. A threshold of 61.39% or higher may serve as an early indicator of structural brain changes, contributing to dementia detection.
• Exploring lifestyle activities as possible protective factors for life satisfaction: a cross-sectional study.
  Fumio Sakimoto; Takehiko Doi; Osamu Katayama; Soichiro Matsuda; Keitaro Makino; Hiroyuki Shimada
  BMC geriatrics, 25, 1, 812, 812, 2025年10月27日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, BACKGROUND AND OBJECTIVE: Life satisfaction is an important factor in maintaining or increasing healthy life expectancy. However, as it is unclear what activities are associated with life satisfaction in older adults, we investigated whether lifestyle activity engagement contributes to higher life satisfaction levels. METHODS: The study participants were 4,167 community-dwelling older adults aged 60 years or above in a cross-sectional survey. Life satisfaction was assessed using the Life Satisfaction Scale, which contains 13 questions, each comprising four levels. A 36-item Lifestyle Activities Questionnaire was used to assess participants' lifestyle activities, with 12 items each covering physical, cognitive, and social activities. The results of each activity were categorized into high-, moderate-, or low-activity tertiles to determine their association with life satisfaction. We also investigated the relationship between life satisfaction and each activity type, stratifying the analysis by associated characteristics (i.e., living alone, gender, and age) using logistic regression, both before and after data imputation. RESULTS: After imputation, the logistic regression analysis adjusted for covariates showed that physical, cognitive, and social activities had protective effects on life satisfaction. The high-activity group had a lower odds ratio (OR) for low life satisfaction compared with the low-activity group (physical activity: moderate group OR 0.91, 95% confidence intervals (CI) 0.77-1.08, high group OR 0.80, 95% CI 0.68-0.95; cognitive activity: moderate group OR 1.00, 95% CI 0.85-1.18, high group OR 0.71, 95% CI 0.59-0.85; social activity: moderate group OR 0.69, 95% CI 0.59-0.82, high group OR 0.66, 95% CI 0.55-0.78). The stratified analysis revealed different associations under each stratum, with only social activities demonstrating a protective effect on life satisfaction across all strata. CONCLUSION: High engagement in lifestyle activities had a protective effect on life satisfaction. The differences in the relationship between each activity type and life satisfaction varied based on participants' characteristics. To maintain life satisfaction, it is necessary to understand the contribution of different activity types and the individual characteristics of the target population.
• Basal metabolic rate predicts dementia in community-dwelling older adults: a 5-year longitudinal study.
  Daiki Yamagiwa; Osamu Katayama; Ryo Yamaguchi; Shoma Akaida; Keitaro Makino; Hiroyuki Shimada
  European geriatric medicine, 2025年10月10日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, PURPOSE: Although basal metabolic rate (BMR) is reportedly associated with physiological function decline, there is no consensus regarding its relationship with cognitive function. Therefore, we investigated the relationship between BMR and dementia risk over a 5-year period in 2550 of the 2975 older adults who were available for analysis (age 73.2 ± 6.0 years, 59.8% women). METHODS: BMR was calculated using the TANITA, Mifflin-St Jeor, Harris-Benedict, and Cunningham equations. Furthermore, the BMR assessment method developed by the National Institute of Health and Nutrition (NIBIOHN) was used. Participants were classified into quartiles for BMR obtained using each method. Cox proportional hazards regression analysis was performed using the highest quartile (Q4) of each BMR to evaluate the association between BMR and dementia risk. Additionally, differences in the performance of each formula in predicting dementia risk were examined using the time-dependent receiver operating characteristic curve. RESULTS: Participants in the lowest BMR quartile (Q1) had a higher risk of dementia than those in Q4 [TANITA BMR: hazard ratio (HR) = 2.49, p < 0.001; Harris-Benedict BMR: HR = 1.70, p < 0.05; Mifflin-St. Jeor BMR: HR: 3.83, p < 0.001; Cunningham BMR: HR = 2.78, p < 0.001; NIBIOHN BMR: HR = 2.98, p < 0.001]. The time-dependent ROC of Harris-Benedict BMR demonstrated the highest predictive accuracy among all BMRs calculated (area under the curve = 0.71, p < 0.05). CONCLUSION: Our results reveal the association of low BMR with increased dementia risk, suggesting its potential as an early predictive biomarker, and demonstrate the usefulness of the Harris-Benedict equation for predicting dementia risk.
• Associations Between Occupational Participation and Depressive Symptoms in Japanese Community-Dwelling Older Adults
  Kiyotaka Shimada; Kazuki Yokoyama; Suguru Shimokihara; Yuriko Matsuzaki-Kihara; Atsushi Mizumoto; Hideyuki Tashiro; Hidekazu Saito; Keitaro Makino; Shunpei Katsuura; Kosuke Yama; Ryo Miyajima; Takeshi Sasaki; Hikaru Ihira; Nozomu Ikeda
  OTJR: Occupational Therapy Journal of Research, SAGE Publications, 2025年10月08日, ［査読有り］, ［国際誌］
  研究論文（学術雑誌）, Depressive symptoms contribute to frailty and care dependency. Participation in meaningful activities is key for preventing depressive symptoms, yet its link to occupational participation remains unclear. This study examined the relationship between occupational participation factors and depressive symptoms in older adults. This cohort study included 278 participants. Occupational participation was measured using the Self-reported Occupational Performance Inventory, and depressive symptoms were measured using the Geriatric Depression Scale. Multiple regression analysis was conducted. Occupational control (β = –0.20, p = .004) and balance (β = –0.18, p = .008) in leisure were negatively correlated with depressive symptoms. Satisfaction with performance correlated negatively with depressive symptoms in leisure (β = –0.15, p = .034) and self-care (β = –0.14, p = .029). Managing leisure activities by ensuring control, balance, and satisfaction is essential for preventing depressive symptoms in older adults.
• 地域在住高齢者の閉眼安静時脳波に対するeLORETA-ICAの軽度認知障害サブタイプ判別精度の検証
  片山 脩; Annabell Coors; 李 相侖; 原田 健次; 牧野 圭太郎; 冨田 浩輝; 森川 将徳; 山口 亨; 西島 千陽; 見須 裕香; 藤井 一弥; 兒玉 隆之; 島田 裕之
  臨床神経生理学, 53, 5, 618, 618, (一社)日本臨床神経生理学会, 2025年10月, ［査読有り］, ［国際共著］, ［国内誌］
  日本語
• Small for gestational age as a predictor of developmental coordination disorders: Exploring early risk from Japan Birth Cohort Consortium
  Iwata H; Tojo M; Tsuchiya K; Ishikuro M; Chen G; Suyama S; Nakai A; Tamura N; Yoshikawa T; Yamagata T; Nishimura T; Yamaguchi T; Yamazaki K; Obara T; Ishitsuka K; Morisaki N; Makino K; Kuriyama S; Kishi R
  Brain and Development, 47, 5, 104435, 2025年10月, ［査読有り］, ［国際誌］
• Impact of Lifestyle Activity Engagement on Incident Disability: A Stratified Analysis by Cardiovascular Disease Risk.
  Fumio Sakimoto; Takehiko Doi; Sho Nakakubo; Soichiro Matsuda; Keitaro Makino; Hiroyuki Shimada
  Neuroepidemiology, 1, 19, 2025年09月29日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, INTRODUCTION: Cardiovascular disease (CVD) is associated with disability, highlighting the need for prevention strategies that assess and mitigate CVD risk. This study aimed to examine the relationship between participation in lifestyle activities and incident disability among older individuals at high risk of CVD. METHODS: This prospective cohort study included 3,217 older adults (mean age 70.7 years, standard deviation ± 6.8; 1,843 women [57.3%]). Absolute CVD risk was estimated using the revised World Health Organization charts, categorizing individuals' risk levels as either low (< 10%) or high (≥ 10%). The incidence of disability was monitored for 60 months. Baseline assessments included the frequency of participation in 36 lifestyle activities spanning physical, cognitive, and social domains, measured by annual participation frequency. A total score was calculated and categorized into three tertiles based on the frequency of participation (low, moderate, and high groups). An adjusted Cox proportional hazard analysis assessed disability risk based on baseline participation in lifestyle activities stratified by CVD risk level. RESULTS: Over 60 months, 326 participants (10.2%) experienced disability. Older adults who were highly active in cognitive and social activities had a lower risk of disability than those who were less active. Stratified analysis based on CVD risk level showed that engagement in lifestyle activities was linked to disability risk among older adults at high risk of CVD, whereas no such association was observed in those at low risk. CONCLUSION: Among older adults at high CVD risk, greater engagement in lifestyle activities was associated with a reduced risk of disability after 60 months.
• Lifestyle activities to protect against depressive symptoms after driving cessation among older adults: A longitudinal study.
  Fumio Sakimoto; Takehiko Doi; Hideaki Ishii; Soichiro Matsuda; Keitaro Makino; Hiroyuki Shimada
  Geriatrics & gerontology international, 2025年08月08日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, AIM: To investigate whether lifestyle activities reduce the risk of depressive symptoms among older adults who have ceased driving. METHODS: This longitudinal, community-based study included 1654 community-dwelling older adults aged ≥60 years, excluding individuals with baseline depressive symptoms or without driver's licenses. Participants recruited from Takahama City, Aichi Prefecture, Japan, between September 2015 and February 2019 were categorized into driving and driving-cessation groups at baseline. Follow-up postal surveys were conducted over an average of 30.7 (standard deviation: 2.4) months. Depressive symptoms at 30 months were assessed using the Geriatric Depression Scale-15. Lifestyle activities were assessed using the 36-item Lifestyle Activities Questionnaire (LAQ), comprising 12 items each for physical, cognitive and social activities. Logistic regression analysis for each activity and the total LAQ score adjusted for potential covariates identified activities that had a protective role against depressive symptom development. RESULTS: During the follow-up period, 213 participants (13.6%) from the driving group (n = 1564) and 16 participants (17.8%) from the driving-cessation group (n = 90) developed depressive symptoms. Logistic regression analysis adjusted for covariates indicated that a higher total LAQ score was associated with depressive symptoms. Engagement in all activities reduced the risk of depressive symptoms in the driving group, whereas only engagement in cognitive activities reduced the risk in the driving-cessation group. CONCLUSIONS: High engagement in lifestyle activities was associated with a decreased risk of developing depressive symptoms. Hence, a conducive environment and support system are required to enhance engagement in lifestyle activities before older adults cease driving. Geriatr Gerontol Int ••; ••: ••- •• Geriatr Gerontol Int 2025; ••: ••-••.
• The Japanese growth charts stratified by birth weight in 500-gram increments: The Japan Environment and Children’s Study
  Yamaguchi T; Tamura N; Iwata H; Itoh S; Itoh M; Tojo M; Makino K; Saijo Y; Nakamura A; Ito Y; Moriichi A; Kono Y; Yamauchi T; Kishi R
  Clinical Pediatric Endocrinology, 34, 4, 226, 239, 2025年07月, ［査読有り］, ［国際誌］
• Wakefulness after sleep offset and the elevated risk of mortality in older adults with evening preferences: A community-based 5-year longitudinal study
  Georg von Fingerhut; Keitaro Makino; Osamu Katayama; Ryo Yamaguchi; Daiki Yamagiwa; Hiroyuki Shimada
  Archives of Gerontology and Geriatrics, 134, 105852, 105852, Elsevier BV, 2025年07月, ［査読有り］, ［国際誌］
  研究論文（学術雑誌）
• Early Detection and Remote Care of Frailty for Older Adults Living in Sparsely Populated Rural Areas in Hokkaido, Japan: A Case Study
  Kazuki Yokoyama; Shuhei Fukagawa; Hideyuki Tashiro; Hajime Toda; Takuto Kida; Lin Takahashi; Atsushi Mizumoto; Keitaro Makino; Kaori Yokoyama; Tomomi Akanuma; Satoshi Kondo; Hikaru Ihira
  Cureus, Springer Science and Business Media LLC, 2025年05月15日, ［査読有り］, ［国際誌］
  研究論文（学術雑誌）
• 位相情報を用いた軽度認知障害を簡易的に評価可能な脳領域の特定
  山口 優馬; 安里 桃花; 牧野 圭太郎; 李 相侖; 島田 裕之; 米田 哲也
  日本磁気共鳴医学会雑誌, 45, 2, 61, 65, (一社)日本磁気共鳴医学会, 2025年05月, ［査読有り］, ［国内誌］
  日本語
• Cognitive activity levels associated with dementia risk in older adults with social frailty: A longitudinal study
  Fumio Sakimoto; Takehiko Doi; Kouki Tomida; Soichiro Matsuda; Keitaro Makino; Hiroyuki Shimada
  Maturitas, 108597, 108597, Elsevier BV, 2025年05月, ［査読有り］, ［国際誌］
  研究論文（学術雑誌）
• Association between Relative Hypothermia and Cognitive Function in Older Adults: A Cross-Sectional Study.
  Daiki Yamagiwa; Osamu Katayama; Ryo Yamaguchi; Keitaro Makino; Hiroyuki Shimada
  Journal of the American Medical Directors Association, 26, 4, 105472, 105472, 2025年04月, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, OBJECTIVES: This study aimed to investigate the association between relative hypothermia measured by a wearable device and cognitive function, and to clarify whether relative hypothermia is a useful indicator for preventing poor cognitive function. DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: The study included 103 community-dwelling older adults aged 60 to 90 years. METHODS: This study measured body temperature with a wrist-worn device equipped with an accelerometer. Subjects were instructed to wear the Silmee 24 hours a day for 1 week, and body temperature data were sampled every minute. Relative hypothermia was calculated as the percentage of time during the daytime active phase in which body temperature was below the 24-hour mean body temperature. Cognitive function was evaluated regarding memory, attention, executive function, processing speed, and general cognitive function. We calculated atrophy within regions of interest such as the parahippocampal gyrus, hippocampus, and amygdala, which show atrophy in the early stages of Alzheimer's disease. Multiple regression analysis was performed, taking into account variables such as age, sex, body mass index, and severity of volume of interest (VOI) atrophy. RESULTS: Relative hypothermia was significantly associated with memory function. Multiple regression analysis considering variables such as age and severity of VOI atrophy also showed that relative hypothermia was independently associated with the decline in memory function. CONCLUSIONS AND IMPLICATIONS: Relative hypothermia was independently associated with the decline in memory function. Our findings suggest that relative hypothermia assessed by a wearable device may be a useful indicator for early prevention of poor cognitive function.
• Association Between Occupational Participation and Quality of Life in Japanese Older Adults
  Suguru Shimokihara; Kazuki Yokoyama; Hikaru Ihira; Yuriko Matsuzaki-Kihara; Atsushi Mizumoto; Hideyuki Tashiro; Hidekazu Saito; Keitaro Makino; Kiyotaka Shimada; Kosuke Yama; Ryo Miyajima; Takeshi Sasaki; Nozomu Ikeda
  OTJR: Occupational Therapy Journal of Research, SAGE Publications, 2025年03月26日, ［査読有り］, ［国際誌］
  研究論文（学術雑誌）, Positive associations between occupational participation and quality of life (QoL) are known in various populations, but there are few reports in older adults in Japan. To quantify the association between occupational participation in meaningful occupations and QoL among Japanese community-dwelling older adults. A self-administered questionnaire was sent to 626 older adults. QoL was assessed using the World Health Organization (WHO)-five well-being index, and occupational participation in meaningful occupations was measured with the self-administered occupational performance index. The association between occupational participation and QoL was analyzed. Among 367 participants, significant associations were found between occupational participation in meaningful occupations and QoL. In addition, participants with lower QoL exhibited lower levels of occupational participation in occupational control, occupational balance, and satisfaction of performance domains. There is a positive association between occupational participation and QoL among Japanese older adults. Occupational therapists should prioritize occupational participation to support the well-being of older adults.
• Association Between the Use of Information and Communication Technology Tools and Each Domain of Cognitive Function Among Community-Dwelling Older Adults: A Prospective Cohort Study
  Kazuki Yokoyama; Hikaru Ihira; Suguru Shimokihara; Yuriko Matsuzaki-Kihara; Atsushi Mizumoto; Hideyuki Tashiro; Hidekazu Saito; Keitaro Makino; Shunpei Katsuura; Kiyotaka Shimada; Kosuke Yama; Ryo Miyajima; Takeshi Sasaki; Nozomu Ikeda
  Cureus, 17, 2, e79188, 2025年02月17日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）
• A New Computer-Based Cognitive Measure for Early Detection of Dementia Risk (Japan Cognitive Function Test): Validation Study.
  Hiroyuki Shimada; Takehiko Doi; Kota Tsutsumimoto; Keitaro Makino; Kenji Harada; Kouki Tomida; Masanori Morikawa; Hyuma Makizako
  Journal of medical Internet research, 27, e59015, 2025年02月14日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, BACKGROUND: The emergence of disease-modifying treatment options for Alzheimer disease is creating a paradigm shift in strategies to identify patients with mild symptoms in primary care settings. Systematic reviews on digital cognitive tests reported that most showed diagnostic performance comparable with that of paper-and-pencil tests for mild cognitive impairment and dementia. However, most studies have small sample sizes, with fewer than 100 individuals, and are based on case-control or cross-sectional designs. OBJECTIVE: This study aimed to examine the predictive validity of the Japanese Cognitive Function Test (J-Cog), a new computerized cognitive battery test, for dementia development. METHODS: We randomly assigned 2520 older adults (average age 72.7, SD 6.7 years) to derivation and validation groups to determine and validate cutoff points for the onset of dementia. The Mini-Mental State Examination (MMSE) was used for comparison purposes. The J-Cog consists of 12 tasks that assess orientation, designation, attention and calculation, mental rotation, verbal fluency, sentence completion, working memory, logical reasoning, attention, common knowledge, word memory recall, and episodic memory recall. The onset of dementia was monitored for 60 months. In the derivation group, receiver operating characteristic curves were plotted to determine the MMSE and J-Cog cutoff points that best discriminated between the groups with and without dementia. In the validation group, Cox proportional regression models were developed to predict the associations of the group classified using the cutoff points of the J-Cog or MMSE with dementia incidence. Harrell C-statistic was estimated to summarize how well a predicted risk score described an observed sequence of events. The Akaike information criterion was calculated for relative goodness of fit, where lower absolute values indicate a better model fit. RESULTS: Significant hazard ratios (HRs) for dementia incidence were found using the MMSE cutoff between 23 and 24 point (HR 1.93, 95% CI 1.13-3.27) and the J-Cog cutoff between 43 and 44 points (HR 2.42, 95% CI 1.50-3.93). In the total validation group, the C-statistic was above 0.8 for all cutoff points. Akaike information criterion with MMSE cutoff between 23 and 24 points as a reference showed a poor fit for MMSE cutoff between 28 and 29 points, and a good fit for the J-Cog cutoff between 43 and 44 points. CONCLUSIONS: The J-Cog has higher accuracy in predicting the development of dementia than the MMSE and has advantages for use in the community as a test of cognitive function, which can be administered by nonprofessionals.
• Association of chronic low back pain and knee pain with subjective fatigue incidence among community-dwelling older adults: A prospective cohort study.
  Soichiro Matsuda; Takehiko Doi; Osamu Katayama; Keitaro Makino; Fumio Sakimoto; Hiroyuki Shimada
  Geriatrics & gerontology international, 2025年01月28日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, AIM: Fatigue is a common health problem in older adults. Chronic pain is associated with fatigue. However, the longitudinal association between chronic pain and the incidence of subjective fatigue among community-dwelling older adults remains unclear. Therefore, this study aimed to investigate the association between chronic pain and subjective fatigue using prospective data. METHODS: The study included 2060 community-dwelling older adults (age 70.5 ± 6.4 years; male: n = 944) without subjective fatigue at baseline. Chronic pain and other data were assessed at baseline. Subjective fatigue incidence was investigated at the follow-up examination 2.5 years from baseline. RESULTS: In total, 389 (18.9%) reported chronic low back pain, 322 (15.6%) reported chronic knee pain at baseline, and 342 (16.6%) reported subjective fatigue at follow-up examination. A logistic regression analysis showed that the odds ratio for the incidence of subjective fatigue in participants with chronic low back pain had a higher odds ratio for the incidence of subjective fatigue compared to participants without chronic low back pain (odds ratio = 1.71, 95% confidence interval = 1.29-2.26). Chronic knee pain had a higher odds ratio for the incidence of subjective fatigue compared to participants without chronic knee pain (odds ratio = 1.63, 95% confidence interval = 1.21-2.20). CONCLUSIONS: These results suggest that chronic low back pain and knee pain increase the risk of subjective fatigue incidence. These findings emphasize the contribution of chronic pain to fatigue among older adults. Therefore, intervention studies are required to prevent subjective fatigue in participants with chronic pain. Geriatr Gerontol Int 2025; ••: ••-••.
• Japanese growth charts stratified by birth weight in 500-gram increments: findings from the Japan environment and children’s study
  Takeshi Yamaguchi; Naomi Tamura; Hiroyoshi Iwata; Sachiko Itoh; Mariko Itoh; Maki Tojo; Keitaro Makino; Yasuaki Saijo; Akie Nakamura; Yoshiya Ito; Kazutoshi Cho; Akinori Moriichi; Yumi Kono; Taro Yamauchi; Reiko Kishi
  Clinical Pediatric Endocrinology, Japanese Society for Pediatric Endocrinology, 2025年, ［査読有り］, ［国際誌］
  研究論文（学術雑誌）
• Toxic metals and trace elements in maternal blood and urinary tract infection during the first 2 years of life: The Japan Environment and Children's Study
  Keitaro Makino; Hiroyoshi Iwata; Takeshi Yamaguchi; Atsuko Ikeda; Yu Ait Bamai; Sachiko Itoh; Mariko Itoh; Maki Tojo; Naomi Tamura; Rieko Yamamoto; Rahel Mesfin Ketema; Yasuaki Saijo; Yoshiya Ito; Reiko Kishi; the Japan Environment and Children's Study (JECS) Group
  Science of The Total Environment, 2025年, ［査読有り］, ［筆頭著者］, ［国際誌］
• Prediction of Kawasaki disease coronary artery lesions in the Japan Environment and Children's Study
  Iwata H; Yamaguchi T; Tamura N; Yu Ait Bamai; Ikeda A; Itoh M; Tojo M; Ketema RM; Yamazaki K; Itoh S; Makino K; Shida S; Saijo Y; Ito Y; Kishi R
  Annals of Pediatric Cardiology, , in press,, 2025年, ［査読有り］, ［国際誌］
• Prediction of dementia risk by instrumental activities of daily living limitations and its impact on dementia onset in combination with mild cognitive impairment: a population- based longitudinal study
  Keitaro Makino; Sangyoon Lee; Osamu Katayama; Kouki Tomida; Ryo Yamaguchi; Daiki Yamagiwa; Hiroyuki Shimada
  BMC Public Health, 25, 1, 1535, 2025年, ［査読有り］, ［筆頭著者, 責任著者］, ［国際誌］
• Cognitive function, health literacy, and subsequent incidence of dementia among Japanese older adults
  Keitaro Makino; Sangyoon Lee; Osamu Katayama; Kouki Tomida; Ryo Yamaguchi; Daiki Yamagiwa; Hiroyuki Shimada
  Alzheimer's & Dementia: Behavior & Socioeconomics of Aging, 1, 1, e70004, 2025年, ［査読有り］, ［筆頭著者, 責任著者］, ［国際誌］
• Combined effects of social isolation and loneliness on disability incidence in older adults
  Hiroyuki Shimada; Takehiko Doi; Kota Tsutsumimoto; Keitaro Makino; Kenji Harada; Kouki Tomida; Masanori Morikawa; Hidenori Arai
  Archives of Gerontology and Geriatrics, 105749, 105749, Elsevier BV, 2025年01月, ［査読有り］, ［国際誌］
  研究論文（学術雑誌）
• Physical inactivity, depressive symptoms, and progression to sarcopenia in older adults: a 4-year longitudinal study.
  Ryo Yamaguchi; Keitaro Makino; Osamu Katayama; Daiki Yamagiwa; Hiroyuki Shimada
  The journal of nutrition, health & aging, 29, 3, 100452, 100452, 2024年12月19日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, OBJECTIVES: To examine the combined association of physical inactivity and depressive symptoms with the progression to sarcopenia in community-dwelling older adults. DESIGN: A 4-year follow-up longitudinal study. SETTING: Community-dwelling older adults living in Japan, who were not sarcopenic at baseline. PARTICIPANTS: The participants were 2,538 community-dwelling older adults and with a mean age of 70.9 ± 4.6 years, of whom 1,327 (52.3%) were women. MEASUREMENTS: Sarcopenia, defined according to the European Working Group on Sarcopenia in Older People 2, was assessed at baseline and at the 4-year follow-up. Participants were divided into four groups according to their inactivity and depressive symptoms. Physical inactivity was assessed using two face-to-face questions regarding the frequency of regular exercise, sports, and light exercise per week. Depressive symptoms were defined as a score of six or higher on the Geriatric Depression Scale 15-item version. Logistic regression analysis was used to determine whether inactivity and depressive symptoms were associated with progression to sarcopenia 4 years later. For participants who could not be followed and participants with missing data in the follow-up assessment, the data at the follow-up assessment were imputed using the multiple imputations. RESULTS: After 4 years, 518 participants (20.4%) with complete data progressed to sarcopenia. The rate of progression to sarcopenia after multiple imputations was 23.4%. Logistic regression analysis after multiple imputations showed that the group with both factors was significantly associated with the progression to sarcopenia [Odds ratio, 1.64 (95% Confidence interval 1.11-2.44), p = 0.014]. By contrast, no significant association was found for either inactivity or depressive symptoms alone. CONCLUSION: This study indicates that the coexistence of physical inactivity and depressive symptoms may contribute to the progression of sarcopenia. Addressing both physical and mental factors, rather than limiting the problem to a single factor, may be essential for preventing sarcopenia.
• Relationship between self-rated health, physical frailty, and incidence of disability among Japanese community-dwelling older adults: A longitudinal prospective cohort study.
  Ryo Yamaguchi; Keitaro Makino; Osamu Katayama; Daiki Yamagiwa; Hiroyuki Shimada
  Preventive medicine, 191, 108210, 108210, 2024年12月16日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, OBJECTIVE: Poor self-rated health (SRH) and physical frailty are both significant predictors of disability in older adults, but their joint association on health outcomes remain unclear. This study aimed to examine the relationship between SRH, physical frailty, and incidence of disability among community-dwelling older adults. METHODS: This longitudinal cohort study included 2838 older adults aged 65 years or older (mean age, 73.1 ± 5.9 years) living in Takahama, Japan, who participated in the baseline assessment from September 2015 to February 2017. Participants were followed prospectively until June 2021. SRH was assessed on a four-point scale, and frailty was evaluated using the Japanese version of the Cardiovascular Health Study criteria. Participants were categorized into four groups based on SRH (Good or Poor) and frailty status (Robust or Frail). Cox proportional hazard models were used to assess the association between these categories and the incidence of disability over a 5-year follow-up. RESULTS: During the median follow-up of 60 months, 349 of the 2838 participants developed a disability. The risk of disability was significantly higher in the Poor/Robust (HR 1.64, 95 % CI 1.20-2.25), Good/Frail (HR 2.58, 95 % CI 1.91-3.49), and Poor/Frail (HR 2.03, 95 % CI 1.37-3.01) groups than in the Good/Robust reference group. CONCLUSIONS: Frail older adults who report good health were associated with the risk of disability, suggesting that discrepancies between subjective and objective health assessments may lead to adverse outcomes. Recognizing and addressing these discrepancies is crucial to promote successful aging.
• An EEG study of neurophysiological markers of cognitive reserve
  Osamu Katayama; Yaakov Stern; Christian G Habeck; Annabell Coors; Sangyoon Lee; Kenji Harada; Keitaro Makino; Kouki Tomida; Masanori Morikawa; Ryo Yamaguchi; Chiharu Nishijima; Yuka Misu; Kazuya Fujii; Takayuki Kodama; Hiroyuki Shimada
  Alzheimer's & Dementia, 20, S2, Wiley, 2024年12月, ［査読有り］, ［国際共著］, ［国際誌］
  研究論文（学術雑誌）, Abstract
  
  Background
  
  Cognitive reserve (CR) is a property of the brain trait that allows for better–than–expected cognitive performance, relative to the degree of brain change over the life course. However, the neurophysiological markers of CR require further investigation. Electroencephalography (EEG) may provide an appropriate neurophysiological marker of CR. Therefore, we tested whether activity in the dorsal attention network (DAN) and the ventral attention network (VAN), as measured during resting–state EEG, moderates the relationship between hippocampal volume and episodic memory.
  
  Method
  
  Participants from the National Center for Geriatrics and Gerontology–Study of Geriatric Syndromes, were included; all underwent determined hippocampal volume using MRI and episodic memory was measured using word lists. After testing the effect of hippocampal volume on memory performance using multiple regression analysis, we evaluated the interactions between hippocampal volume and DAN and VAN network activity. We used the Johnson–Neyman technique to quantify the moderating effects of the DAN and VAN network activity on the relationship between hippocampal volume and word list memory, and to identify specific ranges of the DAN and VAN network activity with significant hippocampal–memory associations.
  
  Result
  
  A total of 449 participants were included in this study. We found significant moderation of DAN with a slope of β = ‐0.0001 (95% CI: ‐0.0002; ‐0.00001, p = 0.041) and VAN was significant, with a slope of β = 0.0001 (95% CI: 0.00001; 0.0003, p = 0.032). We found that larger hippocampal volume was associated with better memory performance, and this association became stronger the lower the DAN activity. However, when the DAN activity was > 944.9, the hippocampal volume was no longer significantly related to word list memory performance. For VAN, we found higher hippocampal volume was more strongly associated with better memory performance when VAN activity was higher. However, when the VAN activity was < 914.6, the hippocampal volume was no longer significantly associated with word list memory.
  
  Conclusion
  
  Our results suggest that attention network helps maintain memory performance in the face of age related structural decline, meeting criteria for a neural implementation of cognitive reserve.
• Life-Space Activities and Incident Dementia Among Older Adults: Insights From a Cohort Study
  Takehiko Doi; Keitaro Makino; Kouki Tomida; Kota Tsutsumimoto; Fumio Sakimoto; Soichiro Matsuda; Hiroyuki Shimada
  Journal of the American Medical Directors Association, 105416, 105416, Elsevier BV, 2024年12月, ［査読有り］
  研究論文（学術雑誌）
• Associations between Japanese calligraphy practice and sleep quality in community-dwelling older adults: A cross-sectional Study
  Georg von Fingerhut; Keitaro Makino; Osamu Katayama; Ryo Yamaguchi; Daiki Yamagiwa; Jessica K. Bone; Hiroyuki Shimada
  Sleep Medicine: X, 8, 100124, 100124, Elsevier BV, 2024年12月, ［査読有り］
  研究論文（学術雑誌）
• Chronic low back pain and decreased physical activity are associated with social frailty incidence among community-dwelling older adults.
  Soichiro Matsuda; Takehiko Doi; Osamu Katayama; Fumio Sakimoto; Keitaro Makino; Motoki Sudo; Yukari Yamashiro; Naoto Takayanagi; Hiroyuki Shimada
  Geriatrics & gerontology international, 2024年11月25日, ［査読有り］, ［国内誌］
  英語, 研究論文（学術雑誌）, AIM: Nearly half of older adults with frailty experience chronic pain. Chronic pain contributes to activity restrictions. Decreased physical activity with chronic pain is associated not only with physical dysfunction but also with reduced engagement in social activities. We aimed to verify the hypothesis that chronic pain and decreased physical activity are associated with social frailty incidence. METHODS: The study included 1198 community-dwelling older adults (aged 70.2 ± 6.3 years) without social frailty at baseline. Chronic pain, physical activity and basic information were assessed at baseline. The participants were divided into two groups based on the presence (yes, n = 167) or absence (no, n = 1031) of chronic low back pain. The incidence of social frailty was investigated during the follow-up examination after 2.5 years. RESULTS: Binomial logistic regression analysis showed that older adults with chronic low back pain and low step counts had a higher odds ratio for the development of incident social frailty than older adults without chronic low back pain and high step counts (odds ratio 1.89, 95% confidence interval 1.03-3.46). CONCLUSION: Our results suggest that a combination of chronic low back pain and low step counts is associated with the incidence of social frailty. Further research is required to establish intervention methods for pain and decreased physical activity to prevent social frailty. Geriatr Gerontol Int 2024; ••: ••-••.
• Examination of Gait Characteristics Related to Sarcopenia in Community-Dwelling Older Adults: A Study Focusing on Plantar Pressure.
  Daiki Yamagiwa; Keitaro Makino; Osamu Katayama; Ryo Yamaguchi; von Fingerhut Georg; Yukari Yamashiro; Motoki Sudo; Hiroyuki Shimada
  Journal of cachexia, sarcopenia and muscle, 2024年11月22日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, BACKGROUND: Sarcopenia is a condition characterized by a decrease in skeletal muscle mass and strength with age, which results in a lower gait speed. Decreased gait speed in older individuals with sarcopenia can lead to adverse events such as falls and mortality. It is a major health issue; several studies have investigated gait speed in sarcopenia. However, plantar pressure has not been sufficiently evaluated. Plantar pressure facilitates gait analysis, including gait speed, and plays an important role in preventing adverse events such as falls and mortality. Therefore, the current study aimed to validate gait characteristics, including plantar pressure in community-dwelling older adults with sarcopenia. METHODS: The current study included community-dwelling Japanese adults aged ≥60 years who participated in health checkups between 2013 and 2018. Sarcopenia was diagnosed by measuring muscle mass and strength based on clinical definition (nonsarcopenia: n = 7662; probable sarcopenia: n = 1208; and sarcopenia: n = 477). Gait parameters (including gait speed, relative plantar pressure, cadence, stride length, step length, step width and foot angle) were measured at a comfortable speed using a computerized electronic walkway. Gait parameters between groups were compared via an analysis of covariance adjusted for age and BMI. In addition, post hoc analyses were performed with Bonferroni correction. RESULTS: The sarcopenia and probable sarcopenia groups had a significantly lower gait speed than the nonsarcopenia group (p < 0.01). Further, the sarcopenia and probable sarcopenia groups had a significantly lower forefoot plantar pressure, stride length and cadence than the nonsarcopenia group (all p < 0.01). When comparing, the sarcopenia group had a greater medial plantar pressure, step length, and foot angle and a lower lateral plantar pressure, cadence, and step width than the probable sarcopenia group (all p < 0.01). CONCLUSION: The sarcopenia, probable sarcopenia and nonsarcopenia groups differed concerning gait characteristics, including plantar pressure. It is thought that exercise instruction that takes into account walking characteristics is important for probable sarcopenia and sarcopenia.
• Linear association between frailty as assessed by the Kihon Checklist and quality of life in community-dwelling older adults: A cross-sectional population-based study
  Suguru Shimokihara; Kazuki Yokoyama; Hikaru Ihira; Yuriko Matsuzaki-Kihara; Atsushi Mizumoto; Hideyuki Tashiro; Hidekazu Saito; Keitaro Makino; Kiyotaka Shimada; Kosuke Yama; Ryo Miyajima; Takeshi Sasaki; Nozomu Ikeda
  Annals of Geriatric Medicine and Research, The Korean Geriatrics Society, 2024年10月14日, ［査読有り］
  研究論文（学術雑誌）
• Detection of neurophysiological markers of cognitive reserve: an EEG study
  Osamu Katayama; Yaakov Stern; Christian Habeck; Annabell Coors; Sangyoon Lee; Kenji Harada; Keitaro Makino; Kouki Tomida; Masanori Morikawa; Ryo Yamaguchi; Chiharu Nishijima; Yuka Misu; Kazuya Fujii; Takayuki Kodama; Hiroyuki Shimada
  Frontiers in Aging Neuroscience, 16, Frontiers Media SA, 2024年08月07日, ［査読有り］
  研究論文（学術雑誌）, Background and objectives
  
  Cognitive reserve (CR) is a property of the brain that allows for better–than–expected cognitive performance relative to the degree of brain change over the course of life. However, neurophysiological markers of CR remain under-investigated. Electroencephalography (EEG) features may function as suitable neurophysiological markers of CR. To assess this, we investigated whether the dorsal attention network (DAN) and ventral attention network (VAN) activities, as measured during resting–state EEG, moderate the relationship between hippocampal volume and episodic memory.
  
  Methods
  
  Participants were recruited as part of the National Center for Geriatrics and Gerontology–Study of Geriatric Syndromes. Hippocampal volume was determined using magnetic MRI, and episodic memory was measured using word lists. After testing the effect of hippocampal volume on memory performance using multiple regression analysis, we evaluated the interactions between hippocampal volume and DAN and VAN network activities. We further used the Johnson–Neyman technique to quantify the moderating effects of DAN and VAN network activities on the relationship between hippocampal volume and word list memory, as well as to identify specific ranges of DAN and VAN network activity with significant hippocampal–memory association.
  
  Results
  
  A total of 449 participants were included in this study. Our analysis revealed significant moderation of DAN with a slope of β = −0.00012 (95% CI: −0.00024; −0.00001, p = 0.040), and VAN with a slope of β = 0.00014 (95% CI: 0.00001; 0.00026, p = 0.031). Further, we found that a larger hippocampal volume was associated with improved memory performance, and that this association became stronger as the DAN activity decreased until a limit of DAN activity of 944.9, after which the hippocampal volume was no longer significantly related to word-list memory performance. For the VAN, we found that a higher hippocampal volume was more strongly associated with better memory performance when VAN activity was higher. However, when VAN activity extended beyond −914.6, the hippocampal volume was no longer significantly associated with word-list memory.
  
  Discussion
  
  Our results suggest that attentional networks help to maintain memory performance in the face of age-related structural decline, meeting the criteria for the neural implementation of cognitive reserve.
• Diversity in productive activities enhances life satisfaction among Japanese community-dwelling older adults: A cross-sectional study
  Kazuya Fujii; Sangyoon Lee; Osamu Katayama; Keitaro Makino; Kenji Harada; Kouki Tomida; Masanori Morikawa; Ryo Yamaguchi; Chiharu Nishijima; Yuka Misu; Hiroyuki Shimada
  Geriatric Nursing, 58, 232, 237, Elsevier BV, 2024年07月, ［査読有り］
  研究論文（学術雑誌）
• Association between Hearing Aid Use and Cognitive Function in Persons with Hearing Impairment Stratified by Cardiovascular Risk
  Kouki Tomida; Sangyoon Lee; Keitaro Makino; Osamu Katayama; Kenji Harada; Masanori Morikawa; Ryo Yamaguchi; Chiharu Nishijima; Kazuya Fujii; Yuka Misu; Hiroyuki Shimada
  Journal of Personalized Medicine, 14, 5, 479, 479, MDPI AG, 2024年04月29日, ［査読有り］
  研究論文（学術雑誌）, 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.
• Impacts of negative and positive life events on development of social frailty among community-dwelling older adults
  Keitaro Makino; Takehiko Doi; Kota Tsutsumimoto; Osamu Katayama; Ryo Yamaguchi; von Fingerhut Georg; Daiki Yamagiwa; Hyuma Makizako; Hiroyuki Shimada
  Journal of the American Medical Directors Association, 25, 4, 690, 696, 2024年04月, ［査読有り］, ［筆頭著者, 責任著者］, ［国際誌］
• Elevated Risk of Dementia Diagnosis in Older Adults with Low Frequencies and Durations of Social Conversation.
  Hiroyuki Shimada; Takehiko Doi; Kota Tsutsumimoto; Keitaro Makino; Kenji Harada; Kouki Tomida; Hidenori Arai
  Journal of Alzheimer's disease : JAD, 2024年03月08日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, BACKGROUND: Social networks and social participation have protective effects on cognitive function maintenance and Alzheimer's disease and general dementia development. OBJECTIVE: We aimed to investigate the association between conversations and dementia incidence in older adults. METHODS: This longitudinal prospective cohort study used population data from the National Center for Geriatric and Gerontology-Study of Geriatric Syndromes (NCGG-SGS) from September 2015 to February 2017. The database included 4,167 individuals in Japan aged ≥60 years who were generally healthy and without major cognitive impairment. Participants were classified into two groups according to six daily conversation measures at baseline. The conversation index was calculated as a composite score for these measures. Participants were tracked monthly over 60 months for new-onset dementia. RESULTS: Data from 2,531 participants were analyzed (72.7±6.7 years; range: 60-96 years). Dementia incidence per 1,000 person-years was 15.7 (95% confidence interval, 13.6-18.1). The Youden index determined the cut-off point for dementia incidence, with a conversation index of 16/17 points. The low conversation group included more participants with new-onset dementia. Cox proportional hazards regression crude models showed remarkable relationships between dementia onset and specific conversation measurements, including conversation index. According to the Cox regression adjusted model, the cut-off point of the conversation index showed only a remarkable relationship with dementia onset. CONCLUSIONS: Dementia risk was extensively associated with low daily conversation statuses. The assessment of conversational factors may be useful as a risk indicator for the development of Alzheimer's disease and general dementia.
• Lifetime physical activity and late-life mild cognitive impairment in community-dwelling older adults
  Keitaro Makino; Parminder Raina; Lauren E. Griffith; Sangyoon Lee; Kenji Harada; Osamu Katayama; Kouki Tomida; Masanori Morikawa; Ryo Yamaguchi; Chiharu Nishijima; Kazuya Fujii; Yuka Misu; Hiroyuki Shimada
  Journal of the American Medical Directors Association, 25, 3, 488, 493, 2024年03月, ［査読有り］, ［筆頭著者, 責任著者］, ［国際共著］, ［国際誌］
• Association between the perceived value of adopting new behaviors and depressive symptoms among older adults.
  Chiharu Nishijima; Osamu Katayama; Sangyoon Lee; Keitaro Makino; Kenji Harada; Masanori Morikawa; Kouki Tomida; Ryo Yamaguchi; Kazuya Fujii; Yuka Misu; Hiroyuki Shimada
  Scientific reports, 14, 1, 4569, 4569, 2024年02月25日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, Early preventive measures against depression have become important with unprecedented global aging. Increase in one's perceived value (PV) may correspond to better mental health outcomes. This cross-sectional observation study aimed to clarify whether the PV of adopting new behaviors is associated with depressive symptoms. The participants were 5266 community-dwelling older adults aged ≥ 65 years. We developed a questionnaire to measure the PV of adopting new behaviors, specifically activities beneficial for preventing depressive symptoms (physical, cognitive, and social activities) in older adults. The questionnaire asked whether adopting the ten selected behaviors was valuable. The scores were added, and the total score ranged from - 20 to 20. The odds ratios (OR) of depressive symptoms were calculated using binomial logistic regression according to the PV score quartiles. Depressive symptoms were reported by 595 (11.3%) participants. After adjusting for potential confounders, higher quartiles of PV scores were significantly associated with lower prevalence of depressive symptoms: vs Q1; Q2 OR 0.76 (95% confidence interval: 0.59-0.97); Q3 0.67 (0.51-0.87); Q4 0.54 (0.40-0.73) (P for trend < .001). Having a higher PV of adopting new behaviors may prevent depressive symptoms among older adults. Healthcare professionals need to pay attention to poor value orientation among older adults.
• Physical frailty and survival time after the onset of functional disability: Is there a sex difference?
  Keitaro Makino; Parminder Raina; Lauren E. Griffith; Sangyoon Lee; Kenji Harada; Ippei Chiba; Osamu Katayama; Kouki Tomida; Masanori Morikawa; Hyuma Makizako; Hiroyuki Shimada
  Journal of the American Geriatrics Society, 72, 2, 399, 409, 2024年02月, ［査読有り］, ［筆頭著者, 責任著者］, ［国際共著］, ［国際誌］
• Combined Social Frailty and Life-Space Activities Associated with Risk of Disability: A Prospective Cohort Study
  Takehiko Doi; K. Tsutsumimoto; K. Makino; S. Nakakubo; F. Sakimoto; S. Matsuda; H. Shimada
  Journal of Frailty and Aging, 2024年, ［査読有り］
  研究論文（学術雑誌）
• Combined impact of physical frailty and social isolation on use of long-term care insurance in Japan: A longitudinal observational study
  Hiroyuki Shimada; Takehiko Doi; Kota Tsutsumimoto; Keitaro Makino; Kenji Harada; Kouki Tomida; Masanori Morikawa; Hidenori Arai
  Maturitas, 107921, 107921, Elsevier BV, 2024年01月, ［査読有り］
  研究論文（学術雑誌）
• Social isolation and risk of disability in older adults: Effect modification of metabolic syndrome
  Masanori Morikawa; Sangyoon Lee; Keitaro Makino; Kenji Harada; Osamu Katayama; Kouki Tomida; Ryo Yamaguchi; Chiharu Nishijima; Kazuya Fujii; Yuka Misu; Hiroyuki Shimada
  Archives of Gerontology and Geriatrics, 116, 105209, 105209, Elsevier BV, 2024年01月, ［査読有り］
  研究論文（学術雑誌）
• Neurophysiological markers in community-dwelling older adults with mild cognitive impairment: an EEG study
  Osamu Katayama; Yaakov Stern; Christian Habeck; Sangyoon Lee; Kenji Harada; Keitaro Makino; Kouki Tomida; Masanori Morikawa; Ryo Yamaguchi; Chiharu Nishijima; Yuka Misu; Kazuya Fujii; Takayuki Kodama; Hiroyuki Shimada
  Alzheimer's Research & Therapy, 15, 1, Springer Science and Business Media LLC, 2023年12月15日, ［査読有り］, ［国際共著］, ［国際誌］
  研究論文（学術雑誌）, Abstract
  
  Background
  
  Neurodegeneration and structural changes in the brain due to amyloid deposition have been observed even in individuals with mild cognitive impairment (MCI). EEG measurement is considered an effective tool because it is noninvasive, has few restrictions on the measurement environment, and is simple and easy to use. In this study, we investigated the neurophysiological characteristics of community-dwelling older adults with MCI using EEG.
  
  Methods
  
  Demographic characteristics, cognitive function, physical function, resting-state MRI and electroencephalogram (rs-EEG), event-related potentials (ERPs) during Simon tasks, and task proportion of correct responses and reaction times (RTs) were obtained from 402 healthy controls (HC) and 47 MCI participants. We introduced exact low-resolution brain electromagnetic tomography-independent component analysis (eLORETA-ICA) to assess the rs-EEG network in community-dwelling older adults with MCI.
  
  Results
  
  A lower proportion of correct responses to the Simon task and slower RTs were observed in the MCI group (p < 0.01). Despite no difference in brain volume between the HC and MCI groups, significant decreases in dorsal attention network (DAN) activity (p < 0.05) and N2 amplitude of ERP (p < 0.001) were observed in the MCI group. Moreover, DAN activity demonstrated a correlation with education (Rs = 0.32, p = 0.027), global cognitive function (Rs = 0.32, p = 0.030), and processing speed (Rs = 0.37, p = 0.010) in the MCI group. The discrimination accuracy for MCI with the addition of the eLORETA-ICA network ranged from 0.7817 to 0.7929, and the area under the curve ranged from 0.8492 to 0.8495.
  
  Conclusions
  
  The eLORETA-ICA approach of rs-EEG using noninvasive and relatively inexpensive EEG demonstrates specific changes in elders with MCI. It may provide a simple and valid assessment method with few restrictions on the measurement environment and may be useful for early detection of MCI in community-dwelling older adults.
• Reciprocal relationship between physical and social frailty among community-dwelling older adults
  Yuka Misu; Osamu Katayama; Sangyoon Lee; Keitaro Makino; Kenji Harada; Kouki Tomida; Masanori Morikawa; Ryo Yamaguchi; Chiharu Nishijima; Kazuya Fujii; Hiroyuki Shimada
  Archives of Gerontology and Geriatrics, 114, 105066, 105066, Elsevier BV, 2023年11月, ［査読有り］
  研究論文（学術雑誌）
• Measures of perceived mobility ability in community-dwelling older adults: a systematic review of psychometric properties
  Marla Beauchamp; Qiukui Hao; Ayse Kuspinar; Gésine Alder; Keitaro Makino; Mina Nouredanesh; Yunli Zhao; Christopher Mikton; Jotheeswaran Amuthavalli Thiyagarajan; Theresa Diaz; Parminder Raina
  Age and Ageing, 52, Supplement_4, iv100, iv111, Oxford University Press (OUP), 2023年10月, ［査読有り］, ［国際共著］, ［国際誌］
  研究論文（学術雑誌）, Abstract
  
  Objectives
  
  The objective of this systematic review was to synthesise the psychometric properties of measures of perceived mobility ability and related frameworks used to define and operationalise mobility in community-dwelling older adults.
  
  Methods
  
  We registered the review protocol with PROSPERO (CRD42022306689) and included studies that examined the psychometric properties of perceived mobility measures in community-dwelling older adults. Five databases were searched to identify potentially relevant primary studies. We qualitatively summarised psychometric property estimates and related operational frameworks. We conducted risk of bias and overall quality assessments, and meta-analyses when at least three studies were included for a particular outcome. The synthesised results were compared against the Consensus-based Standards for the Selection of Health Measurement Instruments criteria for good measurement properties.
  
  Results
  
  A total of 36 studies and 17 measures were included in the review. The Late-Life Function and Disability Index: function component (LLFDI-FC), lower extremity functional scale (LEFS), Mobility Assessment Tool (MAT)-short form (MAT-SF) or MAT-Walking, and Perceived Driving Abilities (PDA) Scale were identified with three or more eligible studies. Most measures showed sufficient test–retest reliability (moderate or high), while the PDA scale showed insufficient reliability (low). Most measures had sufficient or inconsistent convergent validity (low or moderate) or known-groups validity (low or very low), but their predictive validity and responsiveness were insufficient or inconsistent (low or very low). Few studies used a conceptual model.
  
  Conclusion
  
  The LLFDI-FC, LEFS, PDA and MAT-SF/Walking can be used in community-dwelling older adults by considering the summarised psychometric properties. No available comprehensive mobility measure was identified that covered all mobility domains.
• Predictive Validity of Different Walking Measures to Identify the Incident Long-Term Care Needs in Older Adults
  Hiroyuki Shimada; T. Doi; K. Tsutsumimoto; K. Makino; K. Harada; K. Tomida; H. Arai
  The journal of nutrition, health & aging, 27, 9, 759, 766, Springer Science and Business Media LLC, 2023年09月16日, ［査読有り］
  研究論文（学術雑誌）
• Subjective Cognitive Decline and Frailty Trajectories and Influencing Factors in Japanese Community-Dwelling Older Adults: A Longitudinal Study.
  Seongryu Bae; Hiroyuki Shimada; Sangyoon Lee; Keitaro Makino; Ippei Chiba; Osamu Katayama; Kenji Harada; Hyuntae Park; Kenji Toba
  Journal of clinical medicine, 12, 18, 2023年09月06日, ［査読有り］, ［国際共著］, ［国際誌］
  英語, 研究論文（学術雑誌）, We studied frailty and subjective cognitive decline (SCD) trajectories in older Japanese adults and evaluated the influence of various factors on these trajectories. We analyzed data from 1157 non-demented adults aged 70 and above from 2013 to 2019. Frailty was assessed using the self-administered Kihon Checklist (KCL), a Japanese frailty index. SCD was evaluated using the questionnaire of the Subjective Memory Complaints scale. Through group-based joint trajectory models, we discerned three frailty trajectories: non-progressive (n = 775), moderate progressive (n = 312), and rapid progressive (n = 70); and three SCD trajectories: non-progressive (n = 302), moderate progressive (n = 625), and rapid progressive (n = 230). Individuals in the rapid progressive SCD trajectory had a 32.2% probability of also being in the rapid progressive frailty trajectory. In contrast, those in the non-progressive SCD trajectory had zero probability of being in the rapid progressive frailty trajectory. Both the rapid progressive frailty and SCD groups combined had a higher incidence of depressive symptoms and slow gait speed. Our results have found that frailty and SCD share a similar trajectory in Japanese older adults. Additionally, rapid progressive frailty and SCD were associated with the highest risk of depressive symptoms and slow gait speed. Thus, interventions targeting both frailty and cognitive decline should prioritize mental health enhancement and gait speed improvement.
• Differential effects of lifestyle activities on disability incidence based on neighborhood amenities.
  Osamu Katayama; Sangyoon Lee; Seongryu Bae; Keitaro Makino; Ippei Chiba; Kenji Harada; Yohei Shinkai; Hiroyuki Shimada
  BMC geriatrics, 23, 1, 483, 483, 2023年08月10日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, BACKGROUND: This study examined the effect of neighborhood amenities on disability risk among community-dwelling older adults in Japan, based on lifestyle activities. METHOD: This was an observational prospective cohort study. Participants comprised 13,258 older adults from the National Center for Geriatrics and Gerontology-Study of Geriatric Syndromes. We calculated participants' Walk Score using their home addresses and divided them into three groups: "car-dependent," "somewhat walkable," and "very walkable." We then calculated the average value of lifestyle activities. We divided the neighborhood amenity groups into two groups, "fewer lifestyle activities" and "more lifestyle activities," for a total of six groups. After identifying interactions between neighborhood amenities and lifestyle activities, Cox proportional hazard models to calculate hazard ratios for incident disability risk, based on neighborhood amenities and lifestyle activities. RESULTS: An interaction occurred between neighborhood amenities and lifestyle activities (p < 0.05). Survival probabilities for incident disability based on lifestyle activities were estimated for each neighborhood amenity group: car-dependent, 1.62 (95% CI 1.07 to 2.46); somewhat walkable, 1.08 (95% CI 0.84 to 1.40); and very walkable, 1.05 (95% CI 0.87 to 1.27). Those with fewer lifestyle activities in the car-dependent group exhibited the highest risk of incident disability in the unadjusted and adjusted models. CONCLUSION: Given that the aging population is increasing steadily, considering older adults' neighborhood amenities and lifestyle activities in their day-to-day lives can help clinicians to deliver more older adult-centered care. Incorporating the lifestyle activities and neighborhood amenities of older adults into care planning will lead to the design and development of integrated clinical and community screening programs.
• Difference in employment status and onset of disability among Japanese community-dwelling older adults: a prospective cohort study
  Kazuya Fujii; Sangyoon Lee; Osamu Katayama; Keitaro Makino; Kenji Harada; Kouki Tomida; Masanori Morikawa; Ryo Yamaguchi; Chiharu Nishijima; Yuka Misu; Hiroyuki Shimada
  International Archives of Occupational and Environmental Health, Springer Science and Business Media LLC, 2023年07月24日, ［査読有り］
  研究論文（学術雑誌）
• Association between COVID-19 emergency declarations and physical activity among community-dwelling older adults enrolled in a physical activity measurement program: Evidence from a retrospective observational study using the regression discontinuity design.
  Ippei Chiba; Masayoshi Takahashi; Sangyoon Lee; Seongryu Bae; Keitaro Makino; Osamu Katayama; Kenji Harada; Kouki Tomida; Masanori Morikawa; Yukari Yamashiro; Naoto Takayanagi; Motoki Sudo; Hiroyuki Shimada
  BMC public health, 23, 1, 998, 998, 2023年05月30日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, BACKGROUND: The current study examines the negative impact of the coronavirus disease 2019 (COVID-19) emergency declarations on physical activity among the community-dwelling older adults, the participants of a physical activity measurement program, in Japan. METHODS: This retrospective observational study included 1,773 community-dwelling older adults (aged 74.6 ± 6.3 years, 53.9% women) who had participated in the physical activity measurement project from February 2020 to July 2021. We measured physical activity using a tri-axial accelerometer during 547 consecutive days. Three emergency declarations, requesting people to avoid going outside, occurred during the observational period. We multiply-imputed missing values for daily physical activity, such as steps, light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) for several patterns of datasets according to the maximum missing rates on a person level. We mainly report the results based on less than 50% of the maximum missing rate (n = 1,056). Other results are reported in the supplemental file. Changes in physical activity before and after the start of each emergency declaration were examined by the regression discontinuity design (RDD) within 14-, 28-, and 56-day bandwidths. RESULTS: For all the participants in the multiply-imputed data with the 14-day bandwidth, steps (coefficients [Formula: see text] 964.3 steps), LPA ([Formula: see text] 5.5 min), and MVPA ([Formula: see text] 4.9 min) increased after the first emergency declaration. However, the effects were attenuated as the RDD bandwidths were widened. No consistent negative impact was observed after the second and third declarations. After the second declaration, steps ([Formula: see text]-609.7 steps), LPA ([Formula: see text]-4.6 min), and MVPA ([Formula: see text]-2.8 min) decreased with the 14-day bandwidth. On the other hand, steps ([Formula: see text] 143.8 steps) and MVPA ([Formula: see text] 1.3 min) increased with the 56-day bandwidth. For the third declaration, LPA consistently decreased with all the bandwidths ([Formula: see text]-2.1, -3.0, -0.8 min for the 14, 28, 56-day bandwidth), whereas steps ([Formula: see text]-529 steps) and MVPA ([Formula: see text]-2.6 min) decreased only with the 28-day bandwidth. CONCLUSIONS: For the community-dwelling older adults who regularly self-monitor their physical activity, the current study concludes that there is no evidence of consistently negative impacts of the emergency declarations by the COVID-19 pandemic.
• Computer-based cognitive tests and cerebral pathology among Japanese older adults.
  Hiroyuki Shimada; Keitaro Makino; Takashi Kato; Kengo Ito
  BMC geriatrics, 23, 1, 226, 226, 2023年04月10日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, BACKGROUND: This study aimed to identify the appropriate computer-based cognitive tests and cut-off values for estimating amyloid burden in preclinical Alzheimer's disease drug trials. METHODS: Data from 103 older individuals, who underwent 18F-florbetapir positron emission tomography and cognitive testing, were analyzed. Cognitive tests evaluated word list memory (immediate recognition and delayed recall), attention (Trail Making Test-part A), executive function (Trail Making Test-Part B), and processing speed (Digit Symbol Substitution Test [DSST]). RESULTS: The Aβ burden was significantly associated with word list memory (odds ratio [OR] = 0.42, 95% confidence interval [CI], 0.19-0.91) and DSST (OR = 0.35; 95% CI, 0.14-0.85). Positive predictive value and number needed to screen at a cut-off of 1.5 SD were better for word list memory and DSST among predictive values. CONCLUSIONS: The computer-based memory and processing speed tests have the potential to reduce failure rates while screening individuals with Aβ accumulation in community settings.
• Association of Loneliness With the Incidence of Disability in Older Adults With Hearing Impairment in Japan.
  Kouki Tomida; Sangyoon Lee; Keitaro Makino; Osamu Katayama; Kenji Harada; Masanori Morikawa; Ryo Yamaguchi; Chiharu Nishijima; Kazuya Fujii; Yuka Misu; Hiroyuki Shimada
  JAMA otolaryngology-- head & neck surgery, 2023年04月06日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, IMPORTANCE: Loneliness is suggested to negatively affect physical and mental health and influence the development of disability; however, a consensus on the relationship between loneliness and disability has not been reached. Age-related hearing impairment worsens the daily-life activities of older adults, and the association between loneliness and the incidence of disability may be influenced by hearing impairment. OBJECTIVE: To examine the association between loneliness and the incidence of disability among older adults stratified by hearing impairment. DESIGN, SETTING, AND PARTICIPANTS: This prospective observational cohort study included 5563 community-dwelling adults 65 years or older who participated in functional health examinations in Tokai City, Aichi Prefecture, Japan, between September 2017 and June 2018. Data analysis was conducted from August 2022 to February 2023. MAIN OUTCOMES AND MEASURES: Cox proportional hazards regression models were used to examine the association between loneliness and the incidence of disability stratified by hearing impairment. RESULTS: Among the 4739 participants who met the inclusion criteria (mean [SD] age, 73.8 [5.5] years; 2622 [55.3%] female), 3792 (80.0%) were without hearing impairment and 947 (20.0%) were with hearing impairment. Of those who reported experiencing loneliness, 1215 (32.0%) were without hearing impairment, and 441 (46.6%) were with hearing impairment. After 2 years, the number of individuals with disabilities was 172 (4.5%) without hearing impairment and 79 (8.3%) with hearing impairment. Cox proportional hazards regression analysis showed no statistically significant association between loneliness and the incidence of disability in a model adjusted for potential confounding factors among community-dwelling older adults without hearing impairment (hazard ratio, 1.10; 95% CI, 0.80-1.52). Among community-dwelling older adults with hearing impairment, a model adjusted for potential confounding factors showed a statistically significant association between loneliness and the incidence of disability (hazard ratio, 1.71; 95% CI, 1.04-2.81). CONCLUSIONS AND RELEVANCE: This cohort study found that the association between loneliness and the incidence of disability was moderated by the presence or absence of hearing impairment. Hearing impairment is the most common symptom of geriatric syndromes, showing that among the various risk factors, loneliness may require special attention in the prevention of disability in people with hearing impairment.
• Impact of osteosarcopenia on disability and mortality among Japanese older adults.
  Hiroyuki Shimada; Takao Suzuki; Takehiko Doi; Sangyoon Lee; Sho Nakakubo; Keitaro Makino; Hidenori Arai
  Journal of cachexia, sarcopenia and muscle, 14, 2, 1107, 1116, 2023年04月, ［国際誌］
  英語, 研究論文（学術雑誌）, BACKGROUND: In clinical settings, muscle mass and bone mineral density assessments are usually performed using dual-energy X-ray absorptiometry (DXA), the clinical standard technique. However, DXA is often unavailable in community settings. This study aimed to determine whether osteoporosis, osteopenia (OP) and sarcopenia (SP) identified by simplified instruments are associated with the future incidence of disability and mortality and evaluate the validity of these instruments as community screening tools. We also examined osteosarcopenia (OS), defined as the coexistence of OP and SP, as a new indicator of geriatric syndromes to determine whether it has an additive effect on adverse outcome incidence compared with OP and SP alone. METHODS: In total, 8995 older adults participated in the study (women: 51.7%, average age: 73.5 ± 5.4 years). Data were extracted from the Japanese national cohort study, National Center for Geriatrics and Gerontology-Study of Geriatric Syndromes. We determined OP based on T-scores generated based on the speed of sound, which is the time taken for ultrasound waves to go through a determined distance in the calcaneus bone. Skeletal muscle mass was evaluated using a bioimpedance analysis device. Handgrip strength and walking speed were measured as physical performance indicators. Incidences of disability and mortality were prospectively determined for 5 years. RESULTS: The prevalence of OP, SP and OS was 45.5%, 3.9% and 7.4%, respectively. The incidence of disability in the nonOP/nonSP, OP, SP and OS groups was 6.5%, 14.9%, 20.5% and 33.5%, respectively. The incidence of mortality in the nonOP/nonSP, OP, SP and OS groups was 4.0%, 4.9%, 10.3% and 10.2%, respectively. Participants with OP (hazard ratio [HR]: 1.45, 95% confidence interval [CI]: 1.25-1.68), SP (HR: 1.38, 95% CI: 1.08-1.76) and OS (HR: 1.73, 95% CI: 1.43-2.09) had a higher risk of disability than nonOP/nonSP participants. Participants with OP (HR: 1.31, 95% CI: 1.04-1.64) and OS (HR: 1.45, 95% CI: 1.05-2.00) had a higher risk of mortality than nonOP/nonSP participants. SP was not significantly related to mortality (HR: 1.14, 95% CI: 0.90-1.45). There was no statistical interaction between OP and SP in incident disability and mortality. CONCLUSIONS: Among older adults, OS identified by bioimpedance and quantitative ultrasound assessments was associated with an increased risk of disability and mortality. Further research is needed to implement these findings in community health activities, such as setting precise cut-off values and constructing accurate disability and mortality prediction models.
• Sarcopenic Obesity and Risk of Disability in Community-Dwelling Japanese Older Adults: A 5-year Longitudinal Study
  Masanori Morikawa; Sangyoon Lee; Keitaro Makino; Kenji Harada; Osamu Katayama; Kouki Tomida; Ryo Yamaguchi; Chiharu Nishijima; Kazuya Fujii; Yuka Misu; Katashima Mitsuhiro; Hiroyuki Shimada
  Journal of the American Medical Directors Association, Elsevier BV, 2023年04月, ［査読有り］
  研究論文（学術雑誌）
• A non-pharmacological multidomain intervention of dual-task exercise and social activity affects the cognitive function in community-dwelling older adults with mild to moderate cognitive decline: A randomized controlled trial
  Sangyoon Lee; Kenji Harada; Seongryu Bae; Kazuhiro Harada; Keitaro Makino; Yuya Anan; Takao Suzuki; Hiroyuki Shimada
  Frontiers in Aging Neuroscience, 15, Frontiers Media SA, 2023年03月13日, ［査読有り］
  研究論文（学術雑誌）, The present study aimed to determine the impact of a 10-month multidomain program using dual-task exercise and social activity conducted at a community-based facility on improved cognitive function in older adults with mild to moderate cognitive decline. The participants included 280 community-dwelling older adults (age 71–91 years) with mild to moderate cognitive decline. The intervention group exercised for 90 min/day, once a week. Their routine included aerobic exercise and dual-task training which cognitive tasks were performed in combination with exercise. The control group attended health education classes thrice. Before and after the intervention, we measured their cognitive function, physical function, daily conversation, and physical activity. The mean adherence rate of the intervention class was 83.0%. According to a repeated-measures multivariate analysis of covariance in an intent-to-treat analysis, logical memory and 6-min walking distance demonstrated a significant time and group interaction effect. Regarding daily physical activities, we observed significant differences in the daily step count and moderate-to-vigorous physical activity in the intervention group. Our non-pharmacological multidomain intervention resulted in a modest improvement in the cognitive or physical function and building health behavior. It may be a helpful program with a potential role in preventing dementia.
  
  Clinical Trial Registration: http://clinicaltrials.gov Identifier ID: UMIN000013097.
• Association of sarcopenia and systolic blood pressure with mortality: A 5-year longitudinal study
  Ryo Yamaguchi; Osamu Katayama; Sangyoon Lee; Keitaro Makino; Kenji Harada; Masanori Morikawa; Kouki Tomida; Chiharu Nishijima; Kazuya Fujii; Yuka Misu; Hiroyuki Shimada
  Archives of Gerontology and Geriatrics, 104988, 104988, Elsevier BV, 2023年03月, ［査読有り］
  研究論文（学術雑誌）
• Information and Communication Technology Use for Alleviation of Disability Onset in Socially Isolated Older Adults: A Longitudinal Cohort Study
  Masanori Morikawa; Sangyoon Lee; Keitaro Makino; Kenji Harada; Osamu Katayama; Kouki Tomida; Ryo Yamaguchi; Chiharu Nishijima; Kazuya Fujii; Yuka Misu; Hiroyuki Shimada
  Gerontology, S. Karger AG, 2022年12月30日, ［査読有り］
  研究論文（学術雑誌）, Introduction: Delaying the onset of disability is important for maintaining independence and quality of life in community-dwelling older adults. Given that social isolation is a significant risk factor for disability, effective means associated with social isolation are needed to alleviate disability. Although information and communication technology (ICT) may be a reasonable measure considering the recent social contexts due to the coronavirus disease 2019 pandemic, further insights are required. This study aimed to investigate whether ICT use could alleviate the onset of disability in community-dwelling older adults with and without social isolation.Methods: This longitudinal cohort study on 4,346 community-dwelling independent Japanese older adults (mean age, 73.5±5.3 years) was conducted between 2017 and 2018. Participants were classified into four groups based on social isolation (the condition where two or more of the following measures were met: domestic isolation, less social contact, and social disengagement) and ICT users (those who had recently used a computer or a smartphone) and followed up to assess disability incidence for 24 months after baseline assessments. Cox proportional-hazards regression models were used to identify the effect of social isolation and ICT use on the risk of disability onset by adjusting by age, sex, education history, number of medications, eye disease, level of annual income, mini-mental state examination, geriatric depression scale 15, and gait speed.Results: Most participants belonged to the group of non-social isolation and ICT users (44.7%), followed by non-social isolation and ICT non-users (41.7%), social isolation and ICT non-users (8.2%), and social isolation and ICT users (5.4%). At the follow-up, 2.2%, 5.5%, 2.4%, and 12.4% of the participants in the above order developed disability (p < 0.01). Cox regression models revealed a significantly higher risk of disability onset in the social isolation and ICT non-users group than in the social isolation and ICT users group (HR=2.939; 95% Confidence interval [CI] 1.029-8.397; p=0.044). In the subgroup analysis stratified by social isolation, ICT use significantly reduced the risk of disability onset in the socially isolated group (HR=0.320; 95% CI 0.109-0.943; p=0.039), although the same association was not observed in the non-socially isolated group (HR=0.845; 95% CI 0.565-1.264; p=0.411).Conclusion: ICT use can alleviate the onset of disability in socially isolated older adults in a community setting. Considering ICT-applied methods for alleviation of disability is beneficial for older adults in social isolation.
• Differences in Subjective and Objective Cognitive Decline Outcomes Are Associated with Modifiable Protective Factors: A 4-Year Longitudinal Study
  Osamu Katayama; Sangyoon Lee; Seongryu Bae; Keitaro Makino; Ippei Chiba; Kenji Harada; Masanori Morikawa; Kouki Tomida; Hiroyuki Shimada
  Journal of Clinical Medicine, 11, 24, 7441, 7441, MDPI AG, 2022年12月15日, ［査読有り］
  研究論文（学術雑誌）, Subjective cognitive decline (SCD) in older adults has been identified as a risk factor for dementia. However, the literature is inconsistent, and the underlying mechanisms are not well understood. We aimed to determine whether older adults with SCD had more modifiable protective factors against the risk of dementia and a lower risk of developing objective cognitive decline (OCD). We included 4363 older adults (71.7 ± 5.3 [mean ± standard deviation] years of age; 2239 women) from the National Center for Geriatrics and Gerontology Study of Geriatric Syndromes. SCD, OCD, and protective factors against dementia, such as lifestyle and activity, were assessed using interviews and objective cognitive-assessment tools. Based on initial cognitive status, participants were categorized into normal cognition, SCD-only, OCD-only, and both SCD and OCD groups. After 4 years, participants were classified as having either no impairment or mild or global cognitive impairment (i.e., OCD). Binomial logistic regression analyses were performed with the cognitive statuses of the groups at follow-up and baseline as the dependent and independent variables, respectively. After adjusting for potential confounding factors, we found that the SCD-only group had more modifiable protective factors against the risk of dementia than the OCD-only group. Community-dwelling older adults with normal cognition or those part of the SCD-only group had a lower risk of developing OCD during the 4-year follow-up, which may have been due to having more modifiable protective factors against the risk of dementia. Additionally, these factors may contribute to the inconsistencies in the literature on SCD outcomes.
• The association between social activity and physical frailty among community-dwelling older adults in Japan.
  Osamu Katayama; Sangyoon Lee; Seongryu Bae; Keitaro Makino; Ippei Chiba; Kenji Harada; Yohei Shinkai; Hiroyuki Shimada
  BMC geriatrics, 22, 1, 870, 870, 2022年11月16日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, BACKGROUND: Physical frailty is associated with social activity. However, the relationship between physical frailty and levels of engagement with other people during social activities remains unclear. Thus, we aimed to clarify the relationship between physical frailty and social activity using a taxonomy of activity levels among community-dwelling older adults in Japan. METHODS: This cross-sectional observational study analyzed data from 12,788 older adults (7001 women, mean age: 73.8 years, standard deviation = 5.9; range: 60-96 years) from the National Center for Geriatrics and Gerontology-Study of Geriatric Syndromes. Physical frailty was assessed using the following components: slow walking speed, muscle weakness, exhaustion, low activity, and weight loss. We asked participants about seven social activities that included social participation and engagement and examined their relationship to physical frailty. RESULTS: Physical frailty was independently associated with all social activities. Exercise circle activity, which includes a level of social participation, was strongly associated with physical pre-frailty and physical frailty. Results of sub-analyses indicated that the level of social engagement was independently associated with physical frailty in the older group (over 75 years) but not in the younger group (60-74 years). CONCLUSIONS: Our results indicate that the strength of the association between social activity and physical frailty differs by the level of social participation. Given the increasingly high prevalence of physical frailty in Japan and its strong association with numerous adverse health outcomes, the relationship between physical frailty and levels of social participation may assist in developing measures to prevent the incidence and progression of physical frailty.
• Association between driving a car and retention of brain volume in Japanese older adults.
  Hiroyuki Shimada; Seongryu Bae; Kenji Harada; Keitaro Makino; Ippei Chiba; Osamu Katayama; Sangyoon Lee
  Experimental gerontology, 171, 112010, 112010, 2022年11月03日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, BACKGROUND: Driving cessation is a major negative life event that has been associated with a decline in health conditions including dementia. The increase in activity owing to the expansion of life space is a possible explanation for the positive relationship between driving and brain health. The present study examined the association between driving, life space, and structural brain volume in older individuals. METHODS: High-resolution magnetic resonance imaging was employed to examine the brain volume in 1063 older adults. Participants were classified as non-drivers, those who drove <7 days a week, and everyday drivers. They were further classified into a non-driving group, an active group (drove 10 km at least once a week), and a less-active group (drove 10 km less than once a week). RESULTS: The hippocampal volume was greater in drivers than in non-drivers. Occipital cortex volume was greater in low-frequency drivers than in non-drivers and high-frequency drivers. Active drivers exhibited larger temporal cortex volumes than less-active drivers, larger cingulate cortex volumes than non-drivers and less-active drivers, and larger hippocampal volumes than non-drivers. CONCLUSION: Driving was associated with hippocampal brain atrophy attenuation, with active drivers exhibiting decreased brain atrophy in the temporal and cingulate cortices.
• Association of dual sensory impairment with changes in life space: A longitudinal study with two-year follow-up
  Kouki Tomida; Sangyoon Lee; Seongryu Bae; Keitaro Makino; Ippei Chiba; Kenji Harada; Osamu Katayama; Masanori Morikawa; Hiroyuki Shimada
  Maturitas, Elsevier BV, 2022年08月, ［査読有り］
  研究論文（学術雑誌）
• Association of Dual Sensory Impairment with Cognitive Decline in Older Adults
  Kouki Tomida; Sangyoon Lee; Seongryu Bae; Kenji Harada; Osamu Katayama; Keitaro Makino; Ippei Chiba; Masanori Morikawa; Hiroyuki Shimada
  Dementia and Geriatric Cognitive Disorders, 1, 9, S. Karger AG, 2022年07月27日, ［査読有り］
  研究論文（学術雑誌）, <b><i>Introduction:</i></b> The prevalence of hearing and visual impairment (HI and VI) and dual sensory impairment (DSI), which is a combination of both, is increasing as the population ages. These sensory impairments are expected to increase the cognitive load of information processing from hearing and vision and impair appropriate cognitive processing. Although an association between DSI and cognitive decline has been reported, a more detailed study of the effects on each cognitive domain is required. This study aimed to investigate the prevalence of self-reported sensory impairment in community-dwelling older adults and to examine the impact of DSI on the severity of mild cognitive impairment (MCI) and on each cognitive domain (memory, attention, executive function, and processing speed). <b><i>Methods:</i></b> The participants were recruited from a sub-cohort of the National Center for Geriatric Gerontology-Study on Geriatric Syndromes (NCGG-SGS) conducted by the National Center for Geriatrics and Gerontology. We included 4,471 community-dwelling older adults (age: 75.9 ± 4.3 years; females: 52.3%) who fulfilled the inclusion criteria. The HI and VI were identified using a self-report questionnaire. Cognitive and other parameters were also assessed by trained staff. Logistic regression analysis was used to evaluate the relationship between the presence of HI and VI and the severity of MCI, and functional decline in each cognitive domain. <b><i>Results:</i></b> DSI was identified in 11.4% of community-dwelling older adults. Regarding sensory impairment and MCI severity, the odds ratio (OR) for single-domain MCI was significantly higher in VI (OR: 1.31; 95% CI: 1.06–1.61), and the OR for multiple-domain MCI was significantly higher in DSI (OR: 1.58; 95% CI: 1.10–2.29). In relation to the four cognitive domains, ORs for impaired executive function were higher for VI and DSI (VI, OR: 1.37; 95% CI: 1.09–1.72. DSI, OR: 1.39; 95% CI: 1.06–1.81). DSI also exhibited a higher odds ratio for reduced processing speed (OR: 2.03; 95% CI: 1.42–2.91). <b><i>Discussion/Conclusion:</i></b> DSI is predicted to increase as the population ages and is associated with various health problems. Further, DSI has been reported to decrease quality of life, which needed to establish appropriate treatment and prevention measures.
• A simple algorithm to predict disability in community-dwelling older Japanese adults
  Osamu Katayama; Sangyoon Lee; Seongryu; Keitaro Makino; Ippei Chiba; Kenji Harada; Masanori Morikawa; Kouki Tomida; Hiroyuki Shimada
  Archives of Gerontology and Geriatrics, 104778, 104778, Elsevier BV, 2022年07月, ［査読有り］
  研究論文（学術雑誌）
• Light intensity physical activity is beneficially associated with brain volume in older adults with high cardiovascular risk
  Keitaro Makino; Sangyoon Lee; Seongryu Bae; Kenji Harada; Ippei Chiba; Osamu Katayama; Kouki Tomida; Masanori Morikawa; Yukari Yamashiro; Motoki Sudo; Naoto Takayanagi; Hiroyuki Shimada
  Frontiers in Cardiovascular Medicine, 9, 882562, Frontiers Media SA, 2022年07月, ［査読有り］, ［筆頭著者, 責任著者］, ［国際誌］
  研究論文（学術雑誌）, Background
  
  Older people with high cardiovascular risk, including those without cardiovascular diseases, are an at-risk population for dementia. Regular physical activity is generally recommended to maintain brain health; however, the optimal intensity of physical activity for maintaining brain volume in older adults with cardiovascular risk remains unclear. We examined the associations between intensity-specific physical activity and brain volume stratified by absolute cardiovascular risk level in older adults without cardiovascular diseases.
  
  Methods and results
  
  This cross-sectional study involved 725 community-dwelling older Japanese adults without cardiovascular diseases. We estimated absolute cardiovascular risk using the World Health Organization risk estimation charts, which include variables such as age, sex, diabetes mellitus, smoking, systolic blood pressure, and total cholesterol, and stratified cardiovascular risk level into three risk categories: low (≤ 9%), moderate (10–14%), and high (≥15%). We measured daily physical activity using a triaxial accelerometer, and calculated the average time spent in moderate-to-vigorous intensity physical activity (MVPA) and light intensity physical activity (LPA). We performed brain T1-weighted magnetic resonance imaging and calculated the volume of the cortical gray matter, subcortical gray matter, and cerebral white matter, using the FreeSurfer software. In the overall sample, multivariable linear regression analysis showed that greater MVPA was significantly associated with greater volume of the cortical gray matter and cerebral white matter, and greater LPA was significantly associated with greater volume of the cerebral white matter. Additionally, in the analysis of the sample stratified by absolute cardiovascular risk level, cerebral white matter volume was significantly associated with both MVPA and LPA in the high cardiovascular risk group.
  
  Conclusions
  
  The association between physical activity and brain volume differed according to cardiovascular risk level in community-dwelling older adults. In a population at high cardiovascular risk, maintaining or increasing LPA might be a practical and achievable strategy for healthy brain aging.
• Association of Daily Physical Activity with Disability in Community-Dwelling Older Adults With/Without Chronic Kidney Disease
  Ippei Chiba; S. Lee; S. Bae; K. Makino; O. Katayama; K. Harada; K. Tomida; M. Morikawa; Y. Yamashiro; N. Takayanagi; H. Shimada
  The journal of nutrition, health & aging, 26, 5, 521, 528, Springer Science and Business Media LLC, 2022年05月, ［査読有り］
  研究論文（学術雑誌）
• Association of social isolation and smartphone use on cognitive functions.
  Masanori Morikawa; Sangyoon Lee; Keitaro Makino; Seongryu Bae; Ippei Chiba; Kenji Harada; Kouki Tomida; Osamu Katayama; Hiroyuki Shimada
  Archives of gerontology and geriatrics, 101, 104706, 104706, 2022年04月15日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, BACKGROUND: The number of socially isolated older adults has increased owing to the coronavirus disease pandemic, thus leading to a decrease in cognitive functions among this group. Smartphone use is expected to be a reasonable preventive measure against cognitive decline in this social context. Thus, this study aimed to investigate the influence of social isolation and smartphone use on cognitive functions in community-dwelling older adults. METHODS: We divided 4,601 community-dwelling older adults into four groups based on their levels of social isolation and smartphone use. Then, we conducted cognitive functions tests including a word list memory task, trail-making test, and symbol digit substitution task. Social isolation was defined when participants met two or more of the following measures: domestic isolation, less social contact, and social disengagement. We used an analysis of covariance adjusted by background information to measure between-group differences in levels of cognitive functions and social isolation. A linear regression model was used to analyze the association of standardized scores of cognitive function tests with smartphone use. RESULTS: Smartphone users' scores of the symbol digit substitution task were superior compared with both non-users with social isolation and without. All cognitive functions were associated with smartphone use among non-socially and socially isolated participants. Socially isolated older adults showed an association only between trail making test- part A and smartphone use. CONCLUSIONS: Smartphone use was associated with cognitive functions (memory, attentional function, executive function, and processing speed) even in socially isolated community-dwelling older adults.
• 地域在住健常高齢者における身体活動量とうつ状態との関連 身体活動量変化の軌跡に着目した縦断的観察研究
  千葉 一平; 李 相侖; 裴 成琉; 牧野 圭太郎; 新海 陽平; 原田 健次; 島田 裕之
  若手研究者のための健康科学研究助成成果報告書, 36, 47, 52, (公財)明治安田厚生事業団, 2022年04月
  日本語
• Association between Non-Face-to-Face Interactions and Incident Disability in Older Adults
  Osamu Katayama; S. Lee; S. Bae; K. Makino; I. Chiba; K. Harada; M. Morikawa; K. Tomida; H. Shimada
  Journal of Nutrition, Health and Aging, 26, 2, 147, 152, 2022年02月, ［査読有り］
  研究論文（学術雑誌）
• Isotemporal Substitution of Sedentary Behavior with Moderate- to Vigorous- Physical Activity Is Associated with Lower Risk of Disability: A Prospective Longitudinal Cohort Study.
  Ippei Chiba; Sangyoon Lee; Seongryu Bae; Keitaro Makino; Yohei Shinkai; Osamu Katayama; Kenji Harada; Yukari Yamashiro; Naoto Takayanagi; Hiroyuki Shimada
  Physical therapy, 102, 5, 2022年01月13日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, OBJECTIVE: The purpose of the study was to estimate, using an isotemporal substitution model, the effect of replacing sedentary behavior (SB) with physical activity on the incidence of disability in community-dwelling older adults. METHODS: This 2-year longitudinal cohort study enrolled 3691 community-dwelling older adults (57.2% women; mean age = 74.0 [SD = 5.0] years). Individuals with dementia, stroke, Parkinson disease, depression, low Mini-Mental State Examination scores, dependence on basic activities of daily living, and missing data were excluded. Physical activity and potential confounding factors were investigated as a baseline survey of disability incidence, defined by Japanese long-term care insurance certification, for 2 years in 2 regions. Physical activity data (SB, light-intensity physical activity [LPA], and moderate- to vigorous-intensity physical activity [MVPA]) were measured using triaxial accelerometers for 14 days, and daily mean time spent in each physical activity parameter was computed in increments of 10 minutes. The relationship between baseline physical activity and disability incidence adjusted for potential confounders was analyzed using multilevel Cox proportional hazards regression analyses with an isotemporal substitution model. RESULTS: The disability incidence rate was 3.8%, excluding individuals who could not be followed up. Replacing 10 minutes of SB per day with MVPA was associated with a decreased disability incidence (hazard ratio = 0.870; 95% CI = 0.766 to 0.988), whereas no evidence was found for replacing SB with LPA (hazard ratio = 0.980; 95% CI = 0.873 to 1.10). CONCLUSIONS: Replacing SB with MVPA was associated with a lower risk of disability. These findings are helpful for establishing disability prevention strategies. IMPACT: These results suggest that feasible changes in daily behavior, such as replacing 10 minutes of SB with MVPA daily, might have a protective effect on disability incidence. Clarifying these associations is useful for developing disability prevention strategies and may help reduce the incidence of disability in community-dwelling older adults.
• Absolute cardiovascular disease risk assessed in old age predicts disability and mortality: A retrospective cohort study of community-dwelling older adults
  Keitaro Makino; Sangyoon Lee; Seongryu Bae; Ippei Chiba; Kenji Harada; Osamu Katayama; Yohei Shinkai; Hiroyuki Shimada
  Journal of the American Heart Association, 10, 24, e022004, 2021年12月, ［査読有り］, ［筆頭著者, 責任著者］, ［国際誌］
  英語, 研究論文（学術雑誌）, Background Evidence is limited on the predictive validity of absolute cardiovascular disease (CVD) risk, estimated by multivariable assessments in old age, for disability and mortality. We aimed to examine the longitudinal associations of absolute CVD risk assessed using region-specific risk estimation charts with disability and mortality among community-dwelling people aged ≥65 years. Methods and Results This retrospective cohort study included 7456 community-dwelling people aged ≥65 years (mean age, 73.7 years) without CVD and functional decline at baseline. They lived in either Obu City or Midori Ward of Nagoya City, Aichi Prefecture, Japan. We estimated absolute CVD risk using the revised World Health Organization CVD risk estimation charts and stratified risk levels into 3 categories: low (<10%), mid (10% to <20%), and high (≥20%). We followed up the functional disability incidence and all-cause mortality monthly for 5 years. The prevalence of each CVD risk level based on the laboratory-based model was as follows: low CVD risk, 1096 (14.7%); mid CVD risk, 5510 (73.9%); and high CVD risk, 850 (11.4%). During follow-up, the incidence rates of disability and mortality were 33.4 per 1000 and 12.4 per 1000 person-years, respectively. Cox regression analysis showed that the adjusted hazard ratios (95% CIs) for disability incidence were 1.32 (1.13-1.56) and 1.44 (1.18-1.77) in mid and high CVD risk levels, respectively (reference: low CVD risk level); for mortality incidence, they were 1.53 (1.16-2.01) and 2.02 (1.45-2.80) in mid and high CVD risk levels, respectively (reference: low CVD risk level). Conclusions Absolute CVD risk was associated with both disability and mortality in people aged ≥65 years. Estimated CVD risk levels may be useful surrogate markers for disability and mortality risks even when assessed in old age.
• 高齢期の心血管リスクレベルと要介護認定および死亡との関連 NCGG-SGS研究
  牧野 圭太郎; 李 相侖
  日本公衆衛生学会総会抄録集, 80回, 190, 190, 日本公衆衛生学会, 2021年11月
  日本語
• Simplified decision-tree algorithm to predict falls for community-dwelling older adults
  Keitaro Makino; Sangyoon Lee; Seongryu Bae; Ippei Chiba; Kenji Harada; Osamu Katayama; Kouki Tomida; Masanori Morikawa; Hiroyuki Shimada
  Journal of Clinical Medicine, 10, 21, 5184, 2021年11月, ［査読有り］, ［筆頭著者, 責任著者］, ［国際誌］
  英語, 研究論文（学術雑誌）, The present study developed a simplified decision-tree algorithm for fall prediction with easily measurable predictors using data from a longitudinal cohort study: 2520 community-dwelling older adults aged 65 years or older participated. Fall history, age, sex, fear of falling, prescribed medication, knee osteoarthritis, lower limb pain, gait speed, and timed up and go test were assessed in the baseline survey as fall predictors. Moreover, recent falls were assessed in the follow-up survey. We created a fall-prediction algorithm using decision-tree analysis (C5.0) that included 14 nodes with six predictors, and the model could stratify the probabilities of fall incidence ranging from 30.4% to 71.9%. Additionally, the decision-tree model outperformed a logistic regression model with respect to the area under the curve (0.70 vs. 0.64), accuracy (0.65 vs. 0.62), sensitivity (0.62 vs. 0.50), positive predictive value (0.66 vs. 0.65), and negative predictive value (0.64 vs. 0.59). Our decision-tree model consists of common and easily measurable fall predictors, and its white-box algorithm can explain the reasons for risk stratification; therefore, it can be implemented in clinical practices. Our findings provide useful information for the early screening of fall risk and the promotion of timely strategies for fall prevention in community and clinical settings.
• Are non-face-to-face interactions an effective strategy for maintaining mental and physical health?
  Osamu Katayama; Sangyoon Lee; Seongryu Bae; Keitaro Makino; Ippei Chiba; Kenji Harada; Masanori Morikawa; Kouki Tomida; Hiroyuki Shimada
  Archives of gerontology and geriatrics, 98, 104560, 104560, 2021年10月16日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has led to social isolation measures, forcing many people to stay indoors, stop daily outdoor activities, and limit face-to-face social interactions with friends, colleagues, and family. This study aimed to identify if non-face-to-face interaction affects depressive symptoms and frailty in older adults. METHODS: We included 3834 older adults (age: 71.1 ± 6.9 [mean ± standard deviation] years; range: 60-96 years; 2153 women) from the National Center for Geriatrics and Gerontology-Study of Geriatric Syndromes. Interaction status was assessed using a self-reported questionnaire. Participants were categorized into: "both interactions" (both face-to-face and non-face-to-face interactions), "face-to-face only" (only face-to-face interactions), "non-face-to-face only" (only non-face-to-face interactions), "no interactions" (neither face-to-face nor non-face-to-face interactions) groups. Depressive symptoms and frailty were measured using the 15-item Geriatric Depression Scale and Kihon Checklist, respectively. RESULTS: Potential confounding factors-adjusted odds ratios for both, face-to-face only and non-face-to-face only groups for developing depressive symptoms were 0.39 (95%CI, 0.26-0.57; p<0.001), 0.56 (95%CI, 0.38-0.84; p=0.004), and 0.51 (95%CI, 0.27-0.96; p=0.038), respectively, and those for development of frailty were 0.44 (95%CI, 0.30-0.65; p<0.001), 0.59 (95%CI, 0.39-0.87; p=0.008), and 0.63 (95%CI, 0.34-1.15; p=0.128), respectively. CONCLUSIONS: Our findings indicate that non-face-to-face interactions are also important in preventing the deterioration of mental health, which is a concern during the COVID-19 pandemic. However, non-face-to-face interactions alone may not be sufficient to maintain physical health, and it is important to maintain opportunities for face-to-face interaction among older adults, particularly during the COVID-19 pandemic.
• Difference in sarcopenia characteristics associated with physical activity and disability incidences in older adults.
  Ippei Chiba; Sangyoon Lee; Seongryu Bae; Keitaro Makino; Yohei Shinkai; Osamu Katayama; Kenji Harada; Naoto Takayanagi; Hiroyuki Shimada
  Journal of cachexia, sarcopenia and muscle, 12, 6, 1983, 1994, 2021年10月05日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, BACKGROUND: Deteriorated skeletal muscle condition, including sarcopenia, is a risk factor for disability in older adults. Promoting physical activity is a useful treatment for sarcopenia. However, optimal intensity of physical activity according to sarcopenia characteristics is unclear. METHODS: This longitudinal cohort study enrolled 2149 community-dwelling older adults (women 55.7%, mean age: 75.5 ± 4.0 years). Five-year disability incidence defined by Japanese long-term care insurance certification and accelerometer-measured physical activities (light-intensity physical activity [LPA] and moderate-to-vigorous intensity physical activity [MVPA]), which were adjusted for potential confounders, was analysed using cox-proportional hazard model stratified by sarcopenia characteristics based on the diagnostic algorithm by the Asian working group for sarcopenia (robust, low physical function, low muscle mass, and sarcopenia). The sarcopenia group was defined as low muscle mass and low physical function (weakness and/or slowness). The low muscle mass and low physical function groups were each defined by these characteristics alone. Muscle mass was analysed via bioelectrical impedance analysis. Each intensity of physical activity times was divided by median values. RESULTS: The disability incidence rate was 15.4%, excluding those who could not be followed up. Mean LPA times were 43.8 ± 18.0, 45.6 ± 17.5, 45.4 ± 16.6, 40.8 ± 18.6, and 41.4 ± 18.5 min/day and MVPA times were 24.6 ± 17.6, 26.3 ± 18.3, 27.2 ± 17.3, 21.6 ± 16.3, and 21.5 ± 16.4 min/day in all participants, the robust, low muscle mass, low physical function, and sarcopenia groups, respectively. For all participants, higher MVPA was associated with disability incidence [hazard ratios (HR), 0.63; 95% confidence interval (95% CI), 0.49-0.81; P < 0.001], whereas higher LPA showed no association (HR, 0.86; 95% CI, 0.68-1.10; P = 0.22). Higher LPA was associated in the sarcopenia group (HR, 0.35; 95% CI, 0.15-0.85; P = 0.019), and MVPA was associated in the robust (HR, 0.58; 95% CI, 0.39-0.87; P = 0.008) and low physical function (HR, 0.66; 95% CI, 0.45-0.98; P = 0.040) groups. Both LPA and MVPA showed no association in the low muscle mass group. The P values for interactions between sarcopenia characteristics and physical activity were 0.017 for LPA and 0.014 for MVPA. CONCLUSIONS: The LPA was associated with a lower risk of disability in older adults with sarcopenia, whereas MVPA was associated in subjects with robust and low physical function. Our findings indicate a need for individualized approaches to prevent disability based on muscle condition.
• Development and validation of new screening tool for predicting dementia risk in community-dwelling older Japanese adults
  Keitaro Makino; Sangyoon Lee; Seongryu Bae; Ippei Chiba; Kenji Harada; Osamu Katayama; Yohei Shinkai; Hiroyuki Shimada
  Journal of Translational Medicine, 19, 1, 448, 448, 2021年10月, ［査読有り］, ［筆頭著者, 責任著者］, ［国際誌］
  英語, 研究論文（学術雑誌）, BACKGROUND: Established clinical assessments for detecting dementia risk often require time, cost, and face-to-face meetings. We aimed to develop a Simplified Telephone Assessment for Dementia risk (STAD) (a new screening tool utilizing telephonic interviews to predict dementia risk) and examine the predictive validity of the STAD for the incidence of dementia. METHODS: We developed STAD based on a combination of literature review, statistical analysis, and expert opinion. We selected 12 binary questions on subjective cognitive complaints, depressive symptoms, and lifestyle activities. In the validation study, we used STAD for 4298 community-dwelling older adults and observed the incidence of dementia during the 24-month follow-up period. The total score of STAD ranging from 0 to 12 was calculated, and the cut-off point for dementia incidence was determined using the Youden index. The survival rate of dementia incidence according to the cut-off points was determined. Furthermore, we used a decision-tree model (classification and regression tree, CART) to enhance the predictive ability of STAD for dementia risk screening. RESULTS: The cut-off point of STAD was set at 4/5. Participants scoring ≥ 5 points showed a significantly higher risk of dementia than those scoring ≤ 4 points, even after adjusting for covariates (hazard ratio [95% confidence interval], 2.67 [1.40-5.08]). A decision tree model using the CART algorithm was constructed using 12 nodes with three STAD items. It showed better performance for dementia prediction in terms of accuracy and specificity as compared to the logistic regression model, although its sensitivity was worse than the logistic regression model. CONCLUSIONS: We developed a 12-item questionnaire, STAD, as a screening tool to predict dementia risk utilizing telephonic interviews and confirmed its predictive validity. Our findings might provide useful information for early screening of dementia risk and enable bridging between community and clinical settings. Additionally, STAD could be employed without face-to-face meetings in a short time; therefore, it may be a suitable screening tool for community-dwelling older adults who have negative attitudes toward clinical examination or are non-adherent to follow-up assessments in clinical trials.
• Identification of Disability Risk in Addition to Slow Walking Speed in Older Adults.
  Hiroyuki Shimada; Takehiko Doi; Sangyoon Lee; Kota Tsutsumimoto; Seongryu Bae; Keitaro Makino; Sho Nakakubo; Hidenori Arai
  Gerontology, 1, 10, 2021年07月14日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, INTRODUCTION: A cutoff speed of 1.0 m/s for walking at a comfortable pace is critical for predicting future functional decline. However, some older adults with walking speeds below the cutoff point maintain an independent living. We aimed to identify specific predictors of disability development in older adults with slow walking speeds in contrast to those with a normal walking speed. METHODS: This prospective cohort study on 12,046 community-dwelling independent Japanese older adults (mean age, 73.6 ± 5.4 years) was conducted between 2011 and 2015. Participants were classified into slow walking speed (comfortable walking speed slower than 1.0 m/s) and normal walking speed (speed of 1.0 m/s or faster) groups and followed up to assess disability incidence for 24 months after baseline assessments. Cox proportional hazards regression models were used to identify predictors of disability development in the slow and normal walking groups. RESULTS: Overall, 26.8% of participants had a slow walking speed. At follow-up, 17.3% and 5.1% of participants in the slow and normal walking groups, respectively, developed disability (p < 0.01). Cox regression models revealed that age (hazard ratio 1.07, 95% confidence interval 1.05-1.09), walking speed (0.12, 0.07-0.22), grip strength (0.97, 0.95-0.99), Parkinson's disease (4.65, 2.59-8.33), word list memory-immediate recognition score (0.90, 0.85-0.97), word list memory-delayed recall score (0.94, 0.89-1.00), Symbol Digit Substitution Test (SDST) score (0.98, 0.96-0.99), and 15-item Geriatric Depression Scale (GDS) score (1.04, 1.01-1.07) were significantly associated with disability incidence in the slow walking group. In the normal walking group, age, grip strength, depression, diabetes, cognition, GDS score, and reduced participation in outdoor activity were significantly associated with disability incidence; however, there was no significant association with walking speed. CONCLUSIONS: Decreased walking speeds have considerably greater impact on disability development in older adults with a slow walking speed than in those with a normal walking speed. Health-care providers should explore modifiable factors for reducing walking speed; they should also encourage improvement of risk factors such as muscle weakness and depression to reduce disability risk in older adults with slow walking speeds.
• Absolute cardiovascular disease risk is associated with the incidence of non-amnestic cognitive impairment in Japanese older adults
  Keitaro Makino; Sangyoon Lee; Seongryu Bae; Ippei Chiba; Kenji Harada; Osamu Katayama; Yohei Shinkai; Hiroyuki Shimada
  Frontiers in Aging Neuroscience, 13, 685683, 685683, 2021年07月, ［査読有り］, ［筆頭著者, 責任著者］, ［国際誌］
  英語, 研究論文（学術雑誌）, Background: The estimated absolute cardiovascular disease (CVD) risk level is known to be a useful surrogate marker for future cognitive impairment; however, evidence regarding its predictive validity in terms of cognitive subtypes is limited. We aimed to examine subtype-dependent differences in the associations between absolute CVD risk and the incidence of cognitive impairment in a community-dwelling older Japanese cohort. Methods and Results: This study comprised 1,641 cognitively intact older Japanese participants without CVDs at baseline. We estimated absolute CVD risk using WHO region-specific risk estimation charts and included age, sex, diabetes mellitus, smoking, systolic blood pressure, and total cholesterol at baseline, and the CVD risk level was stratified into the three following risk categories: low (<10%), moderate (10 to <20%), and high (≥20%). Objective cognitive screening was performed using a multicomponent neurocognitive test at baseline and follow-up, and the incidence of cognitive impairment over 48 ± 2 months was determined. The incidence of cognitive impairment in low-, moderate-, and high-CVD risk participants was 1.2, 3.0, and 5.4%, respectively, for amnestic subtypes and 5.8, 10.1, and 14.0%, respectively, for non-amnestic subtypes. After adjusting for potential confounding factors, the absolute CVD risk level was significantly associated with non-amnestic impairment but not with amnestic impairment. Conclusions: The absolute CVD risk estimated using region-specific risk estimation charts in old age is useful to predict incidence of cognitive impairment. Strategies to screen populations at risk of cognitive impairment and to prevent progression to dementia should be cognitive subtype-specific.
• Life Satisfaction and the Relationship between Mild Cognitive Impairment and Disability Incidence: An Observational Prospective Cohort Study
  Osamu Katayama; Sangyoon Lee; Seongryu Bae; Keitaro Makino; Ippei Chiba; Kenji Harada; Yohei Shinkai; Hiroyuki Shimada
  International Journal of Environmental Research and Public Health, 18, 12, 6595, 6595, MDPI AG, 2021年06月19日, ［査読有り］
  研究論文（学術雑誌）, The relationship between the incidence of disability and cognitive function has been clarified, but whether life satisfaction is related to this relationship is unclear. Therefore, the purpose of this study was to clarify whether life satisfaction is related to the relationship between the incidence of disability and mild cognitive impairment. We included 2563 older adults from the National Center for Geriatrics and Gerontology–Study of Geriatric Syndromes. Baseline measurements included cognitive, life satisfaction, and demographic characteristics. Life satisfaction was measured using the Life Satisfaction Scale, which was stratified into three levels based on the score: lower, moderate, and higher. Associations between disability incidence and mild cognitive impairment were examined for each group according to life satisfaction, and monthly assessment for disability was monitored through long-term care insurance certification for at least 2 years from the baseline. At a 35.5-month mean follow-up, 150 participants had developed a disability. The potential confounding factors adjusted hazard for incidence of disability in the group with lower life satisfaction was 1.88 (CI: 1.05–3.35; p = 0.034) for mild cognitive impairment. Mild cognitive impairment was associated with disability incidence, and the effect was more pronounced among older adults with lower life satisfaction.
• Prospective associations of physical frailty with future falls and fear of falling: A 48-month cohort study
  Keitaro Makino; Sangyoon Lee; Seongryu Bae; Ippei Chiba; Kenji Harada; Osamu Katayama; Yohei Shinkai; Hyuma Makizako; Hiroyuki Shimada
  Physical Therapy, 101, 6, pzab059, 2021年06月, ［査読有り］, ［筆頭著者, 責任著者］, ［国際誌］
  英語, 研究論文（学術雑誌）, OBJECTIVE: The present study aimed to examine the prospective associations of physical frailty with future falls and fear of falling (FOF) among community-dwelling older adults. METHODS: A prospective cohort study with a 48-month follow-up was conducted in a Japanese community. Participants were 2469 community-dwelling older adults aged 65 years or older who completed baseline and follow-up assessments at intervals of 48 ± 2 months. Primary outcomes were recent falls (defined as at least one fall within the past year) and FOF (determined by response to "Are you afraid of falling?") at follow-up survey. Physical frailty, operationalized by the frailty phenotype (slowness, weakness, exhaustion, weight loss, and low activity) based on the criteria of the Japanese version of the Cardiovascular Health Study (J-CHS), was also assessed as a predictor of future falls and FOF. RESULTS: Multivariable logistic regression showed that prefrailty or frailty increase the risk of not only future falls (odds ratio [OR]: 1.57; 95% CI = 1.20-2.05) but also FOF (OR: 1.33; 95%CI = 1.05-1.69). In addition, the relationship between baseline frailty status and future falls remained significant after adjusting for baseline FOF (OR: 1.55; 95% CI = 1.19-2.02), and the relationship between baseline frailty status and future FOF also remained significant after adjusting for baseline falls (OR: 1.32; 95% CI = 1.04-1.68). CONCLUSIONS: Frailty status may predict future falls and FOF among community-dwelling older adults. Strategies to prevent frailty may be beneficial to prevent not only future falls but also future FOF in a community setting. IMPACT: Falls and FOF have a close relationship but a different clinical meaning. Older adults with physical frailty may require monitoring as high risk not only for falls but also for FOF.
• EWGSOP2基準におけるサルコペニアと新規要介護認定発生との関連
  島田 裕之; 堤本 広大; 土井 剛彦; 李 相侖; 裴 成琉; 中窪 翔; 牧野 圭太郎; 荒井 秀典
  日本老年医学会雑誌, 58, Suppl., 178, 178, (一社)日本老年医学会, 2021年05月
  日本語
• Participation in Social Activities and Relationship between Walking Habits and Disability Incidence.
  Osamu Katayama; Sangyoon Lee; Seongryu Bae; Keitaro Makino; Ippei Chiba; Kenji Harada; Yohei Shinkai; Hiroyuki Shimada
  Journal of clinical medicine, 10, 9, 2021年04月27日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, Identifying the relationship between physical and social activity and disability among community-dwelling older adults may provide important information for implementing tailored interventions to prevent disability progression. The aim of this study was to determine the effect of the number of social activities on the relationship between walking habits and disability incidence in older adults. We included 2873 older adults (mean age, 73.1 years; SD, ±5.9 years) from the National Center for Geriatrics and Gerontology-Study of Geriatric Syndromes. Baseline measurements, including frequencies of physical and social activities, health conditions, physical function, cognitive function, metabolic parameters, and other potential disability risk factors (for example, the number of years of education); monthly assessment for disability was monitored through long-term care insurance certification for at least 2 years from baseline. During a mean follow-up of 35.1 months (SD, 6.4 months), 133 participants developed disability. The disability incidence was 19.0 and 27.9 per 1000 person-years for participants who walked more (≥3 times per week) and less (≤3 times per week) frequently, respectively. The potential confounding factor-adjusted disability hazard ratio was 0.67 (95% confidence interval, 0.46 to 0.96; p = 0.030). The relationship between habitual walking and the number of social activities was statistically significant (p = 0.004). The reduction of disability risk by walking was greater among participants with fewer social activities. Habitual walking was associated with disability incidence, with a more pronounced effect among older adults who were less likely to engage in social activities.
• Effect of Sarcopenia Status on Disability Incidence Among Japanese Older Adults.
  Hiroyuki Shimada; Kota Tsutsumimoto; Takehiko Doi; Sangyoon Lee; Seongryu Bae; Sho Nakakubo; Keitaro Makino; Hidenori Arai
  Journal of the American Medical Directors Association, 22, 4, 846, 852, 2021年04月, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, OBJECTIVES: The updated definition of sarcopenia by the European Working Group on Sarcopenia in Older People (EWGSOP2) recommends both low muscle mass and quality to diagnose sarcopenia; concurrent poor physical performance is considered indicative of severe sarcopenia; however, the relationship between the revised definition and disability incidence among Japanese older adults is unclear. Therefore, we aimed to examine the associations between EWGSOP2-defined sarcopenia and disability incidence among community-dwelling older Japanese adults. DESIGN: Nationwide study. SETTING AND PARTICIPANTS: We included 4561 individuals aged ≥65 years and enrolled in the National Center for Geriatrics and Gerontology-Study of Geriatric Syndromes (NCGG-SGS). METHODS: Skeletal muscle mass was assessed using a bioimpedance analysis device; handgrip strength and walking speed were measured as physical performance indicators. We used the Asian Working Group for Sarcopenia cutoffs to define low muscle mass and poor physical performance. We stratified all participants into nonsarcopenia, sarcopenia, and severe sarcopenia groups. Disability incidence was prospectively determined over 49 months using data extracted from the Japanese long-term care insurance system. RESULTS: The prevalence of sarcopenia and severe sarcopenia was 3.4% and 1.7%, respectively. Participants with any form of sarcopenia were at a higher risk of disability [hazard ratio (HR) 1.78, 95% confidence interval (CI) 1.27-2.49]. Although participants with severe sarcopenia showed a higher risk of disability (HR 2.00, 95% CI 1.32-3.02), there was no significant disability risk in the sarcopenia group (HR 1.54, 95% CI 0.97-2.46). Grip strength (HR 0.96, 95% CI 0.94-0.98) and walking speed (HR 0.19, 95% CI 0.12-0.30) negatively correlated with disability incidence. CONCLUSIONS AND IMPLICATIONS: Severe sarcopenia, involving low muscle mass and poor physical performance, might increase disability risk in older adults, as opposed to low muscle mass alone. Further studies are needed to determine whether sarcopenia without poor physical performance increases disability risk.
• Physical Frailty and Future Costs of Long-Term Care in Older Adults: Results from the NCGG-SGS.
  Hyuma Makizako; Hiroyuki Shimada; Kota Tsutsumimoto; Keitaro Makino; Sho Nakakubo; Hideaki Ishii; Takao Suzuki; Takehiko Doi
  Gerontology, 1, 10, 2021年03月29日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, INTRODUCTION: Frailty is associated with adverse outcomes, but few studies have determined associations between the frailty phenotype and measures of healthcare burden, including long-term care insurance (LTCI) costs, in older community-dwelling populations. OBJECTIVE: The aim of this study was to examine the association between frailty status and subsequent LTCI costs in Japanese community-dwelling older adults. METHODS: The prospective data were from a cohort study (National Center for Geriatrics and Gerontology-Study of Geriatric Syndromes [NCGG-SGS]). The participants were community-dwelling older adults (mean age 71.8 years, women 50.7%) participating in an NCGG-SGS baseline examination held between August 2011 and February 2012 in Obu, Japan (N = 4,539). At baseline, we assessed the physical frailty phenotype using the Japanese version of the CHS criteria and categorized it as robust, pre-frail, or frail. We also ascertained care-needs certification and total costs using long-term care services in Japan's public LTCI system during the 29 months. RESULTS: During the 29-month follow-up period, 239 participants (5.3%) required the LTCI system's care-needs certification and 163 participants (3.6%) used LTCI services. Participants classified as frail (odds ratio 5.85, 95% confidence interval 3.54-9.66) or pre-frail (2.40, 1.58-3.66) at the baseline assessment had an increased risk of requiring care-needs certification compared with robust participants. The mean total costs for LTCI services during the 29 months were \6,434 ($63.1) for robust, \19,324 ($189.5) for pre-frail, and \147,718 ($1,448.2) for frail participants (1 US dollar = 102 Japanese yen in July 2014). There were significantly higher costs associated with advancing frailty status. Individual frailty components (slowness, weakness, exhaustion, low activity, and weight loss) were also associated with higher total costs for using LTCI services. DISCUSSION/CONCLUSION: Frail community-dwelling older adults had a higher risk of requiring the LTCI system's care-needs certification and the subsequent total LTCI costs.
• Lifestyle Activity Patterns Related to Physical Frailty and Cognitive Impairment in Urban Community-Dwelling Older Adults in Japan.
  Osamu Katayama; Sangyoon Lee; Seongryu Bae; Keitaro Makino; Yohei Shinkai; Ippei Chiba; Kenji Harada; Hiroyuki Shimada
  Journal of the American Medical Directors Association, 22, 3, 583, 589, 2021年03月, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, OBJECTIVES: Investigating the lifestyle activity patterns of urban community-dwelling Japanese older adults, focusing on physical frailty and cognitive impairment. DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: Participants comprised 8003 older adults (4489 women; mean age: 72.5 years, SD = ±6.1, range 60-95 years) from the National Center for Geriatrics and Gerontology Study of Geriatric Syndromes. METHODS: Participants reported on their lifestyle activity status, including using public transport, grocery shopping, light exercise, gardening, money management, meeting friends, participating in events, and travel. Several potential confounding variables, such as demographic characteristics, were considered. We assessed their lifestyle activity patterns using a latent class analysis and defined physical frailty by either slow walking speed or poor grip strength. Cognitive impairment was defined by participants exhibiting more than 1 of the following symptoms: poor word list memory, poor attention, reduced executive function, and low processing speed test scores. We also examined the relationship between their lifestyle activity patterns and physical frailty and cognitive impairment. RESULTS: The overall prevalence of robustness, physical frailty, cognitive impairment, and frailty and cognitive impairment was 54.6%, 21.4%, 13.3%, and 10.7%, respectively. We defined 4 classes using latent class analysis: greater engagement in multidomain activities, lower engagement in going-out activities, lower engagement in cognitive and physical activities, and lower engagement in multidomain activities. Moreover, physical frailty and cognitive impairment were independently associated with lower engagement in going-out activity, lower engagement in cognitive and physical activities, and lower engagement in multidomain activities, after adjusting for covariates. CONCLUSIONS AND IMPLICATIONS: Considering an older adult's lifestyle activity patterns in their day-to-day practice, clinicians can deliver more older adult-centered care, which in turn might lead to better outcomes in the primary prevention of disease.
• Visceral fat accumulation is associated with risk of diabetes in community-dwelling Japanese older adults.
  Ippei Chiba; Sangyoon Lee; Seongryu Bae; Keitaro Makino; Yohei Shinkai; Hiroyuki Shimada
  Geriatrics & gerontology international, 21, 3, 306, 312, 2021年03月, ［国内誌］
  英語, 研究論文（学術雑誌）, AIM: The prevalence of diabetes generally increases with age, and older adults with diabetes are at a higher risk of adverse outcomes. Visceral fat accumulation is a well-known risk factor for diabetes in middle-aged adults, and its association with diabetes increases with age. The present study investigated the association between visceral fat and risk of diabetes in older adults that is yet to be completely elucidated. METHODS: This cross-sectional study enrolled 2850 community-dwelling older adults. Participants underwent abdominal bioelectrical impedance analysis to estimate the visceral fat area (VFA). The risk of diabetes was assessed using the value of hemoglobin A1c according to the diagnostic criteria of diabetes. We examined the relationship of VFA and risk of diabetes, and explored the optimal cut-off value stratified by sex. RESULTS: In total, 47 of 1640 (2.9%) women and 41 of 1210 (3.4%) men had a high risk of diabetes. Higher values of VFA in units of 10 cm2 were significantly associated with a higher risk of diabetes for both women (adjusted odds ratio [aOR]: 1.17; 95% confidence interval [95% CI]: 1.02-1.34) and men (aOR: 1.18; 95% CI: 1.06-1.31) in multivariate logistic regression analysis. The cut-off value to classify 30% of subjects into high VFA (72 cm2 ) had a relatively higher sensitivity of 0.660 and was significantly associated with a higher risk of diabetes for women (aOR: 3.49; 95% CI: 1.54-8.12), whereas all cut-off values we examined had no relation in men. CONCLUSIONS: Increases in VFA is associated with a high risk of diabetes in older adults but the optimal cut-off value is inconclusive in men. Geriatr Gerontol Int 2021; ••: ••-••.
• Diabetes and prediabetes inhibit reversion from mild cognitive impairment to normal cognition
  Keitaro Makino; Sangyoon Lee; Seongryu Bae; Ippei Chiba; Kenji Harada; Osamu Katayama; Yohei Shinkai; Hyuma Makizako; Hiroyuki Shimada
  Journal of the American Medical Directors Association, S1525-8610, 21, 00254-1, 2021年03月, ［査読有り］, ［筆頭著者, 責任著者］
• Lifestyle changes and outcomes of older adults with mild cognitive impairment: a 4-year longitudinal study
  Osamu Katayama; Sangyoon Lee; Seongryu Bae; Keitaro Makino; Yohei Shinkai; Ippei Chiba; Kenji Harada; Hiroyuki Shimada
  Archives of Gerontology and Geriatrics, 104376, 104376, Elsevier BV, 2021年02月, ［査読有り］
  研究論文（学術雑誌）
• A New Social Network Scale for Detecting Depressive Symptoms in Older Japanese Adults.
  Seongryu Bae; Kenji Harada; Ippei Chiba; Keitaro Makino; Osamu Katayama; Sangyoon Lee; Yohei Shinkai; Hiroyuki Shimada
  International journal of environmental research and public health, 17, 23, 2020年11月29日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, Social engagement and networking deter depression among older adults. During the COVID-19 pandemic, older adults are especially at risk of isolation from face-to-face and non-face-to-face interactions. We developed the National Center for Geriatrics and Gerontology Social Network Scale (NCGG-SNS) to assess frequency of, and satisfaction with, social interactions. The NCGG-SNS consists of four domains: face-to-face/non-face-to-face interactions with family/friends. Each domain score is obtained by multiplying frequency ratings by satisfaction ratings for each item; all scores were summed to obtain a total NCGG-SNS score (range: 0-64). Additionally, face-to-face and non-face-to-face subscores were calculated. Higher scores indicated satisfactory social networking. A cohort of 2445 older Japanese adults completed the NCGG-SNS and the Geriatrics Depression Scale-Short form. Receiver Operating Characteristic (ROC) analysis and logistic regression determined predictive validity for depressive symptoms. Depressive symptoms were reported by 284 participants (11.6%). The optimal NCGG-SNS cut-off value to identify depressive symptoms was 26.5 points. In logistic regression analysis adjusted for potential confounders, lower NCGG-SNS values were significantly associated with greater prevalence of depressive symptoms. Face-to-face and non-face-to-face subscores were associated with depressive symptoms. The NCGG-SNS is a valid and useful indicator of multidimensional social networking enabling identification of depressive symptoms in older adults.
• The Association between Neighborhood Amenities and Cognitive Function: Role of Lifestyle Activities.
  Osamu Katayama; Sangyoon Lee; Keitaro Makino; Ippei Chiba; Seongryu Bae; Yohei Shinkai; Kenji Harada; Hiroyuki Shimada
  Journal of clinical medicine, 9, 7, 2020年07月04日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, Many of the modifiable risk factors for dementia are lifestyle-related, and multidomain interventions tailored to individual lifestyles are recommended to prevent cognitive decline and dementia. However, studies of the relationship between the environment and cognitive function have shown that cognitive disorders and dementia are more prevalent in rural areas than in urban areas. The purpose of this study was to clarify the role of lifestyle activities on the association between neighborhood amenities and cognitive function. Our data were measured between August 2011 and February 2012. Participants comprised 3786 older adults (mean age: 71.5 years, standard deviation (SD) = ±5.2). We categorized neighborhood amenities as institutional resources that promote cognitively beneficial activities such as physical activity. We calculated the Walk Score® for all participants using their home address and divided them into three groups. We assessed their 12 lifestyle activities performed outdoors. Cognitive function was measured via Mini-Mental Status Exam, word list memory, attention, executive function, and processing speed. We found that participants who were more likely to report many lifestyle activities were more likely to have normal cognition, even in areas where neighborhood amenities were scarce. The clinical significance of this study is that increased lifestyle activity contributes to the prevention of cognitive decline.
• 心理的フレイルの有病率と要介護認定発生に対する影響
  島田 裕之; 土井 剛彦; 李 相侖; 堤本 広大; 裴 成琉; 中窪 翔; 牧野 圭太郎; 荒井 秀典
  日本老年医学会雑誌, 57, Suppl., 63, 63, (一社)日本老年医学会, 2020年07月
  日本語
• Engagement in Lifestyle Activities is Associated with Increased Alzheimer's Disease-Associated Cortical Thickness and Cognitive Performance in Older Adults.
  Seongryu Bae; Sangyoon Lee; Kenji Harada; Keitaro Makino; Ippei Chiba; Osamu Katayama; Yohei Shinkai; Hyuntae Park; Hiroyuki Shimada
  Journal of clinical medicine, 9, 5, 2020年05月11日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, The aim of this study was to examine the association between lifestyle activities, including physical, cognitive, and social activities, and Alzheimer's disease (AD) signature cortical thickness, as well as to examine the mediating role of AD signature cortical thickness in lifestyle activities and cognitive function in community-dwelling healthy older adults. Participants were 1026 older adults who met the study inclusion criteria. The physical, cognitive, and social activities of daily life were assessed using a self-reporting questionnaire. AD signature cortical thickness was determined using FreeSurfer software. Cognitive function was evaluated using the National Center for Geriatrics and Gerontology-Functional Assessment Tool. Path analysis (based on structural equation modeling (SEM)) of cognitive activities indicated that the direct path from cognitive activities to cognitive function was significant (p < 0.001), as was the direct path from AD signature cortical thickness to cognitive function (p < 0.001). Physical (p < 0.05) or social activities (p < 0.05) had a direct effect on cognitive function. However, AD signature cortical thickness did not mediate the relationship between physical or social activities and cognitive function. Our findings suggest that higher levels of cognitive activities later in life have a significant and positive direct effect on cognitive function. Additionally, AD signature cortical thickness significantly mediates the relationship between cognitive activities and cognitive function.
• The Effect of a Multicomponent Dual-Task Exercise on Cortical Thickness in Older Adults with Cognitive Decline: A Randomized Controlled Trial.
  Seongryu Bae; Kenji Harada; Sangyoon Lee; Kazuhiro Harada; Keitaro Makino; Ippei Chiba; Hyuntae Park; Hiroyuki Shimada
  Journal of clinical medicine, 9, 5, 2020年05月02日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, The aim of this study was to examine cortical thickness changes associated with a multicomponent exercise intervention combining physical exercise and cognitive training in older adults with cognitive decline. This study involved a secondary analysis of neuroimaging data from a randomized controlled trial with 280 older adults having cognitive decline who were randomly assigned to either a multicomponent exercise group (n = 140) that attended weekly 90-minute exercise and cognitive training sessions or a health education control group (n = 140). The cortical thickness and cognitive performance were assessed at the baseline and at trial completion (10 months). The cortical thickness in the frontal and temporal regions was determined using FreeSurfer software. Cognitive performance was evaluated using the Gerontology-Functional Assessment Tool (NCGG-FAT). The cortical thickness significantly increased in the middle temporal (p < 0.001) and temporal pole (p < 0.001) in the multicomponent exercise group compared with the control group. Cortical thickness changes were significantly associated with change in trail making test (TMT)-A, TMT-B, and story memory after a 10-month multicomponent exercise intervention. This study suggests that multicomponent exercise programs combining physical exercise and cognitive training have important implications for brain health, especially in providing protection from age-related cortical thinning.
• Combined effects of pain interference and depressive symptoms on dementia incidence: A 36-month follow-up study
  Keitaro Makino; Sangyoon Lee; Seongryu Bae; Yohei Shinkai; Ippei Chiba; Hiroyuki Shimada
  Journal of Alzheimer's Disease, 76, 2, 703, 712, 2020年05月, ［査読有り］, ［筆頭著者, 責任著者］, ［国際誌］
  英語, 研究論文（学術雑誌）, BACKGROUND: Both pain interference and depressive symptoms have certain effects on dementia, and these are reciprocally related. However, comorbid effects of pain interference and depressive symptoms on dementia have not been examined in detail. OBJECTIVE: This longitudinal study aimed to examine the combined effects of pain interference and depressive symptoms on the incidence of dementia in community-dwelling elderly individuals. METHODS: This prospective cohort study with a 36-month follow-up period included 4,326 community-dwelling elderly individuals without dementia at baseline. Pain interference and depressive symptoms were assessed for every participant at baseline. We collected medical records in the Japanese public health insurance system to identify the incidence of dementia for 36 months. RESULTS: The incidence rates of dementia during the follow-up period in the control, pain-interference, depressive-symptoms, and comorbid group were 3.2%, 6.2%, 7.9%, and 11.3%, respectively. A Cox regression analysis showed that the hazard ratios for the incidence of dementia were 1.85 (95% CI: 1.13-3.03) in the pain interference group, 1.87 (95% CI: 1.27-2.76) in the depressive symptoms group, and 2.20 (95% CI: 1.26-3.84) in the comorbid group, after adjusting for covariates. CONCLUSION: The coexistence of pain interference and depressive symptoms had a greater effect on the incidence of dementia than either condition alone in community-dwelling elderly individuals. Pain interference and depressive symptoms are known as common comorbid conditions and often form a negative cycle that accelerates the worsening of the individual symptoms of both. Thus, the comorbidity of these conditions may require monitoring for the prevention of dementia.
• Relationship between instrumental activities of daily living performance and incidence of mild cognitive impairment among older adults: A 48-month follow-up study
  Keitaro Makino; Sangyoon Lee; Seongryu Bae; Yohei Shinkai; Ippei Chiba; Hiroyuki Shimada
  Archives of Gerontology and Geriatrics, 88, 104034, 104034, 2020年05月, ［査読有り］, ［筆頭著者, 責任著者］
• Modifiable Risk Factor Possession Patterns of Dementia in Elderly with MCI: A 4-Year Repeated Measures Study.
  Osamu Katayama; Sangyoon Lee; Seongryu Bae; Keitaro Makino; Yohei Shinkai; Ippei Chiba; Kenji Harada; Hiroyuki Shimada
  Journal of clinical medicine, 9, 4, 2020年04月10日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, This study clarified the patterns of possessing modifiable risk factors of dementia that can be corrected by the elderly who were primarily determined to have mild cognitive impairment (MCI), and then determined the relationship between retention patterns and outcomes from MCI through a 4-year follow-up study. The participants were 789 community-dwelling elders who were ≥65 years old with MCI at baseline. After 4 years, participants were classified into reverters and nonreverters, according to their cognitive function. Repeated measures analysis was performed after imputing missing values due to dropout. Nine modifiable risk factors at baseline were classified by latent class analysis. Subsequently, we performed binomial logistic regression analysis. The reversion rate of 789 participants was 30.9%. The possession patterns of modifiable risk factors among the elderly with MCI were classified into five patterns: low risk, psychosocial, health behavior, educational, and smoking factors. According to logistic regression analysis, the low risk factors class was more likely to recover from MCI to normal cognitive than the other classes (p < 0.05). These results may provide useful information for designing interventions to prevent cognitive decline and dementia in individuals with MCI.
• Predictive validity of a new instrumental activities of daily living scale for detecting the incidence of functional disability among community-dwelling older Japanese adults: A prospective cohort study.
  Keitaro Makino; Sangyoon Lee; Seongryu Bae; Yohei Shinkai; Ippei Chiba; Hiroyuki Shimada
  International Journal of Environmental Research and Public Health, 17, 7, 2020年03月29日, ［査読有り］, ［筆頭著者, 責任著者］, ［国際誌］
  英語, 研究論文（学術雑誌）, We examined the predictive validity of a newly developed scale-the National Center for Geriatrics and Gerontology Activities of Daily Living (NCGG-ADL)-to measure instrumental activities of daily living (IADL) ability. We tested the scale for detecting new incidences of functional disability among community-dwelling older Japanese adults. Participants were 2708 older adults (mean age = 79.0 years, 51.6% women) living in the community who had no functional decline at baseline. We assessed IADL ability using the NCGG-ADL scale, comprising 13 self-report questions. Next, we assessed their functional disability monthly for 24 months, based on the national long-term care insurance (LTCI) system. Among all participants, 430 (15.9%) had an IADL limitation at baseline, and 289 (10.7%) were newly certified as functionally disabled. Participants scoring ≤ 12 of 13 points in the NCGG-ADL showed a significantly higher risk of functional disability than did those scoring 13 points, even after adjusting for covariates (hazard ratio [95% confidence interval] = 1.58 [1.19-2.09]). We thus validated the NCGG-ADL as a screening tool for assessing the risk of functional disability among community-dwelling older Japanese adults. We conclude that IADL limitations, as measured by the NCGG-ADL, could be useful predictors of functional disability.
• Visceral Fat Accumulation Is Associated with Mild Cognitive Impairment in Community-Dwelling Older Japanese Women.
  I Chiba; S Lee; S Bae; K Makino; Y Shinkai; H Shimada
  The journal of nutrition, health & aging, 24, 3, 352, 357, 2020年, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, OBJECTIVES: Visceral fat accumulation is detrimental for brain health and is associated with cognitive impairment in older adults. The objectives of the present study were to examine the association between visceral fat accumulation and prevalence of mild cognitive impairment and its subtypes. DESIGN: a cross-sectional study. PARTICIPANTS: This study enrolled 6,109 community-dwelling older adults, including 3,434 women (mean age: 74.4 years) and 2,675 men (mean age: 74.3 years). Individuals with dementia, Parkinson's disease, stroke, Mini-Mental State Examination scores ≤23, and who could not perform basic activities of daily living independently were excluded. MEASUREMENTS: Participants underwent neurocognitive assessments to assess mild cognitive impairment (MCI) and its subtypes. Visceral fat area (VFA) was measured using abdominal bioelectrical impedance analysis. Participants were divided into quartile groups by VFA. RESULTS: There were 731 (21.3%) women and 562 (21.0%) men with MCI, and the median VFA values were 63.3 cm2 and 96.3 cm2, respectively. Women participants in the second (adjusted odds ratios [aOR], 0.71; 95% confidence interval [95% CI], 0.54-0.94), third (aOR, 0.66; 95% CI, 0.47-0.92), and fourth quartiles of VFA (aOR, 0.62; 95% CI, 0.41-0.93) had a significantly lower risk of MCI than those in the first quartile. Higher VFA quartiles in women were associated with lower risk of non-amnestic MCI. There were no significant differences in men between quartiles. CONCLUSIONS: Visceral fat accumulation was associated with MCI, especially non-amnestic MCI, in community-dwelling older Japanese women. These results suggest that visceral fat accumulation is partially protective against cognitive impairment.
• Exercise and Horticultural Programs for Older Adults with Depressive Symptoms and Memory Problems: A Randomized Controlled Trial.
  Hyuma Makizako; Kota Tsutsumimoto; Takehiko Doi; Keitaro Makino; Sho Nakakubo; Teresa Liu-Ambrose; Hiroyuki Shimada
  Journal of clinical medicine, 9, 1, 2019年12月30日, ［査読有り］, ［国際共著］, ［国際誌］
  英語, 研究論文（学術雑誌）, Depressive symptoms and memory problems are risk factors for dementia. Exercise can reduce these in older people, and horticultural activity can benefit people with dementia. This study assessed the efficacy of exercise and horticultural interventions for community-dwelling older adults with depressive symptoms and mild memory decline. In this randomized controlled trial, older adults (n = 89) were assigned to exercise, horticultural, or control groups. Exercise and horticultural programs included 20 weekly 90-minute sessions. The control group attended two 90-minute classes. Outcomes were assessed at baseline, and then 6- and 12-months post-intervention. Primary outcome measures were the Geriatric Depression Scale-15 (GDS-15) and Wechsler Memory Scale-Revised. Walking speed, two-minute walking test scores, social network, life space, and subjective daily physical activity were secondary outcome measures. Compared with the control group, the exercise group obtained higher immediate and delayed recall logical memory scores, and the increase in immediate recall scores remained 12-months post-intervention. Two-minute walking performance improved in the exercise group, but not after 12 months. GDS-15 scores showed no significant improvements. The horticultural and control groups showed no differences. Exercise may improve memory, while horticultural activity may not. The effects of exercise and horticultural interventions on depressive symptoms remain unclear.
• Daily physical activity and functional disability incidence in community-dwelling older adults with chronic pain: A prospective cohort study.
  Keitaro Makino; Sangyoon Lee; Sungchul Lee; Seongryu Bae; Songee Jung; Yohei Shinkai; Hiroyuki Shimada
  Pain Medicine (Malden, Mass.), 20, 9, 1702, 1710, 2019年09月01日, ［査読有り］, ［筆頭著者, 責任著者］, ［国際誌］
  英語, 研究論文（学術雑誌）, OBJECTIVE: This study examined the association between daily physical activity and functional disability incidence in community-dwelling older adults with chronic pain. DESIGN: Prospective cohort study. SETTING: Japanese community. SUBJECTS: Of the 5,257 participants enrolled for baseline assessment, data on the 693 participants who had chronic lower back or knee pain and underwent daily physical activity assessment using an accelerometer were analyzed. METHODS: Participants were assessed for regular physical activity (step counts, moderate- to vigorous-intensity physical activity duration, and light-intensity physical activity duration) using an accelerometer at baseline and were followed up for monthly functional disability incidence, based on the national long-term care insurance system, for approximately two years. We determined the effect of physical activity cutoff points on functional disability incidence using receiver operating characteristic curves and Youden index. Cox proportional hazards regression models were used to analyze associations between the cutoff points and disability incidence. RESULTS: Among the 693 participants with chronic pain, 69 (10.0%) developed functional disability during the follow-up period. Participants with lower physical activity levels showed significantly higher risk of disability. After adjusting for all covariates, functional disability was associated with step counts (hazard ratio [HR] = 1.79, 95% confidence interval [CI] = 1.02-3.14) and moderate- to vigorous-intensity physical activity duration (HR = 2.02, 95% CI = 1.16-3.51) but had no relationship with light-intensity physical activity duration (HR = 1.72, 95% CI = 0.97-3.05). CONCLUSIONS: Maintenance of physical activity with at least moderate intensity may be effective in preventing disability even among older adults with chronic pain.
• Impact of Sedentary Time on Chronic Kidney Disease and Disability Incidence in Community-Dwelling Japanese Older Adults: A 4-Year Prospective Cohort Study.
  Sungchul Lee; Sangyoon Lee; Seongryu Bae; Kazuhiro Harada; Songee Jung; Keitaro Makino; Hiroyuki Shimada
  Journal of aging and physical activity, 27, 2, 184, 190, 2019年04月01日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, This study examined the association between the estimated glomerular filtration rate (eGFR) and disability incidence according to sedentary time in community-dwelling Japanese older adults. This prospective cohort study sampled 5,104 community-dwelling older adults (≥65 years) enrolled in a health promotion study in a general population. The participants (n = 4,457; ≥65 years) were monitored for inclusion in the long-term care insurance system for 4 years. This study used blood samples to assess eGFR. Cox proportional regression analysis was used to determine predictors of disability. In total, 461 participants (10.3%) became newly certified as needing long-term care insurance services. Cox regression models were adjusted for multiple confounders: eGFR < 45 ml/min/1.73 m2 (hazard ratio = 1.741, 95% confidence interval [1.193-2.539]) and eGFR < 45 ml/min/1.73 m2 with high sedentary time (≥8 hr) (hazard ratio = 4.367, 95% confidence interval [2.021-9.438]) remained significantly associated with disability incidence. Our findings suggest that in the case of chronic kidney disease, the disability incidence rate may be affected by sedentary time.
• Relationship between the occurrence of falls by season and physical functions of community-dwelling old-old people living in cold, snowy areas.
  Yuriko Kihara; Ryo Yamaguchi; Keitaro Makino; Kotaro Shimizu; Kazunari Ito; Taketo Furuna
  Geriatrics & gerontology international, 19, 2, 124, 129, 2019年02月, ［査読有り］, ［国内誌］
  英語, 研究論文（学術雑誌）, AIM: To investigate the functional characteristics of older adults who experienced a fall in the winter season and other seasons. METHODS: Participants were 403 older adults enrolled in the project "Population-Based and Inspiring Potential Activity for Old-old Inhabitants," and were living in cold, snowy regions in Japan. They were aged ≥75 years, and 41.9% (n = 169) were men. Sociodemographic characteristics, and physical, psycho-cognitive and social factors were surveyed. By experiences of falls, they were divided into three groups: the non-fall group, the fall in non-winter group and the fall in winter group. Each factor was compared with a χ2 -test, Student's t-test and Mann-Whitney U-test. Logistic regression analysis was carried out. spss version 25 was used for the statistical analysis. The level of significance was set at 5%. RESULTS: No differences were confirmed between the non-fall and fall in winter groups. In contrast, the maximum walking speed in the fall in non-winter group was significantly slower than the non-fall group, even with adjustment by variables, such as age, sex and self-efficacy. CONCLUSIONS: When considering intervention methods for health promotion, it is necessary to consider not only the presence or absence of falls, but also the seasons of falls. Geriatr Gerontol Int 2019; 19: 124-129.
• The effect of a multicomponent intervention to promote community activity on cognitive function in older adults with mild cognitive impairment: A randomized controlled trial.
  Seongryu Bae; Sangyoon Lee; Sungchul Lee; Songee Jung; Keitaro Makino; Kazuhiro Harada; Kenji Harada; Yohei Shinkai; Ippei Chiba; Hiroyuki Shimada
  Complementary therapies in medicine, 42, 164, 169, 2019年02月, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, OBJECTIVES: This study aimed to examine the effectiveness of a multicomponent intervention combining physical, cognitive, and social activities developed to promote community activity in improving cognitive function in older adults with mild cognitive impairment (MCI). DESIGN: Single-blind randomized controlled trial. SETTING: A total of 83 Japanese older adults with MCI participated in the study from April to September 2017. INTERVENTIONS: Participants were randomly assigned to either the multicomponent intervention group (n = 41), attending 90-minute physical, cognitive, or social activity sessions using community resources twice weekly, or the health education control group (n = 42). OUTCOMES: The primary outcomes were cognitive functions, and the secondary outcomes were grip strength, walking speed, depressive symptoms, physical activities, number of outdoor activities, and conversation time. RESULTS: Analysis using linear mixed models revealed significantly greater improvements in the intervention group in spatial working memory (p =  0.024) following intervention compared with the control group. Time spent in moderate-to-vigorous physical activity (p =  0.048) and step count (p =  0.059) decreased from the baseline post-intervention in the control group, whereas the baseline was maintained in the intervention group. No significant between-group differences were found post-intervention in the other primary and secondary outcomes. CONCLUSIONS: This study showed that a 24-week multicomponent intervention program was effective in improving spatial working memory and maintaining physical activity in older adults with MCI. A follow-up investigation is required to determine whether continuation of physical, cognitive, and social activity can prevent dementia or reverse MCI in older adults.
• Effects of Driving Skill Training on Safe Driving in Older Adults with Mild Cognitive Impairment.
  Hiroyuki Shimada; Ryo Hotta; Hyuma Makizako; Takehiko Doi; Kota Tsutsumimoto; Sho Nakakubo; Keitaro Makino
  Gerontology, 65, 1, 90, 97, 2019年, ［査読有り］, ［国際誌］
  英語, BACKGROUND: Driving cessation is strongly associated with adverse health outcomes in the older adults. Although there were numerous documentations of driving rehabilitation in disabled adults, the effects of interventions on safe driving were not clear in older adults with cognitive impairment who had low driving skills. OBJECTIVE: This randomized controlled trial was designed to determine whether a safe driving skill program consisting of classroom and on-road training could enhance driving performance of older drivers with cognitive impairment in Japan. METHODS: A total of 160 community-living older drivers participated in the randomized controlled trial with blinded endpoint assessment. Participants randomized to intervention underwent 10 1-h classroom sessions and 10 1-h on-road sessions focused on common problem areas of older drivers. Controls received 1 classroom education. On-road driving performance was assessed by certified driving school instructors in a driving school. The participants carried out dynamic vision and cognitive performance tests. RESULTS: One hundred and forty-six (intervention group, n = 71) subjects completed the 3-month follow-up. Mean adherence to classroom-based vision training and driving simulator training and on-road training programs, including the 71 participants, was 99.0 ± 6.4 and 99.0 ± 7.2%, respectively. Regarding the safe driving skill score, there were group × time interactions (p < 0.01) indicating benefits of the intervention over time. Although there were no significant group × time interactions in cognitive tests, dynamic vision showed group × time interactions (p < 0.01). CONCLUSION: The driving skill program significantly improved safe driving performance in older adults with cognitive impairment who were at a potentially high risk of a car accident.
• Study protocol of the self-monitoring activity program: Effects of activity on incident dementia.
  Hiroyuki Shimada; Sangyoon Lee; Takehiko Doi; Seongryu Bae; Keitaro Makino; Ippei Chiba; Hidenori Arai
  Alzheimer's & dementia (New York, N. Y.), 5, 303, 307, 2019年, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, Introduction: Numerous studies have focused on nonpharmacological interventions on cognitive function and the effects of cognitive function on daily living. However, effects of behavior change techniques that promote physical, cognitive, and social activities on cognitive function and incident dementia in the elderly are yet to be elucidated. In this study, we aimed to design a single-blind, randomized controlled trial to study dementia prevention effects of behavior change techniques, using an accelerometer and a newly developed daily activity booklet in community-living older adults. Methods: The study cohort comprised 5390 individuals aged 65 years and older who were randomized into one of the following three groups: accelerometer group (n = 1508), accelerometer and daily activity booklet group (n = 1180), or a control group (n = 2702; vs. accelerometer group [n = 1509] vs. accelerometer and daily activity booklet group [n = 1193]). Incident dementia was diagnosed based on the Japanese Health Insurance System data. The participants without dementia at baseline, who are diagnosed with dementia over a 36-month follow-up period, are considered to have incident dementia. The participants of the accelerometer group were asked to wear the accelerometer everyday and visit a site having data readers to download the accelerometer data every month. The subjects of the booklet group were requested to not only wear the accelerometer but also record the physical, cognitive, and social activities. The participants receive a feedback report from the data of the accelerometer and booklet. Discussion: The study has the potential to provide the first evidence of effectiveness of the self-monitoring tools in incident dementia. In case our trial results suggest a delayed dementia onset upon self-monitoring interventions, the study protocol will provide a cost-effective and safe method for maintaining a healthy cognitive aging.
• Pain characteristics and incidence of functional disability among community-dwelling older adults.
  Keitaro Makino; Sangyoon Lee; Seongryu Bae; Songee Jung; Yohei Shinkai; Ippei Chiba; Hiroyuki Shimada
  PloS One, 14, 4, e0215467, 2019年, ［査読有り］, ［筆頭著者, 責任著者］, ［国際誌］
  英語, 研究論文（学術雑誌）, This study examined the association between pain characteristics and the incidence of functional disability among community-dwelling older adults. This prospective cohort study included 4,365 older adults (mean age 74.7 years, 53.5% female) living in community settings. Pain characteristics, including severity and duration of pain, were assessed in participants who also underwent monthly follow-up assessment of functional disability for 24 months based on the national long-term care insurance system. Among the 4,365 participants, 2,149 (48.7%) reported pain, regardless of severity and duration. Of the 2,149 participants with pain, 950 (44.2%) reported moderate to severe pain and 1,680 (78.2%) reported chronic pain. Based on the univariate analyses, participants with moderate (hazard ratio [95% confidence interval]: 1.48 [1.05-2.09]) or severe (2.84 [1.89-4.27]) pain and chronic pain (1.50 [1.15-1.95]) showed significantly higher risk of disability incidence than did those without pain. After adjusting for covariates, severe pain remained a significant predictor (hazard ratio [95% confidence interval]: 1.66 [1.05-2.62]), but moderate (1.00 [0.69-1.47]) and chronic pain (1.04 [0.77-1.40]) did not. Our results established that moderate to severe pain or chronic pain affects functional disability; in particular, severe pain was independently associated with the incidence of disability. Subjective complaints of pain do not always correspond to physical causes; however, simplified questions regarding pain characteristics could be useful predictors of functional disability in community-dwelling older people.
• Structural analysis of impact of physical, cognitive and social status on the incidence of disability in community-dwelling people aged ≥75 years.
  Keitaro Makino; Hikaru Ihira; Atsushi Mizumoto; Kotaro Shimizu; Toyoaki Ishida; Ryo Yamaguchi; Yuriko Kihara; Kazunari Ito; Takeshi Sasaki; Taketo Furuna
  Geriatrics & Gerontology International, 18, 12, 1614, 1619, 2018年12月, ［査読有り］, ［筆頭著者, 責任著者］, ［国内誌］
  英語, 研究論文（学術雑誌）, AIM: The present study aimed to propose a structural model to explain the interaction of physical, cognitive and social domains of health status in the incidence of disability in community-dwelling people aged ≥75 years. METHODS: We analyzed 185 older adults (mean age 79.4 years, 58.4% female) who participated in a baseline assessment from 2012 to 2013. They were followed for incident certification of care needs in the national long-term care insurance certification system during the 2 years. Baseline assessments included several measurements related to the physical, cognitive and social domains of health status. We compared the model fit index between two hypothesis models - the parallel model and the hierarchical model - using structural equation modeling. RESULTS: During the follow-up period, 15 participants (8.1%) were newly certified as requiring personal support from the long-term care insurance system. The structural equation modeling showed that the hierarchical model, indicating that cognitive and social status were indirectly associated with disability through physical status, had a better fit with the data than the parallel model, indicating that physical, cognitive and social status each were directly associated with disability. CONCLUSIONS: The present results suggest that cognitive and social status might indirectly affect disability incidence through physical aging. Further research is required to examine the temporal relationship between physical, cognitive and social change using data over several time-periods. Geriatr Gerontol Int 2018; 18: 1614-1619.
• Aging-related anorexia and its association with disability and frailty.
  Kota Tsutsumimoto; Takehiko Doi; Hyuma Makizako; Ryo Hotta; Sho Nakakubo; Keitaro Makino; Takao Suzuki; Hiroyuki Shimada
  Journal of cachexia, sarcopenia and muscle, 9, 5, 834, 843, 2018年10月, ［査読有り］, ［国際誌］
  英語, BACKGROUND: Anorexia of ageing may be a precursor to various geriatric syndromes. We elucidated whether anorexia of ageing had a significant impact on incident disability and investigated whether anorexia of ageing had a direct association with future disability or an indirect association with disability via frailty. METHODS: This study employed an observational, longitudinal, cohort design in a community setting. Participants were 4393 older adults (75.9 ± 4.3 years). Anorexia of ageing was assessed by a simplified nutritional appetite questionnaire. Frailty was operationalized as slowness, weakness, exhaustion, low physical activity, and weight loss. Participants who had none of these characteristics were considered robust, those with one or two characteristics were considered pre-frail, and those with three or more characteristics were considered frail. We examined sociodemographic variables (age, sex, and education), medical history (medication and chronic disease history), lifestyle factors (smoking and drinking habits and living arrangement), body mass index, blood nutrition data, depressive symptoms, physical functioning, and cognitive functioning. RESULTS: The prevalence of anorexia of ageing was 10.7% (n = 468). The proportion of physical frailty, pre-frailty, and robustness were 8.4, 52.0, and 39.6%, respectively, in the without anorexia of ageing group, and 20.3, 57.7, and 22.0%, respectively, in the anorexia of ageing group (P < 0.001). During a 2-year follow-up, the prevalence proportion of disability was 5.6% in the without anorexia of ageing group and 10.7% in the anorexia of ageing group (P < 0.001). Adjusted for covariates (except for frailty status), the participants with anorexia of ageing had an independently associated higher risk of incident disability compared with those without anorexia of ageing (hazard ratio: 1.43, 95% confidence interval: 1.04-1.95, P = 0.03). However, adjusted for covariates (including frailty status), anorexia of ageing was not significantly associated with incident disability (P = 0.09). Structural equation models revealed that anorexia of ageing had no direct effect on disability; however, anorexia of ageing was associated with frailty. CONCLUSIONS: Older adults with anorexia of ageing had a higher proportion of frailty and a higher prevalence proportion of disability compared with those without anorexia of ageing. Although anorexia of ageing may not have a direct effect on incident disability, the structural equation model suggests an indirect relationship between anorexia of ageing and incident disability via frailty status.
• Combined effects of mild cognitive impairment and slow gait on risk of dementia.
  Takehiko Doi; Hyuma Makizako; Kota Tsutsumimoto; Ryo Hotta; Sho Nakakubo; Keitaro Makino; Takao Suzuki; Hiroyuki Shimada
  Experimental gerontology, 110, 146, 150, 2018年09月, ［査読有り］, ［国際誌］
  英語, BACKGROUND: Mild cognitive impairment (MCI) is a high risk of conversion to dementia and gait dysfunction is also a risk for dementia. The goal of the study was to examine if co-occurrence of MCI and slow gait (SG) increases the risk of dementia. METHODS: A prospective study was conducted in 3937 older adults who did not have dementia at baseline. Participants were classified into groups based on status of MCI and SG: without MCI and SG (control), without MCI and with SG (SG), without SG and with MCI in a single domain (sMCI) or multiple domains (mMCI), sMCI and SG (sMCI + SG), and mMCI and SG (mMCI + SG). Incident dementia was followed monthly. Cox proportional hazards regression models were used to calculate the hazard ratio for incident dementia in each group. RESULTS: During a mean follow-up period of 43 months, 182 subjects had incident dementia. MCI was a risk factor for dementia and SG increased the risk, even after adjusting for covariates (SG: HR = 1.31 (0.81-2.14), 95% CI = 0.276, sMCI: HR = 1.87, 95% CI = 1.21-2.88, p = .005; mMCI: HR = 3.36, 95% CI = 1.98-5.71, p < .001; sMCI + SG: HR = 3.33, 95% CI = 1.92-5.77, p < .001; mMCI + SG: HR = 5.02, 95% CI = 2.75-9.14, p < .001). CONCLUSIONS: Co-occurrence of MCI and SG has a high risk of dementia compared to that of each condition alone. Evaluation of both gait and cognition is useful in risk assessment of dementia.
• The role of social frailty in explaining the association between hearing problems and mild cognitive impairment in older adults
  Seongryu Bae; Sangyoon Lee; Sungchul Lee; Songee Jung; Keitaro Makino; Hyuntae Park; Hiroyuki Shimada
  Archives of Gerontology and Geriatrics, 78, 45, 50, Elsevier Ireland Ltd, 2018年09月01日, ［査読有り］, ［国際共著］, ［国際誌］
  英語, 研究論文（学術雑誌）
• Cognitive function and unsafe driving acts during an on-road test among community-dwelling older adults with cognitive impairments.
  Ryo Hotta; Hyuma Makizako; Takehiko Doi; Kota Tsutsumimoto; Sho Nakakubo; Keitaro Makino; Hiroyuki Shimada
  Geriatrics & gerontology international, 18, 6, 847, 852, 2018年06月, ［査読有り］, ［国内誌］
  英語, AIM: To examine the relationship between cognitive function and unsafe driving acts among community-dwelling older adults with cognitive impairments. METHODS: Participants (n = 160) were older residents of Obu, Japan, aged ≥65 years with cognitive impairments. They regularly drove and were assessed for the number of unsafe driving acts without adequate verification during an on-road test. We also evaluated cognitive function (attention, executive function and processing speed). Other examined variables included demographics, driving characteristics and visual condition. RESULTS: Participants were classified into two groups according to the number of unsafe driving acts as follows: high group (≥4 unsafe driving acts) and low group (≤3 unsafe driving acts). The high group participants were older in age (P < 0.001) and obtained a lower score on the symbol digit substitution task (P = 0.002) than the low group. The number of unsafe driving acts showed modest significant positive correlations with age (r = 0.396, P < 0.001). The symbol digit substitution task score was significantly associated with the number of unsafe driving acts (β = -0.196, P < 0.05) after adjusting for age group. CONCLUSIONS: Processing speed was associated with unsafe driving acts that became worse with increasing age. Future study will be required to longitudinally examine the influence of processing speed on traffic accidents for those with cognitive impairments. Geriatr Gerontol Int 2018; 18: 847-852.
• Effectiveness of the KENKOJISEICHI local revitalization system on cognitive function change in older adults with mild cognitive impairment: study protocol for a randomized controlled trial.
  Songee Jung; Sungchul Lee; Seongryu Bae; Sangyoon Lee; Keitaro Makino; Yohei Shinkai; Hiroyuki Shimada
  Trials, 19, 1, 276, 276, 2018年05月11日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, BACKGROUND: Physical activity is associated with a lower risk of cognitive decline in older adults. However, past studies have demonstrated that older adults tend to relapse into inactivity after completing interventions. This ongoing study employs a randomized controlled trial design to assess the efficacy and efficiency of the KENKOJISEICHI local revitalization system for promoting daily outdoor behaviors to improve cognitive function in community-dwelling older adults with mild cognitive impairment (MCI). METHODS/DESIGN: This 6-month randomized controlled trial will include 83 community-dwelling older adults aged 65 years or older with MCI. Participants will be randomized to the KENKOJISEICHI experimental group or an educational control group. The KENKOJISEICHI group will receive a 90-minute session twice per week that consists of social, intellectual, and physical activities involving outdoor behaviors intended to support cognitive function. Participants in the educational control group will attend two 120-minute educational classes during the 6-month trial period. Considering a 20-30% dropout rate, a sample size of 35 participants per group is required. DISCUSSION: If the program successfully promotes long-term habitual outdoor behaviors, this will expand knowledge regarding how to support social, intellectual, and physical activities, as well as communication change, among the older population to provide them with cognitive benefits. TRIAL REGISTRATION: University Hospital Medical Information Network (UMIN), Japan, UMIN000026479 . Registered on 9 March 2017.
• Impact of fear of falling and fall history on disability incidence among older adults: Prospective cohort study.
  Keitaro Makino; Hyuma Makizako; Takehiko Doi; Kota Tsutsumimoto; Ryo Hotta; Sho Nakakubo; Takao Suzuki; Hiroyuki Shimada
  International Journal of Geriatric Psychiatry, 33, 4, 658, 662, 2018年04月, ［査読有り］, ［筆頭著者, 責任著者］, ［国際誌］
  英語, OBJECTIVE: Fear of falling (FOF) is a major health problem for older adults, present not just in fallers, but also nonfallers. This study examined the impact of FOF and fall history on disability incidence among community-dwelling older adults from a prospective cohort study. METHODS: A total of 5104 older adults living in community settings participated in baseline assessment and were followed up for about 4 years (median 52 mo, range 49-55 mo). At baseline, participants were assessed the presence of FOF and their fall history, and divided into 4 groups: Fall (-) FOF (-), Fall (+) FOF (-), Fall (-) FOF (+), and Fall (+) FOF (+). Disability incidence was defined as national long-term care insurance certification for personal support or care. RESULTS: During the follow-up period, 429 participants (9.9%) were newly certified as having a disability and needing personal support for long-term care insurance. Fall (-) FOF (+) group and Fall (+) FOF (+) group showed a significantly higher risk of disability incidence than Fall (-) FOF (-) group even after adjusting for covariates (Fall (-) FOF (+): hazard ratio 1.28, 95% confidence interval, 1.01-1.62, Fall (+) FOF (+): hazard ratio 1.44, 95% confidence interval, 1.05-1.98). CONCLUSIONS: Fear of falling could be a simple and useful predictor of disability incidence in community-dwelling older adults. Identifying and decreasing fall risk factors may prevent fall-related injuries, but excessive FOF may be associated with increased risk of disability incidence.
• Social Frailty Leads to the Development of Physical Frailty among Physically Non-Frail Adults: A Four-Year Follow-Up Longitudinal Cohort Study.
  Hyuma Makizako; Hiroyuki Shimada; Takehiko Doi; Kota Tsutsumimoto; Ryo Hotta; Sho Nakakubo; Keitaro Makino; Sangyoon Lee
  International journal of environmental research and public health, 15, 3, 2018年03月10日, ［査読有り］, ［国際誌］
  英語, Social frailty domains may play an important role in preventing physical decline and disability. The aim of this study is to examine the impact of social frailty as a risk factor for the future development of physical frailty among community-dwelling older adults who are not yet physically frail. A total of 1226 physically non-frail older adults were analyzed to provide a baseline. Participants completed a longitudinal assessment of their physical frailty 48 months later. Their baseline social frailty was determined based on their responses to five questions, which identified participants who went out less frequently, rarely visited friends, felt less like helping friends or family, lived alone and did not talk to another person every day. Participants with none of these characteristics were considered not to be socially frail; those with one characteristic were considered socially pre-frail; and those with two or more characteristics were considered socially frail. At the four-year follow-up assessment, 24 participants (2.0%) had developed physical frailty and 440 (35.9%) had developed physical pre-frailty. The rates of developing physical frailty and pre-frailty were 1.6% and 34.2%, respectively, in the socially non-frail group; 2.4% and 38.8%, respectively, in the socially pre-frail group; and 6.8% and 54.5%, respectively, in the socially frail group. Participants classified as socially frail at the baseline had an increased risk of developing physical frailty, compared with participants who were not socially frail (OR = 3.93, 95% CI = 1.02-15.15). Participants who were socially frail at the baseline also had an increased risk of developing physical pre-frailty (OR = 2.50, 95% CI = 1.30-4.80). Among independent community-dwelling older adults who are not physically frail, those who are socially frail may be at greater risk of developing physical frailty in the near future. Social frailty may precede (and lead to the development of) physical frailty.
• The effect of gait speed and gait phase to the allocation of attention during dual task gait.
  Kotaro Shimizu; Hikaru Ihira; Keitaro Makino; Yuriko Kihara; Kazunari Itou; Taketo Furuna
  Journal of physical therapy science, 30, 3, 419, 423, 2018年03月, ［査読有り］, ［国内誌］
  英語, 研究論文（学術雑誌）, [Purpose] The purpose of this study was to determine the change of allocation of attention caused by a difference in gait phase and gait speed. We also determined the relationship between attentional demand and gait automaticity change caused by the gait speed alteration. [Subjects and Methods] Ten male participated. Participants were instructed to perform the probe reaction time (RT) task during treadmill walking in four different gait speed conditions (60%, 80%, 100%, and 120% of preferred speed). Walking ratio in each gait speed conditions were calculated, and RTs and walking ratios were compared in each gait speed condition and in the single-support and double-support gait phase. [Results] RTs were significantly delayed with decline of gait speed. Walking ratio was significantly decreased in proportion of decrement of gait speed. There was no difference of gait phase between single-support and double-support phase. [Conclusion] This study showed that relationship between attentional load and deficit of gait automaticity. While gait phase didn't influence attentional demand, and this result showed the characteristics of treadmill gait.
• Cognitive Frailty is Associated with Fall-Related Fracture Among Older People
  Kota Tsutsumimoto; T. Doi; H. Makizako; R. Hotta; S. Nakakubo; K. Makino; T. Suzuki; H. Shimada
  Journal of Nutrition, Health and Aging, Springer-Verlag France, 2018年, ［査読有り］
  英語, 研究論文（学術雑誌）
• Long and Short Sleep Duration and Physical Frailty in Community-Dwelling Older Adults
  Sho Nakakubo; H. Makizako; T. Doi; K. Tsutsumimoto; R. Hotta; S. Lee; S. Lee; S. Bae; K. Makino; T. Suzuki; H. Shimada
  Journal of Nutrition, Health and Aging, Springer-Verlag France, 2018年, ［査読有り］
  英語, 研究論文（学術雑誌）
• Healthy Behaviors and Incidence of Disability in Community-Dwelling Elderly.
  Ryo Hotta; Hyuma Makizako; Takehiko Doi; Kota Tsutsumimoto; Sho Nakakubo; Keitaro Makino; Takao Suzuki; Hiroyuki Shimada
  American journal of health behavior, 42, 1, 51, 58, 2018年01月01日, ［査読有り］, ［国際誌］
  英語, OBJECTIVES: In this paper and prospective study, we examine the number of healthy behaviors and the incidence of disability in community-dwelling older adults aged 65 years and older. METHODS: Participants (N = 4483) were residents of Obu, Japan who were asked about regular exercise, smoking status, and sleep duration. Demographic variables, history of disease, physi- cal function, and cognitive function were measured as confounders. Information about disabil- ity was obtained from the Obu City Office. RESULTS: At 24 months after baseline assessment, 165 participants (3.7%) were certified as having disability. Participants with 2 healthy behaviors had a 1.61-fold increased risk of disability (95% CI: 1.08 -2.42) compared with those with 3 healthy behaviors; those with one or no healthy behaviors had a 2.01-fold risk (95% CI: 1.26-3.19) even though adjusting for confounders. CONCLUSIONS: The number of healthy behaviors was associated with the incidence of disability, with the hazard ratios increasing progressively as the number of healthy behaviors decreased.
• Associations of Near-Miss Traffic Incidents with Attention and Executive Function among Older Japanese Drivers.
  Makizako H; Shimada H; Hotta R; Doi T; Tsutsumimoto K; Nakakubo S; Makino K
  Gerontology, 64, 5, 495, 502, 2018年, ［査読有り］
• Association Between Insulin-Like Growth Factor-1 and Frailty Among Older Adults
  Takehiko Doi; H. Makizako; K. Tsutsumimoto; R. Hotta; S. Nakakubo; K. Makino; T. Suzuki; H. Shimada
  Journal of Nutrition, Health and Aging, 22, 1, 68, 72, Springer-Verlag France, 2018年01月01日, ［査読有り］
  英語, 研究論文（学術雑誌）
• Fear of falling and gait parameters in older adults with and without fall history.
  Keitaro Makino; Hyuma Makizako; Takehiko Doi; Kota Tsutsumimoto; Ryo Hotta; Sho Nakakubo; Takao Suzuki; Hiroyuki Shimada
  Geriatrics & Gerontology International, 17, 12, 2455, 2459, 2017年12月, ［査読有り］, ［筆頭著者, 責任著者］, ［国内誌］
  英語, AIM: Fear of falling (FOF) is associated with spatial and temporal gait parameters in older adults. FOF is prevalent among older adults, both those with and without fall history. It is still unclear whether the relationships between FOF and gait parameters are affected by fall history. The aim of the present study was to compare gait parameters by the presence of FOF and fall history. METHODS: A total of 3575 older adults (mean age 71.7 years, 49.7% female) met the inclusion criteria for the present study. We assessed the presence of fall history and FOF by face-to-face interview, and gait parameters (gait speed, stride length, step rate, double support time and variation of stride length) at a comfortable speed using a computerized electronic walkway. RESULTS: Prevalences of fall history and FOF were as follows: non-fallers without FOF 52.6% (n = 1881); fallers without FOF 6.3% (n = 227); non-fallers with FOF 34.4% (n = 1229); and fallers with FOF 6.7% (n = 238). Analysis of covariance showed significant differences among the four groups in all gait variables even after adjusting for age, sex and number of medications used. It should be noted that non-fallers with FOF showed significantly slower gait speed, shorter stride length and longer double support time than did non-fallers without FOF (P < 0.001). CONCLUSIONS: The present results suggest that spatial and temporal gait parameters are influenced by FOF, even in the absence of fall history. The assessment of FOF might be helpful for better understanding of age-related changes in gait control. Geriatr Gerontol Int 2017; 17: 2455-2459.
• Association of Social Frailty With Both Cognitive and Physical Deficits Among Older People.
  Kota Tsutsumimoto; Takehiko Doi; Hyuma Makizako; Ryo Hotta; Sho Nakakubo; Keitaro Makino; Takao Suzuki; Hiroyuki Shimada
  Journal of the American Medical Directors Association, 18, 7, 603, 607, 2017年07月01日, ［査読有り］, ［国際誌］
  英語, OBJECTIVES: Our objective was to investigate the association between social frailty and cognitive and physical function among older adults. DESIGN: This was a cross-sectional study. SETTING: We examined community-dwelling adults in Japan. PARTICIPANTS: Participants comprised 4425 older Japanese people from the National Center for Geriatrics and Gerontology-Study of Geriatric Syndromes. MEASUREMENTS: Social frailty was defined by using responses to 5 questions (going out less frequently, rarely visiting friends, feeling unhelpful to friends or family, living alone, and not talking with someone every day). Participants showing none of these components were considered nonfrail; those showing 1 component were considered prefrail; and those showing 2 or more components were considered frail. To screen for cognitive deficits, we assessed memory, attention, executive function, and processing speed. Having 2 or more tests with age-adjusted scores of at least 1.5 standard deviations below the reference threshold was sufficient to be characterized as cognitively deficient. To screen for physical function deficits, we assessed walking speed (<1.0 m/s cut-off) and grip strength (<26 kg for men; <18 kg for women cut-off). Scoring below the cut-off point on 1 or more tests was sufficient to be characterized as physically deficient. RESULTS: The prevalence of social frailty was the following: nonfrailty, 64.1% (N = 2835); social prefrailty, 24.8% (N = 1097); social frailty, 11.1% (N = 493; P for trend < .001). All cognitive function tests (word list memory, Trail Making Test parts A and B, and the symbol digit-substitution task) significantly varied between social frailty groups; physical function (gait speed and grip strength) also varied between social frailty groups (all Ps for trend <.001). Referred to social nonfrailty, social frailty was independently associated with each cognitive deficit (odds ratio = 1.61, 95% confidence interval 1.13-2.30) and deficits in physical function (odds ratio = 1.99, 95% confidence interval 1.57-2.52) after adjusting for covariates. CONCLUSIONS: This study revealed that social frailty is associated with both cognitive and physical function among Japanese older adults. And social frailty status was also negatively associated with physical function. Further studies are needed to elucidate if a casual association exists between social frailty and cognitive and physical function.
• Subjective Memory Complaints are Associated with Incident Dementia in Cognitively Intact Older People, but Not in Those with Cognitive Impairment: A 24-Month Prospective Cohort Study.
  Kota Tsutsumimoto; Hyuma Makizako; Takehiko Doi; Ryo Hotta; Sho Nakakubo; Keitaro Makino; Hiroyuki Shimada; Takao Suzuki
  The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 25, 6, 607, 616, 2017年06月, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）
• The association between anorexia of aging and physical frailty: Results from the national center for geriatrics and gerontology's study of geriatric syndromes.
  Kota Tsutsumimoto; Takehiko Doi; Hyuma Makizako; Ryo Hotta; Sho Nakakubo; Keitaro Makino; Takao Suzuki; Hiroyuki Shimada
  Maturitas, 97, 32, 37, 2017年03月, ［査読有り］, ［国際誌］
  英語, OBJECTIVES: The present study examined the association between anorexia of aging and physical frailty among older people. STUDY DESIGN: An observational, cross-sectional cohort design was used with a sample of 4417 elderly Japanese citizens living in a community setting. MAIN OUTCOME MEASURES: Frailty was operationalized as the following frailty components: slowness, weakness, exhaustion, low level of physical activity, and weight loss. Participants were grouped as non-frail, pre-frail, and frail, and categorized as anorexic or not using questionnaire cutoff scores. Measured covariates were as follows: sociodemographic variables, medical history, life style, body mass index, blood nutrition data, self-rated health, depressive symptoms, and cognitive function. RESULTS: The prevalence of anorexia of aging in each group was as follows: non-frail, 7.9%; pre-frail, 14.8%; frail, 21.2% (P for trend<0.001). After adjusting for all covariates, independent associations were identified between anorexia of aging and slowness (OR 1.42, 95% CI: 1.14-1.75, P=0.002), exhaustion (OR 1.39, 95% CI: 1.11-1.74, P=0.004) and weight loss (OR 1.37, 95% CI: 1.05-1.79, P=0.019), but not weakness or low level of physical activity. CONCLUSIONS: Anorexia of aging is importantly associated with frailty and the following frailty components: slowness, exhaustion, and weight loss. Future research should prospectively examine frailty's causal connection with anorexia of aging.
• 軽度認知機能低下がサルコペニア有病者の新規要介護発生リスクへ与える影響：24ヵ月間の前向き研究
  今岡 真和; 李 相侖; 牧迫 飛雄馬; 李 成喆; 土井 剛彦; 堤本 広大; 中窪 翔; 牧野 圭太郎; 裵 成琉; 鄭 松伊; 島田 裕之
  理学療法学Supplement, 2016, 1522, 日本理学療法士協会（現 一般社団法人日本理学療法学会連合）, 2017年
  日本語, 【はじめに，目的】
  
  
  
  サルコペニアは加齢に伴う筋量や筋力の低下を特徴とする症候群であり，理学療法の重要な対象となる。一方，軽度認知機能低下は認知症発症のリスクだけでなく身体機能低下のリスクにもなるため，要介護発生のリスクを増加させる要因の一つと考えられる。しかし，サルコペニアと軽度認知機能低下が併存する高齢者の要介護発生リスクは未だ明らかではなく，そのような者では要介護発生リスクがさらに高いことが予想され，予防理学療法のより重要な適応となる可能性が極めて高い。そこで，地域在住高齢者を対象とした2年間の前方視的な調査を行い，サルコペニアおよび軽度認知機能低下と要介護発生状況との関連を調査した。
  
  
  
  
  
  【方法】
  
  
  
  対象は，National Center for Geriatrics and Gerontology-Study of Geriatric Syndromesの70歳以上の健診受診者5257名のうち，パーキンソン病，脳卒中，うつ病の既往歴がある者，要介護認定者，MMSE21点未満の者，測定項目に欠損がある者，ペースメーカー使用者，死亡または市外転居した者を除く3900名とした。
  
  
  
  ベースライン評価は骨格筋量，握力，歩行速度，Mini-Mental State Examination（以下：MMSE），Geriatric Depression Scale（以下：GDS），薬剤投与数，教育年数，アルコール摂取，喫煙，その他基本属性を調査した。サルコペニアはAsian Working Group for Sarcopeniaのアルゴリズムにより判定を行い，認知機能低下はMMSEが26点以下の者とした。ベースライン以降の24か月間における新規要支援・要介護発生の有無を調べた。統計解析は，ベースライン評価によって健常群，サルコペニア群，軽度認知機能低下群，サルコペニアと軽度認知機能低下の併存群の4群に分け，Log-rank検定およびCox比例ハザード回帰分析を行い，有意水準は5%未満とした。
  
  
  
  
  
  【結果】
  
  
  
  調査対象3900名のうち，健常群1788名，サルコペニア群120名，軽度認知機能低下群1853名，併存群139名であり，288名（7.4%）が2年間で要支援・要介護を新規に発生した。各群の新規要支援・要介護発生率は，健常群5.1%，サルコペニア群8.3%，軽度認知機能低下群8.6%，併存群18.7%であり，Log-rank検定の結果，併存群とその他3群に有意差があった（p＜0.05）。Cox比例ハザード回帰分析による健常群に対する要介護発生のハザード比は性，年齢，体重，GDS，喫煙，教育年数の調整モデルにおいて，サルコペニア群1.05（信頼区間：0.54-2.02），軽度認知機能低下群1.47（信頼区間：1.12-1.90），併存群1.97（信頼区間1.25-3.10）であり，軽度認知機能低下群と併存群は有意に新規要介護発生との関連が認められた。
  
  
  
  
  
  【結論】
  
  
  
  健常高齢者と比較して，サルコペニアと軽度認知機能低下を併存する者は約2倍，軽度認知機能低下のみでは約1.5倍の要介護発生リスクであることが示唆された。そのため，サルコペニアの有無に加え，認知機能を評価することは新規要介護リスクを客観的に把握するために有用である。
• 地域高齢者の慢性疼痛の強さ別にみた身体活動特性の違い
  牧野 圭太郎; 牧迫 飛雄馬; 土井 剛彦; 堤本 広大; 堀田 亮; 中窪 翔; 鈴木 隆雄; 島田 裕之
  理学療法学Supplement, 2016, 1604, 日本理学療法士協会（現 一般社団法人日本理学療法学会連合）, 2017年
  日本語, 【はじめに，目的】
  
  
  
  慢性疼痛を有する高齢者は，痛みを回避しようと過剰に身体活動量を制限させることで心身の虚弱化および痛み自体のさらなる悪化が引き起こされる悪循環に陥りやすいと考えられている。したがって，慢性期では痛みの強さに応じて無理のない範囲で身体活動を維持させることが重要と考えられる。本研究では，慢性疼痛を有する高齢者の身体活動に関する基礎的知見を得るため，大規模横断調査から痛みの強さ別に身体活動特性の違いを検討した。
  
  
  
  
  
  【方法】
  
  
  
  National Center for Geriatrics and Gerontology-Study of Geriatric Syndromesの参加者のうち，2013年度の調査に参加し活動量計による身体活動量評価を実施した地域在住高齢者2,366名（75.7±4.1歳）を分析対象とした。なお，要介護認定を受けている者，認知症，脳卒中，パーキンソン病の既往を有する者は除外した。また，急性疼痛を持つ者，腰または膝以外の部位に痛みがある者，医師による運動制限を受けている者についても分析から除外した。
  
  
  
  基本属性として年齢，性別，1日の服薬数，歩行速度，Mini-Mental State Examination（MMSE）を評価した。慢性疼痛は，腰または膝に2ヶ月以上継続した痛みがある場合を慢性疼痛ありとし，痛みの強さ別に3段階で評価した（疼痛なし/軽度の慢性疼痛あり/中等度以上の慢性疼痛あり）。身体活動の指標には，3軸加速度計内臓の活動量計で計測した1日あたりの歩数と強度別の身体活動時間を用いた。
  
  
  
  統計解析として，対象者を疼痛なし群，軽度群，中等度以上群に分類し，3群間で基本属性および各身体活動指標を比較した。
  
  
  
  【結果】
  
  
  
  2,366名のうち，906名（38.3%）が慢性疼痛を有しており，そのうち軽度の慢性疼痛が546名，中等度以上の慢性疼痛が360名であった。慢性疼痛の強さによる一元配置分散分析の結果，MMSEを除く全ての基本属性に有意な主効果が認められた（p＜0.01）。各群における歩数の平均値は，疼痛なし群で5,371歩，軽度群で4,770歩，中等度以上群で4,338歩であった。年齢と性別を共変量とした共分散分析および事後検定の結果，歩数および中強度（3METs）以上の身体活動時間に関しては，軽度群と中等度以上群で疼痛なし群よりも少なく（p＜0.01），軽度群と中等度以上群の間に有意差はみられなかった。低強度（1.5～2.9METs）の身体活動時間に関しては，中等度以上群は疼痛なし群よりも少なかった（p＜0.05）のに対し，軽度群は他の群との間に有意差はみられなかった。
  
  
  
  
  
  【結論】
  
  
  
  慢性疼痛を有する高齢者において，身体活動量は慢性疼痛の強さと関連することが示唆され，慢性疼痛が軽度の者は低強度の活動に関しては疼痛のない者と同程度の活動量が維持されていた。慢性疼痛の強さによって異なる強度の身体活動が制限されることを示した本研究結果は，慢性疼痛を有する高齢者の身体活動の維持促進を目的とした理学療法介入にとって有用な知見を提供するものと考える。
• 地域在住高齢者における歩行比からみた歩行パターンと転倒の関連性
  中窪 翔; 牧迫 飛雄馬; 土井 剛彦; 堤本 広大; 堀田 亮; 牧野 圭太郎; 鈴木 隆雄; 島田 裕之
  理学療法学Supplement, 2016, 1484, 日本理学療法士協会（現 一般社団法人日本理学療法学会連合）, 2017年
  日本語, 【はじめに，目的】高齢期における歩行速度の低下は重要な転倒リスクのひとつである。歩行速度は歩幅と歩行率（ケイデンス）から決定され，この両因子から求める歩行比（歩幅/ケイデンス）は歩行速度を維持するための戦略を表す個人の歩行パターンと捉えられる。しかし，歩行比と転倒の関連性については十分に検討されていない。本研究の目的は，地域在住高齢者を対象に歩行比と転倒の関連性を横断的に検討することである。
  
  
  
  
  
  【方法】National Center for Geriatrics and Gerontology-Study of Geriatric Syndromesに参加した65歳以上の地域在住高齢者10,885名のうち，アルツハイマー病，パーキンソン病，脳卒中の現病および既往のある者，MMSEが18点未満の者，欠損値がある者を除外した9,205名（女性4,987名，平均年齢73.7±5.6歳）を解析対象とした。ANIMA社製ウォークWay MV-1000を用いて通常歩行速度にて歩行評価を実施し，歩行速度，歩幅，ケイデンスを評価指標とした。歩行比は歩幅をケイデンスで除して算出し（m/（step/min）），3分位の値を基に対象者を3群（T1，T2：参照，T3）に群分けした。なお，各歩行指標は，関谷ら（1996年）の報告に準じて身長を用いて補正した。転倒経験は，過去1年間の転倒経験の有無を聴取した。共変量として，基本属性，病歴，服薬数，転倒恐怖感の有無，平均歩行時間（分/日）を聴取し，Body Mass Index，うつ症状（Geriatric Depression Scale），MMSEを評価した。統計解析は，転倒の有無を従属変数，歩行速度低下（1.0m/秒未満）の有無および歩行比を独立変数とした多重ロジスティック回帰分析を実施した。さらに，歩行速度の低下の有無による関係性の違いを検討するために歩行速度1.0m/秒以上および未満で層分けして同様の分析を実施した。有意水準は5%未満とした。
  
  
  
  
  
  【結果】全対象者における過去1年間の転倒経験率は17.6％であった。転倒経験に対して，歩行速度低下の有無と歩行比を同時投入した結果，歩行速度低下および歩行比の値が小さいT1群において有意な関係性を示した（歩行速度 OR：1.40，95%CI：1.21-1.62，歩行比 OR：1.18，95%CI：1.03-1.35）。さらに，1.0m/秒未満の群（1,496名）での解析では歩行比は転倒と有意な関連性を認めなかったが，1.0m/秒以上の群（7,709名）ではT1群において転倒と有意な関連性を認めた（OR：1.29，95%CI：1.11-1.50）。
  
  
  
  【結論】本研究より，歩行速度が低下している群では歩行比と過去1年の転倒経験との間に有意な関連性はみられなかったが，歩行速度を維持できている群においては，歩行比が小さいことが転倒経験と関連していることが示唆された。歩行比が小さいことは，歩幅の減少，あるいはケイデンスの増加を反映しており，歩行速度の維持のためにケイデンスを増加させる戦略を選択していると考えられる。今後は，このような歩行戦略の違いが将来の転倒発生と関連するかについて，縦断的な検討する必要である。
• 軽度認知機能障害と歩行速度低下により認知症の発症リスクは増加するか？
  土井 剛彦; 牧迫 飛雄馬; 堤本 広大; 中窪 翔; 牧野 圭太郎; 堀田 亮; 鈴木 隆雄; 島田 裕之
  理学療法学Supplement, 2016, 1520, 日本理学療法士協会（現 一般社団法人日本理学療法学会連合）, 2017年
  日本語, 【はじめに，目的】
  
  
  
  歩行能力低下は軽度認知障害（mild cognitive impairment：MCI）や認知症を有する高齢者の問題点の一つとして認識されている。MCIは，認知症を発症するリスクが高い一方で，健常への改善も認められるため，認知症予防ひいては介護予防の対象として着目すべきであると考えられている。しかし，MCI高齢者において歩行速度低下を伴う場合に，認知症の発症リスクが増加するかについては未だ明らかにされていない。本研究は，縦断研究を実施し，歩行速度低下が認知症のリスクにどのような影響を与えるかをMCIに着目して検討することを目的とした。
  
  
  
  【方法】
  
  
  
  本研究は，National Center for Geriatrics and Gerontology-Study of Geriatric Syndromesの参加者の中から，2011年度に実施した調査に参加した65歳以上の者とし，ベースラインにおいて認知症，パーキンソン病，脳卒中の病歴がある者，MMSEが24点未満の者，診療情報が得られない者を除外した3749名を対象とした。ベースラインにて測定した歩行速度，認知機能，一般特性，服薬数，Geriatric Depression Scale，身体活動習慣に加え，医療診療情報から得られる追跡期間中の認知症の発症をアウトカムとした。歩行が1.0m/s未満の場合を歩行速度低下とし，認知症ではなく日常生活が自立し全般的認知機能は保たれているが，NCGG-FATによる認知機能評価で客観的な認知機能低下を認めた者をMCIとした。
  
  
  
  【結果】
  
  
  
  対象者3749名（平均年齢72歳，女性53％）を，歩行速度低下とMCIのいずれにも該当しない群（control群：n＝2608），歩行速度低下のみを有する群（SG群：n=358），MCIのみを有する群（MCI群：n=628），歩行速度低下とMCIの両方を有する群（MCI+SG群：n=155）に群分けした。追跡期間中（平均追跡期間：42.7ヶ月）に認知症を発症した者は168名であった。目的変数に認知症の発症，説明変数に歩行速度とMCIによる群要因を設定し，その他の測定項目を共変量として調整した生存分析を実施した結果，control群に比べ，SG群（HR：1.12，95%CI：0.67-1.87）は認知症の発症との有意な関係は認めなかったが，MCI群（HR：2.05，95%CI：1.39-3.01）ならびにMCI+SG群（HR：3.49，95%CI：2.17-5.63）は認知症の発症と有意な関係性を有していた。
  
  
  
  【結論】
  
  
  
  MCI高齢者における歩行能力低下は認知症のリスクを増加させることが明らかになった。高齢者が認知機能障害を有する場合には，認知機能だけではなく歩行能力を評価し，適切なリスク評価を考慮して介入を行う必要があると考えられる。
• 身体的フレイル高齢者の認知機能低下は，転倒後の骨折発生と強い関連を有する
  堤本 広大; 土井 剛彦; 牧迫 飛雄馬; 堀田 亮; 中窪 翔; 牧野 圭太郎; 島田 裕之
  理学療法学Supplement, 2016, 1494, 日本理学療法士協会（現 一般社団法人日本理学療法学会連合）, 2017年
  日本語, 【はじめに，目的】身体的フレイルとは包括的に機能が低下した脆弱化した状態を指し，健常高齢者と要介護高齢者の中間的存在とされている。要介護の主要因の一つである転倒は，要介護リスクが高いフレイル高齢者において，特に予防すべき事象である。近年，認知機能の低下が，転倒リスクを高めることが明らかとなってきている。フレイル高齢者の転倒予防を考えていく上で，認知機能低下が転倒とどのように関連しているのか検討することが必要だが，十分に明らかにされていない。そこで，本研究の目的は身体的フレイル高齢者における認知機能低下と転倒との関連性を検討することとする。
  
  
  
  
  
  【方法】地域高齢者10885名のうち，パーキンソン病・認知症既往者，MMSEが21点未満の者，基本的ADLに障害のある者を除く9990名（平均73.5歳）を対象とした。歩行速度低下，筋力低下，体重減少，易疲労感，身体活動量低下の5項目の内，3項目以上が該当したものを身体的フレイルと判定した。認知機能に関しては，記憶・注意機能・遂行機能・処理速度の評価を行い，年齢・教育歴で標準化したデータにもとづき1.5SD以上の機能低下を1領域でも認めた者は認知機能低下ありと定義した。その上で，健常群，認知機能低下群，フレイル群，フレイル+認知機能低下群の4群に分けた。転倒については，過去1年間の転倒経験の有無を聴取し，転倒に伴う骨折の有無も合わせて聴取した。統計解析は，従属変数に転倒経験の有無，独立変数に群要因（健常群を参照値）と共変量を投入した多変量ロジスティック回帰分析を実施した。
  
  
  
  
  
  【結果】転倒経験のある者は，健常群15.7%，認定機能低下群18.6%，フレイル群28.4%，フレイル+認知機能低下群31.6％であった。転倒経験の有無を従属変数としたロジスティック回帰分析において，健常群を参照としたオッズ比は，認知機能低下群で1.17（95%CI 1.03－1.34），フレイル群で1.48（95%CI 1.19－1.83），フレイル+認知機能低下群で1.77（95%CI 1.39－2.27）であった。転倒経験を有する者を抽出し，転倒後の骨折経験の有無を従属変数としたロジスティック回帰分析において，健常群を参照値としたオッズ比は，フレイル+認知機能群にのみ有意な関連が認められた（2.56（95%CI 1.36－4.85））。
  
  
  
  
  
  【結論】転倒に伴う骨折については，身体的フレイルと認定機能低下を併せ持つ高齢者のみ関連性みられた。横断研究のため，因果関係は言及できないが身体的フレイルに認知機能低下が合わさることにより，転倒回避行動の遅延などが生じ，転倒後に生じる骨折との関連が強くなるのではないかと考えられる。一方で，転倒後に骨折した身体的フレイル高齢者の認知機能が低下しているということも考えられるため，今後は前方視的な研究の中で関係性を検討する必要がある。
• 認知的フレイルが認知症発症に及ぼす影響
  島田 裕之; 牧迫 飛雄馬; 土井 剛彦; 堤本 広大; 中窪 翔; 牧野 圭太郎
  理学療法学Supplement, 2016, 1297, 日本理学療法士協会（現 一般社団法人日本理学療法学会連合）, 2017年
  日本語, 【はじめに，目的】認知的フレイルは，身体的フレイルと認知障害を合併した状態として定義され，概念的枠組みが整理されつつある。ただし，その概念を操作的に測定可能な変数に定義して，認知的フレイルが認知症発症に対する影響を調べた研究はない。そこで本研究では，高齢者を対象として，身体的フレイル，認知障害，そしてそれらを合併した認知的フレイルの状況を調べ，認知症発症を追跡調査することで，認知的フレイルと認知症発症との関係を明らかにすることを目的とした。
  
  
  
  
  
  【方法】対象者は愛知県大府市に在住する65歳以上の高齢者4,072名であった。身体的フレイルは，歩行速度低下，筋力低下，疲労感，身体活動低下，体重減少の5つの項目のうち3つ以上の異常とした。認知障害は，National Center for Geriatrics and Gerontology-Functional Assessment Toolの記憶，注意，実行機能，処理速度検査を用いて，5歳年齢階級の平均値から1.5標準偏差以上の認知機能の低下が2つ以上ある状態を認知障害ありとした。認知症の発症情報は，診療情報明細書情報から取得し，24か月間の追跡調査を実施した。統計解析は，混乱要因を調整したCox比例ハザードモデルを用いて，健常，身体的フレイル，認知障害，認知的フレイルの各群における認知症発症を比較した。
  
  
  
  
  
  【結果】身体的フレイル，認知障害，認知的フレイルの有症率は，それぞれ5.1%，5.5%，1.1%であった。追跡期間中，認知症を発症した者は81名（2.0%）であった。健常，身体的フレイル，認知障害，認知的フレイルの各群における認知症発症率は，それぞれ1.3%，5.8%，6.3%，18.6%となり，認知的フレイルにおける発症率が高かった。Cox比例ハザードモデルによる分析の結果，健常な高齢者に対するハザード比は，身体的フレイル1.95（95%信頼区間：0.97-3.91），認知障害3.85（95%信頼区間：2.09-7.10），認知的フレイル6.19（95%信頼区間：2.73-13.99）となり，認知的フレイルにおいて高い認知症発症の危険性が認められた。
  
  
  
  
  
  【結論】身体と認知的問題を合併した高齢者は，認知症になる危険性が高いことが明らかとなった。今後は，これらの高齢者に有効な認知症予防の介入方法を検証していく必要がある。
• 地域在住日本人高齢者に適したShort Physical Performance Batteryの算出方法の修正
  牧迫飛雄馬; 島田裕之; 土井剛彦; 堤本広大; 堀田亮; 中窪翔; 牧野圭太郎; 鈴木隆雄
  理学療法学, 44, 3, 197, 206, 2017年, ［査読有り］
• Comorbid Mild Cognitive Impairment and Depressive Symptoms Predict Future Dementia in Community Older Adults: A 24-Month Follow-Up Longitudinal Study.
  Hyuma Makizako; Hiroyuki Shimada; Takehiko Doi; Kota Tsutsumimoto; Ryo Hotta; Sho Nakakubo; Keitaro Makino; Takao Suzuki
  Journal of Alzheimer's disease : JAD, 54, 4, 1473, 1482, 2016年10月18日, ［査読有り］, ［国際誌］
  英語, BACKGROUND: Older adults with mild cognitive impairment (MCI) are non-demented, but demonstrate cognitive dysfunction, and have significantly higher risk of progressing to dementia. A better understanding of more sensitive risk factors, such as combination of cognitive and psychological status, for progression of MCI to dementia may be crucial for prevention of development of dementia. OBJECTIVE: To examine MCI, depressive symptoms, and comorbid MCI and depressive symptoms as risk factors for development of dementia. METHODS: A total of 3,663 community-dwelling older people were included in this prospective longitudinal study. MCI was determined by age- and education-adjusted objective cognitive impairment using computerized comprehensive cognitive measures including memory, attention/executive function, and processing speed. Depressive symptoms were measured using the 15-item Geriatric Depression Scale (GDS) and defined by a GDS score of 6 or more. RESULTS: During the 24-month follow-up period, 72 participants (2.0%) developed dementia. Baseline MCI was significantly associated with an increased risk of incident dementia (hazard ratio [HR], 3.2; 95% confidence interval [CI], 1.8-5.5) but depressive symptoms were not (2.0; 1.0-4.2) after adjusting for age, sex, education, prescribed medications, and walking speed. Participants with comorbid MCI and depressive symptoms at baseline had a higher risk of developing dementia (HR, 4.8; 2.3-10.5). CONCLUSION: Although MCI and depressive symptoms may be associated with increased risk for incident dementia independently, comorbid MCI and depressive symptoms have a significantly greater impact on dementia development among community-dwelling older adults.
• 地域在住高齢者における睡眠時間と身体的フレイルの関連性
  中窪 翔; 島田 裕之; 牧迫 飛雄馬; 土井 剛彦; 堤本 広大; 堀田 亮; 牧野 圭太郎; 鈴木 隆雄
  理学療法学Supplement, 2015, 1550, 日本理学療法士協会（現 一般社団法人日本理学療法学会連合）, 2016年
  日本語, 【はじめに，目的】高齢期においては，睡眠時間が短いことも長いことも認知機能や身体機能などの心身機能低下に対して悪影響を及ぼすことが報告されている。また，近年では高齢期での夜間覚醒や睡眠効率の低下などの睡眠障害と身体的なフレイルの発症との関連が報告されている。睡眠時間の観点からの報告もなされているものの，睡眠時間が短いことへの検討に留まり，睡眠時間が長いことによる影響も含めた検討がなされていない。本研究の目的は，睡眠時間の長さが身体的フレイルの各要素および判定に関連しているのかどうかを横断的に検討することである。【方法】National Center for Geriatrics and Gerontology-Study of Geriatric Syndromesに参加した65歳以上の地域在住高齢者10,885名のうち，アルツハイマー病，パーキンソン病の既往のある者，及びMini-Mental State Examinationが18点未満の者，欠損値がある者を除外した10,297名（女性5,323名，男性4,974名，平均年齢73.7±5.5歳）を対象とした。就寝時間と起床時間から睡眠時間を算出し，short（6時間以下），mid（6～9時間），long（9時間以上）の3群に群分けした。また，Friedらの基準に従い，体重減少（6か月間での2～3kgの減少），活力低下，握力低下（女性18kg未満，男性26kg未満），歩行速度の低下（1.0m/s未満），活動度の低下を判定の要素とし，1～2個該当する者をpre frailty，3個以上該当する者をfrailtyと判定した。共変量として，基本属性，病歴に加えて，うつ症状，服薬数，喫煙・飲酒習慣を聴取した。統計解析は，physical frailtyの各要素および判定を従属変数とした多重ロジスティック回帰分析を実施した。有意水準は5%未満とした。【結果】睡眠時間による身体的フレイルの有症率は，pre frailtyがshort：55.5%，mid：49.9%，long：53.7%，frailtyがshort：10.8%，mid：7.9%，long：18.8%であり，睡眠時間が長い群で高い身体的フレイルの有症率であった。多重ロジスティック回帰分析の結果，midに比べてshort，longともにpre frailty（short：OR=1.34，long：OR=1.51），frailty（short：OR=1.58，long：OR=2.82）に対するオッズ比が有意に高かった。身体的なフレイルの各要素については，midに比べてshortは体重減少（OR=1.41），活力低下（OR=1.43），歩行速度低下（OR=1.28）において，longは体重減少（OR=1.25），活力低下（OR=1.25），活動低下（OR=1.68），握力低下（OR=1.71），歩行速度低下（OR=1.65）と全要素に対するオッズが有意に高かった。【結論】本研究より，睡眠時間が短い（6時間以下）ことおよび長い（9時間以上）ことが身体的フレイルの判定と関連しており，長時間睡眠がより高齢期におけるfrailtyとの関連が強かった。介護予防の観点において重要視されているフレイルと睡眠時間の関連性を示した本研究結果は，睡眠状況の把握，改善がフレイル発症の予防につながる可能性を示したと考える。
• 地域在住高齢者における下肢機能評価と要介護の新規発生—Five-Times-Sit-to-Stand TestとTimed Up ＆ Go Testのカットオフ値
  牧迫 飛雄馬; 島田 裕之; 土井 剛彦; 堤本 広大; 中窪 翔; 堀田 亮; 牧野 圭太郎; 鈴木 隆雄
  理学療法学Supplement, 2015, 1543, 日本理学療法士協会（現 一般社団法人日本理学療法学会連合）, 2016年
  日本語, 【はじめに，目的】椅子の立ち座り動作で測定するFive-Times-Sit-to-Stand Test（FTSS）および3m歩行路によるTimed Up ＆ Go Test（TUG）は簡便に実施でき，理学療法に関わる評価として汎用性が高い。これらは下肢機能の評価指標とされ，転倒リスクの抽出に有用とされている。しかし，将来の要介護発生リスクを抽出するためのカットオフ値は示されていない。本研究ではFTSSとTUGによって地域高齢者の要介護発生リスクを捉えることができるか，要介護リスクを抽出する適切なカットオフ値があるかを検証した。地域高齢者に対するFTSSとTUGの有用性を提示することが意義となる。【方法】健診に参加した地域高齢者5104名のうち，パーキンソン病・脳卒中の既往者，既に要介護認定がある者，MMSE18点未満者，測定不可者，追跡中の死亡・市外転出者を除く4335名を対象とした。ベースラインでFTSSとTUGを測定した。FTSSは座面高45cmの椅子から5回連続の立ち座り動作の所要時間を計測した。TUGでは，椅子から立ち上がり，3m前方の目印まで通常速度で歩き方向転換し，再び椅子に座るまでの時間を測定した。ベースライン以降，1か月ごとの要介護認定情報を行政の介護保険担当課で照合し，2年間追跡した。追跡中での新規要介護発生者と未発生者でベースライン測定値を比較した。要介護発生に対するFTSSとTUGのカットオフ値を求め，Log-rank検定およびCox比例ハザード回帰分析を用いて要介護発生との関連を調べた。危険率5％未満を有意とした。【結果】2年間で161名（3.7%）が新規に要介護を発生した。全対象者でのベースラインのFTSSは8.5±2.6秒，TUGは8.2±1.6秒であり，要介護発生者ではいずれも未発生者より有意に遅かった（p＜.01）。要介護発生に対するカットオフ値はFTSSで10秒以上（感度49%，特異度78%），TUGで9秒以上（感度60%，特異度74%）であった。要介護発生率は，FTSS（≧10秒）・TUG（≧9秒）ともにカットオフ値よりも遅い群で最も高く（11.8%），FTSS・TUGともにカットオフ値より速い群（1.7%），FTSSのみ遅い群（4.3%），TUGのみ遅い群（5.8%）のいずれの群よりも有意に高い発生率であった（p＜.01）。要介護発生に対するハザード比は，FTSS・TUGとも良好な群に比べて，FTSSのみ遅い群で1.9（95%信頼区間1.1-3.2），TUGのみ遅い群で2.2（1.4-3.5），FTSS・TUGともに遅い群で2. 8（1.8-4.3）であった（年齢，性，各疾患，服薬数，認知機能低下，うつ徴候で調整）。【結論】FTSSとTUGでの下肢機能評価は，将来の要介護発生リスクを見出すための重要な指標となることが確認された。FTSSが10秒以上，TUGが9秒以上では要介護発生リスクが増大し，FTSSおよびTUGともこの基準よりも遅い場合，要介護発生リスクが約3倍となることが示唆された。本研究で将来の要介護発生リスクを抽出する具体的な測定値の候補が確認できたことは，一次予防推進を図る予防理学療法の発展に有益と考える。
• 軽度認知障害を有する高齢者における歩行と白質病変の関係
  土井 剛彦; 島田 裕之; 牧迫 飛雄馬; 堤本 広大; 中窪 翔; 牧野 圭太郎; 鈴木 隆雄
  理学療法学Supplement, 2015, 0969, 日本理学療法士協会（現 一般社団法人日本理学療法学会連合）, 2016年
  日本語, 【はじめに，目的】認知機能と歩行能力は密接に関連しており，軽度認知障害（mild cognitive impairment：MCI）や認知症を有する高齢者に歩行能力の低下が特徴としてみられる。さらに，白質病変などにみられる加齢に伴う脳構造変化が歩行能力と関連することが近年報告されている。しかし，MCI高齢者における歩行能力と白質病変との関連性については明らかにされていない。本研究では，MCI高齢者の歩行能力低下を顕著にする同時課題（dual-task：DT）歩行を測定し，白質病変との関連性を検討した。【方法】本研究はNational Center for Geriatrics and Gerontology-Study of Geriatric Syndromesの参加者の中からMCIと判明した高齢者に対しリクルートを行い，対象者は歩行測定ならびにmagnetic resonance imaging検査を実施した560名とした。歩行条件は通常歩行とDT歩行の2条件で，高齢者の歩行能力として重要とされている体幹安定性を評価するharmonic ratio（HR）を歩行指標として用いた。HRは3軸加速度計により歩行時の体幹加速度を測定した後に3方向各々算出し（前後，垂直，側方方向），値が大きいほど安定性が高い事を意味する。白質病変の評価は，Fazekas scaleを用いて脳室周囲病変ならびに深部皮質下白質病変を評価した。いずれの評価においてグレードIIIと評価された者はsevere white matter lesion（WML）群とした。共変量として生物・医学的特性に加え，遂行機能を評価するSymbol Digit Substitution Task（SDST）を評価した。【結果】対象者を白質病変の程度に基づきnon-severe WML（n=451，平均年齢：73.2歳）とsevere WML（n=109，平均年齢：75.9歳）の各群に群わけした。3方向のHRが通常歩行に比べDT歩行時に有意に低下した（p＜0.05）。DTによる歩行変化は白質病変と関連性がみられ（p＜0.05），共変量（年齢，性別，教育歴，服薬数，高血圧，MCIのsubtype，脳萎縮，歩行速度，SDST）にて調整した混合分析においても側方方向のHRと白質病変の関連性が有意であった（p＜0.05）。【結論】MCI高齢者における歩行能力低下の関連要因として白質病変が関連することが示唆された。認知機能障害を伴う高齢者における歩行能力低下に対して，脳画像を用いた評価を考慮することが重要であると考えられる。
• 軽度認知障害を有する高齢者における灰白質容量と遂行機能は関連するのか？
  堤本 広大; 牧迫 飛雄馬; 土井 剛彦; 中窪 翔; 牧野 圭太郎; 島田 裕之; 鈴木 隆雄
  理学療法学Supplement, 2015, 1499, 日本理学療法士協会（現 一般社団法人日本理学療法学会連合）, 2016年
  日本語, 【はじめに，目的】認知症の前駆症状とされる軽度認知障害（mild cognitive impairment；MCI）では，客観的な認知機能が低下していることが定義とされ，灰白質容量が低下していることが報告されている。認知機能検査の中でも，遂行機能と灰白質容量との関係は多数報告されており，遂行機能が低下している高齢者ほど灰白質容量が低下していることが明らかとなってきている。しかし，MCI高齢者における遂行機能と灰白質容量との関連については議論の余地があり，遂行機能については下位機能が存在するため，灰白質容量低下に関連する下位機能を明らかにすることで，MCI高齢者の早期発見の一助となると考えられる。そこで，本研究では，MCI高齢者における灰白質容量と遂行機能の下位機能検査との関連を横断的に検討する。【方法】対象は，MCIに該当した高齢者83名（平均75.4±6.8歳）とした。遂行機能の下位機能検査として，注意の切り替え機能（Trail Making Test（TMT）），ワーキングメモリ（Digit Span（DS）），および選択的注意・抑制機能（Stroop test（ST））を実施した。灰白質容量の計測については，MRI装置（Magnetom Avanto，Siemens社製）を用いて撮像を行い，FSL（FMRIB's Software Library，Version 5.0）を用いて全脳における灰白質容量を算出した。統計解析では，灰白質容量と各遂行機能との相関関係を調べるためにPearsonの相関係数を算出した。その後，有意な相関関係が認められた遂行機能検査を独立変数とし，従属変数に灰白質容量，共変量に年齢，性別，body mass index，教育歴，mini-mental status examinationスコアを投入した重回帰分析を実施した。なお，統計学的有意水準は5%未満とした。【結果】遂行機能の中で，灰白質容量との有意な相関関係が認められたのはTMTのみで，TMTと灰白質容量との間には負の相関関係が認められた（r=-0.414，p＜0.001）。その後，有意な相関が認められたTMTを独立変数とした重回帰分析を実施した結果，共変量で調整してもTMTと灰白質容量との関連性は有意であった（β=-0.376，p=0.001，R²=0.26）。【結論】本研究では，MCI高齢者における灰白質容量と遂行機能の下位機能検査との関連について検討し，注意の切り替え機能が低下しているMCI高齢者ほど灰白質容量が低下していることが示唆された。今後は，注意の切り替え機能が低下している健常高齢者がより早期にMCIへと移行するかどうかを検討する必要性があると考えらえる。また，本研究結果は，MCIのスクリーニングツールの中でもTMTが有用である可能性を示した。
• 認知機能低下と関係する歩行パラメーター
  島田 裕之; 牧迫 飛雄馬; 土井 剛彦; 堤本 広大; 中窪 翔; 牧野 圭太郎
  理学療法学Supplement, 2015, 1498, 日本理学療法士協会（現 一般社団法人日本理学療法学会連合）, 2016年
  日本語, 【はじめに，目的】認知機能の低下抑制に対して運動の効果が示されるようになり，理学療法領域においても，認知機能低下抑制に対するアプローチが進みつつある。今後，団塊世代が認知症の好発年齢を迎え，認知症予防に対する積極的な取り組みが望まれるが，そのためには認知機能低下の関連因子を同定して，運動療法によって改善可能な要因を検討していく必要がある。本研究では，認知機能低下をmini-mental state examination（MMSE）の得点が23点以下の高齢者を認知機能低下とし，それに関連する歩行パラメーターを大規模集団の横断データによって検討した。【方法】愛知県における高齢者機能健診に参加した地域在住高齢者10885名のうち，パーキンソン病，脳卒中，認知症の既往者，最近3か月以内に入院した者，測定項目に欠損があった者を除く9795名を対象とした。測定項目は，基本属性（年齢，性，教育歴），現病歴（高血圧，心疾患，呼吸器疾患，変形性膝関節症，糖尿病の有無），歩行パラメーター（歩行速度，ケーデンス，ストライド長，歩行速度の変動係数，ケーデンスの変動係数，ストライド長の変動係数），およびMMSEであった。歩行速度の測定は，Walkウェイを用いて通常歩行にて5回計測し，平均値を用いた。統計処理はMMSE（24/23点）を従属変数とし，その他の測定項目を独立変数とした多重ロジスティック回帰分析を実施した。【結果】MMSEの得点が23点以下の全般的認知機能低下に対して有意であった項目のオッズ比は，年齢（オッズ比1.05，95%信頼区間1.03―1.06），性（女性に対して男性のオッズ比2.14，95%信頼区間1.88―2.44），教育歴（オッズ比0.84，95%信頼区間0.82―0.86），変形性膝関節症（なしに対してありのオッズ比0.80，95%信頼区間0.69―0.93），歩行速度の変動係数（オッズ比1.06，95%信頼区間1.02―1.10）であった。有意であった項目を独立変数として，歩行速度の変動係数を四分位に分類して多重ロジスティック回帰分析を実施した結果，Q1に対してQ4のみが有意なオッズ比を示し，その値は1.46（95%信頼区間1.25―1.71）であった。なお，歩行速度の変動係数の75パーセンタイル値は5.95%であった。【結論】全般的認知機能の低下と関連した歩行パラメーターは，歩行速度の変動係数であった。今回の測定方法は，短距離の歩行路を5回に分けて測定する方法を採用しており，連続歩行内での歩行速度の変動を示すものではない。そのため，今回の歩行速度の変動は，前の課題遂行状態をイメージして同様のパフォーマンスを再現できるかといった課題となっている。身体機能の代表的な指標である歩行速度が関連せずに，変動係数が関連したのは，このイメージの再現の過程における脳機能の低下が，全般的認知機能低下と関連したのかもしれない。今後は前方視的な解析によって，歩行速度の変動係数が認知機能低下の予測因子になり得るかを検討していく必要がある。
• Age-related differences in postural control and attentional cost during tasks performed in a one-legged standing posture
  Hikaru Ihira; Hyuma Makizako; Atsushi Mizumoto; Keitarou Makino; Kiyoji Matsuyama; Taketo Furuna
  Journal of Geriatric Physical Therapy, 39, 4, 159, 164, Lippincott Williams and Wilkins, 2016年, ［査読有り］
  英語, 研究論文（学術雑誌）
• Associations between the settings of exercise habits and health-related outcomes in community-dwelling older adults.
  Keitaro Makino; Hikaru Ihira; Atsushi Mizumoto; Kotaro Shimizu; Toyoaki Ishida; Taketo Furuna
  Journal of Physical Therapy Science, 27, 7, 2207, 11, 2015年07月, ［査読有り］, ［筆頭著者, 責任著者］, ［国内誌］
  英語, 研究論文（学術雑誌）, [Purpose] The purpose of this study was to examine the associations between the settings of exercise habits and health-related outcomes in community-dwelling older adults. [Subjects] A total of 304 Japanese community-dwelling older adults (70.3 ± 4.1 years; 113 males and 191 females) participated in this study. [Methods] Demographic characteristics, medical conditions, exercise habits, and health-related outcomes were assessed by face-to-face interviews and self-reported questionnaires. Older adults who had exercise habits were classified into two groups: individual- and group-based exercise habits groups, and the health-related outcomes were compared between groups. [Results] The scores for the Geriatric Depression Scale, exercise self-efficacy, and dietary variety of older adults who had group-based exercise habits were better than those of older adults who had individual-based exercise habits. In addition, the exercise settings (individual- and group-based) were significantly associated with scores for the Geriatric Depression Scale (odds ratio = 0.76) and exercise self-efficacy (odds ratio = 1.26), even after adjusting for age and gender. [Conclusion] These results implied that habitual exercise in group settings may have an effective role in promoting exercise self-efficacy and mental health.
• Physical activity changes in the winter in older persons living in northern Japan: a prospective study.
  Atsushi Mizumoto; Hikaru Ihira; Keitaro Makino; Shigeyuki Saitoh; Hirofumi Ohnishi; Taketo Furuna
  BMC geriatrics, 15, 43, 43, 2015年04月10日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, BACKGROUND: Physical activity affects physical and mental health, prevents disease, and improves quality of life. However, physical activity also decreases with age in older persons, and is affected by adverse climatic periods. This study examined changes in physical activity during the winter season in older persons (≥75 years of age) who were living in northern Japan, and evaluated the factors that were associated with this decline. METHODS: A total of 201 older persons (83 men and 118 women; mean age, 79.7 ± 3.8 years) participated in two separate tests that were conducted in November 2012 and February 2013. Physical activity was monitored using the Kenz Lifecorder, and mean step counts and moderate-vigorous physical activity (MVPA) times were calculated over a 1-week period. We also measured body mass index, handgrip strength, normal walking speed, functional capacity, exercise habits, snow-shovelling habits, a change in frequency (between early winter and midwinter) of outdoor excursions, the length of outdoor excursions, social support, and morbidity. RESULTS: In the group that maintained their frequency of outdoor excursions, step counts significantly increased during midwinter compared with early winter (p < 0.01). In the group with a lower frequency of outdoor excursions, MVPA was significantly decreased during midwinter compared with early winter (p < 0.05). After adjusting for other variables, logistic regression analysis showed that weakness (odds ratio [OR]: 2.89, p < 0.05) was independently associated with a decline in step counts. Age (OR: 1.12, p < 0.05) and a change in frequency of outdoor excursions (OR: 0.75, p < 0.01) were independently associated with a decline in MVPA. CONCLUSIONS: Older persons should be supported in their attempts to go outdoors during midwinter. They should be provided with intervention programs to increase their physical activity at home.
• Association of muscle coactivation during isometric and isokinetic knee extension with muscle strength and physical performance
  Keitaro Makino; Hikaru Ihira; Atsushi Mizumoto; Taketo Furuna
  Rigakuryoho Kagaku, 29, 6, 949, 953, Society of Physical Therapy Science (Rigaku Ryoho Kagakugakkai), 2015年01月21日, ［査読有り］
  英語, 研究論文（学術雑誌）
• Subjective physical and cognitive age among community-dwelling older people aged 75 years and older: differences with chronological age and its associated factors.
  Hikaru Ihira; Taketo Furuna; Atsushi Mizumoto; Keitaro Makino; Shigeyuki Saitoh; Hirofumi Ohnishi; Hiroyuki Shimada; Hyuma Makizako
  Aging & mental health, 19, 8, 756, 61, 2015年, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, OBJECTIVE: The aim of this cross-sectional study was to determine the associations between self-reported subjective physical and cognitive age, and actual physical and cognitive functions among community-dwelling older people aged 75 years and older. METHOD: The sample comprised 275 older adults aged 75-91 years. Two questions were asked regarding subjective age: 'How old do you feel physically?' and 'How old do you feel cognitively?' To assess physical functions, we measured handgrip strength, knee extension strength, standing balance and walking speed. Tests of attention, executive function, processing speed and memory were performed to assess actual cognitive function. RESULTS: Subjective physical and cognitive age was associated with performance on all of the physical and cognitive tests, respectively (p < 0.01). We also found that older adults who reported themselves as feeling older than their chronological age had a slower walking speed and lower scores for word-list memory recall than those who did not report themselves as feeling older than their actual age. CONCLUSION: These findings suggest that promoting a fast walking speed and good memory function may help to maintain a younger subjective physical and cognitive age in older adults aged 75 years and older.
• Physical Activity during Winter in Old-Old Women Associated with Physical Performance after One Year: A Prospective Study.
  Atsushi Mizumoto; Hikaru Ihira; Keitaro Makino; Shigeyuki Saitoh; Hirofumi Ohnishi; Taketo Furuna
  Current gerontology and geriatrics research, 2015, 253451, 253451, 2015年, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, Background. The aim of this study was to evaluate whether the decline of physical activity during winter influences physical performances (after 1 year) in old-old women. Methods. Fifty-three Japanese women (mean age: 78.4 ± 3.2 years) participated in this study. Data of physical activity was collected by using an accelerometer at baseline and 3-month follow-up, and participants who decreased step counts in this period were defined as declining groups. We measured grip strength, knee extensor strength, total length of the center of gravity, hip walking distance, and maximum walking speed to evaluate physical performances at baseline and 1-year follow-up. Repeated-measures analysis of variance determined the difference in physical performance between declining groups and maintenance group with maintained or improved step counts. Results. Daily step counts for 22 older women (41.5%) decreased during winter. A statistically significant interaction effect between group and time was found for maximum walking speed (F(1,50) = 5.23, p = 0.03). Post hoc comparisons revealed that walking speed in the maintenance group significantly increased compared with baseline (p = 0.01); the declining group showed no significant change (p = 0.44). Conclusion. Change of physical activity during winter influences the physical performance level after 1 year in community-dwelling old-old women, particularly its effect on maximum walking speed.
• 等尺性運動と等速性運動における筋の同時活動と発揮筋力および運動パフォーマンスとの関連性
  牧野 圭太郎; 井平 光; 水本 淳; 古名 丈人
  理学療法科学, 29, 6, 949, 953, 2014年07月, ［査読有り］, ［筆頭著者］
• Association between hip walking and physical fitness in the elderly in a community setting
  Atsushi Mizumoto; Hikaru Ihira; Hyuma Makizako; Keisuke Yasuda; Keitaro Makino; Mika Ohguni; Taketo Furuna
  Anthropological Science, 122, 1, 1, 6, 2014年04月, ［査読有り］
  英語, 研究論文（学術雑誌）
• Physical Functions, Health-Related Outcomes, Nutritional Status, and Blood Markers in Community-Dwelling Cancer Survivors Aged 75 Years and Older
  Hikaru Ihira; Atsushi Mizumoto; Keitarou Makino; Keisuke Yasuda; Yoko Miyabe; Shigeyuki Saitoh; Hirofumi Ohnishi; Taketo Furuna
  Asian Pacific Journal of Cancer Prevention, 15, 7, 3305, 3310, 2014年, ［査読有り］
  英語, 研究論文（学術雑誌）
• Associations between serum 25-hydroxyvitamin D concentration and physical performance in old-old people living in a northern area of Japan
  Mizumoto A; Ihira H; Yasuda K; Makino K; Miyabe Y; Saitoh S; Ohnishi H; Suzuki T; Furuna T
  Journal of Gerontology & Geriatric Research, 2, 4, 135, 2013年, ［査読有り］

• 基礎研究から実地診療まで - 老年医学的評価法 高齢者の生活機能の評価
  牧野 圭太郎, 日本臨牀, 83, 増刊8 老年医学 第2版 (上), 238, 242, 2025年08月, ［招待有り］, ［筆頭著者］
• 認知症および軽度認知障害における転倒の特徴
  牧野 圭太郎, 日本転倒予防学会誌, 10, 11, 14, 2023年09月, ［招待有り］, ［筆頭著者］
• 無作為化比較試験
  牧野 圭太郎; 島田 裕之, 理学療法ジャーナル, 57, 5, 589, 592, 2023年05月, ［招待有り］, ［筆頭著者］
• 基礎・臨床研究の最新動向 - 老年医学的評価法 高齢者の生活機能の評価
  牧野 圭太郎, 日本臨床, 76, 増刊5 老年医学(上), 312, 316, 2018年06月, ［招待有り］, ［筆頭著者］
  (株)日本臨床社, 日本語, 記事・総説・解説・論説等（学術雑誌）
• 「コグニサイズ」で認知症を予防 - 集団でできるコグニサイズ
  牧野 圭太郎, 安全と健康, 67, 6, 532, 533, 2016年06月, ［招待有り］, ［筆頭著者］
  中央労働災害防止協会, 日本語

• 〔主要な業績〕指導者のための介護予防ガイド 地域で取り組む健康増進
  島田裕之(編), 第１章 介護予防とは ４. 介護予防のためのアセスメント
  医歯薬出版, 2024年04月, ［分担執筆］
• 〔主要な業績〕コグニサイズ入門 楽しく取り組む認知症予防
  島田裕之, 李相侖(編), 第１章 認知症の理解 認知症になりやすいのはどんなタイプですか？
  医歯薬出版, 2022年03月, ［分担執筆］
• ３STEPで認知症予防 コグニサイズ指導マニュアル
  島田裕之(編), 第２章 認知症予防を目的としたアセスメント ３. 運動機能検査
  医歯薬出版, 2020年03月, ［分担執筆］
• 〔主要な業績〕理学療法士のための 知っておきたい！ 認知症知識Q＆A
  島田裕之(監修), 牧迫飛雄馬(編), 第1章 認知症の病態・メカニズム Q17; 第3章 認知症のリハビリテーション・ケア Q52; 第4章 認知症の予防 Q64, Q68
  医歯薬出版, 2018年05月, ［分担執筆］
• 〔主要な業績〕高齢者理学療法学
  島田裕之(総編); 牧迫飛雄馬, 山田実(編), 第8章 高齢者理学療法の実践 -応用編-, ２. ベッド上ポジショニング
  医歯薬出版, 2017年03月, ［分担執筆］

• 〔主要な業績〕疫学研究の事例から考える研究実践のポイント
  牧野圭太郎
  北海道理学療法士会 道北支部学術部 臨床研究支援, 2026年07月28日
  ［招待講演］
• 積雪寒冷地域に住む高齢者のサルコペニアと冬期間の屋外転倒との関連
  牧野圭太郎; 井平光; 横山和樹; 水本淳; 松崎由里子; 田代英之; 齊藤秀和; 下木原俊; 勝浦駿平; 佐々木健史; 池田望
  第12回日本地域理学療法学会, 2025年10月12日, 口頭発表（一般）
  ［国内会議］
• 〔主要な業績〕サルコペニアに対する簡易スクリーニング指標の判別精度 ―肥満の有無による層別化解析―
  牧野圭太郎; 井平光; 横山和樹; 水本淳; 松崎由里子; 田代英之; 齊藤秀和; 下木原俊; 佐々木健史; 池田望
  第90回日本健康学会総会, 2025年10月11日, ポスター発表
  ［国内会議］
• 〔主要な業績〕老年症候群 ―最近のコホート研究から分かったこと―
  牧野 圭太郎
  札幌医科大学 第11回 集学的理学療法セミナー, 2025年01月17日, 公開講演，セミナー，チュートリアル，講習，講義等
  ［招待講演］, ［国内会議］
• 地域在住高齢者の閉眼安静時脳波に対するeLORETA-ICAの軽度認知障害サブタイプ判別精度の検証
  片山脩; 片山脩; COORS Annabell; 李相侖; 原田健次; 牧野圭太郎; 冨田浩輝; 森川将徳; 山口亨; 西島千陽; 見須裕香; 藤井一弥; 兒玉隆之; 島田裕之
  臨床神経生理学(Web), 2025年
  2025年 - 2025年
• 座位行動時間を身体活動時間に置き換えることで認知症発症リスクが低下する
  山口亨; 片山脩; 山際大樹; 赤井田将真; 冨田浩輝; 牧野圭太郎; 山城由華吏; 高柳直人; 須藤元喜
  日本老年医学会雑誌(Web), 2025年, 口頭発表（一般）
  2025年 - 2025年, ［国内会議］
• 社会的フレイルを有する高齢者の認知症発症リスクに関連する知的活動レベル-60カ月の縦断研究
  崎本史生; 土井剛彦; 冨田浩輝; 松田総一郎; 牧野圭太郎; 島田裕之
  日本老年医学会雑誌(Web), 2025年
  2025年 - 2025年
• デジタル認知機能検査と脳内βアミロイド蓄積との関係
  島田裕之; 牧野圭太郎; 加藤隆司; 伊藤健吾; 土井剛彦; 中窪翔; 原田健次; 片山脩; 冨田浩輝
  日本老年医学会雑誌(Web), 2025年
  2025年 - 2025年
• 〔主要な業績〕高齢期の体組成と健康寿命
  牧野 圭太郎
  日本生理人類学会 2024年度 第1回 健康栄養科学研究部会, 2024年12月14日, 公開講演，セミナー，チュートリアル，講習，講義等
  ［招待講演］, ［国内会議］
• 〔主要な業績〕シンポジウム11「予防理学療法研究への第一歩 ～人生100年時代における予防理学療法研究～」予防理学療法研究の可能性：地域での予防研究の経験を通して
  牧野 圭太郎
  第11回 日本予防理学療法学会学術大会, 2024年11月10日, シンポジウム・ワークショップパネル（指名）
  ［招待講演］, ［国内会議］
• 〔主要な業績〕近隣環境と孤独感の関連性：社会的孤立による層別化解析
  牧野圭太郎; 片山脩; 山口亨; 山際大樹; 島田裕之
  第83回日本公衆衛生学会総会, 2024年10月29日, 口頭発表（一般）
  ［国内会議］
• 中高齢期の生活習慣と健康寿命 ～地域コホート研究の経験を通して～
  牧野 圭太郎
  第3回 CEHS公開セミナー, 2024年08月05日, 公開講演，セミナー，チュートリアル，講習，講義等
  ［招待講演］, ［国内会議］
• 地域高齢者の認知症発症に対するNCGG-IADLスケールの予測妥当性の検証
  牧野圭太郎; 李相侖; 片山脩; 冨田浩輝; 山口亨; 山際大樹; 島田裕之
  第3回日本老年療法学会学術集会, 2024年08月03日
• 高齢期の認知機能とヘルスリテラシーが認知症発症リスクに及ぼす影響
  牧野 圭太郎; 冨田 浩輝; 片山 脩; 山口 亨; von Fingerhut Georg; 山際 大樹; 島田 裕之
  第66回日本老年医学会学術集会, 2024年06月14日
• 地域高齢者のライフイベントと社会的健康度:ポジティブおよびネガティブな側面からの検討
  牧野圭太郎; 土井剛彦; 堤本広大; 片山脩; 山口亨; VON FINGERHUT Georg; 山際大樹; 牧迫飛雄馬; 島田裕之
  日本予防理学療法学会学術大会プログラム・抄録集(Web), 2024年
  2024年 - 2024年
• Physical frailty accelerates death beyond subsequent functional disability among community-dwelling older adults: Evidence from a 5-year cohort study
  Makino K; Raina P; Griffith LE; Lee S; Harada K; Katayama O; Tomida K; Morikawa M; Makizako H; Shimada H
  IAGG Asia/Oceania Regional Congress 2023, 2023年06月, 口頭発表（一般）
• 〔主要な業績〕Lifetime exercise habits and mild cognitive impairment in late life among community-dwelling older adults
  Makino K; Lee S; Harada K; Katayama O; Tomida K; Morikawa M; Yamaguchi R; Nishijima C; Fujii K; Misu Y; Shimada H
  World Physiotherapy Congress 2023, 2023年06月, 口頭発表（一般）
• 〔主要な業績〕シンポジウム9「生活習慣病と認知症予防」地域高齢者における心血管リスクと認知症予防
  牧野 圭太郎
  第11回日本認知症予防学会学術集会, 2022年09月24日, シンポジウム・ワークショップパネル（指名）
  ［招待講演］
• 手指の両側性協調運動制御に関わる神経基盤の加齢変化
  原田健次; 裵成琉; 李相侖; 牧野圭太郎; 千葉一平; 片山脩; 新海陽平; 島田裕之
  日本老年医学会雑誌, 2021年
  2021年 - 2021年
• 心血管リスクレベルと認知機能低下の関連:認知ドメイン別の検討
  牧野圭太郎; 李相侖; 裵成琉; 千葉一平; 片山脩; 原田健次; 新海陽平; 島田裕之
  日本老年医学会雑誌, 2021年
  2021年 - 2021年
• 地域在住高齢者におけるGeriatric Nutritional Risk Indexにより評価した低栄養リスクと要介護発生との関連
  千葉一平; 李相侖; 裵成琉; 牧野圭太郎; 原田健次; 片山脩; 新海陽平; 島田裕之
  日本老年医学会雑誌, 2021年
  2021年 - 2021年
• 身体的フレイルに関連する社会活動レベルの検証
  片山脩; 李相侖; 裵成琉; 牧野圭太郎; 千葉一平; 原田健次; 新海陽平; 島田裕之
  日本老年医学会雑誌, 2021年
  2021年 - 2021年
• 日常生活活動が新規要介護発生に及ぼす影響は自宅近隣の施設資源の豊かさにより異なる
  片山脩; 李相侖; 裵成琉; 牧野圭太郎; 牧野圭太郎; 千葉一平; 原田健次; 新海陽平; 島田裕之
  日本理学療法学術大会(Web), 2021年
  2021年 - 2021年
• 地域在住高齢者における座位時間の身体活動時間への置き換えと要介護発生との関連-isotemporal substitution modelによる検討-
  千葉一平; 李相侖; 裵成琉; 牧野圭太郎; 新海陽平; 原田健次; 片山脩; 島田裕之
  日本理学療法学術大会(Web), 2021年
  2021年 - 2021年
• 自宅近隣の施設資源の豊かさの違いによるライフスタイル活動の実施状況と認知機能との関係
  片山脩; 李相侖; 牧野圭太郎; 千葉一平; 裵成琉; 原田健次; 新海陽平; 島田裕之
  日本理学療法学術大会(Web), 2021年
  2021年 - 2021年
• フレイル発生に関連する行動要因
  島田裕之; 土井剛彦; 堤本広大; 中窪翔; 牧野圭太郎; 石井秀明; 千葉一平; 片山脩
  日本理学療法学術大会(Web), 2021年
  2021年 - 2021年
• 地域高齢者の心理的フレイルと転倒恐怖感との関連:大規模コホートデータによる検討
  牧野圭太郎; 李相侖; 裵成琉; 千葉一平; 片山脩; 原田健次; 新海陽平; 島田裕之
  日本理学療法学術大会(Web), 2021年
  2021年 - 2021年
• 地域在住高齢者の認知症発症年齢に着目した危険因子の検討 老年症候群における大規模地域コホート縦断研究(NCGG-SGS)
  李 相侖; 裴 成琉; 牧野 圭太郎; 原田 健次; 千葉 一平; 片山 脩; 新海 陽平; 島田 裕之
  日本老年医学会雑誌, 2020年07月, (一社)日本老年医学会, 日本語
  2020年07月 - 2020年07月
• 血中HbA1c濃度が軽度認知障害から正常な認知機能への回復に及ぼす影響
  牧野 圭太郎; 李 相侖; 裴 成琉; 新海 陽平; 千葉 一平; 片山 脩; 原田 健次; 島田 裕之
  日本老年医学会雑誌, 2020年07月, (一社)日本老年医学会, 日本語
  2020年07月 - 2020年07月
• 地域在住高齢者における身体的フレイルによる海馬内構造体の容積の違い
  原田 健次; 裴 成琉; 李 相侖; 千葉 一平; 牧野 圭太郎; 片山 脩; 新海 陽平; 島田 裕之
  日本老年医学会雑誌, 2020年07月, (一社)日本老年医学会, 日本語
  2020年07月 - 2020年07月
• 大脳皮質厚はライフスタイル活動と認知機能の媒介要因となりうるか
  裴 成琉; 李 相侖; 原田 健次; 牧野 圭太郎; 新海 陽平; 千葉 一平; 片山 脩; 島田 裕之
  日本老年医学会雑誌, 2020年07月, (一社)日本老年医学会, 日本語
  2020年07月 - 2020年07月
• 地域在住高齢者のライフスタイル活動パターンの検討 フレイルに着目した検討
  片山 脩; 李 相侖; 裴 成琉; 牧野 圭太郎; 新海 陽平; 千葉 一平; 原田 健次; 島田 裕之
  日本老年医学会雑誌, 2020年07月, (一社)日本老年医学会, 日本語
  2020年07月 - 2020年07月
• 地域在住高齢者における身体活動量と要介護発生との関連 運動機能及び骨格筋量による検討
  千葉 一平; 李 相侖; 裴 成琉; 原田 健次; 牧野 圭太郎; 新海 陽平; 片山 脩; 島田 裕之
  日本老年医学会雑誌, 2020年07月, (一社)日本老年医学会, 日本語
  2020年07月 - 2020年07月
• 〔Major achievements〕Association between the components of frailty phenotype and inflammatory markers among community-dwelling older adults
  Makino K; Lee S; Doi T; Bae S; Harada K; Nakakubo S; Chiba I; Katayama O; Shinkai Y; Shimada H
  International Conference on Frailty and Sarcopenia Research, 2020年03月
• 認知症の発症と関連する歩行指標の検討
  土井 剛彦; 堤本 広大; 中窪 翔; 牧野 圭太郎; 牧迫 飛雄馬; 島田 裕之
  理学療法学, 2019年08月, (公社)日本理学療法士協会, 日本語
  2019年08月 - 2019年08月
• 地域高齢者における睡眠状況と社会的フレイルの関連性の検討
  中窪 翔; 土井 剛彦; 牧迫 飛雄馬; 堤本 広大; 牧野 圭太郎; 島田 裕之
  理学療法学, 2019年08月, (公社)日本理学療法士協会, 日本語
  2019年08月 - 2019年08月
• 地域高齢者における身体的フレイルが4年後の転倒および転倒恐怖感に及ぼす影響
  牧野 圭太郎; 土井 剛彦; 堤本 広大; 中窪 翔; 牧迫 飛雄馬; 島田 裕之
  理学療法学, 2019年08月, (公社)日本理学療法士協会, 日本語
  2019年08月 - 2019年08月
• 地域在住後期高齢者の要介護発生に対するNCGG-ADLスケールの予測妥当性の検証
  牧野 圭太郎; 李 相侖; 裴 成琉; 新海 陽平; 千葉 一平; 島田 裕之
  日本老年医学会雑誌, 2019年05月, (一社)日本老年医学会, 日本語
  2019年05月 - 2019年05月
• 地域在住高齢者の大規模コホートを用いた認知症発症時期における関連要因の分析
  李 相侖; 裴 成琉; 牧野 圭太郎; 千葉 一平; 島田 裕之
  日本老年医学会雑誌, 2019年05月, (一社)日本老年医学会, 日本語
  2019年05月 - 2019年05月
• 認知機能低下を有する高齢者の皮質厚に対する複合的運動プログラムの効果検証
  裴 成琉; 李 相侖; 原田 健次; 牧野 圭太郎; 千葉 一平; 島田 裕之
  日本老年医学会雑誌, 2019年05月, (一社)日本老年医学会, 日本語
  2019年05月 - 2019年05月
• 地域在住高齢者における内臓脂肪蓄積と糖尿病リスクとの関連
  千葉 一平; 李 相侖; 裴 成琉; 牧野 圭太郎; 新海 陽平; 島田 裕之
  日本老年医学会雑誌, 2019年05月, (一社)日本老年医学会, 日本語
  2019年05月 - 2019年05月
• 抑うつ高齢者の身体活動量とBDNFおよび脳容量との関連 慢性疼痛の有無に着目した縦断観察研究
  牧野 圭太郎; 牧迫 飛雄馬; 李 相侖; 李 成哲; 裴 成琉; 鄭 松伊; 新海 陽平; 島田 裕之
  若手研究者のための健康科学研究助成成果報告書, 2019年04月, (公財)明治安田厚生事業団, 日本語
  2019年04月 - 2019年04月, 抑うつ高齢者の身体活動量、BDNFおよび脳容量の変化に慢性疼痛が与える影響について検討した。高齢者機能健診に参加した65歳以上の地域在住高齢者59名(男性31名、女性28名、平均73.3±6.0歳)を対象とした。慢性疼痛なし群は36名、慢性疼痛あり群は23名であった。慢性疼痛あり群における各アウトカムの変化量同士の相関分析の結果、ΔGDS(老年期うつ病評価尺度)得点とΔMTL(内側側頭部)萎縮領域の割合との間に有意な正の相関関係が、Δ全脳萎縮領域の割合とΔ歩数との間に有意な負の相関関係が、Δ歩数とΔMVPA(中強度以上の身体活動)との間に有意な正の相関関係が認められた。一方、慢性疼痛なし群における各アウトカムの変化量同士の相関分析の結果では、慢性疼痛あり群と同様にΔ歩数とΔMVPAとの間に有意な正の相関関係が認められたものの、その他の有意な相関関係は認められなかった。
• うつ徴候および軽度記憶低下を有する高齢者に対する運動および菜園介入によるランダム化比較試験
  牧迫飛雄馬; 土井剛彦; 牧野圭太郎; 堤本広大; 中窪翔; 島田裕之
  日本老年医学会雑誌, 2018年05月25日, (一社)日本老年医学会, 日本語
  2018年05月25日 - 2018年05月25日
• 日本人高齢者における慢性腎臓病(CKD)の回復率と関連要因 4年間の前向き研究
  李 成哲; 李 相侖; 裴 成琉; 鄭 松伊; 牧野 圭太郎; 新海 陽平; 島田 裕之
  日本老年医学会雑誌, 2018年05月, (一社)日本老年医学会, 日本語
  2018年05月 - 2018年05月
• うつ徴候および軽度記憶低下を有する高齢者に対する運動および菜園介入によるランダム化比較試験
  牧迫 飛雄馬; 土井 剛彦; 牧野 圭太郎; 堤本 広大; 中窪 翔; 島田 裕之
  日本老年医学会雑誌, 2018年05月, (一社)日本老年医学会, 日本語
  2018年05月 - 2018年05月
• 地域在住高齢者を対象とした年代別の日常生活における身体、知的、社会活動と脳萎縮との関連
  李 相侖; 裴 成琉; 李 成哲; 原田 健次; 原田 和弘; 鄭 松伊; 牧野 圭太郎; 新海 陽平; 朴 眩泰; 島田 裕之
  日本老年医学会雑誌, 2018年05月, (一社)日本老年医学会, 日本語
  2018年05月 - 2018年05月
• 地域在住高齢者における身体活動の変化パターンの特定と身体活動パターンが抑うつに及ぼす影響
  鄭 松伊; 李 成哲; 李 相侖; 裴 成琉; 原田 和弘; 牧野 圭太郎; 島田 裕之
  日本老年医学会雑誌, 2018年05月, (一社)日本老年医学会, 日本語
  2018年05月 - 2018年05月
• 高齢者の共感性に関連する要因と白質神経線維の結合性に関する検討
  裴 成琉; 李 相侖; 原田 健次; 李 成哲; 鄭 松伊; 牧野 圭太郎; 新海 陽平; 朴 眩泰; 島田 裕之
  日本老年医学会雑誌, 2018年05月, (一社)日本老年医学会, 日本語
  2018年05月 - 2018年05月
• 地域高齢者における疼痛の種類と新規要介護発生との関連
  牧野 圭太郎; 李 相侖; 李 成哲; 裴 成琉; 鄭 松伊; 新海 陽平; 島田 裕之
  日本老年医学会雑誌, 2018年05月, (一社)日本老年医学会, 日本語
  2018年05月 - 2018年05月
• 地域在住後期高齢者の新規要支援・要介護認定に関する機能変化モデルの提案
  牧野 圭太郎; 牧迫 飛雄馬; 赤沼 智美; 横山 香理; 古名 丈人
  日本公衆衛生学会総会抄録集, 2017年10月, 日本公衆衛生学会, 日本語
  2017年10月 - 2017年10月
• Subtypes of pain and newly incidence of disability among community-dwelling older people: Prospective cohort study
  Makino K; Lee S; Lee S; Bae S; Jung S; Shinkai Y; Shimada H
  3rd Asian Conference for Frailty and Sarcopenia, 2017年08月
• 地域在住高齢者に対する高齢者機能健診を用いたポピュレーションアプローチの効果検証 大規模縦断研究
  李 相侖; 島田 裕之; 李 成哲; 裴 成琉; 原田 和弘; 鄭 松伊; 今岡 真和; 中窪 翔; 牧野 圭太郎; 鈴木 隆雄
  老年社会科学, 2017年06月, 日本老年社会科学会, 日本語
  2017年06月 - 2017年06月
• 地域在住高齢者の外出範囲と関連する要因の検討
  堀田 亮; 島田 裕之; 牧迫 飛雄馬; 李 相侖; 土井 剛彦; 堤本 広大; 中窪 翔; 牧野 圭太郎; 鈴木 隆雄
  老年社会科学, 2017年06月, 日本老年社会科学会, 日本語
  2017年06月 - 2017年06月
• 身体的フレイルが将来の介護給付額に及ぼす影響
  牧迫飛雄馬; 島田裕之; 土井剛彦; 堤本広大; 堀田亮; 中窪翔; 牧野圭太郎; 李相侖; 李成哲; 鈴木隆雄
  日本老年医学会雑誌, 2017年05月25日, 日本語
  2017年05月25日 - 2017年05月25日
• 高齢者の新規要介護認定における骨格筋力指標と体脂肪率の影響
  堤本広大; 土井剛彦; 牧迫飛雄馬; 堀田亮; 中窪翔; 牧野圭太郎; 裴成琉; 今岡真和; 島田裕之
  日本老年医学会雑誌, 2017年05月25日, (一社)日本老年医学会, 日本語
  2017年05月25日 - 2017年05月25日
• 新規フレイル発症のリスク 4年間の縦断調査より
  土井 剛彦; 島田 裕之; 牧迫 飛雄馬; 堤本 広大; 堀田 亮; 中窪 翔; 牧野 圭太郎; 李 相侖; 李 成哲; 鈴木 隆雄
  日本老年医学会雑誌, 2017年05月, (一社)日本老年医学会, 日本語
  2017年05月 - 2017年05月
• MCIから正常の認知機能に回復する高齢者の割合
  島田 裕之; 牧迫 飛雄馬; 李 相侖; 土井 剛彦; 李 成哲; 堤本 広大; 裴 成琉; 堀田 亮; 中窪 翔; 牧野 圭太郎
  日本老年医学会雑誌, 2017年05月, (一社)日本老年医学会, 日本語
  2017年05月 - 2017年05月
• 地域在住高齢者における睡眠の重要性 MCIへの移行との関連
  中窪 翔; 牧迫 飛雄馬; 土井 剛彦; 堤本 広大; 堀田 亮; 牧野 圭太郎; 鄭 松伊; 今岡 真和; 島田 裕之
  日本老年医学会雑誌, 2017年05月, (一社)日本老年医学会, 日本語
  2017年05月 - 2017年05月
• 高齢期における食欲低下は、新規要支援・要介護認定に影響を与える
  堤本 広大; 土井 剛彦; 牧迫 飛雄馬; 堀田 亮; 中窪 翔; 牧野 圭太郎; 李 成哲; 島田 裕之
  日本老年医学会雑誌, 2017年05月, (一社)日本老年医学会, 日本語
  2017年05月 - 2017年05月
• 高齢者の新規要介護認定における骨格筋力指標と体脂肪率の影響
  堤本 広大; 土井 剛彦; 牧迫 飛雄馬; 堀田 亮; 中窪 翔; 牧野 圭太郎; 裴 成琉; 今岡 真和; 島田 裕之
  日本老年医学会雑誌, 2017年05月, (一社)日本老年医学会, 日本語
  2017年05月 - 2017年05月
• 慢性疼痛を有する高齢者における身体活動量と要介護発生
  牧野 圭太郎; 牧迫 飛雄馬; 土井 剛彦; 堤本 広大; 堀田 亮; 中窪 翔; 李 相侖; 李 成哲; 裴 成琉; 島田 裕之
  日本老年医学会雑誌, 2017年05月, (一社)日本老年医学会, 日本語
  2017年05月 - 2017年05月
• MCI高齢者における自動車運転技能と関連する要因の検討
  堀田 亮; 島田 裕之; 牧迫 飛雄馬; 土井 剛彦; 堤本 広大; 中窪 翔; 牧野 圭太郎
  日本老年医学会雑誌, 2017年05月, (一社)日本老年医学会, 日本語
  2017年05月 - 2017年05月
• 地域在住高齢者の転倒恐怖感が新規要介護発生に及ぼす影響 転倒経験による比較
  牧野 圭太郎; 牧迫 飛雄馬; 土井 剛彦; 堤本 広大; 堀田 亮; 中窪 翔; 鄭 松伊; 今岡 真和; 島田 裕之
  日本老年医学会雑誌, 2017年05月, (一社)日本老年医学会, 日本語
  2017年05月 - 2017年05月
• 身体的フレイル高齢者における身体活動量と要介護の新規発生
  牧迫 飛雄馬; 島田 裕之; 土井 剛彦; 堤本 広大; 堀田 亮; 中窪 翔; 牧野 圭太郎; 裴 成琉; 鄭 松伊; 今岡 真和
  日本老年医学会雑誌, 2017年05月, (一社)日本老年医学会, 日本語
  2017年05月 - 2017年05月
• 身体的フレイルが将来の介護給付額に及ぼす影響
  牧迫 飛雄馬; 島田 裕之; 土井 剛彦; 堤本 広大; 堀田 亮; 中窪 翔; 牧野 圭太郎; 李 相侖; 李 成哲; 鈴木 隆雄
  日本老年医学会雑誌, 2017年05月, (一社)日本老年医学会, 日本語
  2017年05月 - 2017年05月
• 地域在住高齢者における就寝、起床時刻と身体活動量の関連性
  中窪 翔; 牧迫 飛雄馬; 土井 剛彦; 堤本 広大; 堀田 亮; 李 相侖; 李 成哲; 裴 成琉; 牧野 圭太郎; 島田 裕之
  日本老年医学会雑誌, 2017年05月, (一社)日本老年医学会, 日本語
  2017年05月 - 2017年05月
• 地域在住高齢者に対する高齢者機能健診を用いたポピュレーションアプローチの効果検証 大規模縦断研究
  李 相侖; 島田 裕之; 李 成哲; 裴 成琉; 原田 和弘; 鄭 松伊; 今岡 真和; 中窪 翔; 牧野 圭太郎; 鈴木 隆雄
  日本老年医学会雑誌, 2017年05月, (一社)日本老年医学会, 日本語
  2017年05月 - 2017年05月
• 高齢者における聴力低下と社会的活動が新規要介護発生に及ぼす影響 大規模コホートによる前向き調査
  裴 成琉; 李 相侖; 李 成哲; 牧迫 飛雄馬; 土井 剛彦; 鄭 松伊; 今岡 真和; 牧野 圭太郎; 鈴木 隆雄; 島田 裕之
  日本老年医学会雑誌, 2017年05月, (一社)日本老年医学会, 日本語
  2017年05月 - 2017年05月
• IADLとサルコペニアの関連について
  今岡 真和; 李 相侖; 李 成哲; 牧迫 飛雄馬; 土井 剛彦; 裴 成琉; 鄭 松伊; 中窪 翔; 牧野 圭太郎; 島田 裕之
  日本老年医学会雑誌, 2017年05月, (一社)日本老年医学会, 日本語
  2017年05月 - 2017年05月
• 抑うつ傾向高齢者における身体活動量の性差
  鄭 松伊; 李 相侖; 李 成哲; 裴 成琉; 今岡 真和; 原田 和弘; 堀田 亮; 中窪 翔; 牧野 圭太郎; 島田 裕之
  日本老年医学会雑誌, 2017年05月, (一社)日本老年医学会, 日本語
  2017年05月 - 2017年05月
• 認知的フレイルが認知症発症に及ぼす影響
  島田 裕之; 牧迫 飛雄馬; 土井 剛彦; 堤本 広大; 中窪 翔; 牧野 圭太郎
  理学療法学, 2017年04月, (公社)日本理学療法士協会, 日本語
  2017年04月 - 2017年04月, <p>【はじめに，目的】認知的フレイルは，身体的フレイルと認知障害を合併した状態として定義され，概念的枠組みが整理されつつある。ただし，その概念を操作的に測定可能な変数に定義して，認知的フレイルが認知症発症に対する影響を調べた研究はない。そこで本研究では，高齢者を対象として，身体的フレイル，認知障害，そしてそれらを合併した認知的フレイルの状況を調べ，認知症発症を追跡調査することで，認知的フレイルと認知症発症との関係を明らかにすることを目的とした。</p><p></p><p></p><p>【方法】対象者は愛知県大府市に在住する65歳以上の高齢者4,072名であった。身体的フレイルは，歩行速度低下，筋力低下，疲労感，身体活動低下，体重減少の5つの項目のうち3つ以上の異常とした。認知障害は，National Center for Geriatrics and Gerontology-Functional Assessment Toolの記憶，注意，実行機能，処理速度検査を用いて，5歳年齢階級の平均値から1.5標準偏差以上の認知機能の低下が2つ以上ある状態を認知障害ありとした。認知症の発症情報は，診療情報明細書情報から取得し，24か月間の追跡調査を実施した。統計解析は，混乱要因を調整したCox比例ハザードモデルを用いて，健常，身体的フレイル，認知障害，認知的フレイルの各群における認知症発症を比較した。</p><p></p><p></p><p>【結果】身体的フレイル，認知障害，認知的フレイルの有症率は，それぞれ5.1%，5.5%，1.1%であった。追跡期間中，認知症を発症した者は81名（2.0%）であった。健常，身体的フレイル，認知障害，認知的フレイルの各群における認知症発症率は，それぞれ1.3%，5.8%，6.3%，18.6%となり，認知的フレイルにおける発症率が高かった。Cox比例ハザードモデルによる分析の結果，健常な高齢者に対するハザード比は，身体的フレイル1.95（95%信頼区間：0.97-3.91），認知障害3.85（95%信頼区間：2.09-7.10），認知的フレイル6.19（95%信頼区間：2.73-13.99）となり，認知的フレイルにおいて高い認知症発症の危険性が認められた。</p><p></p><p></p><p>【結論】身体と認知的問題を合併した高齢者は，認知症になる危険性が高いことが明らかとなった。今後は，これらの高齢者に有効な認知症予防の介入方法を検証していく必要がある。</p>
• 身体的フレイル高齢者の認知機能低下は、転倒後の骨折発生と強い関連を有する
  堤本 広大; 土井 剛彦; 牧迫 飛雄馬; 堀田 亮; 中窪 翔; 牧野 圭太郎; 島田 裕之
  理学療法学, 2017年04月, (公社)日本理学療法士協会, 日本語
  2017年04月 - 2017年04月, <p>【はじめに，目的】身体的フレイルとは包括的に機能が低下した脆弱化した状態を指し，健常高齢者と要介護高齢者の中間的存在とされている。要介護の主要因の一つである転倒は，要介護リスクが高いフレイル高齢者において，特に予防すべき事象である。近年，認知機能の低下が，転倒リスクを高めることが明らかとなってきている。フレイル高齢者の転倒予防を考えていく上で，認知機能低下が転倒とどのように関連しているのか検討することが必要だが，十分に明らかにされていない。そこで，本研究の目的は身体的フレイル高齢者における認知機能低下と転倒との関連性を検討することとする。</p><p></p><p></p><p>【方法】地域高齢者10885名のうち，パーキンソン病・認知症既往者，MMSEが21点未満の者，基本的ADLに障害のある者を除く9990名（平均73.5歳）を対象とした。歩行速度低下，筋力低下，体重減少，易疲労感，身体活動量低下の5項目の内，3項目以上が該当したものを身体的フレイルと判定した。認知機能に関しては，記憶・注意機能・遂行機能・処理速度の評価を行い，年齢・教育歴で標準化したデータにもとづき1.5SD以上の機能低下を1領域でも認めた者は認知機能低下ありと定義した。その上で，健常群，認知機能低下群，フレイル群，フレイル+認知機能低下群の4群に分けた。転倒については，過去1年間の転倒経験の有無を聴取し，転倒に伴う骨折の有無も合わせて聴取した。統計解析は，従属変数に転倒経験の有無，独立変数に群要因（健常群を参照値）と共変量を投入した多変量ロジスティック回帰分析を実施した。</p><p></p><p></p><p>【結果】転倒経験のある者は，健常群15.7%，認定機能低下群18.6%，フレイル群28.4%，フレイル+認知機能低下群31.6％であった。転倒経験の有無を従属変数としたロジスティック回帰分析において，健常群を参照としたオッズ比は，認知機能低下群で1.17（95%CI 1.03－1.34），フレイル群で1.48（95%CI 1.19－1.83），フレイル+認知機能低下群で1.77（95%CI 1.39－2.27）であった。転倒経験を有する者を抽出し，転倒後の骨折経験の有無を従属変数としたロジスティック回帰分析において，健常群を参照値としたオッズ比は，フレイル+認知機能群にのみ有意な関連が認められた（2.56（95%CI 1.36－4.85））。</p><p></p><p></p><p>【結論】転倒に伴う骨折については，身体的フレイルと認定機能低下を併せ持つ高齢者のみ関連性みられた。横断研究のため，因果関係は言及できないが身体的フレイルに認知機能低下が合わさることにより，転倒回避行動の遅延などが生じ，転倒後に生じる骨折との関連が強くなるのではないかと考えられる。一方で，転倒後に骨折した身体的フレイル高齢者の認知機能が低下しているということも考えられるため，今後は前方視的な研究の中で関係性を検討する必要がある。</p>
• 地域高齢者の慢性疼痛の強さ別にみた身体活動特性の違い
  牧野 圭太郎; 牧迫 飛雄馬; 土井 剛彦; 堤本 広大; 堀田 亮; 中窪 翔; 鈴木 隆雄; 島田 裕之
  理学療法学, 2017年04月, (公社)日本理学療法士協会, 日本語
  2017年04月 - 2017年04月, <p>【はじめに，目的】</p><p></p><p>慢性疼痛を有する高齢者は，痛みを回避しようと過剰に身体活動量を制限させることで心身の虚弱化および痛み自体のさらなる悪化が引き起こされる悪循環に陥りやすいと考えられている。したがって，慢性期では痛みの強さに応じて無理のない範囲で身体活動を維持させることが重要と考えられる。本研究では，慢性疼痛を有する高齢者の身体活動に関する基礎的知見を得るため，大規模横断調査から痛みの強さ別に身体活動特性の違いを検討した。</p><p></p><p></p><p>【方法】</p><p></p><p>National Center for Geriatrics and Gerontology-Study of Geriatric Syndromesの参加者のうち，2013年度の調査に参加し活動量計による身体活動量評価を実施した地域在住高齢者2,366名（75.7±4.1歳）を分析対象とした。なお，要介護認定を受けている者，認知症，脳卒中，パーキンソン病の既往を有する者は除外した。また，急性疼痛を持つ者，腰または膝以外の部位に痛みがある者，医師による運動制限を受けている者についても分析から除外した。</p><p></p><p>基本属性として年齢，性別，1日の服薬数，歩行速度，Mini-Mental State Examination（MMSE）を評価した。慢性疼痛は，腰または膝に2ヶ月以上継続した痛みがある場合を慢性疼痛ありとし，痛みの強さ別に3段階で評価した（疼痛なし/軽度の慢性疼痛あり/中等度以上の慢性疼痛あり）。身体活動の指標には，3軸加速度計内臓の活動量計で計測した1日あたりの歩数と強度別の身体活動時間を用いた。</p><p></p><p>統計解析として，対象者を疼痛なし群，軽度群，中等度以上群に分類し，3群間で基本属性および各身体活動指標を比較した。</p><p></p><p>【結果】</p><p></p><p>2,366名のうち，906名（38.3%）が慢性疼痛を有しており，そのうち軽度の慢性疼痛が546名，中等度以上の慢性疼痛が360名であった。慢性疼痛の強さによる一元配置分散分析の結果，MMSEを除く全ての基本属性に有意な主効果が認められた（p＜0.01）。各群における歩数の平均値は，疼痛なし群で5,371歩，軽度群で4,770歩，中等度以上群で4,338歩であった。年齢と性別を共変量とした共分散分析および事後検定の結果，歩数および中強度（3METs）以上の身体活動時間に関しては，軽度群と中等度以上群で疼痛なし群よりも少なく（p＜0.01），軽度群と中等度以上群の間に有意差はみられなかった。低強度（1.5～2.9METs）の身体活動時間に関しては，中等度以上群は疼痛なし群よりも少なかった（p＜0.05）のに対し，軽度群は他の群との間に有意差はみられなかった。</p><p></p><p></p><p>【結論】</p><p></p><p>慢性疼痛を有する高齢者において，身体活動量は慢性疼痛の強さと関連することが示唆され，慢性疼痛が軽度の者は低強度の活動に関しては疼痛のない者と同程度の活動量が維持されていた。慢性疼痛の強さによって異なる強度の身体活動が制限されることを示した本研究結果は，慢性疼痛を有する高齢者の身体活動の維持促進を目的とした理学療法介入にとって有用な知見を提供するものと考える。</p>
• 軽度認知機能低下がサルコペニア有病者の新規要介護発生リスクへ与える影響 24ヵ月間の前向き研究
  今岡 真和; 李 相侖; 牧迫 飛雄馬; 李 成哲; 土井 剛彦; 堤本 広大; 中窪 翔; 牧野 圭太郎; 裴 成琉; 鄭 松伊; 島田 裕之
  理学療法学, 2017年04月, (公社)日本理学療法士協会, 日本語
  2017年04月 - 2017年04月, <p>【はじめに，目的】</p><p></p><p>サルコペニアは加齢に伴う筋量や筋力の低下を特徴とする症候群であり，理学療法の重要な対象となる。一方，軽度認知機能低下は認知症発症のリスクだけでなく身体機能低下のリスクにもなるため，要介護発生のリスクを増加させる要因の一つと考えられる。しかし，サルコペニアと軽度認知機能低下が併存する高齢者の要介護発生リスクは未だ明らかではなく，そのような者では要介護発生リスクがさらに高いことが予想され，予防理学療法のより重要な適応となる可能性が極めて高い。そこで，地域在住高齢者を対象とした2年間の前方視的な調査を行い，サルコペニアおよび軽度認知機能低下と要介護発生状況との関連を調査した。</p><p></p><p></p><p>【方法】</p><p></p><p>対象は，National Center for Geriatrics and Gerontology-Study of Geriatric Syndromesの70歳以上の健診受診者5257名のうち，パーキンソン病，脳卒中，うつ病の既往歴がある者，要介護認定者，MMSE21点未満の者，測定項目に欠損がある者，ペースメーカー使用者，死亡または市外転居した者を除く3900名とした。</p><p></p><p>ベースライン評価は骨格筋量，握力，歩行速度，Mini-Mental State Examination（以下：MMSE），Geriatric Depression Scale（以下：GDS），薬剤投与数，教育年数，アルコール摂取，喫煙，その他基本属性を調査した。サルコペニアはAsian Working Group for Sarcopeniaのアルゴリズムにより判定を行い，認知機能低下はMMSEが26点以下の者とした。ベースライン以降の24か月間における新規要支援・要介護発生の有無を調べた。統計解析は，ベースライン評価によって健常群，サルコペニア群，軽度認知機能低下群，サルコペニアと軽度認知機能低下の併存群の4群に分け，Log-rank検定およびCox比例ハザード回帰分析を行い，有意水準は5%未満とした。</p><p></p><p></p><p>【結果】</p><p></p><p>調査対象3900名のうち，健常群1788名，サルコペニア群120名，軽度認知機能低下群1853名，併存群139名であり，288名（7.4%）が2年間で要支援・要介護を新規に発生した。各群の新規要支援・要介護発生率は，健常群5.1%，サルコペニア群8.3%，軽度認知機能低下群8.6%，併存群18.7%であり，Log-rank検定の結果，併存群とその他3群に有意差があった（p＜0.05）。Cox比例ハザード回帰分析による健常群に対する要介護発生のハザード比は性，年齢，体重，GDS，喫煙，教育年数の調整モデルにおいて，サルコペニア群1.05（信頼区間：0.54-2.02），軽度認知機能低下群1.47（信頼区間：1.12-1.90），併存群1.97（信頼区間1.25-3.10）であり，軽度認知機能低下群と併存群は有意に新規要介護発生との関連が認められた。</p><p></p><p></p><p>【結論】</p><p></p><p>健常高齢者と比較して，サルコペニアと軽度認知機能低下を併存する者は約2倍，軽度認知機能低下のみでは約1.5倍の要介護発生リスクであることが示唆された。そのため，サルコペニアの有無に加え，認知機能を評価することは新規要介護リスクを客観的に把握するために有用である。</p>
• 軽度認知機能障害と歩行速度低下により認知症の発症リスクは増加するか?
  土井 剛彦; 牧迫 飛雄馬; 堤本 広大; 中窪 翔; 牧野 圭太郎; 堀田 亮; 鈴木 隆雄; 島田 裕之
  理学療法学, 2017年04月, (公社)日本理学療法士協会, 日本語
  2017年04月 - 2017年04月, <p>【はじめに，目的】</p><p></p><p>歩行能力低下は軽度認知障害（mild cognitive impairment：MCI）や認知症を有する高齢者の問題点の一つとして認識されている。MCIは，認知症を発症するリスクが高い一方で，健常への改善も認められるため，認知症予防ひいては介護予防の対象として着目すべきであると考えられている。しかし，MCI高齢者において歩行速度低下を伴う場合に，認知症の発症リスクが増加するかについては未だ明らかにされていない。本研究は，縦断研究を実施し，歩行速度低下が認知症のリスクにどのような影響を与えるかをMCIに着目して検討することを目的とした。</p><p></p><p>【方法】</p><p></p><p>本研究は，National Center for Geriatrics and Gerontology-Study of Geriatric Syndromesの参加者の中から，2011年度に実施した調査に参加した65歳以上の者とし，ベースラインにおいて認知症，パーキンソン病，脳卒中の病歴がある者，MMSEが24点未満の者，診療情報が得られない者を除外した3749名を対象とした。ベースラインにて測定した歩行速度，認知機能，一般特性，服薬数，Geriatric Depression Scale，身体活動習慣に加え，医療診療情報から得られる追跡期間中の認知症の発症をアウトカムとした。歩行が1.0m/s未満の場合を歩行速度低下とし，認知症ではなく日常生活が自立し全般的認知機能は保たれているが，NCGG-FATによる認知機能評価で客観的な認知機能低下を認めた者をMCIとした。</p><p></p><p>【結果】</p><p></p><p>対象者3749名（平均年齢72歳，女性53％）を，歩行速度低下とMCIのいずれにも該当しない群（control群：n＝2608），歩行速度低下のみを有する群（SG群：n=358），MCIのみを有する群（MCI群：n=628），歩行速度低下とMCIの両方を有する群（MCI+SG群：n=155）に群分けした。追跡期間中（平均追跡期間：42.7ヶ月）に認知症を発症した者は168名であった。目的変数に認知症の発症，説明変数に歩行速度とMCIによる群要因を設定し，その他の測定項目を共変量として調整した生存分析を実施した結果，control群に比べ，SG群（HR：1.12，95%CI：0.67-1.87）は認知症の発症との有意な関係は認めなかったが，MCI群（HR：2.05，95%CI：1.39-3.01）ならびにMCI+SG群（HR：3.49，95%CI：2.17-5.63）は認知症の発症と有意な関係性を有していた。</p><p></p><p>【結論】</p><p></p><p>MCI高齢者における歩行能力低下は認知症のリスクを増加させることが明らかになった。高齢者が認知機能障害を有する場合には，認知機能だけではなく歩行能力を評価し，適切なリスク評価を考慮して介入を行う必要があると考えられる。</p>
• 地域在住高齢者における歩行比からみた歩行パターンと転倒の関連性
  中窪 翔; 牧迫 飛雄馬; 土井 剛彦; 堤本 広大; 堀田 亮; 牧野 圭太郎; 鈴木 隆雄; 島田 裕之
  理学療法学, 2017年04月, (公社)日本理学療法士協会, 日本語
  2017年04月 - 2017年04月, <p>【はじめに，目的】高齢期における歩行速度の低下は重要な転倒リスクのひとつである。歩行速度は歩幅と歩行率（ケイデンス）から決定され，この両因子から求める歩行比（歩幅/ケイデンス）は歩行速度を維持するための戦略を表す個人の歩行パターンと捉えられる。しかし，歩行比と転倒の関連性については十分に検討されていない。本研究の目的は，地域在住高齢者を対象に歩行比と転倒の関連性を横断的に検討することである。</p><p></p><p></p><p>【方法】National Center for Geriatrics and Gerontology-Study of Geriatric Syndromesに参加した65歳以上の地域在住高齢者10,885名のうち，アルツハイマー病，パーキンソン病，脳卒中の現病および既往のある者，MMSEが18点未満の者，欠損値がある者を除外した9,205名（女性4,987名，平均年齢73.7±5.6歳）を解析対象とした。ANIMA社製ウォークWay MV-1000を用いて通常歩行速度にて歩行評価を実施し，歩行速度，歩幅，ケイデンスを評価指標とした。歩行比は歩幅をケイデンスで除して算出し（m/（step/min）），3分位の値を基に対象者を3群（T1，T2：参照，T3）に群分けした。なお，各歩行指標は，関谷ら（1996年）の報告に準じて身長を用いて補正した。転倒経験は，過去1年間の転倒経験の有無を聴取した。共変量として，基本属性，病歴，服薬数，転倒恐怖感の有無，平均歩行時間（分/日）を聴取し，Body Mass Index，うつ症状（Geriatric Depression Scale），MMSEを評価した。統計解析は，転倒の有無を従属変数，歩行速度低下（1.0m/秒未満）の有無および歩行比を独立変数とした多重ロジスティック回帰分析を実施した。さらに，歩行速度の低下の有無による関係性の違いを検討するために歩行速度1.0m/秒以上および未満で層分けして同様の分析を実施した。有意水準は5%未満とした。</p><p></p><p></p><p>【結果】全対象者における過去1年間の転倒経験率は17.6％であった。転倒経験に対して，歩行速度低下の有無と歩行比を同時投入した結果，歩行速度低下および歩行比の値が小さいT1群において有意な関係性を示した（歩行速度 OR：1.40，95%CI：1.21-1.62，歩行比 OR：1.18，95%CI：1.03-1.35）。さらに，1.0m/秒未満の群（1,496名）での解析では歩行比は転倒と有意な関連性を認めなかったが，1.0m/秒以上の群（7,709名）ではT1群において転倒と有意な関連性を認めた（OR：1.29，95%CI：1.11-1.50）。</p><p></p><p>【結論】本研究より，歩行速度が低下している群では歩行比と過去1年の転倒経験との間に有意な関連性はみられなかったが，歩行速度を維持できている群においては，歩行比が小さいことが転倒経験と関連していることが示唆された。歩行比が小さいことは，歩幅の減少，あるいはケイデンスの増加を反映しており，歩行速度の維持のためにケイデンスを増加させる戦略を選択していると考えられる。今後は，このような歩行戦略の違いが将来の転倒発生と関連するかについて，縦断的な検討する必要である。</p>
• 地域在住高齢者のがん罹患に関する自己報告の妥当性検証
  井平 光; 牧野 圭太郎; 木原 由里子; 志水 宏太郎; 山口 亨; 伊藤 一成; 田井 啓太; 牧迫 飛雄馬; 島田 裕之; 古名 丈人
  理学療法学, 2017年04月, (公社)日本理学療法士協会, 日本語
  2017年04月 - 2017年04月
• 地域在住高齢者における睡眠時間と身体的フレイルの関連性
  中窪 翔; 島田 裕之; 牧迫 飛雄馬; 土井 剛彦; 堤本 広大; 堀田 亮; 牧野 圭太郎; 鈴木 隆雄
  理学療法学, 2016年10月, (公社)日本理学療法士協会, 日本語
  2016年10月 - 2016年10月, 【はじめに，目的】高齢期においては，睡眠時間が短いことも長いことも認知機能や身体機能などの心身機能低下に対して悪影響を及ぼすことが報告されている。また，近年では高齢期での夜間覚醒や睡眠効率の低下などの睡眠障害と身体的なフレイルの発症との関連が報告されている。睡眠時間の観点からの報告もなされているものの，睡眠時間が短いことへの検討に留まり，睡眠時間が長いことによる影響も含めた検討がなされていない。本研究の目的は，睡眠時間の長さが身体的フレイルの各要素および判定に関連しているのかどうかを横断的に検討することである。【方法】National Center for Geriatrics and Gerontology-Study of Geriatric Syndromesに参加した65歳以上の地域在住高齢者10,885名のうち，アルツハイマー病，パーキンソン病の既往のある者，及びMini-Mental State Examinationが18点未満の者，欠損値がある者を除外した10,297名（女性5,323名，男性4,974名，平均年齢73.7±5.5歳）を対象とした。就寝時間と起床時間から睡眠時間を算出し，short（6時間以下），mid（6～9時間），long（9時間以上）の3群に群分けした。また，Friedらの基準に従い，体重減少（6か月間での2～3kgの減少），活力低下，握力低下（女性18kg未満，男性26kg未満），歩行速度の低下（1.0m/s未満），活動度の低下を判定の要素とし，1～2個該当する者をpre frailty，3個以上該当する者をfrailtyと判定した。共変量として，基本属性，病歴に加えて，うつ症状，服薬数，喫煙・飲酒習慣を聴取した。統計解析は，physical frailtyの各要素および判定を従属変数とした多重ロジスティック回帰分析を実施した。有意水準は5%未満とした。【結果】睡眠時間による身体的フレイルの有症率は，pre frailtyがshort：55.5%，mid：49.9%，long：53.7%，frailtyがshort：10.8%，mid：7.9%，long：18.8%であり，睡眠時間が長い群で高い身体的フレイルの有症率であった。多重ロジスティック回帰分析の結果，midに比べてshort，longともにpre frailty（short：OR=1.34，long：OR=1.51），frailty（short：OR=1.58，long：OR=2.82）に対するオッズ比が有意に高かった。身体的なフレイルの各要素については，midに比べてshortは体重減少（OR=1.41），活力低下（OR=1.43），歩行速度低下（OR=1.28）において，longは体重減少（OR=1.25），活力低下（OR=1.25），活動低下（OR=1.68），握力低下（OR=1.71），歩行速度低下（OR=1.65）と全要素に対するオッズが有意に高かった。【結論】本研究より，睡眠時間が短い（6時間以下）ことおよび長い（9時間以上）ことが身体的フレイルの判定と関連しており，長時間睡眠がより高齢期におけるfrailtyとの関連が強かった。介護予防の観点において重要視されているフレイルと睡眠時間の関連性を示した本研究結果は，睡眠状況の把握，改善がフレイル発症の予防につながる可能性を示したと考える。
• 地域在住高齢者における下肢機能評価と要介護の新規発生 Five-Times-Sit-to-Stand TestとTimed Up & Go Testのカットオフ値
  牧迫 飛雄馬; 島田 裕之; 土井 剛彦; 堤本 広大; 中窪 翔; 堀田 亮; 牧野 圭太郎; 鈴木 隆雄
  理学療法学, 2016年10月, (公社)日本理学療法士協会, 日本語
  2016年10月 - 2016年10月, 【はじめに，目的】椅子の立ち座り動作で測定するFive-Times-Sit-to-Stand Test（FTSS）および3m歩行路によるTimed Up ＆ Go Test（TUG）は簡便に実施でき，理学療法に関わる評価として汎用性が高い。これらは下肢機能の評価指標とされ，転倒リスクの抽出に有用とされている。しかし，将来の要介護発生リスクを抽出するためのカットオフ値は示されていない。本研究ではFTSSとTUGによって地域高齢者の要介護発生リスクを捉えることができるか，要介護リスクを抽出する適切なカットオフ値があるかを検証した。地域高齢者に対するFTSSとTUGの有用性を提示することが意義となる。【方法】健診に参加した地域高齢者5104名のうち，パーキンソン病・脳卒中の既往者，既に要介護認定がある者，MMSE18点未満者，測定不可者，追跡中の死亡・市外転出者を除く4335名を対象とした。ベースラインでFTSSとTUGを測定した。FTSSは座面高45cmの椅子から5回連続の立ち座り動作の所要時間を計測した。TUGでは，椅子から立ち上がり，3m前方の目印まで通常速度で歩き方向転換し，再び椅子に座るまでの時間を測定した。ベースライン以降，1か月ごとの要介護認定情報を行政の介護保険担当課で照合し，2年間追跡した。追跡中での新規要介護発生者と未発生者でベースライン測定値を比較した。要介護発生に対するFTSSとTUGのカットオフ値を求め，Log-rank検定およびCox比例ハザード回帰分析を用いて要介護発生との関連を調べた。危険率5％未満を有意とした。【結果】2年間で161名（3.7%）が新規に要介護を発生した。全対象者でのベースラインのFTSSは8.5±2.6秒，TUGは8.2±1.6秒であり，要介護発生者ではいずれも未発生者より有意に遅かった（p＜.01）。要介護発生に対するカットオフ値はFTSSで10秒以上（感度49%，特異度78%），TUGで9秒以上（感度60%，特異度74%）であった。要介護発生率は，FTSS（≧10秒）・TUG（≧9秒）ともにカットオフ値よりも遅い群で最も高く（11.8%），FTSS・TUGともにカットオフ値より速い群（1.7%），FTSSのみ遅い群（4.3%），TUGのみ遅い群（5.8%）のいずれの群よりも有意に高い発生率であった（p＜.01）。要介護発生に対するハザード比は，FTSS・TUGとも良好な群に比べて，FTSSのみ遅い群で1.9（95%信頼区間1.1-3.2），TUGのみ遅い群で2.2（1.4-3.5），FTSS・TUGともに遅い群で2. 8（1.8-4.3）であった（年齢，性，各疾患，服薬数，認知機能低下，うつ徴候で調整）。【結論】FTSSとTUGでの下肢機能評価は，将来の要介護発生リスクを見出すための重要な指標となることが確認された。FTSSが10秒以上，TUGが9秒以上では要介護発生リスクが増大し，FTSSおよびTUGともこの基準よりも遅い場合，要介護発生リスクが約3倍となることが示唆された。本研究で将来の要介護発生リスクを抽出する具体的な測定値の候補が確認できたことは，一次予防推進を図る予防理学療法の発展に有益と考える。
• 外来化学療法を施行中の進行性がん患者に対する理学療法介入の効果検証 ランダム化比較試験
  井平 光; 牧野 圭太郎; 松田 夕香; 小野 道洋; 石川 和真; 佐藤 昌則; 石合 純夫; 加藤 淳二; 古名 丈人
  理学療法学, 2016年10月, (公社)日本理学療法士協会, 日本語
  2016年10月 - 2016年10月
• 〔主要な業績〕積雪寒冷地域に住む後期高齢者の冬期間の身体活動量低下がその後3年間の認知機能の変化に及ぼす影響
  牧野 圭太郎; 島田 裕之; 牧迫 飛雄馬; 井平 光; 木原 由里子; 石田 豊朗; 志水 宏太郎; 伊藤 一成; 山口 亨; 古名 丈人
  理学療法学, 2016年10月, (公社)日本理学療法士協会, 日本語
  2016年10月 - 2016年10月
• 軽度認知障害を有する高齢者における歩行と白質病変の関係
  土井 剛彦; 島田 裕之; 牧迫 飛雄馬; 堤本 広大; 中窪 翔; 牧野 圭太郎; 鈴木 隆雄
  理学療法学, 2016年10月, (公社)日本理学療法士協会, 日本語
  2016年10月 - 2016年10月, 【はじめに，目的】認知機能と歩行能力は密接に関連しており，軽度認知障害（mild cognitive impairment：MCI）や認知症を有する高齢者に歩行能力の低下が特徴としてみられる。さらに，白質病変などにみられる加齢に伴う脳構造変化が歩行能力と関連することが近年報告されている。しかし，MCI高齢者における歩行能力と白質病変との関連性については明らかにされていない。本研究では，MCI高齢者の歩行能力低下を顕著にする同時課題（dual-task：DT）歩行を測定し，白質病変との関連性を検討した。【方法】本研究はNational Center for Geriatrics and Gerontology-Study of Geriatric Syndromesの参加者の中からMCIと判明した高齢者に対しリクルートを行い，対象者は歩行測定ならびにmagnetic resonance imaging検査を実施した560名とした。歩行条件は通常歩行とDT歩行の2条件で，高齢者の歩行能力として重要とされている体幹安定性を評価するharmonic ratio（HR）を歩行指標として用いた。HRは3軸加速度計により歩行時の体幹加速度を測定した後に3方向各々算出し（前後，垂直，側方方向），値が大きいほど安定性が高い事を意味する。白質病変の評価は，Fazekas scaleを用いて脳室周囲病変ならびに深部皮質下白質病変を評価した。いずれの評価においてグレードIIIと評価された者はsevere white matter lesion（WML）群とした。共変量として生物・医学的特性に加え，遂行機能を評価するSymbol Digit Substitution Task（SDST）を評価した。【結果】対象者を白質病変の程度に基づきnon-severe WML（n=451，平均年齢：73.2歳）とsevere WML（n=109，平均年齢：75.9歳）の各群に群わけした。3方向のHRが通常歩行に比べDT歩行時に有意に低下した（p＜0.05）。DTによる歩行変化は白質病変と関連性がみられ（p＜0.05），共変量（年齢，性別，教育歴，服薬数，高血圧，MCIのsubtype，脳萎縮，歩行速度，SDST）にて調整した混合分析においても側方方向のHRと白質病変の関連性が有意であった（p＜0.05）。【結論】MCI高齢者における歩行能力低下の関連要因として白質病変が関連することが示唆された。認知機能障害を伴う高齢者における歩行能力低下に対して，脳画像を用いた評価を考慮することが重要であると考えられる。
• 軽度認知障害を有する高齢者における灰白質容量と遂行機能は関連するのか?
  堤本 広大; 牧迫 飛雄馬; 土井 剛彦; 中窪 翔; 牧野 圭太郎; 島田 裕之; 鈴木 隆雄
  理学療法学, 2016年10月, (公社)日本理学療法士協会, 日本語
  2016年10月 - 2016年10月, 【はじめに，目的】認知症の前駆症状とされる軽度認知障害（mild cognitive impairment；MCI）では，客観的な認知機能が低下していることが定義とされ，灰白質容量が低下していることが報告されている。認知機能検査の中でも，遂行機能と灰白質容量との関係は多数報告されており，遂行機能が低下している高齢者ほど灰白質容量が低下していることが明らかとなってきている。しかし，MCI高齢者における遂行機能と灰白質容量との関連については議論の余地があり，遂行機能については下位機能が存在するため，灰白質容量低下に関連する下位機能を明らかにすることで，MCI高齢者の早期発見の一助となると考えられる。そこで，本研究では，MCI高齢者における灰白質容量と遂行機能の下位機能検査との関連を横断的に検討する。【方法】対象は，MCIに該当した高齢者83名（平均75.4±6.8歳）とした。遂行機能の下位機能検査として，注意の切り替え機能（Trail Making Test（TMT）），ワーキングメモリ（Digit Span（DS）），および選択的注意・抑制機能（Stroop test（ST））を実施した。灰白質容量の計測については，MRI装置（Magnetom Avanto，Siemens社製）を用いて撮像を行い，FSL（FMRIB's Software Library，Version 5.0）を用いて全脳における灰白質容量を算出した。統計解析では，灰白質容量と各遂行機能との相関関係を調べるためにPearsonの相関係数を算出した。その後，有意な相関関係が認められた遂行機能検査を独立変数とし，従属変数に灰白質容量，共変量に年齢，性別，body mass index，教育歴，mini-mental status examinationスコアを投入した重回帰分析を実施した。なお，統計学的有意水準は5%未満とした。【結果】遂行機能の中で，灰白質容量との有意な相関関係が認められたのはTMTのみで，TMTと灰白質容量との間には負の相関関係が認められた（r=-0.414，p＜0.001）。その後，有意な相関が認められたTMTを独立変数とした重回帰分析を実施した結果，共変量で調整してもTMTと灰白質容量との関連性は有意であった（β=-0.376，p=0.001，R²=0.26）。【結論】本研究では，MCI高齢者における灰白質容量と遂行機能の下位機能検査との関連について検討し，注意の切り替え機能が低下しているMCI高齢者ほど灰白質容量が低下していることが示唆された。今後は，注意の切り替え機能が低下している健常高齢者がより早期にMCIへと移行するかどうかを検討する必要性があると考えらえる。また，本研究結果は，MCIのスクリーニングツールの中でもTMTが有用である可能性を示した。
• 認知機能低下と関係する歩行パラメーター
  島田 裕之; 牧迫 飛雄馬; 土井 剛彦; 堤本 広大; 中窪 翔; 牧野 圭太郎
  理学療法学, 2016年10月, (公社)日本理学療法士協会, 日本語
  2016年10月 - 2016年10月, 【はじめに，目的】認知機能の低下抑制に対して運動の効果が示されるようになり，理学療法領域においても，認知機能低下抑制に対するアプローチが進みつつある。今後，団塊世代が認知症の好発年齢を迎え，認知症予防に対する積極的な取り組みが望まれるが，そのためには認知機能低下の関連因子を同定して，運動療法によって改善可能な要因を検討していく必要がある。本研究では，認知機能低下をmini-mental state examination（MMSE）の得点が23点以下の高齢者を認知機能低下とし，それに関連する歩行パラメーターを大規模集団の横断データによって検討した。【方法】愛知県における高齢者機能健診に参加した地域在住高齢者10885名のうち，パーキンソン病，脳卒中，認知症の既往者，最近3か月以内に入院した者，測定項目に欠損があった者を除く9795名を対象とした。測定項目は，基本属性（年齢，性，教育歴），現病歴（高血圧，心疾患，呼吸器疾患，変形性膝関節症，糖尿病の有無），歩行パラメーター（歩行速度，ケーデンス，ストライド長，歩行速度の変動係数，ケーデンスの変動係数，ストライド長の変動係数），およびMMSEであった。歩行速度の測定は，Walkウェイを用いて通常歩行にて5回計測し，平均値を用いた。統計処理はMMSE（24/23点）を従属変数とし，その他の測定項目を独立変数とした多重ロジスティック回帰分析を実施した。【結果】MMSEの得点が23点以下の全般的認知機能低下に対して有意であった項目のオッズ比は，年齢（オッズ比1.05，95%信頼区間1.03―1.06），性（女性に対して男性のオッズ比2.14，95%信頼区間1.88―2.44），教育歴（オッズ比0.84，95%信頼区間0.82―0.86），変形性膝関節症（なしに対してありのオッズ比0.80，95%信頼区間0.69―0.93），歩行速度の変動係数（オッズ比1.06，95%信頼区間1.02―1.10）であった。有意であった項目を独立変数として，歩行速度の変動係数を四分位に分類して多重ロジスティック回帰分析を実施した結果，Q1に対してQ4のみが有意なオッズ比を示し，その値は1.46（95%信頼区間1.25―1.71）であった。なお，歩行速度の変動係数の75パーセンタイル値は5.95%であった。【結論】全般的認知機能の低下と関連した歩行パラメーターは，歩行速度の変動係数であった。今回の測定方法は，短距離の歩行路を5回に分けて測定する方法を採用しており，連続歩行内での歩行速度の変動を示すものではない。そのため，今回の歩行速度の変動は，前の課題遂行状態をイメージして同様のパフォーマンスを再現できるかといった課題となっている。身体機能の代表的な指標である歩行速度が関連せずに，変動係数が関連したのは，このイメージの再現の過程における脳機能の低下が，全般的認知機能低下と関連したのかもしれない。今後は前方視的な解析によって，歩行速度の変動係数が認知機能低下の予測因子になり得るかを検討していく必要がある。
• 地域在住後期高齢者における身体活動量の縦断調査と関連要因の検討
  伊藤 一成; 井平 光; 牧野 圭太郎; 木原 由里子; 石田 豊朗; 志水 宏太郎; 山口 亨; 牧迫 飛雄馬; 島田 裕之; 古名 丈人
  理学療法学, 2016年10月, (公社)日本理学療法士協会, 日本語
  2016年10月 - 2016年10月
• 地域在住高齢者の社会的サポート低下を予測する因子の検討
  木原 由里子; 井平 光; 牧野 圭太郎; 石田 豊朗; 志水 宏太郎; 伊藤 一成; 山口 亨; 牧迫 飛雄馬; 島田 裕之; 古名 丈人
  理学療法学, 2016年10月, (公社)日本理学療法士協会, 日本語
  2016年10月 - 2016年10月
• 積雪寒冷地域における非冬期の転倒は後期高齢者の運動機能低下を顕在化
  山口 亨; 井平 光; 牧野 圭太郎; 木原 由里子; 石田 豊朗; 志水 宏太郎; 伊藤 一成; 牧迫 飛雄馬; 島田 裕之; 古名 丈人
  理学療法学, 2016年10月, (公社)日本理学療法士協会, 日本語
  2016年10月 - 2016年10月
• 地域在住高齢者における身体機能が転倒恐怖感に及ぼす影響
  石田 豊朗; 井平 光; 牧野 圭太郎; 木原 由里子; 志水 宏太郎; 伊藤 一成; 山口 亨; 古名 丈人
  理学療法学, 2016年10月, (公社)日本理学療法士協会, 日本語
  2016年10月 - 2016年10月
• 地域在住後期高齢者における筋肉量の低下に対するself-efficacyおよび活動能力の影響について
  志水 宏太郎; 井平 光; 牧野 圭太郎; 木原 由里子; 石田 豊朗; 伊藤 一成; 山口 亨; 牧迫 飛雄馬; 島田 裕之; 古名 丈人
  理学療法学, 2016年10月, (公社)日本理学療法士協会, 日本語
  2016年10月 - 2016年10月
• 地域在住高齢者における転倒恐怖感と歩行指標との関連 転倒経験による比較
  牧野 圭太郎; 島田 裕之; 牧迫 飛雄馬; 土井 剛彦; 堤本 広大; 堀田 亮; 中窪 翔; 鈴木 隆雄
  日本老年医学会雑誌, 2016年05月, (一社)日本老年医学会, 日本語
  2016年05月 - 2016年05月
• Insulin-like Growth Factor-1と新規要介護認定発生との関係
  土井 剛彦; 島田 裕之; 牧迫 飛雄馬; 堤本 広大; 中窪 翔; 堀田 亮; 牧野 圭太郎; 鈴木 隆雄
  日本老年医学会雑誌, 2016年05月, (一社)日本老年医学会, 日本語
  2016年05月 - 2016年05月
• 認知症発症の危険因子としての軽度認知障害とうつ徴候
  牧迫 飛雄馬; 島田 裕之; 土井 剛彦; 堤本 広大; 堀田 亮; 中窪 翔; 牧野 圭太郎; 鈴木 隆雄
  日本老年医学会雑誌, 2016年05月, (一社)日本老年医学会, 日本語
  2016年05月 - 2016年05月
• 地域在住高齢者の健康行動と要介護の新規発生の関連
  堀田 亮; 島田 裕之; 牧迫 飛雄馬; 土井 剛彦; 堤本 広大; 中窪 翔; 牧野 圭太郎; 鈴木 隆雄
  日本老年医学会雑誌, 2016年05月, (一社)日本老年医学会, 日本語
  2016年05月 - 2016年05月
• 主観的なもの忘れが認知症発症に与える影響 健常高齢者と認知機能が低下した高齢者の比較
  堤本 広大; 牧迫 飛雄馬; 土井 剛彦; 中窪 翔; 牧野 圭太郎; 島田 裕之; 鈴木 隆雄
  日本老年医学会雑誌, 2016年05月, (一社)日本老年医学会, 日本語
  2016年05月 - 2016年05月
• Motoric Cognitive Risk Syndromeと新規要介護認定発生との関係
  土井 剛彦; 島田 裕之; 牧迫 飛雄馬; 堤本 広大; 中窪 翔; 堀田 亮; 牧野 圭太郎; Verghese Joe; 鈴木 隆雄
  日本老年医学会雑誌, 2016年05月, (一社)日本老年医学会, 日本語
  2016年05月 - 2016年05月
• 地域在住高齢者における身体的フレイルと食欲低下との関連
  堤本 広大; 土井 剛彦; 牧迫 飛雄馬; 堀田 亮; 中窪 翔; 牧野 圭太郎; 島田 裕之; 鈴木 隆雄
  日本老年医学会雑誌, 2016年05月, (一社)日本老年医学会, 日本語
  2016年05月 - 2016年05月
• 地域在住高齢者における歩行指標の加齢変化
  中窪 翔; 島田 裕之; 牧迫 飛雄馬; 土井 剛彦; 堤本 広大; 堀田 亮; 牧野 圭太郎; 鈴木 隆雄
  日本老年医学会雑誌, 2016年05月, (一社)日本老年医学会, 日本語
  2016年05月 - 2016年05月
• 認知症発症の危険因子としての軽度認知障害とうつ徴候
  牧迫 飛雄馬; 島田 裕之; 土井 剛彦; 堤本 広大; 堀田 亮; 中窪 翔; 牧野 圭太郎; 鈴木 隆雄
  日本老年医学会雑誌, 2016年05月, (一社)日本老年医学会, 日本語
  2016年05月 - 2016年05月
• 地域在住後期高齢者における高次生活機能の維持と認知機能との関連
  牧野 圭太郎; 島田 裕之; 牧迫 飛雄馬; 井平 光; 古名 丈人
  日本老年医学会雑誌, 2016年05月, (一社)日本老年医学会, 日本語
  2016年05月 - 2016年05月
• 後期高齢がんサバイバーにおける肉類の摂取と身体活動との関連性
  井平 光; 牧野 圭太郎; 木原 由里子; 石田 豊朗; 志水 宏太郎; 伊藤 一成; 山口 亨; 水本 淳; 古名 丈人
  日本老年医学会雑誌, 2016年05月, (一社)日本老年医学会, 日本語
  2016年05月 - 2016年05月
• 外来化学療法を施行中の進行性がん患者に対する理学療法介入の効果検証
  井平 光; 牧野 圭太郎; 松田 夕香; 小野 道洋; 石川 和真; 佐藤 昌則; 石合 純夫; 加藤 淳二; 古名 丈人
  理学療法学Supplement, 2016年, 公益社団法人 日本理学療法士協会, 日本語
  2016年 - 2016年, 【はじめに，目的】がんの早期発見と治療技術の向上により，がん治療後の患者に対する医療の充実や生活の質（Quality of Life；QOL）の向上が急務の課題となっている。がん治療のなかでも，近年，在宅での生活やQOL向上を目的とした外来化学療法を主体とする治療が増加している。しかしながら，がんと理学療法に関する研究のなかでは，体力向上や副作用軽減を目的とした介入研究は少ない。本研究では外来化学療法施行中の進行性がん患者に対して，在宅で実施可能な理学療法介入が身体機能およびQOLに及ぼす影響を明らかにすることを目的とした。【方法】対象は，2014年7月～2015年7月までに札幌医科大学附属病院で外来化学療法を施行した進行性がん患者24名とした。24名のがん患者は介入群12名と対照群12名にランダムに割り付けられ，ベースライン時と3ヵ月後に機能評価が実施された。ベースライン評価として，握力，膝伸展筋力，および開眼片脚立位時間を実測し，がん患者に対するQOL評価としてEORTC QLQ-C30による質問紙調査を実施した。本研究で実施した理学療法介入は，在宅での筋力増強運動と活動量モニタリングから構成された。筋力増強運動は，ブリッジ運動やスクワットなどを直接指導し，パンフレットを配布することで在宅での実施を促した。活動量モニタリングについては，活動記録器ライフコーダGS（スズケン社）を貸与し，毎日の歩数を運動実施カレンダーに記載させた。外来化学療法の実施ごとに，理学療法士が運動実施カレンダーを通して筋力増強運動と活動量モニタリングの実施状況を確認し，身体活動を促した。統計学的分析は，反復測定の二元配置分散分析を実施し，それぞれの評価項目について群（介入群－対照群）と期間（ベースライン－3ヵ月後）の交互作用を確認した。統計処理にはSPSS22.0を用い，危険率5％未満を有意とした。【結果】年齢，性別，および癌種について介入群（平均年齢63.6±11.2歳，男性7名）と対照群（平均年齢62.3±13.9歳，男性9名）の間に有意な差は認められなかった。介入群と対照群の運動機能をベースラインと3ヵ月後で比較したところ，握力，膝伸展トルク，および開眼片脚立位時間に有意な交互作用は認められなかった。一方で，がん患者のQOL指標であるEORTC QLQ-C30では，身体機能，疲労感，および食欲不振の項目について群と期間の有意な交互作用が認められた（p＜0.05）。【結論】本研究の結果から，筋力増強運動と活動量モニタリングを含む理学療法介入が，実測された運動機能に効果的であったことを示す知見を得ることは出来なかった。しかしながら，質問紙評価による身体機能や疲労感については，3ヵ月後の介入群で良好な値を示した。したがって，本研究の理学療法介入は，直接的には運動機能に影響を与えなかったが，主観的な身体機能や疲労感など一部の機能に対しては良好な影響を及ぼした可能性が示唆された。
• リハビリ専門デイサービス利用者の生活機能が運動介入効果に及ぼす影響
  野上あかり; 綿谷美佐子; 佐藤美歩; 牧野圭太郎; 山口亨; 井平光; 古名丈人
  第2回 日本予防理学療法学会学術集会, 2015年12月
• 地域在住高齢がんサバイバーの罹患年数の違いによる健康関連QOLと認知機能の比較
  井平 光; 牧野 圭太郎; 木原 由里子; 石田 豊朗; 伊藤 一成; 山口 亨; 赤沼 智美; 横山 香理; 牧迫 飛雄馬; 古名 丈人
  日本公衆衛生学会総会抄録集, 2015年10月, 日本公衆衛生学会, 日本語
  2015年10月 - 2015年10月
• 温熱介入によってオキサリプラチン誘発性末しょう神経障害の発症抑制と改善を経験した2症例
  井平光; 瀧本理修; 松田夕香; 牧野圭太郎; 小野道洋; 岡川泰; 石合純夫; 加藤淳二; 古名丈人
  第13回日本臨床腫瘍学会学術集会, 2015年07月
  2015年07月 - 2015年07月
• Characteristics of social function, exercise behaviours, health-related outcome and nutrition status in community-dwelling cancer survivours aged 65 years and older
  Ihira H; Mizumoto A; Makino K; Ishida T; Shimizu K; Saitoh S; Ohnishi H; Furuna T
  World Confederation for Physical Therapy congress, 2015年05月
  2015年05月 - 2015年05月
• 〔Major achievements〕Association between group exercise and exercise self-efficacy in community-dwelling older people
  Makino K; Ihira H; Mizumoto A; Ishida T; Shimizu K; Furuna T
  World Confederation for Physical Therapy congress, 2015年05月
• 地域在住高齢者における転倒恐怖感の有無と身体活動量の関係性
  石田 豊朗; 井平 光; 水本 淳; 牧野 圭太郎; 志水 宏太郎; 古名 丈人
  理学療法学, 2015年04月, (公社)日本理学療法士協会, 日本語
  2015年04月 - 2015年04月
• 地域在住高齢者の活動習慣や食品摂食習慣と認知機能との関連性
  志水 宏太郎; 井平 光; 水本 淳; 牧野 圭太郎; 石田 豊朗; 島田 裕之; 古名 丈人
  理学療法学, 2015年04月, (公社)日本理学療法士協会, 日本語
  2015年04月 - 2015年04月
• 75歳以上の地域在住高齢がんサバイバーにおける心身機能の特徴 運動機能、認知機能、および健康関連指標の比較
  井平 光; 水本 淳; 牧野 圭太郎; 石田 豊朗; 志水 宏太郎; 牧迫 飛雄馬; 島田 裕之; 古名 丈人
  理学療法学, 2015年04月, (公社)日本理学療法士協会, 日本語
  2015年04月 - 2015年04月
• 地域在住後期高齢女性の認知機能が1年後の外出頻度に及ぼす影響
  牧野 圭太郎; 井平 光; 水本 淳; 石田 豊朗; 志水 宏太郎; 牧迫 飛雄馬; 島田 裕之; 古名 丈人
  理学療法学, 2015年04月, (公社)日本理学療法士協会, 日本語
  2015年04月 - 2015年04月
• Association between fall history and subjective age among community-dwelling older people aged 75 and older
  Ihira H; Mizumoto A; Makino K; Furuna T
  9th Pan-Pacific Conference on Rehabilitation cum 21st Annual Congress of Gerontology, 2014年11月
  2014年11月 - 2014年11月
• Factors relate to daily step in community-dwelling older people aged 75 and older
  Makino K; Ihira H; Mizumoto A; Ishida T; Shimizu K; Furuna T
  9th Pan-Pacific Conference on Rehabilitation cum 21st Annual Congress of Gerontology, 2014年11月
• 等尺性膝伸展運動における最大トルクと大腿筋厚、同時収縮率の年代比較
  牧野 圭太郎; 井平 光; 水本 淳; 古名 丈人
  理学療法学, 2014年05月, (公社)日本理学療法士協会, 日本語
  2014年05月 - 2014年05月
• 75歳以上の地域在住高齢者における主観的な体力年齢と認知年齢に関連する要因
  井平 光; 古名 丈人; 水本 淳; 牧野 圭太郎; 島田 裕之; 牧迫 飛雄馬
  理学療法学, 2014年05月, (公社)日本理学療法士協会, 日本語
  2014年05月 - 2014年05月
• 積雪寒冷地域に在住する後期高齢者における冬期間の外出行動と身体機能および生活機能との関係
  安田 圭佑; 井平 光; 水本 淳; 牧野 圭太郎; 宮部 瑶子; 古名 丈人
  理学療法学, 2014年05月, (公社)日本理学療法士協会, 日本語
  2014年05月 - 2014年05月
• 疼痛を有する後期高齢者の身体活動量と活動強度の特性
  村瀬 裕志; 古名 丈人; 井平 光; 水本 淳; 牧野 圭太郎
  理学療法学, 2014年05月, (公社)日本理学療法士協会, 日本語
  2014年05月 - 2014年05月
• 計算課題と語想起課題が地域在住後期高齢者の二重課題歩行に及ぼす影響の比較
  志水 宏太郎; 佐々木 健史; 井平 光; 水本 淳; 牧野 圭太郎; 古名 丈人
  理学療法学, 2014年05月, (公社)日本理学療法士協会, 日本語
  2014年05月 - 2014年05月
• The association between going outdoors daily and physical functions in community-dwelling older adults
  Makino K; Ihira H; Mizumoto A; Yasuda K; Furuna T
  The 20th IAGG World Congress of Gerontology and Geriatrics, 2013年06月
• 地域在住高齢者の1年間の連続歩行距離低下と身体機能との関連
  牧野 圭太郎; 井平 光; 水本 淳; 安田 圭佑; 古名 丈人
  理学療法学, 2013年05月, (公社)日本理学療法士協会, 日本語
  2013年05月 - 2013年05月
• タッチによる姿勢安定化に荷重の加え方が及ぼす影響
  安田 圭佑; 古名 丈人; 井平 光; 水本 淳; 牧野 圭太郎
  理学療法学, 2013年05月, (公社)日本理学療法士協会, 日本語
  2013年05月 - 2013年05月
• 積雪寒冷地域に在住する後期高齢者の冬期間の機能変化(PIPAOI‐study)
  水本淳; 古名丈人; 井平光; 安田圭佑; 牧野圭太郎; 佐々木健史; 宮部瑤子; 赤沼智美; 横山香理; 島田裕之; 斎藤重幸; 大西浩文; 安村誠司; 鈴木隆雄
  日本応用老年学会大会, 2013年, 日本語
  2013年 - 2013年
• タッチによる姿勢安定化に荷重の加え方が及ぼす影響
  安田 圭佑; 古名 丈人; 井平 光; 水本 淳; 牧野 圭太郎
  日本理学療法学術大会, 2013年, 公益社団法人 日本理学療法士協会, 日本語
  2013年 - 2013年, 【はじめに、目的】立位時に固定物に触ることで指先の皮膚を介して機械受容器が興奮し，体性感覚入力が増加することでCOP（Center of Pressure）の動揺が減少すると報告されている。特に，固定物に指先が加える力（コンタクトフォース）が1N以下であると，指先による力学的な支持の影響は小さいと報告されている。このようなタッチを用いた立位姿勢の安定化に関する研究の中で，触圧覚の重要性について報告されている一方で，固定物への荷重の加え方がCOP動揺の減少に影響するかについて明らかとされていない。先行研究のように固定物に触る時のコンタクトフォースを任意とした場合身体の動揺が大きくなると皮膚の変位が大きくなるが，コンタクトフォースを一定にする課題を与えた場合皮膚の変位が小さくなるために従来の方法に比べてCOP動揺が増加する可能性が予想される。本研究では，従来の方法によるタッチの場合とコンタクトフォースを一定とした場合のCOP動揺の比較を行うことで，固定物への荷重の加え方がタッチによる姿勢安定化に影響を与えるのかどうか検討することを目的とした。【方法】対象は健常成人男女16 名（平均年齢22.5 ± 1.3 歳，男8 名，女性8 名）とした。対象者には，床反力計（Kistler社製）の上で左足を前としたタンデム立位を取らせ，体側に垂らした右示指の位置に設置したピンチメータ（Biometrics社製）に示指の指腹を接触させた。被験者の前にはディスプレイを設置し，ピンチメータから得たコンタクトフォースをリアルタイムに掲示した。測定条件は，ピンチメータに触る条件を1）1N以下の任意の力で触るPrefer条件，2）0.2Nの一定の力で触る0.2N条件，3）0.5Nの一定の力で触る0.5N条件の3 条件に設定した。0.2 条件と0.5N条件では，ディスプレイ上の0.2Nおよび0.5Nの位置にターゲットとなるラインを掲示し，出来る限りそのラインにコンタクトフォースを合わせるよう教示した。試行はブロックランダマイズ化し，各4 試行測定した。床反力計およびピンチメータのサンプリング周波数は1000Hz とし，測定した30 秒間のうち最初と最後の2 秒間を除く20 秒間を解析区間とした。床半力データからCOPを算出し，COPおよびピンチメータのデータはフィルター処理後，COPデータから動揺速度および実効値面積，前後・左右方向の平均動揺振幅を算出し，ピンチメータデータから平均値および変動係数を算出した。統計学的分析として3 条件で得られた全ての変数に対し反復測定分散分析を行い，主効果の検討を行った。また，有意性が確認された場合Bonfferoniによる事後検定を行い有意性の検討を行った。統計解析にはSPSS19.0 を使用し，有意水準は5%未満とした。【倫理的配慮、説明と同意】対象者にはヘルシンキ宣言の趣旨に沿い本研究の主旨および目的を口頭と書面にて説明し，書面にて同意を得た。なお，本研究は札幌医科大学倫理審査委員会の承認を受けて実施した。【結果】コンタクトフォースの平均値は，Prefer条件が0.191 ± 0.020N，0.2N条件が0.215 ± 0.005N，0.5N条件が0.498 ± 0.004N であり，Prefer条件および0.2N条件に比べて0.5N条件で有意に大きい値であった（p<0.05）。実効値面積および左右方向の平均動揺振幅は，Prefer条件に比べて0.2N条件および0.5N条件でそれぞれ有意な減少がみられ（p<0.05），0.2N条件と0.5N 条件の間では有意差はみられなかった。動揺速度および前後方向の平均動揺振幅は，3条件の間で有意差はみられなかった。【考察】従来のタッチ課題に比べて一定の力で触る課題を課すことで，左右方向の動揺の大きさおよび重心動揺面積が有意に減少した。動揺速度については3 条件で有意な差がみられなかった。これらのことから，固定物への荷重の加え方の違いは，身体動揺の振幅の大きさに影響を与える一方で，身体動揺の速さには影響を与えない可能性が考えられた。先行研究では0.2-0.5N程度の力が指先に加わったときにCOP動揺が減少すると報告されており，指先に加わる力が変動せずに一定であっても0.2-0.5N程度の力が指先に加わるということが身体動揺の安定化に重要である可能性が示唆された。【理学療法学研究としての意義】感覚障害や加齢によるバランス機能低下に対してアプローチする際に，上肢からの体性感覚入力による姿勢安定化の有用性を考える上での基礎的な知見を得ることが出来る。
• 地域在住高齢者の1年間の連続歩行距離低下と身体機能との関連
  牧野 圭太郎; 井平 光; 水本 淳; 安田 圭佑; 古名 丈人
  日本理学療法学術大会, 2013年, 公益社団法人 日本理学療法士協会, 日本語
  2013年 - 2013年, 【はじめに、目的】高齢者における歩行能力の低下は、加齢に伴う身体機能低下の初期兆候として知られており、その重要性が広く認識されている。高齢者の歩行に関する先行研究では、歩行速度などの機能的変化についての検討が多く報告されているものの、歩行の耐久性などの活動に繋がる能力低下について縦断的に分析したものは散見される程度である。歩行能力低下を早期に発見し、加齢による活動制限に対する予防策を講じるためには、歩行の耐久性を含めてより多面的に身体機能の変化について検討する必要がある。本研究の目的は、地域在住高齢者における1年間の連続歩行距離低下と身体機能との関連について検討することとした。【方法】2009～2012年の間にS市にて年1回の頻度で毎年開催されている体力測定会において、上記の期間の内、連続した2年間のデータが揃っている65歳以上の地域在住高齢者47名（男性13名、女性34名、ベースライン平均年齢74.0±6.2歳）を対象とした。分析に用いた項目は、連続歩行距離、握力、開眼片脚立位時間、5m最大歩行速度、Functional Reach Testとした。連続歩行距離は質問紙を利用して、対象者の休まず歩ける距離を「1：10m未満」「2：10～50m未満」「3：50～100m未満」「4：100～500m未満」「5：500～1km未満」「6：1km以上」の6段階で聴取した。握力は、スメドレー式握力計を用いて測定し、2回の最大値を代表値として採用した。開眼片脚立位時間は、対象者の任意側の脚を拳上し続けることができる時間を計測した。5m最大歩行速度は、対象者に「できるだけ速く歩いてください」と教示し、直線11mの歩行路（加速路および減速路各3m、測定区間5m）上を歩行するのに要した時間を計測し、速度に換算した。Functional Reach Testは、安静立位にて基準線から最も前方に届いた手指先端の位置までの距離を計測し、2回の最大値を採用した。統計学的分析は、各変数の1年間の変化について、対応のあるt検定により検討した。また、対象者を1年後の連続歩行距離が低下した群と低下しなかった群の2群に分け、ベースラインにおける各身体機能の群間差を対応のないt検定を用いて検討した。統計処理にはSPSS19.0を使用し、有意水準は5%未満とした。【倫理的配慮、説明と同意】対象者には本研究の目的について口頭および案内文により説明を行い、書面にて測定参加の同意を得た。なお、本研究は札幌医科大学倫理審査委員会の承認を受けて実施した。【結果】連続歩行距離および各身体機能について、一年間で有意な変化は認められなかった。ベースラインの連続歩行距離は、段階1が1名、段階2が0名、段階3が2名、段階4が4名、段階5が7名、段階6が33名であり、1年後の変化は9名が低下、38名が維持または向上という結果であった。 1年後の連続歩行距離が低下した群は、低下しなかった群と比較してベースラインの5m最大歩行速度が有意に低く（p=0.04）、その他身体機能の指標である握力（p=0.86）、開眼片脚立位時間（p=0.26）、Functional Reach Test（p=0.14）においては有意差が認められなかった。【考察】地域在住高齢者の連続歩行距離は、身体機能が比較的高い高齢者であっても1年間で低下する可能性があることが示された。また、ベースラインの歩行速度低下がその後の連続歩行距離低下と関連していることが確認された。 一般的に加齢に伴う機能低下は、高次の社会的要素から低次の機能的要素へと低下が生じるとされている。本研究結果においても身体機能には1年間で変化が認められなかったが、連続歩行距離低下が低下した群、低下しなかった群に分けてみた場合、ベースラインの歩行速度が高い者が連続歩行距離を維持していたことが明らかとなった。 以上から、運動機能を高いレベルで維持することの重要性が改めて示唆されたと考える。【理学療法学研究としての意義】地域在住高齢者の連続歩行距離の縦断変化を考えるうえで、初期の歩行速度を評価する必要性が示された。今後さらなる研究を行うことで、高齢者の連続歩行距離低下のリスクを発見し、早期介入に繋げるための有用な知見が得られると考える。
• 地域在住高齢者における身体活動量と体幹機能との関連性
  牧野 圭太郎; 古名 丈人; 木村 美佳; 井平 光; 水本 淳; 安田 圭佑; 牧迫 飛雄馬
  日本公衆衛生学会総会抄録集, 2012年10月, 日本公衆衛生学会, 日本語
  2012年10月 - 2012年10月
• 札幌市に在住する高齢者の身体活動量と環境要因の関連性
  水本 淳; 古名 丈人; 井平 光; 安田 圭佑; 牧野 圭太郎; 木村 美佳; 牧迫 飛雄馬
  日本公衆衛生学会総会抄録集, 2012年10月, 日本公衆衛生学会, 日本語
  2012年10月 - 2012年10月
• 地域在住高齢者における体幹の機能的役割について 構造方程式モデリングによる検討
  井平 光; 古名 丈人; 木村 美佳; 水本 淳; 安田 圭佑; 牧野 圭太郎; 牧迫 飛雄馬
  日本公衆衛生学会総会抄録集, 2012年10月, 日本公衆衛生学会, 日本語
  2012年10月 - 2012年10月
• 地域在住高齢者の連続歩行距離には歩行時の体幹動揺が関係するのか?
  安田 圭佑; 古名 丈人; 木村 美佳; 井平 光; 水本 淳; 牧野 圭太郎; 牧迫 飛雄馬
  日本公衆衛生学会総会抄録集, 2012年10月, 日本公衆衛生学会, 日本語
  2012年10月 - 2012年10月
• 下肢の身体図式と障害物跨ぎ動作の関係性の検討
  牧野 圭太郎; 佐々木 健史; 古名 丈人; 小松 愛実; 村瀬 裕志; 安田 圭佑; 井平 光; 水本 淳; 大國 美佳
  理学療法学, 2012年04月, (公社)日本理学療法士協会, 日本語
  2012年04月 - 2012年04月

• 2026年 - 現在
  日本運動疫学会
• 2025年 - 現在
  北海道公衆衛生学会
• 2025年 - 現在
  日本健康学会
• 2021年 - 現在
  日本老年療法学会
• 2017年 - 現在
  日本公衆衛生学会
• 2015年 - 現在
  日本老年医学会
• 2012年 - 現在
  日本理学療法士協会

• 胎児期から続く化学物質によるリプロダクティブヘルスへの影響：分子機構の解明を含む
  科学研究費助成事業
  2025年04月 - 2029年03月
  岸 玲子; アイツバマイ ゆふ; 山口 健史; 伊藤 佐智子; 岩田 啓芳; 牧野 圭太郎; 田村 菜穂美; 馬場 剛; 齊藤 良玄; 江口 哲史; 今 雅史; 村西 雄貴; 平田 由里絵
  日本学術振興会, 基盤研究(A), 北海道大学, 25H01076
• フタル酸エステル類曝露と体組成：幼児期から思春期の運動習慣を加味した長期縦断研究
  2025年04月 - 2029年03月
  牧野 圭太郎; 山口 健史; アイツバマイ ゆふ
  日本学術振興会 科学研究費補助金（基盤研究C）, 研究代表者
• 認知予備能に寄与するライフスタイルの解明：ライフログデータを用いた検討
  科学研究費補助金（基盤研究C）
  2022年04月 - 2025年03月
  牧野 圭太郎
  日本学術振興会, 研究代表者
• 軽度認知障害（MCI）改善のエピゲノム制御解明と介入標的の探索
  特別研究員奨励費（PD）
  2020年04月 - 2023年03月
  牧野 圭太郎
  日本学術振興会, 研究代表者
• 身体活動の抗炎症作用による神経保護メカニズムに脳内Aβ蓄積が及ぼす影響の検討
  科学研究費補助金（若手研究）
  2020年04月 - 2022年03月
  牧野 圭太郎
  日本学術振興会, 研究代表者
• 慢性疼痛高齢者の身体活動量と疼痛強度に関するエピジェネティクス的検討
  科学研究費補助金（若手研究）
  2018年04月 - 2020年03月
  牧野 圭太郎
  日本学術振興会, 研究代表者, 競争的資金
• 抑うつ高齢者の身体活動量とBDNFおよび脳容量との関連 ―慢性疼痛の有無に着目した縦断観察研究―
  第34回 健康科学研究助成
  2017年04月 - 2018年03月
  牧野 圭太郎
  明治安田厚生事業団, 研究代表者, 競争的資金
• うつ徴候および軽度記憶障害を有する高齢者に対する非薬物介入の効果検証
  科学研究費助成事業
  2014年04月 - 2018年03月
  牧迫 飛雄馬; 島田 裕之; 土井 剛彦; 李 相侖; 堤本 広大; 中窪 翔; 堀田 亮; 牧野 圭太郎
  地域高齢者202名を調査した結果、97名（48.0%）が脳の健康のために取組んでいる活動があると回答し、取組んでいない者と比較して、記憶や情報処理課題の成績が良好であった。軽度認知機能障害を有する高齢女性56名を対象に語想起課題中の脳血流と園芸活動の有無との関連を調べたところ、日常的に園芸を実施している者で脳血流が有意に増大していた。また、うつ徴候および軽度記憶障害を有する高齢者89名を運動群、菜園群、対照群にランダムに割り付け6か月間の介入前後での効果を調べたところ、運動介入は記憶および持久性の向上に効果が期待されることが示されたが、菜園作業での介入効果は確認することができなった。
  日本学術振興会, 若手研究(A), 26702033
• 軽度認知障害高齢者の視機能低下が運転技能に与える影響―補足眼野から読み解く―
  科学研究費助成事業
  2015年04月 - 2017年03月
  堤本 広大; 島田 裕之; 鈴木 隆雄; 牧迫 飛雄馬; 土井 剛彦; 堀田 亮; 中窪 翔; 牧野 圭太郎; 山田 実; 小野 玲
  対象者の各視機能評価の平均値は、深視力；3.29±3.62、動体視力；0.21±0.14、動的視野12465.3±2179.3であった。視機能検査と脳構造との関連を示したのは、動的視野のみで（p = 0.022）、島皮質前部との関連を示していた。島皮質は、情動と強い関連があることが報告されており、自己否定的な者において強く活動する。本結果を推察すると、運転に余裕を有するドライバーは、島皮質が異常発達はしておらず、動的な視野が担保されているのではないかと考えられる。これらの関係を検証するには、運転時の情動・余裕について評価して、因果関係を検証する必要があるため、今後さらなる検証をすすめる。
  日本学術振興会, 挑戦的萌芽研究, 国立研究開発法人国立長寿医療研究センター, 15K12593

• 第12回 日本サルコペニア・フレイル学会大会 実行委員
  2025年11月
  企画立案・運営等
• 第3回 日本老年療法学会学術集会 準備委員
  2024年08月
  企画立案・運営等
• 平成28年度 日本地域理学療法フォーラム 運営委員
  2017年02月
  企画立案・運営等
• 第8回 日本応用老年学会大会 大会事務局
  2013年11月
  企画立案・運営等

• 「コグニサイズ研修会 ～運動による認知症予防～」
  2022年01月
  講師
  豊田市 生涯スポーツ推進課
• 「エコロコ！やまべェ誰でも体操」の継続実施による心身への効果検証
  2020年10月 - 2021年03月
  助言・指導
  札幌市 西区 保健福祉部
• 「コグニサイズ合同研修会」
  2020年11月
  講師
  豊田市 生涯スポーツ推進課
• 「日常生活でいま私たちにできる認知症予防」
  2019年03月
  講師
  名古屋市 緑区 地域女性団体連絡協議会
• 介護予防講演会「コグニサイズで認知症予防 ～楽しく脳を活性化しよう～」
  2019年01月
  講師
  蒲郡市 市民福祉部 長寿課
• 市民公開講座「運動による認知症予防 ～コグニサイズのすすめ～」
  2018年12月
  講師
  国立長寿医療研究センター
• スキルアップ研修・認知機能低下予防運動コース
  2018年12月
  講師
  公益財団法人 健康・体力づくり事業財団
• 定期研修「認知症予防の理論と実践」
  2018年10月
  講師
  札幌市 手稲区 通所サービス連絡会
• ボランティア研修会「認知症を予防するために私たちが今できること ～地域みんながいつまでも元気に～」
  2018年06月
  講師
  名古屋市 瑞穂区 穂波学区 地域福祉推進協議会
• スキルアップ研修・認知機能低下予防運動コース
  2017年12月
  講師
  公益財団法人 健康・体力づくり事業財団
• スキルアップ研修・認知機能低下予防運動コース
  2017年01月
  講師
  公益財団法人 健康・体力づくり事業財団
• 「認知症予防プログラム コグニサイズを知ろう」
  2017年01月
  講師
  扶桑町 健康福祉部 介護健康課
• 認知症予防運動 コグニサイズ（連続講座）
  2016年07月 - 2016年12月
  講師
  中日文化センター
• 「今日から始める転倒予防」
  2016年01月
  講師
  医療法人社団 豊生会

• 「高齢者の中高強度身体活動、アミロイドβ蓄積に伴う認知機能低下を緩和か」
  2026年07月
  本人以外
  医療NEWS QLifePro
  ［インターネットメディア］
• 「IADL制限とMCIの併存は認知症発症リスクを約3倍に高める」
  2025年04月
  本人以外
  CareNet Academia
  ［インターネットメディア］
• 「心血管疾患リスクが高くても身体活動量が多い高齢者は脳体積が大きい」
  2022年09月
  本人以外
  ヘルスデージャパン
  HealthDay News
  ［インターネットメディア］

• 主な査読歴
  Geriatrics & Gerontology International, The Journals of Gerontology: Series A, Journal of the American Medical Directors Association