論文 - 井平　光

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

　概要を見る

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.

DOI

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 ( Springer Science and Business Media LLC )   2025年02月

DOI

Effects of Walking-Only Intervention on Physical Function, Fall-Related Outcomes, and Health-Related Quality of Life in Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis.

Tomoya Ishigaki, Shogo Misu, Toshinori Miyashita, Daisuke Matsumoto, Midori Kamiya, Akio Okamae, Tatsuya Ogawa, Hikaru Ihira, Yoshiaki Taniguchi, Takeshi Ohnuma, Tomohisa Chibana, Natsu Morikawa, Tome Ikezoe, Hyuma Makizako

Journal of aging and physical activity     1 - 13  2024年08月  [査読有り]  [国際誌]

　概要を見る

This study aimed to determine the effects of walking-only intervention (walking was the only exercise in which people participated) on physical function, fall-related outcomes, and health-related quality of life in community-dwelling older adults. We conducted a systematic search across five electronic databases, assessing risk of bias using Minds Manual for Guideline Development. Meta-analyses were performed, and pooled standardized mean differences were calculated. Nine studies (a total of 1,309 participants) were included, showing that walking-only interventions improved walking endurance (standardized mean difference: 1.11, 95% confidence interval: [0.08, 2.15]) and health-related quality of life (standardized mean difference: 0.71, 95% confidence interval: [0.18, 1.25]). However, there were no significant improvements in other outcomes. The certainty of the evidence based on the Grading of Recommendations, Assessment, Development, and Evaluation approach for all outcomes was graded as very low, primarily due to significant inconsistency and imprecision. Our results suggest that walking-only intervention can be effective for enhancing walking endurance and health-related quality of life for community-dwelling older adults. Further studies are required to investigate the effects of walking-only intervention. This need stems from the limited number of randomized controlled trials, heterogeneous intervention settings and results, and the very low certainty of the evidence.

DOI PubMed

Plasma Albumin, Bilirubin, and Uric Acid and the Subsequent Risk of Cancer: A Case-Cohort Study in the Japan Public Health Center-based Prospective Study.

Hikaru Ihira, Shiori Nakano, Taiki Yamaji, Ryoko Katagiri, Norie Sawada, Manami Inoue, Shoichiro Tsugane, Motoki Iwasaki

American journal of epidemiology    2024年05月  [国際誌]

　概要を見る

Several epidemiological studies have investigated the circulating levels of albumin, bilirubin, and uric acid (UA) in relation to cancer risk; however, they have provided equivocal evidence. In this prospective case-cohort study, we aimed to explore the association of plasma albumin, bilirubin, and UA levels with cancer incidence. We measured the plasma levels of albumin, bilirubin, and UA and investigated their association with cancer incidence in 3,584 cases and 4,270 randomly selected participants with a median follow-up of 15.8 years. The adjusted hazard ratios (HR) and 95% confidence intervals (CI) of total cancer for the highest (Q4) versus lowest quartile (Q1) was 0.77 (95% CI: 0.67-0.90, P for trend: <0.001) for albumin. This association was attenuated after excluding liver cancer cases with lower plasma albumin levels. Plasma bilirubin levels were positively related to liver cancer but inversely to total cancer after excluding liver cancer with adjusted HR Q4 vs. Q1 of 0.86 (95% CI: 0.74-0.99, P for trend = 0.015). Plasma UA levels were not dose-responsively associated with total cancer risk. Higher plasma bilirubin levels were associated with a decreased risk of total cancer after excluding liver cancer, which is likely attributed to the antioxidant properties of bilirubin.

DOI PubMed

Development of the Self-Assessment Self-Disclosure Questionnaire to Examine the Association between Self-Disclosure and Frailty among Community-Dwelling Older Adults in Japan

Kazuki Yokoyama, Hikaru Ihira, Yuriko Matsuzaki-Kihara, Atsushi Mizumoto, Hideyuki Tashiro, Kiyotaka Shimada, Kosuke Yama, Ryo Miyajima, Takeshi Sasaki, Naoki Kozuka, Nozomu Ikeda

Geriatrics ( MDPI AG )  9 ( 3 ) 67 - 67  2024年05月

　概要を見る

Self-disclosure is the attitude of communicating one’s experiences and condition to others and is an indicator of mental health and an open personality. Frailty, characterized by reduced physical and psychological resistance, predicts the incidence of dependency and mortality. Although low self-disclosure may be associated with frailty, there is no scale to measure older adults’ self-disclosure. This cross-sectional study assessed the validity of a self-assessment self-disclosure questionnaire and examined the association between the content of self-disclosures to friends and acquaintances and frailty among community-dwelling older adults. A total of 237 adults aged ≥65 in Japan were surveyed using a mailed self-administered questionnaire in 2021. The self-disclosure scale consisted of 10 items and showed adequate validity. Participants were classified into a robust group (n = 117, women 57.3%) and a frailty group (n = 120, women 73.3%) using the Kihon Checklist. After adjusting for covariates, multivariate-adjusted logistic regression models revealed frailty was associated with lower self-disclosure of recent positive events, motivation and strengths (indicating strong points) in life, relationships with family and relatives, experiences of work and social activities, and financial status. The proposed questionnaire must still be further tested in other populations, but our initial results may contribute to preventing frailty and improving mental health among community-dwelling older adults.

DOI

Validity of self-reported Helicobacter pylori eradication treatment from questionnaire and interview surveys of the JPHC-NEXT study: comparison with prescription history from insurance claims data.

Tomomi Kihara, Kazumasa Yamagishi, Takuya Imatoh, Hikaru Ihira, Atsushi Goto, Hiroyasu Iso, Norie Sawada, Shoichiro Tsugane, Manami Inoue

Journal of epidemiology    2024年01月  [国内誌]

　概要を見る

BACKGROUND: We aimed to evaluate the validity of self-administered questionnaire surveys and face-to-face interview surveys for the detection of Helicobacter pylori eradication therapy. METHODS: Participants were a cohort, aged 40-74 years, living in three different locations of Japan, who took part in the baseline survey (2011-2012) of the Japan Public Health Center-based Prospective Study for the Next Generation (JPHC-NEXT). Five years after the baseline survey, a questionnaire and interview survey were independently conducted to determine the history of Helicobacter pylori eradication treatment over the 5-year period. Prescription of Helicobacter pylori eradication medications in national insurance claims data from the baseline survey to the 5-year survey was used as a reference standard. RESULTS: In total, 15,760 questionnaire surveys and 8,006 interview surveys were included in the analysis. There were 3,471 respondents to the questionnaire and 2,398 respondents to the interview who reported having received Helicobacter pylori eradication treatment within the past five years. Comparison of the questionnaire survey to national insurance claims data showed a sensitivity of 95.1% (2213/2328), specificity of 90.6% (12174/13432), positive predictive value of 63.8% (2213/3471), negative predictive value of 99.1% (12174/12289), and Cohen's Kappa value of 0.71. Respective values of the interview survey were 94.4% (1694/1795), 88.7% (5507/6211), 70.6% (1694/2398), 98.2% (5507/5608), and 0.74. CONCLUSION: Both the questionnaire and the interview showed high sensitivity, high specificity, and good agreement with the insurance claim prescriptions data. Some participants may have received eradication treatment without going through the public insurance claim database, resulting in a low positive predictive value.

DOI PubMed

Relationships of Total and Domain-Specific Moderate-to-Vigorous Physical Activity with All-Cause and Disease Specific Mortality.

Hiroyuki Kikuchi, Shigeru Inoue, Shiho Amagasa, Keisuke Kuwahara, Hikaru Ihira, Manami Inoue, Hiroyasu Iso, Shoichiro Tsugane, Norie Sawada

Medicine and science in sports and exercise   56 ( 3 ) 520 - 527  2023年10月  [国際誌]

　概要を見る

PURPOSE: This study aims to investigate the relationships of moderate-to-vigorous physical activity (MVPA) with all-cause and disease-specific mortality. We also investigated how the association between MVPA at leisure time (LT-MVPA) and health outcomes differs at different MVPA at work (WT-MVPA) levels. METHODS: The 81,601 community-dwelling Japanese persons aged 50-79 years who responded to a questionnaire in 2000-2003 were followed until 2018. Cox proportional hazard model was used to examine the association of total MVPA with risks of all-cause, cancer, heart disease, stroke and respiratory disease mortality. Then, we compared the mortality risk according to the tertile of LT-MVPA, stratified by the tertile of WT-MVPA. RESULTS: During the 15.1 years of average follow-up, 16,951 deaths were identified. Even total MVPA below the recommended volume (i.e., 0.1-1.49 METs-h/day) was associated with 11% to 24% reductions in all-cause (hazard ratio [HR]: 0.89, 95% confidence interval [CI]: 0.82-0.96) and heart disease mortality (HR:0.76, CI: 0.61-0.94), compared to no MVPA at all. The further reduced risks were seen in MVPA up to 10 METs-h/day. The inverse association between LT-MVPA and mortality risks was more evident at lower WT-MVPA, which WT-MVPA was also inversely associated with the risks. CONCLUSIONS: Health benefits were observed at low levels of MVPA and up to 10 METs-h/day although the fine threshold for excessive MVPA was not clear. LT-MVPA had distinct health benefits especially for persons with lower WT-MVPA.

DOI PubMed

A cross-sectional study of the association between periodontitis and physical activity in the Japanese population.

Masanori Iwasaki, Akihiro Yoshihara, Kana Suwama, Takashi Zaitsu, Seitaro Suzuki, Hikaru Ihira, Norie Sawada, Jun Aida

Journal of periodontal research   58 ( 2 ) 350 - 359  2023年04月  [国際誌]

　概要を見る

OBJECTIVE: The aim of this study was to determine whether physical activity (PA) is associated with periodontitis in the Japanese population. BACKGROUND: The potential association between PA and periodontitis has not been thoroughly investigated in the Japanese population. METHODS: We used cross-sectional data from the Japan Public Health Center-based Prospective Study for the Next-Generation Oral Health Study. Periodontitis was determined by a full-mouth periodontal examination. PA was assessed using a validated questionnaire. We performed multivariable ordinal logistic regression analyses to assess the association of total PA (the first quintile was set as the reference category) with periodontitis (three categories: no/mild, moderate, and severe), stratified by sex. The associations of periodontitis with domain- and intensity-specific PA were also studied in separate logistic regression models. RESULTS: This study included 2160 Japanese adults [1414 women and 746 men; mean (standard deviation) age 58.1 (9.6) years]. After adjusting for potential confounders, total PA was inversely associated with the presence and severity of periodontitis in women. The multivariable-adjusted odds ratios (95% confidence intervals) for periodontitis in the second to fifth quintiles (compared with the first quintile) of total PA were 0.81 (0.59-1.12), 0.74 (0.53-1.02), 0.77 (0.55-1.06), and 0.64 (0.46-0.89), respectively (p for trend = .01). We did not find different results when we further investigated the associations of periodontitis with domain- and intensity-specific PA. By contrast, PA was not associated with periodontitis in men. CONCLUSION: Total PA had an inverse, linear association with the presence and severity of periodontitis in Japanese women but not in Japanese men. Further prospective studies are required to determine the association between PA and periodontitis.

DOI PubMed

Dietary diversity and risk of late-life disabling dementia in middle-aged and older adults.

Rei Otsuka, Shu Zhang, Hikaru Ihira, Norie Sawada, Manami Inoue, Kazumasa Yamagishi, Nobufumi Yasuda, Shoichiro Tsugane

Clinical nutrition (Edinburgh, Scotland)   42 ( 4 ) 541 - 549  2023年04月  [国際誌]

　概要を見る

BACKGROUND & AIMS: A balanced diet integrating several foods and nutrients may promote the maintenance of brain function. Previous studies have substantiated the above hypothesis in the regional population in Japan. This study aimed to investigate the potential effect of dietary diversity on the risk of disabling dementia in a nationwide large-scale cohort of the Japanese population. METHODS: A total of 38,797 participants (17,708 men and 21,089 women) aged 45-74 years were followed up for a median of 11.0 years. The daily frequencies of the consumption of each of the 133 food and beverage items listed on a food frequency questionnaire (excluding five alcoholic beverages) were measured. The dietary diversity score was calculated as the number of food items consumed per day. Multivariable adjusted Cox proportional hazards regression models were used to calculate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) of the dietary diversity score quintile groups. RESULTS: We documented 4302 participants with disabling dementia (11.1%) during the follow-up period. Among women, the dietary diversity score was inversely associated with disabling dementia (highest quintile HR [with the lowest quintile as the reference]: 0.67; 95% CI: 0.56-0.78; Q1-Q5 p for trend <0.001), but this was not true among men (highest quintile HR: 1.06; 95% CI: 0.87-1.29; Q1-Q5 p for trend = 0.415). These results did not change substantially when using disabling dementia with stroke as the outcome; the association remained significant among women but was absent among men. CONCLUSIONS: Our findings indicate that eating a variety of foods may prevent disabling dementia only among women. Thus, the habit of consuming a variety of food items has important public health implications for women.

DOI PubMed

Alcohol consumption from midlife and risk of disabling dementia in a large population-based cohort study in Japan.

Yoko Shimizu, Norie Sawada, Hikaru Ihira, Sarah Krull Abe, Manami Inoue, Nobufumi Yasuda, Kazumasa Yamagishi, Motoki Iwasaki, Shoichiro Tsugane

International journal of geriatric psychiatry   38 ( 3 ) e5896  2023年03月  [国際誌]

　概要を見る

OBJECTIVES: The association between alcohol consumption and dementia in Japanese is poorly understood, and use of single-point alcohol assessment may cause measurement error. We explored this association in Japanese using repeated alcohol assessments. METHODS: Participants in the Japan Public Health Center-based Prospective Study (JPHC Study) since 1990 and who were alive in 2006 were followed from 2006 until 2016 for dementia ascertainment. Disabling dementia was identified through long-term care insurance records. Alcohol consumption was assessed at the 5-year questionnaire survey (1995-1999) and drinking patterns were assessed on repeated follow-up (2000-2003). We performed Cox proportional hazards models with age as the time-scale with adjustment for various lifestyle factors and medical history using light consumption (<75 g ethanol/week, hereinafter "g") as reference. Analysis considering death as a competing risk was also conducted. RESULTS: Among 42,870 participants aged 54-84 years, 4802 cases of disabling dementia were newly diagnosed. Average years from alcohol assessment until dementia incidence was 14.9 years. Non-drinkers and regular drinkers with ≥450 g at 5 years had adjusted HRs (95% CI) of 1.29 (1.12-1.47) and 1.34 (1.12-1.60). Patterns of long-term abstinence, former drinking, and regular heavy weekly consumption of ≥450 g showed increased adjusted HRs of 1.61 (1.28-2.03), 2.54 (1.93-3.35), and 1.96 (1.49-2.59), respectively. Competing risk analysis yielded similar results. CONCLUSIONS: In Japanese, non-drinking and regular weekly consumption of ≥450 g from midlife were associated with high risk of disabling dementia compared with light drinking.

DOI PubMed

Prevalence of family history of cancer in the NC-CCAPH consortium of Japan.

Sarah Krull Abe, Hikaru Ihira, Tetsuji Minami, Takuya Imatoh, Yosuke Inoue, Kota Tsutsumimoto, Nozomu Kobayashi, Rena Kashima, Maki Konishi, Takehiko Doi, Masayuki Teramoto, Isamu Kabe, Sangyoon Lee, Makoto Watanabe, Seitaro Dohi, Yukie Sakai, Yukiko Nishita, Naho Morisaki, Hisateru Tachimori, Yoshihiro Kokubo, Taiki Yamaji, Hiroyuki Shimada, Tetsuya Mizoue, Norie Sawada, Shoichiro Tsugane, Motoki Iwasaki, Manami Inoue

Scientific reports   13 ( 1 ) 3128 - 3128  2023年02月  [国際誌]

　概要を見る

The objective of this study was to identify the prevalence of family history of cancer using cohorts participating in the Japanese National Center Cohort Collaborative for Advancing Population Health (NC-CCAPH). We pooled data from seven eligible cohorts of the Collaborative with available data on family history of cancer. Prevalence of family history of cancer and corresponding 95% confidence intervals are presented for all cancers and selected site-specific cancers for the total population and stratified by sex, age, and birth cohort. Prevalence of family history of cancer increased with age ranging from 10.51% in the 15 to 39 year age category to 47.11% in 70-year-olds. Overall prevalence increased in birth cohorts from ≤ 1929 until 1960 and decreased for the next two decades. Gastric cancer (11.97%) was the most common site recorded for family members, followed by colorectal and lung (5.75%), prostate (4.37%), breast (3.43%) and liver (3.05%) cancer. Women consistently had a higher prevalence of family history of cancer (34.32%) versus men (28.75%). Almost one in three participants had a family history of cancer in this Japanese consortium study highlighting the importance of early and targeted cancer screening services.

DOI PubMed

Low-intensity resistance training to improve knee extension strength in community-dwelling older adults: Systematic review and meta-analysis of randomized controlled studies

Midori Kamiya, Hikaru Ihira, Yoshiaki Taniguchi, Daisuke Matsumoto, Tomoya Ishigaki, Akio Okamae, Tatsuya Ogawa, Shogo Misu, Toshinori Miyashita, Takeshi Ohnuma, Tomohisa Chibana, Natsu Morikawa, Tome Ikezoe, Hyuma Makizako

Experimental Gerontology ( Elsevier BV )  112041   112041 - 112041  2022年12月  [査読有り]  [国際誌]

　概要を見る

AIM: The purpose of this systematic review and meta-analysis was to investigate the effects of low-intensity resistance training on knee extension strength with respect to intensity, frequency, duration and training site in community-dwelling older adults. METHODS: A literature search was conducted for articles published up to December 2018 on PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Physiotherapy Evidence Database (PEDro), OTseeker and Ichushi-Web. Randomized controlled trials involving resistance training with <60 % one repetition maximum (1RM) in community-dwelling older adults aged 60 years and older were eligible. RESULTS: In total, 7 studies involving 275 participants were included in the meta-analysis. The results showed significant improvements in knee extension strength with low-intensity resistance training [standardized mean difference (SMD) 0.62, 95 % confidence interval (CI) 0.32 to 0.91]. In subgroup analyses, significant improvements were observed in the group with intensity at 50-60 % 1RM (0.83, 0.46 to 1.19), but not in the group at 40 % or less 1RM (0.30, 95%CI: -0.08 to 0.68). Concerning frequency, there were significant improvements in knee strength for those receiving training three times (0.90, 0.52 to 1.27) and two times (0.36, 0.03 to 0.69) per week, with a significant difference between the groups (p = 0.04). CONCLUSIONS: Low-intensity resistance training should be considered as an effective intervention to improve knee extension strength in community-dwelling older adults. Older adults may show more improvement in knee extension strength if intensity of the training is set at 50-60 % 1RM and frequency of training is three times per week.

DOI PubMed

Efficacy of therapeutic exercise on activities of daily living and cognitive function among older residents in long-term care facilities: A systematic review and meta-analysis of randomized controlled trials

Akio Okamae, Tatsuya Ogawa, Hyuma Makizako, Daisuke Matsumoto, Tomoya Ishigaki, Midori Kamiya, Toshinori Miyashita, Hikaru Ihira, Yoshiaki Taniguchi, Shogo Misu, Takeshi Ohnuma, Tomohisa Chibana, Natsu Morikawa, Tome Ikezoe

Archives of Physical Medicine and Rehabilitation ( Elsevier BV )  104 ( 5 ) 812 - 823  2022年11月  [査読有り]  [国際誌]

　概要を見る

OBJECTIVES: This study aimed to systematically analyze the efficacy of therapeutic exercise on activities of daily living (ADL) and cognitive function among older residents in long-term care facilities. DATA SOURCES: PubMed, Cochrane Central of Register Trials, Physiotherapy Evidence Database, OTseeker, and Ichushi-Web were searched from inception until December 2018. STUDY SELECTION: Databases were searched to identify randomized controlled trials (RCTs) of therapeutic exercise for long-term care facility residents aged 60 years and older, focusing on ADL and cognitive function as outcomes. DATA EXTRACTION: Two independent reviewers extracted the key information from each eligible study. Two reviewers independently screened and assessed all studies for eligibility, extracting information on study participants, details of interventions, outcome characteristics, and significant outcomes. Any discrepancies were resolved by a third reviewer. DATA SYNTHESIS: A total of 11 RCTs with 1,280 participants were eligible for analyses. Therapeutic exercise had a significant benefit on ADL (standard mean difference [SMD] = 0. 22, 95% confidence interval [CI]: 0.02, 0.42, p = 0.03)]. Subgroup analyses indicated that interventions were conducted ≥ 3 days per week [SMD = 0.42, 95% CI 0.02, 0.82, p = 0.04]. For cognitive function, group exercise and ≥ 3 days/week of intervention had a significant benefit (group exercise: mean difference [MD] = 3.36, 95% CI 0.91, 5.80, p = 0.007; ≥ 3 days/week of intervention: MD = 2.28, 95% CI 0.07, 4.49, p = 0.04). CONCLUSIONS: Therapeutic exercise conducted 3 or more days per week may be effective for improving ADL and cognitive function among older residents in long-term care facilities. This meta-analysis suggested that group exercise for cognitive functions was effective. However, the effective method of intervention delivery for ADL was unclear.

DOI PubMed

Association between Productive Roles and Frailty Factors among Community-Dwelling Older Adults: A Cross-Sectional Analysis

Kazuki Yokoyama, Hikaru Ihira, Yuriko Matsuzaki-Kihara, Atsushi Mizumoto, Ryo Miyajima, Takeshi Sasaki, Naoki Kozuka, Nozomu Ikeda

International Journal of Environmental Research and Public Health ( MDPI AG )  19 ( 17 ) 10838 - 10838  2022年08月  [国際誌]

　概要を見る

The employment rate of older people in Japan is expected to increase in the future owing to the increase in the retirement age. Preventing frailty is imperative to maintaining productive roles of older adults. Therefore, this study aimed to examine the association between productive roles and frailty factors among community-dwelling older adults. A total of 135 older adults, enrolled in 2017, participated in the study. Productive roles and domains related to frailty were measured. We measured usual gait speed and grip strength for the physical domain; Mini-Mental State Examination (MMSE) and Geriatric Depression Scale (GDS-15) scores for the cognitive and mental domains; and social role and group activity for the social domain. Multivariate-adjusted logistic regression models revealed that having productive roles was associated with faster usual gait speed (odds ratios [OR] = 1.05; 95% confidence interval [CI], 1.01–1.08; p = 0.005) and lower GDS-15 score (OR = 0.79; 95% CI, 0.64–0.97; p = 0.023). These results suggest that health promotion to maintain gait speed and prevent depressive symptoms may contribute to maintaining productivity in community-dwelling older adults.

DOI PubMed

Association of plasma iron status with subsequent risk of total and site-specific cancer: A large case-cohort study within JPHC Study.

Yoshihisa Miyamoto, Shiori Nakano, Hikaru Ihira, Taiki Yamaji, Ryoko Katagiri, Norie Sawada, Manami Inoue, Shoichiro Tsugane, Motoki Iwasaki

Cancer prevention research (Philadelphia, Pa.)   15 ( 10 ) 669 - 678  2022年07月  [国際誌]

　概要を見る

It is unclear whether prediagnostic iron-related biomarkers in circulation are associated with cancer risk. We constructed a case-cohort of participants who had plasma samples available from the Japan Public Health Center-based Prospective Study and determined the incidence of cancer in these participants. We measured plasma concentrations of iron, ferritin, and hepcidin and assessed the association between each biomarker and cancer incidence using a weighted Cox regression model. There were 4,253 participants in the sub-cohort (the randomly selected participants from an eligible, at-risk population) and 3,596 incident cancer cases (499 cases occurred in the sub-cohort). Median follow-up was for 16.5 years. In the multivariable adjusted analysis, iron deficiency (plasma ferritin <30 ng/ml) was associated with a higher risk of total cancer (adjusted hazard ratio [HR]: 1.23, 95% confidence interval [CI]: 1.07-1.42) and the association was weaker after excluding those followed-up for <3 years. Iron overload was not significantly associated with total cancer (HR: 1.04, 95% CI: 0.82-1.33), but was associated with liver cancer (HR: 4.49, 95% CI: 2.71-7.43). Lower plasma levels of hepcidin and ferritin are associated with an increased gastrointestinal cancer risk. Meanwhile, lower plasma hepcidin and higher plasma ferritin levels were associated with an increased liver cancer risk. In conclusion, there was no association between iron overload and cancer risk, besides liver cancer.

DOI PubMed

Validity of claims data for identifying cancer incidence in the Japan public health center-based prospective study for the next generation.

Hikaru Ihira, Atsushi Goto, Kazumasa Yamagishi, Hiroyasu Iso, Motoki Iwasaki, Norie Sawada, Shoichiro Tsugane

Pharmacoepidemiology and drug safety   31 ( 9 ) 972 - 982  2022年06月  [国際誌]

　概要を見る

PURPOSE: This study determined the validity of claims-based definitions for identifying the incidence of total and site-specific cancers in a population-based cohort study. METHODS: Claims data were obtained for 21 946 participants aged 40-74 years enrolled in the Japan Public Health Center-based Prospective Study for the Next Generation. We defined total and site-specific cancer incidence using combinations of codes from claims data, including diagnosis and procedure codes for cancer therapy. Data from the cancer registry were used as the gold standard to evaluate validity. RESULTS: Among 21 946 participants, 454 total, 89 stomach, 67 colorectal, 51 lung, 39 breast and 99 prostate invasive cancer cases were newly diagnosed in the cancer registry. For invasive cancer, the sensitivity and specificity of the definition that combined codes for diagnosis and procedures for cancer therapy were 87.0% and 99.4% for total, 88.8% and 99.9% for stomach, 80.6% and 99.9% for colorectal, 86.3% and 99.9% for lung, 100% and 99.9% for breast and 91.9% and 99.9% for prostate cancer, respectively. Furthermore, for invasive and/or in situ cancer, the sensitivity and specificity of the definition were 84.5% and 99.5% for total, 66.7% and 99.9% for colorectal and 100% and 99.9% for breast cancer. CONCLUSIONS: Our findings suggest that claims-based definitions using diagnosis and procedure codes generally have high validity for total, stomach, lung, breast and prostate cancer incidence, but may underestimate colorectal cancer incidence.

DOI PubMed

Association Between Physical Activity and Risk of Disabling Dementia in Japan.

Hikaru Ihira, Norie Sawada, Manami Inoue, Nobufumi Yasuda, Kazumasa Yamagishi, Hadrien Charvat, Motoki Iwasaki, Shoichiro Tsugane

JAMA network open   5 ( 3 ) e224590  2022年03月  [査読有り]  [国際誌]

　概要を見る

Importance: The associations of daily total physical activity and total moderate to vigorous physical activity (MVPA) with dementia are still unclear. Objective: To investigate the association between daily total physical activity and subsequent risk of disabling dementia in large-scale, extended follow-up prospective study. Design, Setting, and Participants: This prospective cohort study used data from questionnaires collected between 2000 and 2003 from 8 areas from the Japan Public Health Center-based Prospective Disabling Dementia Study. Participants included adults aged 50 to 79 years in with available follow-up data on disabling dementia. Data analysis was performed from February 1, 2019, to July 31, 2021. Exposures: Daily total physical activity, total MVPA, and leisure-time MVPA. Main Outcomes and Measures: The main outcome was incidence of disabling dementia during the dementia ascertainment period between 2006 and 2016, based on the national long-term care insurance system. Risks of dementia in association with daily total physical activity, total MVPA, and leisure time MVPA were calculated using multivariable adjusted hazard ratios (aHRs). Results: Among 43 896 participants (mean [SD] age, 61.0 [7.5] years; 23 659 [53.9%] women), 5010 participants were newly diagnosed with disabling dementia during a mean (SD) of 9.5 (2.8) years in the dementia ascertainment period. In the highest daily total physical activity group, compared with the lowest activity group, risk of dementia was lower in men (aHR, 0.75 [95% CI, 0.66-0.85]; P for trend < .001) and women (aHR, 0.75 [95% CI, 0.67-0.84]; P for trend < .001). Similar inverse associations were observed in men and women for total MVPA (men: aHR, 0.74 [95% CI, 0.65-0.84]; P for trend < .001; women: aHR, 0.74 [95% CI, 0.66-0.83]; P for trend < .001) and leisure-time MVPA (men: aHR, 0.59 [95% CI, 0.53-0.67]; P for trend < .001; women: aHR, 0.70 [95% CI, 0.63-0.78]; P for trend < .001). However, these inverse associations disappeared when participants diagnosed with disabling dementia within 7 years of the starting point were excluded in men (aHR, 0.93 [95%CI, 0.77-1.12]) and within 8 years were excluded in women (aHR, 0.86 [95%CI, 0.71-1.04]). The association remained significant among men in the highest vs lowest group of leisure-time MVPA, after excluding participants diagnosed within the first 9 years (aHR, 0.72 [95% CI, 0.56-0.92]; P for trend = .004). Conclusions and Relevance: This cohort study examined associations of daily total physical activity and total MVPA with risk of disabling dementia. The findings suggest that a high level of leisure-time MVPA was associated with decreased risk of disabling dementia in men.

DOI PubMed

Association between C-reactive protein and risk of overall and 18 site-specific cancers in a Japanese case-cohort.

Shiori Suzuki, Ryoko Katagiri, Taiki Yamaji, Norie Sawada, Takuya Imatoh, Hikaru Ihira, Manami Inoue, Shoichiro Tsugane, Motoki Iwasaki

British journal of cancer   126 ( 10 ) 1481 - 1489  2022年02月  [査読有り]  [国際誌]

　概要を見る

BACKGROUND: Evidence of the association between chronic low-grade inflammation, as reflected by C-reactive protein (CRP) measurements, and cancer risk is equivocal. Specifically, few studies have examined this in uncommon cancers and Asian populations. METHODS: We utilised a case-cohort design consisting of multi-types of cancer (N = 3608), and a random subcohort (N = 4432) in a Japanese large population-based study, with a median follow-up time of 15.6 years, and measured baseline plasma CRP using high sensitivity assay. The hazard ratios (HRs) were estimated using weighted Cox proportional hazards methods. RESULTS: The multivariable-adjusted HR (95% confidence interval) for the top quartile of CRP was 1.28 (1.11‒1.48) (Ptrend < 0.001) for overall cancer compared to the bottom quartile of CRP. Among site-specific cancers, higher CRP levels were associated with an increased risk of colorectal, lung, breast, biliary tract, and kidney cancer, and leukaemia. These positive associations remained among participants after >3 years' follow-up. Furthermore, subgroup analyses for overall cancer robustly showed a positive association with CRP levels, regardless of sex and obesity. CONCLUSION: Our consistent findings suggested that chronic low-grade inflammation measured by CRP is associated with the risk of cancer.

DOI PubMed

DPCデータによる糖尿病有無の妥当性検討

金原 里恵子, 後藤 温, 後藤 麻貴, 高橋 俊明, 岩崎 基, 野田 光彦, 井平 光, 津金 昌一郎, 澤田 典絵

Journal of Epidemiology ( (一社)日本疫学会 )  32 ( Suppl.1 ) 161 - 161  2022年01月

身体活動と泌尿器がん罹患との関連

井平 光, 澤田 典絵, 津金 昌一郎

泌尿器科 ( (有)科学評論社 )  14 ( 6 ) 747 - 751  2021年12月

Validation study on diabetes definitions using Japanese Diagnosis Procedure Combination data among hospitalized patients.

Rieko Kanehara, Atsushi Goto, Maki Goto, Toshiaki Takahashi, Motoki Iwasaki, Mitsuhiko Noda, Hikaru Ihira, Shoichiro Tsugane, Norie Sawada

Journal of epidemiology   33 ( 4 ) 165 - 169  2021年07月  [査読有り]  [国内誌]

　概要を見る

BackgroundValidation studies on diabetes definitions using nationwide healthcare databases are scarce. We evaluated the validity of diabetes definitions using disease codes and antidiabetic drug prescriptions in the Japanese Diagnosis Procedure Combination (DPC) data via medical chart review.MethodsWe randomly selected 500 records among 15,334 patients who participated in the Japan Public Health Center-Based Prospective Study for the Next Generation in Yokote City and who had visited a general hospital in Akita between October 2011 and August 2018. Of the 500 patients, 98 were linked to DPC data; however, only 72 had sufficient information in the medical chart. Gold standard confirmation was performed by board-certified diabetologists. DPC-based diabetes definitions were based on the International Classification of Diseases, 10th Revision codes, and antidiabetic prescriptions. Sensitivity, specificity, and the positive and negative predictive values (PPV and NPV, respectively) of DPC-based diabetes definitions were evaluated.ResultsOf 72 patients, 23 were diagnosed with diabetes by chart review; 19 had a diabetes code, and 13 had both a diabetes code and antidiabetic prescriptions. The sensitivity, specificity, PPV, and NPV were 89.5% (95% confidence interval: 66.9-98.7), 96.2% (87.0-99.5), 89.5% (66.9-98.7), and 96.2% (87.0-99.5), respectively, for (i) diabetes codes alone; 89.5% (66.9-98.7), 94.3% (84.3-98.8), 85.0% (62.1-96.8), and 96.2 (86.8-99.5) for (ii) diabetes codes and/or prescriptions; 68.4% (43.4-87.4), 100% (93.3-100), 100% (75.3-100), and 89.8% (79.2-96.2) for (iii) both diabetes codes and prescriptions.ConclusionsOur results suggest that DPC data can accurately identify diabetes among inpatients using (i) diabetes codes alone or (ii) diabetes codes and/or prescriptions.

DOI PubMed

Smoking and colorectal cancer: A pooled analysis of 10 population-based cohort studies in Japan.

Shamima Akter, Zobida Islam, Tetsuya Mizoue, Norie Sawada, Hikaru Ihira, Shoichiro Tsugane, Yuriko N Koyanagi, Hidemi Ito, Chaochen Wang, Akiko Tamakoshi, Keiko Wada, Chisato Nagata, Kenta Tanaka, Yuri Kitamura, Mai Utada, Kotaro Ozasa, Yumi Sugawara, Ichiro Tsuji, Taichi Shimazu, Keitaro Matsuo, Mariko Naito, Keitaro Tanaka, Manami Inoue

International journal of cancer   148 ( 3 ) 654 - 664  2021年02月  [査読有り]  [国際誌]

　概要を見る

Smoking has been consistently associated with the risk of colorectal cancer (CRC) in Western populations; however, evidence is limited and inconsistent in Asian people. To assess the association of smoking status, smoking intensity and smoking cessation with colorectal risk in the Japanese population, we performed a pooled analysis of 10 population-based cohort studies. Study-specific hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox's proportional hazards model and then pooled using a random-effects model. Among 363 409 participants followed up for 2 666 004 person-years, 9232 incident CRCs were identified. In men, compared with never smokers, ever smokers showed higher risk of CRC. The HRs (95% CI) were 1.19 (1.10-1.29) for CRC, 1.19 (1.09-1.30) for colon cancer, 1.28 (1.13-1.46) for distal colon cancer and 1.21 (1.07-1.36) for rectal cancer. Smoking was associated with risk of CRC in a dose-response manner. In women, compared with never smokers, ever smokers showed increased risk of distal colon cancer (1.47 [1.19-1.82]). There was no evidence of a significant gender difference in the association of smoking and CRC risk. Our results confirm that smoking is associated with an increased risk of CRC, both overall and subsites, in Japanese men and distal colon cancer in Japanese women.

DOI PubMed

疾病予防の基礎研究と臨床応用(第1回) がんリハビリテーションにおけるフレイル予防の基礎的研究と臨床への応用

井平 光

理学療法学 ( (公社)日本理学療法士協会 )  47 ( 6 ) 624 - 629  2020年12月

Intensity-specific validity and reliability of the Japan Public Health Center-based prospective study-physical activity questionnaire.

Hiroyuki Kikuchi, Shigeru Inoue, Yuko Odagiri, Hikaru Ihira, Manami Inoue, Norie Sawada, Mitsuhiko Noda, Shoichiro Tsugane

Preventive medicine reports   20   101169 - 101169  2020年12月  [査読有り]  [国際誌]

　概要を見る

The Japan Public Health Center-based prospective study- physical activity questionnaire (JPHC-PAQ) was originally developed and validated for total physical activity (total PA). However, it is uncertain whether JPHC-PAQ could also estimate intensity-specific physical activity. The present study aims to evaluate the validity and reliability of intensity-specific physical activity by the JPHC-PAQ against 24-hour activity records (24 h-R). One-hundred and ten participants were chosen from those who had enrolled in the JPHC cohort. Time spent for total PA and intensity-specific physical activity, i.e. moderate (MPA), vigorous (VPA) and moderate-to-vigorous physical activity (MVPA) was estimated by JPHC-PAQ. In addition, the volume of PA was calculated by time of each activity multiplied by intensity of activity. For validity assessment, estimated physical activities were compared with 24 h-R. For reliability evaluation, a retest was conducted 3-6 months after the first survey was answered. Moderately strong correlation between JPHC-PAQ and 24 h-R was observed for total PA estimations (Spearman's rho = 0.672). In addition, moderate correlations were found for MPA (activity time: rho = 0.345, activity volume: rho = 0.300) and MVPA (activity time: rho = 0.563, activity volume: rho = 0.672). Whereas, little association was found for VPA time and volume. As for reliability, moderately strong correlation was found for both total and intensity-specific physical activity in the test-retest (rho = 0.482-0.745). In addition to total PA, the JPHC-PAQ showed acceptable validity and reliability for intensity-specific physical activity, especially in estimating MVPA and MPA.

DOI PubMed

Occupational sitting time and subsequent risk of cancer: The Japan Public Health Center-based Prospective Study.

Hikaru Ihira, Norie Sawada, Taiki Yamaji, Atsushi Goto, Taichi Shimazu, Hiroyuki Kikuchi, Shigeru Inoue, Manami Inoue, Motoki Iwasaki, Shoichiro Tsugane

Cancer science   111 ( 3 ) 974 - 984  2020年03月  [査読有り]  [国際誌]

　概要を見る

Although occupational sitting time has been associated with adverse health outcomes and mortality, the association with cancer incidence remains unknown. This study investigated the association between occupational sitting time and risk of total and site-specific cancer in a Japanese population. We evaluated 33 307 participants aged 50-79 years who responded to a questionnaire in 2000-2003 in the Japan Public Health Center-based Prospective Study and were followed until 2013. Participants were grouped by sitting time at work. Hazard ratio (HR) and 95% confidence interval (CI) of cancer incidence were calculated with adjustment for potential confounders including moderate-to-vigorous physical activity. During 10.2 years of follow-up, 3807 newly diagnosed cases of cancer were identified. Occupational sitting time was marginally associated with total cancer, with multivariable HRs for the ≥7 h/d vs 1 to <3 h/d category of 1.12 (95% CI, 0.99-1.26; P for trend = .071) in men, but not women. Among findings for cancers at specific sites, long occupational sitting time was associated with increased risk of pancreas cancer, with multivariable HRs for the ≥7 h/d vs 1 to <3 h/d category of 2.25 (95% CI, 1.17-4.34; P for trend = .021) in men, and lung cancer, with multivariable HRs for the ≥7 h/d vs 1 to <3 h/d category of 2.80 (95% CI, 1.33-5.90; P for trend = .013) in women. Extended sitting time at work was associated with an increased risk of pancreas cancer in men and lung cancer in women.

DOI PubMed

Physical activity and subsequent risk of kidney, bladder and upper urinary tract cancer in the Japanese population: the Japan Public Health Centre-based Prospective Study

Hikaru Ihira, Norie Sawada, Taiki Yamaji, Atsushi Goto, Taichi Shimazu, Manami Inoue, Motoki Iwasaki, Shoichiro Tsugane

British Journal of Cancer ( Springer Science and Business Media LLC )  120 ( 5 ) 571 - 574  2019年03月  [査読有り]  [国際誌]

　概要を見る

BACKGROUND: Although physical activity has been reported as a protective factor for kidney and bladder cancer in epidemiological studies, it is not clear. METHODS: In a population-based prospective study of 76,795 Japanese aged 45-74 years, participants were evaluated physical activity by self-administered questionnaire. Hazard ratios (HRs) and 95% confidence intervals (CIs) of the risk of urological cancer were calculated by the Cox proportional hazards models. RESULTS: During the 15.1-year follow-up, 202 kidney, 373 bladder and 83 upper urinary tract cancer cases were identified. Physical activity was not significantly associated with kidney, bladder and upper urinary tract cancer risks, with multivariate HRs in the highest versus lowest group of 1.05 (95% CI: 0.74-1.49), 1.06 (95% CI: 0.81-1.39) and 0.80 (95% CI: 0.48-1.35), respectively. CONCLUSIONS: Physical activity was not associated with the risk of urological cancer in the Japanese population.

DOI PubMed

介護予防を目的とした郵便による食習慣介入の効果:積雪・寒冷・過疎地域在住高齢者における検討

木村美佳, 守安愛, 牧迫飛雄馬, 井平光, 古名丈人

日本公衆衛生雑誌   66 ( 11 ) 681 - 689  2019年  [査読有り]  [国内誌]

　概要を見る

Objectives The aim of this study was to investigate the effect of mail-based intervention using the TAKE10! Program to improve dietary habits in cases where direct intervention is not possible.Methods Subjects aged 70-91 years (77.6±5.0) were randomly assigned to two groups: 72 in the intervention group and 71 in the control group. The intervention group received monthly mail, which included self-check sheets (TAKE10! Check sheet and TAKE10! Calendar) and a letter with feedback and comments for 5 months. The outcome measures were changes in the intake frequency of 10 food groups, Dietary Variety Score (DVS), and Food Frequency Score (FFS).Results Compared to baseline, the post-intervention intake frequencies for 9 of 10 food groups, DVS, and FFS significantly increased in the intervention group. No significant differences were observed between baseline and post-intervention in the control group. In the subgroup analysis of the intervention group, post-intervention DVS and FFS of both subjects who cooked their own food and those who did not showed significant increases compared to baseline.Conclusion The mail-based TAKE10! Program resulted in improved dietary habits and could be shared with families in addition to direct interventions and could also be used in regions with inadequate transportation systems or frequent poor weather conditions.

DOI PubMed J-GLOBAL

Structural analysis of impact of physical, cognitive and social status on the incidence of disability in community-dwelling people aged ≥75 years.

Makino K, Ihira H, Mizumoto A, Shimizu K, Ishida T, Yamaguchi R, Kihara Y, Ito K, Sasaki T, Furuna T

Geriatrics & gerontology international   18 ( 12 ) 1614 - 1619  2018年12月  [査読有り]  [国内誌]

　概要を見る

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.

DOI PubMed

The effect of gait speed and gait phase to the allocation of attention during dual task gait.

Shimizu K, Ihira H, Makino K, Kihara Y, Itou K, Furuna T

Journal of physical therapy science   30 ( 3 ) 419 - 423  2018年03月  [査読有り]  [国内誌]

　概要を見る

[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.

DOI PubMed

Adult height and all-cause and cause-specific mortality in the Japan Public Health Center-based Prospective Study (JPHC)

Hikaru Ihira, the JPHC Study Group, Norie Sawada, Motoki Iwasaki, Taiki Yamaji, Atsushi Goto, Mitsuhiko Noda, Hiroyasu Iso, Shoichiro Tsugane

PLoS ONE ( Public Library of Science )  13 ( 5 ) e0197164  2018年  [査読有り]  [国際誌]

　概要を見る

Adult height is determined by both genetic characteristics and environmental factors in early life. Although previous studies have suggested that adult height is associated with risk of mortality, comprehensive associations between height and all-cause and cause-specific mortality in the Japanese population are unclear. We aimed to evaluate the associations between adult height and all-cause and cause-specific mortality among Japanese men and women in a prospective cohort study. We investigated 107,794 participants (50,755 men and 57,039 women) aged 40 to 69 years who responded to the baseline questionnaire in the Japan Public Health Center-based Prospective Study. Participants were classified by quartile of adult height obtained from a self-reported questionnaire in men (< 160cm, 160-163cm, 164-167cm, 168cm) and women (< 149cm, 149-151cm, 152-155cm, 156cm). Hazard ratios (HR) and 95% confidence intervals (CI) for mortality from all-cause, cancer, heart disease, cerebrovascular disease, respiratory disease, and other cause mortality were calculated using Cox proportional hazards models. During follow-up, 12,320 men and 7,030 women died. Taller adult height was associated with decreased risk for mortality from cerebrovascular disease (HR< 160cm vs.168cm (95% CI) = 0.83 (0.69–0.99) HRfor 5-cm increment (95% CI) = 0.95 (0.90–0.99)) and respiratory disease (HR< 160cm vs.168cm (95% CI) = 0.84 (0.69–1.03) Rfor 5-cmincrement (95% CI) = 0.92 (0.87–0.97)), but was also associated with increased risk for overall cancer mortality (HR< 160cm vs.168cm (95% CI) = 1.17 (1.07–1.28) HRfor -mincrement (95% CI) = 1.04 (1.01–1.07)) in men. Taller adult height was also associated with decreased risk for mortality from cerebrovascular disease (HR< 149cm vs. 156cm (95% CI) = 0.84 (0.66–1.05) HRfor 5-cmincrement (95% CI) = 0.92 (0.86–0.99)) in women. Our results confirmed that adult height is associated with cause-specific mortality in a Japanese population.

DOI PubMed

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Supplement ( 公益社団法人 日本理学療法士協会 )  2016   1596 - 1596  2017年

　概要を見る

【はじめに，目的】

がん罹患の高齢化を背景に，高齢がん罹患者の運動機能に着目した報告が増加している。実際に，高齢がん罹患者の歩行機能や筋力が低下していることが示されており，この対象への改善策が課題となっている。これらの報告のなかで，がんの罹患を判断するために，基本的には調査時の自己報告によって得られた情報を採用する場合が多い。しかしながら，その自己報告が正確なものであるかどうかは検証が必要であり，特に高齢者のがん罹患に関する妥当性の検証はなされていない。本研究では，75歳以上の地域在住高齢者を対象に，がん罹患に関する自己報告の妥当性を検証し，自己報告の有無による縦断的な機能変化を明らかにすることを目的とした。

【方法】

対象は，測定調査会に参加した75歳以上の地域在住高齢者411名のうち，がん罹患に関する調査データに不備のあった1名を除外した410名（男性169名，女性241名，平均年齢80.0±4.1歳）とした。ベースライン時におけるがんの自己報告については，がん罹患の有無，罹患時期，がんの種類などを面接聴取した。また，がんの発症を同定するために，後期高齢者医療制度における診療報酬請求（レセプト）情報を活用した。さらに，機能指標として運動機能，認知機能，および健康関連指標を測定した。統計解析は，レセプト情報によってがん罹患を同定された者のうち，がんの罹患を自ら報告した高齢者の陽性的中率を算出し，自己報告による妥当性を検証した。また，がん罹患者を自己報告群と非自己報告群に分類し，2群間の各変数を比較した。さらに，2群間における各機能の縦断的変化についても検討した。

【結果】

レセプト情報によると，ベースライン調査の時点でがんに罹患していた者は51名だった。このうち，がんに罹患したことを自ら報告した高齢者は28名であり，陽性的中率は54.9%だった。報告群と非報告群の比較では，年齢（p=0.710）と性別（p=0.601）に有意な差は認められなかった。また，測定したすべての変数で有意な差は認められなかった。さらに，二元配置分散分析の結果からも，交互作用の見られた項目はなかった。

【結論】

国立がん研究センターによると，40～69歳を対象とした自己報告によるがん罹患の陽性的中率は53%であった。本研究においても同等の結果が得られ，がん罹患に関しては自己報告による調査だけでは正確に把握することが難しいことを示唆するものであった。理由として，高齢者のなかにはがんに対して誤った理解や病識を有している方がおり，自らをがん罹患者と表出することに抵抗感がある可能性が挙げられた。また，自己報告の有無によって諸機能の差異は認められず，将来的な機能低下に影響を及ぼすことも明らかにされなかった。今後は，がん罹患の陽性的中率を上げる工夫をするとともに，虚弱な高齢がん罹患者に対して機能向上を目的としたアプローチを検討する必要がある。

DOI CiNii

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 ( LIPPINCOTT WILLIAMS & WILKINS )  39 ( 4 ) 159 - 164  2016年10月  [査読有り]

　概要を見る

Background and Purpose: In dual-task situations, postural control is closely associated with attentional cost. Previous studies have reported age-related differences between attentional cost and postural control, but little is known about the association in conditions with a one-legged standing posture. The purpose of this study was to determine age-related differences in postural control and attentional cost while performing tasks at various difficulty levels in a one-legged standing posture. Methods: In total, 29 healthy older adults aged 64 to 78 years [15 males, 14 females, mean (SD) = 71.0 (3.8) years] and 29 healthy young adults aged 20 to 26 years [14 males, 15 females, mean (SD) = 22.5 (1.5) years] participated in this study. We measured the reaction time, trunk accelerations, and lower limb muscle activity under 3 different one-legged standing conditions-on a firm surface, on a soft surface with a urethane mat, and on a softer more unstable surface with 2 piled urethane mats. Reaction time as an indication of attentional cost was measured by pressing a handheld button as quickly as possible in response to an auditory stimulus. A 2-way repeated-measures analysis of variance was performed to examine the differences between the 3 task conditions and the 2 age groups for each outcome. Results and Discussion: Trunk accelerations showed a statistically significant group-by-condition interaction in the anteroposterior (F = 9.1, P < .05), mediolateral (F = 9.9, P < .05), and vertical (F = 9.3, P < .05) directions. Muscle activity did not show a statistically significant group-by-condition interaction, but there was a significant main effect of condition in the tibialis anterior muscle (F = 33.1, P < .01) and medial gastrocnemius muscle (F = 14.7, P < .01) in young adults and the tibialis anterior muscle (F = 24.8, P < .01) and medial gastrocnemius muscle (F = 10.8, P < .01) in older adults. In addition, there was a statistically significant interaction in reaction time (F = 8.2, P < .05) for group-by-condition. Conclusions: The study results confirmed that reaction times in older adults are more prolonged than young adults in the same challenging postural control condition.

DOI PubMed

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Supplement ( 公益社団法人 日本理学療法士協会 )  2015   1600 - 1600  2016年

　概要を見る

【はじめに，目的】身体活動量は加齢により低下することが報告されている。しかし，75歳以上の後期高齢者を対象に身体活動量を調査した報告は少なく，その多くが横断研究である。本研究の目的は，縦断調査によって地域在住後期高齢者における身体活動量の経時的変化と関連要因を明らかにすることであった。【方法】対象は，2012年11月～2013年11月のベースライン調査に参加した地域在住高齢者411名のうち，2015年9月の追跡調査に参加した188名からデータ欠損などの理由により29名を除外した159名（平均年齢82.1±3.7歳）とした。ベースライン調査と追跡調査時には，身体活動量（歩数，活動時間）の他，基本情報（年齢，性別等），身体機能指標（歩行速度，下肢筋力等），健康関連指標（ソーシャルサポート，運動習慣，主観的健康度等）の測定を行った。身体活動量の測定には，生活習慣記録器（ライフコーダ，スズケン社製）を用い，一週間の身体活動量を記録した。また，記録されたデータから，一日あたりの歩数（以下歩数）と一日あたりの活動時間を算出した。更に，一日あたりの活動時間を3METs以上の中強度活動時間と，3METs未満の低強度活動時間に分類した。統計解析は，身体活動量（歩数，中強度活動，低強度活動）の平均値をベースライン調査時と追跡調査時で比較した。また，ベースライン調査時と追跡調査時の身体活動量の変化により対象者を2群（低下群/維持向上群）に分類し，ベースライン調査時の各測定項目を比較した。さらに，身体活動量の変化（低下群/維持向上群）を従属変数とし，群間比較によってp＜0.25であった項目を独立変数として多重ロジスティック回帰分析を実施した。統計解析にはIBM SPSS Statistics 22.0を使用し，有意水準は5%とした。【結果】ベースライン調査時と比較して追跡調査時の低強度活動が有意に低下した（p＜0.05）。身体活動量の変化について，低下群は84名，維持向上群は75名であった。2群間で各測定項目を比較した結果，ソーシャルサポートのみに有意な差が認められた（p＜0.05）。また，多重ロジスティック回帰分析では，性別（p＜0.01，OR：0.311），ソーシャルサポート（p＜0.05，OR：1.435），および主観的健康度（p＜0.05，OR：1.946）が，身体活動量の変化に関連する有意な独立変数として抽出された。【結論】低強度活動時間は3METs未満の運動強度を示す指標とされ，歩行以下の日常生活の活動時間を反映していると報告されている。結果より，後期高齢者では歩数や中強度の活動時間ではなく，低強度の活動時間が減少することが示された。また，調査期間に低強度の活動時間が低下した要因としては，ベースライン調査時における周囲環境のサポートや心理的な健康感が影響を与えていることが示唆された。後期高齢者の周囲環境のサポートの充足や心理的な健康感の向上が，日常生活の活動時間を維持するために重要な役割を担う可能性があると考えられる。

DOI CiNii

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Supplement ( 公益社団法人 日本理学療法士協会 )  2015   1495 - 1495  2016年

　概要を見る

【はじめに，目的】高齢期における身体活動量の維持は，健康増進や介護予防において重要な役割を果たす。その中でも中強度（3METs）以上の身体活動は，身体機能や疾病リスクとの関連の強さから特に推奨されている。身体活動量に影響する因子の一つである季節変化について，寒冷積雪地域では冬期間に身体活動量が低下しやすいことや，冬期間の身体活動量低下が将来の運動機能に悪影響を及ぼすことが先行研究において報告されている。しかしながら，冬期間の身体活動量低下がその後の認知機能の変化にどのような影響を与えるのかについては明らかにされていない。そこで本研究では，積雪寒冷地域に住む後期高齢者を対象とし，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について縦断的に検討した。【方法】対象は，2012年11月（初冬：第1回調査）と2013年2月（晩冬：第2回調査），2015年9月（第3回調査）の全3回の調査に参加した，積雪寒冷地域に住む75歳以上の高齢者93名（平均年齢79.5±3.3歳，男性41名/女性52名）とした。調査項目は，握力，快適歩行速度，全般的認知機能（Mini Mental State Examination：MMSE），外出頻度，活動セルフエフィカシー，中強度以上の身体活動時間とした。なお，中強度以上の身体活動時間は生活習慣記録機（ライフコーダ，スズケン社）を用いて測定し，装着1週間における1日あたりの平均活動時間を算出した。統計解析として，冬期間（第1回調査～第2回調査）における対象者全体の各変数の変化の有無を検討した。また，冬期間における中強度以上の身体活動時間低下の有無により対象者を2群化（維持向上群/低下群）した上で，年齢と性別を共変量とした二元配置分散分析を用い，その後3年間における各変数の変化を群間で比較した。なお，有意水準は5%とした。【結果】対象者全体における冬期間の変化として，外出頻度（p＜0.01）および快適歩行速度（p＜0.01）に有意な低下が認められた。身体活動時間の維持向上群は41名（44.1%），低下群は52名（55.9%）であり，群間で年齢と性別に有意差はなかった。分散分析の結果，MMSE得点（p＜0.01）および中強度以上の身体活動時間（p＜0.01）において群と時期による交互作用が認められ，冬期間に身体活動時間が低下した者はその後3年間において全般的な認知機能と身体活動時間が低下しやすいことが明らかになった。【結論】生活環境が大きく変化する冬期間において身体活動量を維持できない者は，その後の認知機能や身体活動量の長期的な低下を招くリスクが高いことが明らかとなり，冬期間に身体活動量を確保することの重要性が示された。また，身体活動量の低下と同時に認知機能の低下が生じていたことから，高齢者の身体活動を維持する上で認知機能を評価することの重要性が改めて確認されたと考える。

DOI CiNii

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Supplement ( 公益社団法人 日本理学療法士協会 )  2015   1335 - 1335  2016年

　概要を見る

【はじめに，目的】筋肉量の低下は筋力低下を引き起こし，結果として日常生活動作や生活の質に影響を与えることは広く知られている。近年では高齢者における「活動」や「社会参加」が身体機能の維持にも重要であり，self-efficacyも関連することが明らかとされている。しかしながら高齢者における筋肉量低下と活動や社会参加，self-efficacyとの関連については詳細に明らかにされていない。そこで本研究は高齢者におけるself-efficacy，運動習慣や外出頻度などの活動能力に注目し，筋肉量の縦断的変化に対する影響を明らかにすることを目的とする。【方法】後期高齢者女性36名（平均年齢82.1±4.1歳）を対象とし，平成25年2月と平成27年9月の計二回の調査を実施した。筋肉量は生体インピーダンス法にて，50kMzの抵抗値を測定し，吉田らの方法に準拠し性別，身長，体重で補正した骨格筋量指表（Skeletal-Muscle-Mass-Index：以下SMI）を算出した。SMIは二回の調査間の変化量を算出し，低下群と維持・向上群の二群に分類した。self-efficacyは運動および活動のself-efficacy scale（以下，運動SEF，活動SEF）について質問紙留め置き法を用いて聴取し，活動能力については1週間の平均的な外出頻度と運動行動変容ステージを聴取した。なお調査期間中の運動習慣の変化を検討するため，運動行動変容ステージについては二回の調査期間内を比較し変化量を求めた。統計解析についてはSMIの低下群と維持・向上群の二群を従属変数，一回目調査時の運動SEF，活動SEFのそれぞれの合計点，外出頻度，および運動行動変容ステージの変化量を独立変数としたロジスティック回帰をステップワイズ法を用いた実施した。なお有意水準は5%とした。【結果】SMI変化量の平均値は-.035±1.64kgであった。またSMIの群分けについては低下群に分類された者が10名，維持・向上群に分類された者が26名であった。ステップワイズ法を用いたロジスティック回帰分析の結果，運動行動変容ステージの変化量（オッズ比=0.367，95%信頼区間；0.148-0.914，p＜0.031），外出頻度（オッズ比0.398=95%信頼区間；0.171-.0927，p=0.033）および活動SEF（オッズ比=2.430，95%信頼区間；1.141-5.176，p=0.033）が有意な項目として抽出された。【結論】本研究の結果より，外出頻度と活動を行う自信については，縦断的な筋肉量の低下との関係性が明らかとなり，外出頻度が多いことや自己効力感が高いこと筋肉量の維持に繋がる可能性が示唆された。また運動行動変容ステージについては，調査期間内に運動習慣に関する行動変容ステージが低下した者ほど期間内に筋肉量が低下した結果となり，筋肉量は習慣が変わることにより変化することが明らかとなり，高齢者における筋のトレーナビリティーの特徴の一部が示された。本研究で得られた知見は，高齢期の理学療法における在宅および地域での運動習慣や活動を促す上での一助となり得る。

DOI CiNii

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Supplement ( 公益社団法人 日本理学療法士協会 )  2015   1521 - 1521  2016年

　概要を見る

【はじめに，目的】高齢者の転倒はしばしば重篤な障害を引き起こしQOLの低下につながる。転倒に関する要因は様々報告されているが，環境などの外的要因は転倒を引き起こす重要な要因の一つと考えられている。しかしながら，積雪寒冷地域において，転倒に関連する環境要因は冬期と非冬期で大きく異なる。そのため冬期に発生する転倒と非冬期に発生する転倒を同一のモデルで検討することは適切ではないと考えられる。そこで本研究では，積雪寒冷地域在住の後期高齢者を対象に，転倒時期の違いによる身体的特徴を縦断的調査によって明らかにすることを目的とした。【方法】対象は，2012年11月から2013年11月のベースライン調査と2015年9月のフォローアップ調査に参加した積雪寒冷地域在住の75歳以上の高齢者186名（平均年齢80.6±4.3歳，男性17名/女性23名）とした。調査項目は，基本情報の他に，転倒に関する情報と運動機能を測定した。転倒に関しては転倒回数と転倒時期を聴取した。運動機能は，最大歩行速度，TUG，坐骨歩き，握力，および膝伸展筋力を測定した。統計解析として，ベースライン調査における転倒の有無および時期により対象者を3群化（非転倒群，非冬期転倒群，冬期転倒群）した上で，群と調査時期を要因とする二元配置分散分析を用い，その後3年間における運動機能の変化を群間で比較した。なお，統計解析にはIBM SPSS Statics 21を用い，有意水準は5%とした。【結果】186名の後期高齢者のうち，BLの転倒経験者は54名（29.0％）であった。「非転倒群」に属したのが132名（71.0％），「非冬期転倒群」に属したのが35名（18.8％），「冬期転倒群」に属したのが19名（10.2％）であり，群間で年齢と性別に有意な差は認められなかった。分散分析の結果，有意な交互作用は認められなかった。膝伸展筋力（p＜0.01）に群および時期の主効果が認められ，最大歩行速度（p＜0.01），TUG（p＜0.01），坐骨歩き（p＜0.01），握力（p＜0.01）に群の主効果が認められた。【結論】本研究の結果から，ベースラインのみならず，その後3年間においても冬期以外に転倒を経験した後期高齢者はその他の高齢者と比較していくつかの運動機能が低下していることが明らかになった。積雪寒冷地域において，冬期は積雪や路面凍結といった環境の影響が大きく，そのような環境制約のない非冬期に転倒した高齢者は運動機能の低下が顕在化したものと推察される。また，虚弱高齢者をスクリーニングする上で，非冬期の転倒の有無は重要な因子であると考えられる。

DOI CiNii

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 ( 公益社団法人 日本理学療法士協会 )  2015   1528 - 1528  2016年

　概要を見る

【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。

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外来化学療法施行中のがん患者に対する在宅理学療法の効果検証:─ランダム化比較試験─

井平 光, 古名 丈人

理学療法学 ( 日本理学療法士学会 )  43 ( 2 ) 166 - 167  2016年

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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 ( ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD )  19 ( 8 ) 756 - 761  2015年08月  [査読有り]  [国際誌]

　概要を見る

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 75years and older. Method: The sample comprised 275 older adults aged 75-91years. 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 75years and older.

DOI PubMed

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 ( SOC PHYSICAL THERAPY SCIENCE )  27 ( 7 ) 2207 - 2211  2015年07月  [査読有り]  [国内誌]

　概要を見る

[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.

DOI PubMed

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 ( BIOMED CENTRAL LTD )  15   43 - 43  2015年04月  [査読有り]  [国際誌]

　概要を見る

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.

DOI PubMed

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]

　概要を見る

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.

DOI PubMed

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 ( ANTHROPOLOGICAL SOC NIPPON )  122 ( 1 ) 1 - 6  2014年04月  [査読有り]

　概要を見る

This study examined the use of the hip walking (HW) distance test as a physical performance parameter, and investigated the association between HW distance and strength, balance, and gait speed in the elderly. The study involved 106 community-dwelling elderly individuals (mean age 75.4 years). Participants performed the following physical performance tests: the HW distance test, the functional reach test (FRT), and tests for knee extensor strength, trunk extensor, and flexor strength, and 5 m maximum gait speed. For the HW distance test, participants were asked to move forward as fast as possible from the starting position with legs stretched out forwards and arms folded across the chest. Trunk rotation with lifting of the ischium was permitted during HW. The distances between right lateral malleoli was measured for HW distances of 10 seconds. To assess the test-retest reliability of HW, intra-class correlation coefficients (ICCs) were calculated from two trials. Pearson's correlation analysis and linear regression analysis were used to examine the association between HW and physical performance using adjusted variables such as age, sex, and body mass index. ICC (1.1) for the test -retest reliability of HW was 0.95. HW was significantly associated with all physical performance tests according to Pearson's correlation analysis (trunk flexor strength, r = 0.31; trunk extensor strength, r = 0.31; knee extensor strength, r = 0.29; FRT, r = 0.29; gait speed, r = 0.45). In linear regression analyses, HW distance scores were found to be significant determinants of each physical performance parameter. HW influenced physical performance by affecting muscle strength, balance, and gait ability. HW can be easily and safely performed on a floor or platform without the risk of falling. These results indicate that HW is a safe, simple, and reliable method for the assessment of physical performance in the elderly.

DOI

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 ( ASIAN PACIFIC ORGANIZATION CANCER PREVENTION )  15 ( 7 ) 3305 - 3310  2014年  [査読有り]  [国際誌]

　概要を見る

Background: A cancer survivor is defined as anyone who has been diagnosed with cancer, from the time of diagnosis through the rest of their life. The purpose of this study was to examine whether physical functions, health-related outcomes, nutritional status and blood markers in community-dwelling cancer survivors aged 75 years and older are different from those who do not have cancer Materials and Methods: Two hundred seventy-five participants were asked by physicians, nurses, and physical therapists, questions regarding cancer history in a face-to-face interview. Data were collected for demographic information, physical functions, such as handgrip strength, knee extension power, abdominal muscle strength, static standing balance, walking speed and the timed-up-and-go test, health-related outcomes, nutritional status, and blood markers. The measured parameters of survivor diagnosed with cancer were compared with those without a history of cancer. Results: Thirty-seven older adults were previously diagnosed with cancer. Female cancer survivors had lower knee extension power (p<0.05), abdominal muscle strength (p<0.05), walking speed (p<0.05), timed-up-and-go test score (p<0.05), and time to spend on walking per day (p<0.05) than older women without a history of cancer. In men, none of the measured parameters were significantly different between cancer survivors and older men with no history of cancer. Conclusions: The present study shows that partial physical function of women cancer survivors aged 75 years and older differs from that in women with no history of cancer.

DOI PubMed

Age-related Differences in the Influence of Cognitive Task Performance on Postural Control Under Unstable Balance Conditions

Hyuma Makizako, Taketo Furuna, Hikaru Ihira, Hiroyuki Shimada

INTERNATIONAL JOURNAL OF GERONTOLOGY ( ELSEVIER TAIWAN )  7 ( 4 ) 199 - 204  2013年12月  [査読有り]

　概要を見る

Background: Poor multitask performance is commonly used as an indicator of age-related changes in attentional capacity. An inability to allocate sufficient attention to postural control under multitask conditions is thought to be a contributing factor to the risk of falling in older adults. This study examined age-related differences in the influence of cognitive task performance on postural sway and muscle activity on unstable balance conditions. Methods: Thirty healthy younger adults (22.2 +/- 1.5 years of age, 15 men and 15 women) and 27 healthy older adults (713 +/- 3.4 years of age, 13 men and 14 women) participated in the study. Participants performed a reaction time task under three conditions during standing on a compliant foam surface: holding a glass full of sand (control task), holding a glass of water (dual-manual task), and performing a control task while simultaneously performing a verbal fluency task (dual-cognitive task). Results: Both younger and older adults had a longer reaction time for the dual-cognitive task compared to the other two tasks (p < 0.01). Older participants exhibited decreased lower limb muscle activity and increased anterior-posterior trunk acceleration during the dual-cognitive task, while these effects were not observed in younger adults. Conclusion: Increasing attentional demand by implementing a cognitive task concomitant with a balance task had a greater influence on postural control in older compared to younger adults. Copyright (C) 2013, Taiwan Society of Geriatric Emergency 82 Critical Care Medicine. Published by Elsevier Taiwan LLC. All rights reserved.

DOI

これからの筋力トレーニングのあり方 高齢者に対する筋力トレーニングのあり方

井平光, 古名丈人

理学療法(東京)   30 ( 9 ) 1010 - 1016  2013年09月

J-GLOBAL

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]

Age-Related Differences in Reaction Time Responses under Simple- and Dual-task Conditions in Middle-Aged Ski Marathon Amateur Males

H. Makizako, F. Kaneko, N. Aoki, H. Ihira

International Journal of Sport and Health Science ( Japan Society of Physical Education, Health and Sport Sciences )  11   33 - 38  2013年  [査読有り]

　概要を見る

The present study sought to examine age-related differences in reaction time responses under simple- and dual-task conditions in active middle-aged males. Fifty healthy males aged 42 to 64 years who took part in public marathon events in 2010 or 2011, and who had participated in ski marathon events for more than 2 years were assessed, and whole body reaction times (WBRTs) were measured by under simple-task and dual-task conditions. In the dual-task condition, participants performed WBRTs measurements while they counted backwards aloud to 1, starting from 100. Although reaction times in the simple-task condition were not associated with age (r=0.21, p=0.14), a significant positive correlation was found between age and reaction times in a dual-task task condition involving concurrent cognitive tasks (r=0.45, p<0.01). One-way analysis of variance revealed that older subjects (60 years and older) responded more slowly than two younger groups (aged <50 and 50-59 years) in dual-task conditions (F=7.87, p<0.01). However these age-related differences were not found in simple-task reaction times (F=1.74, p=0.19). The present findings suggest that attentional capacity assessed by reaction time in dual-task conditions declined with age in active middle-aged males.


DOI CiNii

Differences between Proximal and Distal Muscle Activity of the Lower Limbs of Community-dwelling Women during the 6-minute Walk Test

Hikaru Ihira, Hiroyuki Shimada, Megumi Suzukawa, Taketo Furuna, Kiyoji Matsuyama, Sumio Ishiai

JOURNAL OF PHYSICAL THERAPY SCIENCE ( SOC PHYSICAL THERAPY SCIENCE )  24 ( 2 ) 205 - 209  2012年03月  [査読有り]

　概要を見る

[Purpose] This study examined the change in the muscle activities of the lower limbs during the 6-minute walk test to identify the relationship between the change in muscle activity and physical performance of community-dwelling elderly women. [Methods] Twenty-three elderly women (mean age: 77.9 years) were recruited from the community to participate. Their muscle activities were recorded using surface electromyography of the gastrocnemius, tibialis anterior, vastus medialis, hamstrings, and gluteus medius, and muscle strength, mobility, balance and 6-minute walking distance were also measured. [Results] The decrease of electromyography activity during the 6-minute walk test was significantly greater in the gastrocnemius and tibialis anterior than in the other muscles. The decrease of electromyography activity in the gastrocnemius was correlated with the timed up-and-go time (r=-0.435) and that of the tibialis anterior was correlated with the timed up-and-go time (r=-0.530) and walking distance (r= 0.482). [Conclusions] The electromyogram activities of the gastrocnemius and the tibialis anterior showed deterioration during the 6-minute walk test, and they were correlated with gait performance. These results suggest that muscle activity of the distal muscles plays an important role in the walking ability of elderly women.

DOI

ステップエルゴメーターのアイソキネティック運動におけるピークパワーと筋活動特性との関連 -表面筋電図周波数分析による検討-

水本淳, 島田裕之, 井平光, 野村知広, 古名丈人, 鈴川芽久美

理学療法科学 ( The Society of Physical Therapy Science )  27 ( 4 ) 411 - 415  2012年  [査読有り]

　概要を見る

〔目的〕Biostepのアイソキネティック運動時の筋パワーと筋活動特性との関連を調べ，速度条件による活動特性の違いを検討した．〔対象と方法〕高齢女性12名に対し60 steps / minと90 steps / min駆動時の筋パワーと表面筋電図を測定した．筋電図はウェーブレット変換を行った後，MPF，LF/TP，HF/TPを算出した．各変数の相関分析と，条件比較のためwilcoxon検定を行った．〔結果〕60 stepの筋パワーと前脛骨筋のLF/TPの間に有意な正の相関を認めた．内側広筋，前脛骨筋のMPF，HF/TPが90 stepで有意に高かった．〔結語〕90 stepの運動において速筋線維の活動が増加することが推察され，加齢による速筋線維の萎縮に対して高速運動が有効であると考えられた．

DOI CiNii J-GLOBAL

後期高齢者における新規要介護認定の発生と5m歩行時間との関連 : 39ヵ月間の縦断研究

牧迫 飛雄馬, 古名 丈人, 島田 裕之, 赤沼 智美, 吉田 裕人, 井平 光, 横山 香理, 鈴木 隆雄

理学療法学 ( 公益社団法人日本理学療法士協会 )  38 ( 1 ) 27 - 33  2011年02月  [査読有り]

　概要を見る

【目的】75歳以上の高齢者における新規要介護認定の発生に対する歩行能力の影響を明らかにすることを目的とした。【方法】要介護認定を受けていない75歳以上の地域在住高齢者190名を対象とした。ベースライン調査として5m歩行時間(通常速度)を測定し,以降39ヵ月間の要介護認定発生状況との関連を調べた。【結果】39ヵ月間で34名(17.9%)が新規に要介護認定を受けた。5m歩行時間を男女別に4分位で速い群から遅い群のI〜IV群に分類し,要介護発生率曲線の差をLog-rank検定にて検討した結果,5m歩行時間が遅いIV群(男性5.2秒以上,女性5.8秒以上)では,それ以上に速い歩行速度を有する群(I〜III群)と比べて有意に高い要介護認定発生率を認めた(p<0.01)。Cox回帰分析の結果,新規要介護の発生と有意な関連を認めた変数は,BMIと5m歩行時間(秒)であり,5m歩行時間のハザード比は1.65(p<0.01)であった。【考察と結論】地域在住後期高齢者の歩行速度は,将来の要介護認定発生に影響を与える要因のひとつであることが確認された。

CiNii J-GLOBAL

Usual Walking Speed Predicts Decline of Functional Capacity among Community-Dwelling Older Japanese Women: a 4-year Longitudinal Study

Hyuma Makizako, Taketo Furuna, Hiroto Yoshida, Hiroyuki Shimada, Katsunori Satoh, Tomomi Akanuma, Hikaru Ihira, Takao Suzuki

JOURNAL OF PHYSICAL THERAPY SCIENCE ( SOC PHYSICAL THERAPY SCIENCE )  22 ( 4 ) 405 - 412  2010年11月  [査読有り]

　概要を見る

[Purpose] In this study, we examined the physical predictors of the decline of functional capacity among community-dwelling older Japanese individuals. [Methods] A total of 265 Japanese individuals aged 68-96 years participated in a baseline survey and a follow-up 4 years later. In this survey, participants performed tests for grip strength, one-legged standing, and 5-m walking. At baseline and the follow-up survey, we measured functional capacity using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC), which consists of the instrumental self-maintenance scale, the intellectual activity scale, and the social role scale. [Results] There was only a weak association between physical performance and the decline of functional status in men. The 5-m walking time was most sensitive at predicting the future decline of the instrumental self-maintenance scale in women. Even after controlling for age, body mass index, grip strength, and one-legged standing, a slower 5-m walking time (greater than 4.6 sec) indicated an increased risk of future decline in instrumental self-maintenance in women (odds ratio = 5.31, p<0.01). [Conclusions] The usual walking speed is the best performance measure for predicting the decline of instrumental self-maintenance among Japanese older women.

DOI

Association between a history of falls and the ability to multi-task in community-dwelling older people

Hyuma Makizako, Taketo Furuna, Hiroyuki Shimada, Hikaru Ihira, Mika Kimura, Eiichi Uchiyama, Lars I. E. Oddsson

AGING CLINICAL AND EXPERIMENTAL RESEARCH ( SPRINGER )  22 ( 5-6 ) 427 - 432  2010年10月  [査読有り]

　概要を見る

Background and aims: Many older people fall when they perform tasks which require increased attention. The aim of this study was to determine differences in reaction times, during simple-, dual- and triple-task conditions requiring differing levels of motor coordination, balance control and cognitive attention, between groups of fallers and non-fallers in community-dwelling older individuals. Methods: The study involved the recruitment of 87 older individuals living at home, 57 women and 30 men aged 75 to 91 years. Reaction times, measured by pushing a handheld button as quickly as possible in response to a visual stimulus, were measured in four conditions: 1) quiet standing (simple-task); 2) counting backward during quiet standing (dual-task with cognitive demand); 3) stepping in place (dual-task with balance demand); and 4) counting backward while stepping in place (triple-task with cognitive and balance demands). Results: Twenty-nine (33.3%) participants had fallen at least once during the past year. There were no statistically significant differences in reaction times between non-fallers and fallers during any of the tasks. Reaction times were significantly longer during the dual- and triple-tasks compared with the simple-task conditions in both groups. The ratio between reaction times during dual-tasks with balance demands (stepping in place) and those in the simple-task condition were significantly related to a history of falls and showed the highest odds ratio (OR 3.16, 95% CI 1.06-9.45, p=0.04). Conclusions: Relative changes in reaction times during a dual-task with balance demands were related to a history of falls in community-dwelling older individuals. Reaction times in dual-task conditions with a balance demand were more sensitive to past falls than those during a dual-task with cognitive demands. (Aging Clin Exp Res 2010; 22: 427-432) (C) 2010, Editrice Kurtis

DOI PubMed

Age-Related Changes in Attentional Capacity and the Ability to Multi-Task as a Predictor for Falls in Adults Aged 75 Years and Older

Hyuma Makizako, Taketo Furuna, Hiroyuki Shimada, Hikaru Ihira, Mika Kimura, Lars I. E. Oddsson, Takao Suzuki

JOURNAL OF PHYSICAL THERAPY SCIENCE ( SOC PHYSICAL THERAPY SCIENCE )  22 ( 3 ) 323 - 329  2010年08月  [査読有り]

　概要を見る

[Purpose] Examine the age-related deterioration of attentional capacity and predictive validity of multi-tasking performances for falls in adults aged 75 and older. [Methods] This study involved 45 elderly individuals and 15 healthy and young volunteers. Reaction times to a visual stimulus were measured under three different conditions: 1) stepping in place (dual-tasking condition with dynamic balance demands); 2) counting backwards during quiet standing (dual-tasking condition with cognitive demands); and 3) counting backwards while stepping in place (triple-tasking condition). The participating elderly individuals reported subsequent falls after a 5-month follow-up period. [Results] Elderly adults demonstrated significantly longer reaction time responses in all task conditions in comparison to young adults. There were statistically significant differences in reaction times between fallers and non-fallers during dual-tasking conditions, but not during triple-tasking conditions. The slower reaction times during dual-tasking conditions with dynamic balance demands were significantly related to the occurrence of subsequent falls, whereas there was only a weak association in model-adjusted physical performance tests. [Conclusions] Attentional capacity in multi-tasking conditions decreases with aging. Slow reaction time response during dual-tasking conditions with dynamic balance demands may be a predictor of falls in adults aged 75 and older.

DOI

健康寿命の延伸と理学療法 健康寿命の延伸と体力の維持・向上のための理学療法

牧迫飛雄馬, 井平光, 古名丈人

理学療法(東京)   27 ( 4 ) 542 - 547  2010年04月

CiNii J-GLOBAL

姿勢制御課題の難易度とプローブ反応時間の関係

井平 光, 古名 丈人, 牧迫 飛雄馬, 宮部 謡子

理学療法科学 ( 理学療法科学学会 )  24 ( 5 ) 727 - 732  2009年10月

DOI CiNii