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  • MDPI AG  (10)
  • 1
    Online Resource
    Online Resource
    The Effect of a Multicomponent Dual-Task Exercise on Cortical Thickness in Older Adults with Cognitive Decline: A Randomized Controlled Trial
    MDPI AG ; 2020
    In:  Journal of Clinical Medicine Vol. 9, No. 5 ( 2020-05-02), p. 1312-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 9, No. 5 ( 2020-05-02), p. 1312-
    Abstract: 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.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm9051312
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
    detail.hit.zdb_id: 2662592-1
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  • 2
    Online Resource
    Online Resource
    Participation in Social Activities and Relationship between Walking Habits and Disability Incidence
    MDPI AG ; 2021
    In:  Journal of Clinical Medicine Vol. 10, No. 9 ( 2021-04-27), p. 1895-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 10, No. 9 ( 2021-04-27), p. 1895-
    Abstract: 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.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm10091895
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
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  • 3
    Online Resource
    Online Resource
    Subjective Cognitive Decline and Frailty Trajectories and Influencing Factors in Japanese Community-Dwelling Older Adults: A Longitudinal Study
    MDPI AG ; 2023
    In:  Journal of Clinical Medicine Vol. 12, No. 18 ( 2023-09-06), p. 5803-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 12, No. 18 ( 2023-09-06), p. 5803-
    Abstract: 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.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm12185803
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
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  • 4
    Online Resource
    Online Resource
    Modifiable Risk Factor Possession Patterns of Dementia in Elderly with MCI: A 4-Year Repeated Measures Study
    MDPI AG ; 2020
    In:  Journal of Clinical Medicine Vol. 9, No. 4 ( 2020-04-10), p. 1076-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 9, No. 4 ( 2020-04-10), p. 1076-
    Abstract: 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.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm9041076
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
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  • 5
    Online Resource
    Online Resource
    A New Social Network Scale for Detecting Depressive Symptoms in Older Japanese Adults
    MDPI AG ; 2020
    In:  International Journal of Environmental Research and Public Health Vol. 17, No. 23 ( 2020-11-29), p. 8874-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 17, No. 23 ( 2020-11-29), p. 8874-
    Abstract: 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.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph17238874
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
    detail.hit.zdb_id: 2175195-X
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  • 6
    Online Resource
    Online Resource
    Life Satisfaction and the Relationship between Mild Cognitive Impairment and Disability Incidence: An Observational Prospective Cohort Study
    MDPI AG ; 2021
    In:  International Journal of Environmental Research and Public Health Vol. 18, No. 12 ( 2021-06-19), p. 6595-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 18, No. 12 ( 2021-06-19), p. 6595-
    Abstract: 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.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph18126595
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
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  • 7
    Online Resource
    Online Resource
    Engagement in Lifestyle Activities is Associated with Increased Alzheimer’s Disease-Associated Cortical Thickness and Cognitive Performance in Older Adults
    MDPI AG ; 2020
    In:  Journal of Clinical Medicine Vol. 9, No. 5 ( 2020-05-11), p. 1424-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 9, No. 5 ( 2020-05-11), p. 1424-
    Abstract: 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.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm9051424
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
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  • 8
    Online Resource
    Online Resource
    The Association between Neighborhood Amenities and Cognitive Function: Role of Lifestyle Activities
    MDPI AG ; 2020
    In:  Journal of Clinical Medicine Vol. 9, No. 7 ( 2020-07-04), p. 2109-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 9, No. 7 ( 2020-07-04), p. 2109-
    Abstract: 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.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm9072109
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
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  • 9
    Online Resource
    Online Resource
    Simplified Decision-Tree Algorithm to Predict Falls for Community-Dwelling Older Adults
    MDPI AG ; 2021
    In:  Journal of Clinical Medicine Vol. 10, No. 21 ( 2021-11-05), p. 5184-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 10, No. 21 ( 2021-11-05), p. 5184-
    Abstract: 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.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm10215184
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
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  • 10
    Online Resource
    Online Resource
    Differences in Subjective and Objective Cognitive Decline Outcomes Are Associated with Modifiable Protective Factors: A 4-Year Longitudinal Study
    MDPI AG ; 2022
    In:  Journal of Clinical Medicine Vol. 11, No. 24 ( 2022-12-15), p. 7441-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 11, No. 24 ( 2022-12-15), p. 7441-
    Abstract: 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.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm11247441
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
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