Effects of gentle mechanical skin stimulation on subjective symptoms and joint range of motions in people with chronic neck and shoulder discomfort.

This study aimed to examine the efficacy of a 2-week self-administered gentle mechanical skin stimulation on chronic neck and shoulder discomfort. In participants (n = 12) with chronic neck and shoulder discomfort, subjective measures of pain sensation, discomfort, and difficulty in moving using a visual analog scale (VAS, 0-10) and objective measures of 12 different joint range of motions (ROMs) for the cervical and shoulder regions, using a digital goniometer, were collected before and after self-care with contact acupuncture, called microcones. The self-care for 2 weeks significantly (p < 0.001) decreased all VAS scores to 2.2-2.3 from baseline values of 6.0-7.4. Of the 12 ROMs tested, 8 were significantly increased (p < 0.013). This open-label study suggests the use of self-care with microcones in improving subjective symptoms and joint ROMs in people suffering from chronic neck and shoulder discomfort. However, a randomized, double-blind, controlled clinical trial is needed to further investigate the efficacy and safety of microcones.

Prevalence, overlap, and interrelationships of physical, cognitive, psychological, and social frailty among community-dwelling older people in Japan.

Background The aim of this study is to explore the prevalence and overlap of physical, cognitive, psychological, and social frailty and their negative-interrelationships. Methods We conducted a survey of people aged ≥75 years in the region with the oldest population in Japan. Frailty was divided into physical, cognitive, psychological, and social frailty, which were evaluated with the Japanese version of the Cardiovascular Health Study (J-CHS) criteria, J-CHS and the Japanese version of the Montreal Cognitive Assessment, the Geriatric Depression Scale-15 and the Lubben Social Network Scale, respectively. Results Of the 268 participants (aged 81.5 ± 4.5 years), 48.1% and 8.6% had physical prefrailty and frailty; 68.3%, 13.0%, and 5.2% had mild cognitive impairment, dementia, and cognitive frailty; 25.7% and 5.2% had depressive mood and depression as psychological frailty; and 7.8% had social frailty, respectively. Path analysis showed that social frailty was associated with psychological frailty. Psychological frailty was associated with physical frailty. Physical frailty was associated with cognitive frailty. Multiple logistic regression analysis showed that independent determinants of physical robustness were female sex, age, and psychological robustness (odds ratio (OR) = 2.166, 0.831, 3.625, respectively). Determinants of cognitive robustness were age and psychological robustness (OR = 0.837, 7.079). Determinants of psychological robustness were physical, cognitive, and social robustness (OR = 3.759, 6.829, 5.037), and the determinant of social robustness was psychological robustness (OR = 4.489), respectively. Conclusions We demonstrated the prevalence, overlap, and interrelationships of different types of frailty and clarified the factors that may help to reduce frailty.

Effectiveness of a far-infrared low-temperature sauna program on geriatric syndrome and frailty in community-dwelling older people.

AIM: Although it is known that geriatric syndrome is associated with the development of frailty, it is not known whether an amelioration of geriatric syndrome also improves shared risk factors and frailty. METHODS: In total, 67 community-dwelling older people (79.6 ± 6.5 years, 49 women) participated in this study (41 were classified as pre-frail and 26 as frail). We analyzed indices of physical frailty and cognitive depression, exercise tolerance and health-related quality of life as frailty related indices, and the participants completed a questionnaire regarding common geriatric symptoms (cold extremities, leg edema, breathlessness, urinary incontinence, chronic headache, chronic pain, a sense of numbness, anorexia, constipation, insomnia and skin trouble) using numeric ratings. Frailty was evaluated using the Japanese version of the Cardiovascular Health Study (J-CHS) criteria. The participants then underwent a far-infrared low-temperature sauna (FILTS) program twice a week for 3 months and the above parameters were reassessed. RESULTS: After the FILTS program, there were significant differences in usual walking speed, peak oxygen uptake, Geriatric Depression Scale-15, health-related quality of life and the severity of several geriatric symptoms. Of the 67 participants, 18 showed improvements in their J-CHS frailty score, 47 showed no change and two showed reductions. Linear regression analysis showed that the change in the numeric rating of the coldness of extremities (B = -0.105, P = 0.013) and the cumulative numeric rating for geriatric syndromes (B = 0.044, P < 0.001) were independent determinants of the change in the J-CHS score. CONCLUSIONS: A 3-month FILTS program ameliorates geriatric syndrome, the severity of frailty and frailty related indices in older Japanese people. Geriatr Gerontol Int 2020; 20: 892-898.

Peak exercise stroke volume effects on cognitive impairment in community-dwelling people with preserved ejection fraction.

AIMS: The association of vascular dysfunction and amyloid beta deposition attracted attentions for its relationship with cognitive decline. Previous studies show the correlation between the declined cardiac function and the cognitive impairment. In the present study, we analysed the association between cognitive functions and cardiac parameters in community-dwelling people with preserved ejection fraction without heart failure. METHODS AND RESULTS: Subjects were 108 Japanese community-dwelling middle-aged and older adults with preserved ejection fraction (25 men and 83 women; mean age 74.7 years). Cardiac functional parameters at rest were assessed with B-type natriuretic peptide and echocardiography. The cardiopulmonary exercise test was used to test these parameters during exercise. Cognitive function was assessed with the Japanese version of the Montreal Cognitive Assessment (MoCA-J). Other indices were assessed biochemically, physiologically, and physically. There were significant correlations between MoCA-J score and age (r = -0.388), peak oxygen uptake (VO2 , r = 0.201), peak VO2 /heart rate (HR, r = 0.243), peak VO2 /weight (r = 0.244), peak metabolic equivalents (r = 0.244), usual walking speed (r = -0.200), and the Timed Up and Go test (r = -0.230). Multiple linear regression analysis showed peak VO2 /HR was an independent determinant of MoCA-J score after adjusting for potential confounders (B = 0.424). After 6 months of exercise training with 64 subjects, we found that the per cent change of peak VO2 /HR was related to the per cent change of MoCA-J score (r = 0.296). CONCLUSIONS: These results suggested that peak VO2 /HR (an index of stroke volume at peak exercise) might be associated with cognitive impairment based on the vascular cascade hypothesis.

Japanese version of the Montreal Cognitive Assessment cut-off score to clarify improvement of mild cognitive impairment after exercise training in community-dwelling older adults.

AIM: Physical exercise improves cognitive function in people with mild cognitive impairment (MCI). However, information about whether the degree of MCI before exercise training affects improvement in cognitive function is lacking. Therefore, we aimed to investigate the cut-off value in a MCI screening tool that predicts reversal to normal cognitive function after exercise training in older adults with MCI. METHODS: Participants included 112 Japanese community-dwelling older adult outpatients (37 men, 75 women; mean age 76.3 years). We administered the Japanese version of the Montreal Cognitive Assessment (MoCA-J) before and after exercise training. MCI was defined as a MoCA-J score <26. All participants underwent exercise training 2 days per week for 6 months, according to American Heart Association guidelines. RESULTS: The prevalence of MCI was 65.2%. After exercise training, 46.6% of participants with MCI reversed to normal cognitive function. The MoCA-J cut-off score to predict cognitive function potentially reversible to normal was 23, with receiver operating characteristic analysis showing an area under the curve of 0.80, sensitivity of 79.4% and specificity of 69.2%. Multiple logistic regression analysis to predict non-MCI after exercise training showed that MoCA-J score ≥23 (OR 6.9, P < .001), female sex (OR 3.4, P = .04) and age (OR 0.9, P = .04) were independent determinants. CONCLUSIONS: The MoCA-J cut-off score of 23 might be useful to predict cognitive function that is potentially reversible to normal among community-dwelling Japanese older adults with MCI. Geriatr Gerontol Int 2018; 18: 833-838.

Relationship between skeletal muscle mass and cardiac function during exercise in community-dwelling older adults.

AIMS: This study aimed to investigate the relationship between skeletal muscle mass and cardiac functional parameters in older adults during cardiopulmonary exercise testing (CPET). METHODS AND RESULTS: Sixty-three Japanese community-dwelling older adults were enrolled (20 men and 43 women; mean age 80 years, range 65-97 years). Cardiac functional parameters during exercise were assessed using CPET. Skeletal muscle mass index (SMI) was calculated by dividing the appendicular lean mass (measured using dual-energy X-ray absorptiometry) by height in metres squared. Subjects were divided into two groups: men with SMI ≥ 7.0 kg/m2 and women with SMI ≥ 5.4 kg/m2 (non-sarcopenic group); or men with SMI < 7.0 kg/m2 and women with SMI < 5.4 kg/m2 (sarcopenic group). There were significant positive correlations between SMI and peak oxygen uptake (VO2 ) (r = 0.631, P < 0.001), and between SMI and peak VO2 /heart rate (HR) (r = 0.683, P < 0.001). However, only peak VO2 /HR significantly differed between groups in both sexes. Multiple linear regression analyses with peak VO2 /HR as a dependent variable showed that SMI was the only independent determinant after adjusting for potential confounders. After 4 month follow-up of 47 participants, there was still a significant positive correlation between SMI and peak VO2 /HR (r = 0.567, P < 0.001), and between percent change of SMI and percent change of peak VO2 /HR (r = 0.305, P < 0.05). CONCLUSIONS: Peak VO2 /HR, an index of stroke volume at peak exercise, was associated with SMI. This indicates that skeletal muscle mass might affect cardiac function during exercise.

Femoral muscle mass relates to physical frailty components in community-dwelling older people.

AIM: To examine the relationship between lower limb muscle (femoral muscle, calf muscle) mass and exercise capacity, and frailty components in community-dwelling older people. METHODS: Participants included 121 community-dwelling individuals. There were 42 men and 79 women, and the mean age was 77.7 years (range 56-97 years). Appendicular skeletal muscle mass was determined using dual-energy X-ray absorptiometry, and the skeletal muscle index was calculated using the following formula: appendicular skeletal muscle / body height2 . Femoral muscle mass and calf muscle mass were determined, respectively, by dividing the femoral bone and tibial bone at the knee joint space. A symptom-limited cardiopulmonary exercise testing was carried out and peak oxygen uptake was measured. Functional exercise performance was evaluated using the handgrip strength measurement, comfortable walking speed, and the Timed Up and Go test. All patients gave written, informed consent before data collection. RESULTS: Peak oxygen uptake correlated positively with the skeletal muscle index (r = 0.491). Only femoral muscle mass that was corrected with the whole body muscle mass was positively correlated with peak oxygen uptake (r = 0.473), handgrip strength (r = 0.382), comfortable walking speed (r = 0.427), and the Timed Up and Go test (r = 0.379). Calf muscle mass that was corrected with the whole-body muscle mass showed no correlation with exercise capacity and frailty components. A similar tendency was observed in both men and women. CONCLUSIONS: Femoral muscle mass influenced exercise capacity and physical frail components compared with calf muscle mass. These results suggest the importance of the femoral muscle in physical frailty. Geriatr Gerontol Int 2017; 17: 1636-1641.