[A longitudinal study of the association between physical activity and apathy among community-dwelling older adults].

AIM: This study clarified the association between the amount of physical activity and apathy after one year among community-dwelling older adults. METHODS: Two hundred community-dwelling older adults (mean age: 74.3±5.0 years old, female: 52.5%) who participated in the 2018 and 2019 "Kasama Longevity Health Examination" were included. Apathy was assessed using the Apathy Scale (0-42 points; the higher the score, the lower the motivation), physical activity by Physical Activity Scale for the Elderly (PASE), and Geriatric Depression Scale-15 (GDS). The 2018 PASE data were grouped into tertiles. A multiple regression analysis was performed with the 2019 Apathy Scale as the dependent variable and the 2018 PASE as the independent variable, and the sex, age, years of education, economic situation, body mass index, chronic illness, smoking history, alcohol drinking habits, physical function, cognitive function, GDS, and the 2018 Apathy Scale as adjustment variables. The PASE subcategories (leisure-time, household, and work-related activities) were examined using a similar method. RESULTS: The mean Apathy Scale in 2019 was 14.0±6.2 for the low physical activity group, 12.8±6.0 for the medium physical activity group, and 10.1±5.9 for the high physical activity group. The high physical activity group showed a significant negative association with the Apathy Scale (B=-1.56, 95% confidence interval=-2.91 to -0.21, p=0.023). No association was found for any activity of the PASE sub-items. CONCLUSIONS: A high level of physical activity may protect against apathy among community-dwelling older adults.

Functional remodeling of intraperitoneal macrophages by oncolytic adenovirus restores anti-tumor immunity for peritoneal metastasis of gastric cancer.

Intraperitoneal tumor-associated macrophages (TAMs) are involved in evading anti-tumor immunity and promoting the peritoneal metastasis (PM) of gastric cancer (GC). Oncolytic viruses are known to induce the activation of host anti-tumor immunity in addition to tumor lysis. This study investigated whether a wild-type p53-loading telomerase-specific oncolytic adenovirus (OBP-702) could elicit the remodeling of intraperitoneal macrophages and enhance the efficacy of immune therapy. Increased numbers of CD163 TAMs and few CD8+ lymphocytes were immunohistochemically observed in clinical samples with PM, which suggested that TAMs were associated with the suppression of anti-tumor immunity. OBP-702 induced immunogenic cell death and upregulated PD-L1 expression in human and murine GC cell lines. Intraperitoneal administration of OBP-702 increased recruitment of CD8+ lymphocytes into the PM via the functional remodeling of intraperitoneal macrophages from TAM toward a pro-inflammatory phenotype, resulting in significantly suppressed tumor growth for the in vivo model. Furthermore, the combination of intraperitoneal OBP-702 with anti-programmed cell death-1 antibody enhanced anti-tumor immunity and prolonged the survival of mice bearing PM. Intraperitoneal immunotherapy using OBP-702 restores anti-tumor immunity via the remodeling of intraperitoneal macrophages in addition to direct tumor lysis and cooperates with immune checkpoint inhibitors to suppress PM in GC.

Senescent Fibroblasts Potentiate Peritoneal Metastasis of Diffuse-type Gastric Cancer Cells via IL-8-mediated Crosstalk.

BACKGROUND/AIM: Diffuse-type gastric cancer (DGC) often forms peritoneal metastases, leading to poor prognosis. However, the underlying mechanism of DGC-mediated peritoneal metastasis is poorly understood. DGC is characterized by desmoplastic stroma, in which heterogeneous cancer-associated fibroblasts (CAFs), including myofibroblastic CAFs (myCAFs) and senescent CAFs (sCAFs), play a crucial role during tumor progression. This study investigated the CAF subtypes induced by GC cells and the role of sCAFs in peritoneal metastasis of DGC cells. MATERIALS AND METHODS: Conditioned medium of human DGC cells (KATOIII, NUGC-4) and human intestinal-type GC (IGC) cells (MKN-7, N87) was used to induce CAFs. CAF subtypes were evaluated by analyzing the expression of α-smooth muscle actin (α-SMA), senescence-associated ß-galactosidase (SA-ß-gal), and p16 in human normal fibroblasts (GF, FEF-3). A cytokine array was used to explore the underlying mechanism of GC-induced CAF subtype development. The role of sCAFs in peritoneal metastasis of DGC cells was analyzed using a peritoneally metastatic DGC tumor model. The relationships between GC subtypes and CAF-related markers were evaluated using publicly available datasets. RESULTS: IGC cells significantly induced α-SMA+ myCAFs by secreting transforming growth factor-ß, whereas DGC cells induced SA-ß-gal+/p16+ sCAFs by secreting interleukin (IL)-8. sCAFs further secreted IL-8 to promote DGC cell migration. In vivo experiments demonstrated that co-inoculation of sCAFs significantly enhanced peritoneal metastasis of NUGC-4 cells, which was attenuated by administration of the IL-8 receptor antagonist navarixin. p16 and IL-8 expression was significantly associated with poor prognosis of DGC patients. CONCLUSION: sCAFs promote peritoneal metastasis of DGC via IL-8-mediated crosstalk.

Association between comorbidities associated with diabetes and higher-level functional status in older patients with type 2 diabetes mellitus: a cross sectional study.

PURPOSE: To investigate the association between comorbidities associated with diabetes and higher-level functional status as well as the relationship between comorbidities associated with diabetes and higher-level functional status in older patients with type 2 diabetes mellitus who have better social networks. METHODS: Participants were outpatients with type 2 diabetes aged ≥ 65 years, excluding individuals with severe cardiovascular or respiratory illness, hyperglycaemic crisis, type 1 diabetes, or diabetic foot. The Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) was used to evaluate the higher-level functional status. A TMIG-IC score of ≤ 9, instrumental activities of daily living (IADL) ≤ 4, intellectual activity or social role ≤ 3 were defined as decline in higher-level functional status. The comorbidities investigated included peripheral neuropathy, retinopathy, nephropathy, cognitive impairment, depression, frailty, sarcopenia, low muscle strength, stroke, heart disease, and arthritis. RESULTS: The analysis included 198 patients (mean age 75.9 ± 5.7 years, male 60.1%). After adjusting for potential confounders, depression was associated with TMIG-IC (Prevalence ratio (PR) 2.34, 95% confidence interval (CI) 1.44-3.82), low muscle strength was associated with IADL (PR 2.85, 95% CI 1.30-6.27), and frailty was associated with intellectual activity (PR 1.38, 95% CI 1.10-1.74). In the model with social networks added as a confounder, the relationship between depression or low muscle strength and higher-level functional status was not statistically significant. CONCLUSION: Comorbidities of depression and low muscle strength for older patients with type 2 diabetes mellitus increase the risk of malfunctioning of higher-level functional status. Increased interactions with family, friends and neighbours may reduce this event.

The relationship between acceleration in sit-to-stand and falls in community-dwelling older adults: cross-sectional study.

[Purpose] This study aimed to determine the relationship between acceleration parameters in the sit-to-stand (STS) movement and falls, and the strength of the association between acceleration in STS movements and falls in older adults. [Participants and Methods] In total, 330 older adults were included. Four acceleration parameters were measured in STS movement: maximum acceleration (MA), velocity (MV), power (MP), and stand-up time (ST). For the conventional STS tests, 5 times STS test (5xSTS) and ground reaction force (maximal rate of force development per body weight: RFD/w, peak reaction force per body weight: F/w, chair-rise time: T) were measured. Poisson regression analysis adjusted for confounding factors was used. [Results] In the model adjusted for confounders, significant associations were observed among MV (Prevalence ratio (PR): 0.75; 95% confidence interval (CI): 0.58-0.98), MP (PR: 0.67; 95% Cl: 0.68-0.93), RFD/w (PR: 0.70; 95% Cl: 0.56-0.87), and T (PR: 1.14; 95% Cl: 1.05-1.24). [Conclusion] Among the acceleration parameters, MP was most strongly associated with falls and was considered the most useful parameter for evaluation. In addition, comparisons with the conventional chair rise tests suggested that MP was stronger than the 5xSTS test and may be equally related to the RFD/w.

Relationship between Acceleration in a Sit-To-Stand Movement and Physical Function in Older Adults.

Acceleration parameters in sit-to-stand (STS) movements are useful for measuring lower-limb function in older adults. The purpose of this study was to examine the relationship between acceleration in STS movements and physical function and the test-retest reliability of acceleration parameters in older adults. We performed cross-sectional analyses on 244 older adults including 107 men (mean age: 77.4 ± 4.7) and 137 women (mean age: 75.6 ± 5.3). Four acceleration parameters were measured in STS movements: maximum acceleration (MA), maximum velocity (MV), maximum power (MP), and stand-up time (ST). Good intraclass correlation coefficients (ICC > 0.70) were observed for all parameters. For the acceleration parameters, MA, MV, and MP were relatively strongly associated with the 5-time STS test (men: r = -0.36~-0.47; women: r = -0.37~-0.45) and the timed up and go test (men: r = -0.39~0.47, women: r = -0.43~-0.51): MP was also strongly associated with grip strength (men: r = 0.48, women: r = 0.43). All acceleration parameters were poorer in participants reporting mobility limitations than in those reporting no mobility limitations. These findings support the usefulness of sensor-based STS measurement. The system is expected to be useful in various settings where care prevention is addressed.

Intraperitoneal Administration of p53-armed Oncolytic Adenovirus Inhibits Peritoneal Metastasis of Diffuse-type Gastric Cancer Cells.

BACKGROUND/AIM: Diffuse-type gastric cancer (GC) frequently exhibits peritoneal metastasis, leading to poor prognosis. However, efforts to develop antitumor strategies for preventing the peritoneal metastasis of GC have been unsuccessful. As diffuse-type GC cells often carry a genetic alteration in the tumor suppressor p53 gene, p53 restoration may be a potent strategy for preventing peritoneal metastasis of GC. In this study, we investigated the therapeutic potential of p53-expressing adenoviral vectors against peritoneal metastasis of diffuse-type GC cells. MATERIALS AND METHODS: Three diffuse-type human GC cell types with different p53 statuses (p53-wild type NUGC-4, p53-mutant type GCIY, and p53-null type KATOIII) were used to evaluate the therapeutic potential of p53 activation induced by the p53-expressing, replication-deficient adenovirus Ad-p53 and oncolytic adenovirus OBP-702. Viability, apoptosis, and autophagy of virus-treated GC cells were analyzed under normal and sphere-forming culture conditions using the XTT assay and western blot analysis. The in vivo antitumor effects of OBP-702 and Ad-p53 were assessed using xenograft tumor models involving peritoneal metastasis of NUGC-4 and GCIY cells. RESULTS: Under normal and sphere-forming culture conditions, OBP-702 induced a significantly greater antitumor effect in GC cells compared with Ad-p53 by strongly inducing p53-mediated apoptosis and autophagy and receptor tyrosine kinase suppression. In vivo experiments demonstrated that intraperitoneal administration of OBP-702 significantly suppressed the peritoneal metastasis of NUGC-4 and GCIY cells compared with Ad-p53, leading to prolonged survival of mice. CONCLUSION: Intraperitoneal administration of OBP-702 inhibits the peritoneal metastasis of GC cells by inducing p53-mediated cytopathic activity.

Evaluation of Cognitive and Physical Function Among Older Adults by Their Physical Activity: A Cross-Sectional Kasama Study, Japan.

BACKGROUND: The amyloid-ß1-42 (Aß42) level is a biomarker that is widely used to evaluate individual cognitive dysfunction early in neurodegenerative diseases, as well as differentiate between normal cognitive function, mild cognitive impairment, Alzheimer's disease, and vascular cognitive impairment. OBJECTIVE: Our cross-sectional study evaluated the association between daily exercise and physical and cognitive function and Aß42 levels among a subsample of 325 older adults from the Kasama Study. METHODS: Participants (age: 74.5 [range 65-90] years) were classified into three exercise groups: the dual-task (DEG, n = 128), single-task (SEG, n = 122), and non-exercise (NEG, n = 75) groups. The main outcomes were the plasma Aß42 levels and the scores of the five cognitive (5-COG) tests and five cognition-related physical function (5-PHYS) tests. RESULTS: The Aß42 levels and 5-COG and 5-PHYS scores were higher in the SEG and DEG than in the NEG. The Aß42 levels were higher in the DEG than in the NEG (p = 0.008). CONCLUSIONS: Physical activities such as regular exercise may benefit older adults, improving their cognitive and physical function.

Segmental extracellular-to-intracellular water resistance ratio and physical function in older adults.

OBJECTIVES: This study aimed to investigate the association between whole-body (WB), arm, and leg extracellular-to-intracellular water resistance (Recw/Ricw) ratios and various physical functions of each segment and muscle mass using segmental multifrequency bioelectrical impedance analysis. METHODS: In total, 988 community-dwelling older adults were included in the analysis. Physical function was assessed using hand grip, 5-repetition sit-to-stand, 5-m habitual walk, Timed Up and Go, and single-leg balance with eyes open tests. Each segmental Recw/Ricw ratio and muscle mass were assessed at 5 and 250 kHz resistances using a segmental multifrequency bioelectrical impedance analysis device. Pearson's correlation between the segmental Recw/Ricw ratio and muscle mass and physical function was calculated, and the difference in correlation coefficients was tested using Bonferroni correction. Multiple linear regression analysis was conducted using physical function as the dependent variable and the segmental Recw/Ricw ratio as the independent variable, adjusting for sex, age, body mass index, and segmental muscle mass. RESULTS: WB and leg Recw/Ricw ratios were significantly positively correlated with good hand grip performance, gait speed, mobility, balance, and standing power (p < 0.05), after adjusting for sex, age, body mass index, and muscle mass. Furthermore, the leg Recw/Ricw ratio was positively associated with lower extremity physical function compared with WB and arm Recw/Ricw ratios and muscle mass (p < 0.01). Conversely, WB muscle mass was more strongly related to grip strength than WB, arm, and leg Recw/Ricw ratios (p < 0.01). CONCLUSIONS: The Recw/Ricw ratio is useful for identifying older adults with worse physical function. The Recw/Ricw ratio allows for easy and timely screening of older adults with worse physical function in clinical settings.

Effects of Desert Olive Tree Pearls Containing High Hydroxytyrosol Concentrations on the Cognitive Functions of Middle-Aged and Older Adults.

The Japanese population has the world's longest life expectancy but faces the challenge of extending the healthy life expectancy without developing chronic diseases. Therefore, the effectiveness of products derived from olives used in the Mediterranean diet as a potential dietary solution has attracted attention. This study examined the effects of desert olive tree pearls (DOTPs), which contain 162 times more polyphenol hydroxytyrosol than olive oil, on the cognitive function of middle-aged and older adults using the Cognitrax test. Participants (aged 51-82 years) were assigned to the DOTP intake (n = 36) or placebo group (n = 36) in a randomized, double-blind, placebo-controlled, parallel-group study. The participants received 3 g of DOTPs or placebo in olive oil twice daily for 12 weeks. Among cognitive domains, complex attention had a significant time × group interaction effect (p = 0.049) between the DOTP and placebo groups. The simple main effect for this item was significantly different (p < 0.001 and p = 0.572, respectively). Time effects were significant (p < 0.05) for the psychomotor speed, reaction time, cognitive flexibility, processing speed, and executive function domains. Therefore, DOTPs have the potential to alleviate cognitive problems faced by middle-aged and older adults in Japan.

Energy metabolism and thermoregulation during sleep in young and old females.

Core body temperature (CBT) shows a diurnal rhythm, and the nocturnal decrease in CBT is blunted in older people. The physiological mechanisms responsible for the blunted nocturnal decrease in CBT in older people remain to be revealed. The aim of this study was to compare heat production and heat dissipation in young and old subjects during sleep, as assessed by indirect calorimetry and the distal-proximal temperature gradient (DPG) of skin temperature. A complete dataset of 9 young (23.3 ± 1.1 years) and 8 old (72.1 ± 2.5 years) females was analyzed. CBT and energy metabolism were monitored during sleep using an ingestible temperature sensor in a metabolic chamber maintained at 25 °C. Skin temperature was measured at proximal and distal parts of the body. CBT, distal skin temperature, and DPG in older subjects were higher than in young subjects. Protein oxidation was similar between the two groups, but fat oxidation was lower and carbohydrate oxidation was higher in old subjects compared to young subjects. On the other hand, energy expenditure was similar between the two age groups. Thus, the elevated CBT in older subjects was not attributed to deteriorated heat dissipation or enhanced heat production, suggesting an alternative explanation such as deteriorated evaporative heat loss in old subjects.

Association of 24-h movement behaviors with phase angle in community-dwelling older adults: a compositional data analysis.

BACKGROUND: Phase angle (PhA) is an indicator of cellular conditions. Recent studies have suggested that PhA supports healthy aging. Identifying modifiable lifestyle factors for PhA is important. The associations of PhA in 24-h movement behaviors, including physical activity (PA), sedentary behavior (SB), and sleep, have not been studied in older adults. OBJECTIVES: We investigated the cross-sectional associations between 24-h movement behaviors and PhA in community-dwelling older adults while appropriately considering the co-dependent nature of daily time use using compositional data analysis. METHODS: The participants were 113 healthy older adults. PhA was measured using a bioelectrical impedance device. Time spent in light-intensity PA (LPA), moderate- to vigorous-intensity PA (MVPA), and SB was measured using a tri-axial accelerometer. Sleep duration information was self-reported in a questionnaire. Compositional multiple linear regression and compositional isotemporal substitution were performed to examine the associations of 24-h movement behaviors with PhA and hypothetical time reallocation in movement behaviors with PhA, respectively. RESULTS: Even after adjusting for potential confounders, relative to other behaviors more time spent in MVPA was significantly associated with higher PhA (p < 0.001). The 30 min/day of time reallocation from the other behaviors (SB, LPA, and sleep) to MVPA was predicted to be 0.12 higher PhA (corresponding to 2.3% increase; 95% CI 0.01, 0.24). CONCLUSIONS: Our results suggest that increasing or maintaining the daily time spent in MVPA is important for managing PhA in older adults, regardless of the other behaviors time consumed instead.

Effects of home-based manual dexterity training on cognitive function among older adults: a randomized controlled trial.

BACKGROUND: The relationship between manual dexterity and cognitive function among older adults is well known; however, few studies have focused on manual dexterity training that confirms cognitive load of training in older adults through functional near-infrared spectroscopy (fNIRS) and verifies the effect of training. This study examined the effects of home-based manual dexterity training on cognitive function in older adults using a digital trail-making peg test device combining two conventional assessment tools namely, the peg and trail-making tests. METHODS: For 12 weeks, 57 healthy older adults aged 65-88 years participated in a parallel-group, randomized controlled trial, wherein home-based manual dexterity training was performed for approximately 20 min daily. To quantify the cognitive load in different manual dexterity conditions, we assessed the cortical activation patterns of the prefrontal cortex via a wearable four-channel fNIRS device. Participants in the control group were asked to continue their usual daily routines during the intervention period. Cognitive function was assessed using the Stroop Color and Word and Cognitive Impairment Tests. Manual dexterity was assessed using the Purdue Pegboard Test. All outcomes were estimated before and after the intervention. RESULTS: We observed significant differences in prefrontal cortical activation between the different manual dexterity conditions. Only the intervention group showed a significant improvement in Stroop interference (169.0-108.9 ms, p = 0.032) and an executive function and assembly task of the Purdue Pegboard Test (22.5-26.4 counts, p < 0.001). Additionally, except the clock drawing task, cognitive function had a larger effect size (Cohen's d) in the intervention group (d = 0.26-0.45) than in the control group (d = 0.11-0.28). CONCLUSIONS: Home-based manual dexterity training can improve performance in a complex manual dexterity task and executive functioning in older adults. TRIAL REGISTRATION: UMIN-CTR Clinical Trial, UMIN000047203. Registered 17 March 2022 - Retrospectively registered, https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&recptno=R000053844&type=summary&language=E.

Novel Approach for Glycemic Management Incorporating Vibration Stimulation of Skeletal Muscle in Obesity.

Because obesity is associated with impaired glucose tolerance and type 2 diabetes (T2D), it is important to manage the blood glucose level at an early stage. Nevertheless, people with obesity have significantly lower resistance to muscle fatigue after exercise and exercise adherence. Therefore, we developed a novel "Relaxing-Vibration Training (RVT)" consisting of 25 postures using vibration stimulation of skeletal muscle and determined the feasibility of RVT for glycemic management. Thirty-one participants with obesity were enrolled in a controlled trial (CT) and experimental trial (ET) based on a 75 g oral glucose tolerance test (OGTT). During the CT, participants were required to rest in a quiet room. During the ET, the RVT program (50 Hz, 4 mm), consisting of 25 postures of relaxation and stretching on the vibratory platform, was performed for 40 min. Subsequently, the participants rested as in the CT. Subjective fatigue and muscle stiffness measurements and blood collection were conducted before and after RVT. In both the CT and ET, interstitial fluid (ISF) glucose concentrations were measured every 15 min for 2 h. The incremental area under the curve value of real-time ISF glucose during an OGTT was significantly lower in the ET than in the CT (ET: 7476.5 ± 2974.9, CT: 8078.5 ± 3077.7, effect size r = 0.4). Additionally, the levels of metabolic glucose regulators associated with myokines, muscle stiffness, and subjective fatigue significantly improved after RVT. This novel RVT suggests that it is effective in glycemic management with great potential to improve impaired glucose tolerance and T2D with obesity in the future.

Cross-sectional and longitudinal study of the relationship between phase angle and physical function in older adults.

AIM: Although the validity of the assessment in older adults has been supported by several studies, cross-sectional and longitudinal relationships between phase angle (PhA) and physical function by sex have not been clarified. This study aimed to examine (i) cross-sectional relationships and (ii) longitudinal relationships between PhA and physical function in older adults. METHODS: A total of 816 and 445 community-dwelling older adults were included in cross-sectional and longitudinal analyses, respectively. We evaluated their physical function using grip strength, 5-repetition sit-to-stand test (5-STS), 5-meter habitual walk, Timed Up and Go test (TUG), single-leg balance with eyes open, and sit-and-reach test. A multifrequency bioelectrical impedance analyzer was used to determine the PhA at 50 kHz as well as the participants' body composition. RESULTS: In the cross-sectional analysis, a higher PhA was significantly associated with higher grip strength, sit-and-reach, single-leg balance with eyes open, 5-STS and lower TUG in women, as well as higher grip strength, single-leg balance with eyes open, lower 5-STS and TUG in men, adjusting for age, body mass index and muscle mass. In the longitudinal analysis, there was a significant interaction between PhA and year in the TUG test (B = -0.08; 95% CI, -0.136 to -0.025; P = 0.005) in men. There was no significant interaction between the PhA value and year for the other physical functions. CONCLUSIONS: The PhA is a useful indicator for assessing physical function in both older men and women. Furthermore, the PhA may be able to predict mobility limitation in older men. Geriatr Gerontol Int 2023; 23: 141-147.

Acceptable walking and cycling distances and functional disability and mortality in older Japanese adults: An 8-year follow-up study.

We prospectively investigated the association between acceptable travel distances (i.e., walking and cycling) and the incidence of functional disability and mortality among older Japanese adults. A baseline survey was conducted in 2013 among 7618 individuals aged ≥65 years in Kasama City, Japan, and they were tracked through the city's database until 2021. Acceptable travel distances were assessed using a questionnaire. Outcomes (i.e., functional disability and mortality) were gathered as binary (incident or not) with survival time. A multivariable-adjusted Cox proportional-hazards model indicated that shorter acceptable walking and cycling distances were markedly linked with higher risks of functional disability and mortality. In conclusion, acceptable distances of ≤500 m for walking and ≤1 km for cycling were associated with higher risks of functional disability and mortality among older adults.

Impact of exercising alone and exercising with others on the risk of cognitive impairment among older Japanese adults.

PURPOSE: This longitudinal study investigates the influence of the stratified frequency of exercising alone and exercising with others on the prevention of cognitive impairment among older Japanese adults. METHODS: This four-year follow-up study targeted 4,358 individuals (mean age: 76.9 ± 5.6 years, female: 51.8%) who participated in an inventory mail survey in one region of Japan. The exercise forms surveyed involved the frequency of exercising alone and with others. Cognitive impairment was assessed using the nationally standardized dementia scale proposed by the Ministry of Health, Labour and Welfare of Japan. Adjusted Cox proportional-hazard models were used to examine the association between the exercise forms and the development of cognitive impairment, and calculate population-attributable fractions (PAFs). RESULTS: The cumulative incidence of cognitive impairment throughout the study was 7.7%. Participants who exercised ≥ 2 times/week alone (hazard ratio [HR] = 0.78; 95% confidence interval [CI] = 0.61-0.998) had a lower risk of developing cognitive impairment than those who did not exercise alone. Similarly, participants who exercised ≥ 2 times/week with others (HR = 0.66; 95% CI = 0.47-0.94) showed a lower risk of developing cognitive impairment than those who did not exercise with others. The scenarios involving PAFs demonstrated that, if all participants exercised alone or with others ≥ 2 times/week, the risk of cognitive impairment decreased by 15.1% and 29.2%, respectively. CONCLUSION: Both forms of exercise reduced the development of cognitive impairment, with exercising with others potentially being highly effective in preventing cognitive impairment.

[Changes in the physical fitness of elderly people in the COVID-19 pandemic: An examination using performance tests].

OBJECTIVE: This study aimed to ascertain the physical-fitness trends among community-dwelling older adults using performance testing. The results of the evaluation conducted during the COVID-19 pandemic were compared to data from the pre-pandemic period. METHODS: A total of 240 community-dwelling older adults who participated in a health checkup program from 2016-2020 underwent the following tests: grip strength (upper limb muscle), single-leg balance with eyes open (static balance), sit-and-reach test (flexibility), timed up-and-go test (TUG, functional mobility), 5 meter habitual walk (walking ability), and hand working with pegboard (hand dexterity). Linear mixed effect models were applied to the hierarchical dataset: repeated data (Level 1), pre-pandemic (2016-2019), pandemic (2019-2020) (Level 2), and individuals (Level 3). Fixed effects and interactions were estimated for the survey year (Level 1), and between the survey year and pre- and post-pandemic (Level 2), with the range of decline set measured in terms of its standardized partial regression coefficient, "B," from 2019-2020. RESULTS: The items for which significant cross-level interactions were identified. In males, the following items showed significant cross-level interactions: sit and reach test (B=-2.56, 95% CI: -4.45--0.66 cm), TUG (+0.39, 0.21-0.56 sec) and 5 meter habitual walk (+0.15, 0.04-0.27 sec). In females items except single-leg balance with eyes open showed significant cross-level interactions: grip strength (-0.58, -1.11--0.05 kg), sit-and-reach test (-3.53, -5.11--1.95 cm), TUG (+0.15, 0.03-0.27 sec), for 5 meter habitual walk (+0.14, 0.04-0.24 sec), and hand working with pegboard (+0.89, 0.28-1.51 sec). CONCLUSION: In both males and females, a significant deterioration in flexibility and mobility movement ability was observed in 2019-2020. In addition, upper limb muscle strength and hand dexterity movement deteriorated in females.

Instability of non-REM sleep in older women evaluated by sleep-stage transition and envelope analyses.

Study objective: Traditionally, age-related deterioration of sleep architecture in older individuals has been evaluated by visual scoring of polysomnographic (PSG) recordings with regard to total sleep time and latencies. In the present study, we additionally compared the non-REM sleep (NREM) stage and delta, theta, alpha, and sigma wave stability between young and older subjects to extract features that may explain age-related changes in sleep. Methods: Polysomnographic recordings were performed in 11 healthy older (72.6 ± 2.4 years) and 9 healthy young (23.3 ± 1.1 years) females. In addition to total sleep time, the sleep stage, delta power amplitude, and delta, theta, alpha, and sigma wave stability were evaluated by sleep stage transition analysis and a novel computational method based on a coefficient of variation of the envelope (CVE) analysis, respectively. Results: In older subjects, total sleep time and slow-wave sleep (SWS) time were shorter whereas wake after sleep onset was longer. The number of SWS episodes was similar between age groups, however, sleep stage transition analysis revealed that SWS was less stable in older individuals. NREM sleep stages in descending order of delta power were: SWS, N2, and N1, and delta power during NREM sleep in older subjects was lower than in young subjects. The CVE of the delta-band is an index of delta wave stability and showed significant differences between age groups. When separately analyzed for each NREM stage, different CVE clusters in NREM were clearly observed between young and older subjects. A lower delta CVE and amplitude were also observed in older subjects compared with young subjects in N2 and SWS. Additionally, lower CVE values in the theta, alpha and sigma bands were also characteristic of older participants. Conclusion: The present study shows a decrease of SWS stability in older subjects together with a decrease in delta wave amplitude. Interestingly, the decrease in SWS stability coincided with an increase in short-term delta, theta, sigma, and alpha power stability revealed by lower CVE. Loss of electroencephalograms (EEG) variability might be a useful marker of brain age.