[The factors influencing motivation to start exercise among elderly people in an urban area].

AIM: The purpose of the present study was to identify the influence of information resources and interpersonal networks on motivation to start exercise among elderly people living in an urban area. METHODS: The subjects were 235 elderly people living in an urban area who previously had no exercise habits. We examined their motivation to start exercise as potentially influenced by frequency of interpersonal communication, presence of friends and other persons who invite them to participate in health-promoting activities, having someone to invite to such activities, and the use of information resources. To identify the factors which influence the motivation to start exercise among subjects who did not previously have exercise habits, we used binomial logistic regression. RESULTS: A major factor which influenced the motivation to start exercise was the presence of people who invite subjects to participate in health-promoting activities. This result showed that being invited to health-promoting activities encouraged elderly people to start exercising. Of the covariates, only age negatively influenced the intention to start exercise. The same result was also seen in a subgroup comparative analysis of groups of young and old adults. CONCLUSION: Being invited to participate in active pursuits was useful to encourage elderly people to start exercise, indicating that intervention at an earlier age would be beneficial.

Brief screening tool for mild cognitive impairment in older Japanese: validation of the Japanese version of the Montreal Cognitive Assessment.

AIM: The Montreal Cognitive Assessment (MoCA), developed by Dr Nasreddine (Nasreddine et al. 2005), is a brief cognitive screening tool for detecting older people with mild cognitive impairment (MCI). We examined the reliability and validity of the Japanese version of the MoCA (MoCA-J) in older Japanese subjects. METHODS: Subjects were recruited from the outpatient memory clinic of Tokyo Metropolitan Geriatric Hospital or community-based medical health check-ups in 2008. The MoCA-J, the Mini-Mental State Examination (MMSE), the revised version of Hasegawa's Dementia Scale (HDS-R), Clinical Dementia Rating (CDR) scale, and routine neuropsychological batteries were conducted on 96 older subjects. Mild Alzheimer's disease (AD) was found in 30 subjects and MCI in 30, with 36 normal controls. RESULTS: The Cronbach's alpha of MoCA-J as an index of internal consistency was 0.74. The test-retest reliability of MoCA, using intraclass correlation coefficient between the scores at baseline survey and follow-up survey 8 weeks later was 0.88 (P < 0.001). MoCA-J score was highly correlated with MMSE (r = 0.83, P < 0.001), HDS-R (r = 0.79, P < 0.001) and CDR (r = -0.79, P < 0.001) scores. The areas under receiver-operator curves (AUC) for predicting MCI and AD groups by the MoCA-J were 0.95 (95% confidence interval [CI] = 0.90-1.00) and 0.99 (95% CI = 0.00-1.00), respectively. The corresponding values for MMSE and HDS-R were 0.85 (95% CI = 0.75-0.95) and 0.97 (95% CI = 0.00-1.00), and 0.86 (95% CI = 0.76-0.95) and 0.97 (95% CI = 0.00-1.00), respectively. Using a cut-off point of 25/26, the MoCA-J demonstrated a sensitivity of 93.0% and a specificity of 87.0% in screening MCI. CONCLUSION: The MoCA-J could be a useful cognitive test for screening MCI, and could be recommended in a primary clinical setting and for geriatric health screening in the community.

[The assessment of the reliability and the validity of the EOQOL questionnaire of osteoporotics--QOL assessment of elderly osteoporotics by EOQOL].

We presented a novel and specific questionnaire for quality of life of elderly subjects with osteoporosis (EOQOL), and analyzed its reliability and validity. Based on the discussions with elderly people of osteoporosis, we extracted key words related to complaints of patients with vertebral fractures. A 49 questionnaire was developed on concepts derived from key words. The subdirectories of the questionnaire for elderly osteoporotic subjects consisted of pain, daily activity, movement, physiological activity, duty, recreation and well-being. To analyze the reliability and the validity of EOQOL, it was evaluated in 101 elderly subjects with osteoporosis. Crohnbach's alpha coeffient was 0.82 for pain, 0.86 for daily activity, 0.73 for movement, 0.83 for mood, 0.78 for anxiety against falls, 0.84 for physiological activity, 0.85 for duty, 0.66 for free time, 0.78 for a nice feeling about life. These results indicated that EOQOL is useful as a disease specific questionnaire for elderly osteoporotic patients with osteoporosis.

Recognition of facial expressions and emotional situations in patients with dementia of the Alzheimer and vascular types.

The aim of this study was to investigate the ability of patients with dementia to recognize facial expressions and emotional situations. We evaluated 16 patients with dementia of the Alzheimer type (DAT) and 15 with vascular dementia (VD) for general cognition, discrimination of facial expressions and individual faces, and recognition of facial expressions and emotional situations. VD patients performed significantly worse than DAT patients at recognizing facial emotions, even though there was no difference between them in their general cognition and visuoperceptual abilities. There was no significant difference between them in their ability to recognize emotional situations. The results of this and past studies suggest that caregivers in nursing homes and hospitals need to be aware that VD patients lose the ability to comprehend facial expressions.