Biomedical subjects

Taketo Furuna

Publications and source records attributed to Taketo Furuna.

9 recordsLinked to original sources

PubMed2006

[Correlates of change in cognitive function during a two-year follow-up period in a comprehensive health examination for the community-dwelling elderly for the prevention of geriatric syndromes and bed-ridden state].

PURPOSE: We explored correlates of change in cognitive function during a two-year follow-up period among the community-dwelling elderly in Japan, using a population-based prospective approach. METHOD: The participants analyzed in the present study were 260 men and 222 women aged 70 to 84 years at baseline, living in an urban Japanese community. Data such as change in cognitive function during two years (calculated by subtracting baseline Mini-Mental State Examination [MMSE] score from follow-up MMSE score: a negative value means a decrease in MMSE scores during the two-year period) as an outcome variable, age, education, hearing and vision problems, IADL deficit (measured by the Tokyo Metropolitan Institute of Gerontology of Index of Competence), problems related to memory complaint, living alone, hemoglobin level, as explanatory variables, and the baseline MMSE score, depressive status (measured by the Mini-International Neuropsychiatric Interview), chronic conditions (hypertension, stroke, and diabetes mellitus) as covariates, were collected during a comprehensive health examination survey for the elderly. RESULTS AND CONCLUSION: We conducted multivariate regression analysis by genders to explore correlates of change in cognitive function. The results showed that higher age (beta = -0.18), presence of hearing problem (beta = -0.21), presence of IADL deficit (beta = -0.15), and memory complaint (beta = -0.20) in men, and higher age (beta = -0.27), low education level (beta = -0.25) and lower hemoglobin level (beta = 0.16) in women, were significantly associated with change in cognitive function when adjusting for the potential confounders. These factors may be reliable predictors for cognitive decline.

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PubMed2005

[Functional status of very old people in urban area: the Itabashi Oldest-Old Study I].

It is predicted that the future increase in the oldest-old (85 years and older) population will have a marked influence on society. However, little is known about the features of various functions in the oldest-old. The purpose of this study was to clarify the functional status of the oldest-old. We surveyed all oldest-old residents in a small area of Itabashi ward in metropolitan Tokyo to clarify their living conditions. The oldest-old themselves and their family members were invited to participate, and 235 out of 311 residents (75.6%) agreed to do so. Forty-two percent of the participants were dependent and needed care from others. The ADL status measured by the Barthel Index showed that 30% of independent participants also had some deterioration of physical function. These results are indicative of increased frailty in the oldest-old. Comparison between independent and dependent (need care from others in daily living) showed that the functional status was lower in dependent group. However, the psychological well-being was the same in this two groups. These results indicate progressive functional deterioation and psychological adaptation to it, in the oldest-old. Further research to elucidate the process of psychological adaptation to frailty is necessary in order to promote the well-being among the oldest-old, in whom functional limitation is evident.

Activities of Daily Living↗

PubMed2005

[Cognitive function among physically independent very old people in an urban community in Japan: the Itabashi Oldest-Old Study II].

This study was conducted to clarify the characteristics of cognitive function among physically independent very old people dwelling in an urban community in Japan. Five hundred and thirteen Old-Old (aged 75-84 years) and 168 Oldest-Old (aged 85-100 years) adults participated. We carried out the Mini-Mental State Examination (MMSE) for measuring cognitive functions in the elderly. Age-related differences in the total score and sub-scale scores of the MMSE were analyzed by sex using ANCOVA, controlling for education, vision and hearing problems. Mean MMSE scores for Old-Old and Oldest-Old males were 27.53 and 25.88, respectively, and those for Old-Old and Oldest-Old females were 27.77 and 24.98, respectively. Age-related differences in the MMSE total score between the Old-Old and Oldest-Old were observed in both sexes, suggesting that overall cognitive functions continue to decline over time in very old age. Age-related differences between the Old-Old and Oldest-Old in items measuring, registration, calculation and delayed recall were observed in both sexes, and in addition, time orientation, place orientation, delayed recognition, writing sentences, and copying figures were observed in females. These findings suggest that the faculties are those most sensitive to normal aging among very old individuals. There were no age group differences in five items: reverse spelling, naming objects, repeating a sentence, listening and obeying, and reading and obeying.

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PubMed2005

[Memory complaints among community-dwelling elderly in Japan: comprehensive health examination for the community elderly for prevention of the geriatric syndrome and a bed-ridden state ("Otasha-kenshin") part III].

PURPOSE: Previous studies have indicated that memory complaints may predict cognitive decline and dementia among the elderly. The present study was therefore conducted to clarify memory complaint characteristics among elderly dwelling in an urban community in Japan. METHOD: The participants analyzed in the present study were 453 men and 385 women aged 70 to 84 years living in an urban Japanese community. Data on problems related to memory complaints, cognitive decline (below 24 points on Mini-Mental State Examination), depression (measured by Mini-International Neuropsychiatric Interview), hearing and vision problems, I-ADL (measured by TMIG Index of Competence), self-rated health, age, sex, and years of education were collected at a comprehensive mass health examination for the elderly ("Otasha-kenshin"). RESULTS AND DISCUSSION: Twenty-seven percent of male respondents and 32% of female respondents reported having current trouble remembering things (reported as "frequently" or "sometimes"). We collected specific descriptions of the memory complaint difficulties the subjects were experiencing. A quarter of the responses indicated problems with forgetting persons' names, a fifth with forgetting where things had been left, 15% with leaving things behind, and a quarter with prospective memory failure. The results of multivariate logistic regression analysis to explore correlates showed that in men self-rated health and cognitive decline, and in women hearing problems and self-rated health were significantly and independently related to the memory complaint. These findings suggest that in addition to cognitive decline, self-rated health and hearing problems may influence memory complaints, and that memory complaints in men may be a reliable, simple indicator of cognitive decline. We now need to carry out a longitudinal study to clarify predictive validity.

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PubMed2004

New intervention program for preventing falls among frail elderly people: the effects of perturbed walking exercise using a bilateral separated treadmill.

OBJECTIVE: To determine the effects of a perturbed walking exercise using a bilateral separated treadmill in physically disabled elderly. DESIGN: Participants of the study were 32 long-term care facility residents and outpatients aged 66-98 yrs. Participants were randomly assigned to a usual exercise group or to a treadmill exercise group. Perturbed gait exercise on a treadmill continued for 6 mos. Number of falls and time to first fall during a 6-mo period, balance and gait functions, and reaction time were evaluated before and after intervention. RESULTS: The treadmill exercise group showed significant improvement in balance and reaction time when compared with the usual exercise group. Number of falls in the treadmill exercise group was 21% lower than that in the usual exercise group. However, this difference was not significant. No significant differences were seen in time to first fall. CONCLUSIONS: Gait training with unexpected perturbation seems to have a beneficial impact on physical function in disabled elderly individuals. The results suggest that this program may be used as an exercise intervention to reduce falls in institutional settings.

Accidental Falls↗

PubMed2004

[Effects of introducing a risk manager for prevention of falls in a long-term care facility].

The purpose of this study was to identify the effects of an effort to prevent accidental falls by supervising residents with a high risk of falling in a long-term care facility. Sixty-four subjects with physical disabilities or cognitive impairment who were receiving residential care participated in this study. The fall-risk manager kept the residents under observation through recreational activities or conversation. The intervention was carried out for 50 days, three times per week (Tuesday, Thursday, and Saturday), eight hours per day. There was no significant difference in the total number of falls between the intervention days and non-intervention days (Monday, Wednesday, and Friday). However, introducing the fall-risk manager into the long-term care facility resulted in a slight improvement in cognitive function in the residents. Although this study did not show a significant beneficial effect for fall prevention, potential effects of fall-risk reduction were noted by the intervention method through introducing a fall-risk manager in a long-term care facility.

Accidental Falls↗

PubMed2004

[Risk factors associated with onset of urinary incontinence in a community-dwelling elderly population: a 4-year follow-up study].

OBJECTIVE: To estimate the risk factors associated with onset of urinary incontinence in a rural community-dwelling elderly population. METHODS: The study area, village N in Akita Prefecture, is a rural community in which a baseline survey of TMIG-LISA (Tokyo Metropolitan Institute of Gerontology, Longitudinal and Interdisciplinary Study on Aging) was undertaken in 1996. Among the baseline subjects, 760 (314 males and 446 females) community-dwelling elderly people aged over 65, who did not suffer from urinary incontinence at entry of the survey were selected. This cohort has been followed for four years by multi-dimensional medical examination including interviews and physical performance tests, conducted on a yearly basis using similar methods to these for the baseline survey. RESULTS: After the 4-year follow-up, the incidence of urinary incontinence was 7.0% (22/314) in men and 12.3% (55/446) in women. The urinary incontinence group (UIG) had a significantly higher age and lower level of functional fitness at baseline for both sexes. In the UIG, the men but not the women had significantly lower serum levels of albumin and total cholesterol. By the logistic model, age (per 1-year increase: OR = 1.23, 95%CI: 1.11-1.38), and serum albumin (per 0.1 g/dl increase: OR = 0.70, 95%CI: 0.54-0.88) in men; and grip strength (per 1-kg increase: OR = 0.92, 95%CI: 0.86-0.98), social role (per 1-point decrease: OR = 1.81, 95%CI: 1.19-2.73), BMI (per 1-kg/m2 increase: OR = 1.10, 95%CI: 1.01-1.20) and smoking status (never smoker = 1.00, 3 = current smoker: OR = 7.53, 95%CI: 1.36-41.63) in women were independent variables significantly associated with onset of urinary incontinence. CONCLUSIONS: Lifestyle and functional fitness are significantly associated with onset of urinary incontinence in this population. Our findings suggest that intervention programs are needed to improve pelvic floor muscle and to provide social support for the elderly.

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PubMed2003

[Comprehensive health examination ("Otasha-Kenshin") for the prevention of geriatric syndromes and a bed-ridden state in the community elderly. 1. Differences in characteristics between participants and non-participants].

PURPOSE: We conducted a comprehensive mass health examination for elderly subjects aged 70 or above, living in the community, to assess early deterioration to long-term care conditions and promote healthy and successful aging ("Otasha-Kenshin"). In this study, we clarified characteristic differences between participants and non-participants. SUBJECTS & METHODS: A mass health examination was offered in October 2001 to 863 community elderly, including individuals suffering from falls (and fractures), incontinence, malnutrition, depression, mild cognitive impairment and less of functional capacity. Among the total, 438 (50.8%) opted for the "Otasha-Kenshin" examination. Differences in characteristics between the participants and non-participants were examined, parameters including sex and age distribution, self-rated health, functional capacity by the TMIG Index of Competence, depressed status by the General Health Questionnaire (GHQ), subjective well-being by the Philadelphia Geriatric Center Morale Scale: A revision (PGC-MS), frequency of falls, and prevalence of chronic diseases. The comparison was based on the results of measurements from the final survey conducted in 2000. RESULTS: 1) The participation rate in the "Otasha-Kenshin" was 49.0% in males and 51.0% in females. The average age was 75.3 year olds in participants and 76.4 in non-participants, the difference being significant (t = 3.97, P < 0.0001). 2) Non-participants had a significantly lower level of self-rated health than participants. 3) There was no significant difference in hand grip strength between participants and non-participants. 4) Non-participants showed significantly lower level of functional capacity and subjective well-being, and they were more likely to be in a depressed state than participants. 5) There was no significant difference in fall rate between participants and non-participants. 6) The prevalence of hypertension and diabetes (found in more than 5% among the subjects surveyed in 2000) was not significantly different between participants and non-participants. CONCLUSION: With aging of society, new and specialized health maintenance systems for the elderly are essential, both for the prevention of deterioration to a long-term care condition (a bed-ridden status) and for the promotion of successful aging with autonomy. Participants in "Otasha-Kenshin" appear to be healthier and more independent than non-participants who were more frail and at higher risk group of a long-term care condition and a bed-ridden status. The major reason for non-participation in the health examination found in this study was subjective or mental deterioration rather than the presence of chronic illness or any geriatric syndrome per se. Frail elderly people like the non-participants in this study should be encouraged and mentally supported to avoid aggravation of their health status through intensive or specialized health surveillance system such as home-visit nursing.

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PubMed2003

[Cognitive function as the factor determining higher-level competence in community-dwelling elderly: comprehensive health examination for the community elderly for the prevention of the geriatric syndrome and a bed-ridden state ("otasha-kenshin")].

PURPOSE: This study was conducted to examine age-related differences in cognitive function, and their relation to higher-level competence of elderly living in an urban community. METHOD: Participants were 438 individuals (males 168, females 270) aged 70 to 84 years living in an urban community in Tokyo. Three cognitive performance tests, the Wechsler Adult Intelligence Scale-Revised (WAIS-R) Digit Symbol, Word Fluency Test, and the WAIS-R Digit Span, were employed for estimating cognitive function, and the TMIG Index of Competence for measuring higher-level competence. In the Index, three constructions: "Instrumental Self-Maintenance", "Intellectual Activity", and "Social Role" were involved. RESULTS AND CONCLUSIONS: Age-related differences in the cognitive tests were analyzed using ANCOVA controlling for educational year. Age-related differences between younger elderly (70-79 years old) and older elderly (80-84 years old) were observed with the WAIS-R Digit Symbol, Word Fluency Test and the WAIS-R Digit Span. The results indicate that information processing speed, executive function and primary memory in community-dwelling elderly continue to decline in old age, and this trend is salient in the old-old. We carried out partial correlation analysis and multiple regression analysis for exploring the relationships between cognitive function and the sub-scales in the TMIG Index of Competence, controlling for age and educational year. Cognitive function was significantly and positively related with the sub-scales in the Index, this being especially robust for "Intellectual Activity". The results suggest that higher-level competence can be modestly determined with reference to cognitive function, and "Intellectual Activity" may have a stronger relation with cognitive function than the other two sub-scales in the Index.

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