Objectives To examine the effects of a multifactorial intervention for improving frailty-comprising resistance exercise and nutritional and psychosocial programs-on the risk of long-term care insurance (LTCI) certification, death, and long-term care (LTC) cost among community-dwelling older adults.Methods Seventy-seven individuals (47 in 2011 and 30 in 2013) from the Hatoyama Cohort Study (742 individuals) participated in a multifactorial intervention. Non-participants were from the same cohort (including people who were invited to participate in the multifactorial intervention but declined). We performed propensity score matching with a ratio of 1 : 2 (intervention group vs. non-participant group). Afterward, 70 individuals undergoing the multifactorial intervention and 140 non-participants were selected. The risk of LTCI certification and/or death and the mean LTC cost during the follow-up period (32 months) were compared using the Cox proportional hazards model and generalized linear model (gamma regression model).Results The incidence of new LTCI certification (per 1,000 person-years) tended to be lower in the intervention group than in the non-participant group (1.8 vs. 3.6), but this was not statistically significant as per the Cox proportional hazards model (hazard ratio=0.51, 95% confidence interval [CI]=0.17-1.54). Although the incidence of LTC cost was not significant, the mean cumulative LTC cost during the 32 months and the mean LTC cost per unit during the follow-up period (1 month) were 375,308 JPY and 11,906 JPY/month, respectively, in the intervention group and 1,040,727 JPY and 33,460 JPY/month, respectively, in the non-participant group. Cost tended to be lower in the intervention group than in the non-participant group as per the gamma regression model (cumulative LTC cost: cost ratio=0.36, 95%CI=0.11-1.21, P=0.099; LTC cost per unit follow-up period: cost ratio=0.36, 95%CI=0.11-1.12, P=0.076).Conclusions These results suggest that a multifactorial intervention comprising resistance exercise, nutritional, and psychosocial programs is effective in lowering the incidence of LTCI certification, consequently saving LTC cost, although the results were not statistically significant. Further research with a stricter study design is needed.
To verify the regional distribution, especially off-target binding, of the tracer 18F-MK-6240, on tau PET images obtained with a high-resolution dedicated brain PET scanner. We retrospectively analyzed the 18F-MK-6240 PET data from subjects with cognitive decline who were enrolled in the BATON study. All scans were acquired using the same high-resolution brain-dedicated PET system. We calculated the standardized uptake value ratios (SUVRs) by using manually defined restricted cerebellar volumes of interest (VOIs) excluding meningeal spill-in, and we compared these SUVRs with those obtained using the conventional CenTauR cerebellar gray matter reference. We also quantified the off-target uptake in regions including the meninges, retina, and ethmoid sinus. Group comparisons and interaction effects were analyzed by t-tests and an ANOVA, and ROC analyses were performed to assess the diagnostic accuracy of each method. Off-target accumulations were clearly observed in the substantia nigra, globus pallidum, and pineal gland. Higher extra-cerebral cortical uptake was observed in the meninges and centrum semiovale in tau-positive individuals, although these differences did not remain significant after a multiple comparison correction. The SUVRs derived with the use of restricted cerebellar VOIs were significantly higher than those from the CenTauR cerebellar VOIs in both the tau-positive and tau-negative groups (p < 0.01). A significant interaction between the diagnostic group and the reference VOI choice was detected (p = 0.019). The ROC analysis showed excellent diagnostic performance, with AUCs of 0.930 for CenTauR and 0.984 for the restricted reference VOIs (a nonsignificant difference). 18F-MK-6240 PET imaging using a high-resolution brain-dedicated PET scanner revealed notable off-target binding and meningeal spill-in, which significantly affect quantification depending on the reference VOI selection. Optimizing reference regions by excluding extracerebral contamination enhances the reliability of tau PET analyses and may be crucial for longitudinal studies and multicenter trials.
BACKGROUND:Given that the relationship between the duration and content of golf and cognitive function remains unclear, this study determined the relationship between golf and cognitive decline among older adults. METHODS:Overall, 4575 older participants were analyzed cross-sectionally. Participants were divided into three groups based on their current golf status: golf players, golf cessation, and no golf experience. Participants who scored below the threshold on one or more of four cognitive tests were classified as having cognitive decline. RESULTS:There were 72 (14.1%), 115 (20.1%), and 755 (21.6%) golfers with cognitive decline in the golf player, golf cessation, and no golf experience groups, respectively. The golf player group exhibited significantly lower odds ratios (ORs) for cognitive decline than the no golf experience group. A significantly lower OR was noted for cognitive decline with a longer golf history (p < 0.01) but without association between the number of rounds and practice sessions. The golf cessation and golf player groups had significantly lower ORs for memory decline compared with the no golf experience group. The golf player group had significantly lower ORs for executive functional decline than the non-golf group. CONCLUSIONS:Continuing to play golf during older age was associated with lower odds of cognitive decline. This association was not observed among older adults who had ceased playing golf. Longer golfing history was associated with lower odds of cognitive decline, whereas the number of rounds or practice sessions was not clearly associated with cognitive status. These findings suggest that continued golf participation, rather than a higher frequency of play or practice, may be related to cognitive function in older adults.
BACKGROUND:The number of individuals with dementia in Japan is increasing rapidly, placing a significant burden on family caregivers. Following a diagnosis, caregivers often experience confusion and psychological distress. Although early support can help alleviate these challenges, time and geographic constraints frequently limit access. Telephone-based counselling may offer a practical alternative, particularly for older adults who are comfortable using telephones. METHODS:This prospective cohort study targeted 266 primary caregivers of individuals newly diagnosed with dementia or mild cognitive impairment at Nippon Medical School Musashikosugi Hospital between June 2022 and December 2023. A self-administered questionnaire was distributed following the initial consultation. Of the 125 respondents, 116 provided complete data and were included in the analysis. Variables assessed included caregiver demographics, care context, health status, social support and willingness to use telephone consultations. Chi-square tests were used to compare the characteristics of those who were willing versus unwilling to use telephone consultation support. RESULTS:A total of 48 caregivers expressed willingness to use telephone consultation support. This group exhibited significantly higher rates of depressive symptoms, lack of instrumental support and a greater likelihood of handling medical or service-related calls. Conversely, patients with chronic shoulder pain were less likely to use telephone consultation support. Many participants were in the early stages of caregiving, reported relatively low burden, yet demonstrated a high need to continue. CONCLUSION:Telephone consultation support appears particularly beneficial for caregivers who serve as primary communicators with health services, lack adequate support and exhibit signs of depression. Alternative support formats are needed for caregivers with physical limitations. Tailored, early-stage interventions are crucial to effectively support family caregivers in the period following their relative's dementia diagnosis.
Background Dairy product consumption is associated with a lower risk of all-cause mortality. However, the evidence regarding probiotic-fermented milk products remains unclear. This study examined the association between the intake of fermented milk products containing lactic acid bacteria, including Lacticaseibacillus paracasei strain Shirota (LcS), and all-cause mortality. Methods A total of 1,280 community-dwelling Japanese aged ≥65 years (519 men, 761 women; mean age 73.5 years) were included in the analyses. Participants were categorized in two groups based on the retrospectively recalled intake frequency of fermented milk products (<3 or ≥3 days/week) over 5- and 10-year periods. All-cause mortality risk was evaluated using Cox proportional hazards regression analyses in the full sample and propensity score-matched subsamples. Results During the 9.3-year follow-up period (112.05 months), deaths occurred in 147 men (28.3%) and 114 women (15.0%). Among men, consumption of fermented milk products containing LcS for ≥3 days/week over five years was significantly associated with a lower risk of all-cause mortality in both full sample analysis (hazard ratio [HR] 0.648, 95% confidence interval [CI] 0.438–0.958, p = 0.030) and matched analysis (HR 0.640, 95% CI 0.434–0.943, p = 0.024), compared with those consuming <3 days/week. Similar associations were observed for overall fermented milk products, including the LcS products. No associations were found among women for either LcS or overall fermented milk products. Conclusion Habitual intake of fermented milk products containing LcS was associated with a lower risk of all-cause mortality in older Japanese men.
