Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
Print ISSN : 0300-9173
Volume 37 , Issue 1
Showing 1-15 articles out of 15 articles from the selected issue
  • Koji Miura
    2000 Volume 37 Issue 1 Pages 1-6
    Published: January 25, 2000
    Released: November 24, 2009
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  • Chisato Miyaura
    2000 Volume 37 Issue 1 Pages 7-11
    Published: January 25, 2000
    Released: November 24, 2009
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  • Toru Kita
    2000 Volume 37 Issue 1 Pages 12-17
    Published: January 25, 2000
    Released: November 24, 2009
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  • Yoshio Wakatsuki
    2000 Volume 37 Issue 1 Pages 18
    Published: January 25, 2000
    Released: November 24, 2009
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  • Fuyuki Ishikawa
    2000 Volume 37 Issue 1 Pages 19-25
    Published: January 25, 2000
    Released: November 24, 2009
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  • Naoaki Ishii
    2000 Volume 37 Issue 1 Pages 26-29
    Published: January 25, 2000
    Released: November 24, 2009
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  • Yoichi Nabeshima
    2000 Volume 37 Issue 1 Pages 30-33
    Published: January 25, 2000
    Released: November 24, 2009
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  • Yasuhiro Furuichi
    2000 Volume 37 Issue 1 Pages 34-40
    Published: January 25, 2000
    Released: November 24, 2009
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  • Takao Suzuki, Harumi Yukawa, Hideyo Yoshida, Tatsuro Ishizaki, Hongkyo ...
    2000 Volume 37 Issue 1 Pages 41-48
    Published: January 25, 2000
    Released: November 24, 2009
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    Alcohol consumption has both adverse and beneficial effects on survival. We examined the baseline status of alcohol consumption and the changes of instrumental activity of daily living (I-ADL) by a prospective survey for the elderly living in an urban community who were participants in the “Longitudinal and Interdisciplinary Study on Aging by the Tokyo Metropolitan Institute of Gerontology (TMIG-LISA)”. Detailed information on alcohol intake was collected during a structured interview. At a baseline survey in 1991, 1) the frequency of current drinkers decreased lineally by age. 2) the most popular alcohol beverage was beer for both sexes and average ethanol intake per day were 41 (10-45) g in men and 24 (8-28) g in women. Current drinkers had significantly stronger grip strength, higher velocity in maximum walking and higher score on the TMIG Index of Competence, designed to measure the higher-level competence in elderly community residents. After 4 years follow-up, in 1995, 73.3 percent of the participants completed the examination. They were classified into five categories as “current drinkers”, “lifetime abstainers”, “beginning to drink during follow-up period”, “quit drinking during follow-up period” and “quit drinking at baseline”. The decline of I-ADL was significantly greater among the elderly who “quit drinking during follow-up period” than “current drinkers”. Further “current drinkers” had significantly lower decline of I-ADL than “lifetime abstainers”. Our findings show beneficial effects of moderate alcohol intake in the maintenance of a higher level of competence in the elderly living in a community.
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  • Seigo Nakano, Takashi Asada, Hiroshi Matsuda, Masatake Uno, Masaru Tak ...
    2000 Volume 37 Issue 1 Pages 49-55
    Published: January 25, 2000
    Released: November 24, 2009
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    To clarify the effects of normal aging on the cerebral blood flow, regional cerebral blood flow mesurments using a Patlak Plot method of 99mTc-ECD were performed in 53 normal volunteers aged 18 to 87 years old (mean=47.9 years). The subjects, 29 men and 24 women, were normal on clinical examination, and had neither a history of neurological nor psychiatric disease and no abnormal CT or MRI images. Statistical parametric mapping (SPM) was used for automatching and an objective approach to analysis of SPECT image data. Global cerebral blood flow showed a significant decline with age (r=0.406). The SPM analysis (voxel height; p<0.001, Bonferroni correction; p<0.05) demonstrated significant age-related decrease of relative rCBF in prefrontal cortices, anterior cingulate giri. and insular cortices-temporal poles bilaterally. these affected areas belonged to limbic or association cortices. Therefore, these decreases in rCBF may suggest cognitive changes that occur during normal aging.
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  • Michiko Yamada, Yasuyo Mimori, Hideo Sasaki, Junko Ikeda, Shigenobu Na ...
    2000 Volume 37 Issue 1 Pages 56-62
    Published: January 25, 2000
    Released: November 24, 2009
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    The Cognitive Abilities Screening Instrument (CASI) was developed by Japanese and American researchers, including the authors, to examine cognitive functions, based on previous neuropsychological tests, such as Hasegawa's Dementia Scale and the MMSE. From the Adult Health Study (AHS) population of the Radiation Effects Research Foundation, 2052 men and women aged 60 or over and living in Hiroshima were evaluated for their cognitive functions using the CASI. Dementia was diagnosed in 93 and 1, 959 were considered not to suffer from dementia based on the DSM-III-R criteria using neurological examination and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) completed by caregivers. Multivariate regression analysis not only indicated that total score was higher with lower age and higher education but that the slope of its decrease is steeper with higher age and fewer years of education. The slope of score decrease with increase of age was steeper for women than for men. Furthermore, CASI items were categorized by domains of cognitive function. Multivariate regression analysis for each cognitive domain showed clear effects of age and level of education. The effect of age for the nondementia subjects was large in cognitive domains dealing with temporal orientation, shortterm memory, and list-generating fluency. The most useful cognitive domains for diagnosing dementia were temporal orientation, short-term memory, and list-generating fluency, as was indicated by high sensitivity and specificity.
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  • Yoshiya Hasegawa, Toshinobu Yamamoto, Toshiaki Inagaki, Kanzou Suzuki
    2000 Volume 37 Issue 1 Pages 63-67
    Published: January 25, 2000
    Released: November 24, 2009
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    A clinico-pathological evaluation was performed on patients requiring nasogastric nutritional support. As a result, it was found that nasogastric tube feeding was common in patients with cerebrovascular diseases (CVD) and senile dementia of Alzheimer's type (SDAT). Pneumonia was anamnestic in many CVD patients, which was frequently the direct indication for nasogastric tube feeding and the major cause of death in these patients. On the other hand, pneumonia was not common in SDAT in which the major indication of nasogastric tube feeding was abnormal appetite. However, pneumonia was an infrequent cause of death in SDAT compared to CVD patients. The mean age in which nasogastric tube feeding was started was 8 years older in SDAT than CVD patients, however, there was no significant difference in the duration of nasogastric tube feeding ranging from initiation to death.
    A swallowing study, based on a clinico-pathological evaluation, was performed by video-fluoroscopy on healthy seniors and senior patients neurological diseases. There was no abnormal finding in the healthy seniors. Findings in CVD patients with single-sided neurological diseases indicated that 27.3% had moderate abnormalities and 18.2% had severe abnormalities. In CVD with bilateral defects, 35.7% had moderate abnormalities and 42.9% had severe abnormalities. Though even single-sided CVD defects can frequently cause swallowing disorder, oral food intake was maintained in nearly half of the patients with bilateral CVD, despite high incidence of severe swallowing disorder. In the mild SDAT group, rated on a scale from 0.5 to 1.0 according to the Clinical Dementia Rating (CDR), 11.1% had moderate swallowing disorder. In the CDR 2-3 group, 23.1% had moderate disability and 15.4% had severe disability. It appears that SDAT patients do not suffer from rapid deterioration in swallowing ability, which was relatively retained in this disease group. In Parkinson's disease patients with a Yahr grade of I-II, 55.6% had normal findings and 44.4% had mild abnormalities. In Yahr grade III-IV patients, 28.6% had mild and 28. 6% had severe disability. Patients with severe dysfunction had a high incidence of silent aspiration. The swallowing function was maintained in the early course of mild Parkinson's disease patients, however the ability rapidly deteriorated with the course of the disease. The radiological findings of the swallowing study supported the clinicopathological characteristics of each disease.
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  • Osamu Nishikaze, Etsuko Furuya
    2000 Volume 37 Issue 1 Pages 68-73
    Published: January 25, 2000
    Released: November 24, 2009
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    In terms of adaptability, unlike inanimate objects, living organisms exist in a dynamic balance between “wear and tear” and “repair and recovery”. We regarded 17-hydroxycorticosteroids (17-OHCS) as a compound related to tissue “wear and tear” (Hans Selye) and sought for a compound related to tissue “repair and recovery”. This led us to the discovery of 17-ketosteroid sulfates (17-KS-S) in urine. Elderly persons, unlike young adults, show low levels in 17-KS-S and little diurnal changes. In an elderly person 17-KS-S can decrease on significant life events (e. g.a spouse's death) and remain at low levels for a long time. Elderly persons with frailty need to improve their lifestyle (meals, exercise, rest, sleep, etc.) qualitatively and quantitatively to adapt themselves to stress adequately. Increased 17-KS-S levels were to be related to improvement in lifestyle.
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  • Norifumi Takeda, Shinji Teramoto, Hironobu Ihn, Toshihiro Arao, Takesh ...
    2000 Volume 37 Issue 1 Pages 74-79
    Published: January 25, 2000
    Released: November 24, 2009
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    A 88-year-old woman was admitted with appetite loss and dehydration in April 1999. She first noticed finger swelling in May 1996 and systemic sclerosis (SSc) was diagnosed in February 1997 on the basis of a clinical picture of low-grade fever, diffuse skin thickening, Raynaud's phenomenon, and pulmonary fibrosis. Retrospectively pulmonary fibrosis could have been identified on chest X ray film in September 1995. Although her appetite loss and dehydration were improved by hydration, pleural effusion continued. After detalied examinations, anti-topoisomerase 1 (Scl-70) antibody, anti-Sm antibody, and an anti-double-stranded DNA antibody (dsDNA) were found in her serum. However, the other antibodies to anti-SS-A, SS-B, Jo-1, and RNP were not detected. These results suggest that this elderly case was a very late onset overlap syndrome of systemic lupus erythematosus (SLE) and SSc. Thus, the pleural effusion in this case may have been caused by SLE-associated pleuritis. Although the late onset elderly cases with overlap syndrome are very rare, SLE, SSc, and their combination can be found in aged patients over 80 years old. SLE and SSc should be carefully considered for the differential diagnosis of pleural effusion and skin thickening even in elderly patients.
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  • 2000 Volume 37 Issue 1 Pages 80-94
    Published: January 25, 2000
    Released: November 24, 2009
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