[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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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.

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Aim: The objective of this study was to evaluate the effects of a comprehensive intervention program named SPRING, which utilizes a hot spring facility, in community-dwelling older adults in a randomized controlled trial.
Methods: A total of 60 community-dwelling elderly people (mean age, 72.7±6.0 years) participated in this program. After baseline investigation, participants were randomly assigned to an intervention group (n=31) or a control group (n=29). The intervention group participated in a comprehensive intervention program (including exercise classes, nutrition classes and bathing) twice a week for 3 months. After 3 months and 6 months, we evaluated the effects of the intervention.
Results: The attendance rate of the intervention group was 76%, and there were no accidents or injuries associated with this program. After 3 months, grip strength and one-leg standing with eyes-open scores significantly improved among the intervention group, compared with the control group (p=0.028; p=0.003, respectively). On follow-up, grip strength, one-leg standing with eyes-open scores and the World Health Organization Well-Being Index (WHO-5) scores were statistically significantly maintained or had improved in the intervention group (p=0.001; p=0.024; p=0.027, respectively).
Conclusion: The comprehensive intervention program SPRING may improve physical function among community-dwelling older adults. In addition, SPRING may have long-term beneficial effects for older adults.

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AIM: To apply nutrition care management to elderly female patients, we predicted serum albumin (s-Alb) levels by non-invasive factors.
METHODS: After excluding patients with lesions/diseases which were directly related to s-Alb levels, we investigated 147 elderly women aged 75-years or over who were taking meals orally and were hospitalized from April 2008 to April 2009 at a hospital in Toyota. The patients were classified into 2 groups, one of patients with s-Alb levels of 3.5 g/dl or below (n=80), and the other of those with s-Alb levels of over 3.5 g/dl (n=67). Between the 2 groups, we examined differences in age, body mass index (BMI), living arrangements, necessary nursing care level (NNCL), bed confinement level (BCL), OH scale level (OHSL), and dietary intake either by the Student t-test, Mann-Whitney U test or chi-square test. Pearson correlation coefficients were calculated among s-Alb levels and selected variables. Taking into account the correlation coefficients, we conducted multiple regression analysis adopting the s-Alb level as a dependent variable and non-invasive factors as independent variables. For all the performed tests and analyses, a p value of less than 0.05 (on two-tailed analysis) was assumed to represent a statistically significant difference.
RESULTS: S-Alb level was significantly associated with variables, including age, BMI, NNCL, BCL, OHSL, and percentage of protein intake (PPI). Multiple regression analysis revealed 4 significant variables: age, BCL, OHSL, and PPI. The multiple regression equation was y=4.977-(0.098×OHSL)-(0.080×BCL)-(0.016×age)+(0.003×PPI), and the multiple correlation coefficient R² was 0.398 (p <0.001).
CONCLUSIONS: S-Alb levels among elderly female patients may be predicted by 4 non-invasive variables: age, BCL, OHSL, and PPI.

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Aim: The objectives of this study were to examine the relationship between nutritional status indicators such as body mass index (BMI) and serum albumin, and the effects of exercise intervention in community-dwelling frail elderly people.
Methods: We enrolled 44 subjects aged 65 years and older (average age 73.9±5.1 years) in this study. The subjects participated in exercise intervention, including muscle strength training twice a week for 3 months. We evaluated various functional performance measures at the start and end of the intervention, and calculated the measurement differences. We then evaluated any relationships between nutritional status and the amount of changes.
Results: Some physical functions improved after exercise intervention, even in participants with under-nutritional status. There were no significant differences or relationships found between nutritional status and improvements in physical function.
Conclusions: These results suggest that the physical functions of frail elderly people can improve regardless of their nutritional status. Further study is necessary to evaluate the influence of nutritional status on exercise effects, and the optimal method of applying exercise interventions, primarily for community-dwelling frail older people.

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Aim: We investigated the cerebral activity of elderly persons living in a nursing home in the sitting position by analyzing the electroencephalography findings of postural changes in the supine and sitting positions.
Methods: This study was approved by the Health Ethics Committee of Osaka University. The subjects were 17 elderly people (4 men and 13 women, average age 85.35±8.26 years) living in a nursing home. Electroencephalograms were obtained in 8 cerebral regions (the left front-polar (Fp₁); right front-polar (Fp₂); left frontal (F₃); right frontal (F₄); left central (C₃); right central (C₄); left occipital (O₁) and right occipital (O₂)) while subjects sat in a head-up position in bed, or in a chair or wheelchair. Measurement was obtained over 5-minute supine, 15-minute sitting, and 5-minute conversation periods. We performed the fast Fourier transform on measured electroencephalograms to calculate the average power values of alpha band components (8-13 Hz) and beta band components (13-30 Hz) for each cerebral section.
Results: Compared with the supine position, the sitting position in bed did not show a significant increase in power values, whereas the sitting position in a chair showed significant increases in power values in all regions. Most of the time, the findings of patients sitting position in a chair showed significantly higher power values than those of patients sitting in bed in all regions.
Conclusions: During the 20 minutes after postural change from the supine to sitting positions, the cerebral activity of subjects sitting in a chair was higher than that of subjects sitting in bed.

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Aim: The purpose of this study was to ascertain the current statuses and problems of dental home care patients by surveying the oral care status and needs of patients in the home medical care support ward at the National Center for Geriatrics and Gerontology. Patients that required continuous oral management even after discharge from the hospital were referred to local dental clinics to receive home dental care. We investigated the suitability and problems associated with such care, and identified the dental care needs of home patients and the status of local care coordination, including those in hospitals.
Methods: The subjects were 82 patients. We ascertained their general condition and oral status, and also investigated the problems associated with patients judged to need specialized oral care by a dentist during oral treatment. Patients who required continuous specialized oral care after discharge from hospital were referred to dental clinics that could provide regular care, and the problems at the time of referral were identified.
Results: Dry mouth was reported by many patients. A large number of patients also needed specialized dental treatment such as the removal of dental calculus or tooth extraction. Problems were seen in oral function, with 38 of the patients (46%) unable to gargle and 23 (28%) unable to hold their mouths open. About half of the patients also had dementia, and communication with these patients was difficult. Of the 43 patients who were judged to need continuing oral care after discharge from hospital, their referral to a dental clinic for regular care was successful for 22 (51%) patients and unsuccessful for 21 (49%) patients. The reasons for unsuccessful referrals included the fact that the family, patient, nurse, or caregiver did not understand the need for specialized oral care.
Conclusion: The present results suggest the need for specialized oral treatment in home medical care. These findings also suggest that coordinating seamless dental care among primary physicians, intermediates, and transferring care after hospital discharge to regular dentists is difficult.

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