Purpose: The purpose of this study is to determine the relationship between the preoperative nutrition state and the progression of rehabilitation after cardiovascular surgery. Methods: Consecutive 479 patients who underwent an elective cardiovascular surgery (male: 317, female: 162, age: 67 ± 13 years old) were recruited. The patients were classified into four groups according to the severity of preoperative GNRI; Geriatric Nutritional Risk Index. We retrospectively examined the relationship between the severity of preoperative GNRI and the progression of postoperative rehabilitation (the postoperative duration until the patient started sitting, standing, walking and completed 100-m walking without assistance). In addition, we examined whether the severity of preoperative GNRI would become a predictive factor of the delay of progression of postoperative rehabilitation. Results: The high-risk group in preoperative GNRI showed a significantly higher ratio of patients with chronic heart failure compared with other groups (p <0.05). Moreover, the high-risk group in preoperative GNRI was delayed in the start of standing-up and walking (p <0.05), and also showed a significantly higher ratio of the delay of progression of postoperative rehabilitation (p < 0.05). The preoperative GNRI was extracted as one of the predicted factors of the progression of postoperative rehabilitation (p <0.001). Conclusion: The preoperative GNRI has a relation to postoperative progression of rehabilitation after cardiovascular surgery.

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Purpose: The purpose of this study was to examine the relationship between physical performance and a decline in activities of daily living (ADL) in elderly people who were certified by Japanese long-term care insurance. Methods: The subjects were 2,695 elderly people who used day-care services (mean age: 81.9 ± 6.7 years; men: 916; women: 1,779). The 13 motor subscales of the Functional Independence Measure were used to assess ADL. The subjects were divided into two groups: the ADL independent group, who scored &ge; 6 points in all ADL measures, and the ADL care need group, who scored &le; 5 points for at least one item in all ADL measures. Physical performance tests included grip strength, the chair stand test 5 times, one leg standing with the eyes open, walking speed, and the timed "up & go" test. The multiple logistic regression analysis was used to identify the relationships between ADL status and physical performances which were showed significant differences in univariate analysis. Results: The multiple logistic regression model showed that all physical performances were significantly associated with a decline in ADL. By the analysis for the level of care, the moderately disabled group, performance in grip strength, the chair stand test 5 times, walking speed and the timed "up & go" test were significantly associated with a decline in ADL. In the severely disabled group, walking speed was significantly associated with a decline in ADL. Walking speed showed a particularly strong correlation with a decline in ADL (moderately disabled: OR, 2.56; 95% CI, 1.57-4.16; p<0.01; severely disabled: OR, 2.36, 95% CI, 1.12-5.50; p<0.05). Conclusions: Our results suggest that targeted intervention to improve walking speed may be useful for preventing a decline in ADL in elderly people.

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Purpose: Patients with sarcopenia experience an impaired state of health with various comorbidities, including mobility disorders, increased risk of falls and fractures, impaired ability to perform activities of daily living, and other disabilities. The prevalence of sarcopenia differs with population, age, and gender. The aim of this study was to assess the prevalence of sarcopenia and its association with functional and nutritional status in community-dwelling frail elderly people. Methods: Seventy-two community-dwelling frail elderly individuals (55 women) above the age of 75 years were included in the study. The European Working Group on Sarcopenia in Older People (EWGSOP) criteria were adopted. Accordingly, sarcopenia was diagnosed in cases with documented low muscle mass and either low muscle strength (grip strength) or low physical performance (short physical performance battery [SPPB]). We also assessed the participants' nutritional status (Mini Nutritional Assessment Short Form [MNA-SF]), mental state (Mini Mental State Examination [MMSE]), and daily activities (Barthel Index [BI]). Results: Sarcopenia was diagnosed in 27 participants (37.5%). MNA - SF score in elderly people with sarcopenia was significantly lower than that in those without sarcopenia. MMSE score were not significantly different between the participants with sarcopenia and those without sarcopenia. The multivariate logistic regression analysis showed a high increase in risk of sarcopenia for malnutrition (OR 5.94; 95% CI 1.62-21.81). Conclusions: The prevalence of sarcopenia was high in community-dwelling frail elderly people. Sarcopenia was associated with low nutritional status but not with cognitive status.

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Purpose: The purpose of this study was to examine the accuracy of subjective judgments regarding motor learning in the elderly people. Methods: Healthy young adults (n = 14) and healthy older adults (n = 16) participated in this study. Participants were required to reach for a target key without visual information and to learn the location of the target key by using extrinsic visual feedback. Participants performed an initial session that including 20 trials before the learning phase. Then, participants performed three learning blocks, one block consisted of three sessions with 20 trials in each session. In addition, participants were asked to make the following subjective judgments: ease of learning (before performing experimental tasks), judgments of learning (between sessions), and judgment of performance (after completing all the tasks). Results: In both age groups, the success ratio increased with the progress of the task. There was no significant difference in the ease of learning between the two age groups. In younger adults, accuracy of the judgments of learning increased with the progress of the task, whereas this was not the case in older adults. Furthermore, judgment of performance in younger adults was more accurate than that in older adults. Conclusion: These results suggest that the subjective judgment during motor learning in the elderly people is inaccuracy.

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