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Association between cognitive function and body composition in community-dwelling older women
Get PDFIn the current global aging society, attempts should be made to help limit future health problems by promoting the effective maintenance of cognitive function among the aged. Therefore, this study aimed to investigate the association between cognitive function and body composition parameters. The study participants were 296 community-dwelling older women. The Mini-Mental State Examination (MMSE) was used to evaluate cognitive function, with poor cognitive performance (cognitive impairment) defined as an MMSE score 26 group, the MMSE 0.6, with threshold scores of 5.00 kg/m2, 17.60 kg, 33.60 kg, 14.00 kg, 2.75 kg, and 9.51 kg, respectively. Logistic regression analysis adjusted for age, years of education, and body mass index (BMI) showed that participants with skeletal muscle mass 26. Furthermore, skeletal muscle mass < 17.60 kg was associated with lower scores on the working memory subscale of the MMSE (OR: 0.694; 95% CI: 0.534 - 0.902; p = 0.0058). These findings suggest that cognitive impairment is associated with muscle mass, especially skeletal muscle mass. A certain amount of skeletal muscle mass may therefore be beneficial to maintain cognitive function.Original Articleothe
Frontal activation patterns during Tetris game play and estimated differences between high and low performers: a preliminary functional near-infrared spectroscopy study
Get PDFTetris has recently expanded its place of activity not only to an entertainment but also to clinical applications such as cognitive training and prevention of trauma flashback. However, to our knowledge, no studies focused on cortical activation patterns themselves when playing Tetris in a natural form. This study aimed to investigate activation patterns in the frontal cortex during naturally-performed Tetris in healthy subjects using functional near-infrared spectroscopy robust to artifacts by motion and electric devices. We also attempted to explore the frontal areas required to play Tetris successfully. We measured activations at 52 frontal areas for 90 seconds during Tetris play in 24 subjects, and the activations and correlations among those were compared between the high and low performers. The results demonstrated that significant activations had two factors, each showing a similar activation pattern. One of the factors was distributed over the lateral prefrontal cortex bilaterally, and the other was localized to the right prefrontal cortex. Moreover, exploratory analyses estimated that the activations of the areas centered on the right dorsolateral prefrontal cortex (DLPFC) increase and correlations of the activations between those areas and the other areas decrease, in the high performers compared with the low performers. In Conclusion, playing Tetris significantly activated both sides of the lateral prefrontal cortex. Furthermore, it was suggested that the high performers probably reduce functional connectivity between activations of the areas centered on the right DLPFC and the other areas, and increase the local activations compared with the low performers. This study would give important suggestions not only for information on brain activation patterns during Tetris play but also for the future development of neurocognitive clinical interventions using Tetris.Original Articleothe
The relevance of cognitive dysfunction and comprehension of abstract words
Get PDFIn healthy subjects, the comprehension process is different between abstract words and concrete words. Previous studies reported that the understanding speed is faster and more accurate for concrete words than abstract words; however, this difference is increased in subjects who have language dysfunction due to brain damage. In this report, we focused on abstract words, and investigated how the ability to comprehend them may be used in the evaluation of language acquisition and adult cognitive function. In the literature, studies on the understanding and expression of abstract words rarely included patients with dementia. In this study, we examined the understanding and expression of abstract words in three patients with dementia using the Mini-Mental State Examination (MMSE), the Abstract Word Understanding Test (SCTAW), and a free conversation analysis. The SCTAW results showed that all subjects had scores below the average of the same age group. Moreover, the most common false-reaction pattern was observed, and it was found to be associated with "semantic-related" stimuli, with the same type of error most frequently occurring in healthy subjects. In addition, the results of the conversation analysis showed that MMSE scores and the number of abstract words expressed by the patients tended to be correlated. Therefore, the results suggested that cognitive function was correlated with the number of abstract words expressed.Original Articleothe
Load-dependent Differences in the Muscle Activity Level and Muscle Power Output Timing during Shoulder External Rotation
Get PDF肩関節障害において腱板断裂は多くみられ、肩関節外旋筋力の低下が問題になることが多い。本研究は、肩関節外旋の運動方法によって外旋筋および他の肩関節周囲筋にどのような筋活動がみられ、どのような外旋筋筋力増強運動が有効なのかを表面筋電図を用いて検討した。対象は肩関節に疾患のない健常成人（男性 3 名、女性 2 名）とした。肩関節外旋運動は CKC運動とOKC運動の2種類とした。いずれも3秒間の筋活動を測定し、各筋の最大等尺性収縮時の筋活動に対する割合を算出した。CKC 運動では種類の運動間で全ての筋活動量に有意差は認められなかった。OKC 運動では全ての筋で負荷量が 0% と 5％との間に有意差が認められた (p<0.01)。CKC 運動は負荷量の少ない肩関節外旋筋運動として有効であり、OKC 運動は負荷量が 5%未満であれば肩関節外旋筋の筋力増強運動として有効であった。articl
Pathophysiology of major depressive disorder related to the relationship between inflammation and the nervous system
Get PDFMajor depressive disorder (MDD) is a leading cause of disability. It is associated with the highest disability-adjusted life year (DALY) value among all diseases and disorders, placing a significant burden on society. Thus, new advances in treatment methods based on the pathogenesis of MDD are strongly required. Historically, the monoamine hypothesis has been the major theory of depression, but it is too simplistic. It cannot explain the latency of response in the therapeutic action of antidepressants, and up to 30% of depressed patients fail to achieve remission despite multiple treatment trials. Over the past three decades, research has suggested that inflammatory processes are involved in the onset and maintenance of MDD; the inflammatory hypothesis has been proposed. This review will highlight the association between inflammation and the nervous system and the role of inflammation in the pathogenesis of MDD, including whether chronic stress (e.g., psychosocial stress) activates the inflammatory response, what kind of upstream neurogenic processes translate physiologic stress into inflammatory responses, communication pathways, or mechanisms by which the peripheral immune system can influence the brain and behavior; and the pathophysiology by which inflammation affects the nervous system and leads to MDD. Once cytokine signals reach the brain, they can interact with every pathophysiologic domain relevant to mood regulation, which includes neurotransmitter function, hypothalamic-pituitary-adrenal (HPA) axis activity, neural plasticity, and alteration of brain circuitry. Recent data demonstrating the importance of cytokines as biomarkers will also be presented.Review Articleothe
Gait characteristics measured with a standard smartphone, muscle weakness, and benzodiazepine in chronic psychiatric patients: a preliminary study
Get PDFObjectives: To evaluate gait disturbances using a smartphone and reveal the association between gait, muscle strength, and medication in patients with chronic psychiatric disorders. Methods: Chronic psychiatric patients were recruited from March 2019 to February 2020. We evaluated gait velocity, cadence, and stride length through a 10 m walking test (10mWT), and measured three direction acceleration of the body center of gravity (COG) using the iPhone6. The mean vertical (mVA), medio-lateral (mMLA), and antero-posterior (mAPA) amplitude of the relative trajectory of the COG were calculated from the acceleration data using MATLAB R2016a. Grip strength, drug induced extra-pyramidal symptoms scale (DIEPSS), and medication information were collected. Spearman's rank correlation coefficients were used to investigate associations among gait velocity, cadence, stride length, mVA, mMLA, mAPA, grip strength, and chlorpromazine/diazepam/biperiden equivalent doses. The level of statistical significance was set at p < 0.05, and p-values were adjusted using the Benjamini-Hochberg method for multiple comparisons. Results: Fourteen males and six females participated, with 12 having schizophrenia spectrum disorders. The mean (SD) age and grip strength were 66.2 (12.4) years and 24.6 (8.5) kg, respectively. The mean (SD) velocity, cadence, and stride length were 1.0 (0.4) m/sec, 2.0 (0.2) steps/sec, and 0.5 (0.2) m/step, respectively in 10mWT. Velocity and stride length were significantly associated with mVA and mAPA. Velocity, stride length, and mVA were also significantly and positively related to grip strength, but not DIEPSS and medication. Cadence and mMLA were not related to any gait parameters. Diazepam equivalent doses were positively associated with mMLA. Conclusion: Muscle weakness may affect gait disturbances with a small step in chronic psychiatric patients. The results suggest that sarcopenia has an impact on the physical performance of such patients. In addition, benzodiazepine medication may affect the impaired balance in these patients.Original Articleothe
Behavioral interventions for reducing aggressive behavior of individuals with a brain injury
Get PDFIndividuals who suffer a brain injury often exhibit challenging behaviors that they previously did not display. Challenging behaviors may include various types of aggressive behaviors such as physical aggression toward individuals and/or objects as well as verbal aggression. Behavioral approach is one of psychological intervention procedures that are often employed to eliminate or reduce the frequency of aggressive behaviors. This article over viewed the occurrence of aggressive behaviors of individuals with a brain injury and outlined three types of behavioral interventions, the contingency management procedure, positive behavior intervention support, and a combination of both. All are based on the theory of operant conditioning that posits that behaviors are learned through consequences. Although behavioral interventions are widely employed to ameliorate undesirable behaviors, their effectiveness varies among individuals. Tips for choosing an appropriate procedure are discussed.Review Articleothe
Rehabilitative and habilitative perspectives of exercise in treating major depressive disorder
Get PDFBackground: Major depressive disorder (MDD) is a most frequently occurred neuropsychiatric condition. About 25% of the female and 12% of the male in the population suffer from MDD at least one time in their lifetime. The treatment with currently available antidepressants are mostly effectively. Among other benefits to the health, exercise has been found to have therapeutic effect on improving MDD, and preventing from a new-onset MDD. But those benefits are often overlooked by psychiatrists, non-psychiatrist physicians, physical therapists, speech therapists, and occupational therapists. Methods: Besides my lifetime experiences of living my life, receiving training, teaching, and practicing psychiatry, I also collected information from published papers pertinent to beneficial issue related to exercise for patients with MDD in this review. Results: In this review, I have highlighted some important information that exercise helps in improving patients with MDD, and in preventing a new onset episode of MDD. Discussion: To keep the readership for rehabilitation therapists to be in mind, the author discusses the issue of exercise in the rehabilitative and habilitative perspectives in MDD treatment and prevention of future occurrence of MDD. Therefore, I also recommend that all patients with MDD are encouraged to start with a lifestyle of more physical activities and routine exercise.Review Articleothe
Relationship between subjective health and frailty in community-dwelling elders
Get PDF[Purpose] This study investigated the relationship between subjective health impression and frailty among community-dwelling elderly persons. [Participants and Methods] In all, 215 (female 161) elderly persons participated in a survey, and the mean age was 73.6 +- 6.8 years. The measurement items were age, sex, BMI, muscle strength, SMI, gait speed, frailty, depression, cognitive function, subjective health impression, and number of medications. [Results] There were significant differences in subjective health impression, frailty, depression, and number of medications between a subjective healthy group and subjective unhealthy group. In addition, it was suggested that frailty, depression, and number of medications were independent related factors of subjective health impression. [Conclusion] Subjective unhealthy impression was associated with frailty, depression, and large number of medications.〔目的〕本研究の目的は地域在住高齢者を対象に主観的健康感とフレイルとの関連を明らかにすることである。 〔対象と方法〕対象は貝塚市内在住60歳以上の男性54名(平均年齢75.4±6.6歳)、 女性161名(平均年齢73.0±6.7歳)、 計215名(平均年齢73.6±6.8歳)である。 調査項目は、 年齢、 性別、 BMI、 筋力、 骨格筋指数、 歩行速度、 フレイル5項目、 うつ状態、 服薬数、 認知機能、 主観的健康感を実測または自記式調査した。 〔結果〕主観的健康群と主観的不健康群の2群比較ではフレイル分類、 GDS分類、 服薬数で有意差(p<0.05)を認めた。 ロジスティック回帰分析の結果、 フレイルであること、 GDS得点が高くうつ傾向またはうつ状態であること、 服薬数が多いことは主観的不健康感の独立関連因子であることが示唆された。 〔結語〕主観的健康感はフレイル、 うつ傾向・うつ状態および服薬の多さが関連していることが明らかとなった。Original Articledepartmental bulletin pape
Purposeful activity and electrical stimulation therapy for transition from severely paralysed upper limb to auxiliary upper limb : Programme development for purposeful electrical stimulation therapy to be used in a day care centre
Get PDFOwing to the after-effects of stroke, people with severe hemiplegia in the upper limbs who live at home are no longer used by the experience of paralysis. If the paralysed upper limb is not used, posture imbalance easily occurs, and the risk of falling is high. The use of the paralysed upper limb for daily activities is one of the basic problems in such patient. The objective of this study was to develop a programme that combines the purposeful activities and electrostimulation therapy at day care centre so as to promote the transition from useless upper limb to auxiliary upper limb. This report is a case study of purpose-based electrostimulation therapy administered to patients in a day care centre who had chronic severe hemiplegia in the upper limbs.脳卒中の後遺症により、 在宅で生活している重度の片麻痺上肢をもった人は、 麻痺側上肢の失敗体験や使用しない経験によって、 麻痺側を不使用となる。 長期に非麻痺側上肢のみを使う経験が続けば、 麻痺側上肢を使用せず使われない手として学習される。 特に、 通所施設では、 療法士が少ない現状であるため、 麻痺側上肢を維持や管理を目標とすることが多い。 麻痺側上肢が使われないと姿勢バランスを崩しやすく、 転倒の危険性が高くなる。 麻痺側上肢の使用は、 その後の日常生活の運動や健康において、 基礎的な課題の一つといえる。 我々は、 慢性重度麻痺側上肢に対して本人の合目的的活動を明確にし、 電気刺激装置の刺激を組み合わせることで、 麻痺側上肢を生活のなかで参加させるプログラムを提案してきた(Minami et al., 2018)。 本報告は, 通所施設で合目的的活動と電気刺激療法を併用したプログラムを慢性重度麻痺上肢に実施し、 廃用的上肢から補助的上肢に移行に至る基礎的能力を高めるプログラム開発である。Original Articledepartmental bulletin pape