Development of a new health survey system for independence and long-term care prevention in the elderly

Leader :
Hunkyung Kim
Members :
Yutaka Watanabe, Yuko Yoshida, Narumi Kojima, Yosuke Osuka, Ken Fujino, Hirohiko Hirano, Shuichi Obuchi, Yoshinori Fujiwara, Hiroyuki Suzuki, Akihito Ishigami, Hisashi Kawai

Frailty, sarcopenia, cognitive function, long-term care, depression, MMSE, MCI

1. 1.Association between cognitive function decline and depression
2. 2.Development of new performance tests to predict declines in cognitive function
3. 3.Association between lung function and sarcopenia
4. 4.Association between physical and oral frailty
5. 5.Muscle quality based on frequency analysis of quadriceps echo intensity

The new health survey system will detect high risk elderly people with the purpose of preventing geriatric syndromes, as well as maintaining health and independence in old age. We will investigate the efficacy of the survey system designed to more efficiently run exercise and nutritional intervention programs for high risk elderly people with geriatric syndromes.

1. Based on 4 year follow-up data from the 2008 cohort (follow-up in 2012), the association between cognitive function measured by MMSE and depression assessed by the Kihon Checklist was investigated. Cognitive decline was operationally defined as MMSE score below 23 points and depression was defined as Kihon Checklist score over 2 points. Among those with declined cognitive function (MMSE <23), 41.7% were depressed (17.3% in those with MMSE over 23, Χ²=4.752, P=0.029). These results suggest that there may be an association between cognitive decline and depression.

2. We tested the hypothesis that our newly developed Stepping train making test (S-TMT) and MMSE as well as other cognitive function tests were correlated. The results showed that with longer S-TMT time, MMSE declined (Jonckheere-Terpstra trend test, P<0.01), which suggested that slow S-TMT time was associated with cognitive decline.

3. Among 1,029 people whose lung capacity we measured in 2008, 891 were classified as the normal group, and 138 were classified as sarcopenic. The comparison of lung function showed that the sarcopenia group had total lung capacity of 1815cc (normal group 2057 cc, P<0.001), forced vital capacity of 1568cc (normal group 1748cc, P<0.001), forced expiratory volume in 1 second of 1286cc (normal group 1442cc, P<0.001), all which were significantly lower than the normal group. These results suggest an association between sarcopenia and lung capacity variables.

4. Participants of the 2013 and 2015 comprehensive geriatric health survey, over 65 years of age were screened for changes in health status (n=491; 213 men and 278 women). In two years, 72 peoples status changed from healthy to prefrail, and 39 people changed from prefrail to frail (total of 111). Factors associated with the health status change in these 111 people were assessed. The results revealed mastication function, usual walking speed, MMSE and SDS were significant predictive factors. Based on the chewing gum test, mastication function, usual walking speed and MMSE showed significant preventive effects in the progression of frailty, and SDS was a risk factor for frailty progression.

5. Ultrasound imaging and echo intensity are used to assess muscle thickness, quality, and mass; however, the imaging can be greatly affected by fat infiltration in the muscle, and echo intensity can be affected by edema or depth of measurement. These are problematic in the assessment of elderly people and the vast differences in physical function and body size between individuals. By analyzing the frequencies in high resolution pulse echo imaging device scans on 831 community-dwelling elderly people, we were able to more accurately evaluate muscle quality.