Longitudinal study on frailty and its prevention strategy

Leader :
Akihiko Kitamura
Members :
Yu Nofuji, Satoshi Seino, Yuri Yokoyama, Mariko Nishi, Hidenori Amano, Mari Yamashita, Miki Narita, Yui Tomine, Toshiki Hata, Takumi Abe, Yoshinori Fujiwara, Hiroyuki Suzuki, Ryota Sakurai, Ai Iizuka (Research Team for Social Participation and Community Health)
Hirohiko Hirano, Yuki Ohara (Research Team for Promoting Independence and Mental Health)
Tatsuro Ishizaki, Tomoko Ikeuchi, Seigo Mitsutake (Research Team for Human Care)
Akihito Ishigami, Yasunori Fujita (Research Team for Functional Biogerontology)
Heying Zhou (Research Team for Geriatric Medicine)
Kazuhiro Shigemoto (Vice-director, Biology and Medical Sciences)
Takashi Takei, Mitsuyo Itabashi (Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology)

Frailty, Preventive Strategy, Longitudinal Study, Cohort Study, Epidemiological Study, Pooled Analysis, Repeated Measures Data, Predictor, Comprehensive Geriatric Assessment, Randomized Controlled Trial

1. 1.Identification of risk factors associated with frailty and the need for long-term care based on longitudinal data
2. 2.Implementation and evaluation of anti-frailty measures at the community level based on comprehensive geriatric assessment and randomized controlled trials (RCT)
3. 3.Collaborative study

Frailty is one of the main risk factors for loss of independence in older adults making it an important target for preventing long-term care. The ultimate goal of this study is to “develop a strategy for preventing frailty in older adults” which will contribute to the promotion of a healthy aging society in Japan. In this regard, we aim to: 1) demonstrate the evidence of the frailty prevention system through high-quality epidemiological research, 2) clarify the long-term effects and longitudinal changes in exposures of interest, and 3) evaluate the effects of mid- to long-term community measures.
Specifically, we are working to identify risk factors associated with frailty and the need for long-term care based on longitudinal data, and implement and evaluate anti-frailty measures at the community level based on comprehensive geriatric assessment and randomized controlled trials (RCT) within cohorts using long-term longitudinal studies carried out in the towns of Kusatsu, Gunma Prefecture and Hatoyama, Saitama Prefecture. One advantage of this research is the use of objective indicators (e.g., biomarkers, blood pressure, arteriosclerosis, body composition, and physical function, among others) and detailed test data (e.g., cognitive function, and oral/swallowing functions, among others) in addition to questionnaire surveys.
Along with these studies, we are also actively involved in research integrating cohort studies (pooled analyses) and collaborative research.

1) Kusatsu Longitudinal Study (Kusatsu Town, Gunma)
In 2001, we entered into a collaborative research agreement with the town of Kusatsu and began to collect data through yearly health checkups for residents 65 years and older. We further administered surveys to individuals who did not receive the health checkups once every three years in an effort to understand the health status of all older adults in the town. We also collected data regarding outcomes (i.e., death, transfer), need for long-term care certification, and medical/long-term care expenses and combined this information with data from health checkups and overall surveys. These strategies have enabled extensive longitudinal analysis. Spanning nearly 20 years, this is among the longest studies performed exclusively among older adults in the country.

2) Hatoyama Cohort Study (Hatoyama Town, Saitama)
Since the beginning of 2001, we have been conducting social activity surveys and intervention research concerning the training of community welfare volunteers. In 2010, we signed a collaborative research agreement with the town of Hatoyama and began a cohort study of a stratified random sample of residents between 65 and 84 years old. From 2010 to 2018, we carried out health checkups, home visit health checkups, self-administered questionnaire surveys, and multifactorial intervention for preventing frailty. We also collected data on outcomes (i.e., death, transfer), need for long-term care certification, and medical/long-term care expenses, evaluated measures for the prevention of long-term care, and conducted epidemiological studies to identify risk factors regarding frailty and the need for long-term care.

3) Collaborative Study
We are organizing interdisciplinary joint studies in collaboration with multiple research teams from the research institute and hospital departments at Tokyo Metropolitan Institute of Gerontology to accomplish the aims of this study. Research using pooled analysis integrating multiple cohort data is also underway. Presently, we are primarily working on the following studies:

• Association between dietary patterns and sarcopenia in an integrated cohort from Kusatsu, Hatoyama, and Itabashi;
• Risk factors of decreased oral function;
• Association between walkability, medical expenses (outpatient/inpatient), and long-term care expenses;
• Determining a “healthy age” through the integration of data on community residents and frail outpatients;
• Association between renal function, sarcopenia, and frailty;
• Association between the number of remaining teeth, number of functional teeth, and mortality (Continuation);
• A large-scale joint cohort study to identify intervenable factors promoting and inhibiting dementia requiring long-term care;
• Risks leading to certification of the need for long-term care and diversity in progression thereafter: A multi-facility joint study;
• Association between brain MRI, cognitive impairment, and functional impairment in older adults receiving health screenings;
• A comparative study of retinal OCT findings and dementia-related neuropathology;
• Development of a brief intervention for preventing exacerbation of chronic low back pain/knee pain;
• A study on physical function at discharge and prognosis of older adults with heart failure.

1) Kusatsu Longitudinal Study (Kusatsu Town, Gunma)

1. 1. Kaito S, Taniguchi Y, Kitamura A, Seino S, Amano H, Yokoyama Y, Fukuda H, Yokokawa H, Fujiwara Y, Shinkai S, Naito T. Trajectories of kidney function and associated factors among community‑dwelling older Japanese: a 16‑year longitudinal study. Clin Exp Nephrol. 2020 Apr;24(4):330-338. doi: 10.1007/s10157-019-01837-z. Epub 2019 Dec 26.
2. 2. Kugimiya Y, Watanabe Y, Igarashi K, Hoshino D, Motokawa K, Edahiro A, Ueda T, Takano T, Sakurai K, Taniguchi Y, Kitamura A, Nasu I, Shinkai S, Hirano H. Factors associated with masticatory performance in community-dwelling older adults: a cross-sectional study. J Am Dent Assoc. 2020 Feb;151(2):118-126. doi: 10.1016/j.adaj.2019.10.003.
3. 3. Kugimiya Y, Watanabe Y, Ueda T, Motokawa K, Shirobe M, Igarashi K, Hoshino D, Takano T, Sakurai K, Taniguchi Y, Kitamura A, Shinkai S, Hirano H. Rate of Oral Frailty and Oral Hypofunction in Rural Community-Dwelling Older Japanese Individuals. Gerodontology. 2020 Mar 6. doi: 10.1111/ger.12468. [Epub ahead of print]
4. 4. Taniguchi Y, Kitamura A, Ishizaki T, Fujiwara Y, Shinozaki T, Seino S, Mitsutake S, Suzuki H, Yokoyama Y, Abe T, Ikeuchi T, Yokota I, Matsuyama Y, Shinkai S. Association of Trajectories of Cognitive Function with Cause-Specific Mortality and Medical and Long-Term Care Costs. Geriatr Gerontol Int. 2019 May;19(5):423-428. doi: 10.1111/ggi.13637.
5. 5. Kitamura A, Taniguchi Y, Seino S, Yokoyama Y, Amano H, Y, Fujiwara Y, Shinkai S. Combined effect of diabetes and frailty on mortality and incident disability in older Japanese adults. Geriatr Gerontol Int. 2019 May;19(5):423-428. doi: 10.1111/ggi.13637. Epub 2019 Feb 20.
6. 6. Taniguchi Y, Kitamura A, Kaito S, Yokoyama Y, Yokota I, Shinozaki T, Seino S, Murayama H, Matsuyama Y, Ikeuchi T, Fujiwara Y, Shinkai S. Albumin and Hemoglobin Trajectories and Incident Disabling Dementia in Community-Dwelling Older Japanese. Dement Geriatr Cogn Disord. 2019;47(4-6):233-242. doi: 10.1159/000499837. Epub 2019 Jul 17.
7. 7. Abe T, Kitamura A, Taniguchi Y, Amano H, Seino S, Yokoyama Y, Nishi M, Narita M, Ikeuchi T, Fujiwara Y, Shinkai S. Pathway from gait speed to incidence of disability and mortality in older adults: A mediating role of physical activity. Maturitas. 2019 May;123:32-36. doi: 10.1016/j.maturitas.2019.02.002. Epub 2019 Feb 7.
8. 8. Taniguchi Y, Kitamura A, Nofuji Y, Ishizaki T, Seino S, Yokoyama Y, Shinozaki T, Murayama H, Mitsutake S, Amano H, Nishi M, Shinkai S. Association of trajectories of higher-level functional capacity with mortality and medical and long-term care costs among community-dwelling older Japanese. J Gerontol A Biol Sci Med Sci. 2019 Jan 16;74(2):211-218. doi: 10.1093/gerona/gly024.
9. 9. Kojima G, Taniguchi Y, Kitamura A, Shinkai S. Are the Kihon Checklist and the Kaigo-Yobo Checklist compatible with the Frailty Index? J Am Med Dir Assoc. 2018 Sep;19(9):797-800.e2. doi: 10.1016/j.jamda.2018.05.012. Epub 2018 Jul 3.
10. 10. Taniguchi Y, Kitamura A, Shinozaki T, Seino S, Yokoyama Y, Narita M, Amano H, Matsuyama Y, Fujiwara Y, Shinkai S. Trajectories of arterial stiffness and all-cause mortality among community-dwelling older Japanese. Geriatr Gerontol Int. 2018 Jul;18(7):1108-1113. doi: 10.1111/ggi.13323. Epub 2018 Apr 2.
11. 11. Takagi D, Watanabe Y, Edahiro A, Ohara Y, Murakami M, Murakami K, Hironaka S, Taniguchi Y, Kitamura A, Shinkai S, Hirano H. Factors affecting masticatory function of community-dwelling older people: Investigation of the differences in the relevant factors for subjective and objective assessment. Gerodontology. 2017 Sep;34(3):357-364. doi: 10.1111/ger.12274. Epub 2017 May 29.
12. 12. Cabral MMS, Bos AJ, Amano H, Seino S, Shinkai S. Relationship between skin color, sun exposure, UV protection and fish intake and serum levels of vitamin D in Japansese community-dwelling older adults. Nutrition and Food Science. 2017, 47(3), 409-422. doi: 10.1108/NFS-09-2016-0136
13. 13. Taniguchi Y, Kitamura A, Seino S, Murayama H, Amano H, Nofuji Y, Nishi M, Yokoyama Y, Shinozaki T, Yokota I, Matsuyama Y, Fujiwara Y, Shinkai S. Gait Performance Trajectories and Incident Disabling Dementia Among Community-Dwelling Older Japanese. J Am Med Dir Assoc. 2017 Feb 1;18(2):192.e13-192.e20. doi: 10.1016/j.jamda.2016.10.015. Epub 2016 Dec 31.
14. 14. Taniguchi Y, Kitamura A, Murayama H, Amano H, Shinozaki T, Yokota I, Seino S, Nofuji Y, Nishi M, Yokoyama Y, Matsuyama Y, Fujiwara Y, Shinkai S. Mini-Mental State Examination Score Trajectories and Incident Disabling Dementia Among Community-Dwelling Older Japanese. Geriatr Gerontol Int. 2017 Nov;17(11):1928-1935. doi: 10.1111/ggi.12996. Epub 2017 Mar 14.
15. 15. Murayama H, Shinkai S, Nishi M, Taniguchi Y, Amano H, Seino S, Yokoyama Y, Yoshida H, Fujiwara Y, Ito H. Albumin, hemoglobin, and the trajectory of cognitive function in community-dwelling older Japanese: a 13-year longitudinal study. J Prev Alzheimers Dis. 2017;4(2):93-99. doi: 10.14283/jpad.2016.113.
16. 16. Taniguchi Y, Fujiwara Y, Murayama H, Yokota I, Matsuo E, Seino S, Nofuji Y, Nishi M, Matsuyama Y, Shinkai S. Prospective Study of Trajectories of Physical Performance and Mortality Among Community-Dwelling Older Japanese. J Gerontol A Biol Sci Med Sci. 2016 Nov;71(11):1492-1499. Epub 2016 Mar 1.
17. 17. Taniguchi Y, Fujiwara Y, Nishi M, Murayama H, Nofuji Y, Seino S, Shinkai S. Prospective study of arterial stiffness and subsequent cognitive decline among community-dwelling older Japanese. J Epidemiol. 2015;25(9):592-9. doi: 10.2188/jea.JE20140250. Epub 2015 Aug 1.
18. 18. Taniguchi Y, Shinkai S, Nishi M, Murayama H, Nofuji Y, Yoshida H, Fujiwara Y. Nutritional biomarkers and subsequent cognitive decline among community-dwelling older Japanese: A prospective Study. J Gerontol A Biol Sci Med Sci. 2014 Oct;69(10):1276-83. doi: 10.1093/gerona/glt286. Epub 2014 Feb 2.
19. 19. Ohara Y, Hirano H, Watanabe Y, Edahiro A, Sato E, Shinkai S, Yoshida H, Mataki S. Masseter muscle tension and chewing ability in older persons. Geriatr Gerontol Int. 2013 Apr;13(2):372-7. doi: 10.1111/j.1447-0594.2012.00909.x. Epub 2012 Jul 17.
20. 20. Ohara Y, Hirano H, Watanabe Y, Edahiro A, Sato E, Shinkai S, Yoshida H, Mataki S. Masseter muscle tension and chewing ability in older persons. Geriatr Gerontol Int. 2013 Apr;13(2):372-7. doi: 10.1111/j.1447-0594.2012.00909.x. Epub 2012 Jul 17.
21. 21. Fujiwara Y, Chaves PH, Takahashi R, Amano H, Yoshida H, Kumagai S, Fujita K, Wang DG, Shinkai S. Arterial pulse wave velocity as a marker of poor cognitive function in an elderly community-dwelling population. J Gerontol A Biol Sci Med Sci. 2005 May;60(5):607-12.

2) Hatoyama Cohort Study (Hatoyama Town, Saitama)

1. 1. Seino S, Nishi M, Murayama H, Narita M, Yokoyama Y, Nofuji Y, Taniguchi Y, Amano H, Kitamura A, Shinkai S. Effects of a multifactorial intervention comprising resistance exercise, nutritional, and psychosocial programs of frailty and functional health in community-dwelling older adults: A randomized, controlled, crossover trial. Geriatr Gerontol Int. 2017 Nov;17(11):2034-2045. doi: 10.1111/ggi.13016. Epub 2017 Apr 10.
2. 2. Murayama H, Nishi M, Nofuji Y, Matsuo E, Taniguchi Y, Amano H, Yokoyama Y, Fujiwara Y, Shinkai S. Longitudinal association between neighborhood cohesion and depressive mood in old age: A Japanese prospective study. Health Place. 2015 Jul;34:270-8. doi: 10.1016/j.healthplace.2015.05.015. Epub 2015 Jun 23.
3. 3. Aoki A, Tan X, Yamagishi R, Shinkai S, Obata R, Miyaji T, Yamaguchi T, Numaga J, Ito H, Yanagi Y. Risk Factors for Age-Related Macular Degeneration in an Elderly Japanese Population: The Hatoyama Study. Invest Ophthalmol Vis Sci. 2015 Apr;56(4):2580-5. doi: 10.1167/iovs.14-16339.
4. 4. Murayama H, Nishi M, Matsuo E, Nofuji Y, Shimizu Y, Taniguchi Y, Fujiwara Y, Shinkai S. Do bonding and bridging social capital affect self-rated health, depressive mood and cognitive decline in older Japanese? a prospective cohort study. Soc Sci Med. 2013 Dec;98:247-52. doi: 10.1016/j.socscimed.2013.09.026. Epub 2013 Oct 9.
5. 5. Murayama H, Nishi M, Shimizu Y, Kim MJ, Yoshida H, Amano H, Fujiwara Y, Shinkai S. The Hatoyama Cohort Study: design and profile of participants at baseline. J Epidemiol. 2012;22(6):551-8. doi: 10.2188/jea.JE20120015. Epub 2012 Oct 27.

3) Collaborative Study

1. 1. Seino S, Kitamura A, Abe T, Taniguchi Y, Yokoyama Y, Amano H, Nishi M, Nofuji Y, Narita M, Ikeuchi T, Fujiwara Y, Shinkai S. Dose-Response Relationships between Body Composition Indices and All-Cause Mortality in Older Japanese Adults. J Am Med Dir Assoc. 2020 Feb 14. pii: S1525-8610(19)30827-8. doi: 10.1016/j.jamda.2019.11.018. [Epub ahead of print]
2. 2. Osuka Y, Kim H, Kawai H, Taniguchi Y, Yokoyama Y, Seino S, Obuchi S, Kitamura A, Shinkai S. Sarcoscore: a novel approach for assessing sarcopenia and functional disability in older adulsts. J Clin Med. 2020 Mar 4;9(3). pii: E692. doi: 10.3390/jcm9030692.
3. 3. Abe T, Kitamura A, Seino S, Yokoyama Y, Amano H, Taniguchi Y, Nishi M, Narita M, Ikeuchi T, Tomine Y, Fujiwara Y, Shinkai S. Differences in the Prevalence of and Factors Associated with Frailty in Five Japanese Residential Areas. Int J Environ Res Public Health. 2019 Oct 18;16(20). pii: E3974. doi: 10.3390/ijerph16203974.
4. 4. Yokoyama Y, Kitamura A, Yoshizaki T, Nishi M, Seino S, Taniguchi Y, Amano H, Narita M, Shinkai S. Score-Based and Nutrient-Derived Dietary Patterns Are Associated with Depressive Symptoms in Community-Dwelling Older Japanese: A Cross-Sectional Study. J Nutr Health Aging. 2019;23(9):896-903. doi: 10.1007/s12603-019-1238-2.
5. 5. Yokoyama Y, Kitamura A, Nishi M, Seino S, Taniguchi Y, Amano H, Ikeuchi T, Shinkai S. Frequency of Balanced-Meal Consumption and Frailty in Community-Dwelling Older Japanese: A Cross-Sectional Study. J Epidemiol. 2019 Oct 5;29(10):370-376. doi: 10.2188/jea.JE20180076. Epub 2018 Nov 17.
6. 6. Seino S, Sumi K, Narita M, Yokoyama Y, Ashida K, Kitamura A, Shinkai S. Effects of low-dose dairy protein plus micronutrient supplementation during resistance exercise on muscle mass and physical performance in older adults: A randomized, controlled trial. J Nutr Health Aging. 2018;22(1):59-67. doi: 10.1007/s12603-017-0904-5.
7. 7. Kojima G, Iliffe S, Taniguchi Y, Shimada H, Rakugi H, Walters K. Prevalence of Frailty in Japan. A Systematic Review and Meta-analysis. J Epidemiol. 2017 Aug;27(8):347-353. doi: 10.1016/j.je.2016.09.008. Epub 2016 Nov 15.
8. 8. Yamada Y, Sakuma J, Takeuchi I, Yasukochi Y, Kato K, Oguri M, Fujimaki T, Horibe H, Muramatsu M, Sawabe M, Fujiwara Y, Taniguchi Y, Obuchi S, Kawai H, Shinkai S, Mori S, Arai T, Tanaka M. Identification of TNFSF13, SPATC1L, SLC22A25 and SALL4 as novel susceptibility loci for atrial fibrillation by an exome‑wide association study. Mol Med Rep. 2017 Nov;16(5):5823-5832. doi: 10.3892/mmr.2017.7334. Epub 2017 Aug 23.
9. 9. Yamada Y, Sakuma J, Takeuchi I, Yasukochi Y, Kato K, Oguri M, Fujimaki T, Horibe H, Muramatsu M, Sawabe M, Fujiwara Y, Taniguchi Y, Obuchi S, Kawai H, Shinkai S, Mori S, Arai T, Tanaka M. Identification of C21orf59 and ATG2A as novel determinants of renal function-related traits in Japanese by exome-wide association studies. Oncotarget. 2017 Jul 11;8(28):45259-45273. doi: 10.18632/oncotarget.16696.
10. 10. Yamada Y, Sakuma J, Takeuchi I, Yasukochi Y, Kato K, Oguri M, Fujimaki T, Horibe H, Muramatsu M, Sawabe M, Fujiwara Y, Taniguchi Y, Obuchi S, Kawai H, Shinkai S, Mori S, Arai T, Tanaka M. Identification of polymorphisms in 12q24.1, ACAD10, and BRAP as novel genetic determinants of blood pressure in Japanese by exome-wide association studies. Oncotarget. 2017 Jun 27;8(26):43068-43079. doi: 10.18632/oncotarget.17474.
11. 11. Yamada Y, Sakuma J, Takeuchi I, Yasukochi Y, Kato K, Oguri M, Fujimaki T, Horibe H, Muramatsu M, Sawabe M, Fujiwara Y, Taniguchi Y, Obuchi S, Kawai H, Shinkai S, Mori S, Arai T, Tanaka M. Identification of eight genetic variants as novel determinants of dyslipidemia in Japanese by exome-wide association studies. Oncotarget. 2017 Jun 13;8(24):38950-38961. doi: 10.18632/oncotarget.17159.
12. 12. Yamada Y, Sakuma J, Takeuchi I, Yasukochi Y, Kato K, Oguri M, Fujimaki T, Horibe H, Muramatsu M, Sawabe M, Fujiwara Y, Taniguchi Y, Obuchi S, Kawai H, Shinkai S, Mori S, Arai T, Tanaka M. Identification of rs7350481 at chromosome 11q23.3 as a novel susceptibility locus for metabolic syndrome in Japanese individuals by an exome-wide association study. Oncotarget. 2017 Jun 13;8(24):39296-39308. doi: 10.18632/oncotarget.16945.
13. 13. Yamada Y, Sakuma J, Takeuchi I, Yasukochi Y, Kato K, Oguri M, Fujimaki T, Horibe H, Muramatsu M, Sawabe M, Fujiwara Y, Taniguchi Y, Obuchi S, Kawai H, Shinkai S, Mori S, Arai T, Tanaka M. Identification of six polymorphisms as novel susceptibility loci for ischemic or hemorrhagic stroke by exome-wide association studies. Int J Mol Med. 2017 Jun;39(6):1477-1491. doi: 10.3892/ijmm.2017.2972. Epub 2017 May 3.
14. 14. Yamada Y, Sakuma J, Takeuchi I, Yasukochi Y, Kato K, Oguri M, Fujimaki T, Horibe H, Muramatsu M, Sawabe M, Fujiwara Y, Taniguchi Y, Obuchi S, Kawai H, Shinkai S, Mori S, Arai T, Tanaka M. Identification of STXBP2 as a novel susceptibility locus for myocardial infarction in Japanese individuals by an exome-wide association study. Oncotarget. 2017 May 16;8(20):33527-33535. doi: 10.18632/oncotarget.16536.
15. 15. Yamada Y, Sakuma J, Takeuchi I, Yasukochi Y, Kato K, Oguri M, Fujimaki T, Horibe H, Muramatsu M, Sawabe M, Fujiwara Y, Taniguchi Y, Obuchi S, Kawai H, Shinkai S, Mori S, Arai T, Tanaka M. Identification of EGFLAM, SPATC1L and RNASE13 as novel susceptibility loci for aortic aneurysm in Japanese individuals by exome-wide association studies. Int J Mol Med. 2017 May;39(5):1091-1100. doi: 10.3892/ijmm.2017.2927. Epub 2017 Mar 21.
16. 16. Tanisawa K, Hirose N, Arai Y, Shimokata H, Yamada Y, Kawai H, Kojima M, Obuchi S, Hirano H, Suzuki H, Fujiwara Y, Taniguchi Y, Shinkai S, Ihara K, Sugaya M, Higuchi M, Arai T, Mori S, Sawabe M, Sato N, Muramatsu M, Tanaka M. Inverse Association Between Height-Increasing Alleles and Extreme Longevity in Japanese Women. J Gerontol A Biol Sci Med Sci. 2018 Apr 17;73(5):588-595. doi: 10.1093/gerona/glx155.
17. 17. Yokoyama Y, Nishi M, Murayama H, Amano H, Taniguchi Y, Nofuji Y, Narita M, Matsuo E, Seino S, Kawano Y, Shinkai S. Dietary variety and decline in lean mass and physical performance in community-dwelling older Japanese: A 4-year follow-up study. J Nutr Health Aging. 2017;21(1):11-16. doi: 10.1007/s12603-016-0726-x.
18. 18. Yokoyama Y, Nishi M, Murayama H, Amano H, Taniguchi Y, Nofuji Y, Narita M, Matsuo E, Seino S, Kawano Y, Shinkai S. Association of dietary variety with body composition and physical function in community-dwelling elderly Japanese. J Nutr Health Aging. 2016;20(7):691-6. doi: 10.1007/s12603-015-0632-7.
19. 19. Nofuji Y, Shinkai S, Taniguchi Y, Amano H, Nishi M, Murayama H, Fujiwara Y, Suzuki T. Associations of Walking Speed, Grip Strength, and Standing Balance with Total and Cause-Specific Mortality in a General Population of older Japanese. J Am Med Dir Assoc. 2016 Feb;17(2):184.e1-7. doi: 10.1016/j.jamda.2015.11.003. Epub 2015 Dec 21.
20. 20. Shinkai S, Yoshida H, Taniguchi Y, Murayama H, Nishi M, Amano H, Nofuji Y, Seino S, Fujiwara Y. Public health approach to preventing frailty in the community and its effect on healthy aging in Japan. Geriatr Gerontol Int. 2016 Mar;16 Suppl 1:87-97. doi: 10.1111/ggi.12726.
21. 21. Zhou H, Mori S, Tanaka M, Sawabe M, Arai T, Muramatsu M, Naka Mieno M, Shinkai S, Yamada Y, Miyachi M, Murakami H, Sanada K, Ito H. A missense single nucleotide polymorphism, V114I of the Werner syndrome gene, is associated with risk of osteoporosis and femoral fracture in the Japanese population. J Bone Miner Metab. 2015 Nov;33(6):694-700. doi: 10.1007/s00774-014-0636-0. Epub 2015 Jan 31.
22. 22. Seino S, Shinkai S, Iijima K, Obuchi S, Fujiwara Y, Yoshida H, Kawai H, Nishi M, Murayama H, Taniguchi Y, Amano H, Takahashi R. Reference values and age differences in body composition of community-dwelling older Japanese men and women: A pooled analysis of four cohort studies. PLoS One. 2015 Jul 6;10(7):e0131975. doi: 10.1371/journal.pone.0131975. eCollection 2015.
23. 23. Kim M, Shinkai S, Murayama H, Mori S. Comparison of segmental multifrequency bioelectrical impedance analysis with dual-energy X-ray absorptiometry for the assessment of body composition in a community-dwelling older population. Geriatr Gerontol Int. 2015 Aug;15(8):1013-22. doi: 10.1111/ggi.12384. Epub 2014 Oct 27.
24. 24. Seino S, Shinkai S, Fujiwara Y, Obuchi S, Yoshida H, Hirano H, Kim HK, Ishizaki T, Takahashi R , TMIG-LISA Research Group. Reference values and age and sex differences in physical performance measures for community-dwelling older Japanese: A pooled analysis of six cohort studies. PLoS One. 2014 Jun 12;9(6):e99487. doi: 10.1371/journal.pone.0099487. eCollection 2014.
25. 25. Taniguchi Y, Yoshida H, Fujiwara Y, Motohashi Y, Shinkai S. A prospective study of gait performance and subsequent cognitive decline in a general population of older Japanese. J Gerontol A Biol Sci Med Sci. 2012 Jun;67(7):796-803. doi: 10.1093/gerona/glr243. Epub 2012 Mar 2.
26. 26. Fujimaki T1, Kato K, Oguri M, Yohida T, Horibe H, Yokoi K, Watanabe S, Satoh K, Aoyagi Y, Tanaka M, Yoshida H, Shinkai S, Nozawa Y, Shin DJ, Lee JH, Jang Y, Yamada Y. Association of a polymorphism of BTN2A1 with dyslipidemia in East Asian populations. Exp Ther Med. 2011 Jul;2(4):745-749. Epub 2011 May 12.
27. 27. Horibe H, Kato K, Oguri M, Yoshida T, Fujimaki T, Kawamiya T, Yokoi K, Watanabe S, Satoh K, Aoyagi Y, Tanaka M, Yoshida H, Shinkai S, Nozawa Y, Murohara T, Yamada Y. Association of a polymorphism of BTN2A1 with hypertension in Japanese individuals. Am J Hypertens. 2011 Aug;24(8):924-9. doi: 10.1038/ajh.2011.74. Epub 2011 Apr 28.
28. 28. Yoshida T, Kato K, Oguri M, Horibe H, Kawamiya T, Yokoi K, Fujimaki T, Watanabe S, Satoh K, Aoyagi Y, Tanaka M, Yoshida H, Shinkai S, Nozawa Y, Yamada Y. Association of polymorphisms of BTN2A1 and ILF3 with myocardial infarction in Japanese individuals with different lipid profiles. Mol Med Rep. 2011 May-Jun;4(3):511-8. doi: 10.3892/mmr.2011.441. Epub 2011 Feb 18.
29. 29. Yamada Y, Nishida T, Ichihara S, Sawabe M, Fuku N, Nishigaki Y, Aoyagi Y, Tanaka M, Fujiwara Y, Yoshida H, Shinkai S, Satoh K, Kato K, Fujimaki T, Yokoi K, Oguri M, Yoshida T, Watanabe S, Nozawa Y, Hasegawa A, Kojima T, Han BG, Ahn Y, Lee M, Shin DJ, Lee JH, Jang Y. Association of a polymorphism of BTN2A1 with myocardial infarction in East Asian populations. Atherosclerosis. 2011 Mar;215(1):145-52. doi: 10.1016/j.atherosclerosis.2010.12.005. Epub 2010 Dec 15.

※The information mentioned above is current as of May 2020.