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
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.
Healthy Aging Innovation Center
Integrated Research Initiative for Living Well with Dementia