研究等業績 - 原著論文 - 久米 裕
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秋田県在宅高齢者の緊急事態宣言による日常生活変化に影響を与える要因について
小玉 鮎人, 菅原 薫, 久米 裕, 高橋 智子, 小野 剛, 大田 秀隆
日本老年医学会雑誌 ( (一社)日本老年医学会 ) 59 ( 1 ) 58 - 66 2022年01月 [査読有り]
研究論文（学術雑誌） 国内共著
本研究の目的は新型コロナウイルス(COVID-19)感染拡大防止による緊急事態宣言(緊急宣言)が地域在住高齢者の日常生活変化に与えた影響について明らかにすることである.秋田県内の地域在住高齢者506名(2019年度:332名,2020年度:174名)に対して,通常歩行速度(Usual Walking Speed;UWS),握力,National Center for Geriatrics and Gerontology Functional Assessment Tool(NCGG-FAT)による認知機能,Geriatrics Depression Scale-15(GDS-15),基本チェックリストについて評価した.また緊急宣言後の対象者に対して,COVID-19感染拡大が日常生活へ与えた影響(交流,外出,運動,睡眠の減少)に関する5項目のアンケート調査(COVID-19アンケート調査)を行った.予想に反し,緊急宣言後が緊急宣言前よりもUWSにおいて有意に高値を示し,他の項目に関しても有意差は認められなかった.アンケート調査結果と心身機能評価との相関分析の結果,「睡眠時間減少の有り」とGDS-15(rs=0.200,p=0.019),COVID-19アンケート調査の該当合計数とBMI(rs=0.282,p=0.001)との間に有意な正の相関が認められた.以上により,本研究はさらに詳細な長期にわたる追跡調査が必要であるものの,感染者数の少ない秋田県の高齢者に心身機能の低下は明らかではなかった可能性がある.またそういった地域であっても,高齢者に対する自粛生活の影響として,うつと睡眠,もしくは自粛による日常生活の変化と肥満に有意な関連がある可能性が示唆され,今後感染者数や大都市と地域の違いなども考慮に入れた解析が必要と考える.(著者抄録)
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Yu Kume, Seongryu Bae, Sangyoon Lee, Hyuma Makizako, Yuriko Matsuzaki-Kihara, Ichiro Miyano, Hunkyung Kim, Hiroyuki Shimada, Hidetaka Ota
PLoS ONE 16 ( 6 ) e0252723 2021年06月 [査読有り]
研究論文（学術雑誌） 国内共著
Objective Older adults in Japan are tackling health-related challenges brought by comprehensive geriatric symptoms, such as physical and cognitive problems and social-psychological issues. In this nationwide study, we mainly focused on the Kihon checklist (KCL) as certificated necessity of long-term care for Japanese older adults and investigated whether the KCL score was associated with geriatric depression. In addition, we aimed to identify critical factors that influence the relationship between the KCL score and geriatric depression. Methods This survey was a cross-sectional observational study design, performed from 2013 to 2019. A total of 8, 760 participants aged 65 years and over were recruited from five cohorts in Japan, consisting of 6, 755 persons in Chubu, 1, 328 in Kanto, 481 in Kyushu, 49 in Shikoku and 147 in Tohoku. After obtaining informed consent from each participant, assessments were conducted, and outcomes were evaluated according to the ORANGE protocol. We collected data on demographics, KCL, physical, cognitive and mental evaluations. To clarify the relationship between the KCL and geriatric depression or critical factors, a random intercept model of multi-level models was estimated using individual and provincial variables depending on five cohorts. Results The KCL score was correlated with depression status. Moreover, the results of a random intercept model showed that the KCL score and geriatric depression were associated, and its association was affected by provincial factors of slow walking speed, polypharmacy and sex difference. Conclusions These results suggest that provincial factors of low walking performance, polypharmacy and sex difference (female) might be clinically targeted to improve the KCL score in older adults.
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Polypharmacy and Lack of Joy Are Related to Physical Frailty among Northern Japanese Community-Dwellers from the ORANGE Cohort Study
Yu Kume, Tomoko Takahashi, Yuki Itakura, Sangyoon Lee, Hyuma Makizako, Tsuyosi Ono, Hiroyuki Shimada, Hidetaka Ota.
Gerontology 67 ( 2 ) 184 - 193 2021年04月
研究論文（学術雑誌） 国内共著
Introduction: A prevalence of frailty is gradually increasing with the progress of aging in Japan, and critical challenges regarding early diagnosis and prevention of frailty were necessary in community. Although previous studies have well documented the characteristics of physical disability, there is limited information on frail state differences among older adults in Japanese rural areas. The aim of our cross-sectional observational study was to clarify the association of frail status in northern Japanese community-dwellers aged 65 or more. Methods: 345 participants were recruited from 2018 to 2020, and after getting informed consent from each participant, assessments and outcomes were evaluated according to the ORANGE protocol. We applied the frailty index of Gerontology-the Study of Geriatric Syndromes (NCGG-SGS) to classify frailty status by collecting data of demographics and psychosocial status using the Kihon checklist (KCL) and cognitive domains used by the National Center for Geriatrics and Gerontology-Functional Assessment Tool (NCGG-FAT). Results: Our subjects included 313 older adults divided into 138 robust, 163 prefrail, and 12 frail. For statistical analysis, we found that the frail group had a lower educational duration, worsened KCL items, lower cognitive functions, and a tendency toward depression compared to the other groups. Moreover, physical frailty and cognitive decline were related, and polypharmacy and a lack of joy in daily life were explanatory variables of frail status. Conclusions: We suggest that KCL is important for frail discrimination, and in order to prevent physical frailty, our community should take care of not only exercise and nutrition but also cognitive functioning and depressive tendencies. In particular, polypharmacy and the presence of fun in your life are possible to be related to frailty.
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Yu Kume, Hidetaka Ota
International Journal of Gerontology ( Taiwan Society of Geriatric Emergency and Critical Care Medicine (TSGECM) ) 15 ( 2 ) 183 - 184 2021年04月 [査読有り]
研究論文（学術雑誌） 国内共著
The present study aimed to clarify whether a multicomponent exercise program could effectively enhance physical and cognitive performances among community-dwellers in a rural area of northern Japan. Community-dwellers aged 60 years or more participated in an exercise program for 90 min/day, once every 2 weeks for 6 months, according to instructions supervised by a trained occupational therapist and a medical doctor specializing in geriatrics. The exercise program consisted of multitask conditions for cognition and physical performance. Physical and cognitive assessments were completed at baseline and after the 6-month intervention. The physical measurements consisted of body mass index, grip strength and usual walking speed, while the cognitive items included memory, attention, executive function and information processing speed. Fifty-eight participants (mean age, 76.2 years; % female, 82.8%) completed the 6-month follow-up period. Statistically, significant improvements in the usual walking speed (p = 0.0001),word recognition as memory score (p ＜ 0.0001), and information processing speed (p = 0.02) were observed after the intervention. Our study suggests that a multicomponent, dual-task exercise program combining physical exercise and cognitive training could be an effective strategy for enhancing physical and cognitive function among older individuals living in rural areas of Japan.
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Sachiko Makabe, Hidetomo Saito, Katsuya Fujiwara, Yu Kume, Yuko Akagawa, Wanda Wendel-Vos, Kazutaka Mitobe
International Journal of Science and Research Archive ( Magna Scientia ) 2 ( 1 ) 39 - 46 2021年02月 [査読有り]
研究論文（学術雑誌） 国際共著
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Ayuto Kodama, Yasuhiro Suzuki, Yu Kume, Hidetaka Ota
Annals of Alzheimer's and Dementia Care ( Peertechz Publication Inc. ) 5 ( 1 ) 001 - 003 2021年01月 [査読有り]
研究論文（学術雑誌） 国内共著
This study aimed to preliminary examine the effect of DMV stimulation on cognitive function in the elderly with moderate dementia. In the single arm study, 5 participants over 85 years old (% female: 100%) with Alzheimer's disease completed treatment of DMV stimulation with 15-40 Hz. 15-40 Hz DMV stimulation was provided during the entire day for 4 weeks. We evaluated therapeutic efficacy on cognitive function including WM, trail making test-part A & part B and the symbol digit substitution task in the participants, comparing outcomes at baseline with those after the 4 weeks intervention. According to statistical analyses, the WM improved significantly after the intervention (p = 0.043), and the others didn't have significant improvement. Our result showed that this DMV stimulation might have potentially positive impact on cognitive memory function in older adults with moderate level of dementia. In conclusion, living environmental intervention utilized 15-40 Hz DMV stimulation can contribute to the new nonpharmacological treatments without invasiveness for the elderly with dementia.
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Effect of Multicomponent Dual-Task Exercise Program to Gait Performance, Memory and Information Processing Speed in Older Community-Dwellers
久米 裕
International Journal of Gerontology 15 183 - 184 2021年 [査読有り]
研究論文（学術雑誌）
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Sachiko Makabe, Yu Kume, Tomohiro Kamata, Hataichanok Apikomonkon, Jiranan Griffiths, Junko Takagai, Yuko Akagawa, Hideaki Ando,Naruemol Singha-dong
Journal of Community Health 45 ( 4 ) 768 - 774 2020年08月 [査読有り]
研究論文（学術雑誌） 国内共著
Aging societies are a worldwide concern, as people are living longer than ever before. The success of the "barbershop project" in improving community health in the USA suggests that the aging issue can be tackled using this method even in Asia. Nevertheless, the health promotion awareness of barbers/stylists has barely been reported in Asia. This study aimed to identify the health promotion awareness of barbers and stylists in Japan and Thailand. An international cross-sectional survey was conducted between March and December 2017. Questionnaire contents included the "current status of existing health-promotion-related services," "awareness of contribution to maintaining people's health," and "awareness of collaboration with health care professionals." Participants were 99 Japanese and 101 Thai shop owners. In Japan, more health-promotion-related services were already provided through shops, and health care awareness was higher than in Thailand. In both countries, some shops were willing to collaborate with health care professionals. In Japan, "barbers/stylists have consultation opportunities with health care professionals," "health-related leaflets are provided," "development of therapy/care," and "barbershops/salons become a bridge between communities and hospitals" were mentioned as ideas for collaboration. In conclusion, barbers/stylists are highly interested in health due to the direct connection between beauty and health. Collaboration between barbershops/salons and health care professionals is possible, especially in Japan due to its super-aging society. Further development of the barbershop/salon project is needed.
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Yu Kume, Ayuto Kodama, Hiroki Maekawa.
Chronobiology International 37 ( 7 ) 1099 - 1105 2020年03月 [査読有り]
研究論文（学術雑誌） 国内共著
We investigated in a preliminarily study the circadian rest-activity rhythm of elderly Japanese community-dwellers according to sarcopenia status based upon the 2019 updated classification criteria of the Asian Working Group for Sarcopenia. A total of 30 participants were recruited from a single rehabilitation center in northern Japan between July and November 2019. The rest-activity rhythm of those with and without sarcopenia was assessed for 7 consecutive 24 h spans by wrist actigraphy in free-living condition and gait performance in the clinic. As group phenomena, the circadian activity rhythm of the sarcopenia cohort (N = 11) was of significantly lower amplitude and more fragmented than the non-sarcopenia cohort (N = 19). The nonparametric circadian rest activity (RAR) parameters of intra-daily variability (IV), relative amplitude (RA), most active 10-h span (M10), and the least active 5-h span (L5), but not interdaily stability (IS), of the sarcopenia group, were all significantly worse than those of the non-sarcopenia group. Gait performance for the sarcopenia group correlated strongly with the fragmentation and altered amplitude of the RAR. These preliminary findings motivated future longitudinal investigation both to improve the detection of sarcopenia in community dwelling elderly and to inform novel preventive or rehabilitative strategies.
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Yu Kume, Tomoe Fujita, Sachiko Uemura, Shoko Inomata, Megumi Tsugaruya, Akiko Sato, Yoriko Nakamura, Yuki Itakura, Hidetaka Ota
International Psychogeriatrics 32 ( 2 ) 285 - 286 2020年02月 [査読有り]
研究論文（学術雑誌） 国内共著
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Kenya Oga, Arito Yozu, Yu Kume, Hiroyuki Seki, Nobuhito Tsuchiya, Kei Nakai, Akira Matsushita, Hirotaka Mutsuzaki, Yutaka Kohno
Journal of Physical Therapy Science 32 ( 2 ) 192 - 196 2020年02月 [査読有り]
研究論文（学術雑誌） 国内共著
[Purpose] Recent studies have reported the effectiveness of robotic rehabilitation of paralyzed upper limbs in stroke patients. For example, the Single-Joint Hybrid Assistive Limb has been shown to improve upper limb impairments. However, limited data are available on the effectiveness of robotic rehabilitation of the upper limb with regards to daily living. In this case study, an accelerometer was adopted to examine whether rehabilitation using the Single-Joint Hybrid Assistive Limb improved upper limb activity during daily living in a stroke patient. [Participant and Methods] The participant was a 69-year-old male diagnosed with stroke and left hemiparesis. The Single-Joint Hybrid Assistive Limb was applied to the participant's elbow on the paralyzed side. The participant wore an accelerometer on each wrist to measure the activities of the upper limbs. Clinical tests of the paralyzed upper limb were also performed. [Results] The activity of the paralytic limb was significantly higher after Single-Joint Hybrid Assistive Limb intervention than before the intervention. On the other hand, none of the results of the clinical tests changed beyond a clinically important difference. [Conclusion] The Single-Joint Hybrid Assistive Limb could be useful for promoting active use of a paralyzed upper limb in daily living. In addition, an accelerometer could be especially useful for evaluating the effects of robotic rehabilitation.
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Telerehabilitation with Tablet Computers Replaces Face-to-Face Rehabilitation
Masahiko Wakasa, Tsubasa Odashima, Akira Saito, Minoru Kimoto, Isao Saito, Shogo Handa, Kazuki Syukunobe, Yu Kume, Kyoji Okada
Physical & Occupational Therapy In Geriatrics 38 ( 1 ) 85 - 97 2020年01月 [査読有り]
研究論文（学術雑誌） 国内共著
Aims: The objective of this study was to introduce mobile telerehabilitation with tablet computers and to verify its practical effectiveness in improving physical function and health status. Methods: In this study, nine adults aged 76.3 ± 3.3 years old participated in 13 exercise sessions led by a physical therapist each lasting 60 min every 2 weeks for a total of 6 months. A physical therapist performed exercises in front of a digital camera which was connected to a lab computer. In a community center, participants performed the exercises while watching the exercise performance on a screen. Intervention was delivered by video conferencing over high-speed mobile Internet. Results: All participants were satisfied with telerehabilitation. We found that patients experienced significant improvement in physical function following participation. Conclusion: Mobile telerehabilitation provides an alternative option for delivering physical exercise and supervision, especially for those with geographical restrictions and limited local professional resources.
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Yu Kume, Tomoko Takahashi, Yuki Itakura, Sangyoon Lee, Hyuma Makizako, Tsuyoshi Ono, Hiroyuki Shimada, Hidetaka Ota.
Journal of Clinical Medicine 8 ( 11 ) 1937 2019年11月 [査読有り]
研究論文（学術雑誌） 国内共著
A gradually increasing prevalence of mild cognitive impairment (MCI) is recognized in the super-aging society that Japan faces, and early detection and intervention in community-dwellers with MCI are critical issues to prevent dementia. Although many previous studies have revealed MCI/non-MCI differences in older individuals, information on the prevalence and characteristics of MCI in rural older adults is limited. The aim of this study was to investigate differential characteristics between older adults with and without MCI. The investigation was conducted over one year from 2018 to 2019. Participants were recruited from Akita in northern Japan. Neuropsychological assessments were applied to classify MCI, including the National Center for Geriatrics and Gerontology Functional Assessment Tool (NCGG-FAT) and the Touch panel-type Dementia Assessment Scale (TDAS) based on the Alzheimer's disease assessment scale. Our samples consisted of 103 older adults divided into 54 non-MCI and 49 MCI. The MCI group had lower scores of all cognitive items. Our results showed that individuals with MCI had significantly slower walking speed (WS) and worse geriatric depression scale (GDS) compared to non-MCI. In addition, WS was significantly associated with some cognitive items in non-MCI, but not in MCI. Finally, we showed that predictive variables of MCI were WS and GDS. Our study provides important information about MCI in rural community-dwellers. We suggest that older adults living in a super-aging society should receive lower limb training, and avoiding depression in older adults through interaction of community-dwellers may contribute to preventing the onset of MCI.
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Hiroki Maekawa, Yu Kume
Chronobiology International 36 ( 9 ) 1208 - 1216 2019年08月 [査読有り]
研究論文（学術雑誌） 国内共著
Background: Sleep health-related issues, such as poor subjective sleep quality during the night and nocturnal wakefulness, have been a focus of recent research on frailty. However, current trends regarding the chronotypes of older individuals with frailty have not been well documented, and information on the impact of frailty on circadian rest-activity patterns is limited. The aim of this research was to clarify the relationship among frailty, nonparametric rest-activity patterns, and chronotype in older community-dwelling subjects. Method: A survey was conducted between June and December 2018, and the participants of this study were recruited from among community-dwellers aged 60 years or older living in Akita prefecture, Japan. The frailty phenotype defined by the National Center for Geriatrics and Gerontology Study of Geriatric Syndromes (NCGG-SGS) was used to evaluate the frailty status of each participant. To evaluate nonparametric rest-activity rhythm (RAR) parameters (e.g., interdaily stability [IS], intradaily variability [IV], and relative amplitude [RA]), each participant wore an Actiwatch Spectrum Plus device on his or her non-dominant wrist for seven continuous days without removal. The Munich chronotype questionnaire-Japanese version (MCTQ-J) was also used to measure the midpoint of sleep in free days (MSF). Results: The final study cohort was composed of 105 participants (85.7% women) and was divided into 58 non-frail subjects, 45 pre-frail subjects, and 2 frail subjects. According to a binomial logistic regression analysis, the pre-frail individuals had a weaker grip strength (coefficient [beta], -0.18; odds ratio, 0.84; 95% confidence interval [CI], 0.76-0.93; p = .001) and a lower RA (beta, -8.78; odds ratio, 0.0002; 95% CI, 0.00-0.15; p = .01). In addition, correlation analyses also showed that the MSF was negatively associated with the RA in the pre-frail group (r = -0.30, p < .05) and positively correlated with the RA in the non-frail group (r = 0.26, p < .05); furthermore, the MSF of the pre-frail group occurred at a later time than that of the non-frail one (p = .03). Conclusion: The present study provides grounds for our proposal that pre-frailty is significantly associated with a low grip power and relative imbalance between rest and active statuses as indexed using nonparametric RAR parameters. Furthermore, elderly individuals with pre-frailty or frailty may have a later MSF time. However, these potential findings need to be validated in future research.
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Yu Kume, Megumi Tsugaruya, Shoko Inomata, Akiko Sato, Tomoe Fujita, Yoriko Nakamura
International Journal of Gerontology 13 ( 2 ) 183 - 184 2019年06月 [査読有り]
研究論文（学術雑誌） 国内共著
The aim of this study was to examine whether the multicomponent exercise program based on an independent home-training can become effective strategy for Japanese older people in a depopulated rural region. Twenty participants over 65 years old without cognitive impairment exercised for 90-min a day, once per 2 weeks for 6 months, according to education regarding an independent home-exercise. The exercise program was conducted under multitask conditions to cognition, including an aerobic exercise. Physical and cognitive measurements were carried out at baseline and after the 6-month intervention. The physical measurement consisted of four domains, and the cognitive evaluation included four domains. 12 older adults (age mean: 76.9 years, % female: 91.6%) completed the 6-month follow-up. According to statistical analyses, the walking speed was significantly faster, and the executive function also had significantly increased after the intervention. Our findings suggest that the multicomponent exercise program based on home-training can be effective for enhancements of the gait ability and the executive function for older individuals in a depopulated rural region.
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Akira Saito, Masahiko Wakasa, Minoru Kimoto, Takashi Ishikawa, Megumi Tsugaruya, Yu Kume, Kyoji Okada.
Geriatrics & Gerontology International 19 ( 1 ) 61 - 65 2019年01月 [査読有り]
研究論文（学術雑誌） 国内共著
Aim: To clarify the age-related changes in muscle elasticity or thickness of the lower extremities in older women, and to analyze their relationship with physical functions. Methods: The muscle elasticity and thickness of the rectus femoris and medial head of the gastrocnemius of 102 young women (young group) and 221 elderly women (elderly group) were measured using ultrasonography. In the elderly group, physical functions, including knee extension strength, Timed Up and Go test, single-leg standing, maximum gait speed and Four Square Step Test were also measured. Results: The elasticity of the rectus femoris and medial head of the gastrocnemius were significantly higher, but the muscle thickness of both muscles was significantly lower in the elderly group than in the young group (both P < 0.001). In the elderly group, the elasticity of the rectus femoris was significantly correlated with Timed Up and Go test, maximum gait speed and Four Square Step Test (ρ = 0.481, r = −0.387 and ρ = 0.401, respectively, all P < 0.001), and the medial head of the gastrocnemius was similar (ρ = 0.471, r = −0.489 and ρ = 0.422, respectively, all P < 0.001). The muscle thickness of the rectus femoris was significantly associated with knee extension strength (r = 0.444, P < 0.001). Conclusions: Older women showed age-related changes in high elasticity and atrophy of the rectus femoris and medial head of the gastrocnemius. The high elasticity of both muscles, not muscle thickness, was associated with dynamic balance and walking ability.
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Yuma Saito, Yu Kume, Ayuto Kodama, Kotaro Sato, Megumi Yasuba
Chronobiology International 35 ( 12 ) 1670 - 1679 2018年12月 [査読有り]
研究論文（学術雑誌） 国内共著
BACKGROUND: Limited information is available on the relationship between sleep disturbances during nighttime and the behavioral and psychological symptoms of dementia in older nursing-home residents. However, a few reports on the association between the circadian rest-activity rhythm and the behavioral and psychological symptoms of dementia in older residents have been published. The main objective of the present study was to examine the association among the circadian rest-activity rhythm, behavioral and psychological symptoms, and the cognitive function status among older individuals living in facilities. METHOD: The investigation was conducted from September 2017 to February 2018, and participants were recruited from five nursing homes in Akita prefecture, Japan, after obtaining patient agreement to participate in the study. To measure nonparametric circadian rest-activity parameters such as interdaily stability, intradaily variability, relative amplitude, mean of the least active 5-h period, and mean of the most active 10-h period, Actigraph devices were worn on the participants' nondominant wrists continuously for seven days. The score or classification of the cognitive status and the severity of the behavioral and psychological symptoms of dementia (BPSD) were assessed using the clinical dementia rating (CDR) and the dementia behavior disturbance scale (DBD), respectively. The binomial logistic regression model was applied to clarify which kinds of circadian rest-activity parameters predicted the cognitive status in nursing home residents as well as the BPSD outcome. A multi-level model was also used to examine the association between the nonparametric rest-activity parameters and the BPSD outcome explained by the cognitive status among older individuals in facilities. RESULTS: Seventy-seven participants (49 residents with dementia, and 28 residents without dementia) were included in this study. According to the binomial logistic regression analysis after adjusting for covariates, the classification of the cognitive status for older residents was associated with the DBD score (odds ratio, 1.22; 95% confidence interval [CI], 1.08, 1.38; p < 0.001), the IS (odds ratio, 0.01; 95% CI, 0.00, 1.00; p = 0.05) and the L5 (odds ratio, 0.99; 95% CI, 0.99, 1.00; p = 0.05). The results of a multi-level model also indicated that the IV at individual-level was significantly associated with the DBD score for nursing home residents, with the CDR score at cluster-level as an explanatory variable. As well, a significant association between the RA at individual level and the DBD score was observed in a multi-level model explained by the CDR score at cluster-level. CONCLUSION: Of these models, the multi-level model provided grounds for our proposal that the fragmentation or the amplitude of rest-activity parameters might be associated with the outcome of BPSD, considering the cognitive status of older individuals in different facilities. The findings offer practical insight into the prevention of BPSD and the improvement of rest-activity rhythms in rehabilitative care in nursing homes.
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Yu Kume, Tomoe Fujita, Ayako Sasaki, Saeko Kurosawa, Akiko Sato, Sachiko Uemura, Shoko Inomata, Megumi Tsugaruya, Yoriko Nakamura
Geriatrics & Gerontology International 17 ( 12 ) 2639 - 2640 2017年12月 [査読有り]
研究論文（学術雑誌） 国内共著
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Yu Kume, Sachiko Makabe, Naruemol Singha-Dong, Patama Vajamun, Hataichanok Apikomonkon, Jiranan Griffiths
Chronobiology International 34 ( 10 ) 1377 - 1387 2017年10月 [査読有り]
研究論文（学術雑誌） 国際共著
BACKGROUND: The sleep-wake cycle and the rest-activity rhythm are known to change with aging, and such changes have been implicated in higher levels of depression as well as an increased incidence of dementia. However, information supporting seasonal changes in the sleep-wake cycle, the rest-activity rhythm and quality of life in older community-dwelling people remains insufficient. The aim of the present study was to prospectively investigate seasonal effects on the sleep-wake cycle, the rest-activity rhythm and quality of life among older people living in areas of Japan or Thailand with different climate classifications. METHOD: The survey was conducted from March 2016 to May 2017, and 109 participants were recruited from Japan and Thailand: 47 older people living in Akita prefecture, Japan, and 62 older people living in Chiang Mai or Nakhon Ratchasima, Thailand. According to the Koppen-Geiger classification of Asian climates comprising tropical, desert, steppe, temperate and subarctic climates, Akita prefecture, which is located in northern Japan, is classified as a humid subarctic climate, while the Thai study areas are classified as tropical savanna. To monitor parameters of the sleep-wake cycle during nighttime (e.g. total sleep time, sleep latency, sleep efficiency, awaking time and frequency of sleep interruptions) and to calculate parameters of the rest-activity rhythm over the 24 h profile (e.g., interdaily stability, intradaily variability, relative amplitude, mean of least active 5 h period and mean of most active 10 h period), all the participants from both countries wore an Actiwatch 2 device on their nondominant wrist continuously for 7 days during each local season. The World Health Organization Quality of Life Questionnaire-BREF (WHOQOL-BREF) was also assessed during each local season. RESULTS: The final sample size was 37 older people living in Akita prefecture, Japan, and 44 older people living in Thailand; these subjects completed the data collections during each local season. The dropout rates were 21% in Japan and 29% in Thailand. The results for the Japanese subjects showed a significantly shorter sleep time with higher levels of activity during the nighttime on summer (p < 0.001) and a fragmented rest-activity rhythm over the 24 h profile on winter (p < 0.001). The older Thai participants exhibited a poor state of night sleeping year-round, and a significant relationship was observed between seasonal variations in motor activity and the social domain of WHOQOL-BREF for each Thai season (|r| = 0.4, p < 0.01). CONCLUSION: These findings provide new and important information regarding seasonal effects on the sleep-wake cycle, the rest-activity rhythm and quality of life in older community-dwelling people living in two different Asian climates. Consequently, clinical preventions targeting such seasonal variations might be useful for improving the quality of life of older Japanese and Thai individuals.
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Yu Kume, Ayuto Kodama, Kotaro Sato, Satoko Kurosawa, Takashi Ishikawa, Sachiko Ishikawa
International Psychogeriatrics 28 ( 12 ) 2001 - 2008 2016年12月 [査読有り]
研究論文（学術雑誌） 国内共著
BACKGROUND: Sleep disturbances are commonly observed in older nursing home residents, mainly in combination with dementia. However, sleep-associated circadian motor activity patterns have not been thoroughly investigated in Japanese nursing homes. The present study aimed to respectively clarify the effect of community living and the presence of dementia on sleep disturbances and interrupted activity rhythm of older nursing-home residents with or without dementia and older community-dwelling people without dementia. METHODS: Actigraph devices worn on the participants' non-dominant wrists for seven days were used to collect objective measurements of the sleep/awake status throughout the night and the circadian motor activity patterns. The presence of dementia was assessed by a trained medical doctor using the residents' records and the Clinical Dementia Rating (CDR). The functional capacity of the participants was determined using the Barthel Index (BI). RESULTS: Fifty-one older people in Akita prefecture were included in the current study, consisting of 17 residents with dementia (mean age: 82.2 years), 17 residents without dementia (84.5 years), and 17 community-dwelling people (83.6 years). The results showed that older nursing-home residents with dementia had significantly a lower rate of sleep efficiency and a longer awake time throughout the night than the other groups. Older nursing-home residents with and without dementia had more fragmented rhythm than community-dwelling people without dementia. CONCLUSION: These results provide evidence of poor sleep/awake status throughout the night and interrupted circadian activity rhythms in nursing-home residents with and without dementia. However, further studies performed according to dementia classifications are needed.