研究等業績 - 原著論文 - 久米 裕
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Mobilising Cross-Sectoral Collaboration in Creating Age-Friendly Cities: Case Studies from Akita and Manchester
Patty Doran, Sophie Yarker, Tine Buffel, Hisami Satake, Fumito Watanabe, Minoru Kimoto, Ayuto Kodama, Yu Kume, Keiko Suzuki, Sachiko Makabe, Hidetaka Ota
International Journal of Environmental Research and Public Health 22 ( 1 ) 73 2025年01月 [査読有り]
研究論文（学術雑誌） 国際共著
Developing Age-Friendly Cities and Communities (AFCCs) is an increasingly popular policy response to supporting ageing populations. AFCC programmes rely on cross-sectoral collaboration, involving partnerships among diverse stakeholders working across sectors to address shared goals. However, there remains a limited understanding of what mechanisms and strategies drive collaboration among diverse actors within age-friendly cities. To address this gap, this empirical paper draws on examples from a comparative case study across Akita (Japan) and Manchester (UK), two cities with distinct demographic profiles but both with a longstanding commitment to the age-friendly approach. Case studies were created through a range of data collection methods, namely, a review of secondary data sources, semi-structured interviews with key stakeholders, and fieldwork in each city. Key insights from the case studies relating to the mobilisation of cross-sectoral collaboration were categorised into three themes: leadership and influencing, co-production, and place-based working. These mechanisms are not mutually exclusive; collaboration building through co-production and place-based working is essential to deliver age-friendly programmes, but these mechanisms rely on leadership and influence. Therefore, it is recommended that all three mechanisms be used to effectively mobilise cross-sectoral collaborations to collectively create AFCC and support healthy ageing.
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Yu Kume, Ayuto Kodama, Sayaka Arai, Makiko Nagaoka, Akiko Sato, Akira Saito, Hidetaka Ota, Hideaki Ando
Chronobiology International ( Taylor & Francis Group ) 2024年08月 [査読有り]
研究論文（学術雑誌） 国内共著
Our study, conducted between April 2022 and January 2024, was aimed at clarifying components of the rest-activity rhythm (RAR) involved in improvement of social frailty state before or after a 3-month multi-component exercise intervention in the elderly. Participants were recruited from the general population in Akita prefecture, Japan. We administered a four-item social frailty screening questionnaire to classify the severity of social frailty in each participant before and after the 3-month intervention. The RAR parameters were measured on an Actiwatch Spectrum Plus device worn by the subjects for 7 continuous days. As the final sample, 65 participants classified into the improved/maintained group (n = 36) or the deteriorated group (n = 29) according to the change in the social frailty classification after the intervention were included in the analysis. The results of a binomial logistic regression analysis showed significantly higher values of interdaily stability (IS) and usual walking speed at the post-test after the intervention. Based on our findings, we propose that stability of the rest-activity rhythm related to synchronization with external stimuli (such as social effect and physical activity) might have clinical impact on improvement of social frailty state in elderly community-dwellers.
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ウェアラブル・ノンウェアラブルデバイスを活用した生活リズム評価とその応用
久米 裕
リハビリテーション・エンジニアリング ( 一般社団法人 日本リハビリテーション工学協会 ) 39 ( 2 ) 75 - 79 2024年05月 [招待有り]
研究論文（学術雑誌） 単著
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Tatsunori Shimizu, Ayuto Kodama,Yu Kume, Masahiro Iwakura,Katsuya Iijima, Hidetaka Ota
International journal of environmental research and public health ( MDPI ) 21 ( 5 ) 611 2024年05月 [査読有り]
研究論文（学術雑誌） 単著
Background: Frailty leads to vulnerability to stress, impaired daily functioning, and an increased need for care. Frailty is considered reversible, and it is crucial to detect the risk of frailty early and investigate factors that may delay its progression. Objectives: To identify tests that can explain frailty risk and compare the situation of local residents with and without frailty support. Methods: Participants were recruited in two ways: through public advertisements in Akita City (open recruitment group) and through invites from frailty supporters in their immediate communities (community-based group). We examined the differences in frailty risk and oral, motor, and social functions between the two groups and identified factors associated with frailty risk in both groups. Results: The community-based group exhibited a lower risk of frailty than the open recruitment group despite having more older members on average. Additionally, the community-based group demonstrated better social functioning than the open-recruitment group. Furthermore, factors such as oral diadochokinesis (ODK), one-leg stand test (OLS), and grip strength (GS) showed significant association with frailty risk. Conclusion: The ODK, OLS, and GS were identified as factors explaining frailty risk, and Frailty Supporters may reduce the risk of frailty.
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Kodama A, Kume Y, Watanabe N, Iino Y, Imamura S, Ota H
Clinical Case Reports International 7 ( 1 ) 1592 2023年08月 [査読有り]
研究論文（学術雑誌） 国内共著
Background: In recent years, theatrical approach has been reported to improve the health promotion of the older adults. Our study aimed to clarify the effects of a theater program intervention on the cognitive, physical, and social functions of older adults living in the community. Methods: Of the 43 participants, they were assigned to the control group and theatre intervention group, each group received intervention for three months. We compared participants' pre-test and post-test physical, cognitive, and social functioning results of the program. Moreover, the amount of change in physical and cognitive items in the control and theater groups was compared. Results: A comparison of pre-test and post-test results showed significant improvements in the UWS and physical and social frailty for the control and theatre group. Furthermore, amount of the change in UWS in the theatre group was significantly higher than in the control group. Conclusion: In conclusion, we have shown that a theatrical intervention can be as effective as the multicomponent exercise recommended, the theatrical approach was suggested to be effective in improving social frailty.
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Effect of a multicomponent programme based on reality orientation therapy on the physical performance and cognitive function of elderly community-dwellers: a quasi-experimental study
Yu Kume, Makiko Nagaoka, Sachiko Uemura, Akira Saito, Megumi Tsugaruya, Tomoe Fujita, Yoshino Terui, Ayuto Kodama, Akiko Sato, Hidetaka Ota, Hideaki Ando
Psychogeriatrics ( Wiley ) 23 ( 5 ) 847 - 855 2023年07月 [査読有り]
研究論文（学術雑誌） 国内共著
Background:Effects of a multicomponent exercise programme have an impact on the physical, cognitive, and psychological domains in elderly community-dwellers. However, some individuals aged 65 years or more have not shown positive effects after the intervention as reported in similar research. The objective of this quasi-experimental study was to clarify the effectiveness of a multicomponent programme based on reality orientation therapy (ROT) on the physical performance, cognitive ability, and psychological state in the elderly.
Method:Participants were recruited from the general public in 20 areas of Akita Prefecture, Japan, and they took part in each exercise programme for 90 min a day, once every 2 weeks, for 3 months, according to the group classification using cluster randomization into 20 cohorts in Akita. Physical, cognitive, and geriatric depression assessments were performed at baseline and after the 3-month intervention in both the ROT-based intervention group and the control group.
Result:The final samples for analysis consisted of 31 participants in the control group and 30 participants in the intervention group. The results of the statistical analysis comparing the two groups showed that the 5-repetition sit-to-stand test was performed significantly faster (P < 0.05) and that the results of the word list memory (WM) test and the Symbol Digit Substitution Task also had significantly improved (P < 0.05) after the intervention in both groups. The WM score did not show an interactive effect between the group and time factors, but it had a significant main effect on time in both groups (P < 0.05).
Conclusion:The results of our quasi-experimental study indicated that the multicomponent programme based on the ROT would be as effective as the original multicomponent programme combined with aerobic exercise and cognitive tasks, as highlighted in the WM. -
24-Hour Rest-Activity Rhythm in Middle-Aged and Older Persons with Depression
Masaki Hayashi,Masahiro Takeshima,Tomoko Hosoya, Yu Kume
International journal of environmetal research and public health 20 ( 7 ) 5275 2023年03月 [査読有り]
研究論文（学術雑誌） 国内共著
Changes in rest or active states were clinically observed in persons with depression. However, the association between symptoms of depression and 24 h rest-activity rhythm (RAR) components that can be measured using wearable devices was not clarified. This preliminary cross-sectional study aimed to clarify the 24 h RAR components associated with symptoms of depression in middle-aged and older persons. Participants were recruited from among inpatients and outpatients requiring medical treatment at Akita University Hospital for the group with depression and from among healthy volunteers living in Akita prefecture, Japan, for the healthy control group. To assess RAR parameters including inter-daily stability (IS), intra-daily variability (IV), relative amplitude (RA), and average physical activity level for the most active 10 h span (M10) or for the least active 5 h span (L5), all the participants were instructed to wear an Actiwatch Spectrum Plus device on their non-dominant wrist for seven days. Twenty-nine persons with depression and 30 controls were included in the analysis. The results of a binomial regression analysis showed that symptoms of depression were significantly associated with a high IS value (odds ratio [OR], 1.20; 95% confidence interval [95% CI], 1.01–1.44; p = 0.04) and a low M10 value (OR, 0.85; 95% CI, 0.74–0.96; p = 0.01). Our findings suggest potential components of 24 h RAR are associated with depression.
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Discharge Planning and Challenges for Patients With Asian Lifestyles Following Total Hip Arthroplasty: National Survey Design in Japan
Sachiko Makabe, Yu Kume, Yuko Akagawa, Masahiko Wakasa, Kaina Ito, Hiroaki Kijima
Orthopaedic nursing / National Association of Orthopaedic Nurses 42 ( 2 ) 115 - 122 2023年03月 [査読有り]
研究論文（学術雑誌） 国内共著
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認知症と生活リズム
久米 裕
日本老年療法学会誌 ( 一般社団法人 日本老年療法学会 ) 2 ( 0 ) 1 - 6 2023年02月 [招待有り]
研究論文（学術雑誌） 単著
<p>睡眠，食事，仕事，余暇活動を含む一日を通した生活リズムを整えることは，人の健康を保つために周知の事実である。認知症高齢者に観察される夜間せん妄や徘徊などの不穏行動には，生活リズムの障害が背景にあると指摘されており，毎日の生活にリズムをもたせ，そのリズムに沿って休息をとり活動することは，認知症の行動・心理症状（Behavioral and Psychological Symptoms of Dementia, BPSD）を軽減させるのみならず，心身の健康を維持または改善するために重要である。しかしながら，日々の活動や休息を自力では管理が難しい認知症高齢者に対して，周囲が認知症における生活リズムの特徴を捉えて支援しなければならない。近年のInformation and Communication Technology（ICT）が応用されたウェアラブル技術は，認知症の生活リズムをより定量的に把握する上で有用であることがわかってきた。特に，腕時計型ウェアラブル端末Actigraphを応用した国内外の研究知見は，認知症における休息・活動リズム（Rest-Activity Rhythm）の特徴を明らかにしている。認知症の生活リズムを適切に理解することによって，専門職による治療的介入の発展につながるだけでなく，対象者本人とその関係者の健康を保つ一助となることを期待する。</p>
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Yu Kume, Ayuto Kodama
Chronobiology International ( Taylor & Francis ) 39 ( 12 ) 1665 - 1673 2022年10月 [査読有り]
研究論文（学術雑誌） 国内共著
Reversibility of frailty in the elderly has been discussed comprehensively and but association between recovery of frail state and rest-activity rhythm (RAR) patterns remains unclear. The aim of the current study was to examine a predictor of RAR patterns at the baseline against change of frail state after the intervention in the elderly community-dwellers. This study was performed during Covid-19 pandemic, at the period from April in 2020 to March in 2022. Participants were publicly recruited from senior’s exercise program hosted by Akita city or Yurihonjo city. The revised Japanese version of the Cardiovascular Health Study criteria (revised J-CHS criteria) was used to assess frail state in each participant before and after the 6-month intervention. To measure the nonparametric RAR parameters consisting of interdaily stability (IS), intra-daily variability (IV), relative amplitude (RA) and average physical activity for the most active 10-h span (M10) or for the least active 5-h span (L5) over the average 24-h profile, an Actiwatch Spectrum Plus device was worn on each participant’s non-dominant wrist for seven continuous days. The final samples were 75 participants except for persons with uncompleted data, classified into the improved group (n = 12), the maintained group (n = 53) and the deteriorated group (n = 10) according to frail alteration after the six-month intervention. As a result of the multinomial logistic regression analysis with the reference of the maintained group, the improvement of frail state associated with a low value of IS and total night-sleep time at the baseline, and M10 and L5 at the initial time were also able to predict worsening of frail state after the six-months intervention. A result of this follow-up study provides grounds for our proposal that alterations of RAR patterns in the elderly could be observed in association with recovery or worsening of frail state after the intervention. The potential finding, however, warrants further longitudinal investigation.
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A Pilot Survey: Oral Function as One of the Risk Factors for Physical Frailty
Ayuto Kodama, Yu Kume, Masahiro Iwakura, Katsuya Iijima, Hidetaka Ota
International journal of environmental research and public health 19 ( 10 ) 6136 2022年05月 [査読有り]
研究論文（学術雑誌） 国内共著
Background: The aim of this study was to examine the association of the multiple facets of oral, motor, and social functions in community-dwelling older adults, to identify factors that might influence the risk of frailty. Methods: Of the 82 participants included in the study, 39 (5 males and 34 females) were young-old adults, with an average age of 70.5 ± 2.8 years, and 43 (14 males and 29 females) were old-old adults, with an average age of 78.7 ± 2.9 years. We assessed the risk factors for frailty among oral, motor, and social functions. Results: Statistical analysis showed a significant difference in the oral diadochokinesis between the groups (p = 0.006). According to the Spearman correlation analysis, a significant association was observed with age and oral diadochokinesis (rs = −0.262, p = 0.018), and social support (rs = −0.219, p = 0.049). Moreover, binomial logistic regression analysis revealed a significant association of frailty with the occlusal force (odds ratio, 0.031; 95% confidence interval (95% CI), 0.002–0.430; p = 0.010), General Oral Health Index (odds ratio, 0.930; 95% CI, 0.867–0.999, p = 0.046), and availability of social support (odds ratio, 0.803, 95% CI, 0.690–0.934, p = 0.004). Conclusions: To prevent frailty at an early stage, assessments of oral functions, and also that of the availability of social support, are important.
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Evaluating a frailty education program implemented through barbershops/salons in Japan: A preliminary study
Sachiko Makabe, Katsuya Fujiwara, Yu Kume, Midori Kaga, Nobuko Munemura, Shoko Kemuyama, Kazutaka Mitobe
SN Social Sciences 2 55 2022年04月 [査読有り]
研究論文（学術雑誌） 国内共著
Although frailty has detrimental physical and psychological effects on elderly people, it is potentially reversible. In this study, we aim to evaluate the effectiveness of a pilot frailty education program implemented through barbershops/salons in Japan. In January 2018, we selected five barbershops/salons in Japan where customers were educated on frailty, which was classified as “normal,” “prefrail,” and “frail.” We developed a web-based assessment tool to reduce the workload for barbers/stylists. Participants included 45 customers (82% women), with a median (interquartile range) age of 53.0 (47.5–57.5) years, and a mean ± SD BMI of 22.3 ± 2.7. Frailty scores indicated that 35% of participants were normal, 58% were prefrail, and 7% were frail. Frailty status scores reflected no significant differences after the intervention. Customers classified as frail were advised to visit the regional comprehensive support center for further professional frailty assessment. Participants, especially those aged over 65 years, found the web-based assessment difficult to use. In conclusion, a frailty education program implemented through barbershops/salons is possible because barbers/stylists can provide information on and assessment of frailty. Females and highly educated customers are more likely to be interested in participating. Nevertheless, a simple intervention is essential to expand the program nationwide.
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Pilot experimental study; Effect of environmental stimulation consisting of sound with high- frequency components, aromas, and light exposure from organic light-emitting diodes (OLEDs) toward rest-activity rhythm in institutionalized patients with dementia
Yu Kume, Motoshi Tanaka, Katsutoshi Saito
Annals of Alzheimer's and Dementia Care 6 ( 1 ) 19 - 25 2022年04月 [査読有り]
研究論文（学術雑誌） 国内共著
Environmental stimulation is expected to have a positive impact on night sleep, psychological or functional states in dementia. The objective of this pilot study was to examine the effects of environmental stimulation consisting of sounds with high-frequency components, aromas, and light exposure from organic light-emitting diodes (OLEDs) to create comfortable living spaces for persons with dementia. Subjects (n =6) were recruited from elderly persons admitted to a single nursing home in Akita Prefecture, Japan, between August and September 2020. The night-time sleep state, the rest-activity rhythm, and the light exposure of the subjects living in environments with or without environmental stimulation consisting of sounds with high-frequency components, aromas, and light exposure from OLEDs were measured for 46.3 consecutive days using wrist activate devices under free-living conditions in a nursing home. In a period of environmental stimulation depending on the presence or absence of sounds with high-frequency components, reduction of the fragmented rest-activity rhythms was signifi cantly observed in the subjects (p < 0.05). However, changes in the night-time sleep state had no signifi cant difference during the study period. In conclusion, these preliminary results suggest that future examinations are warranted not only to inform effective or comfortable living conditions for elderly persons with dementia but also to improve the disruption of rest-activity rhythms in persons with dementia.
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Word Memory was Related to Walking Speed Change in a Pre-Frailty One-Year Follow-Up Survey
Ayuto Kodama, Yu Kume, Tomoko Takahashi, Tsuyoshi Ono, Hidetaka Ota
International Journal of Gerontology ( Taiwan Society of Geriatric Emergency and Critical Care Medicine (TSGECM) ) 16 ( 2 ) 153 - 154 2022年04月 [査読有り]
研究論文（学術雑誌） 国内共著
The aim of this study was to clarify the association between physical and cognitive functions in older adults who converted from a robust health state to a pre-frailty in a one-year follow-up survey. A total of 82 participants were enrolled and classified by the Fried frailty index. The physical and cognitive functions of the participants were evaluated. Complete data samples were available for 35 participants, including 11 who remained robust and 24 who converted to a pre-frailty during the follow-up. Multiple regression analysis was performed to examine the association between the change of the usual walking speed (UWS) (± m/s) during the one-year observation period and the cognitive functions converted to a pre-frailty after one-year. The results revealed a significant association between the change of the UWS and the score for word list memory (WM) (p = 0.026). Our results suggest that decline of WM with much slower UWS might be associated with conversion to a pre-frailty.
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The Effect of Deep Micro Vibrotactile Stimulation on Cognitive Function of Mild Cognitive Impairment and Mild Dementia
Ayuto Kodama, Yasuhiro Suzuki, Kazuki Sakuraba,Yu Kume, Hidetaka Ota
International Journal of Environmental Research and Public Health 19 ( 7 ) 3803 2022年03月 [査読有り]
研究論文（学術雑誌） 国内共著
Background: The purpose of this study was to clarify the effect of Deep Micro Vibrotactile (DMV) stimulation on the cognitive functions in elderly people with mild cognitive impairment or mild dementia. Methods: A total of 35 participants with dementia from three nursing homes, who had completed treatment with DMV stimulation at 15–40 Hz (hereinafter, 15–40 Hz DMV stimulation) for a month were recruited for this study. The subjects had received continuous 15–40 Hz DMV stimulation for 24 h a day for 1 month. We assessed the effect of the treatment on the cognitive functions (by the word list memory (WM) test, trail making test-part A (TMT-A) and part B (TMT-B), and symbol digit substitution task (SDST)) and physical functions (grip strength (GS) and usual walking speed (UWS)), by comparing the results at the baseline and after the 1-month intervention (DMV stimulation). Results: The results revealed that the performances in the WM test (p < 0.05), TMT-B (p < 0.05), and SDST (p < 0.01) improved significantly after the intervention. Conclusion: Our findings suggest that 15–40 Hz DMV stimulation is might be effective for improving the cognitive functions in elderly people with dementia. Furthermore, our novel findings showed the different effectiveness of the treatment depending on the stage of cognitive impairments.
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Ayuto Kodama, Kaoru Sugawara, Yu Kume, Tomoko Takahashi, Tsuyoshi Ono, Hidetaka Ota.
Nihon Ronen Igakkai zasshi. Japanese journal of geriatrics ( Nihon Ronen Igakkai zasshi. Japanese journal of geriatrics ) 59 ( 1 ) 58 - 66 2022年03月 [査読有り]
研究論文（学術雑誌）
The present study is assessed the effects of COVID-19 on the mental and physical function after the declaration of an emergency situation, which included the request that residents refrain from going out, in order to prevent the spread of COVID-19 infection. The investigation was conducted from 2019 to 2020. Our samples consisted of 506 older adults (332 people in 2019 and 174 people in 2020), whose physical, cognitive, depression, and independence in daily and social activities were measured annually. Furthermore, a questionnaire survey (COVID-19 questionnaire) on the impact of the spread of COVID-19 infection on respondents' daily lives (reduction in social interaction, going out, exercise, and sleep time) was conducted among participants in 2020. According to a statistical analysis, the UWS (Usual Walking Speed) was significantly faster in 2020 than it had been in 2019 (p<0.000). However, no significant differences were found in other items. A correlation analysis, revealed a significant association between the reduction in sleep time and GDS-15 (Geriatric Depression Scale) score (r=0.200, p=0.019) and between the COVID-19 questionnaire total score and body mass index (r=0.282, p=0.001).These results suggest that the decline in the physical and mental function might not have been evident in older adults in Akita Prefecture, where the number of infected people is small, although a more detailed long-term follow-up is needed. Even in such areas, there might be a significant relationship between depression and sleep or between changes in daily life due to self-imposed restraint and obesity as an effect of self-imposed restraint among older adults.
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Yu Kume, Ayuto Kodama, Tomoko Takahashi, Sangyoon Lee, Hyuma Makizako, Tsuyosi Ono, Hiroyuki Shimada, Hidetaka Ota.
Geriatrics & Gerontology International 22 ( 2 ) 145 - 151 2022年02月 [査読有り]
研究論文（学術雑誌） 国内共著
Aim: To clarify prevalence of social frailty among older adults living in a rural Japanese community, and factors associated with social frailty status. Methods: In total, 322 adults aged ≥65 years living in a Japanese rural community took part in the study from 2018 to 2020. Social frailty was defined as deficiencies of: (i) living alone; (ii) talking with someone every day; (iii) feeling helpful to friends or family; (iv) going out less frequently compared with last year; and (v) visiting friends sometimes. Social frail status was categorized as robust (0), social prefrail (1), and social frail (≥2), according to the summated score of Makizako's criteria. Multiple logistic regression analysis was applied to clarify factors associated with social frailty status. Results: Final samples were classified into 68 persons with social frailty, 98 persons with social prefrailty and 147 persons as robust. We observed the prevalence of social frailty (21.7%) and social prefrailty (31.3%) and the GDS-15 had significantly high scores in the social frail groups. Social frailty was significantly associated with the GDS-15 score (odds ratio, 1.33; 95% CI, 1.19–1.49) and TMT-A (odds ratio, 1.04; 95% CI, 1.01–1.08) and GDS-15 (odds ratio, 1.13; 95% CI, 1.03–1.26) were extracted as independent variables of social prefrail status, with adjustment for demographics, polypharmacy and lifestyle-related diseases. Conclusions: Our results suggest that social frailty tends to be increasing gradually in a Japanese rural area, and social prefrailty might be potentially associated with attentional function, as well as the GDS-15 score.
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Yuta Tanaka, Yu Kume, Ayuto Kodama.
Traffic Injury Prevention 23 ( 1 ) 57 - 60 2022年01月 [査読有り]
研究論文（学術雑誌） 国内共著
Objective: An increase in older drivers has been widely recognized in Japan; accordingly, screening to prevent traffic accidents is a crucial issue for safe driving. As a preliminary study, we examined the association between on-road driving performance and cognition or physical performance in older individuals. Methods: The survey was conducted in 2020, and the participants were recruited in Katagami City, Akita, Japan. The Road Test was used to assess on-road driving performance. The physical assessment comprised the usual walking speed (UWS) and grip strength (GS), and the cognitive evaluation consisted of the National Center for Geriatrics and Gerontology Functional Assessment Tool (NCGG-FAT) and the Japanese version of Stroke Drivers’ Screening Assessment (J-SDSA). A multiple regression model was also applied to examine the association between on-road driving performance and the physical items or cognitive domains of the NCGG-FAT and the J-SDSA in older individuals. Results: Twenty-one participants (mean age ± standard deviation [SD], 77.0 ± 5.5 years) were included in this study. A correlation analysis showed that the on-road test score was correlated with performances on the UWS (r = 0.53, p =.002), the word list memory (WM) test (r = 0.44, p =.046), the trail-making test-A (TMT-A) (r = −0.44, p =.048), the SDSA dot cancelation (DC) test (r = −0.63, p =.002), and the SDSA squares matrix compass test (SM) (r = 0.54, p =.048). According to a stepwise linear regression, the on-road test score was associated with the UWS (β = −0.01, p =.003) and the SDSA DC (β = 4.89, p =.01), with an adjusted R 2 = 0.54. Conclusions: The results of the study suggested that the UWS and sustainable attention might be potential factors influencing on-road driving performance. Our preliminary findings warrant further investigation.
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Impact of COVID-19 Pandemic Exacerbation of Depressive Symptoms for Social Frailty from the ORANGE Registry
Ayuto Kodama,Yu Kume,Sangyoon Lee,Hyuma Makizako,Hiroyuki Shimada,Tomoko Takahashi,Tsuyoshi Ono, Hidetaka Ota
International Journal of Environmental Research and Public Health 19 ( 2 ) 986 2022年01月 [査読有り]
研究論文（学術雑誌） 国内共著
Background: Recent longitudinal studies have reported proportion of frailty transition in older individuals during the COVID-19 pandemic. Our study aimed at clarifying the impact of social frailty in community-dwelling older adults during the COVID-19 pandemic and at identifying factors that can predict transition to social frailty. Methods: We performed this study from 2019 (before declaration of the state of emergency over the rising number of COVID-19 cases) to 2020 (after declaration of the emergency). We applied Makizako’s social frail index to our study subjects at the baseline and classified into robust, social prefrailty, and social frailty groups. Multiple logistic regression analysis was performed using robust, social prefrailty, or social frailty status as dependent variable. Results: Analysis by the Kruskal–Wallis test revealed significant differences in the score on the GDS-15 among the robust, social prefrailty, and social frailty groups (p < 0.05). Furthermore, multiple regression analysis identified a significant association between the social frailty status and the score on GDS-15 (odds ratio, 1.57; 95% confidence interval (95% CI), 1.15–2.13; p = 0.001). Conclusion: The increase in the rate of transition of elderly individuals to the social frailty group could have been related to the implementation of the stay-at-home order as part of the countermeasures for COVID-19. Furthermore, the increased prevalence of depressive symptoms associated with the stay-at-home order could also have influenced the increase in the prevalence of social frailty during the COVID-19 pandemic.
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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.
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Spatial compatibility and affordance compatibility in patients with chronic schizophrenia
Yu Kume, Fumiyasu Sato, Yuya Hiraoka, Shingo Suzuki, Yositsugu Niyama
Asian Journal of Psychiatry 24 33 - 40 2016年12月 [査読有り]
研究論文（学術雑誌） 国内共著
A deterioration in information-processing performance is commonly recognized in patients with chronic schizophrenia. Although the enhancement of cognitive skills in patients with schizophrenia is important, the types of external stimuli that influence performance have not received much attention. The aim of present study was to clarify the effects of spatial and affordance compatibility in patients with schizophrenia, compared with those in healthy people. The subjects (25 patients with schizophrenia and 25 healthy controls) participated in two experiment examining the effects of the spatial location of stimuli and the action-relevance of objects. The results showed that the effect of spatial compatibility was similar in both the patients and the controls, whereas the influence of action-relevant objects was not highlighted in either patients with chronic schizophrenia or healthy controls. These findings provide important evidence of a normal spatial compatibility effect in patients with chronic schizophrenia. However, further research examining the affordance compatibility effect is needed, taking into consideration the symptomatology and the severity of the social functioning level in patients with schizophrenia.
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Ayuto Kodama, Yu Kume, Megumi Tsugaruya, Takashi Ishikawa
Chronobiology International 33 ( 8 ) 1056 - 1063 2016年07月 [査読有り]
研究論文（学術雑誌） 国内共著
BACKGROUND: The circadian rhythm in older adults is commonly known to change with a decrease in physical activity. However, the association between circadian rhythm metrics and physical activity remains unclear. The objective of this study was to examine circadian activity patterns in older people with and without dementia and to determine the amount of physical activity conducive to a good circadian measurement. METHOD: Circadian parameters were collected from 117 older community-dwelling people (66 subjects without dementia and 52 subjects with dementia); the parameters were measured continuously using actigraphy for 7 days. A receiver operating characteristic (ROC) curve was applied to determine reference values for the circadian rhythm parameters, consisting of interdaily stability (IS), intradaily variability (IV), and relative amplitude (RA), in older subjects. RESULTS: The ROC curve revealed reference values of 0.55 for IS, 1.10 for IV, and 0.82 for RA. In addition, as a result of the ROC curve in the moderate-to-vigorous physical Activity (MVPA) conducive to the reference value of the Non-parametric Circadian Rhythm Analysis per day, the optimal reference values were 51 minutes for IV and 55 minutes for RA. However, the IS had no classification accuracy. CONCLUSIONS: Our results demonstrated the reference values derived from the circadian parameters of older Japanese population with or without dementia. Also, we determined the MVPA conducive to a good circadian rest-active pattern. This reference value for physical activity conducive to a good circadian rhythm might be useful for developing a new index for health promotion in the older community-dwelling population.
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入院および地域で生活している統合失調症患者の生活リズムと認知機能の特徴～Actiwatch2とBACS-Jによる定量的評価を用いた検討～
久米裕, 雄鹿賢哉, 鈴木新吾, 谷本歩, 金澤洋輝
作業療法 34 ( 2 ) 169 - 179 2015年04月 [査読有り]
研究論文（学術雑誌） 国内共著
要旨：1年以上の入院生活および地域の中で生活している統合失調症患者22名（入院群11名，地域群11名）を対象に，腕時計型加速度計Actiwatch2（以下，AW2）による生活リズム評価と，統合失調症認知機能簡易評価尺度日本語版（以下，BACS-J）による認知機能評価を用いて，異なる環境下で生活する統合失調症患者の特性について比較・検討した．入院群は認知機能の著しい低下を示し，地域群は生活リズムの不安定さが認められた．主観的な評価に加え，AW2とBACS-Jは地域生活支援における精神科作業療法の効果の検証において有用な評価法になると考える．
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Yu Kume, Takio Sugita, Kenya Oga, Kai Kagami, Hitomi Igarashi
International Psychogeriatrics 27 ( 1 ) 135 - 143 2015年01月 [査読有り]
研究論文（学術雑誌） 国内共著
ABSTRACT Background: Irregular circadian rhythm and cognitive impairment are frequently observed in patients with chronic schizophrenia. However, their effects in different living environments or with aging remain unclear. The aim of this study was to clarify the characteristics of circadian rhythm and cognition function in the patients with chronic schizophrenia. METHODS: This report described data collected using continuous wrist-active monitoring in real-life settings for seven days and the Brief Assessment of Cognition in Schizophrenia Japanese Version (BACS-J) from 10 inpatients with chronic schizophrenia, 10 outpatients with chronic schizophrenia, and 15 healthy elderly people. The Global Assessment of Functioning (GAF) Scale was used to measure the social functioning in the patients with chronic schizophrenia. RESULTS: The outpatients with chronic schizophrenia exhibited highly interrupted circadian patterns in terms of stability and the fragmentation of activity (p < 0.05) as indexed according to Interdaily Stability (IS) and Intradaily Variability (IV). The inpatients with chronic schizophrenia indicated the most stable rhythm (p < 0.05) and inactive state (p = 0.001) among the groups. Also, the inpatients with chronic schizophrenia showed poorer cognitive functioning with Z-scores of subtests except digit sequencing (p < 0.01). According to stepwise linear regression analysis, the motor speed of BACS-J and IS of circadian parameters were the most powerful variables to predict the GAF in patients with chronic schizophrenia. CONCLUSIONS: The characteristics of circadian rhythm and cognition function in the inpatients with chronic schizophrenia appear distinct from those in the outpatients and the healthy elderly people. Circadian rhythm and cognition function in the patients with chronic schizophrenia may, in part, be affected by different living environments.
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久米裕,石川隆志,佐竹將宏,水戸部一孝
ヘルスプロモーション・リサーチ 7 ( 1 ) 28 - 35 2014年12月 [査読有り]
研究論文（学術雑誌） 国内共著
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秋田県美郷町の湧水についての住民意識調査－アンケートの定量的・定性的分析から－
湯浅孝男, 高橋恵一, 久米裕, 石川隆志
秋田県公衆衛生学雑誌 ( 秋田県公衆衛生学会 ) 11 ( 1 ) 51 - 56 2013年12月 [査読有り]
研究論文（学術雑誌） 国内共著
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入院から地域生活へ移行するアルコール性認知症のクライアントに対する人間作業モデルアプローチの有用性．
久米裕,石井良和
作業行動研究会 17 ( 1 ) 46 - 55 2013年06月 [査読有り]
研究論文（学術雑誌） 国内共著
アルコール依存症による認知機能の低下を示したクライアントに対し、人間作業モデル(Model of Human Occupation、以下、MOHO)の評価ツールである「作業に関する自己評価・改訂版(Occupational Self Assessment,Revised.以下、OSA-II)」を用いて、入院時から在宅による地域生活まで協業によるアプローチを実施した。OSA-IIによる協業により表出された意志と役割を踏まえたプログラムと生活環境の調整により、作業機能状態が改善し、在宅生活が実現した。地域支援にOSA-IIを用いた協業によるアプローチを継続することで、クライアントが生活を見直す機会となり、MOHOによるアプローチが入院生活から地域生活の支援に有用であることが示唆された。(著者抄録)