ミラーニューロンから認知症患者の食行動関連障害を解明する

2015 Fiscal Year Annual Research Report

• Project/Area Number: 25463282
• Research Institution: National Center for Geriatrics and Gerontology
• Principal Investigator: 渡邊 裕 国立研究開発法人国立長寿医療研究センター, 口腔疾患研究部, 室長 (30297361)
• Project Period (FY): 2013-04-01 – 2016-03-31
• Keywords: 認知症 / 食行動関連障害 / 孤食 / ミラーニューロンシステム / 栄養状態 / 食欲

Outline of Annual Research Achievements

本研究の目的は、認知症に伴う食行動関連障害への対応について検証することである。そこで平成25年度から平成27年度まで、国立長寿医療研究センターもの忘れ外来受診中の患者を対象に孤食と食行動関連障害の関係について横断的、縦断的にデータを収集して検討を行った。また、平成26年度からは軽度認知障害者を対象に各種脳機能計測装置を用いて、脳の解剖的変化、ミラーニューロンと認知機能に関連した脳機能の状態を包括的に検索した。さらに平成27年度からは軽度認知障害者に対して孤食の制限と嚥下運動に関するミラーニューロンシステムを賦活するプログラムの提供が、食行動関連障害を抑制する可能性について検討を行った。また、認知症病型別に低栄養リスクを増大させる要因に関して食行動関連障害を中心に検討した。
孤食と食行動関連障害の関係については平成25年9月から平成28年3月までの間に国立長寿医療研究センターのもの忘れ外来を受診した延べ3500名の患者（1年後の2回目の評価を行った軽度認知機能障害者300名を含む）を対象として、基本情報、認知症の原因疾患、認知機能、うつ傾向、栄養状態、Barthel Index、Vitality Index、食欲など食行動関連障害に影響する因子を調査し、孤食が食行動関連障害の発現にどの程度影響しているかを検討した。
対象者の認知症病型別内訳は診断が確定しているものでアルツハイマー型1309名、軽度認知機能障害506名、脳血管障害型237名、レビー小体型157名であった。横断的な分析の結果、孤食に関しては有意な結果は得られなかったが、アルツハイマー型認知症において食行動関連障害のうち、食事の中断が低栄養リスクに有意に関連していることが明らかになった。
軽度認知障害者の脳機能計測と孤食の制限と嚥下に関するミラーニューロンシステムを賦活するためのプログラムによる介入調査については現在分析中である。

Research Products

• [Journal Article] The need and availability of dental services for terminally ill cancer patients: a nationwide survey in Japan. (2016)
  • Author(s): Ohno T, Morita T, Tamura F, Hirano H, Watanabe Y, Kikutani T.
  • Journal Title: Support Care Cancer. Volume: 24 Pages: 19-22
  • DOI: 10.1007/s00520-015-2734-5.
  • Peer Reviewed
• [Journal Article] An examination of factors related to aspiration and silent aspiration in older adults requiring long-term care in rural Japan. (2016)
  • Author(s): Sakai K, Hirano H, Watanabe Y, Tohara H, Sato E, Sato K, Katakura A.
  • Journal Title: J Oral Rehabil. Volume: 43 Pages: 103-10
  • DOI: 10.1111/joor.12349.
  • Peer Reviewed
• [Journal Article] Factors associated with the need of older adults for oral hygiene management by dental professionals. (2016)
  • Author(s): Morishita S, Watanabe Y, Ohara Y, Edahiro A, Sato E, Suga T, Hirano H.
  • Journal Title: Geriatr Gerontol Int. Volume: - Pages: -
  • DOI: 10.1111/ggi.12585.
  • Peer Reviewed
• [Journal Article] Relationship between Skeletal Muscle Mass and Swallowing Function in Patients with Alzheimer’s Disease. (2016)
  • Author(s): Takagi D, Hirano H, Watanabe Y, Edahiro A, Ohara Y, Yoshida H, Kim H, Murakami K, Hironaka S.
  • Journal Title: Geriatr Gerontol Int. Volume: - Pages: -
  • Peer Reviewed
• [Journal Article] Sarcopenia: Prevalence and associated factors based on different suggested definitions in community-dwelling older adults. (2016)
  • Author(s): Kim H, Hirano H, Edahiro A, Ohara Y, Watanabe Y, Kojima N, Kim M, Hosoi E,Yoshida Y, Yoshida H, Shinkai S.
  • Journal Title: Geriatr Gerontol Int. Volume: 16 Pages: 110-22
  • DOI: 10.1111/ggi.12723.
  • Peer Reviewed
• [Journal Article] Relationship between chewing ability and sarcopenia in Japanese community-dwelling older adults. (2015)
  • Author(s): Murakami M, Hirano H, Watanabe Y, Sakai K, Kim H, Katakura A.
  • Journal Title: Geriatr Gerontol Int. Volume: 15 Pages: 1007-12
  • DOI: 10.1111/ggi.12399.
  • Peer Reviewed
• [Journal Article] Factors associated with self-rated oral health among community-dwelling older Japanese (2015)
  • Author(s): Ohara Y, Hirano H, Watanabe Y, Obuchi S, Yoshida H, Fujiwara Y, Ihara K, Kawai H, Mataki S
  • Journal Title: Geriatr Gerontol Int. Volume: 15 Pages: 755-61
  • DOI: 10.1111/ggi.12345.
  • Peer Reviewed
• [Journal Article] Relationship between swallowing function and the skeletal muscle mass of elderly persons requiring long-term care. (2015)
  • Author(s): Murakami K, Hirano H, Watanabe Y, Edahiro A, Ohara Y, Yoshida H, Kim H, Takagi D, Hironaka S.
  • Journal Title: Geriatr Gerontol Int. Volume: 15 Pages: 1185-92
  • DOI: 10.1111/ggi.12572.
  • Peer Reviewed / Open Access
• [Journal Article] 認知症グループホーム入居高齢者における認知症重症度と口腔機能および栄養状態の関連 (2015)
  • Author(s): 小原由紀, 高城大輔, 枝広あや子, 森下志穂, 渡邊 裕,平野浩彦
  • Journal Title: 日衛学誌 Volume: 9 Pages: 69-79
  • Peer Reviewed
• [Journal Article] オーラル・フレイルとは (2015)
  • Author(s): 渡邊 裕
  • Journal Title: 臨床栄養 Volume: 127 Pages: 742-743
• [Presentation] 認知症患者の食欲に影響を与える要因の検討 (2016)
  • Author(s): 須磨紫乃、渡邊 裕、松下健二、荒井秀典、櫻井 孝
  • Organizer: 第26回日本疫学会学術総会
  • Place of Presentation: 米子
  • Year and Date: 2016-01-22
  • Int'l Joint Research
• [Presentation] The relationship between frailty and oral function in community-dwelling elderly people (2015)
  • Author(s): Watanabe Y., Morishita S., Suma S., Edahiro A., Hirano H.o, Motokawa K., Ohara Y., Arai H., Suzuki T.
  • Organizer: International Association of Gerontology and Geriatrics 2015
  • Place of Presentation: Chiang Mai
  • Year and Date: 2015-10-22
  • Int'l Joint Research
• [Presentation] Effect of the comprehensive oral care program on oral function and frailty in community-dwelling older adults (2015)
  • Author(s): Suma S., Watanabe Y., Morishita S., Edahiro A., Hirano H., Motokawa K., Hironaka S., Takagi D., Ohara Y., Arai H., Suzuki T.
  • Organizer: International Association of Gerontology and Geriatrics 2015
  • Place of Presentation: Chiang Mai
  • Year and Date: 2015-10-22
  • Int'l Joint Research
• [Presentation] Relationship between sarcopenia and chewing ability in japanese community-dwelling elderly–is Sarcopenia a contributing factor for decline in chewing ability (2015)
  • Author(s): Hirano H., Watanabe Y., Edahiro A., Kawai H., Kim H., Yoshida H., Obuchi S.
  • Organizer: International Association of Gerontology and Geriatrics 2015
  • Place of Presentation: Chiang Mai
  • Year and Date: 2015-10-22
  • Int'l Joint Research
• [Presentation] A statement of position for oral health management for the elderly peoples with dementia from The Japanese Society of Gerodontology（JSG） (2015)
  • Author(s): Edahiro A., Hirano H., Watanabe Y., Ichikawa T., Sakurai K.
  • Organizer: International Association of Gerontology and Geriatrics 2015
  • Place of Presentation: Chiang Mai
  • Year and Date: 2015-10-21
  • Int'l Joint Research
• [Presentation] Relationship between Nutritional Status and Severity of Dementia in Group Homes for Dementia (2015)
  • Author(s): Motokawa K., Edahiro A., Hirano H., Watanabe Y., Hironaka S., Takagi D.
  • Organizer: International Association of Gerontology and Geriatrics 2015
  • Place of Presentation: Chiang Mai
  • Year and Date: 2015-10-21
  • Int'l Joint Research
• [Presentation] Meal care for eating dysfunction in Alzheimer’s disease, relationship with declines of attention and consciousness (2015)
  • Author(s): Edahiro A., Hirano H., Watanabe Y., Hironaka S., Takagi D., Awata S.
  • Organizer: International Association of Gerontology and Geriatrics 2015
  • Place of Presentation: Chiang Mai
  • Year and Date: 2015-10-21
  • Int'l Joint Research
• [Presentation] Nutrition of elderly person with Alzheimer’s disease, related with eating dysfunction; examination on the basis of functional assessment staging (FAST) (2015)
  • Author(s): Edahiro A., Hirano H., Motokawa K., Watanabe Y.
  • Organizer: The 16th Parenteral and Enteral Nutrition Society of Asia 2015
  • Place of Presentation: Nagoya
  • Year and Date: 2015-07-25
  • Int'l Joint Research
• [Presentation] Relationship between severity of dementia and nutritional status among older people with dementia in group homes (2015)
  • Author(s): Motokawa K., Hirano H., Edahiro A., Watanabe Y.
  • Organizer: The 16th Parenteral and Enteral Nutrition Society of Asia 2015
  • Place of Presentation: Nagoya
  • Year and Date: 2015-07-25
  • Int'l Joint Research
• [Presentation] Risk factors for appendicular skeletal muscle mass decline in elderly people with Alzheimer’s Disease (2015)
  • Author(s): Watanabe Y., Hirano H., Edahiro A., Ohara Y., Takagi D., Murakami K., Hironaka S.
  • Organizer: The 30th International Conference of Alzheimer’s Disease International
  • Place of Presentation: Perth
  • Year and Date: 2015-04-16 – 2015-04-17
  • Int'l Joint Research
• [Presentation] Transitions of Eating and Swallowing Function Accompanying Dementia Progression - Examination on The Basis Of Functional Assessment Staging (FAST) (2015)
  • Author(s): Edahiro A., Hirao H., Watanabe Y., Ohara. Y.
  • Organizer: The 30th International Conference of Alzheimer’s Disease International
  • Place of Presentation: Perth
  • Year and Date: 2015-04-16 – 2015-04-17
  • Int'l Joint Research
• [Presentation] Relationship between nutritional status and severity of Alzheimer's disease (2015)
  • Author(s): Motohashi Y., Hirano H., Watanabe Y., Edahiro A., Ohara Y., Takagi D., Hironaka S.
  • Organizer: The 30th International Conference of Alzheimer’s Disease International
  • Place of Presentation: Perth
  • Year and Date: 2015-04-16 – 2015-04-17
  • Int'l Joint Research
• [Book] 口腔内科学 (2016)
  • Author(s): 渡邊 裕
  • Total Pages: 43-53
  • Publisher: 永末書店
• [Book] 完全版介護予防マニュアル (2015)
  • Author(s): 渡邊 裕
  • Total Pages: 400-42
  • Publisher: 法研
• [Book] 老年歯科医学 (2015)
  • Author(s): 渡邊 裕
  • Total Pages: 419-429
  • Publisher: 医歯薬出版