脳MRIを用いた認知症の予測因子の解明：統合型大規模住民コホート研究

2014 Fiscal Year Research-status Report

• Project/Area Number: 26670307
• Research Institution: The University of Tokyo
• Principal Investigator: 村木 重之 東京大学, 医学部附属病院, 准教授 (40401070)
• Co-Investigator(Kenkyū-buntansha): 吉村 典子 東京大学, 医学部附属病院, 准教授 (60240355) ; 阿久根 徹 国立障害者リハビリテーションセンター(研究所), その他部局等, その他 (60282662) ; 岡 敬之 東京大学, 医学部附属病院, 助教 (60401064) ; 庄島 正明 東京大学, 医学部附属病院, 講師 (80376425)
• Project Period (FY): 2014-04-01 – 2017-03-31
• Keywords: 医療・福祉 / 老化 / MRI / 疫学 / 認知症

Outline of Annual Research Achievements

本研究の対象者は、平成25年度に立ち上げた住民コホートの対象者、1,690名である。本コホートは、住民票よりランダムに抽出した40歳以上の高齢男女を対象に行われていた住民検診の対象者に同意を得て、認知症疫学調査へと拡大させたものであり、地域代表性は確立されている。ベースライン調査項目は、全例に対して脳MRIを撮像するとともに、Mini Mental State examination (MMSe)、長谷川式簡易知能評価スケールを含む認知機能、老年期うつ病評価尺度(GDS)を含むうつ状態のほか、生活歴・ADL・QOL（SF-8, EQ-5D, WOMACなど）・既往歴・職業歴などを含めた200項目以上にわたる問診調査、歩行速度、片足立ち時間、椅子立ち上がり時間を含む運動機能調査、血液検査（血算、腎機能、肝機能、糖・脂質・尿酸代謝、炎症マーカー等）、尿検査（潜血、糖、蛋白検査等）である。その結果、MMSeが24点未満を軽度認知症（Mild cognitive impairment: MCI）と定義した場合の有病率は、全体で4.5％（男性 5.1％、女性 4.2％）であった。MCIの有病率は、年齢と有意な相関を示しており、80歳代では全体で17.1％（男性 16.7％、女性 17.3％）と高い有病率を示していた。次に、重大な運動器疾患の一つである変形性膝関節症（膝OA）との関連を検討したところ、追跡調査時に膝OAが発生した対象者は、発生しなかった対象より、ベースライン調査におけるMCIの有病率が有意に高く、年齢、性別、BMI、地域にて補正した多重ロジスティック回帰分析を用いたところ、MCIは膝OAの有意なリスクファクターであった（オッズ比 4.59、95%信頼区間 1.18-17.7）。さらに、本年度は、脳MRIの読影およびVSRADを用いた海馬傍回の体積の萎縮度に関する測定を行い、既に全例完了している。

Current Status of Research Progress

2: Research has progressed on the whole more than it was originally planned.

Reason

既に、認知症の有病率や運動器疾患との関連は明らかになったうえ、脳MRIの読影およびVSRAD測定は済んでおり、おおむね順調に進展している。

Strategy for Future Research Activity

本研究ではすでに横断研究にてMCIの有病率や関連因子を明らかにする事は出来ているが、横断研究では、関連性は明らかにできても、因果関係を持って危険因子や防御因子を明らかにすることはできない。そこで、平成27年度は上記コホートの追跡調査を行うが、研究者は対象者と極めて良好な関係を築いているうえ、すでに参加者の同意は得ており、高い追跡率が期待できる。調査項目は、Mini Mental State examination (MMSe)、長谷川式簡易知能評価スケールを含む認知機能、老年期うつ病評価尺度(GDS)やWHO-5を含むうつ状態のほか、基本チェックリスト、生活歴・ADL・QOL（SF-8, EQ-5D, WOMACなど）・既往歴・職業歴などを含めた400項目以上にわたる問診調査、歩行速度、片足立ち時間、椅子立ち上がり時間を含む運動機能調査、血液検査（血算、腎機能、肝機能、糖・脂質・尿酸代謝、炎症マーカー等）、尿検査（潜血、糖、蛋白検査等）である。追跡調査のデータをベースラインデータと統合することにより、認知症の発生率、増悪率の解明できるとともに、その疾病自然史、ADL、QOL、要介護度への影響、さらにはMCIの危険因子、防御宇因子を解明する。これらのデータを基に、高いエビデンスレベルにおける早期予測判定指標の確立および効果的な予防法を提言する。

Causes of Carryover

本年度は、これまでに蓄積したデータの解析を行ったため、想定より支出が少なく済み、結果、次年度使用額が生じた。

Expenditure Plan for Carryover Budget

次年度はコホート追跡調査を行うため、同調査に対する物品費、旅費、人件費に
充てる予定である。

Research Products

• [Journal Article] Incidence of disability and its associated factors in Japanese men and women: The Longitudinal Cohorts of Motor System Organ (LOCOMO) study (2015)
  • Author(s): Yoshimura N, Akune T, Fujiwara S, Shimizu Y, Yoshida H, Nishiwaki Y, Sudo A, Omori G, Yoshida M, Shimokata H, Suzuki T, Muraki S, Oka H, Nakamura K.
  • Journal Title: J Bone Miner Metab Volume: 33 Pages: 186-91
  • DOI: 10.1007/s00774-014-0573-y.
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Prevalence of diffuse idiopathic skeletal hyperostosis of the whole spine and its association with knee osteoarthritis: the ROAD study. (2015)
  • Author(s): Kagotani R, Yoshida M, Muraki S, Oka H, Hashizume H, Yamada H, Enyo Y, Nagata K, Ishimoto Y, Teraguchi M, Tanaka S, Nakamura K, Kawaguchi H, Akune T, Yoshimura N
  • Journal Title: J Bone Miner Metab Volume: 33 Pages: 221-9
  • DOI: 10.1007/s00774-014-0583-9.
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Serum levels of 25-hydroxyvitamin D and the occurrence of musculoskeletal diseases: A three-year follow-up to the ROAD study (2015)
  • Author(s): Yoshimura N, Muraki S, Oka H, Nakamura K, Kawaguchi H, Tanaka S, Akune T
  • Journal Title: Osteoporos Int Volume: 26 Pages: 438-4
  • DOI: 10.1007/s00198-014-2844-9.
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] The association of combination of disc degeneration, endplate signal change, and Schmorl's node with low back pain in a large population study: the Wakayama Spine Study (2015)
  • Author(s): Teraguchi M, Yoshimura N, Hashizume H, Muraki S, Yamada H, Oka H, Minamide A, Nakagawa H, Ishimoto Y, Nagata K, Kagotani R, Tanaka S, Kawaguchi H, Nakamura K, Akune T, Yoshida M.
  • Journal Title: Spine J Volume: 15 Pages: 622-8
  • DOI: 10.1016/j.spinee.2014.11.012.
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Joint space narrowing, body mass index, and knee pain: The ROAD study (2015)
  • Author(s): Muraki S, Akune T, En-yo Y, Yoshida M, Suzuki T, Yoshida H, Ishibashi H, Tokimura F, Yamamoto S, Tanaka S, Nakamura K, Kawaguchi H, Oka H, Yoshimura N
  • Journal Title: Osteoarthritis Cartilage Volume: 23 Pages: 874-81
  • DOI: 10.1016/j.joca.2015.01.011.
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Urinary 8-isoprostane as a Biomarker of Metabolic Syndrome Risk in the General Japanese Population: The ROAD Study. (2015)
  • Author(s): Mure K, Yoshimura N, Hashimoto M, Muraki S, Oka H, Tanaka S, Kawaguchi H, Nakamura K, Akune T, Takeshita T.
  • Journal Title: Obesity Volume: 23 Pages: 1517-24
  • DOI: 10.1002/oby.21130
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Does Osteophytosis at the Knee Predict Health-related Quality of Life Decline? A 3-Year Follow-up of the ROAD Study (2015)
  • Author(s): Muraki S, Akune T, Nagata K, Ishimoto Y, Yoshida M, Tokimura F, Tanaka S, Kawaguchi H, Nakamura K, Oka H, Yoshimura N.
  • Journal Title: Clin Rheumatol Volume: in press Pages: in press
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Mutual associations among musculoskeletal diseases and metabolic syndrome components: A 3-year follow-up of the ROAD study (2015)
  • Author(s): Yoshimura N, Muraki S, Oka H, Tanaka S, Kawaguchi H, Nakamura K, Akune T.
  • Journal Title: Modern Rheum Volume: in press Pages: in press
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Prevalence, Incidence, and Progression of Lumbar Spondylosis by Gender and Age Strata (2014)
  • Author(s): Muraki S, Yoshimura N, Akune T, Sakae Tanaka, Ikuno Takahashi, Saeko Fujiwara.
  • Journal Title: Modern Rheum Volume: 24 Pages: 657-61
  • DOI: 10.3109/14397595.2013.843761.
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Prevalence and progression of radiographic ossification of the posterior longitudinal ligament and associated factors in the Japanese population: A 3-year follow-up of the ROAD study (2014)
  • Author(s): Yoshimura N, Nagata K, Muraki S, Oka H, Yoshida M, Enyo Y, Kagotani R, Hashizume H, Yamada H, Ishimoto Y, Teraguchi M, Tanaka S, Kawaguchi H, Toyama Y, Nakamura K, Akune T.
  • Journal Title: Osteoporos Int Volume: 25 Pages: 1089-98
  • DOI: 10.1007/s00198-013-2489-0.
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Incidence of certified need of care in the long-term care insurance system and its risk factors in the elderly of Japanese population-based cohorts: The ROAD study. (2014)
  • Author(s): Akune T, Muraki S, Oka H, Tanaka S, Kawaguchi H, Tokimura F, Yoshida H, Suzuki T, Nakamura K, Yoshimura N. I
  • Journal Title: Geriatr Gerontol Int Volume: 14 Pages: 695-701
  • DOI: 10.1111/ggi.12155.
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Prevalence of knee pain, lumbar pain and its co-existence in Japanese men and women: The LOCOMO (Longitudinal Cohorts of Motor System Organ) study. (2014)
  • Author(s): Yoshimura N, Akune T, Fujiwara S, Shimizu Y, Yoshida H, Omori G, Sudo A, Nishiwaki Y, Yoshida M, Shimokata H, Suzuki T, Muraki S, Oka H, Nakamura K.
  • Journal Title: J Bone Miner Metab. Volume: 32 Pages: 524-32
  • DOI: 10.1007/s00774-013-0522-1.
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Exercise habits during middle age are associated with lower prevalence of sarcopenia: the ROAD study. (2014)
  • Author(s): Akune T, Muraki S, Oka H, Tanaka S, Kawaguchi H, Nakamura K, Yoshimura N
  • Journal Title: Osteoporos Int Volume: 25 Pages: 1081-8
  • DOI: 10.1007/s00198-013-2550-z.
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Prevalence and distribution of intervertebral disc degeneration over the entire spine in a population-based cohort: The Wakayama Spine Study (2014)
  • Author(s): Teraguchi M, Yoshimura N, Hashizume H, Muraki S, Yamada H, Minamide A, Oka H, Ishimoto Y, Nagata K, Kagotani R, Takiguchi N, Akune T, Kawaguchi H, Nakamura K, Yoshida M.
  • Journal Title: Osteoarthritis Cartilage Volume: 22 Pages: 104-10
  • DOI: 10.1016/j.joca.2013.10.019.
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Association of knee osteoarthritis with onset and resolution of pain and physical functional disability: The ROAD Study (2014)
  • Author(s): Muraki S, Akune T, Nagata K, Ishimoto Y, Yoshida M, Tokimura F, Tanaka S, Oka H, Kawaguchi H, Nakamura K, Yoshimura N.
  • Journal Title: Modern Rheum Volume: 24 Pages: 966-73
  • DOI: 10.3109/14397595.2014.883055.
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Association of physical activities of daily living with the incidence of certified need of care in the long-term care insurance system of Japan: the ROAD study. (2014)
  • Author(s): Akune T, Muraki S, Oka H, Tanaka S, Kawaguchi H, Tokimura F, Yoshida H, Suzuki T, Nakamura K, Yoshimura N
  • Journal Title: J Orthop Sci Volume: 19 Pages: 489-96
  • DOI: 10.1007/s00776-014-0537-z.
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] The prevalence of cervical myelopathy among subjects with narrow cervical spinal canal in a population-based MRI study: The Wakayama Spine Study. (2014)
  • Author(s): Nagata K, Yoshimura N, Hashizume H, Muraki S, Ishimoto Y, Yamada H, Takiguchi N, Nakagawa Y, Minamide A, Oka H, Kawaguchi H, Nakamura K, Akune T, Yoshida M.
  • Journal Title: Spine J Volume: 14 Pages: 2811-7
  • DOI: 10.1016/j.spinee.2014.03.051.
  • Peer Reviewed / Acknowledgement Compliant
• [Presentation] Prognosis of Vitamin D Insufficiency: A 3-Year Follow-Up of the ROAD Study. (2015)
  • Author(s): Yoshimura N, Muraki S, Oka H, Tanaka S, Kawaguchi H, Nakamura K, Akune T
  • Organizer: The European League Against Rheumatism (EULAR)2015
  • Place of Presentation: Rome, Italy
  • Year and Date: 2015-06-10 – 2015-06-13
  • Int'l Joint Research
• [Presentation] Knee Symptoms Are More Strongly Associated With Quadriceps Muscle Strength Than Grip Strength Or Muscle Mass: The ROAD Study. (2015)
  • Author(s): Muraki S, Akune T, Oka H, Tanaka S, Kawaguchi H, Nakamura K, Yoshimura N
  • Organizer: The European League Against Rheumatism (EULAR) 2015
  • Place of Presentation: Rome, Italy
  • Year and Date: 2015-06-10 – 2015-06-13
• [Presentation] 変形性股関節症と股関節痛との関連 (2015)
  • Author(s): 村木重之
  • Organizer: 日本整形外科学会
  • Place of Presentation: 神戸
  • Year and Date: 2015-05-21 – 2015-05-24
  • Invited
• [Presentation] Muscle strength rather than muscle mass of the lower limb is associated with knee pain: The ROAD study. (2015)
  • Author(s): 70.Muraki S, Akune T, Oka H, Tanaka S, Kawaguchi H, Nakamura K, Yoshimura N
  • Organizer: World Congress on Osteoporosis,Osteoarthritis and Musculoskeletal Diseases (WCO-IOF-ESCEO)2015
  • Place of Presentation: Milan, Italy
  • Year and Date: 2015-03-26 – 2015-03-29
• [Presentation] Locomotive Syndrome in Japan. (2015)
  • Author(s): Muraki S.
  • Organizer: The 10th International Symposium on Geriatrics and Gerontology.
  • Place of Presentation: Nagoya
  • Year and Date: 2015-02-07 – 2015-02-07
  • Invited
• [Presentation] 大規模縦断研究による変形性膝関節症の疫学 (2015)
  • Author(s): 村木重之
  • Organizer: 膝OAと運動・装具療法セミナー
  • Place of Presentation: 仙台
  • Year and Date: 2015-01-23 – 2015-01-23
  • Invited
• [Presentation] X線画像診断による軟骨変性の特異度 (2014)
  • Author(s): 村木重之
  • Organizer: 第31回膝関節フォーラム
  • Place of Presentation: 東京
  • Year and Date: 2014-12-06 – 2014-12-06
  • Invited
• [Presentation] Effect of Osteophytosis at the Knee on Health-related Quality of Life: A 3-year follow-up of the ROAD study (2014)
  • Author(s): Muraki S, Akune T, Oka H, Tanaka S, Kawaguchi H, Nakamura K, Yoshimura N.
  • Organizer: IOF regionals
  • Place of Presentation: Taipei
  • Year and Date: 2014-11-14 – 2014-11-16
• [Presentation] Mutual associations among diseases causing disability, such as musculoskeletal diseases, metabolic syndrome components, and mild cognitive impairment: A 3-year follow-up of the population-based cohort ROAD (2014)
  • Author(s): Yoshimura N, Muraki S, Oka H, Tanaka S, Kawaguchi H, Nakamura K, Akune T.
  • Organizer: IOF regionals
  • Place of Presentation: Taipei
  • Year and Date: 2014-11-14 – 2014-11-16
• [Presentation] Prevalence of Hand Osteoarthritis in the General Japanese Population: The ROAD Study. (2014)
  • Author(s): Kodama R, Oka H, Muraki S, Kawaguchi H, Tanaka S, Nakamura K, Akune T, Yoshimura N.
  • Organizer: IOF regionals
  • Place of Presentation: Taipei
  • Year and Date: 2014-11-14 – 2014-11-16
• [Presentation] 変形性関節症と骨粗鬆症の最新疫学知見 The ROAD Study (2014)
  • Author(s): 村木重之
  • Organizer: 日本関節病学会
  • Place of Presentation: 東京
  • Year and Date: 2014-11-06 – 2014-11-07
  • Invited
• [Presentation] Does Osteophytosis at the Knee Predict Health-related Quality of Life Decline? A 3-Year Follow-up of the ROAD Study (2014)
  • Author(s): Muraki S, Akune T, Tanaka S, Kawaguchi H, Nakamura, K, Oka H, Yoshimura N
  • Organizer: EULAR (the European league against rheumatism) Congress
  • Place of Presentation: Paris, France
  • Year and Date: 2014-06-12 – 2014-06-15
• [Presentation] Mutual associations among musculoskeletal diseases, metabolic syndrome, and cognitive impairment: A 3-year follow-up of the ROAD study (2014)
  • Author(s): Yoshimura N, Muraki S, Oka H, Tanaka S, Kawaguchi H, Nakamura K, Akune T
  • Organizer: EULAR (The European League Against Rheumatism) Congress
  • Place of Presentation: Paris, France
  • Year and Date: 2014-06-12 – 2014-06-15
• [Book] 検査値読み方事典 (2014)
  • Author(s): 村木 重之
  • Total Pages: 937
  • Publisher: 総合医学社
• [Book] 運動とサルコペニア (2014)
  • Author(s): 村木 重之
  • Total Pages: 8
  • Publisher: Clinical Calcium
• [Book] 変形性腰椎症 リスク因子、腰痛・QOLとの関連 (2014)
  • Author(s): 村木 重之
  • Total Pages: 8
  • Publisher: 整形・災害外科
• [Book] 変形性膝関節症 リスク因子、膝痛・QOLとの関連 (2014)
  • Author(s): 村木 重之
  • Total Pages: 8
  • Publisher: 整形・災害外科