高齢者の認知機能低下予防に有効な介入プログラム開発と効果検証

2013 Fiscal Year Annual Research Report

• Project/Area Number: 11J09862
• Research Institution: National Center for Geriatrics and Gerontology
• Principal Investigator: 牧迫 飛雄馬 独立行政法人国立長寿医療研究センター, 生活機能賦活研究部, 特別研究員(PD)
• Keywords: 軽度認知障害 / 認知症 / 高齢者 / 運動 / 歩行 / 脳容量 / 身体活動

Research Abstract

軽度認知機能障害(mild cognitive impairment : MCI)を有する高齢者における脳活動の活性化の促進を目的とした効果的な介入方法を探り、その介入効果を明らかとすることを目的とした。特に後期高齢者や超高齢者においても安全に実施可能なプログラムを作成することとした。
MCI高齢者(n=310)を対象として、3軸加速度内蔵の身体活動量計によって計測した強度の異なる身体活動量と海馬容量、記憶機能との相互関連性を検証した結果、中強度の身体活動時間は海馬容量と有意な正の相関関係(r=.20, p<.01)を認め、年齢で調整した後も関連性は有意であった(β=.17, p<.01)。しかし、低強度の身体活動時間と海馬容量の有意な関連性は認められず、いずれの強度の身体活動量も記憶検査とは有意な相関関係を示さなった。共分散構造分析において最良な適合度を示したモデルでは、中強度の身体活動量は記憶機能とは直接的な関連は認めなかったが、中強度の身体活動量は海馬容量と有意な関連性を有しており(β=.20, p<.01)、海馬容量が記憶機能と直接的な関連性を示した(β=28, p<.01)。つまり、中強度の身体活動量は海馬容量を介して記憶機能に影響していることが示された。
MCIを有する75歳以上の後期高齢者(n=43)に対する中強度の運動や対人コミュニケーションを促す介入による効果を検証した結果、内側側頭領域における脳萎縮が対照群では有意に進行しており(p=.01)、全脳における萎縮領域の割合も増加していたが(p=.01)、運動教室群では有意な変化は認められず、脳萎縮の程度は維持されていた。認知機能検査値については、群(対照と介入)と時間(介入前と後)を要因とする二元配置分散分析の結果、verbal fluency testにおいて有意な交互作用を認め、介入群での改善を認めた。

Strategy for Future Research Activity

(抄録なし)

Research Products

• [Journal Article] Combined status using physical performance and depressive symptoms is strongly associated with a history of falling in community-dwelling elderly : cross-sectional findings from the Obu Study of Health Promotion for the Elderly (OSHPE). (2014)
  • Author(s): Makizako H, Shimada H, Doi T, Yoshida D, Tsutsumimoto K, Uemura K, Anan Y, Park H, Lee S, Ito T, Suzuki T.
  • Journal Title: Archives of Gerontology and Geriatrics Volume: 58 Pages: 327-331
  • DOI: 10.1016/j.archger.2014.01.001.
  • Peer Reviewed
• [Journal Article] A large, cross-sectional observational study of serum BDNF, cognitive function, and mild cognitive impairment in the elderly. (2014)
  • Author(s): Shimada H, Makizako H, Doi T, Yoshida D, Tsutsumimoto K, Anan Y, Uemura K, Lee S, Park H, Suzuki T
  • Journal Title: Frontiers in Aging Neuroscience Volume: (未定)(印刷中)
  • DOI: 10.3389/fnagi.2014.00069
  • Peer Reviewed
• [Journal Article] Cognitive function and gait speed under normal and dual-task walking among older adults with mild cognitive impairment. (2014)
  • Author(s): Doi T, Shimada H, Makizako H, Tsutsumimoto K, Uemura K, Anan Y, Suzuki T.
  • Journal Title: BMC Neurology Volume: (未定)(印刷中)
  • DOI: 10.1186/1471-2377-14-67.
  • Peer Reviewed
• [Journal Article] Effects of mild and global cognitive impairment on the prevalence of fear of falling in community- dwelling older adults. (2014)
  • Author(s): Uemura K, Shimada H, Makizako H, Doi T, Tsutsumimoto K, Yoshida D, Anan Y, Ito T, S, Lee S, Park H, Suzuki T.
  • Journal Title: Maturitas Volume: 78(1) Pages: 62-66
  • DOI: 10.1016/j.maturitas.2014.02.018.
  • Peer Reviewed
• [Journal Article] Olfactory identification and cognitive performance in community-dwelling older adults with mild cognitive impairment. (2014)
  • Author(s): Makizako M, Makizako H, Doi T, Uemura K, Tsutsumimoto K, Miyaguchi H, Shimada H.
  • Journal Title: Chemical Senses Volume: 39(1) Pages: 39-46
  • DOI: 10.1093/chemse/bjt052.
  • Peer Reviewed
• [Journal Article] Cognitive activities and instrumental activity of daily living in older adults with mild cognitive impairment. (2014)
  • Author(s): Doi T, Shimada H, Makizako H, Lee S, Park H, Tsutsumimoto K, Uemura K, Yoshida D, Anan Y, Suzuki T.
  • Journal Title: Dementia and Geriatric Cognitive Disorders Extra Volume: 3(1) Pages: 398-406
  • DOI: 10.1159/000355553.
  • Peer Reviewed
• [Journal Article] Association between hip walking and physical fitness in the elderly of a community setting (2014)
  • Author(s): Mizumoto A, Ihira H, Makizako H, Yasu da K, Makino K, Ohguni M, Furuna T.
  • Journal Title: Anthropological Science Volume: (未定)(印刷中)
  • DOI: 10.1537/ase.131026
  • Peer Reviewed
• [Journal Article] Using two different algorithms to determine the prevalence of sarcopenia. (2014)
  • Author(s): Yoshida D, Suzuki T, Shimada H, Park H, Makizako H, Doi T, Anan Y, Tsutsumimoto K, Uemura K, Ito T, Lee S.
  • Journal Title: Geriatrics & Gerontology International Volume: 14 Pages: 46-51
  • DOI: 10.1111/ggi.12210.
  • Peer Reviewed
• [Journal Article] Brain activation during dual-task walking and executive function among older adults with mild cognitive impairment : a fNIRS study. (2013)
  • Author(s): Doi T, Makizako H, Shimada H, Park H , Tsutsumimoto K, Uemura K, Suzuki T.
  • Journal Title: Aging Clinical and Experimental Research Volume: 25(5) Pages: 539-544
  • DOI: 10.1007/s40520-013-0119-5.
  • Peer Reviewed
• [Journal Article] Poor balance and lower gray matter volume predict falls in older adults with mild cognitive impairment. (2013)
  • Author(s): Makizako H, Shimada H, Doi T, Park H, Yoshida D, Uemura K, Tsutsumimoto K, Liu-Ambrose T, Suzuki T.
  • Journal Title: BMC Neurology Volume: 13(1) Pages: 102
  • DOI: 10.1186/1471-2377-13-102
  • Peer Reviewed
• [Journal Article] Six-minute walking distance is correlated with memory and brain volume in older adults with mild cognitive impairment : A voxel-based morphometry study (2013)
  • Author(s): Makizako H, Shimada H, Doi T, Park H, Suzuki T.
  • Journal Title: Dementia and Geriatric Cognitive Disorders Extra Volume: 3(1) Pages: 223-32
  • DOI: 10.1159/000354189.
  • Peer Reviewed
• [Journal Article] Performance-based assessments and demand for personal care in older Japanese people : a cross-sectional study. (2013)
  • Author(s): Shimada H, Suzuki T, Suzukawa M, Makizako H, Doi T, Yoshida D, Tsutsumimoto K, Anan Y, Uemura K, Ito T, Lee S, Park H.
  • Journal Title: BMJ Open Volume: 3(4) Pages: e002424
  • DOI: 10.1136/bmjopen-2012-002424.
  • Peer Reviewed
• [Journal Article] Age-related differences in reaction time responses under simple- and dual-task conditions in middle-aged ski marathon amateur males (2013)
  • Author(s): Makizako H, Kaneko F, Aoki N, Ihira H
  • Journal Title: International Journal of Sport and Health Science Volume: 11 Pages: 33-38
  • DOI: 10.5432/ijshs.201228
  • Peer Reviewed
• [Journal Article] Age-related differences in the influence of cognitive task performance on postural control under unstable balance conditions. (2013)
  • Author(s): Makizako H, Furuna T, Ihira H, Shimada H.
  • Journal Title: International Journal of Gerontology Volume: 7 Pages: 199-204
  • DOI: 10.1016/j.ijge.2013.01.014
  • Peer Reviewed
• [Journal Article] Combined prevalence of frailty and mild cognitive impairment in a population of elderly Japanese people. (2013)
  • Author(s): Shimada H, Makizako H, DoiT, Yoshida D, Tsutsumimoto K, Anan Y, Uemura K. Ito T, Lee S, Park H, Suzuki T.
  • Journal Title: Journal of the American Medical Directors Association Volume: 14(7) Pages: 518-524
  • DOI: 10.1016/j.jamda2013.03.010.
  • Peer Reviewed
• [Journal Article] A randomized controlled trial of multicomponent exercise in older adults with mild cognitive impairment. (2013)
  • Author(s): Suzuki T, Shimada H, Makizako H, Doi T, Yoshida D, Ito K, Shimokata H, Washimi Y, Endo H, Kato T.
  • Journal Title: PLoS One Volume: 8(4) Pages: e61483
  • DOI: 10.1186/1471-2377-12-128.
  • Peer Reviewed
• [Presentation] 日本語版―改訂Gait Efficacy Scaleの信頼性および妥当性. (2013)
  • Author(s): 牧迫飛雄馬, 島田裕之, 吉田大輔, 阿南祐也, 伊藤忠, 土井剛彦, 堤本広大, 上村一貴, Brach Jennfier, 朴眩泰, 李相侖, 鈴木隆雄.
  • Organizer: 第48回日本理学療法学術大会
  • Place of Presentation: 名古屋
  • Year and Date: 2013-05-25
• [Book] 標準理学療法学 専門分野理学療法研究法, 第3版 (2013)
  • Author(s): 牧迫飛雄馬
  • Total Pages: 176-182
  • Publisher: 医学書院
• [Book] サルコペニア24のポイント-高齢者への適切なアプローチをめざして-, 初版 (2013)
  • Author(s): 牧迫飛雄馬
  • Total Pages: 78-82
  • Publisher: 有限会社フジメディカル出版
• [Remarks]
  • URL: http://www.ncgg.go.jp/department/cre/index.html