Faculty Profiles - MAKIZAKO Hyuma

Papers - MAKIZAKO Hyuma

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Hiroyuki Shimada, Takehiko Doi, Sangyoon Lee, Hyuma Makizako, Liang-Kung Chen, Hidenori Arai . Cognitive Frailty Predicts Incident Dementia among Community-Dwelling Older People. . Journal of clinical medicine7 ( 9 ) 2018.8Reviewed International journal

Language：English

Cognitive frailty, defined as the presence of both frailty and cognitive impairment, is a risk factor for adverse events in older adults. However, prevalence rates of cognitive frailty are low (1.1⁻2.5%), so primary screening is unsuitable in community settings. The aim of the study was to examine whether a new definition of cognitive frailty, which was developed for primary screening, is useful to predict incident dementia in community-dwelling older adults. A total of 4570 older adults participated in the study (2326 women; average age, 71.9 ± 5.5 years). We defined physical frailty as the presence of ≥1 of the following symptoms: slow walking speed and muscle weakness. Cognitive impairment was defined as ≥1 symptom of cognitive impairment, indicated by an age- and education-adjusted score that was ≥1.5 standard deviations below the reference threshold in word list memory, attention, executive function, and processing speed tests. Cognitive frailty was defined as comorbid physical frailty and cognitive impairment. The incidence of dementia was determined using data collected by the Japanese Health Insurance System over 36 months. The prevalence rates of physical frailty, cognitive impairment, and cognitive frailty were 17.5%, 15.3%, and 9.8%, respectively. Cognitive impairment (hazard ratio [HR]: 2.06, 95% confidence interval [95% CI]: 1.41⁻3.02) and cognitive frailty (HR: 3.43, 95% CI: 2.37⁻4.97) were found to be significant risk factors for dementia. However, the association between dementia and physical frailty was not significant (HR: 1.13, 95% CI: 0.76⁻1.69). Individuals with comorbid physical frailty and cognitive impairment could have a higher risk of dementia than healthy older adults or older adults with either physical frailty or cognitive impairment alone.

DOI： 10.3390/jcm7090250

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Hiroyuki Shimada, Hyuma Makizako, Takehiko Doi, Hyuntae Park, Kota Tsutsumimoto, Joe Verghese, Takao Suzuki . Effects of Combined Physical and Cognitive Exercises on Cognition and Mobility in Patients With Mild Cognitive Impairment: A Randomized Clinical Trial. . Journal of the American Medical Directors Association19 ( 7 ) 584 - 591 2018.7Reviewed International journal

Language：English

IMPORTANCE: Although participation in physical and cognitive activities is encouraged to reduce the risk of dementia, the preventive efficacy of these activities for patients with mild cognitive impairment is unestablished. OBJECTIVE: To compare the cognitive and mobility effects of a 40-week program of combined cognitive and physical activity with those of a health education program. DESIGN: A randomized, parallel, single-blind controlled trial. SETTING: A population-based study of participants recruited from Obu, a residential suburb of Nagoya, Japan. PARTICIPANTS: Between August 2011 and February 2012, we evaluated 945 adults 65 years or older with mild cognitive impairment, enrolled 308, and randomly assigned them to the combined activity group (n = 154) or the health education control group (n = 154). INTERVENTIONS: The combined activity program involved weekly 90-minute sessions for 40 weeks focused on physical and cognitive activities. The control group attended 90-minute health promotion classes thrice during the 40-week trial period. MEASUREMENT: The outcome measures were assessed at the study's beginning and end by personnel blinded to mild cognitive impairment subtype and group. The primary endpoints were postintervention changes in scores on (1) the Mini-Mental State Examination as a measure of general cognitive status and memory, (2) the Wechsler Memory Scale-Revised-Logical Memory II, and (3) the Rey Auditory Verbal Learning Test. We applied mobility assessments and assessed brain atrophy with magnetic resonance imaging. RESULTS: Compared with the control group, the combined activity group showed significantly greater scores on the Mini-Mental State Examination (difference = 0.8 points, P = .012) and Wechsler Memory Scale-Revised-Logical Memory II (difference = 1.0, P = .004), significant improvements in mobility and the nonmemory domains and reduced left medial temporal lobe atrophy in amnestic mild cognitive impairment (Z-score difference = -31.3, P < .05). CONCLUSION: Combined physical and cognitive activity improves or maintains cognitive and physical performance in older adults with mild cognitive impairment, especially the amnestic type.

DOI： 10.1016/j.jamda.2017.09.019

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Kazuki Uemura, Hyuma Makizako, Sangyoon Lee, Takehiko Doi, Sungchul Lee, Kota Tsutsumimoto, Hiroyuki Shimada . The impact of sarcopenia on incident homebound status among community-dwelling older adults: A prospective cohort study. . Maturitas113 26 - 31 2018.7Reviewed International journal

Language：English

OBJECTIVES: Whether sarcopenia predicts incident homebound status remains unclear. This prospective cohort study aimed to determine the impact of sarcopenia on the incidence of homebound status in community-dwelling older adults. METHODS: The study included 3958 community-dwelling elderly people aged ≥65 years who were not homebound at baseline. Sarcopenia was defined as the presence of both poor muscle function (low physical performance or low muscle strength) and low muscle mass. Potential confounding factors, such as physical status, mental status, and level of social participation, were also assessed. Fifteen months after the baseline measurements, data regarding the incidence of homebound status were obtained using a postal survey. RESULTS: In the 15-month follow-up survey, 83 participants (2.1%, 95% confidence interval = 1.6-2.5) were reported to have become homebound. A multiple logistic regression analysis indicated that age (odds ratio = 1.06, 95% confidence interval = 1.02-1.10), sarcopenia (1.98, 1.04-3.77), and limited contact with friends (1.82, 1.03-3.23) were independently associated with an increased risk of becoming homebound. In a stratified analysis for age group, a significant odds ratio for low level of social role (2.50, 1.06-5.91) was observed in young-old subjects (aged 65-74 years), whereas significant odds ratios for sarcopenia (2.80, 1.33-5.91) and physical inactivity (2.85, 1.28-6.37) were observed in old-old subjects (aged 75 years and over). CONCLUSION: Sarcopenia had a strong impact on the risk of becoming homebound. Particularly in old-old subjects, sarcopenia and physical inactivity may impair people's ability to engage in activities outside the home much more than either their mental status or their level of social participation.

DOI： 10.1016/j.maturitas.2018.03.007

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Ryo Hotta, Hyuma Makizako, Takehiko Doi, Kota Tsutsumimoto, Sho Nakakubo, Keitaro Makino, Hiroyuki Shimada . Cognitive function and unsafe driving acts during an on-road test among community-dwelling older adults with cognitive impairments. . Geriatrics & gerontology international18 ( 6 ) 847 - 852 2018.6Reviewed

Language：English

AIM: To examine the relationship between cognitive function and unsafe driving acts among community-dwelling older adults with cognitive impairments. METHODS: Participants (n = 160) were older residents of Obu, Japan, aged ≥65 years with cognitive impairments. They regularly drove and were assessed for the number of unsafe driving acts without adequate verification during an on-road test. We also evaluated cognitive function (attention, executive function and processing speed). Other examined variables included demographics, driving characteristics and visual condition. RESULTS: Participants were classified into two groups according to the number of unsafe driving acts as follows: high group (≥4 unsafe driving acts) and low group (≤3 unsafe driving acts). The high group participants were older in age (P < 0.001) and obtained a lower score on the symbol digit substitution task (P = 0.002) than the low group. The number of unsafe driving acts showed modest significant positive correlations with age (r = 0.396, P < 0.001). The symbol digit substitution task score was significantly associated with the number of unsafe driving acts (β = -0.196, P < 0.05) after adjusting for age group. CONCLUSIONS: Processing speed was associated with unsafe driving acts that became worse with increasing age. Future study will be required to longitudinally examine the influence of processing speed on traffic accidents for those with cognitive impairments. Geriatr Gerontol Int 2018; 18: 847-852.

DOI： 10.1111/ggi.13260

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Kota Tsutsumimoto, Takehiko Doi, Hyuma Makizako, Ryo Hotta, Sho Nakakubo, Minji Kim, Satoshi Kurita, Takao Suzuki, Hiroyuki Shimada . Social Frailty Has a Stronger Impact on the Onset of Depressive Symptoms than Physical Frailty or Cognitive Impairment: A 4-Year Follow-up Longitudinal Cohort Study. . Journal of the American Medical Directors Association19 ( 6 ) 504 - 510 2018.6Reviewed International journal

Language：English

OBJECTIVES: To examine the association between each type of frailty status and the incidence rate of depressive symptoms among community-dwelling older adults. DESIGN: Prospective cohort study. SETTING: General communities in Japan. PARTICIPANTS: Participants comprised 3538 older Japanese adults. MEASUREMENTS: We assessed our participants in terms of frailty status (physical frailty, cognitive impairment, and social frailty), depressive symptoms (geriatric depression scale ≥6), and other covariates, and excluded those who showed evidence of depression. Then, after a 4-year interval, we again assessed the participants for depressive symptoms. Physical frailty was defined by the Fried criteria, showing 1 or more of these were physical frailty. To screen for cognitive impairment, receiving a score below an age-education adjusted reference threshold in 1 or more tests was cognitive impairment. Finally, social frailty was defined using 5 questions, and those who answered positively to 1 or more of these were considered to have social frailty. RESULTS: After multiple imputations, the incidence rate of depressive symptoms after 4 years of follow-up was 7.2%. The incidence rates of depressive symptoms for each frailty status were as follows: 9.6% for physical frailty vs 4.6% without, 9.3% for cognitive impairment vs 6.5% without, and 12.0% for social frailty vs 5.1% without. Finally, through the application of multivariable logistic regression analysis, the incidence of depressive symptoms was found to have a significant association with social frailty (odds ratio 1.55; 95% confidence interval 1.10-2.20) but not with physical frailty or cognitive impairment. CONCLUSIONS: This study revealed that social frailty, in comparison with physical frailty and cognitive impairment, is more strongly associated with incidences of depressive symptoms among elderly.

DOI： 10.1016/j.jamda.2018.02.008

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Shimada H, Doi T, Lee S, Makizako H, Chen LK, Arai H. . Cognitive frailty predicts incident dementia among community-dwelling older people. . Journal of Clinical Medicine7 ( 9 ) 2018.5Reviewed

富岡一俊, 宮崎宣丞, 竹下康文, 園田耕一, 加治智和, 桑波田聡, 安部智, 竹中俊宏, 牧迫飛雄馬, 窪薗琢郎, 大石充 . 垂水研究からみた地方高齢者の運動習慣と血圧パイロット・スタディから見えてきたもの . 日本高血圧学会臨床高血圧フォーラムプログラム・抄録集7回 161 - 161 2018.5Reviewed

牧迫飛雄馬, 窪薗琢郎, 木山良二, 竹中俊宏, 桑波田聡, 田平隆行, 鹿屋勉, 堀之内貢子, 島田裕之, 大石充 . 高齢者の社会的フレイルと骨格筋量、握力との関連 . 日本老年医学会雑誌55 ( Suppl. ) 118 - 118 2018.5

Makino K, Makizako H, Doi T, Tsutsumimoto K, Hotta R, Nakakubo S, Suzuki T, Shimada H. . Impact of fear of falling and fall history on disability incidence among older adults: Prospective cohort study . Int J Geriatr Psychiatry33 ( 4 ) 658 - 662 2018.4Reviewed

Keitaro Makino, Hyuma Makizako, Takehiko Doi, Kota Tsutsumimoto, Ryo Hotta, Sho Nakakubo, Takao Suzuki, Hiroyuki Shimada . Impact of fear of falling and fall history on disability incidence among older adults: Prospective cohort study. . International journal of geriatric psychiatry33 ( 4 ) 658 - 662 2018.4Reviewed International journal

Language：English

OBJECTIVE: Fear of falling (FOF) is a major health problem for older adults, present not just in fallers, but also nonfallers. This study examined the impact of FOF and fall history on disability incidence among community-dwelling older adults from a prospective cohort study. METHODS: A total of 5104 older adults living in community settings participated in baseline assessment and were followed up for about 4 years (median 52 mo, range 49-55 mo). At baseline, participants were assessed the presence of FOF and their fall history, and divided into 4 groups: Fall (-) FOF (-), Fall (+) FOF (-), Fall (-) FOF (+), and Fall (+) FOF (+). Disability incidence was defined as national long-term care insurance certification for personal support or care. RESULTS: During the follow-up period, 429 participants (9.9%) were newly certified as having a disability and needing personal support for long-term care insurance. Fall (-) FOF (+) group and Fall (+) FOF (+) group showed a significantly higher risk of disability incidence than Fall (-) FOF (-) group even after adjusting for covariates (Fall (-) FOF (+): hazard ratio 1.28, 95% confidence interval, 1.01-1.62, Fall (+) FOF (+): hazard ratio 1.44, 95% confidence interval, 1.05-1.98). CONCLUSIONS: Fear of falling could be a simple and useful predictor of disability incidence in community-dwelling older adults. Identifying and decreasing fall risk factors may prevent fall-related injuries, but excessive FOF may be associated with increased risk of disability incidence.

DOI： 10.1002/gps.4837

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川田将之, 木山良二, 牧迫飛雄馬, 窪薗琢郎 . ウェアラブルセンサーを用いた臨床応用可能な歩行トレーニングシステムの開発 . 若手研究者のための健康科学研究助成成果報告書 ( 33 ) 72 - 76 2018.4

Makizako H, Tsutsumimoto K, Shimada H, Arai H . Social frailty among community-dwelling older adults: Recommended assessments and implications . Ann Geriatr Med Res22 ( 1 ) 3 - 8 2018.3Reviewed

Makizako H, Shimada H, Doi T, Tsutsumimoto K, Hotta R, Nakakubo S, Makino K, Lee S . Social frailty leads to the development of physical frailty among physically non-frail adults: A four-year follow-up longitudinal cohort study . Int J Environ Res Public Health15 ( 3 ) 2018.3Reviewed

Hyuma Makizako, Hiroyuki Shimada, Takehiko Doi, Kota Tsutsumimoto, Ryo Hotta, Sho Nakakubo, Keitaro Makino, Sangyoon Lee . Social Frailty Leads to the Development of Physical Frailty among Physically Non-Frail Adults: A Four-Year Follow-Up Longitudinal Cohort Study. . International journal of environmental research and public health15 ( 3 ) 2018.3Reviewed International journal

Language：English Publishing type：Research paper (scientific journal)

Social frailty domains may play an important role in preventing physical decline and disability. The aim of this study is to examine the impact of social frailty as a risk factor for the future development of physical frailty among community-dwelling older adults who are not yet physically frail. A total of 1226 physically non-frail older adults were analyzed to provide a baseline. Participants completed a longitudinal assessment of their physical frailty 48 months later. Their baseline social frailty was determined based on their responses to five questions, which identified participants who went out less frequently, rarely visited friends, felt less like helping friends or family, lived alone and did not talk to another person every day. Participants with none of these characteristics were considered not to be socially frail; those with one characteristic were considered socially pre-frail; and those with two or more characteristics were considered socially frail. At the four-year follow-up assessment, 24 participants (2.0%) had developed physical frailty and 440 (35.9%) had developed physical pre-frailty. The rates of developing physical frailty and pre-frailty were 1.6% and 34.2%, respectively, in the socially non-frail group; 2.4% and 38.8%, respectively, in the socially pre-frail group; and 6.8% and 54.5%, respectively, in the socially frail group. Participants classified as socially frail at the baseline had an increased risk of developing physical frailty, compared with participants who were not socially frail (OR = 3.93, 95% CI = 1.02-15.15). Participants who were socially frail at the baseline also had an increased risk of developing physical pre-frailty (OR = 2.50, 95% CI = 1.30-4.80). Among independent community-dwelling older adults who are not physically frail, those who are socially frail may be at greater risk of developing physical frailty in the near future. Social frailty may precede (and lead to the development of) physical frailty.

DOI： 10.3390/ijerph15030490

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Lee S, Lee S, Bae S, Harada K, Jung S, Imaoka M, Makizako H, Doi T, Shimada H. . Relationship between chronic kidney disease without diabetes mellitus and components of frailty in community-dwelling Japanese older adults . Geriatr Gerontol Int18 ( 2 ) 286 - 292 2018.2Reviewed

Kazuki Uemura, Hyuma Makizako, Sangyoon Lee, Takehiko Doi, Songchul Lee, Kota Tsutsumimoto, Hiroyuki Shimada . Behavioral protective factors of increased depressive symptoms in community-dwelling older adults: A prospective cohort study. . International journal of geriatric psychiatry33 ( 2 ) e234 - e241 2018.2Reviewed International journal

Language：English

BACKGROUND: It remains unclear what kinds of behavior prevent the development of geriatric depression. This study aimed to elucidate behavioral predictors of increased depressive symptoms in older adults focusing on gender differences. METHODS: A total of 3106 community-dwelling older people aged older than or equal to 65 years without depressive symptoms at baseline participated. The 15-item Geriatric Depression Scale was used to assess depressive symptoms with a score of 6 or more at baseline and 15 month follow-up. Behavioral status was investigated by using dichotomous questions about the aspects of physical, cognitive, and social activities. Each category included 3 specific items. Demographic data and other potential confounding factors were also assessed. RESULTS: In the 15 month follow-up survey, 239 participants (7.7%) reported increased depressive symptoms. Multiple logistic regression analysis indicated that engagement in light physical exercise (odds ratio = 0.74, 95%, CI = 0.56-0.98), taking enrichment lessons (0.62, 0.46-0.85), using a personal computer (0.68, 0.48-0.97), participation in events at the community center (0.54, 0.40-0.72), and attending a community meeting (0.69, 0.52-0.92) were independently associated with lower risk of increased depressive symptoms. In a separate analysis for each gender, significant odds ratios of using a personal computer were observed in men, whereas significant odds ratios of light physical exercise, participation in events at the community center, and attending a community meeting were observed in women. CONCLUSIONS: Light physical exercise, taking lessons, usage of a computer, and participation in community events showed protective effects against depressive symptoms. However, the significance of each behavioral factor may vary according to gender.

DOI： 10.1002/gps.4776

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Sho Nakakubo, Takehiko Doi, Hiroyuki Shimada, Rei Ono, Hyuma Makizako, Kota Tsutsumimoto, Ryo Hotta, Takao Suzuki . The Association Between Excessive Daytime Sleepiness and Gait Parameters in Community-Dwelling Older Adults: Cross-Sectional Findings From the Obu Study of Health Promotion for the Elderly. . Journal of aging and health30 ( 2 ) 213 - 228 2018.2Reviewed International journal

Language：English

OBJECTIVE: This study examined the association between excessive daytime sleepiness (EDS) and gait characteristics (e.g., speed, variability) in community-dwelling older adults. METHOD: This cross-sectional study included 3,901 individuals aged ≥65 years. Participants answered questions about EDS, sleep duration, and other sleep-related symptoms. Gait speed, stride length, and the variability in stride length were assessed by using a stopwatch and a WalkWay device. RESULTS: EDS was significantly associated with slower gait speed among younger subjects (<75 years, p = .021) and with both slower gait speed ( p = .045) and greater variability in stride length among older subjects (≥75 years, p = .048) in a multivariate analysis adjusted for age, sex, body mass index, medication, number of comorbidities, and education. DISCUSSION: EDS associates with gait ability, particularly in older old adults. Further prospective studies are needed to determine the causal association between gait ability and sleep disturbances, including EDS.

DOI： 10.1177/0898264316673253

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Sungchul Lee, Sangyoon Lee, Seongryu Bae, Kazuhiro Harada, Songee Jung, Masakazu Imaoka, Hyuma Makizako, Takehiko Doi, Hiroyuki Shimada . Relationship between chronic kidney disease without diabetes mellitus and components of frailty in community-dwelling Japanese older adults. . Geriatrics & gerontology international18 ( 2 ) 286 - 292 2018.2Reviewed

Language：English Publishing type：Research paper (scientific journal)

AIM: To evaluate the relationship between kidney function without diabetes and components of the frailty phenotype in community-dwelling Japanese older adults. METHODS: Participants were 8343 residents who completed baseline assessments, classified into four categories according to eGFR. Frailty status was defined using five criteria: (i) slow gait speed; (ii) muscle weakness; (iii) low physical activity; (iv) exhaustion; and (v) unintentional weight loss. RESULTS: After multivariate adjustment, participants with the lowest kidney function were at higher risk of frailty (OR 1.57, 95% CI 1.02-3.50) than those with normal kidney function. In addition, after adjustment for multiple confounders, estimated glomerular filtration rate <30 was associated with a greater risk of the individual frailty components of weight loss (OR 2.14, 95% CI 1.11-4.12), low physical activity (OR 1.35, 95% CI, 1.01-2.54) and slowness (OR 1.82, 95% CI 1.36-3.77) compared with estimated glomerular filtration rate ≥60. CONCLUSIONS: Lower kidney function was associated with a higher risk of weight loss, low physical activity and slowness among community-dwelling Japanese older adults. Geriatr Gerontol Int 2018; 18: 286-292.

DOI： 10.1111/ggi.13180

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吉松竜貴, 加辺憲人, 橋本祥行, 牧迫飛雄馬 . 回復期脳卒中患者の歩行自立予測信号検出分析による臨床応用を目指した検討 . 理学療法科学33 ( 1 ) 145 - 150 2018.2Reviewed

Language：Japanese Publisher：(一社)理学療法科学学会

[目的]脳卒中患者の回復期リハビリテーション病棟入院時情報から3ヵ月後の歩行自立を判別するための予測チャートを作成すること。[対象と方法]初発脳卒中患者251例を対象として、入院時の身体機能と認知機能、基本動作自立度、バランス能力、日常生活自立度から入院3ヵ月後の歩行自立を予測するための決定木を、信号検出分析法にて求めた。[結果]起居動作能力、バランス能力、認知機能が有意な予測因子として抽出され、入院3ヵ月後の歩行自立を予測するための決定木が得られた。[結語]脳卒中の回復期に適応した歩行自立の予測チャートが作成された。(著者抄録)

Takehiko Doi, H. Makizako, K. Tsutsumimoto, R. Hotta, S. Nakakubo, K. Makino, T. Suzuki, H. Shimada . Association Between Insulin-Like Growth Factor-1 and Frailty Among Older Adults . Journal of Nutrition, Health and Aging22 ( 1 ) 68 - 72 2018.1Reviewed

Language：English Publishing type：Research paper (scientific journal) Publisher：Springer-Verlag France

Objectives: Frailty is a course experienced in advanced aging. Identification of a biological factor associated with frailty is required. Although serum insulin-like growth factor-1 (IGF-1) is a potential factor related with frailty, consensus has not been reached regarding this relationship. This study aimed to investigate the association between IGF-1 and frailty in older adults. Design: Cross-sectional study. Setting: Cohort study that was part of the “National Center for Geriatrics and Gerontology–Study of Geriatric Syndromes.” Participants: The study participants were 4133 older adults (mean age, 71.8 ± 5.4 years). Measurements: We assessed serum IGF-1 levels and frailty status and collected demographic variables, including cognitive function, as covariates. Results: Frailty and pre-frailty were present in 274 subjects (7%) and 1930 subjects (47%), respectively. Subjects were divided into four groups based on quartiles of IGF-1 levels. Multinomial logistic analysis showed that the lowest group had significant odds of pre-frailty (crude model: odds ratio [OR] 1.58, 95% confidence interval [CI] 1.30–1.90, p OpenSPiltSPi.001
adjusted model: OR 1.38, 95% CI 1.13–1.68, p =.002) and frailty (crude model: OR 3.42, 95% CI 2.38-4.92, p OpenSPiltSPi.001
adjusted model: OR 1.54, 95% CI 1.02–2.32, p =.039), compared with the highest group. Conclusion: Lower serum IGF-1 levels were independently related with frailty in older adults.

DOI： 10.1007/s12603-017-0916-1

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Papers - MAKIZAKO Hyuma