Relationships between body mass index, lifestyle habits, and locomotive syndrome in young- and middle-aged adults: A cross-sectional survey of workers in Japan

Prevalence and associated factors of locomotive syndrome in young Japanese adults: a cross-sectional study

BACKGROUND

The onset of locomotive syndrome (LS) precedes that of frailty. Therefore, the first step in extending healthy life expectancy is to implement measures against LS in young adults. The aim of this study was to investigate the prevalence of LS and its associated factors in young adults for early detection and prevention of LS.

METHODS

The participants of this study comprised 413 university students specializing in health sciences (192 males and 221 females) with an average age of 19.1 ± 1.2 years. All participants voluntarily participated in the study and reported no serious health problems. The presence or absence of LS was evaluated using the stand-up test, two-step test, and the 25-question Geriatric Locomotive Function Scale. Additionally, musculoskeletal assessment (one-leg standing, squatting, shoulder elevation, and standing forward bend), body composition analysis (weight, body mass index, body fat mass, body fat percentage, skeletal muscle mass index (SMI), and phase angle), handgrip strength test, physical activity assessment, and nutritional assessment were conducted. Sex-stratified analyses were performed, comparing groups with and without LS. Factors associated with LS were explored using binomial logistic regression.

RESULTS

Of the 413 young adults studied, 86 individuals (20.8%) were found to have LS. When stratified by sex, LS was observed to have a considerably higher prevalence in females (55, 24.9%) than in males (31, 16.1%). In males, the notable differences between the groups with and without LS were observed in one-leg standing and phase angle, whereas in females, differences were identified in body fat mass, body fat percentage, SMI, musculoskeletal pain, and handgrip strength. Two types of binomial logistic regression analysis revealed that the inability to perform one-leg standing was associated with LS in males, while the presence of musculoskeletal pain and a high body fat percentage were identified as factors associated with LS in females.

CONCLUSIONS

One in five young adults were found to have LS in this study, underscoring the necessity for early intervention and LS health education. Furthermore, effective management of musculoskeletal pain is also crucial.

Risk factors for progression of the severity of locomotive syndrome: A two-year longitudinal observational study

BACKGROUND

The risk factors for progression of severity of locomotive syndrome (LS) remain unclear.

METHODS

We conducted a longitudinal observational study of 1148 community-dwelling residents (median age, 68.0 years old; 548 males, 600 females) from 2016 to 2018. LS was assessed by the 25-question Geriatric Locomotive Function Scale (GLFS-25), and total scores of ≤6 points, 7-15 points, 16-23 points, and ≥24 points were diagnosed as non-LS, LS-1, LS-2, and LS-3, respectively. If the LS severity in 2018 was higher than in 2016, the case was defined as progression of LS severity; otherwise, it was defined as non-progressive LS. We compared the age, gender, body mass index, smoking status, alcohol consumption, living situation, car use, chronic musculoskeletal pain, comorbidities, metabolic syndrome, physical activity, and LS severity in 2016 between the progression and non-progression groups. Furthermore, a multivariate logistic regression analysis was performed to elucidate the risk factors for progression of LS severity.

RESULTS

Participants in the progression group had a significantly older age, a lower rate of car use, a higher rate of low back pain, a higher rate of hip pain, a higher rate of knee pain, a higher GLFS-25 total score, and a higher rate of LS-2 than those in the non-progression group. The multivariate logistic regression analysis revealed that older age, female gender, higher body mass index (≥25.0 kg/m2), presence of low back pain, and presence of hip pain were risk factors for the progression of LS within two years.

CONCLUSIONS

To prevent the progression of LS severity, related prophylaxis strategies should be implemented, especially for individuals with the above-mentioned characteristics. Further longitudinal studies with a longer observation period are necessary.

Relationship between physical activity and locomotive syndrome among young and middle-aged Japanese workers

OBJECTIVES

This study aimed to examine the relationship between physical activity (PA) and locomotive syndrome (LS) among young and middle-aged Japanese workers.

METHODS

This cross-sectional study included 335 participants from a company in Kumamoto, Japan. LS was evaluated using the 25-question Geriatric Locomotive Function Scale (GLFS-25); a GLFS-25 score ≥7 was defined as LS. Weekly PA was measured using the International Physical Activity Questionnaire. Work-related PA (time spent sitting, standing, walking, and strenuous work per day) and sedentary breaks were measured using a Work-related Physical Activity Questionnaire. Screen usage (television [TV], smartphones, tablets, and personal computers) during leisure time was recorded. The association between PA and LS was examined using a multivariate logistic regression analysis adjusted for age, sex, body mass index, history of musculoskeletal disorders, cancer, stroke, occupation, employment type, work time, shift system, employment status, and body pain.

RESULTS

A total of 149 participants had LS. Fewer sedentary breaks during work (>70-minute intervals, odds ratio [OR] = 2.96; prolonged sitting, OR = 4.12) and longer TV viewing time (≥180 minutes, OR = 3.02) were significantly associated with LS. In contrast, moderate PA (OR = 0.75) was significantly associated with a lower risk of LS.

CONCLUSIONS

Fewer sedentary breaks during work and longer TV viewing time could increase the risk of LS in young and middle-aged Japanese workers.

Relationship between oral frailty and locomotive syndrome in working-age individuals: a cross-sectional survey of workers in Japan

BACKGROUND

Although the relationship between oral and physical frailty in older adults has been investigated, few studies have focused on the working-age population. This study examined the relationships of the number of remaining teeth and masticatory ability, i.e., signs of oral frailty, with locomotive syndrome (LS) in the working-age population.

METHODS

The number of remaining teeth, masticatory ability, and presence of LS in 501 participants from four companies were examined. The relationships between the number of remaining teeth groups (≥ 20 teeth or ≤ 19 teeth) and LS and between the masticatory ability groups (high or low) and LS were examined. A binomial logistic regression analysis was conducted using LS from the stand-up test as the objective variable and the two subgroups based on the number of remaining teeth and potential crossover factors as covariates.

RESULTS

The analysis included 495 participants (354 males and 141 females; median age, 43 years). The median number of remaining teeth among the participants was 28, and 10 participants (2.0%) had ≤ 19 teeth. The mean masticatory ability values were 39.9 for males and 37.7 for females, and 31 participants (6.3%) had low masticatory ability. In the stand-up test, those with ≤ 19 teeth had a higher LS rate than those with ≥ 20 teeth. The odds ratio for LS in the group with ≤ 19 remaining teeth was 5.99, and the confidence interval was 1.44-24.95.

CONCLUSIONS

The results confirmed signs of oral frailty in the working-age population. Further, the number of remaining teeth possibly affects standing movement. Thus, oral frailty is associated with LS in the working-age population.

Locomotive syndrome in rheumatoid arthritis patients during the COVID-19 pandemic

This study aimed to longitudinally evaluate the development of locomotive syndrome (LS) in rheumatoid arthritis (RA) patients during the COVID-19 pandemic using the 25-question Geriatric Locomotive Function Scale (GLFS-25). Subjects were 286 RA patients (female, 70.6%; mean age, 64.2 years) who had GLFS-25 and Clinical Disease Activity Index (CDAI) data available for a 1-year period during the COVID-19 pandemic and who did not have LS at baseline. Associations between subject characteristics and development of LS were determined using logistic regression analysis. Among the 286 patients, 38 (13.3%, LS group) developed LS at 1 year after baseline. In the LS group, scores of the GLFS-25 categories "GLFS-5" and "Social activities" were significantly increased at 1 year relative to baseline. GLFS-5 is a quick 5-item version of the GLFS-25, including questions regarding the difficulty of going up and down stairs, walking briskly, distance able to walk without rest, difficulty carrying objects weighing 2 kg, and ability to carry out load-bearing tasks and housework. A significant correlation was also observed between changes in "Social activities" and that of "GLFS-5." Multivariable logistic regression analysis revealed that the development of LS was significantly associated with BMI (OR: 1.11 [95% confidence interval (CI): 1.00-1.22]) and CDAI (OR: 1.08 [95%CI: 1.00-1.16]) at baseline. Adequate exercise and tight control of RA disease activity are important for preventing the development of LS in view of restrictions on going out imposed during the COVID-19 pandemic. GLFS-5 is useful for evaluating the physical function of RA patients.

Frequency-Response Relationship Between Exercise and Locomotive Syndrome Across Age Groups: Secondary Analysis of a Nationwide Cross-Sectional Study in Japan

OBJECTIVES

This study aimed to clarify the frequency-response relationship between exercise habits and locomotive syndrome in different age groups.

METHODS

We analyzed 8,681 independent community dwellers who participated in a nationwide cross-sectional locomotive syndrome study. Participants were divided into young (20-39 years), middle (40-64 years), and old (≥ 65 years) groups. The presence of locomotive syndrome was evaluated using the locomotive syndrome risk tests. Exercise habits were assessed by exercise frequency (almost every day/sometimes/occasionally/never). The association between locomotive syndrome and exercise was assessed using the multiple logistic regression analysis adjusted for participant characteristics for each age category.

RESULTS

Overall, 3,528 (41%) participants had locomotive syndrome. In the old group, the risk of locomotive syndrome was lower with an increased exercise frequency. However, this dose-response relationship was not found in the young group. The proportion of locomotive syndrome was lower even in participants who occasionally exercised (1-3 days/month) than those who never exercise in the young and middle age groups.

CONCLUSIONS

Regular exercise reduced the risk of locomotive syndrome not only in middle and older adults but also in young adults. Moreover, increasing exercise frequency may provide benefits for locomotive syndrome prevention, especially among older adults.

Are lifestyle factors significantly associated with self-rated health among Japanese female healthcare students?

Background

Self-rated health (SRH), a subjective perception of an individual’s overall health, is widely used in public health assessment. The transition from adolescence to young adulthood is a critical period involving substantial changes in lifestyle and dietary habits. Therefore, it is important to understand SRH among young Japanese females. The present study aimed to investigate the relationships between SRH among female healthcare students and their lifestyle factors, such as living status (living with others or living alone), smoking habit, alcohol consumption, frequency of breakfast consumption (FBC), physical activity, insomnia, and physique recognition.

Methods

A cross-sectional survey was conducted on 1101 female healthcare students in Japan. The body mass index was calculated from the body height and weight using data from periodic health examinations. Self-reported sociodemographic, lifestyle or dietary habits, physical activity, and SRH were used through a self-administered questionnaire. Participants were classified as having either good SRH (excellent, very good, or good) or impaired SRH (fair or poor). Multivariate logistic regression analysis was performed to investigate the independent relationships between SRH and lifestyle factors.

Results

A total of 11.4% participants demonstrated impaired SRH. Multivariate logistic regression analysis showed that the University of California Los Angeles activity score, Athens Insomnia Scale, and physique recognition were associated with SRH.

Conclusions

It was suggested that public health activities that consider physical activity, sleep, and physique recognition may help maintain and improve SRH in female university students in Japan.

Impact of Habitual Exercise on Locomotive Function of Middle-aged and Elderly Volunteers: A Longitudinal Study

OBJECTIVES

This longitudinal study aimed to evaluate the effect of acquisition of an exercise habit on locomotive dysfunction (LD).

METHODS

The subjects were 121 male and 196 female volunteers aged more than 50 years who attended health checkups in Toei, central Japan, in 2012 and 2014. We divided the subjects into three groups: an acquiring exercise group (Ac-Ex) composed of those who acquired an exercise habit between 2012 and 2014, a non-exercise group (Non-Ex) who did not acquire an exercise habit, and an exercise group (Ex) who already had an exercise habit in 2012. We compared the 25-question Geriatric Locomotive Function Scale (GLFS-25) score among the three groups.

RESULTS

In men in the Ac-Ex group, the GLFS-25 score improved significantly between 2012 and 2014 (P=0.046), and sub-analysis of the GLFS-25 responses showed that fundamental and instrumental activities of daily living (ADL) improved significantly. In women in the Ac-Ex group, the prevalence of radiologically diagnosed knee osteoarthritis was significantly higher (P=0.027) than that for the other two groups, and there was no significant improvement in GLFS-25 score over the 2-year period.

CONCLUSIONS

The acquisition of an exercise habit had a positive effect on the locomotive function in men. Orthopedic surgeons must enlighten people on the need for a continuous exercise habit.

Association between Drinking Habits and Oral Symptoms: A Cross-Sectional Study Based on Japanese National Statistical Data

Aim

The purpose of this study was to investigate the association between drinking habits and subjective symptoms of the oral cavity based on Japanese national statistical data.

Methods

The subjects were 8,698 respondents of the Japan National Livelihood Survey 2013, in their 30s to 60s. The association between drinking habits and each survey item was investigated by contingency table analysis and binary logistic regression analysis.

Results

The proportion of people with drinking habits was 55.3% among men and 20.3% among women, and the proportion of men with drinking habits above the age of 40 years was high. Contingency table analysis indicated an association between drinking habits and the following items in men: subjective symptoms (p < 0.01), chewing difficulty (p < 0.05), subjective impression of health (p < 0.01), smoking habit (p < 0.01), and income level (p < 0.01). Analysis indicated an association between drinking habits and hospital visits (p < 0.01) and smoking habits (p < 0.01) in women. When comparing the response rates of symptoms and presence of disease stratified according to drinking habits, inflammatory and sensory system symptoms were common in those who had drinking habits, as were diabetes and gout. Binomial logistic regression analysis with drinking habit as the objective variable indicated statistically significant odds ratios for smoking habit (2.13; 95% CI: 1.65-2.75), difficulty in chewing (1.63; 95% CI: 1.01-2.62), and working hours (1.50; 95% CI: 1.10-2.04). This study identified a correlation between drinking habits and masticatory disorders, suggesting that the effects of drinking as a risk factor for dental diseases should be examined in greater detail in the future.

Association between Trunk Muscle Strength, Lumbar Spine Bone Mineral Density, Lumbar Scoliosis Angle, and Skeletal Muscle Volume and Locomotive Syndrome in Elderly Individuals: A Dual-Energy X-ray Absorptiometry Study

Introduction

The present study aimed to investigate the association between trunk muscle strength, lumbar spine bone mineral density (BMD), lumbar scoliosis angle (LSA), and appendicular skeletal muscle mass index (ASMI) and the severity locomotive syndrome (LS) using dual-energy X-ray absorptiometry (DXA) technology in elderly individuals.

Methods

In this cross-sectional study, we enrolled 168 individuals aged >60 years. We measured their trunk muscle strength (flexion and extension) and BMD, LSA, and ASMI using DXA. We defined degenerative lumbar scoliosis (DLS) as LSA ≥ 10° by the Cobb method using the DXA image. The locomotor function was evaluated using the timed up-and-go (TUG) test and the 25-question Geriatric Locomotive Function Scale (GLFS-25) score. Normal locomotor function, LS-1, and LS-2 were defined as a GLFS-25 score of <7, ≥7 and <16, and ≥16, respectively. We compared the three groups, analyzing the associations between all variables and the locomotor function using univariate and multivariate analyses.

Results

Although there was no significant difference in sex ratio, BMD, ASMI, and trunk-flexor strength, significant differences were observed in age (p < 0.01), the prevalence of DLS (p = 0.02), trunk-extensor strength (p < 0.01), and trunk-extensor/flexor strength ratio (p < 0.01) among the three groups. In multiple regression analyses, the significant risk factors of the TUG test were age (β = 0.26), body mass index (β = 0.36), LSA (β = 0.15), ASMI (β = -0.30), and trunk-extensor strength (β = -0.19), whereas the significant factor of the GLFS-25 score was trunk-extensor strength (β = -0.31).

Conclusions

The results indicate that it is clinically important for LS to pay careful attention not only to BMD but also to lumbar scoliosis when DXA examination of the lumbar spine is routinely conducted. Moreover, it is essential to note that trunk-extensor strength is more important than trunk-flexor strength in maintaining locomotor function in elderly individuals.

Relationships between body mass index, lifestyle habits, and locomotive syndrome in young- and middle-aged adults: A cross-sectional survey of workers in Japan

OBJECTIVES

Although many studies have examined locomotive syndrome (LS) among elderly people, few studies have examined LS in young- and middle-aged adults. This study aimed to provide basic data on the epidemiological characteristics of LS, including in young- and middle-aged adults.

METHOD

We conducted a cross-sectional survey of a nonrandom sample of 852 adults aged 18-64 (678 males, 174 females) working in five companies in Japan, between December 2015 and February 2018. LS stage was determined using the criteria proposed by the Japanese Orthopaedic Association (JOA). LS stage 0 was defined as No-LS, and stages 1 and 2 were defined as LS. Multiple logistic regression analysis was used to investigate the independent relationship between LS and sociodemographic, smoking, alcohol drinking (AD), frequency of breakfast consumption (FBC), dietary variety score (DVS), and the University of California Los Angeles (UCLA) activity score after adjusting for age and sex.

RESULTS

We found that 23.1% of participants were evaluated as LS, including 21.5% of males and 29.3% of females (P < 0.05). Participants aged ≥45 years exhibited higher rates of LS (males: 23.1%, females: 43.6%) compared with those aged <45 years (P < 0.05). Logistic regression analysis revealed that age, body mass index (BMI), AD, UCLA activity score, and FBC were also related to LS.

CONCLUSION

Education initiatives about LS should be targeted not only to elderly populations but also to young- and middle-aged adults in the workplace.