Associations Between Cognitive Function and Muscle Quality Among Community-Dwelling Older Adults: A Cross-Sectional Study

OBJECTIVE

To investigate whether muscle quality is related to cognitive function in older adults living in the community.

METHODS

The participants were 40 community-dwelling older adults without a diagnosis of dementia (mean age, 78.85 ± 6.40 years; 31 women). The dependent variable was the score on the mild cognitive impairment (MCI) index of the Japanese version of the Neurobehavioral Cognitive Status Examination Five (range: 0-6; higher scores indicate MCI or possible dementia).

RESULTS

Multiple regression with Bayesian statistics was performed for analysis of muscle quality, as indicated by echo intensity (EI), with skeletal muscle mass index, gait speed, physical activity level, age, and sex as covariates. EI was significantly associated with the MCI index (expected a posterior = 0.04 [95% Bayesian confidence interval: 0.01, 0.07], t = 2.47, β = 0.41, p = 0.019).

CONCLUSIONS

The results suggest that EI may be related to the cognitive function of older adults living in the community. Future studies should examine whether focusing on EI can help prevent cognitive decline among older adults..

Phase Angle as a Nutritional Assessment Method in Patients with Hip Fractures: A Cross-Sectional Study

BACKGROUND

Phase angle, which is associated with cellular health, has attracted attention as a noninvasive and objective method for nutritional assessment. However, the association between malnutrition and phase angle in older inpatients with hip fractures has not been reported. Therefore, this study investigated this association in older inpatients (aged ≥65 years) with hip fractures and determined the cutoff phase angle for determining malnutrition.

METHODS

This cross-sectional study retrospectively analyzed the data of 96 inpatients with hip fractures who were hospitalized in rehabilitation units after surgery (male, 29.4%; mean age, 82.4±6.2 years). Nutritional status was assessed using the Geriatric Nutritional Risk Index (GNRI), with malnutrition defined as a GNRI ≥98. Bioelectrical impedance analysis was used to measure phase angles.

RESULTS

The phase angle was associated with malnutrition (B=-1.173; odds ratio=0.310; 95% confidence interval 0.58-0.83; p=0.015). The area under the receiver operating characteristic curve was 0.71. The cutoff phase angle for malnutrition was 3.96° (sensitivity=0.85, specificity=0.63).

CONCLUSION

Phase angle could be an indicator of malnutrition in older inpatients with hip fractures. Our findings will help formulate rehabilitation strategies for these patients.

Appetite and family and friends network among community-dwelling older adults: A cross-sectional study

OBJECTIVES

The aim of this study was to investigate the stronger correlate of appetite-family or friend networks-in community-dwelling older adults, given that undernutrition can impair physical function, increase mortality, and be influenced by social networks.

METHODS

A cross-sectional study was conducted in Kasugai City, Aichi Prefecture, and Nara City, Nara Prefecture, Japan, between August 2019 and March 2023. The analysis included 119 participants (women: 79%, mean age: 76.5 ± 5.6 y). A multiple regression analysis was performed, using the scores from the Japanese version of the Simplified Nutritional Appetite Questionnaire (SNAQ-J) as the dependent variable and family network and friend network as the independent variables. The analysis included social participation, living alone status, sex, age, body mass index, skeletal muscle mass index, grip strength, walking speed, and the Japanese version of the 15 Geriatric Depression Scale score as covariates to examine their relationship with appetite.

RESULTS

The mean value of the SNAQ-J score of the participants was 15.4 ± 1.2. Seven participants (6%) had a loss of appetite. Family network was significantly associated with appetite (B = 0.121, β = 0.266, P <0.05; 95% condidence interval [CI], 0.030-0.212). In the single regression analysis, the friend network was significantly associated with the total score of the SNAQ-J (B = 0.115, P <0.001; 95% CI, 0.052-0.177); however, this association was not observed in the multiple regression analysis (B = 0.002, β = 0.006, P = 0.954; 95% CI, -0.074-0.078).

CONCLUSION

Appetite was associated with family networks. Among social networks, focusing on family networks may help prevent the loss of appetite in older adults in Japan.

Relationship between Phase Angle and Physical Activity Intensity among Community-Dwelling Older Adults in Japan: A Cross-Sectional Study

This cross-sectional study aimed to determine the association between phase angle (PhA) and physical activity intensity in community-dwelling older Japanese adults. The intensity and time of physical activity for predicting high PhA were also examined. This study involved 67 community-dwelling older adults (mean age: 78.3 ± 5.5; female: 83.6%). We measured the physical activity and body composition of the participants. Physical activity was measured using a triaxial accelerometer, and light-intensity physical activity (LPA) and moderate-to-vigorous intensity physical activity (MVPA) hours per day were calculated from the results. Body composition was measured using Inbody S10, and the PhA was calculated from the measurements of the right side of the body. Bayesian statistical modeling revealed an association between PhA and MVPA (β = 0.256; p = 0.022; 95% Bayesian confidence interval [CI] = 0.001, 0.012), but not LPA (β = -0.113; p = 0.341; 95% Bayesian CI = -0.002, 0.001), even after adjustment for confounders. The cutoff value of MVPA predicting high PhA, calculated by the receiver operator characteristic curve, was 19.7 min/d (sensitivity = 0.906; specificity = 0.429). These results can be used to develop strategies to increase PhA in older adults and suggest that MVPA is important in this population.

Effects of depression on the condition of older inpatients with fracture and preexisting cognitive impairment

AIM

Few studies of depression have examined older inpatients with fracture and preexisting cognitive impairment. The current study sought to confirm whether depression affects the condition of older inpatients with fracture who also have cognitive impairment, and to investigate the extent to which depression affects activities of daily living.

METHODS

This was a retrospective cross-sectional study. The subjects were older inpatients with fracture and preexisting cognitive impairment. We examined data within 1 week of hospitalization, obtained from medical records. The data included demographic information, the motor Functional Independence Measure, Charlson Comorbidity Index, Mini-Mental State Examination, Geriatric Depression Scale 15, Geriatric Nutritional Risk Index, Skeletal Muscle Index and maximum grip strength test. These variables were compared between the two groups (with and without depression), and multiple regression analysis was performed with the motor Functional Independence Measure as the dependent variable.

RESULTS

The subjects were 68 patients. Only the motor Functional Independence Measure was significantly lower in the depression group than the non-depression group. Multiple regression analysis confirmed that depression strongly affected activities of daily living.

CONCLUSIONS

In considering the recovery of older inpatients with fracture and preexisting cognitive impairment, it is important to take the effects of depression into account.Implications for rehabilitationThe number of older fracture inpatients with cognitive impairment is predicted to increase, and such patients have a high prevalence of depression.Depression strongly affected Activities of Daily Living in older inpatients with fracture and pre-existing cognitive impairment.Focusing on depression assessment and intervention is important for rehabilitation of older fracture inpatients with cognitive impairment.

Experiment study on fracture fixation with low rigidity titanium alloy: plate fixation of tibia fracture model in rabbit

In order to investigate bone tissue reaction to the low rigidity titanium alloy of TNTZ in bone plate fixation, animal experiment with rabbit was performed with X-ray follow-up and histological observation. Experimental fractures were made in rabbit tibiae, and fixed by different bone plates of SUS316L, Ti-6Al-4V and TNTZ. Although there was no significant difference in fracture healing, bone atrophy was observed in cortical bone especially under the bone plate, which was different in time course among three materials. The bone atrophy under the bone plate was confirmed as porous or poor bone tissue in histological observation. In addition, the diameter of the tibia bone was increased in TNTZ as the result of bone remodeling with a new cortical bone. It is confirmed that the elastic modulus of the bone plate will naturally influence bone tissue reaction to the bone plate fixation according to the Wolff's law of functional restoration.

Dopamine and serotonin uptake inhibitors on the release of dopamine and serotonin in the nucleus accumbens of young and aged rats

Nucleus accumbens (ACC) of young (4 months old) and aged (24 months old) Wistar rats were perfused with dopamine (DA) uptake blocker, cocaine, or the serotonin (5-HT) selective reuptake inhibitor, fluoxetine, through the microdialysis probe membrane, used to assess the dopamine transporter (DAT) or serotonin transporter (SERT) modulation. The basal extracellular DA release in the ACC was significantly lower in aged rats than young rats. Analysis of DA and 5-HT concentrations in the ACC with increased positive GFAP revealed that DA and DOPAC levels of aged rats were decreased to 55 and 60% of those in young rats, respectively. After co-perfusion with cocaine, both DA and 5-HT releases in the ACC were increased in the young and aged groups. However, the magnitude of the increased DA release was lower in aged rats than young rats. Co-perfusion with fluoxetine showed lower magnitude of the increased DA release in aged rats. It appears that the DAT and SERT system responds initially to ACC cell loss with age, and that especially ACC DAT in the aged rat is more degenerative compared with the young rats. These findings suggest that the serotonergic system with SERT in the remaining ACC neurons show an early adaptive response and resistance to the normal aging and maintain the multiple regulatory system in the ACC despite neural loss since the dopaminergic neurons in the aged animals are vulnerable to aging.

Alcohol enhances characteristic releases of dopamine and serotonin in the central nucleus of the amygdala

The amygdaloid complex (AMY) is implicated in emotional and motivational aspects of behavior, including the formation of positive reinforcement association. AMY may also associated with brain rewarding circuitry. In the present study, the effect of ethanol (EtOH) on the release of dopamine (DA) and serotonin (5-HT) was studied in the central amygdaloid nucleus (CeAMY), and projecting excitatory afferents to the ventral tegmental area (VTA), of freely moving Wistar rats by brain microdialysis. Within 20 min of i.p. injection of EtOH (2 g/kg), the levels of DA and 5-HT in the CeAMY dialysate increased over the baseline value by 270 and 160% (N = 6-7), respectively. Addition of EtOH (25, 50 and 100 mM) to the microdialysis perfusion medium for 1 h caused a 115-150% dose-related increase in the extracellular level of DA in the CeAMY. 100 mM EtOH-induced CeAMY DA release continued to increase for 1 h after the perfusion medium was returned to normal perfusion medium. In contrast, the CeAMY 5-HT level was increased only by the addition of 100 mM EtOH for 1 h to 130% for 80 min. The stimulation of the CeAMY by EtOH through the microdialysis membrane showed delayed responses of DA and 5-HT compared with the i.p. injection of EtOH. Overall, the present findings are not sufficient to conclude whether EtOH acts directly or indirectly on the major monoamine nerve cells in the CeAMY, but the degree of acute EtOH action affected the differences in time at the peak response on EtOH-induced DA and 5-HT releases in the CeAMY via VTA.

Changes in dopamine transporter and c-Fos expression in the nucleus accumbens of alcohol-tolerant rats

BACKGROUND

We have shown that neurochemical functions of 5-HT3 receptors in regulating dopamine (DA) release in the nucleus accumbens (ACC) after alcohol exposure compensate for the dysfunction of serotonergic activity to restore the original properties in processing alcohol tolerance, and that the development of alcohol dependence may be mediated by ACC 5-HT3 receptors. In the present study, the effects of chronic alcohol consumption on the functions of the dopamine transporter (DAT) and the expression of c-Fos proteins were investigated using in vivo brain microdialysis and immunocytochemistry.

METHODS

Perfusion of cocaine and 1-(2-Bis-(4-fluorophenyl) methoxy) ethyl)-4-(3-phenylpropyl) piperizine (GBR 12909) through the microdialysis probe membrane increased the extracellular levels of DA in ACC of alcohol-treated rats that had developed alcohol tolerance by drinking 10% EtOH for 30 days.

RESULTS

The magnitudes of DA reuptake or DAT inhibitors, cocaine, and GBR 12909 that induced DA availability in the ACC were significantly higher in alcohol-treated rats than in controls. When compared with control rats, the alcohol-treated rats exhibited higher levels of DA and its metabolite, DOPAC, in the ACC. Increased expression of the c-Fos-like protein was found in the ACC of alcohol-treated rats. These results show that (1) chronic alcohol consumption desensitizes or decreases the DAT of DA terminals in the ACC and that (2) EtOH causes cellular hyperexcitability of ACC dopaminergic neurons with increased Fos expression during alcohol tolerance.

CONCLUSION

The findings suggested that an abnormality of the dopaminergic neurons in the ACC that are involved with DAT dysfunction is associated with the development of alcohol tolerance.

Legg-Calvé-Perthes disease in the evolutionary period: comparison of magnetic resonance imaging with bone scintigraphy

Magnetic resonance images (MRIs) and pinhole scintigraphs were obtained in 40 patients (40 hips) with Legg-Calvé-Perthes disease in the evolutionary phase, the mean age at onset of symptoms being 6 years 7 months. The correlation between the uptake of the pinhole scintigraphs and the signal intensity of MRIs was examined in reference to the extent of the involved femoral epiphysis. MRIs depicted the extent of the involved femoral epiphysis more clearly than did pinhole scintigraphs. The uptakes of the pinhole scintigraphs corresponded with high or normal intensity of T2-weighted images on MRI. The femoral epiphysis in the initial phase (in which the signal intensity of the lateral area of the epiphysis on T1-weighted coronal images was low or intermediate and high or unchanged on T2-weighted coronal images corresponded to the lateral column [recanalization] on the pinhole scintigraphs) suggested a low risk of subsequent deformity. MRI is a powerful new technique to evaluate the femoral epiphysis in Legg-Calvé-Perthes disease.

Acetabular development after closed reduction of congenital dislocation of the hip

We reviewed the serial radiographs of 54 hips in 47 children treated by closed reduction for congenital dislocation of the hip and followed to at least 14 years of age, to determine the causes of acetabular dysplasia. We excluded hips with femoral head deformity or residual subluxation and compared the results with those from a control series of unaffected hips of patients with unilateral CDH. Acetabular development after the age of 11 or 12 years was significantly worse in Severin group III than in Severin group I hips on the affected side or Severin group III in unaffected control hips. One of the causes of acetabular dysplasia at maturity was found to be impairment of acetabular development after 11 or 12 years of age. This may be attributable to impaired secondary ossification in the acetabular rim. Our findings emphasise the importance of continuing the follow-up of patients treated for congenital dislocation of the hip until full skeletal maturity.