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Kuroda Y, Fujita K, Sugimoto T, Uchida K, Shimazu T, Saito J, Arai H, Sakurai T. Feasibility of a community-adapted multi-domain intervention for dementia prevention among older adults: a research protocol. Arch Public Health 2023; 81:191. [PMID: 37907936 PMCID: PMC10617126 DOI: 10.1186/s13690-023-01205-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 10/20/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Multi-domain interventions effectively prevent dementia in clinical settings; however, their efficacy within local communities is unclear. This study assesses the feasibility of an adapted multi-domain intervention for dementia prevention in community-dwelling older adults. METHODS The single-arm trial enrolls 60 participants from two Obu City communities, Japan. PRIMARY OUTCOME participant retention in the adapted multi-domain intervention; secondary outcomes: health and implementation outcomes. Over 12 months, a team of researchers and public health nurse oversees the study in the first half, gradually shifting the management to public health nurses in the second half. Using the Framework for Reporting Adaptations and Modifications-Enhanced, the clinical programme is adjusted for the local community. It includes a 60-minute exercise and 30-minute group sessions, targeting lifestyle, diet, and social participation. DISCUSSION This pioneer study evaluates the feasibility of an adapted intervention programme for dementia prevention in a community setting. Challenges in disseminating dementia prevention programmes warrant further investigation into effective implementation as well as strategies and methods to appeal to the target population. Upon confirming this programme's feasibility, future studies can further evaluate its broader effectiveness. TRIAL REGISTRATION The protocol is registered with the Clinical Trials Registry (UMIN-CTR) of the University Hospital's Medical Information Network, under registration number UMIN000050581.
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Affiliation(s)
- Yujiro Kuroda
- Department of Prevention and Care Science, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, 474-8511, Aichi, Japan.
| | - Kosuke Fujita
- Department of Prevention and Care Science, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, 474-8511, Aichi, Japan
| | - Taiki Sugimoto
- Department of Prevention and Care Science, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, 474-8511, Aichi, Japan
| | - Kazuaki Uchida
- Department of Prevention and Care Science, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, 474-8511, Aichi, Japan
| | - Taichi Shimazu
- Division of Behavioural Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Junko Saito
- Division of Behavioural Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Hidenori Arai
- Department of Prevention and Care Science, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, 474-8511, Aichi, Japan
- National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Takashi Sakurai
- Department of Prevention and Care Science, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, 474-8511, Aichi, Japan
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Arai H, Maeda K, Wakabayashi H, Naito T, Konishi M, Assantachai P, Auyeung WT, Chalermsri C, Chen W, Chew J, Chou M, Hsu C, Hum A, Hwang IG, Kaido T, Kang L, Kamaruzzaman SB, Kim M, Lee JSW, Lee W, Liang C, Lim WS, Lim J, Lim YP, Lo RS, Ong T, Pan W, Peng L, Pramyothin P, Razalli NH, Saitoh M, Shahar S, Shi HP, Tung H, Uezono Y, von Haehling S, Won CW, Woo J, Chen L. Diagnosis and outcomes of cachexia in Asia: Working Consensus Report from the Asian Working Group for Cachexia. J Cachexia Sarcopenia Muscle 2023; 14:1949-1958. [PMID: 37667992 PMCID: PMC10570088 DOI: 10.1002/jcsm.13323] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 07/05/2023] [Accepted: 08/02/2023] [Indexed: 09/06/2023] Open
Abstract
Chronic diseases often lead to metabolic disorders, causing anabolic resistance and increased energy consumption, which result in cachexia. Cachexia, in turn, can lead to major clinical consequences such as impaired quality of life, shortened life expectancy, and increased healthcare expenditure. Existing international diagnostic criteria for cachexia employ thresholds derived from Western populations, which may not apply to Asians due to differing body compositions. To address this issue, the Asian Working Group for Cachexia (AWGC) was initiated. The AWGC comprises experts in cachexia research and clinical practice from various Asian countries and aims to develop a consensus on diagnostic criteria and significant clinical outcomes for cachexia in Asia. The AWGC, composed of experts in cachexia research and clinical practice from several Asian countries, undertook three-round Delphi surveys and five meetings to reach a consensus. Discussions were held on etiological diseases, essential diagnostic items for cachexia, including subjective and objective symptoms and biomarkers, and significant clinical outcomes. The consensus highlighted the importance of multiple diagnostic factors for cachexia, including chronic diseases, either or both weight loss or low body mass index, and at least one of the following: anorexia, decreased grip strength (<28 kg in men and <18 kg in women), or elevated C-reactive protein levels (>5 mg/L [0.5 mg/dL]). The AWGC proposed a significant weight change of 2% or more over a 3-6 month period and suggested a tentative cut-off value of 21 kg/m2 for low body mass index in diagnosing cachexia. Critical clinical outcomes were determined to be mortality, quality of life as assessed by tools such as EQ-5D or the Functional Assessment of Anorexia/Cachexia Therapy, and functional status as measured by the Clinical Frailty Scale or Barthel Index, with significant emphasis on patient-reported outcomes. The AWGC consensus offers a comprehensive definition and user-friendly diagnostic criteria for cachexia, tailored specifically for Asian populations. This consensus is set to stimulate future research and enhance the multidisciplinary approach to managing cachexia. With plans to develop further guidelines for the optimal treatment, prevention, and care of cachexia in Asians, the AWGC criteria are expected to drive research across chronic co-morbidities and cancer in Asia, leading to future refinement of diagnostic criteria.
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Affiliation(s)
- Hidenori Arai
- National Center for Geriatrics and GerontologyObuJapan
| | - Keisuke Maeda
- Nutrition Therapy Support CenterAichi Medical University HospitalNagakuteJapan
- Department of Geriatric MedicineNational Center for Geriatrics and GerontologyObuJapan
| | - Hidetaka Wakabayashi
- Department of Rehabilitation MedicineTokyo Women's Medical University HospitalTokyoJapan
| | - Tateaki Naito
- Division of Thoracic OncologyShizuoka Cancer CenterShizuokaJapan
| | - Masaaki Konishi
- Department of CardiologyYokohama City University School of MedicineYokohamaJapan
| | | | - Wai Tung Auyeung
- Jockey Club Institute of AgeingThe Chinese University of Hong KongShatinHong KongChina
| | - Chalobol Chalermsri
- Department of Preventive and Social Medicine, Division of Geriatric Medicine, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
- Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
| | - Wei Chen
- Department of Clinical Nutrition, Department of Health MedicinePeking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Justin Chew
- Department of Geriatric MedicineTan Tock Seng HospitalSingapore
- Institute of Geriatrics and Active AgeingTan Tock Seng HospitalSingapore
| | - Ming‐Yueh Chou
- Center for Geriatrics and GerontologyKaohsiung Veterans General HospitalKaohsiung CityTaiwan
| | - Chih‐Cheng Hsu
- National Center for Geriatrics and Welfare ResearchMiaoli CountyTaiwan
| | - Allyn Hum
- Department of Geriatrics and Palliative CareTan Tock Seng HospitalSingapore
| | - In Gyu Hwang
- Department of Internal MedicineChung‐Ang University Hospital, Chung‐Ang University College of MedicineSeoulRepublic of Korea
| | - Toshimi Kaido
- Department of Gastroenterological and General SurgerySt. Luke's International HospitalTokyoJapan
| | - Lin Kang
- Department of Geriatric MedicinePeking Union Medical College HospitalBeijingChina
| | | | - Miji Kim
- Department of Biomedical Science and Technology, College of Medicine, East‐West Medical Research InstituteKyung Hee UniversitySeoulRepublic of Korea
| | - Jenny Shun Wah Lee
- Institute of AgingThe Chinese University of Hong Kong, Department of Medicine, Alice Ho Miu Ling Nethersole HospitalTai PoHong Kong
| | - Wei‐Ju Lee
- Aging and Health Research CenterNational Yang Ming Chiao Tung UniversityTaipei CityTaiwan
| | - Chih‐Kuang Liang
- Center for Geriatrics and GerontologyKaohsiung Veterans General HospitalKaohsiung CityTaiwan
- Center for Healthy Longevity and Aging SciencesNational Yang Ming Chiao Tung UniversityTaipei CityTaiwan
| | - Wee Shiong Lim
- Department of Geriatric Medicine, Institute of Geriatric MedicineTan Tock Seng HospitalSingapore
- Lee Kong Chian School of MedicineNanyang Technological UniversitySingapore
| | - Jae‐Young Lim
- Department of Rehabilitation MedicineSeoul National University College of Medicine, Seoul National University Bundang HospitalSeongnamRepublic of Korea
| | - Yen Peng Lim
- Department of Nutrition and DieteticsTan Tock Seng HospitalSingapore
| | - Raymond See‐Kit Lo
- Department of Medicine and TherapeuticsChinese University of Hong Kong, Shatin HospitalMa On ShanHong Kong
| | - Terence Ong
- Department of Medicine, Faculty of MedicineUniversity MalayaKuala LumpurMalaysia
| | - Wen‐Harn Pan
- Institute of Biomedical SciencesAcademia Sinica, TaiwanTaipei CityTaiwan
| | - Li‐Ning Peng
- Aging and Health Research CenterNational Yang Ming Chiao Tung UniversityTaipei CityTaiwan
| | - Pornpoj Pramyothin
- Division of Nutrition, Department of Medicine, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Nurul Huda Razalli
- Centre for Healthy Aging and Wellness (H‐CARE), Faculty of Health SciencesUniversiti Kebangsaan Malaysia, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul AzizKuala LumpurMalaysia
| | - Masakazu Saitoh
- Department of Physical Therapy, Faculty of Health ScienceJuntendo UniversityTokyoJapan
| | - Suzana Shahar
- Center for Healthy Aging and Wellness, Faculty Health SciencesUniversiti Kebangsaan MalaysiaKuala LumpurMalaysia
| | - Han Ping Shi
- Department of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan HospitalCapital Medical University of ChinaBeijingChina
| | - Heng‐Hsin Tung
- National Yang Ming Chiao Tung UniversityTaipei CityTaiwan
| | - Yasuhito Uezono
- Department of Pain Control ResearchThe Jikei University School of MedicineTokyoJapan
| | - Stephan von Haehling
- Department of Cardiology and PneumologyUniversity of Goettingen Medical Center, Georg‐August‐University GoettingenGoettingenGermany
- German Center for Cardiovascular Research (DZHK), partner site GöttingenGöttingenGermany
| | - Chang Won Won
- Department of Family MedicineCollege of Medicine, Kyung Hee UniversitySeoulRepublic of Korea
| | - Jean Woo
- Department of Medicine & TherapeuticsThe Chinese University of Hong Kong, Prince of Wales HospitalHong Kong SARChina
| | - Liang‐Kung Chen
- Center for Healthy Longevity and Aging SciencesNational Yang Ming Chiao Tung UniversityTaipei CityTaiwan
- Center for Geriatrics and GerontologyTaipei Veterans General Hospital; Taipei Municipal Gan‐Dau HospitalTaipei CityTaiwan
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Maeda K, Nagasaka M, Nagano A, Nagami S, Hashimoto K, Kamiya M, Masuda Y, Ozaki K, Kawamura K. Ultrasonography for Eating and Swallowing Assessment: A Narrative Review of Integrated Insights for Noninvasive Clinical Practice. Nutrients 2023; 15:3560. [PMID: 37630750 PMCID: PMC10460049 DOI: 10.3390/nu15163560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/28/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
Dysphagia is a syndrome of abnormal eating function resulting from a variety of causative diseases, and is associated with malnutrition. To date, the swallowing function has been difficult to examine without the use of invasive and expensive methods, such as the videofluorographic swallowing study or fiberoptic endoscopic evaluation of swallowing. In recent years, progress has been made in the clinical application of ultrasound equipment for the evaluation of body compositions near the body surface, including the assessment of nutritional status. Ultrasound examination is a noninvasive procedure and relatively inexpensive, and the equipment required is highly portable thanks to innovations such as wireless probes and tablet monitoring devices. The process of using ultrasound to visualize the geniohyoid muscle, digastric muscle, mylohyoid muscle, hyoid bone, tongue, masseter muscle, genioglossus muscle, orbicularis oris muscle, temporalis muscle, pharynx, esophagus, and larynx, and the methods used for evaluating these structures, are provided in this study in detail. This study also aims to propose a protocol for the assessment of swallowing-related muscles that can be applied in real-world clinical practice for the diagnosis of sarcopenic dysphagia, which can occur in elderly patients with sarcopenia, and has received much attention in recent years.
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Affiliation(s)
- Keisuke Maeda
- Nutrition Therapy Support Center, Aichi Medical University Hospital, Nagakute 480-1195, Japan
- Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan
| | - Motoomi Nagasaka
- Department of Rehabilitation Medicine, Hospital, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan; (M.N.); (K.H.); (M.K.); (Y.M.); (K.O.); (K.K.)
| | - Ayano Nagano
- Department of Nursing, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya 663-8211, Japan;
| | - Shinsuke Nagami
- Department of Speech Language Pathology and Audiology, Faculty of Rehabilitation, Kawasaki University of Medical Welfare, Okayama 701-0193, Japan;
| | - Kakeru Hashimoto
- Department of Rehabilitation Medicine, Hospital, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan; (M.N.); (K.H.); (M.K.); (Y.M.); (K.O.); (K.K.)
| | - Masaki Kamiya
- Department of Rehabilitation Medicine, Hospital, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan; (M.N.); (K.H.); (M.K.); (Y.M.); (K.O.); (K.K.)
| | - Yuto Masuda
- Department of Rehabilitation Medicine, Hospital, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan; (M.N.); (K.H.); (M.K.); (Y.M.); (K.O.); (K.K.)
| | - Kenichi Ozaki
- Department of Rehabilitation Medicine, Hospital, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan; (M.N.); (K.H.); (M.K.); (Y.M.); (K.O.); (K.K.)
| | - Koki Kawamura
- Department of Rehabilitation Medicine, Hospital, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan; (M.N.); (K.H.); (M.K.); (Y.M.); (K.O.); (K.K.)
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