Abstract
Objective : The purpose of this study was to verify characteristics, including changes in emotional state and finger motor function, in elderly subjects over the course of piano lessons.
Methods : Fifty-five healthy elderly subjects took part in this study. Subjects were assigned to either a “piano group” (total no. 32) or a “control group” (total no. 22), respectively. Piano group subjects participated in piano lessons for 3 months (total of 6 sessions). Characteristics of the elderly piano-learning subjects were analysed by noting the frequency and length of practice, by a tapping speed test and an emotion scale (the Mood Check List-Short Form 1 : MCL-S1 and the Face Scale).
Results : A significant difference was found when comparing the pre-score and post-score results of the piano group with those of control group in both the MCL-S1 “anxiety” test (p=0.04) and the rapid finger tapping test (p<0.01), with the latter test results being significantly better in the piano group, with four kinds of assessment. Comparing the difference between the pre-score and post-score results for Face Scale in the piano group with that of the control group, revealed no statistically significant difference (p=0.16).
Conclusion : In elderly subjects, learning piano is effective for relieving anxiety and improving finger motor tapping speed.

Abstract
Objective : The purpose of this study was to compare the effects of the emotional response to “pleasant conversation” and “reading aloud”, on the autonomic nervous system of elderly subjects, in addition to the value of conversational exchange and its usefulness as part of a care strategy in the elderly.
Methods : Twelve elderly subjects aged 65 years and over were included in this study. Three kinds of interventions were used including : (1) reading aloud, (2) pleasant conversation and (3) silent reading, respectively. Each task was carried out daily and the resulting effects were recorded. A task typically lasted 20 minutes in duration followed by 10 minutes of rest after which, the task was repeated for another 5 minutes followed by 5 minutes of rest. We examined changes in the autonomic nervous system by using a power spectrum analysis of heart rate variability.
Results : Strong stimulation of the autonomic nervous system occurred with the implementation of the five-minutes of “pleasant conversation” in keeping with the results of previous studies. Following completion of this task, the sympathetic activity decreased with a subsequent increase in parasympathetic nervous activity which was different compared to “reading aloud”. It is considered that changes of parasympathetic activity impact on the relaxation and satisfaction centers of the brain in the elderly.
Conclusion : This study identified that the introduction of “pleasant conversation”, activates a function of the autonomic nervous system involved in stimulating brain relaxation and satisfaction centers within a short time period compared to “reading aloud”. It is considered that changes in emotion brought about by the interventions in this study occurred in a short period of time and can potentially be used in clinical practice. It is suggested that “pleasant conversation” is introduced as part of a comprehensive care plan in the elderly.

Introduction : The aim of this study was to determine the significance of the effects of hearing loss and different hearing abilities of both ears on mental activity and social interaction in the elderly.
Methods : Fifty-six community dwelling elderly subjects were included in this study. Hearing acuity was measured and a questionnaire was undertaken in all subjects to evaluate their mental activity and social interaction. Based on the answers, the subjects were divided into (1) 3 groups, according to the level of hearing loss, and (2) 2 groups, according to the differences in hearing.
Results : (1) When hearing by audiometric testing was compared to mental activity, no direct effects were found. Based on the questionnaire results, the subjects in the group with the greatest hearing loss were determined to be psychologically affected, and they therefore avoided social interactions. These patients were at risk of being socially isolated. (2) One group showed differences in hearing abilities of both ears, which could be a possible risk factor for loneliness and depression.
Conclusion : This study suggests that hearing loss and different hearing ability of both ears affects mental activity and social interaction in the elderly. Both depression and being socially isolated are included under the Long-Term Care Prevention Project. It is necessary to determine the degree of hearing loss by using both subjective and objective evaluations.

Purpose : This study aimed to explore the factors which interfere with advance decision-making with regards to artificial hydration and nutrition (AHN) in the senescent population.
Methods : Subjects were local residents aged 60 years or older who were leading an independent life and who could go out by themselves. A cross-sectional study using a self-administered questionnaire was conducted from August to November 2011. Valid responses were obtained from 116 subjects, for a valid response rate of 90.6%. Advance AHN decisions, knowledge about AHN, intentions regarding advance directives and end-of-life care, experience providing long-term care, in addition to other questions, were analyzed using a multiple logistic regression model.
Results : With respect to advance decisions regarding AHN, 25 respondents (21.6%) indicated that they could not make a decision, while 91 respondents (78.4%) could. Sixteen respondents (13.8%) desired some component of AHN, while 75 respondents (64.7%) did not desire any AHN. Factors related to difficulty with advance decisions regarding AHN were : 1) lack of adverse experiences associated with decreased cognitive function (“experience of failure”) (OR=12.0, 95%CI=1.42-100.41, p<.022), 2) lack of experience providing long-term care for a family member (“experience of caring”) (OR=3.0, 95%CI=1.04-8.53, p<.042), and 3) desire to defer such decisions to others in the event of unconsciousness or other incompetency rather than an advance decision (“reliance on others”) (OR=5.6, 95%CI=1.95-16.24, p<.001).
Conclusion : Factors related to difficulty with advance decisions regarding AHN in the senescent population were lack of adverse experiences associated with decreased cognitive function, lack of experience providing long-term care for a family member, and desire to defer such decisions to others in the event of unconsciousness or other incompetency rather than an advance decision.

Introduction: This study used a meta-analysis to investigate factors related to dizziness/vertigo and their effect size in community-dwelling elderly people.Methods: The search terms "elderly," "dizzy," "community dwelling," and others were used, and a database search was conducted using Ichushi Web and PubMed.Result: In total, 10 studies were extracted. Meta-analysis calculated 28 items as significantly related factors: anxiety, fatigue, taking nitric acid drugs, taking anxiolytics, low self-rated health, memory impairment, depression, sleep disorder, dementia, cancer, balance failure, gait disturbance, physical dysfunction, taking diuretics, living alone, heart disease, fall history, rheumatoid arthritis, stroke, taking sleeping pills, taking multiple drugs, visual impairment, female, ADL impairment, osteoporosis, taking antihypertensive drugs, hypertension, and low education level.Conclusion: The above items may be key variables for investigating dizziness/vertigo in the future.