The purpose of this study was to examine the effects of a six-month Square-Stepping Exercise (SSE) program on physical fitness and cognitive function in elderly and the effects of differences in cognitive function levels before the program on cognitive function. Twenty-four elderly (≧75 years old, mean age: 80.7±3.8 years) participated in the SSE program (once a week, 90 minutes/session, for six months). Grip strength, single leg balance with eyes open, chair stand, figure-8 walking test, and cognitive function (Five Cog) were measured before and after the program. Physical function did not improve during the SSE program. Significant memory and language improvements in Five Cog were observed. There was no significant interaction between the pre cognitive function level and the pre results. In conclusion, the six-month SSE program is an effective exercise for improving memory and language in cognitive function of elderly women and prevented physical function decline. However, there was no difference in the improvement due to the pre cognitive function level.

A 60-year-old woman was treated with oxycodone extended-release tablets for the cancer pain due to cervical cancer, and oxycodone was continued for abdominal pain due to radiation enteritis, laparotomy, small bowel obstruction, and constipation even after the cancer had been cured with chemoradiotherapy. The patient experienced severe drowsiness, and the opioid analgesics dose was gradually reduced. The dose was reduced by switching from oxycodone extended-release tablets to morphine powder. The patient’s drowsiness, constipation, and abdominal pain improved with reduction in opioid dosage, but she developed malaise, sweating, and agitation. These symptoms improved with morphine powder; thus, she was diagnosed with opioid withdrawal syndrome. We attempted to further reduce the dose gradually over a period of four years, but withdrawal symptoms reappeared when morphine powder was discontinued. Therefore, at present, we are administering her small doses of morphine powder. Though inappropriate use of opioid analgesics should be strictly avoided, in some cases, long-term use under careful specialist supervision may be necessary before discontinuation of opioid analgesics.

This study aimed to investigate the effects of participating in a voluntary community-based square-stepping exercise (SSE) salon and analyze the effects of different activity frequencies (weekly or biweekly) in the SSE salon on the physical functions of community-dwelling older women. Older women attending the SSE salon were enrolled in the study, and measurements of physical functions (grip strength, one-leg standing, 5 m walk, timed up and go [TUG], and chair-stand in 30 s) were performed at pre and post intervention for SSE salon development and at 1 year following voluntary activity initiation (1-year follow-up) (mean age: 77.1 ± 7.2 years). Participants were divided into two groups (a weekly group performing SSE once a week and a biweekly group performing SSE once every 2 weeks) and were analyzed accordingly. The results revealed interaction in the TUG test, with significant improvement observed in the weekly group at preintervention, postintervention, and 1-year follow-up. Conversely, the biweekly group significantly improved at the 1-year follow-up compared with the pre and postintervention groups. No significant difference was observed in other parameters. In conclusion, regular participation in the SSE salon, even if the frequency is biweekly, was suggested to be effective in maintaining and improving physical function.