Background: Calf muscle circumference is a potential alternative for measuring skeletal muscle mass. However, the association between calf muscle circumference and sarcopenia and the reliability of sarcopenia diagnosis based on calf muscle circumference have not been well reported. In this study, we aimed to determine the usefulness of calf muscle circumference measurement in the diagnosis of sarcopenia. Methods: A cross-sectional study was conducted using data collected from 63 older adults (40 male and 23 female; mean age, 79.7±6.5 years) using day-care rehabilitation. Sarcopenia was defined according to the guidelines of the 2019 Asian Working Group for Sarcopenia (AWGS 2019). The association between sarcopenia and calf muscle circumference was determined using multiple regression analysis, and the reliability of sarcopenia diagnosis based on calf muscle circumference was determined using the kappa coefficient. Results: Overall, 36.5% (30.4% female and 40.0% male) of the participants had sarcopenia. Calf muscle circumference was independently associated with sarcopenia. The best cutoff points for calf muscle circumference to identify older adults at risk of low skeletal muscle mass were 28.7 cm and 31.1 cm for female and male participants, respectively. Furthermore, the kappa coefficient between sarcopenia diagnosed using calf muscle circumference and that diagnosed using the AWGS 2019 criteria was 0.80. Conclusions Calf muscle circumference is independently and significantly associated with sarcopenia in older adults requiring long-term care. Calf muscle circumference is a surrogate for skeletal muscle mass and thus may be used to diagnose sarcopenia.

Background: Calf muscle circumference is a potential alternative for measuring skeletal muscle mass. However, the association between calf muscle circumference and sarcopenia and the reliability of sarcopenia diagnosis based on calf muscle circumference have not been well reported. In this study, we aimed to determine the usefulness of calf muscle circumference measurement in the diagnosis of sarcopenia. Methods: A cross-sectional study was conducted using data collected from 63 older adults (40 male and 23 female; mean age, 79.7±6.5 years) using day-care rehabilitation. Sarcopenia was defined according to the guidelines of the 2019 Asian Working Group for Sarcopenia (AWGS 2019). The association between sarcopenia and calf muscle circumference was determined using multiple regression analysis, and the reliability of sarcopenia diagnosis based on calf muscle circumference was determined using the kappa coefficient. Results: Overall, 36.5% (30.4% female and 40.0% male) of the participants had sarcopenia. Calf muscle circumference was independently associated with sarcopenia. The best cutoff points for calf muscle circumference to identify older adults at risk of low skeletal muscle mass were 28.7 cm and 31.1 cm for female and male participants, respectively. Furthermore, the kappa coefficient between sarcopenia diagnosed using calf muscle circumference and that diagnosed using the AWGS 2019 criteria was 0.80. Conclusions Calf muscle circumference is independently and significantly associated with sarcopenia in older adults requiring long-term care. Calf muscle circumference is a surrogate for skeletal muscle mass and thus may be used to diagnose sarcopenia.

Background: Calf muscle circumference is a potential alternative for measuring skeletal muscle mass. However, the association between calf muscle circumference and sarcopenia and the reliability of sarcopenia diagnosis based on calf muscle circumference have not been well reported. In this study, we aimed to determine the usefulness of calf muscle circumference measurement in the diagnosis of sarcopenia. Methods: A cross-sectional study was conducted using data collected from 63 older adults (40 male and 23 female; mean age, 79.7±6.5 years) using day-care rehabilitation. Sarcopenia was defined according to the guidelines of the 2019 Asian Working Group for Sarcopenia (AWGS 2019). The association between sarcopenia and calf muscle circumference was determined using multiple regression analysis, and the reliability of sarcopenia diagnosis based on calf muscle circumference was determined using the kappa coefficient. Results: Overall, 36.5% (30.4% female and 40.0% male) of the participants had sarcopenia. Calf muscle circumference was independently associated with sarcopenia. The best cutoff points for calf muscle circumference to identify older adults at risk of low skeletal muscle mass were 28.7 cm and 31.1 cm for female and male participants, respectively. Furthermore, the kappa coefficient between sarcopenia diagnosed using calf muscle circumference and that diagnosed using the AWGS 2019 criteria was 0.80. Conclusions Calf muscle circumference is independently and significantly associated with sarcopenia in older adults requiring long-term care. Calf muscle circumference is a surrogate for skeletal muscle mass and thus may be used to diagnose sarcopenia.

BACKGROUND: Although serum carotene may contribute to dementia prevention, there is a lack of longitudinal evidence for early cognitive decline before dementia symptoms. The aim of this study was to examine whether serum carotene levels were associated with annually evaluated cognitive trajectories among the Japanese general population. METHODS: Among 581 baseline participants, 199 individuals (83 males; mean age [min, max], 62.7 [39, 90] years) who underwent cognitive assessments more than twice after baseline were analyzed. "Attention" levels were assessed using one- and three-target Digit Cancellation Tests (D-CAT1 and D-CAT3). "General cognitive ability" was assessed by the short version of Mini-Mental State Examination (SMMSE). Serum carotenes (α-carotene, β-carotene and lycopene) were measured by high-performance liquid chromatography. After the measurements, we calculated total carotene levels by summing up the levels of all measured carotene. Carotene levels were categorized into three groups for analysis (low: 0%-25%, middle: 25%-75%, and high: 75%-100%). A linear mixed model was used to estimate the slope of the D-CAT score trajectory and to compare it between three categories. RESULTS: Compared with the middle carotene group, decline of attention was faster in the D-CAT1 for low β-carotene (β = -3.48, p = 0.035), lycopene (β = -3.10, p = 0.062), and total carotene (β = -4.75, p = 0.003), but not for α-carotene (β = -2.60, p = 0.111). For the D-CAT3, decline of attention was faster in the group of low lycopene (β = -3.17, p = 0.002) and total carotene (β = -2.17, p = 0.037) compared with the middle carotene group, while no clear association for α-carotene (β = -0.67, p = 0.521) and β-carotene (β = -0.64, p = 0.639). There were no clear associations between serum carotene and the SMMSE score. CONCLUSIONS These findings suggest low levels of serum lycopene are associated with a decline of attention in the setting of the general population.
Humans ; Male ; Carotenoids/blood* ; Female ; Longitudinal Studies ; Middle Aged ; Japan ; Aged ; Adult ; Aged, 80 and over ; Attention ; Lycopene ; East Asian People

Background and aims:Lenvatinib(LEN)is a newly developed tyrosine kinase inhibitor,and is approved as a first-line treatment for advanced hepatocellular carcinoma(HCC)in Japan.This retrospective multi-center study investigated the effect of the relative dose intensity(RDI)of LEN on response rate,progression-free survival(PFS),and overall survival(OS). Methods:This retrospective study enrolled 123 patients with advanced HCC who were treated with LEN at six hospitals in Japan between March 2018 and December 2019.These patients were divided into two groups:RDI ≥70％(RDI 70 group,N=70)or RDI＜70％(control group,N=53)in the first 30 days.The following data were compared between groups:patient backgrounds,adverse events,treatment out-comes,PFS,and OS.PFS and OS were analyzed using the Kaplan-Meier method,followed by the log-rank test.To identify significant factors that contributed to response,PFS,and OS,multivariate analysis was performed using factors for which P-values were ＜0.10 in univariate analysis. Results:The proportion of patients with Child-Pugh class 5A was significantly greater in the RDI 70 group than that in the control group(64.3％ vs. 28.3％,P＜0.01).Dose interruption due to adverse events was significantly more common in the control group.The response rate was significantly higher in the RDI 70 group than that in the control group(35.7％ vs. 11.3％,P＜0.01).Median PFS was significantly longer in the RDI 70 group(9.4 vs.4.7 months,P＜0.01).Multivariate analysis showed that RDI ≥70％(hazard ratio(HR)=0.55,P=0.025),hypertension grade ≥2(HR=0.47,P=0.019),and response(HR=0.52,P=0.033)were independently associated with improved PFS.Median OS was also significantly longer in the RDI 70 group(20.0 vs.13.3 months,P=0.045).Multivariate analysis showed that female sex(HR=0.33,P=0.034)and disease control(HR=0.31,P＜0.01)were independently associated with improved OS.RDI ≥70％ was not statistically significant in multivariate analysis. Conclusions:Our study revealed the importance of achieving RDI ≥70％ in the first 30 days of treatment to maximize the effects of LEN.

An 81-year-old woman sustained a fracture of the vertebra, resulting in grace deformation. After surgery for the spinal fixation, she suffered from left femoral neuropathic pain and motor weakness of both lower extremities. Daily repetitive transcranial magnetic stimulation (rTMS) of the lower extremity area in the right motor cortex was applied using a figure-8 coil connected to a magnetic stimulator (MagPro R30；Nagventure)．One thousand pulses per session were delivered (10 trains of 10Hz for 10 seconds with 25-seconds intertrain interval) in one day, and this treatment continued for 2 weeks except Sunday. The intensity of rTMS was set at the resting motor threshold for that day. rTMS together with physical therapy resulted in a remarkable amelioration of the femoral pain and motor weakness of both lower extremities. Pain on a Visual Analogue Scale dropped from 70％ to 22％, and walking speed and walking rate increased. Functional Independence Measure score increased from 58 to 79, and Euro QOL 5 score increased from 0.419 to 0.768. As previously reported in cases of post-stroke pain and motor weakness, rTMS together with physical therapy exerted measurable beneficial effects on intractable pain and motor weakness caused by spinal orthodontic fixation.