1.Prospective Associations between Self-perceived Voice Disorders and Psychological, Social, and Physical Well-being among Community-Dwelling Older Adults
Iku NISHIMURA ; Kenji TSUNODA ; Yuya FUJII ; Koki NAGATA ; Bora HWANG ; Tomohiro OKURA
Annals of Geriatric Medicine and Research 2026;30(2):161-169
Background:
Self-perceived voice disorders (PVD) are common in later life and may affect psychological, social, and physical well-being. However, longitudinal evidence in community settings remains limited. This study sought to examine whether PVD predicted changes in well-being among community-dwelling older adults.
Methods:
Data were obtained from a community cohort in Kasama City, Japan. Older adults (n=273; aged 76.5 years; 57.1% female) were classified based on baseline Voice Handicap Index-10 scores (0, no; 1–4, mild; and ≥5, PVD). Outcomes were assessed annually through 2025 using the Geriatric Depression Scale (GDS), Lubben Social Network Scale (LSNS), Physical Activity Scale for the Elderly, and physical performance measures (handgrip strength, single-leg balance with eyes open, sit-and-reach, and 5-m habitual walk). Linear mixed models analyzed the fixed effects of group, time, and their interaction while adjusting for selected covariates.
Results:
Significant group effects were observed for the GDS, total LSNS scores, and the LSNS family scale, indicating that participants with PVD had weakened psychological and social well-being and smaller family networks. Additionally, a notable group effect was observed in sit-and-reach, with PVD participants showing less flexibility than those without it in the physical performance measures.
Conclusion
Among community-dwelling older adults, PVD was prospectively associated with increased depressive symptoms, diminished social networks, particularly smaller family networks, and reduced physical flexibility. These findings suggest that PVD preceding medical diagnosis may signal broader declines in psychological, social, and physical well-being, highlighting the importance of early identification and support.
2.Dose-Response Association between Hand Dexterity and Functional Disability: A Longitudinal Study from the Kasama Study
Namhoon LIM ; Kenji TSUNODA ; Jaehoon SEOL ; Yujiro ASANO ; Koki NAGATA ; Taishi TSUJI ; Keisuke FUJII ; Yuya FUJII ; Kaori TERAOKA ; Tomohiro OKURA
Annals of Geriatric Medicine and Research 2025;29(4):468-476
Background:
Poor hand dexterity may increase the risk of functional disability; however, few studies have examined the relationship between hand dexterity and incident functional disability. The aim of this study was to prospectively investigate the dose-response association of hand dexterity with incident functional disability in community-dwelling older adults.
Methods:
This study included 1,069 older adults aged ≥65 years in Kasama City, Japan. Peg-moving and circle-drawing tasks were used to evaluate hand dexterity. Functional disability was identified using the Japanese Long-Term Care Insurance System database. Restricted cubic spline analysis was performed to investigate the dose-response association between hand dexterity and incident functional disability.
Results:
During a mean follow-up of 8.5 years (maximum 14.0 years), 248 participants (23.2%) developed functional disability. The lowest performance group in each hand dexterity test had a significantly higher risk of functional disability than the highest performance group—peg-moving (hazard ratio [HR]=1.92, 95% confidence interval [CI] 1.29–2.87) and circle drawing (HR=1.66, 95% CI 1.15–2.41). Spline analysis confirmed curvilinear dose-response associations between hand dexterity and incident functional disability. Increased risk was observed when participants performed worse than the cut points (peg-moving, 37.9/38.0 seconds; circle drawing, 21/20 points), and no decreased risk was observed for those who performed better than these cut points.
Conclusion
Easily evaluated hand dexterity tests may be valuable for predicting functional disability in older adults. Curvilinear dose-response associations suggest that maintaining adequate hand dexterity could be a key strategy to support functional independence.
3.Associations of objectively measured sedentary behavior and physical activity with cognitive function among older Japanese adults: An isotemporal substitution model
Koki NAGATA ; Yuya FUJII ; Jaehoon SEOL ; Takafumi MONMA ; Tomohiro OKURA
Japanese Journal of Physical Fitness and Sports Medicine 2021;70(2):149-156
Increasing light-intensity physical activity (LPA) or moderate-to-vigorous physical activity (MVPA) and decreasing sedentary behavior (SB) are important to maintain cognitive function in older adults. However, there is a lack of studies examining the influence of replacing time spent in SB, LPA and MVPA on cognitive function. Therefore, this study applied an isotemporal substitution (IS) model approach to examine the associations of objectively measured SB, LPA, and MVPA on multiple cognitive functions in older adults. We analyzed data from 145 older persons (mean age, 75.1 ± 4.5 years; 61.4% women) in Kasama City, Japan. We assessed SB, LPA, and MVPA for seven consecutive days with a triaxial accelerometer. To evaluate the cognitive function, we used the Five-Cog test (character position referencing task, category cued recall task, clock drawing task, animal name listing task, and analogy task). The IS model of the multiple regression analysis was used to examine the effects of replacing time spent on one activity type with 30 minutes per day of SB, LPA, and MVPA on multiple cognitive functions, adjusting for age, gender, body mass index, education, smoking, sleep duration, history of stroke, medication for hypertension, dyslipidemia, and diabetes and accelerometer wear time. The results showed that reallocation from SB to LPA was significantly related to the category cued recall task score (B = 0.69, 95% confidence interval 0.07 - 1.31). In contrast, other reallocations were not associated with any cognitive tasks. The results suggest that substituting SB with LPA is positively associated with verbal episode memory among older Japanese adults.
4.Factors Related to Exercise Habits of Maintenance Hemodialysis Patients
Tomoya YAMAGUCHI ; Hiroki YABE ; Yuya MITAKE ; Aika CHISHIKI ; Tomohiro SHIRAI ; Takayuki FUJII
The Japanese Journal of Rehabilitation Medicine 2021;58(4):434-442
Hemodialysis patients need to acquire exercise habits because physical inactivity in hemodialysis patients is associated with increased mortality. However, factors associated with exercise habits in hemodialysis patients are unknown. The purpose of this study was to investigate the factors related to exercise habits in hemodialysis patients. We measured 104 hemodialysis patients' exercise habits (transtheoretical model:TTM), laboratory data, self-efficacy (SE), short physical performance battery and grip strength, nutritional index, dialysis vintage, fluid removal, and Kt/V. Multiple linear regression analysis was carried out to assess the association of the aforementioned factors with TTM. As a result, in multiple linear regression analysis, SE, age, and Kt/V were associated with TTM (R2=0.34, p<0.05). hemodialysis patients may require mental support, such as SE and adequate dialysis dose, to acquire exercise habits.
5.Factors Related to Exercise Habits of Maintenance Hemodialysis Patients
Tomoya YAMAGUCHI ; Hiroki YABE ; Yuya MITAKE ; Aika CHISHIKI ; Tomohiro SHIRAI ; Takayuki FUJII
The Japanese Journal of Rehabilitation Medicine 2020;():20008-
Hemodialysis patients need to acquire exercise habits because physical inactivity in hemodialysis patients is associated with increased mortality. However, factors associated with exercise habits in hemodialysis patients are unknown. The purpose of this study was to investigate the factors related to exercise habits in hemodialysis patients. We measured 104 hemodialysis patients' exercise habits (transtheoretical model:TTM), laboratory data, self-efficacy (SE), short physical performance battery and grip strength, nutritional index, dialysis vintage, fluid removal, and Kt/V. Multiple linear regression analysis was carried out to assess the association of the aforementioned factors with TTM. As a result, in multiple linear regression analysis, SE, age, and Kt/V were associated with TTM (R2=0.34, p<0.05). hemodialysis patients may require mental support, such as SE and adequate dialysis dose, to acquire exercise habits.
6.Association between the timing of habitual physical activity and sleep in older adults
Jaehoon Seol ; Yuya Fujii ; Naruki Kitano ; Yosuke Osuka ; Kiyoji Tanaka ; Tomohiro Okura
Japanese Journal of Physical Fitness and Sports Medicine 2017;66(6):417-426
We examined the relationship between the timing of habitual physical activities and sleep quality in older adults. The subjects were Japanese community-dwelling older adults (n=49, average age 70.1±3.5 years; men: 36.7%). We measured habitual physical activity using a 3-axis accelerometer (HJA-350 IT, Omron) for a week. Timing of physical activity was classified into the following three periods: (1) morning: waking to 11:59, (2) afternoon: 12:00 to 17:59, and (3) night: 18:00 to bedtime. We also categorized the intensity of habitual physical activity during 2 sessions as either (1) low (1.6-2.9 METs) or (2) moderate-to-vigorous (≧3.0 METs) intensity. The subjective sleep parameters were assessed using the Pittsburgh Sleep Quality Index (PSQI). We used a forced-entry multiple regression analysis to investigate the relationships between subjective sleep parameters and the timing of physical activities. Forced-entry multiple regression analysis revealed that sleep latency and PSQI global score were positively correlated with low-intensity physical activity at night. However, there was no significant correlation with moderate-to-vigorous activity. These results suggest that low-intensity habitual physical activity at night would be one useful and modifiable factor to improve sleep quality in the elderly.


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