Japan University of Health Sciences

In female patients with osteoporosis, low body mass index (BMI), impaired locomotive function, and low bone mineral density (BMD) are presumed to be associated with an increased risk of mortality; however, the specific factors contributing to all-cause mortality have not yet been clearly identified. The purpose of this study was to determine the incidence of death among osteoporotic women in the community and to explore the factors involved in mortality risk. A total of 451 postmenopausal women undergoing outpatient osteoporosis treatment at our hospital between November 2013 and March 2024 were longitudinally evaluated in this study. Underlying diseases, history of femoral and vertebral fractures, femoral and lumbar spine BMD, locomotive syndrome (LS) risk tests, and BMI were obtained at baseline. The LS risk test results were utilized to classify LS severity, which was assessed on a four-point scale ranging from stage 0 (robust) to stage 3 (severe deterioration). This study used all-cause mortality as the outcome, and we examined factors related to mortality using Cox proportional hazards regression analysis. Covariates included in the Cox proportional hazards regression analysis were age, BMI, history of femoral and vertebral fractures, lumbar spine and femoral BMD, underlying diseases, and LS severity. The mean follow-up was 5.0 years (2.7 years), and death occurred in 20 of 451 patients. The incidence of mortality in this study was 0.91 cases per 100 person-years of risk. Cox proportional hazards regression analysis adjusted for all variables, and this study showed that cardiovascular disease (CD) (hazard ratio (HR) = 5.209, 95% confidence interval (CI) 1.794-15.128, p-value = 0.002) and severity of LS (HR = 2.006, 95% CI 1.063-3.784, 0.032) were shown to be independent risk factors for the occurrence of all-cause mortality. To the best of our knowledge, this is the first study to demonstrate a significant association between the severity of LS and mortality in patients with osteoporosis. The severity of LS may be useful as a screening tool for all-cause mortality in women with osteoporosis.

To investigate the effects of customized web video-based vestibular rehabilitation in patients with chronic vestibular hypofunction. This study is a randomized controlled trial. The dizziness specialty clinic. The participants were diagnosed with chronic vestibular hypofunction. The study used a randomized controlled trial design, in which participants were randomly assigned to either the customized web video-based vestibular rehabilitation or booklet-based vestibular rehabilitation in a 1:1 ratio. Patients were assessed at three time points: before-intervention (baseline), post-intervention completion (6 wk), and follow-up (12 wk). The primary outcome was the Dynamic Gait Index (DGI), the secondary outcome was the Dizziness Handicap Inventory (DHI), and tertiary outcomes included other functional and psychological assessments. The baseline characteristics of the patients were comparable between the two groups. Statistical analysis revealed a significant time effect for the DGI score ( p < 0.0001). Comparing the post-intervention and follow-up assessments to the baseline assessment, the customized web video-based VR group showed a significant increase in the DGI score. Time × group interaction effects were observed ( F = 5.739, p < 0.01). Both groups showed decreased DHI_total scores when comparing the postintervention and follow-up assessments to the baseline assessment. No serious adverse events were reported during intervention period. The present study demonstrated that customized web video-based VR improved DGI compared with booklet-based VR, and the intervention effect was maintained at 6-week follow-up. Additionally, the findings suggested that both interventions improve to a similar extent DHI. Therefore, vestibular rehabilitation with motion visualized by video may be more effective than that with still image by booklet.

This study clarified the association between the amount of physical activity and apathy after one year among community-dwelling older adults. Two hundred community-dwelling older adults (mean age: 74.3±5.0 years old, female: 52.5%) who participated in the 2018 and 2019 "Kasama Longevity Health Examination" were included. Apathy was assessed using the Apathy Scale (0-42 points; the higher the score, the lower the motivation), physical activity by Physical Activity Scale for the Elderly (PASE), and Geriatric Depression Scale-15 (GDS). The 2018 PASE data were grouped into tertiles. A multiple regression analysis was performed with the 2019 Apathy Scale as the dependent variable and the 2018 PASE as the independent variable, and the sex, age, years of education, economic situation, body mass index, chronic illness, smoking history, alcohol drinking habits, physical function, cognitive function, GDS, and the 2018 Apathy Scale as adjustment variables. The PASE subcategories (leisure-time, household, and work-related activities) were examined using a similar method. The mean Apathy Scale in 2019 was 14.0±6.2 for the low physical activity group, 12.8±6.0 for the medium physical activity group, and 10.1±5.9 for the high physical activity group. The high physical activity group showed a significant negative association with the Apathy Scale (B=-1.56, 95% confidence interval=-2.91 to -0.21, p=0.023). No association was found for any activity of the PASE sub-items. A high level of physical activity may protect against apathy among community-dwelling older adults.

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Determining the optimal cut-off value of sagittal alignment for detecting osteoporotic patients at high risk for fall-related fractures is essential for understanding fracture risk and informing clinicians and physical therapists. We determined the optimal cut-off value of sagittal alignment for detecting osteoporotic patients at high risk for fall-related fractures in this study. In the retrospective cohort study, we enrolled a total of 255 women aged ≥ 65years who visited an outpatient osteoporosis clinic. We measured participants' bone mineral density and sagittal alignment, including sagittal vertical axis (SVA), pelvic tilt, thoracic kyphosis, pelvic incidence, lumbar lordosis, global tilt, and gap score at the initial visit. The cut-off value for sagittal alignment that was significantly associated with fall-related fractures was calculated after using multivariate Cox proportional hazards regression analysis. Ultimately, 192 patients were included in the analysis. After a mean follow-up of 3.0years, 12.0% (n = 23) had fractures due to falls. Multivariate Cox regression analysis confirmed that SVA (hazard ratio [HR] = 1.022, 95% confidence interval [CI] = 1.005-1.039) was the only independent predictor of fall-related fracture occurrence. The predictive ability of SVA for the occurrence of fall-related fractures was moderate (area under the curve [AUC] = 0.728, 95% CI = 0.623-0.834), with a cut-off value of 100mm for SVA. SVA classified by cut-off value was also associated with an increased risk of developing fall-related fractures (HR = 17.002, 95% CI = 4.102-70.475). We found that assessing the cut-off value of sagittal alignment would be useful information in understanding fracture risk in postmenopausal older women.

Introduction: Although exercise can prevent cognitive decline due to aging, few elderly individuals are able to exercise for long. Therefore, an exercise method for older adults that is feasible for a long duration without overexertion is necessary. In this study, we focused on exercise by shaking. This study examined the possibility to prevent the decline in memory through regular and long-term shaking exercise using a senescence-accelerated mouse (SAM) model. Behavioral analysis was conducted, and histological changes in the mouse brain were examined to evaluate whether this stimulation method could become a novel exercise method. Materials and Methods: The shaking exercise was applied to SAMP10 mice for 30 min 3 times per week for 25 continuous weeks. Behavioral analysis included a step-through passive avoidance test, whereas the histological analysis involved immunohistochemical staining using the anti-glutamate receptor (α-amino-3-hydroxy-5-methyl-4-isoxazole-propionate receptors [AMPAR]) antibody in the hippocampus. The number and area of nerve cells in the hippocampal regions were measured and compared between groups. Results: Behavioral analysis revealed that the shaking group retained memory longer than the control group, and memory capacity decline was suppressed. Additionally, histological examination showed that the shaking group had a higher number of AMPAR receptor-positive neurons per area in the hippocampal CA1 and CA3 regions than the control group, suggesting that degeneration and shedding of neurons due to aging was suppressed. Discussion/Conclusion: We believe that shaking could become an exercise therapy that can reduce the decline in memory with aging and expect its human application in the future.

Abstract The authors have requested that this preprint be removed from Research Square.

Lessons for developing students&amp;#39; communication skills have been recently introduced to university English education in Japan, and the lesson format has become student-centered. As lessons are given in English and students have more opportunities to practice speaking in English, there are likely to be controversies over the proper balance between the use of the target language (TL) and the first language (L1) in EFL classrooms. However, no clear consensus concerning the relationship between these has been reached yet. The present research investigated the factors that were related to TL/L1 use among Japanese university students. A questionnaire containing background information and a five&amp;ndash;point Likert scale of anxiety was filled in by 252 students. Following this, individual interviews with five students were conducted. The results revealed that while the advantages of L1 use for the students were reported, the students had negative feelings about their use of the L1 due to decreasing the contact with the TL and/or increasing peer and self&amp;ndash;pressure. Therefore, students should gradually become accustomed to English&amp;ndash;only instruction in an unthreatening environment.&#x0D; &amp;nbsp;