Takashi Jindo

Abstract A growing number of studies have revealed that higher aerobic fitness is associated with better working memory (WM) performance in older adults. However, the underlying functional neural mechanisms of this association remain under debate. It has been reported that aging increases recruitment of the prefrontal cortex (PFC) during cognitive tasks, and that this is associated with task performance in a compensatory manner. Therefore, this study aimed to clarify the prefrontal activation pattern that is associated with the relationship between aerobic fitness and WM performance in older adults, focusing on age-related extended prefrontal recruitment. Forty-seven older adults (65–74 years, 29 females) and 49 younger adults (18–24 years, 23 female) performed verbal and spatial n-back tasks, which included 0-, 1-, and 2-back conditions. Reaction time (RT) and accuracy (ACC) were assessed as indices of task performance. Prefrontal activation during the experimental tasks was monitored using functional near-infrared spectroscopy (fNIRS) and analyzed using an adaptive GLM method. We compared task performance and prefrontal activation between age groups to find age-related prefrontal activation patterns. Only older adults underwent a graded exercise test (GXT) to determine their ventilation thresholds (VT) as a measure of aerobic fitness, and, subsequently, the relationships among aerobic fitness, n-back task performance, and prefrontal activation in older adults were examined using correlation analysis and mediation analysis controlling for possible covariates. A comparison of task performance between groups revealed that older adults had slower RT and lower ACC than did younger adults, especially in the higher WM load 2-back condition. Group comparisons of prefrontal activation showed that older adults exhibited additional or greater activation than younger adults mainly in the ventrolateral PFC (VLPFC) and front polar area (FPA) in both the verbal and spatial 2-back conditions. Correlation analysis showed a relationship between higher VT, shorter RT for the verbal 2-back condition, and greater prefrontal activation of the bilateral FPA and right VLPFC during verbal 2-back conditions in older adults. In addition, mediation analyses indicated the possibility of a mediation effect of the prefrontal activation on the relationship between VT and RT for the verbal 2-back condition. These results suggest that older adults with higher aerobic fitness levels recruited more extended PFC regions, possibly for compensatory activation, to enhance their performance of the verbal n-back task. This study sheds light on the neural mechanisms underpinning the relationship between aerobic fitness and cognitive function in older adults.

The correlation between early attrition and school sports clubs has been underexplored. This study aims to clarify the correlates of early attrition from school sports clubs at a private male senior high school in Fukuoka Prefecture, Japan. Of the 928 first-year students, 331 belonging to the school's sports clubs were included in this study. A baseline survey was conducted in May 2017 and a follow-up survey was conducted in October 2019. This study defined early attrition as a student who quit a sports club earlier than April in their third year. Examined correlates for early attrition consisted of biological, intrapersonal, interpersonal, and institutional factors. We used univariate logistic regression analysis, in which early attrition was the response variable and the examined correlates were the explanatory variables, and calculated the odds ratios (OR) and 95% confidence intervals (CI). Overall, 232 students (85.0%) continued to participate in sports clubs after April of their third year, and 41 students (15.0%) experienced early attrition. Statistically significant correlates for early attrition were weight (OR = 0.94, 95% CI = 0.90–0.98), body mass index (OR = 0.84, 95% CI = 0.74–0.97), experience of injury or disability (OR = 0.40, 95% CI = 0.19–0.87), athletic achievement (OR = 0.29, 95% CI = 0.13–0.62), and duration of experience of the sport (OR = 0.99, 95% CI = 0.98–1.00). Our findings suggest that the school officers or family members of students should recognize the possibility of early attrition and provide appropriate support if a student experiences early attrition. The athletic level or norms of school sports club activities may differ among other schools and sports clubs; therefore, it is necessary to examine whether our findings are applicable to other schools and sports clubs.

This study aimed to examine the factors related to participation in volunteer-managed preventive care exercises by focusing on the distance to exercise facilities and interpersonal social networks. A postal mail survey was conducted in 2013 in Kasama City in a rural region of Japan. Older adults (aged ≥ 65 years) who were living independently (n = 16,870) were targeted. Potential participants who were aware of silver-rehabili taisou exercise (SRTE) and/or square-stepping exercise (SSE) were included in the analysis (n = 4005). A multiple logistic regression analysis revealed that social and environmental factors were associated with participation in SRTE and SSE. After adjusting for confounding variables, exercise participation was negatively associated with an extensive distance from an exercise facility in both sexes for SRTE and SSE. Among women, participation in SRTE was negatively associated with weak interpersonal social networks (odds ratio (OR) = 0.57), and participation in SRTE and SSE was negatively associated with being a car passenger (SRTE, OR = 0.76; SSE, OR = 0.60). However, there were no significant interactions between sex and social and environmental factors. Our findings suggest the importance of considering location and transportation to promote participation in preventive care exercise.

BACKGROUND: Although a few studies have confirmed the association of accelerometer-measured sedentary behaviour (SB) and physical activity (PA) with non-alcoholic fatty liver disease (NAFLD), PA intensity and co-dependent daily time-use of movement behaviours are yet to be studied. AIMS: To cross-sectionally examine the dose-response relationship between accelerometer-measured SB or PA and NAFLD using cubic spline analysis and the interdependence of movement behaviours over 24 hours with compositional data analysis. METHODS: Data were obtained between May 2017 and February 2020 from 1914 people who were not heavy alcohol drinkers using health check-ups at the Meiji Yasuda Shinjuku Medical Center, Tokyo. SB, light-intensity PA (LPA) and moderate- to vigorous-intensity PA (MVPA) were evaluated using a triaxial accelerometer. Fatty liver was diagnosed by ultrasonography. RESULTS: A multivariable-adjusted logistic model showed an inverse association between MVPA and NAFLD (odds ratio [OR] per 600 metabolic equivalents [MET]-min/week = 0.85, 95% confidence interval [CI] = 0.76-0.96). MVPA showed rapidly decreasing odds of NAFLD to approximately 1800 MET-min/week in cubic spline analysis and then a moderate decline. Although SB was significantly associated with NAFLD in a body mass index (BMI)-unadjusted model, it was not significant in a BMI-adjusted model. In the compositional isotemporal substitution, reallocating 60 min/day of SB to MVPA decreased the odds of NAFLD by 22% (OR = 0.78, 95% CI: 0.65-0.93), whereas reallocating 60 min/day of MVPA to SB increased it by 69% (OR = 1.69, 95% CI: 1.12-2.38). CONCLUSIONS: The inverse dose-response association between MVPA and NAFLD confirms increased MVPA as a target for the prevention of NAFLD.

Objective: Ergonomic office redesigning possibly improves physical activity (PA) and sedentary behavior (SB); however, its impact on cardiometabolic risk has not yet been determined. This study aimed to examine the effect of office relocation on cardiometabolic risk factors. Methods: Annual health check-up data of 95 office workers from four offices in Tokyo, Japan, who relocated to an office with activity-based working (ABW) and height-adjustable desk (HAD) and a propensity-score matched control-cohort were analyzed. PA and SB on weekdays were measured only in the relocation group before and 10 months after relocation. Results: Significant interactions were observed for waist circumference, high-density lipoprotein cholesterol, and glycosylated hemoglobin (HbA1c). HbA1c changes showed a significant negative association with moderate-to-vigorous-intensity PA. Conclusion: An ABW office with HAD improves cardiometabolic risk factors in office workers, possibly through changes in PA and SB.

We clarified the effect of exercising with others on the risks of incident functional disability and all-cause mortality among community-dwelling adults. We used an inventory mail survey with a five-year follow-up for 1520 independently living older adults (mean age: 73.4 ± 6.3 years) in Kasama City, Japan. Subjects responded to a self-reported questionnaire in June 2014. Exercise habits and the presence of exercise partners were assessed. Subjects were classified into three groups: Non-exercise, exercising alone, and exercising with others. Follow-up information and date of incident functional disability and death during the five-year follow-up were collected from the database. To compare the association between exercise habits and functional disability and mortality, Cox regression analysis was conducted. Compared with the non-exercise group, exercising with others had significantly lower hazard ratios (HRs) for functional disability (0.59, 95% confidence interval (CI) 0.40–0.88) and mortality (0.40, 95% CI 0.24–0.66) in the covariate models. Compared with exercising alone, exercising with others decreased the HRs for incident functional disability (0.53, 95% CI: 0.36–0.80) and mortality (0.50, 95% CI 0.29–0.85) rates in the unadjusted model; these associations were not significant in the covariate models. Exercising with others can contribute to functional disability prevention and longevity.

We investigated the relationship between workplace exercise and psychological distress, and work engagement, both of which are factors related to the mental health and work productivity of employees. Data from the Meiji Yasuda Lifestyle study, collected from July 2017 through December 2017, were used. Data from an annual health checkup and questionnaire were collected from the Meiji Yasuda Shinjuku Medical Center in Tokyo, Japan. The 1321 participants (mean age: 50.8 ± 9.5 years, rate of female: 68.2%, rate of white-collar workers: 64.7%) were divided into three groups based on the frequency of performing workplace exercise: less than once, once or twice, and three or more times a week. Vigor of work engagement and psychological distress were assessed using the Utrecht Work Engagement Scale and Kessler Psychological Distress Scale (K6). Logistic regression analyses were performed to examine relationships between workplace exercise frequencies and work engagement or psychological distress. Demographic variables, health behaviors, health status, work characteristics, and objectively measured physical activity and sedentary behavior were adjusted for odds ratio (OR) and 95% confidence interval (95% CI). Participants who performed workplace exercise once or twice and three or more times a week showed a significantly higher OR (OR = 1.93, 95% CI = 1.00-3.71, p = 0.049, OR = 1.63, 95% CI = 1.23-2.15, p = 0.001, respectively) for vigor of work engagement. Neither groups of workplace exercise showed a significant OR for psychological distress even when adjusted for covariates. The practice of workplace exercise is positively and independently related to vigor of work engagements of physical activity and sedentary behavior, and the association was observed regardless of the frequency of once or twice, or three or more times a week. Workplace exercise, however, does not correlate with psychological distress. Our findings indicated that workplace exercise at least once or twice a week could have practical implications for the enhancement of vigor of work engagement, especially among white-collar workers.

It has been reported that office environment is an important determinant of physical activity (PA) and sedentary behavior (SB) in office workers. However, the effect of changes in office environment (office renovation) is unclear. The purpose of this study was to examine PA, SB, and space utilization changes among office workers in response to office renovation. This study was a natural experiment at three offices of a single company in Tokyo, Japan. The participants were, 13 workers from one office in the renovation group (mean age: 37.9 ± 10.8 years, percentage of females: 23.1%) and 29 from two offices in the control group (mean age: 42.3 ± 11.2 years, percentage of females: 31.0%). In the renovation, introduction of activity-based working (ABW) and installation of height-adjustable desks (HAD) were adopted. The ABW office was designed to provide various shared workstations, enabling the workers to choose workstations depending on their task or mood. Accelerometer measurement and object detection method using artificial intelligence (AI) technology for video images were used to assess behavior and space utilization before and after the renovation. Two weeks after the renovation, significant improvements in SB (pre- to post-renovation improvements: 346.8 ± 28.6 to 321.2 ± 17.8 min/working-hours) and PA (total PA: 173.2 ± 28.6 to 198.8 ± 17.8 min/working-hours; and light-intensity PA: 130.4 ± 27.1 to 150.7 ± 31.0 min/working-hours) were observed. In addition, the results of the object detection analysis showed that the central aisle of the office and shared HAD workstations near the entrance or window were utilized more frequently than the other spaces. This study suggested that office renovation could improve SB and PA immediately after the renovation. Moreover, utilized spaces and HAD workstations could play an important role to enhance employees' activity in an ABW office.

Although a growing number of studies have reported the positive effects of acute aerobic exercise on mood and executive function in older adults, little is known about the effect of aerobic dance exercise（ADE）on executive function. In the present study, we aimed to compare the acute effects of light-intensity, slow-tempo ADE and light-intensity cycling exercise（CE）on mood and executive function in older adults. Twenty-one older adults performed each type of exercise for 10 minutes on separate days. The intensity of the CE was set at 60% of the ventilatory threshold. Before and after the exercise, mood（i.e., vitality, stability, pleasure, and arousal）and executive function were assessed by using the Two-Dimensional Mood Scale and the Stroop task, respectively. The heart rates and ratings of perceived exertion during exercise indicated that the intensities of both types of exercise were within the light-intensity range. Vitality and pleasure levels were increased following ADE, but no such changes were observed following CE. Although no differences in stability levels were observed following either type of exercise, we observed a significant interaction between time and e

Installation of height-adjustable desks（HAD）are recommended to reduce sitting behaviors in the workplace. However, it is still unclear whether standing desk work using the HAD could decrease sitting time and increase physical activity（PA）during in-office working hours. This study aims to investigate the association of the usage of HADs with objectively measured sitting behaviors, or PA, among Japanese employees. This study was conducted in Tokyo in November 2018 at a single office of an office furniture manufacturing and sales company. Participants included 90 employees that completed a self-reported questionnaire survey and wore a tri-axial accelerometer to measure PA and sitting time（ST）. In the target office, electric HADs were installed on hot-desking spaces, and fixed seats which were available for all employees. Participants were divided into two groups of users or non-users of HADs based on their responses to the questionnaire. Independent t-tests were applied to examine the differences in ST and PA between HAD users and non-users for participants stratified by job type（sales work or other office work）. Among the office workers, users showed less ST and greater PA（ST: 377.4 ± 51.7, PA: 142.6 ± 51.7 min/8.67-hours）than non-users during working hours（ST: 412.0 ± 42.6, PA: 108.0 ± 42.6 min/8.67-hours）, and greater non-locomotive activities（99.7 ± 45.1 min/8.67-hours）than non-users（67.1 ± 29.1 min/8.67-hours）. HAD users showed fewer bouts of prolonged ST（consecutive ST for 30 minutes or longer）than non-users（1.2 ± 0.8 vs. 1.8 ± 0.6 time/8.67-hours）. There were no significant differences observed between the two sales groups. These results suggest that working in a standing position using an HAD effectively improves ST in office workers. On the other hand, using an HAD might enhance non-locomotive activities, such as standing or posture adjust-ments at or around the desk, but it may not enhance locomotive activities.

Both school and public sports clubs play an important role in the development of athletes in Japan. Althoughsome studies have investigated the relationship of mental health and numerous factors, including level of athleticperformance, and years of experience with sports, limited studies have examined the differences among athletic organizations for adolescents. Focusing on soccer, the most popular sport among Japanese adolescents, we conducted the present investigation with participants from a school soccer club and J-League youth teams. This study aimed to reveal the relationship of athletic sports with coping skills and psychological distress in male high school students, with special reference to differences among athletic organizations. This study was conducted in a boys' senior high school and 4 J-League youth teams, from April to June 2017. Thehigh school has a strong soccer club that has regularly won a national level tournament. We selected students whobelonged to the school soccer club（n = 108）and those who did not belong to a school or public sports club（the donot belong to a sports club group, n = 333）. Moreover, students who belonged to school soccer club were dividedinto 2 groups based on whether they had won a prize or not in a previous tournament larger than a prefecture levelcompetition（school soccer club without a winning experience, n = 50; school soccer club with a winning experience,n = 58）. For the J-League youth team, we used 51 students' data for the analysis. To evaluate the participants' ability to cope with stress, we used the three-item sense of coherence（SOC）scale. For psychological distress, we used the Japanese version of the profile of mood states（POMS）short form, and we calculated the total mood disturbance（TMD）score. To compare SOC and TMD scores between the groups, we used the Kruskal-Wallis test and Bonferroni post hoc tests. The analysis revealed significant group differences in the SOC score. Specifically, the school soccer club with awinning experience group and the J-League youth group had higher scores than those of the group that did not belong to a sports club. There was no significant difference between the scores of the school soccer club without a winning experience group and the other groups. Further, there were significant group differences in the TMD score,with the J-League youth group exhibiting lower score as compared to all other groups. This study indicated that, regardless of athletic organization, male senior high school students who played soccerat a high level had higher scores related to coping skills as compared to students who did not belong to a sports club.Meanwhile, psychological distress scores differed across athletic organizations, with students in the J-League youthteam exhibiting favorable mood states.

It is still unclear what timing and intensity of physical activity（PA）is effective to promote good sleep for workers.This study investigates associations of objectively measured timing and intensity of PA with subjective sleep qualityin Japanese employees. Data were gathered from 104 Japanese employees（age 46.1 ± 10.0 years; women 64.4%）who mainly engaged indesk work. Participants wore an accelerometer （HJA-750C, Omron Healthcare Co.）for a month, and we calculatedaverage daily low-intensity PA（LPA, 1.6–2.9 METs）, moderate-intensity PA（MPA, 3.0–5.9 METs）, and vigorousintensity PA（VPA, ≥ 6.0 METs）in the morning（05:00–11:59）, afternoon（12:00–17:59）and evening（18:00–24:00）, respectively. We used the Pittsburgh Sleep Quality Index（PSQI）to assess subjective sleep quality, and calculated sleep efficiency, daytime dysfunction score and PSQI global score. Adjusted multiple regression models revealed that LPA in the afternoon have significant favorable associations with daytime dysfunction score（β = －0.353）and PSQI global score（β = －0.333）. In the evening, VPA was significantly associated with higher sleep efficiency（β = 0.261）. To maintain a good sleep quality for employees, our findings are the first pointing at LPA in the afternoon, and at VPA after office hours would be effective.

<p>The purpose of this study was to investigate the association between continuous exercise and engagement in sports activities from junior high school and generalized self-efficacy (GSE) during senior high school in male students.<br> Methods: <br> We conducted this study at a private boys' senior high school in Japan. A self-report questionnaire assessing previous (i.e., junior high school) and current (i.e., senior high school) exercise and sports practices was administered to all 1st and 2nd year students in physical education classes; cross-sectional data were obtained from 1,187 students (response rate: 83.0％). We evaluated current GSE using the Japanese version of the GSE Scale. Subjects were divided into the following six groups based on whether they belonged to a sports club at junior high school (belonged or did not belong to sports club) and exercise and sports habits in senior high school (no practice, individual practice, belonged to a sports club): 1) never belonged to a sports club (did not belong/no practice, n＝96), 2) stopped belonging to a sports club (belonged/no practice, n＝454), 3) began sports individually (did not belong/individual practice, n＝10), 4) continued sports individually (belonged/individual practice, n＝79), 5) began belonging to a sports club (did not belong/belonged, n＝21), and 6) continued belonging to a sports club (belonged/belonged, n＝527). We used analysis of covariance (ANCOVA), adjusting for potential cofounders, to compare GSE between the six groups.<br> Results: <br> As a result of the ANCOVA, the following three groups had significantly higher GSE than the never belonged to sports club group: the stopped belonging to a sports club, continued sports individually and continued belonging to a sports club groups. Additionally, the continued sports individually and continued belonging to a sports club groups had significantly higher GSE than the stopped belonging to a sports club group.<br> Conclusion: <br> These results suggest that belonging to a sports club from junior high school to senior high school may enhance GSE in male adolescents. However, stopping involvement with a sports club and individually continuing exercise or sports may also be effective for enhancing GSE.</p>

[Purpose] There is a relationship between physical and cognitive functions therefore, impairment of physical function would mean cognitive decline. This study aimed to investigate the association between change in physical and cognitive functions. [Subjects and Methods] Participants were 169 healthy community-dwelling older adults who attend the survey after three years from baseline (mean age, 72.4 ± 4.8 years). Grip strength, one-leg standing balance, five-times-sit-to-stand test, timed up and go, 5-m habitual walk, and a peg-moving task were used to evaluate physical performance. Five cognitive function tests were used to assess attention, memory, visuospatial function, verbal fluency, and reasoning. Cognitive function was defined as the cumulative score of these tests. [Results] At baseline, five-times-sit-to-stand test, timed up and go, and hand dexterity were independently associated with cognitive function. In longitudinal analyses, changes in habitual walking speed and hand dexterity were significantly associated with change in cognitive function. [Conclusion] Deterioration of specific physical function, such as hand dexterity and walking ability, may be associated with progression of cognitive decline. Decreasing extent of daily functions, such as hand dexterity and walking ability, can be useful indices to grasp changes in cognitive function.

Background and Purpose: Decreasing daily life physical activity (PA) outside an exercise program might hinder the benefit of that program on lower-extremity physical function (LEPF) in older adults. The purpose of this study was to investigate how daily life PA modulates the effects of an exercise program on LEPF. Methods: The participants were 46 community-dwelling older adults (mean age, 70.1 +/- 3.5 years) in Kasama City, a rural area in Japan. All participated in a fall-prevention program called square-stepping exercise once a week for 11 weeks. We evaluated their daily life PA outside the exercise program with pedometers and calculated the average daily step counts during the early and late periods of the program. We divided participants into 2 groups on the basis of whether or not they decreased PA by more than 1000 steps per day between the early and late periods. To ascertain the LEPF benefits induced by participating in the exercise program, we measured 5 physical performance tests before and after the intervention: 1-leg stand, 5-time sit-to-stand, Timed Up and Go (TUG), habitual walking speed, and choice-stepping reaction time (CSRT). We used a 2-way analysis of variance to confirm the interaction between the 2 groups and the time effect before and after the intervention. Results: During the exercise program, 8 participants decreased their daily life PA (early period, 6971 (+/-) 2771; late period, 5175 +/- 2132) and 38 participants maintained PA (early period, 6326 +/- 2477; late period, 6628 +/- 2636). Both groups significantly improved their performance in TUG and CSRT at the posttest compared with the baseline. A significant group-by-time interaction on the walking speed (P = .038) was observed: participants who maintained PA improved their performance more than those who decreased their PA. Discussion: Square-stepping exercise requires and strengthens dynamic balance and agility, which contributed to the improved time effects that occurred in TUG and CSRT. On the contrary, because PA is positively associated with walking speed, maintaining daily life PA outside an exercise program may have a stronger influence on walking speed. To enhance the effectiveness of an exercise program for young-old adults, researchers and instructors should try to maintain the participant's daily life PA outside the program. Conclusion: Regardless of decreasing or maintaining daily life PA, the square-stepping exercise program could improve aspects of LEPF that require complex physical performance. However, a greater effect can be expected when participants maintain their daily life PA outside the exercise program.

Aim: To explore the relationships between the built environment and older adults' physical function. Methods: The present cross-sectional study carried out in 2010-2012 used data drawn from 509 community-dwelling older adults aged 65-86 years living in Kasama City, a Japanese rural region. We evaluated physical function with the following performance tests: grip strength, sit-to-stand, timed up & go and walking speed. Using geographic information systems, we measured population density and the number of destinations related to daily life, community centers, medical facilities and recreational facilities within participants' neighborhoods. Results: After adjusting for potential confounders, we found lower population density was related to poor performance of sit-to-stand and walking speed in both sexes, and grip strength in women (trend P < 0.05). A lower number of daily life-related destinations was related to poor performance of sit-to-stand and walking speed in men, and grip strength and sit-to-stand in women. Similarly, the number of community centers was related to walking speed in both sexes. The number of medical and recreational facilities was also related to some physical performance in both sexes. A lower land use mix score, calculated by principal component analysis, was related to lower performance of sit-to-stand and walking speed in men, and grip strength and sit-to-stand in women. Conclusion: The present study suggests that, although there are some sex differences, low population density, land use mix, and fewer daily life-related destinations, community centers, medical facilities and recreational facilities are negative determinants of physical function.

[Purpose] This study aimed to clarify the association between depression and participation in community activities among older adults living alone. [Subjects and Methods] The subjects were 9,004 community-dwelling older adults who did not require nursing care. Self-administered questionnaires were conducted to evaluate the community activity participation and living arrangements of the older adults. Depressive status was evaluated using the Kihon Checklist, a screening tool used to identify pre-frail older adults in Japan. [Results] For both males and females, those who lived alone and did not participate in any community activity showed a higher tendency of depression than those who lived alone and did participate in community activities. There was no difference in depressive state between the older adults living alone and participating in community activities, and those who were not living alone. [Conclusion] Based on the beneficial association between healthy mental status and community activities shown by older adults who live alone, we conclude that it is important to encourage older adults who live alone to participate in community activities.

<p><b>Introduction: </b>The purpose of this study was to investigate the effects that a group exercise activity managed by elderly volunteers would have on the physical function of older women after they participated in a formal exercise program taught by fitness experts.</p><p><b>Methods: </b>Subjects were 47 community-dwelling older women who had completed a 3-month exercise program led by expert instructors in Kasama City, Ibaraki. After completing this exercise program, 28 subjects continued to participate in a group exercise activity led by elderly volunteers for approximately 11 months. The remaining 19 subjects did not join the group activities after the formal program. In both the initial, expert-led exercise program and the subsequent, volunteer-led group activity, subjects mainly engaged in the square-stepping exercise, which is a novel exercise for improving lower extremity physical function. In order to assess participants' physical function, we conducted five physical performance tests at both the baseline and follow-up; the former is the last day of the exercise program and the latter is approximately a year after the baseline.</p><p><b>Results: </b>Two-way ANOVA demonstrated a significant interaction in the timed up and go test (P=0.003). The performance of subjects who had participated in the volunteer-managed group activity improved between the baseline and follow-up tests (P=0.007).</p><p><b>Conclusion: </b>Participating in a group exercise activity managed by elderly volunteers can improve mobility skills of older women who had previously completed a formal exercise program led by expert instructors.</p>

Generalized self-efficacy（GSE）is a belief that a person can successfully perform the behavior in question， and aperson who has high GSE will adopt positive coping behavior in a difficult situation. Although a sports activitymight contribute to enhance GSE, there are only a few studies that focused on the association between GSE andsports activity in adolescents. The purpose of this study was to compare GSE between male adolescents who belongedto sports club and those who did not belong to it, and investigate associated factors of GSE in sports activitycharacteristics. The study subjects were 186 junior high and 1169 high school male students in Fukuoka, Japan. We conducted theinvestigation in a physical education class using a self-reported questionnaire. We evaluated GSE by using thegeneralized self-efficacy scale. Participants were divided into following 2 groups based on whether the subjectsbelonged to a school extracurricular sports activity or a community sports club: belong to sports club（junior highschool: n = 143, high school: n = 519）and do not belong to sports club（junior high school: n = 43, high school: n =650）. We used ANCOVA adjusted for grades to compare the GSE between the two groups. A multiple regression analysiswas used for investigating the associated factors of GSE in the group that belonged to the sports club. Theindependent variables were grades, sports activity days, regular player or not, perceived exertion in daily activity,sports type, and social support. Social support was evaluated by using the athletic social support scale, which assessesperceived social support from coaches, parents, or peers in sports activity. These analyses were conducted separatelyfor junior high school and high school subjects. In both junior high and high school subjects, GSE was significantly higher in the group which belonged to asports club than the other group. There was a significant association between GSE and sports activity days（β = 0.20）and social suppor（t β = 0.34）in junior high school subjects. As for high school subjects, GSE was significantly associatedwith grade（s β = －0.12）, regular playe（r β = 0.13）, team sport（s β = 0.14）and social suppor（t β = 0.28）. This study indicates that belonging to a sports club contributes to improving GSE in male adolescents. Sincesocial support showed high standardized partial regression coefficient for both junior high and high school subjects,it is important to enhance social support in a sports activity to improve GSE.

Purpose of this study was to investigate whether the difference in leisure-time physical activity（LTPA）patternaffects one-year after incident of poor subjective sleep quality（SSQ）in Japanese workers. Study data were obtained from a health check-up program in Tokyo, Japan in 2013. Participants of the study consisted of 3621 workers who met the following criteria: 1）not diagnosed with history of mental illness including depression, 2）not using the hypnotic and 3）not complaining of poor SSQ. LTPA was evaluated using International Physical Activity Questionnaire long version and participants were divided into 4 groups with criteria of ≥ 10 METs-hour/week: 1）notengaging in LTPA, 2）engaging in LTPA but not meeting the criteria, 3）meeting at ≤ 2 days（weekend warrior） and4）meeting at ≥ 3 days（regularly active）. A question concerning SSQ in Pittsburgh Sleep Quality Index was usedand participants who answered "fairly bad" or "very bad" were defined as poor SSQ. Logistic regression analysis was performed adjusting for age, gender, body mass index, economic status, non-working days, alcohol consumption,smoking status, psychological distress and non-LTPA（model 1）. An additional analysis adjusting for the aboveconfounders and LTPA was performed using data from participants meeting the LTPA criteria（model 2）. Participants who engaged in ≥ 10 METs-h/wk of LTPA at ≥ 3 days significantly reduced incident of poor SSQ compared with people with not engaging in LTPA（OR = 0.57, 95%CI = 0.42–0.78）. In model 2, regularly active workerssignificantly reduced incident of poor SSQ compared with weekend warrior（OR = 0.62, 95%CI = 0.41–0.96）. InJapanese workers, to maintain good SSQ, engaging in LTPA regularly/habitually and obtaining ≥ 10 METs-h/w would be more effective than practicing like a weekend warrior.

During an exercise program for older adults, it is important that participants exercise not only in the exercise classroom but also in their daily lives. The present study investigated how goal-setting aimed at increasing daily physical activity by 1,000 steps per day, influenced lower-extremity physical function during the exercise program. The participants were non-randomly allocated to two groups: with goal-setting (n = 19, mean age: 68.9 � 3.3 years) and without goal-setting (n = 13, mean age: 69.9 � 4.2 years). Participants in the group with goal-setting were encouraged to increase their physical activity by 1,000 steps/day above their baseline step counts. All of the subjects in both groups participated in a square-stepping exercise program for 90 min once a week for 9 weeks. To determine the lower-extremity physical function benefits of the program, six types of test were performed before and after the program. There was a significant group-by-time interaction on daily physical activity (p &lt 0.001). The group with goal-setting significantly increased their physical activity, and the group without goal-setting did not change their physical activity. There were significant time effects in the 5-m habitual walk, choice stepping reaction time, and 6-min walk. There was a significant group-by-time interaction in the five-repetition sit-to-stand test (p = 0.006), and only the group without goal-setting improved their performance. Although we successfully increased daily physical activity using goal-setting, we could not confirm the effect of goal-setting on lower-extremity physical function.

Background and Purpose: Pedometers are often used as motivational tools to increase physical activity. Hence, providing a pedometer during an exercise intervention may enhance the benefit of exercise on lower-extremity physical function (LEPF) by maintaining or increasing daily physical activity. The purpose of this study was to compare the effect on LEPF between an exercise intervention with and without the use of a pedometer. Methods: The subjects of this study were 68 community-dwelling older adults (mean age: 70.0 +/- 3.6 years) in Kasama City, rural Japan. All subjects participated in a fall-prevention exercise program called square-stepping exercise (SSE) conducted once a week for 11 weeks. Participants were allocated to 2 groups: SSE with pedometer group (n = 34) and SSE without pedometer group (n = 34). We matched the participants of both groups by their standardized score of physical function tests. To ascertain the LEPF benefits induced by the exercise intervention, we measured 5 physical function tests: single-leg balance with eyes open, 5-repetition sit-to-stand, timed up and go, 5-m habitual walk, and choice stepping reaction time. We used a 2-way analysis of variance to confirm the interaction between the 2 groups. Results: Significant group-by-time interactions were observed on timed up and go (P < .01) and 5-m habitual walk (P = .02); participants in the SSE with pedometer group enhanced their physical function more than the SSE without pedometer group participants. Conclusions: This study suggests that providing a pedometer during an exercise intervention is an effective addition to an exercise program to improve LEPF.

認知課題を伴う運動（スクエアステップ）のステップパターンの達成度が3ヵ月間の運動教室前後の体力変化に与える影響を検討した。その結果、達成度にかかわらず平衡性、起居移動能力、反応性などの体力が向上したことから、スクエアステップは個人に合った難度のステップパターンに取り組むことで、体力への効果が見込める運動課題であることが示唆された。

<p>The purpose of this study was to examine relationships between age-associated loss of muscle mass (sarcopenia), muscle strength (dynapenia) and physical functions in community-dwelling older adults. This cross-sectional study included 400 older adults (73.7 ± 5.2 years) conducted in Kasama city, Ibaraki prefecture (2011-2012). Participants were classified to following four groups based on their appendicular skeletal muscle mass (sum of skeletal muscle mass in the arms and legs evaluated by bioelectric impedance analysis), and appendicular skeletal muscle strength (grip strength for upper extremity and peak reaction force during sit-to-stand movement for lower extremity): sarcopenic-dynapenia (SD), dynapenia (D), sarcopenia (S) and non-S/non-D (NSD). We evaluated participants' physical function using 7 physical performance tests. We conducted partial correlation analysis and analysis of covariance adjusted for age, medical history of knee pain and low back pain. Appendicular skeletal muscle strength was significantly associated with all physical performance tests in both genders (<i>P</i> < 0.05), however appendicular skeletal muscle mass index was not. As for the results of analysis of covariance, one-leg balance with eyes open, standing time from long sitting position, functional reach, 5-repetition sit-to-stand, timed up and go, and 5-m habitual walk were significantly poorer in SD and D groups than S and NSD groups in men. On the other hand, standing time from long sitting position, functional reach, 5-repetition sit-to-stand, timed up and go, and 5-m habitual walk were significantly poorer in D group than the S group and NSD group in women. These results suggest that dynapenia has a stronger relationship with poor physical performance than sarcopenia.</p>

Aim: To investigate the validity and reliability of a novel performance test, called the “Trail Making Peg”（TMP) test, for evaluating the cognitive function. Methods: We recruited 632 community-dwelling older adults (mean age: 73.3 ± 5.2 years) as subjects for the assessment of the validity of the test and 319 adults (mean age: 73.1±5.2 years) as subjects for the assessment of reliability. Five cognitive tests (5- Cog) were used to evaluate the cognitive function, and the degree of cognitive decline was delineated for subjects scoring below 1SD from the mean 5-Cog score. A receiver operating characteristic analysis was employed to calculate the cut-off point. Results: There were no sex differences in the TMP scores (P = 0.951)，and the TMP and 5-Cog scores were found to correlate significantly (r =0.63) with each other. The Trail Making Peg test demonstrated an area under the curve of 0.855 for discriminat¬ing between non-cognitive decline and cognitive decline. At this cutoff point, the sensitivity was 85% and the specificity was 69%. The intraclass correlation coefficient of the TMP was 0.746. Conclusions: The TMP exhibits sufficient validity and reliability. Our results suggest that TMP is a useful screening test for detecting cognitive decline.

Objective: The purpose of this study was to cross-sectionally examine associations between frequencies of bicycle and motor vehicle travel, physical and mental statuses and social networks. Methods: This study was conducted from 2009 to 2012 with 629 community-dwelling older adults (73.3 +/- 5.2 years old, female 53.7%) in Kasama City, Rural Japan. Travel status, physical activity scale for the elderly, Lubben social network scale and geriatric depression scale were collected via a self-administrated questionnaire. We also calculated a standardized physical function score through physical performance tests. Results: After adjusting for age, gender, education, living arrangement, body mass index and clinical history, we found a positive association between frequency of bicycle and motor vehicle travel and physical activity, social networks and mental status (Trend P < 0.05). Physical function was also significantly associated with motor vehicle travel (Trend P < 0.05). Additional analysis revealed that older adults who mainly stayed within a walking area were more likely to experience less physical activity and social networking and have diminished mental status and physical function (Trend P < 0.05). Conclusion: Extending the travel area through use of transportation modes might provide health benefits. Assessing transportation mode usage could improve screening and assistance strategies for people who are physically or mentally frail or lonely. (C) 2014 Elsevier Ltd. All rights reserved.

Objectives The present study examines factors affecting individuals' awareness of certain types of preventive care exercises, particularly the distance from their home to an exercise facility and their social networks.<br/>Methods Participants were 3206 men (age, 73.0±6.2 years) and 3395 women (age, 73.2±6.4 years) aged ≥65 years who had not been certified as persons with care needs and who had responded to an inventory survey conducted in Kasama City, Japan, in 2013. We performed multiple logistic regression analysis to assess the characteristics associated with participants' awareness of two types of exercises for preventive care: "silver rehabili taisou" (SRT) and "square-stepping exercise" (SSE). Independent variables were distance from home to the exercise facility, social networks, transportation availability, physical function, cognitive function, and neighborhood population density.<br/>Results Older adults who were aware of the exercises lived significantly closer to an exercise facility (SRT, aware: 1,148.5±961.3 m vs. unaware: 1,284.2±1,027.4 m; SSE, aware: 1,415.9±1104.1 m vs. unaware: 1,615.7±1,172.2 m). Multiple logistic regression analysis showed that participation in community activities (men, SRT–odds ratio [OR]=2.54 and SSE–OR=2.19; women, SRT–OR=4.14 and SSE–OR=3.34] and visiting friends (men, SRT–OR=1.45 and SSE–OR=1.49; women SRT–OR=1.44 and SSE–OR=1.73) were promoting factors for awareness of both types of exercises. In men and women, low physical function (SRT–OR=0.73 and SSE–OR=0.56) and dependence on another person to drive them to the destination (SRT–OR=0.79 and SSE–OR=0.78) were inhibiting factors, respectively. A distance of >500 m between their home and the facility tended to be an inhibiting factor.<br/>Conclusion A shorter distance from home to an exercise facility and better social networks increased awareness of preventive care exercises in both sexes and for both types of exercise. Establishing exercise centers and devising effective methods of imparting information to individuals (e.g., via community magazines and home visits) may promote participation in preventive care exercises.

Background: Research has shown that engaging in leisure-time physical activity (LTPA) and consuming dairy foods can lead to better sleep. Combining these two non-invasive prescriptions may be more effective for helping people fall asleep. This study investigates whether participating in LTPA in conjunction with consuming milk and milk products has a beneficial association with difficulty initiating sleep (DIS) among older adults. Methods: The present study looked at 421 community-dwelling older people aged 65 years and older living in Ibaraki prefecture, Japan (mean age 74.9 +/- 5.5 years, male 43.7%). We measured LTPA and sleep latency with the Physical Activity Scale for the Elderly and the Pittsburgh Sleep Quality Index, respectively. Participants who needed 30 minutes or more to fall asleep were defined as having DIS. We assessed dairy consumption as participants' habitual intake of milk, yogurt and cheese. Results: After adjusting for covariates, participants who engaged in sufficient levels of LTPA as well as consumed milk (OR = 0.27, 95% CI = 0.10-0.73) or cheese (OR = 0.34, 95% CI = 0.14-0.85) were less likely to complain of DIS compared with people who neither engaged in LTPA nor ingested milk or cheese. Conclusions: Our findings suggest that the combination of engaging in LTPA and consuming milk or cheese is necessary as a prescription to improve falling asleep for older adults suffering from DIS. Additionally, engaging in LTPA along with dairy consumption may effectively improve a problem with falling asleep.

Aim: The purpose of this study was to investigate determinants of changes in physical fitness after a fall-prevention exercise program in older females. Methods: The study subjects included 83 community-dwelling females 65 years of age or older (mean age: 70.4 ± 4.0 years) living in Kasama City, rural Japan. All subjects participated in a fall-prevention exercise program called square-stepping exercise (SSE) conducted once a week for 11 weeks. In order to assess the physical fitness benefits of by the exercise program, we measured the results of five physical performance tests: grip strength, one leg stand, sit and reach, timed up and go and the choice-stepping reaction time. In addition, we evaluated comprehensive physical fitness scores based on the standardized total score of the five physical performance tests. The changes in the comprehensive physical fitness score between baseline and after the program was used as the dependent variable, while the baseline values of age, education, clinical history, physical activity, Lubben social network scale, geriatric depression scale, five cognitive function test result, comprehensive physical fitness score and percentage of attendance were treated as independent variables. Results: A stepwise multiple regression analysis revealed that the change in comprehensive physical fitness score correlated significantly with the baseline values of age (β = - 0.273), the five cognitive function test result (P = 0.293) and comprehensive physical fitness score (β = - 0.607). Conclusions: These results suggest that older females with a low level of physical fitness at baseline are more likely to improve their physical fitness with a period of exercise training. However, the improvements in physical fitness are lower in older females with a low level of cognitive function than in those with a high level of cognitive function.