Updated on 2021/03/31

写真a

 
KOMIYA Hitoshi
 
Organization
Nagoya University Hospital Community Liaison Center Lecturer of hospital
Title
Lecturer of hospital

Degree 2

  1. 博士(医学) ( 2019.3   名古屋大学 ) 

  2. 法務博士(専門職) ( 2011.3   京都大学 ) 

Research Interests 6

  1. 高齢者法

  2. 高齢者医療

  3. 認知症

  4. 医療情報

  5. 医療倫理

  6. 医事法

Research Areas 3

  1. Humanities & Social Sciences / New fields of law  / 医事法

  2. Life Science / Medical management and medical sociology  / 医療情報、医療倫理、医事法

  3. Life Science / General internal medicine  / 老年内科

Professional Memberships 2

  1. 日本老年医学会

  2. 日本泌尿器科学会

Committee Memberships 3

  1. 日本老年医学会   代議員  

    2020   

  2. 日本老年医学会   学術委員会CGAツール選定・最適化WG委員  

    2020   

  3. 日本老年医学会   倫理委員会委員  

    2019   

 

Papers 12

  1. Use of Anti-Dementia Drugs Reduces the Risk of Potentially Inappropriate Medications: A Secondary Analysis of a Nationwide Survey of Prescribing Pharmacies

    Suzuki Yusuke, Sakakibara Mikio, Shiraishi Nariaki, Komiya Hitoshi, Akishita Masahiro, Kuzuya Masafumi

    DEMENTIA AND GERIATRIC COGNITIVE DISORDERS   Vol. 49 ( 5 ) page: 526 - 532   2021.2

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    Publisher:Dementia and Geriatric Cognitive Disorders  

    DOI: 10.1159/000512043

    Web of Science

    Scopus

  2. Copyright of comprehensive geriatric assessment tools

    Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics   Vol. 58 ( 1 ) page: 1 - 12   2021

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    Publisher:The Japan Geriatrics Society  

    DOI: 10.3143/geriatrics.58.1

    CiNii Article

  3. Chronic Dehydration in Nursing Home Residents

    Nagae Masaaki, Umegaki Hiroyuki, Onishi Joji, Huang Chi Hsien, Yamada Yosuke, Watanabe Kazuhisa, Komiya Hitoshi, Kuzuya Masafumi

    NUTRIENTS   Vol. 12 ( 11 ) page: 1 - 12   2020.11

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    Publisher:Nutrients  

    DOI: 10.3390/nu12113562

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    Scopus

  4. Association of the Qualitative Clock Drawing Test with Progression to Dementia in Non-Demented Older Adults. Reviewed International journal

    Hiroyuki Umegaki, Yusuke Suzuki, Yosuke Yamada, Hitoshi Komiya, Kazuhisa Watanabe, Masaaki Nagae, Masafumi Kuzuya

    Journal of clinical medicine   Vol. 9 ( 9 )   2020.9

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    Publishing type:Research paper (scientific journal)  

    To evaluate the predictability of progression of cognitive impairment to dementia using qualitative clock drawing test (CDT) scores, we administered both the CDT using Cahn et al.'s qualitative scoring system and the Mini-Mental State Examination (MMSE) to assess cognitive function in non-demented older individuals attending a memory clinic at a university hospital. Patients visiting the clinic for assessment of cognitive function between January 2015 and December 2019 were enrolled, and only those who were diagnosed as not having dementia at the time of initial assessment completed a follow-up assessment at 1 y (n = 163). To examine any association of qualitative CDT score with progression to dementia, multiple logistic regression analysis was conducted with the change in diagnosis from non-dementia to dementia at 1 y as the dependent variable. A total of 26 participants (16.0%) were diagnosed as having converted to dementia. Multiple logistic regression analysis revealed that both the qualitative CDT score using Cahn et al.'s scoring system and the existence of conceptual deficits were significantly associated with progression to dementia at 1 y after initial assessment of cognitive function, irrespective of the MMSE score, among non-demented older individuals. The CDT may be a useful predictor of progression to dementia in primary care settings.

    DOI: 10.3390/jcm9092850

    Web of Science

    PubMed

  5. Association Between Sarcopenia and Quality of Life in Patients with Early Dementia and Mild Cognitive Impairment. Reviewed International journal

    Hiroyuki Umegaki, Viviana Bonfiglio, Hitoshi Komiya, Kazuhisa Watanabe, Masafumi Kuzuya

    Journal of Alzheimer's disease : JAD   Vol. 76 ( 1 ) page: 435 - 442   2020

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    Publishing type:Research paper (scientific journal)  

    BACKGROUND: Cognitive impairment is linked to decreased quality of life (QOL), but few studies have investigated the impact of comorbid sarcopenia. OBJECTIVE: The aim of this study was to elucidate the association of sarcopenia with QOL in patients with early dementia and mild cognitive impairment. METHODS: Individuals with a Clinical Dementia Rating of 0.5 or 1 and a Mini-Mental State Examination score of 20-30 underwent a battery of neuropsychological assessments administered by a group of well-trained clinical psychologists. The EQ-5D was completed by both the patients and their main caregivers. EQ-5D utility and visual analog scale scores were measured. Sarcopenia was defined according to the criteria published in the 2019 consensus update by the Asian Working Group for Sarcopenia. RESULTS: Patients with sarcopenia had significantly lower scores on the Digit Symbol Substitution Test and Trail Making Test Part A. There was a significant negative association between sarcopenia and both self- and proxy-rated EQ-5D utility scores independent of potential confounding factors. However, there was no association between QOL visual analog scale scores and sarcopenia. CONCLUSION: Given that sarcopenia is often found in individuals with cognitive impairment, early detection by timely screening and effective intervention may help to maintain or improve QOL in this population. However, this study could not determine whether reduced QOL is a direct consequence of sarcopenia.

    DOI: 10.3233/JAD-200169

    Web of Science

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    PubMed

  6. Plasma orexin-A levels in patients with delirium. Reviewed International journal

    Hirotaka Nakashima, Hiroyuki Umegaki, Madoka Yanagawa, Hitoshi Komiya, Kazuhisa Watanabe, Masafumi Kuzuya

    Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society   Vol. 19 ( 6 ) page: 628 - 630   2019.11

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1111/psyg.12444

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  7. Polypharmacy and gait speed in individuals with mild cognitive impairment. Reviewed

    Hiroyuki Umegaki, Madoka Yanagawa, Hitoshi Komiya, Masaki Matsubara, Chisato Fujisawa, Yusuke Suzuki, Masafumi Kuzuya

    Geriatrics & gerontology international   Vol. 19 ( 8 ) page: 730 - 735   2019.8

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    Publishing type:Research paper (scientific journal)  

    AIM: Polypharmacy has been reported to be associated with poor outcomes, including falls and frailty, in older populations. Past studies have found that slower walking speed is a good predictor of progression to frank dementia in mild cognitive impairment (MCI). Some studies of the general population reported that polypharmacy was associated with slower gait speed; however, it remains to be elucidated whether polypharmacy affects gait speed even in individuals with MCI, who already have some deterioration in gait compared with cognitively preserved individuals. The current study explored the association between the number of medications and gait speed in older adults with MCI who have a Clinical Dementia Rating score of 0.5. METHODS: A total of 128 individuals with MCI were included in the present study. The participants were divided into three groups according to the number of medications they were taking: up to four medications was non-polypharmacy; five to nine medications was polypharmacy; and ≥10 medications was hyperpolypharmacy. The background characteristics were compared by analysis of variance for numerical numbers, and by χ2 analysis for categorical factors. Multiple regression and logistic analysis were applied to investigate the association between gait speed and polypharmacy status or number of medications. RESULTS: Gait speed was significantly negatively associated with hyperpolypharmacy status and the number of medications. Slow gait speed (<1 m/s) was also significantly associated with polypharmacy status and the number of medications. CONCLUSIONS: We found that polypharmacy was associated with slow gait speed in older adults with MCI. Geriatr Gerontol Int 2019; 19: 730-735.

    DOI: 10.1111/ggi.13688

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    PubMed

  8. Plasma orexin-A-like immunoreactivity levels and renal function in patients in a geriatric ward. Reviewed International journal

    Hirotaka Nakashima, Hiroyuki Umegaki, Madoka Yanagawa, Hitoshi Komiya, Kazuhisa Watanabe, Masafumi Kuzuya

    Peptides   Vol. 118   page: 170092 - 170092   2019.8

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    Publishing type:Research paper (scientific journal)  

    Orexin-A is a neuropeptide mainly produced by hypothalamic neurons with functions in the central nervous system such as regulation of the sleep-wake cycle. Recent studies suggest that orexin-A also plays major roles in peripheral tissues. Although a few studies have reported a role for the kidney in the dynamics of orexin-A, little is known about the association between plasma orexin-A-like immunoreactivity (orexin-A-LI) levels and renal function. We evaluated this association, and also explored other clinical characteristics associated with plasma orexin-A-LI levels. In this cross-sectional study, we included 70 consecutive patients aged ≥65 years admitted to the geriatric ward of Nagoya University Hospital from December 2017 to January 2018. Patients taking suvorexant (an orexin receptor antagonist) were excluded. On hospital days 2-4, fasting blood was collected in the morning. We evaluated associations between plasma orexin-A-LI levels and renal function and other clinical characteristics. Renal function was evaluated in two ways: the estimated glomerular filtration rate (eGFR) using serum creatinine, and estimated creatinine clearance (eCrCl) using the Cockroft-Gault formula. Pearson's correlation coefficient revealed that plasma orexin-A-LI levels were negatively correlated with the eGFR (r = -0.351, p = 0.003) and eCrCl (r = -0.342, p = 0.004). There were no significant associations between plasma orexin-A-LI levels and the primary diagnosis, body mass index, duration of fasting, or other clinical characteristics. In conclusion, plasma orexin-A-LI levels were negatively correlated with renal function in patients in a geriatric ward. Renal function may affect the study design and data interpretation in studies of plasma orexin-A-LI.

    DOI: 10.1016/j.peptides.2019.170092

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  9. Prevalence and risk factors of constipation and pollakisuria among older home-care patients. Reviewed

    Hitoshi Komiya, Hiroyuki Umegaki, Atsushi Asai, Shigeru Kanda, Keiko Maeda, Hideki Nomura, Masafumi Kuzuya

    Geriatrics & gerontology international   Vol. 19 ( 4 ) page: 277 - 281   2019.4

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    Publishing type:Research paper (scientific journal)  

    AIM: The prevalence of constipation and prevalence of pollakisuria among older patients receiving home medical care have not been reported, and risk factors for these symptoms are not clear in this setting. The present study sought to determine the prevalence and risk factors of constipation and pollakisuria among older patients receiving home medical care in Japan. METHODS: This study utilized data from patients in the Observational Study of Nagoya Elderly with Home Medical Care (n = 153). We carried out univariate and multivariate logistic regression analyses with the presence of constipation or pollakisuria as the dependent variable to evaluate the relationships between constipation or pollakisuria and several covariates. RESULTS: The prevalence of constipation and pollakisuria were 56.9% and 15.7%, respectively. Multivariate logistic analysis showed that constipation was associated with Charlson Comorbidity Index score, polypharmacy and pollakisuria, and pollakisuria was associated with constipation and insomnia. Cardiovascular disease was inversely associated with constipation. CONCLUSIONS: The prevalence of constipation among home-care patients was as high as that reported for nursing home residents and higher than that among community-dwelling individuals. Clinicians should be aware of increased constipation risk among home-care patients, particularly for those with a high Carlson Comorbidity Index score, polypharmacy and/or pollakisuria. Geriatr Gerontol Int 2019; 19: 277-281.

    DOI: 10.1111/ggi.13610

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  10. The 9th IAGG Master Class on Ageing in Asia体験記

    小宮 仁

    日本老年医学会雑誌   Vol. 56 ( 1 ) page: 86 - 86   2019

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    Publisher:一般社団法人 日本老年医学会  

    DOI: 10.3143/geriatrics.56.86

    CiNii Article

  11. Factors associated with polypharmacy in elderly home-care patients. Reviewed

    Hitoshi Komiya, Hiroyuki Umegaki, Atsushi Asai, Shigeru Kanda, Keiko Maeda, Takuya Shimojima, Hideki Nomura, Masafumi Kuzuya

    Geriatrics & gerontology international   Vol. 18 ( 1 ) page: 33 - 41   2018.1

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    Publishing type:Research paper (scientific journal)  

    AIM: Polypharmacy, which is often observed in elderly patients, has been associated with several unfavorable outcomes, including an increased risk of potentially inappropriate medications, medication non-adherence, drug duplication, drug-drug interactions, higher healthcare costs and adverse drug reactions. A significant association between polypharmacy and adverse outcomes among older people living in the community has also been confirmed. A reduction in the number of medications should thus be pursued for many older individuals. Nevertheless, the factors associated with polypharmacy in elderly home-care patients have not been reported. Here, we investigated those factors in elderly home-care patients in Japan. METHODS: We used the data of the participants in the Observational Study of Nagoya Elderly with Home Medical investigation. Polypharmacy was defined as the current use of six or more different medications. We carried out univariate and multivariate logistic regression analyses to assess the associations between polypharmacy and each of several factors. RESULTS: A total of 153 home-care patients were registered. The mean number of medications used per patient was 5.9, and 51.5% of the patients belonged to the polypharmacy group. The multivariate model showed that the patients' scores on the Charlson Comorbidity Index and the Mini-Nutrition Assessment Short Form were inversely associated with polypharmacy, and potentially inappropriate medication was most strongly associated with polypharmacy (odds ratio 4.992). CONCLUSIONS: The present findings showed that polypharmacy was quite common among the elderly home-care patients, and they suggest that home-care physicians should prescribe fewer medications in accord with the deterioration of home-care patients' general condition. Geriatr Gerontol Int 2018; 18: 33-41.

    DOI: 10.1111/ggi.13132

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  12. [State of glycemic control in elderly diabetic patients]. Reviewed

    Koji Hattori, Hiroyuki Umegaki, Hitoshi Komiya, Kazuhisa Watanabe, Masafumi Kuzuya

    Nihon Ronen Igakkai zasshi. Japanese journal of geriatrics   Vol. 54 ( 4 ) page: 531 - 536   2017

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    Language:Japanese   Publishing type:Research paper (scientific journal)  

    AIM: The Japan Diabetes Society and The Japan Geriatric Society made a joint committee and published a new glycemic target in May 2016. Because reports on the state of glycemic control in elderly diabetic patients are insufficient, we investigated the state of glycemic control in this population before the new glycemic target was established. METHODS: We enrolled patients older than 65 years of age who had been prescribed antidiabetic drugs and hospitalized in the geriatric department of Nagoya University Hospital from April 1, 2015, to March 31, 2016. We investigated the participants' HbA1c, prescription of antidiabetic drugs carrying risks of severe hypoglycemia (risk drugs) at hospitalization, cognitive function, basic activities of daily living, and instrumental activities of daily living. RESULTS: A total of 63 patients were enrolled. Thirty-five patients were male, the mean age was 83.1±5.9 years old, and the average HbA1c was 7.6%±1.5%. The numbers of patients assigned to categories I, II, and III were 10, 12, and 41, respectively. For prescription of risk drugs, 6 participants were assigned to category I, 8 to category II, and 22 to category III. Prescription of risk drugs was associated with the HbA1c. Approximately one third of the patients using risk drugs had a lower HbA1c than the target value. CONCLUSIONS: Risk drugs was not significantly associated with the established categories or age. Many of the patients who were prescribed risk drugs had a lower HbA1c than the target values.

    DOI: 10.3143/geriatrics.54.531

    PubMed

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Presentations 1

  1. 脳白質病変と過活動膀胱の関連性

    小宮 仁, 梅垣 宏行, 大釜 典子, 鈴木 裕介, 櫻井 孝, 葛谷 雅文

    第62回日本老年医学会学術集会  2020.6 

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    Event date: 2020.6.3 - 2020.6.5

    Language:Japanese  

 

Teaching Experience (On-campus) 2

  1. 高齢者医療における多剤投与、高齢者の摂食・排泄障害

    2021

  2. PBLチュートリアル

    2020

Teaching Experience (Off-campus) 1

  1. 老年科学(高齢者医療における多剤投与、高齢者の摂食・排泄障害)