Updated on 2022/03/23

写真a

 
KOMIYA Hitoshi
 
Organization
Nagoya University Hospital Center for Community Liaison and Patient Consultations Lecturer of hospital
Title
Lecturer of hospital
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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. 認知症

  2. 医療情報

  3. 医療倫理

  4. 医事法

  5. 高齢者医療

  6. 高齢者法

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

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  2. 日本泌尿器科学会

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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 36

  1. Relationships between overactive bladder and cerebral white matter hyperintensity in outpatients at a memory clinic

    Komiya Hitoshi, Umegaki Hiroyuki, Ogama Noriko, Sakurai Takashi, Kuzuya Masafumi

    GERIATRICS & GERONTOLOGY INTERNATIONAL   Vol. 21 ( 11 ) page: 996 - 1002   2021.11

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    Language:Japanese   Publisher:Geriatrics and Gerontology International  

    Aim: Cerebral small vessel disease and lower urinary tract symptoms are common in older people. However, the association between white matter hyperintensity (WMH) and overactive bladder (OAB) is not fully understood. We aimed to identify the relationship between WMH and OAB. Methods: We carried out neuropsychological testing and head magnetic resonance imaging (T2-weighted and fluid-attenuated inversion recovery) of 72 outpatients at a memory clinic and evaluated their Overactive Bladder Symptom Score. WMH was assessed using the Fazekas scale, and WMH volumes were determined using Software for Neuro-Image Processing in Experimental Research. OAB was diagnosed based on a urinary urgency score (the third question of the Overactive Bladder Symptom Score) of two or higher and a total Overactive Bladder Symptom Score of three or higher. Multivariate logistic analysis was carried out, with the presence/absence of overactive bladder as the outcome variable, and age, sex, body mass index and diabetes mellitus as covariates. Results: Of the 72 participants, 17 (24%) were diagnosed with OAB. WMH assessed by the visual rating scale was not associated with OAB. However, participants with OAB showed significantly higher WMH volume than those without OAB. Regionally, participants with OAB showed high WMH volume in the frontal, occipital and parietal lobes. Multiple logistic regression analysis showed that WMH was significantly associated with OAB (OR 1.82, 95% CI 1.11–2.98), after adjustment for clinically important confounders. Conclusions: Cerebral WMH volume is associated with OAB, independent of age, sex, body mass index and diabetes mellitus. Geriatr Gerontol Int 2021; 21: 996–1002.

    DOI: 10.1111/ggi.14279

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  2. Copyright of comprehensive geriatric assessment tools

    Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics   Vol. 58 ( 1 ) page: 1 - 12   2021.1

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    Language:Japanese   Publisher:The Japan Geriatrics Society  

    DOI: 10.3143/geriatrics.58.1

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  3. 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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    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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  4. 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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    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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  5. Lysinibacillus fusiformis bacteremia: Case report and literature review

    Morioka Hiroshi, Oka Keisuke, Yamada Yosuke, Nakane Yoshimasa, Komiya Hitoshi, Murase Chiaki, Iguchi Mitsutaka, Yagi Tetsuya

    JOURNAL OF INFECTION AND CHEMOTHERAPY   Vol. 28 ( 2 ) page: 315 - 318   2022.2

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    Language:Japanese   Publisher:Journal of Infection and Chemotherapy  

    A 93-year-old woman was diagnosed with Lysinibacillus fusiformis bacteremia complicated with coma blisters. Initial gram staining for L. fusiformis indicated the presence of gram-negative rods; however, subsequent staining of colonies from Mueller-Hinton agar revealed the presence of gram-positive and gram-negative rods with spherical endospores, and Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (VITEK ® MS and microflex® LT/SH) definitively identified the organism as L. fusiformis. The two-week administration of piperacillin/tazobactam and ampicillin resulted in an improvement of the patient's general condition, and the skin lesions gradually improved.

    DOI: 10.1016/j.jiac.2021.10.030

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  6. Sedentary behavior is associated with arteriosclerosis in frail older adults

    Shiraishi Nariaki, Suzuki Yusuke, Kuromatsu Isao, Komiya Hitoshi, Kuzuya Masafumi

    NAGOYA JOURNAL OF MEDICAL SCIENCE   Vol. 84 ( 1 ) page: 91 - 100   2022.2

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    Language:Japanese   Publisher:Nagoya Journal of Medical Science  

    This prospective, cross-sectional, cohort observational study was conducted to evaluate the associations between sedentary behavior and arteriosclerosis-related vascular issues in community-dwelling frail older adults. We included 116 Japanese community-dwelling older adults (92 females and 24 males) who availed daycare at two long-term care insurance facilities in the cities of Yokkaichi and Handa between 2017 and 2019. An unpaired t-test and the chi-square test were used for intergroup comparisons. Logistic regression analysis was conducted with cardio–ankle vascular index as the dependent variable, sedentary behavior as the explanatory variable, and the other evaluated factors as covariates. Long-time sedentary behavior (based on the median value for all participants) was associated with high cardio–ankle vascular index after adjusting for age, sex, body mass index, ankle–brachial index, and walking MET-minutes in 1 week (odds ratio 3.086, 95% confidence interval 1.275–7.467, p=0.012). After adjusting for other variables (care needs certificate, skeletal muscle mass index, body fat percentage, grip strength, 4-m walking duration, etc), there was a significant association between long-time sedentary behavior and high cardio–ankle vascular index values (odds ratio 4.977, 95% confidence interval 1.497–16.554, p=0.009). The results study confirmed an association between long-time sedentary behavior in frail older adults and the degree of arterial stiffness assessed by the cardio–ankle vascular index. Interventions in older adults that focus on daily sedentary time to prevent the onset and exacerbation of geriatric syndromes secondary to the progression of arteriosclerosis warrant further investigation

    DOI: 10.18999/nagjms.84.1.91

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  7. Association of dehydration with development of dementia among non-demented geriatric outpatients.

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

    Geriatrics & gerontology international   Vol. 21 ( 10 ) page: 963 - 964   2021.10

  8. Echo intensity is more useful in predicting hospital-associated complications than conventional sarcopenia-related parameters in acute hospitalized older patients. International journal

    Masaaki Nagae, Hiroyuki Umegaki, Akito Yoshiko, Kosuke Fujita, Hitoshi Komiya, Kazuhisa Watanabe, Yosuke Yamada, Masafumi Kuzuya

    Experimental gerontology   Vol. 150   page: 111397 - 111397   2021.7

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    BACKGROUND: Hospital-associated complications are associated with adverse outcomes after discharge, and a method to help predict the occurrence of these complications needs to be established. Sarcopenia is thought to be one of the factors associated with hospital-associated complication, but sarcopenia assessment in hospitalized patients is often difficult. Focus has recently been placed on morphological and qualitative evaluation of muscle by ultrasound as an index of sarcopenia. Therefore, in this study, we sought to clarify the association of hospital-associated complication with muscle thickness or echo intensity measured by ultrasound and with commonly used sarcopenia-related parameters. METHODS: This is a prospective observational cohort study with 156 hospitalized older patients recruited over a year. Bilateral thigh muscle thickness of rectus femoris and vastus intermedius, echo intensity and corrected echo intensity of rectus femoris were measured by ultrasound. Also measured were the sarcopenia-related parameters of handgrip strength, skeletal muscle index, and maximum calf circumference. Hospital-associated complication was defined as the occurrence of any of the following complications: delirium, functional decline, incontinence, falls, pressure injuries, and nosocomial infections. RESULTS: Of 156 patients enrolled at admission, hospital-associated complication was observed in 70 (54.3%). With-hospital-associated complication group had a higher prevalence of emergency admission and a higher corrected echo intensity than without-hospital-associated complication group. Multivariate logistic regression analysis showed that only higher corrected echo intensity was associated with hospital-associated complication (odds ratio 1.036; 95% confidence interval, 1.001-1.072), while handgrip strength, bilateral thigh muscle thickness, skeletal muscle index, and maximum calf circumference were not. CONCLUSIONS: Corrected echo intensity might be a useful parameter to help predict hospital-associated complication in acute hospitalized older patients and might contribute to establishing a strategy to prevent hospital-associated complication.

    DOI: 10.1016/j.exger.2021.111397

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

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

    Dementia and geriatric cognitive disorders   Vol. 49 ( 5 ) page: 526 - 532   2021.2

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    AIMS: As the number of older people with dementia increases, safe pharmacotherapy in this population has attracted attention in recent years. The aims of this study were to clarify the prescribing patterns in older patients who were prescribed anti-dementia drugs and to investigate the association of potentially inappropriate medications (PIMs) with the use of anti-dementia drugs. METHODS: Adults aged ≥65 years, who were prescribed anti-dementia drugs at 585 pharmacies across Japan (N = 7,953), were surveyed. The percentage of prescriptions of anti-dementia drugs and the effect of those prescriptions on PIMs were investigated. RESULTS: Prescriptions of anti-dementia drugs were found in 4.4% of the entire study population. A multiple logistic regression analysis revealed that the use of anti-dementia drugs reduced the risk of prescribing psychotropic drugs, which represented PIMs, and that a combination of anti-dementia drugs (e.g., cholineesterase inhibitor with memantine) may reduce the risk of prescribing PIMs compared with monotherapy. CONCLUSION: The use of anti-dementia drugs was associated with fewer prescriptions of drugs considered as PIMs.

    DOI: 10.1159/000512043

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  10. Sedentary Behavior Is Associated with Dynapenia in Older Adults Using Day-care Facilities

    SHIRAISHI Nariaki, SUZUKI Yusuke, MATSUBAYASHI Yoshito, KOMIYA Hitoshi, KUZUYA Masafumi

    Rigakuryoho Kagaku   Vol. 36 ( 6 ) page: 783 - 788   2021

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    Language:Japanese   Publisher:The Society of Physical Therapy Science  

    <p>[Purpose] This study clarified the relationship between sedentary behavior and dynapenia in community-dwelling elderly using ambulatory service implementation facilities. [Participants and Methods] The subjects were 161 users of two outpatient nursing homes who met the conditions. A cross-sectional design was adopted for this study. Determination of dynapenia was performed via grip strength (28 kg for men, and 18 kg for women) with reference to the definition of the Asian Working Group for Sarcopenia. [Results] Sedentary behavior showed an association with dynapenia even after controlling for age, sex, physical activity, cognitive function, and comorbidities. [Conclusion] Interventions focusing on sedentary behavior are important for preventing the development and exacerbation of geriatric syndromes in the elderly due to the progression of dynapenia.</p>

    DOI: 10.1589/RIKA.36.783

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  11. Associations Between Polypharmacy and Gait Speed According to Cognitive Impairment Status: Cross-Sectional Study in a Japanese Memory Clinic. International journal

    Kazuhisa Watanabe, Hiroyuki Umegaki, Taiki Sugimoto, Chisato Fujisawa, Hitoshi Komiya, Masaaki Nagae, Yosuke Yamada, Masafumi Kuzuya, Takashi Sakurai

    Journal of Alzheimer's disease : JAD   Vol. 82 ( 3 ) page: 1115 - 1122   2021

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    BACKGROUND: Polypharmacy, usually defined as the use of 5 or more drugs, is associated with reduced quality of life, adverse events, and frailty. Slow gait speed is a component of physical frailty, and some studies have suggested an association between polypharmacy and slow gait speed. OBJECTIVE: We aimed to determine the effects of polypharmacy on the gait difference according to stages of cognitive decline in a cross-sectional study of memory clinic patients. METHODS: Participants were 431 outpatients aged 65 year or older who were cognitively normal (CN) or had mild cognitive impairment (MCI) or dementia due to Alzheimer's disease. Participants were divided into a polypharmacy group and a non-polypharmacy group in each group. Multiple regression analysis and logistic analysis were used for data analysis. RESULTS: There were 182 patients in the polypharmacy group and 249 patients in the non-polypharmacy group. Multiple regression analysis revealed that gait speed had significant negative associations with number of medications and polypharmacy status in the CN group (β: -0.026 [-0.041 to -0.0018] and -0.128 [-0.022 to -0.0033], respectively) and MCI group (-0.018 [-0.028 to -0.0009] and -0.100 [-0.166 to -0.0034]). Logistic regression analysis also showed that number of medications was associated with slow gait status (< 1 m/s) in the CN group (OR: 1.336 [1.115 to 1.601]) and MCI group (1.128 [1.022 to 1.244]). CONCLUSION: CN and MCI patients with polypharmacy have slower gait speed. Attention should be paid to decreased gait speed in older adults with polypharmacy even when their cognitive function is relatively preserved.

    DOI: 10.3233/JAD-201601

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  12. Cross-Sectional Examination of Homocysteine Levels with Sarcopenia and Its Components in Memory Clinic Outpatients. International journal

    Yosuke Yamada, Hiroyuki Umegaki, Fumie Kinoshita, Chi Hsien Huang, Taiki Sugimoto, Chisato Fujisawa, Hitoshi Komiya, Kazuhisa Watanabe, Masaaki Nagae, Masafumi Kuzuya, Takashi Sakurai

    Journal of Alzheimer's disease : JAD   Vol. 82 ( 3 ) page: 975 - 984   2021

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    BACKGROUND: Homocysteine is a common risk factor for cognitive impairment and sarcopenia. However, very few studies have shown an association between sarcopenia and serum homocysteine levels after adjustment for cognitive function. OBJECTIVE: The purpose of this study was to investigate the relationship between homocysteine and sarcopenia in memory clinic patients. METHODS: This cross-sectional study investigated outpatients in a memory clinic. We enrolled 1,774 participants (≥65 years old) with measured skeletal muscle mass index (SMI), hand grip strength (HGS), and homocysteine. All participants had undergone cognitive assessments and were diagnosed with dementia, mild cognitive impairment, or normal cognition. Patient characteristics were compared according to sarcopenia presence, SMI level, or HGS. Multivariate logistic regression analysis was performed to determine the association of homocysteine with sarcopenia, low SMI, or low HGS. Next, linear regression analysis was performed using HGS as a continuous variable. RESULTS: Logistic regression analysis showed that low HGS was significantly associated with homocysteine levels (p = 0.002), but sarcopenia and low SMI were not. In linear regression analysis, HGS was negatively associated with homocysteine levels after adjustment for Mini-Mental State Examination score (β= -2.790, p < 0.001) or clinical diagnosis of dementia (β= -3.145, p < 0.001). These results were similar for men and women. CONCLUSION: Our results showed a negative association between homocysteine and HGS after adjustment for cognitive function. Our findings strengthen the assumed association between homocysteine and HGS. Further research is needed to determine whether lower homocysteine levels lead to prevent muscle weakness.

    DOI: 10.3233/JAD-210083

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  13. Frequencies and Neuropsychological Characteristics of Errors in the Clock Drawing Test. International journal

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

    Journal of Alzheimer's disease : JAD   Vol. 82 ( 3 ) page: 1291 - 1300   2021

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    BACKGROUND: Few studies have investigated associations between types of clock drawing test (CDT) errors and cognitive impairment. OBJECTIVE: To explore associations of qualitative errors in the CDT with comprehensive neurocognitive assessment scores and clinical diagnosis. METHODS: Outpatients at a memory clinic were enrolled. Frequencies of errors determined by Cahn's method were explored according to cognitive status (cognitively normal [CN] (n = 279), mild cognitive impairment [MCI] (n = 321), and Alzheimer's disease [AD]) (n = 575). Neuropsychological assessment scores were compared between participants with and without errors. RESULTS: Stimulus-bound response (SB) was relatively rare (6.8%) in the CN group but was markedly more common in the MCI (23.4%) and AD (33.2%) groups. Conceptual deficit (CD) was found in more than 20%of CN individuals, as well as about 50%of AD patients. Planning deficit (PD) frequencies were relatively similar among the groups. SB in both of CN and MCI individuals, and CD in both of CN and MCI individuals were associated with lower scores in several neuropsychological assessments. Meanwhile, PD was not associated with lower assessment scores in any of CN, MCI, or AD individuals. CONCLUSION: The frequencies of SB and CD increased from CN, MCI, to AD but showed somewhat different patterns. Both SB and CD were associated with lower cognition in all three cognitive stages.

    DOI: 10.3233/JAD-210456

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  14. Chronic Dehydration in Nursing Home Residents. International journal

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

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

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    Chronic dehydration mainly occurs due to insufficient fluid intake over a lengthy period of time, and nursing home residents are thought to be at high risk for chronic dehydration. However, few studies have investigated chronic dehydration, and new diagnostic methods are needed. Therefore, in this study, we aimed to identify risk factors for chronic dehydration by measuring serum osmolality in nursing home residents and also to evaluate whether examining the inferior vena cava (IVC) and determining the IVC collapsibility index (IVC-CI) by ultrasound can be helpful in the diagnosis of chronic dehydration. A total of 108 Japanese nursing home residents aged ≥65 years were recruited. IVC measurement was performed using a portable handheld ultrasound device. Fifteen residents (16.9%) were classified as having chronic dehydration (serum osmolality ≥295 mOsm/kg). Multivariate logistic regression analysis showed that chronic dehydration was associated with dementia (odds ratio (OR), 6.290; 95% confidential interval (CI), 1.270-31.154) and higher BMI (OR, 1.471; 95% CI, 1.105-1.958) but not with IVC or IVC-CI. Cognitive function and body weight of residents should be considered when establishing a strategy for preventing chronic dehydration in nursing homes.

    DOI: 10.3390/nu12113562

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  15. 名古屋市の訪問看護ステーションの現状と課題についての考察

    辻 典子, 鈴木 裕介, 小宮 仁, 広瀬 貴久, 葛谷 雅文

    日本老年医学会雑誌   Vol. 57 ( 4 ) page: 506 - 506   2020.10

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  16. 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 ) page: 1 - 9   2020.9

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    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.

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  17. 高齢者のフレイルと軽度低ナトリウム血症の関係

    藤沢 知里, 梅垣 宏行, 杉本 大貴, 黄 継賢, 三溝 啓, 大西 丈二, 小宮 仁, 鈴木 裕介, 葛谷 雅文, 櫻井 孝

    日本老年医学会雑誌   Vol. 57 ( Suppl. ) page: 68 - 68   2020.7

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  18. 処方箋調剤薬局の処方箋内容の全国調査 抗認知症薬の処方実態と高齢者に特に慎重を要する薬剤との関連性の検討

    鈴木 裕介, 白石 成明, 榊原 幹夫, 小宮 仁, 葛谷 雅文

    日本老年医学会雑誌   Vol. 57 ( Suppl. ) page: 74 - 75   2020.7

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  19. 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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    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

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  20. 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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    DOI: 10.1111/psyg.12444

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  21. 裁判例データベースにおける「痴呆」から「認知症」への変遷

    小宮 仁, 梅垣 宏行, 葛谷 雅文

    日本老年医学会雑誌   Vol. 56 ( 4 ) page: 552 - 552   2019.10

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  22. 処方箋調剤薬局の抗認知症薬処方例の処方内容の解析

    鈴木 裕介, 榊原 幹夫, 白石 成明, 小宮 仁, 葛谷 雅文

    Dementia Japan   Vol. 33 ( 4 ) page: 564 - 564   2019.10

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  23. 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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    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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  24. 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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    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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  25. 高齢の脳梗塞再発患者における臨床的特徴

    服部 孝二, 小宮 仁, 鈴木 裕介, 葛谷 雅文

    日本老年医学会雑誌   Vol. 56 ( Suppl. ) page: 153 - 154   2019.5

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  26. せん妄患者における血漿中オレキシン濃度

    中嶋 宏貴, 梅垣 宏行, 柳川 まどか, 小宮 仁, 渡邊 一久, 葛谷 雅文

    日本老年医学会雑誌   Vol. 56 ( Suppl. ) page: 144 - 144   2019.5

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  27. 在宅療養患者における血清総コレステロール値と初回入院に関する検討

    渡邊 一久, 梅垣 宏行, 柳川 まどか, 中嶋 宏貴, 藤沢 知里, 小宮 仁, 山田 洋介, 葛谷 雅文

    日本老年医学会雑誌   Vol. 56 ( Suppl. ) page: 177 - 177   2019.5

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  28. 在宅療養患者のリビングウィルの有無に関連する因子の検討

    山田 洋介, 梅垣 宏行, 渡邊 一久, 小宮 仁, 中嶋 宏貴, 柳川 まどか, 黄 継賢, 葛谷 雅文

    日本老年医学会雑誌   Vol. 56 ( Suppl. ) page: 177 - 177   2019.5

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  29. 新聞、学会誌、裁判例データベースにおける「痴呆」から「認知症」への変遷

    小宮 仁, 梅垣 宏行, 渡邊 一久, 藤沢 知里, 中嶋 宏貴, 柳川 まどか, 鈴木 裕介, 葛谷 雅文

    日本老年医学会雑誌   Vol. 56 ( Suppl. ) page: 171 - 171   2019.5

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  30. 物忘れ外来患者における低ナトリウム血症と歩行障害

    藤沢 知里, 梅垣 宏行, 小宮 仁, 中嶋 宏貴, 山田 洋介, 渡邊 一久, 柳川 まどか, 葛谷 雅文, 山森 有夏, 櫻井 孝

    日本老年医学会雑誌   Vol. 56 ( Suppl. ) page: 122 - 122   2019.5

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  31. 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   2019.1

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    Language:Japanese   Publisher:一般社団法人 日本老年医学会  

    DOI: 10.3143/geriatrics.56.86

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  32. 医師の意識調査および判例検索システムを用いた在宅医療における民事医療過誤訴訟のリスクの検討

    小宮 仁, 梅垣 宏行, 鈴木 裕介, 葛谷 雅文

    日本老年医学会雑誌   Vol. 55 ( 4 ) page: 705 - 705   2018.10

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  33. 入院時に容易に入手できる情報からせん妄を予測する

    中嶋 宏貴, 梅垣 宏行, 柳川 まどか, 小宮 仁, 渡邊 一久, 葛谷 雅文

    Dementia Japan   Vol. 32 ( 3 ) page: 513 - 513   2018.9

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  34. 認知機能と下部尿路症状との関連性

    小宮 仁, 梅垣 宏行, 鈴木 裕介, 葛谷 雅文

    日本老年医学会雑誌   Vol. 55 ( Suppl. ) page: 161 - 161   2018.5

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  35. 在宅高齢者における不適切処方と入院との関連の検討

    梅垣 宏行, 野村 秀樹, 神田 茂, 紙谷 博子, 渡邉 雄貴, 中嶋 宏貴, 小宮 仁, 渡邊 一久, 葛谷 雅文

    日本老年医学会雑誌   Vol. 55 ( Suppl. ) page: 141 - 141   2018.5

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  36. [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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    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

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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

    Language:Japanese  

 

Teaching Experience (On-campus) 3

  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

    2021

  3. 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)

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