Updated on 2023/03/08

写真a

 
WATANABE Kazuhisa
 
Organization
Nagoya University Hospital Geriatrics Lecturer of hospital
Title
Lecturer of hospital

Degree 1

  1. 博士(医学) ( 2020.3   名古屋大学 ) 

Research Interests 4

  1. 老年医学

  2. 嚥下障害

  3. 認知症

  4. 糖尿病

Professional Memberships 4

  1. 日本老年医学会

  2. 日本認知症学会

  3. 日本糖尿病学会

  4. 日本内科学会

 

Papers 22

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

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

    JOURNAL OF ALZHEIMERS DISEASE   Vol. 82 ( 3 ) page: 1115 - 1122   2021

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    Authorship:Lead author   Language:Japanese   Publisher:Journal of Alzheimer's Disease  

    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 (<1m/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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  2. Association between dysphagia risk and unplanned hospitalization in older patients receiving home medical care

    Watanabe Kazuhisa, Umegaki Hiroyuki, Huang Chi-Hsien, Arakawa Martins Beatriz, Asai Atsushi, Kanda Shigeru, Nomura Hideki, Kuzuya Masafumi

    GERIATRICS & GERONTOLOGY INTERNATIONAL   Vol. 19 ( 10 ) page: 977 - 981   2019.10

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    Authorship:Lead author   Language:Japanese   Publisher:Geriatrics and Gerontology International  

    Aim: Home medical care for older adults with chronic conditions is becoming an increasing important issue in Japan. We need to support long-term medical care at home and avoid unplanned hospitalizations, which can adversely affect activities of daily living and quality of life. In this study, we investigated whether swallowing function is a risk for unplanned hospitalization in older patients with functional decline who are receiving home medical care. Methods: In the current study, we examined data obtained in the Observational study of Nagoya Elderly with HOme MEdical study (ONEHOME) that investigated the medical health of older adults receiving home medical care services in Nagoya City, Japan. The data analyzed were patients’ age, sex, number of medications, Dysphagia Severity Scale, Charlson Comorbidity Index, Barthel Index, Mini Nutritional Assessment – Short Form, Frailty Index and dementia independent scale. The Dysphagia Severity Scale was categorized into the presence or absence of dysphagia risk. The association between dysphagia risk and days until first hospitalization was investigated by Cox regression analysis. Results: In total, 86 out of 178 patients had a hospitalization during the study period of 4 years. Cox regression analysis with adjustment for age, sex, Charlson Comorbidity Index, Barthel Index and Mini Nutritional Assessment – Short Form scores showed that a lower Dysphagia Severity Scale score was significantly associated with unexpected hospitalization. Conclusions: Dysphagia risk predicts the first unexpected hospitalization in older individuals receiving home medical care. Patients’ swallowing function is an important factor for estimating prognosis. Geriatr Gerontol Int 2019; 19: 977–981.

    DOI: 10.1111/ggi.13753

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  3. Clinical significance of geriatric conditions in acute hospitalization

    Umegaki Hiroyuki, Nagae Masaaki, Komiya Hitoshi, Watanabe Kazuhisa, Yamada Yosuke, Sakai Tomomichi, Tajima Tomihiko

    GERIATRICS & GERONTOLOGY INTERNATIONAL   Vol. 23 ( 1 ) page: 50 - 53   2023.1

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    Language:English   Publisher:Geriatrics and Gerontology International  

    Background: Geriatric conditions (GCs) are common in the elderly population, but their clinical significance in acute care is not well understood. In this study, we first investigated the cross-sectional associations of GCs with frailty and polypharmacy at the time of admission to an acute care geriatric ward. Then, to clarify the clinical significance of GCs in acute care, we prospectively examined the association of GCs with the incidence of hospital-acquired complications and consequences after discharge. Methods: Participants were 184 patients (40.2% men: mean age 85.0 ± 6.0 years) hospitalized in an acute care geriatric ward at a university hospital. We examined the cross-sectional associations of GCs with frailty and polypharmacy by multiple regression analysis, and then the associations of GCs with the incidence of hospital-acquired complications, falls and death within 3 months of discharge by multiple logistic regression analysis. Results: GCs were associated with frailty and use of polypharmacy, independent of multiple morbidity. GCs were also associated with readmission within 3 months of discharge; however, there was no significant association with the incidence of hospital-acquired complications, falls, or mortality after discharge. Conclusions: These findings suggest that GCs are clinically significant in the hospitalized elderly and further research on GCs is warranted. Geriatr Gerontol Int 2023; 23: 50–53.

    DOI: 10.1111/ggi.14523

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  4. Association between changes in frailty during hospitalization in older adults and 3-month mortality after discharge

    Umegaki Hiroyuki, Nagae Masaaki, Komiya Hitoshi, Watanabe Kazuhisa, Yamada Yosuke, Sakai Tomomichi

    EUROPEAN GERIATRIC MEDICINE   Vol. 13 ( 6 ) page: 1403 - 1406   2022.12

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    Language:English   Publisher:European Geriatric Medicine  

    Frailty is a dynamic status that can worsen or improve. However, changes in their frailty status that occur during hospitalization and their significance have not been comprehensively investigated. In this study, we explored the association between such changes and mortality 3 months after discharge in older adults hospitalized for acute care. In total, 257 participants (mean age 84.95 ± 5.88, 41.6% male) completed comprehensive geriatric assessments, including the Clinical Frailty Scale (CFS) at admission and discharge. Mean CFS score was 5.14 ± 1.35 at admission. CFS scores increased, indicating deteriorating frailty, in 29.2% of the participants (75/257) during hospitalization. Multiple logistic regression analysis demonstrated a positive association between increased CFS score during hospitalization and mortality (odds ratio, 2.987) independent of potential co-founding factors. This deterioration in frailty during hospitalization may be modifiable risk factor of poor prognosis in older adults who need acute care hospitalization.

    DOI: 10.1007/s41999-022-00704-7

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  5. Dehydration and hospital-associated disability in acute hospitalized older adults

    Nagae Masaaki, Umegaki Hiroyuki, Komiya Hitoshi, Fujisawa Chisato, Watanabe Kazuhisa, Yamada Yosuke, Miyahara Shuzo

    EUROPEAN GERIATRIC MEDICINE   Vol. 14 ( 1 ) page: 113 - 121   2022.11

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    Language:English   Publisher:European Geriatric Medicine  

    Purpose: Dehydration is highly prevalent in hospitalized older adults and has been linked to poor outcomes. It is considered a modifiable factor, so early identification and intervention may avoid adverse events and improve quality of life after discharge. Hospital-associated disability (HAD) is known to be a poor prognostic factor and can be categorized into mobility impairment and self-care impairment in setting goals for management. Few studies have directly examined the association between dehydration and HAD and therefore here we examined whether dehydration is a predictor of HAD categorized into mobility and self-care impairment among acute hospitalized older adults. Methods: Patients aged 65 years or older who were admitted to the geriatric ward of an acute hospital were recruited for this prospective cohort study. Estimated serum osmolarity > 300 mOsm/kg was defined as current dehydration. HAD was assessed between baseline and discharge and at 3 months after discharge, and was evaluated separately for mobility and self-care impairments. Results: In total, 192 patients (mean age, 84.7 years; male, 41.1%; dehydration, 31.3%) were analyzed. The occurrence of HAD was significantly higher in the dehydrated group than in the non-dehydrated group (42.4% vs 26.5%) from baseline to 3 months after discharge. In multiple logistic regression analysis, dehydration was significantly associated with HAD in self-care from baseline to 3 months after discharge (odds ratio, 2.25; 95% confidence interval, 1.03–4.94). Conclusions: Dehydration could predict the occurrence of HAD in acute hospitalized older adults. A multifaceted approach may be necessary to improve the management of dehydration in these patients.

    DOI: 10.1007/s41999-022-00722-5

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  6. Relationship of creatinine cystatin C ratio with muscle mass and grip strength in memory clinic outpatients

    Yamada Yosuke, Umegaki Hiroyuki, Sugimoto Taiki, Nagae Masaaki, Komiya Hitoshi, Watanabe Kazuhisa, Sakurai Takashi

    EXPERIMENTAL GERONTOLOGY   Vol. 168   page: 111935   2022.10

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    Language:English   Publisher:Experimental Gerontology  

    Objectives: The purpose of this study was to examine the relationship of the serum creatinine/cystatin C ratio (CCR) with hand grip strength (HGS), total body muscle mass, trunk muscle mass, and skeletal muscle mass index (SMI) in patients attending a memory clinic. Design: This cross-sectional study enrolled outpatients of a memory clinic in Japan from October 2010 to July 2017. Setting and participants: We enrolled 1945 participants aged 60 years or older with measured skeletal muscle mass, HGS, and serum creatinine and serum cystatin C levels. Measures: Linear multiple regression analysis was performed for men and women using total body muscle mass, trunk muscle mass, and SMI as objective variables. The exposure variables were selected from previous reports if they were strongly linked to muscle mass. Total body muscle mass and trunk muscle mass were corrected by dividing by body weight. Multiple regression analysis was also conducted for men and women using HGS as an objective variable. Because cognitive function and HGS are strongly related, we also conducted sensitivity analysis by excluding participants with a Mini-Mental State Examination score < 24 to alleviate any concern that we did not fully adjust for the effect of cognitive dysfunction. Results: In men, CCR was significantly associated with total body muscle mass, trunk muscle mass, and SMI (P = 0.013, P = 0.008, and P < 0.001, respectively). In women, CCR was significantly associated with total body muscle mass and trunk muscle mass (P = 0.013 and P < 0.001, respectively), but not with SMI (P = 0.932). On the other hand, CCR was significantly associated with grip strength in both men and women (P < 0.001 and P < 0.001, respectively). Conclusions: CCR was associated with both muscle mass and muscle strength. This study suggests that CCR is a useful marker not only for muscle mass but also for muscle strength.

    DOI: 10.1016/j.exger.2022.111935

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  7. Muscle changes on muscle ultrasound and adverse outcomes in acute hospitalized older adults

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

    NUTRITION   Vol. 102   page: 111698   2022.10

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    Objectives: Muscle ultrasound is a non-invasive technique that enables identification of the quantity and quality of muscle tissue. It has been used not only for diagnosis of sarcopenia but also for prediction of outcomes in clinical practice. There is now increasing awareness that muscle changes detected during acute hospitalization indicate acute sarcopenia leading to worse outcomes. However, to our knowledge, few studies have investigated this in hospitalized older adults. The aim of this study was to determine whether muscle changes on muscle ultrasound can predict poor outcomes in acute hospitalized older adults. Methods: This prospective, observational cohort study involved 145 acute hospitalized older adults. Bilateral anterior thigh thickness (BATT), echo intensity (EI), and corrected EI of the quadriceps were assessed on admission and 7 d later. The primary outcome was mortality, and the secondary outcomes were hospital-associated complications and decline in activities of daily living (ADLs) at 3 mo after discharge. Results: Changes in BATT, EI, and corrected EI at 7 d after admission were found in 0.2%, 0.0%, and 0.2% of cases, respectively. The respective rates for mortality, hospital-associated complications, and ADL decline were 8.7%, 52.8%, and 43%, respectively. Multivariable logistic regression analysis showed that the BATT value at admission tended to be associated with mortality. Changes in BATT, EI, and collected EI were not associated with adverse outcomes. Conclusions: Acute muscle changes on muscle ultrasound were not associated with mortality, ADL decline, or hospital-associated complications in acute hospitalized older adults. More research in various settings is needed to clarify the value of muscle ultrasound in clinical practice.

    DOI: 10.1016/j.nut.2022.111698

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  8. Association between gait speed and errors on the Clock Drawing Test in older adults with mild cognitive impairment

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

    SCIENTIFIC REPORTS   Vol. 12 ( 1 ) page: 9929   2022.6

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    Individuals with mild cognitive impairment (MCI) often make qualitative errors on the Clock Drawing Test (CDT), and these errors are reported to be associated with lower scores on neuropsychological assessments. Gait speed is also closely associated with cognitive dysfunction. However, the association between CDT errors and gait speed has not been investigated in individuals with MCI. Therefore, in this study, we explored the association between gait speed and qualitative errors on the CDT. Participants were 196 outpatients at a memory clinic with a clinical dementia rating of 0.5. The CDT was evaluated using the method of Cahn et al. The participants were divided into tertiles of normal and maximum gait speeds. The CDT error types of stimulus-bound response, conceptual deficit (CD), and planning deficit were found in 24.5%, 29.6%, and 30.1% of the participants, respectively. CD was found in 43.6% of the slowest tertile of maximum gait and in 22.2% of the fastest tertile. Multiple linear regression analysis gait speeds as objective continuous variables revealed that CD was significantly negatively associated with maximum gait, but not with normal gait. No other error types were associated with gait speeds. Only CD type error on the CDT was negatively associated with maximum gait speed, but not normal gait speed in the current study. The association between the qualitative error on the CDT and gait speed provides further basis of the clinical importance of qualitative assessments of CDT.

    DOI: 10.1038/s41598-022-14084-2

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  9. Impact of Sarcopenia on Decline in Quality of Life in Older People with Mild Cognitive Impairment

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

    JOURNAL OF ALZHEIMERS DISEASE   Vol. 88 ( 1 ) page: 23 - 27   2022

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    Language:English   Publisher:Journal of Alzheimer's Disease  

    Quality of life (QOL) was assessed using the EQ-5D twice in 1 year in 57 older community-dwelling people (age 79.1±5.9 years) with mild cognitive impairment in a memory clinic. Screening for sarcopenia at the initial assessment revealed 40.1% of participants (23/57) were sarcopenic. QOL declined in 33.3% of participants (19/57) after around 1 year. Multiple logistic regression analysis showed that sarcopenia was associated with a decline in QOL around 1 year after initial assessment. Sarcopenia may be a risk factor for decline in QOL in older people with mild cognitive impairment.

    DOI: 10.3233/JAD-220123

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

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

    GERIATRICS & GERONTOLOGY INTERNATIONAL   Vol. 21 ( 10 ) page: 963 - 964   2021.10

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    Language:Japanese   Publisher:Geriatrics and Gerontology International  

    DOI: 10.1111/ggi.14251

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  11. Cerebral pathological findings in long-lived patient with Werner syndrome and dementia

    Kuzuya Masafumi, Shi Rong Q., Yanagawa Madoka, Watanabe Kazuhisa, Samizo Satoshi, Ando Ryota, Miyahara Hiroaki, Iwasaki Yasushi, Yoshida Mari

    GERIATRICS & GERONTOLOGY INTERNATIONAL   Vol. 21 ( 8 ) page: 743 - 745   2021.8

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    DOI: 10.1111/ggi.14206

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

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

    EXPERIMENTAL GERONTOLOGY   Vol. 150   page: 111397   2021.7

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    Language:Japanese   Publisher:Experimental Gerontology  

    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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  13. Long-lived Werner syndrome patient autopsy report: The presence of liver cirrhosis

    Kuzuya Masafumi, Shi Rong Qian, Yanagawa Madoka, Watanabe Kazuhisa, Samizo Satoshi, Ando Ryota

    GERIATRICS & GERONTOLOGY INTERNATIONAL   Vol. 21 ( 5 ) page: 433 - 435   2021.5

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    DOI: 10.1111/ggi.14149

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

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

    JOURNAL OF ALZHEIMERS DISEASE   Vol. 82 ( 3 ) page: 975 - 984   2021

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    Language:Japanese   Publisher:Journal of Alzheimer's Disease  

    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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  15. Frequencies and Neuropsychological Characteristics of Errors in the Clock Drawing Test

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

    JOURNAL OF ALZHEIMERS DISEASE   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.

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  16. 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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    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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  17. Association of the Qualitative Clock Drawing Test with Progression to Dementia in Non-Demented Older Adults

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

    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.

    DOI: 10.3390/jcm9092850

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  18. Association Between Sarcopenia and Quality of Life in Patients with Early Dementia and Mild Cognitive Impairment

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

    JOURNAL OF ALZHEIMERS DISEASE   Vol. 76 ( 1 ) page: 435 - 442   2020

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    Language:Japanese   Publisher:Journal of Alzheimer's Disease  

    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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  19. Plasma orexin-A levels in patients with delirium

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

    PSYCHOGERIATRICS   Vol. 19 ( 6 ) page: 628 - 630   2019.11

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    Language:Japanese   Publisher:Psychogeriatrics  

    DOI: 10.1111/psyg.12444

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  20. Plasma orexin-A-like immunoreactivity levels and renal function in patients in a geriatric ward

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

    PEPTIDES   Vol. 118   page: 170092   2019.8

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    Language:Japanese   Publisher:Peptides  

    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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  21. Cilostazol for the prevention of pneumonia: a systematic review

    Nakashima Hirotaka, Watanabe Kazuhisa, Umegaki Hiroyuki, Suzuki Yusuke, Kuzuya Masafumi

    PNEUMONIA   Vol. 10   page: 3   2018.4

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  22. State of glycemic control in elderly diabetic patients

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

    Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics   Vol. 54 ( 4 ) page: 531 - 536   2017

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    Language:Japanese   Publisher:The Japan Geriatrics Society  

    <p><b>Aim: </b>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.</p><p><b>Methods: </b>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.</p><p><b>Results: </b>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.</p><p><b>Conclusions: </b>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.</p>

    DOI: 10.3143/geriatrics.54.531

    PubMed

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