Chisato Hayashi

<title>Abstract</title><sec> <title>Background</title> How community-based group resistance exercises affect the transition from robustness to frailty remains unclear. Thus, we conducted a retrospective cohort study to determine whether the trajectory from robustness to frailty over age differed depending on the duration of participation in group exercises. </sec><sec> <title>Methods</title> We analyzed the Kihon Checklist (KCL) score of community-dwelling elderly residents of Sumoto city, Hyogo prefecture, who participated in community-based group resistance exercises between April 2010 and December 2019. Finally, 2567 older individuals were analyzed using multilevel modeling. The explanatory variables of interest were the frailty score measured using the KCL for each individual, where 0–3, 4–7, and ≥8 points denoted robustness, pre-frailty, and frailty, respectively. We considered age, sex, systolic blood pressure, pulse, duration of participation, and change in KCL score from baseline as possible confounders. Participants were classified as follows based on the duration of participation in the exercises: &lt;3 times, short-term participation group; 4–6 times; mid-term participation group; and 7–13 times, long-term participation group. The mean duration from the baseline physical test for the total sample was 2.35 years (SD=2.51). </sec><sec> <title>Results</title> The participants’ mean total KCL score at baseline was 4.9±3.7. Multilevel modeling analysis revealed that the KCL scores changed by 0.82 points for each additional year of age (<italic>p</italic>&lt;0.001) and changed by − 0.93 points for long-term participate group (<italic>p</italic>&lt;0.001). The Estimated Marginal Means (EMM) of the KCL score was 3.98 (95%CI: 3.69, 4.28) points in the short-term participation group and was significantly worse than that of the long-term participation group at 70 years of age (<italic>p</italic>=0.001). The EMM was 4.49 (95%CI: 4.24, 4.74) at 75 years of age in the mid-term participation group and was significantly worse than that of the long-term participation group. The EMM was 3.87 (95%CI: 3.57, 4.16) in the long-term participation group and significantly better than that of the short-term (<italic>p</italic>&lt;0.001) and mid-term (<italic>p</italic>=0.002) participation groups. </sec><sec> <title>Conclusion</title> Participation in community-based group resistance exercises prolongs the transition from robustness to frailty. The improved KCL scores at baseline in the long-term participation group remained in the robust range at 75 years of age, which suggests the importance of initiating participation before the onset of functional decline. </sec>

<title>Abstract</title><sec> <title>Background</title> The effects of group exercise on the physical function of community-dwelling older adults remain unclear. The changes in lower extremity muscle strength, timed up and go (TUG) time, and the motor fitness scale (MFS), over time, among older adults who expressed a willingness to participate in community-based physical exercise groups, were determined using multilevel modelling. </sec><sec> <title>Methods</title> We analyzed data of 2407 older adults between April 2010 and December 2019 from the registry of physical tests of community-based physical exercise groups. We conducted a retrospective cohort study to assess the effect of physical exercise on lower extremity muscle strength, TUG time, and MFS scores. The durations of the exercises were evaluated by frequency of physical test’s participate. </sec><sec> <title>Results</title> A deterioration in lower extremity muscle strength was found in the short-term participant group only. However, in the mid-term and long-term participation groups, lower extremity muscle strength showed a trend of improvement. The TUG time and the MFS score were negatively correlated with increasing age in both groups divided by the duration of participation. However, there was a slower rate of deterioration in the long-term participation group. </sec><sec> <title>Discussion</title> Lower extremity muscle strength, TUG time, and MFS scores decline with increasing age and there were differences in the slope of deterioration that depended on the duration of participation in community-based group exercise. </sec><sec> <title>Conclusion</title> Participation in group exercise improved lower extremity muscle strength, TUG time, and MFS scores of older adults living in a community. The positive effects of group exercise were dependent on long-term participation. </sec>

Sex differences in social adjustment are frequently observed; however, there has been very little research on adaptability in the individual and social domains. The aim of this study was to investigate the sex difference in social abilities, such as high self-appeal, sociability, school adaptation, and home adaptation between school-age males and females. The sample for this study included both same-sex and opposite-sex twin pairs: a total of 467 twin pairs. We classified them into three groups: a group of those in lower classes of elementary school, a group of those in higher classes of elementary school, and a group of those in junior high school. The heritability of school adaptation was estimated to be 95% in males and 54% in females in the junior high school group. The full sex-limitation model showed a better fit in this group, and this means that a qualitative genetic difference exists. For school adaptation, there was no sex difference in lower elementary school classes; however, a quantitative difference appeared in higher classes of elementary school. Moreover, a qualitative difference appeared in junior high school. From this research, it became clear that sex differences in heritability exist for school adaptation, and there was a marked increase from the elementary school children to the junior high school children.

<title>Abstract</title><sec> <title>Background</title> The purpose of this study was to examine the differences of timewise changes in life-space mobility between elderly people living alone and those living with others among community-dwelling elderly people from a day care facility with a rehabilitation service for seniors. </sec><sec> <title>Methods</title> The present study used a longitudinal design with repeated measures every 3 months. In conformity with our inclusion criteria, this study included 233 community-dwelling elderly users of a day care facility with rehabilitation services for seniors in Japan. We analyzed the life-space assessment (LSA) scores collected at five time points (baseline, 3 months, 6 months, 9 months, and 12 months) using mixed-effects models with random intercepts and slopes over time. In the present study, the explanatory variables of interest were time, and living situation (living alone or with others). As possible confounders, we considered the following: (a) age, (b) sex, (c) social frailty, (d) physical frailty, (e) mild cognitive impairment (MCI), (f) depression, and (g) economic satisfaction. </sec><sec> <title>Results</title> The mean age of participants was 78.9 years (SD = 7.7), their mean LSA score was 60.1 points (SD = 25.7), and 42.9% of the participants were men. After adjusting for age, gender, frailty, depression, MCI, and economic satisfaction, the mean LSA score of older adults who lived with others was significantly lower (7.42 points, 95%CI = − 18.30 to − 0.15, <italic>p</italic> = 0.048) than that older adults who lived alone. </sec><sec> <title>Discussion</title> Community-dwelling older adults who used a day care center with rehabilitation services and lived with others had a smaller life-space at baseline than those who lived alone. This suggests that there is a need to pay more attention to social frailty among both older adults who live alone and those who live with others. </sec><sec> <title>Conclusions</title> According to a multilevel analysis growth model, elderly persons who lived with others had significantly lower life-space mobility than those who lived alone. </sec>

Depressive state has been reported to be significantly associated with higher-level functional capacity among community-dwelling elderly. However, few studies have investigated the associations among people with long-term care requirements. We aimed to investigate the associations between depressive state and higher-level functional capacity and obtain marginal odds ratios using propensity score analyses in people with long-term care requirements. We conducted a cross-sectional study based on participants aged ≥ 65 years (n = 545) who were community dwelling and used outpatient care services for long-term preventive care. We measured higher-level functional capacity, depressive state, and possible confounders. Then, we estimated the marginal odds ratios (i.e., the change in odds of impaired higher-level functional capacity if all versus no participants were exposed to depressive state) by logistic models using generalized linear models with the inverse probability of treatment weighting (IPTW) for propensity score and design-based standard errors. Depressive state was used as the exposure variable and higher-level functional capacity as the outcome variable. The all absolute standardized differences after the IPTW using the propensity scores were < 10% which indicated negligible differences in the mean or prevalence of the covariates between non-depressive state and depressive state. The marginal odds ratios were estimated by the logistic models with IPTW using the propensity scores. The marginal odds ratios were 2.17 (95%CI: 1.13-4.19) for men and 2.57 (95%CI: 1.26-5.26) for women. Prevention of depressive state may contribute to not only depressive state but also higher-level functional capacity.

Objective: We aimed to investigate the association between subjective memory complaints and higher-level functional capacity in either people with long-term care needs or those who require help to maintain functional capacity. Methods: We conducted a cross-sectional study among participants aged 60 years or older. We measured subjective memory complaints, higher-level functional capacity, and depressive symptoms, and then estimated odds ratios (ORs) by multiple logistic analysis. Subjective memory complaints were used as the predictor variable, higher-level functional capacity as the outcome variable, and age, depressive symptoms, medical history of diabetes and hypertension, frequency of going out, falling within a year, and body mass index as possible confounders. We assessed higher-level functional capacity using the Tokyo Metropolitan Institute of Gerontology (TMIG) index of competence score &lt;= 5 as a cut-off (which is associated with higher one-year mortality rates). Results: We conducted analyses using 501 people aged 60 years or older. Among women, subjective memory complaints were associated with impaired higher-level functional capacity after adjustment for age and depressive symptoms (OR = 3.36; 95% confidence interval [CI], 1.59-7.08). Among the men, subjective memory complaints were not significantly associated with impaired higher-level functional capacity after adjustment for age and depressive symptoms (OR = 1.91; 95% CI, 0.88-4.12). Conclusions: Subjective memory complaints among women can indicate impaired higher-level functional capacity and may suggest higher one-year mortality rates. (C) 2014 Elsevier Ireland Ltd. All rights reserved.

This study investigated the relationship between twin language, twins' close ties, and social competence in a prospective longitudinal study. We hypothesized that twins whose tie is close would be more likely to develop a twin language, and these twins would be less likely to develop social competence. In addition, we hypothesize that some environmental factors, such as having an older sibling, preschool attendance, zygosity, and sex are also related to twin language, twins' close ties, and social competence. At baseline in 1999 a mailed questionnaire survey was conducted, and a follow-up questionnaire was distributed in 2004 among 958 mothers. As a result, 516 respondents returned the questionnaire (53.9%). In this study, we used 261 twin pairs aged from 6 to 12 years (school-age children) for analysis, excluding those with missing values. In the present study, we found that zygosity and sex were associated with twins' close ties. Having an older sibling and preschool attendance did not affect the twins' close tie, twin language, or social competence. One of the most important findings was that social competence was not affected directly by twins' close tie, but was affected when a twin language was found.

Purpose : Identify the factors capable of predicting the degree of fathers' participation in care of preschool children, specifically of fathers of single-birth child and those of multiple-birth children. Method : Self-administered questionnaires were distributed to 1,016 fathers of multiple-birth children and 300 fathers of single-birth child. We received responses from 211 fathers of multiple-birth children and 101 fathers of single-birth child. The response rates were 20.8% and 33.7%, respectively. Results : In the multiple regression model for fathers of multiple-birth children who were younger than one year, the regression coefficients for "the father accompanied the mother to her pregnancy checkup," "the father consulted his friends and colleagues about problems related to child-raising," "the father received compliments from the mother for his efforts in childcare," "the father received compliments from the mother for his efforts at his job" (negative correlation), and "the father believes that both parents should participate in childcare" were significant, yielding an adjusted-R2 of 0.326. On the other hand, in the regression model for fathers of single-birth children who were younger than one year, the coefficients for "the father received compliments from the mother for his efforts in childcare," "the father has little interest in raising a child" (negative correlation), "the father wants to be involved in the child's life through local and job-related activities," and "the father feels the need for understanding from his manager and colleagues" were significant, resulting in an adjusted-R2 of 0.366. Similarly, we have also analyzed models that child was 1-2 and 3-5 years old. A few factors that were identified as significant predictors at 0 years old were not significant, but a similar trend was observed as a whole. Conclusion : For the cases of single-child fathers and multiple-children fathers, different factors were identified as significant predictors of fathers' participation in childcare. A different measure is necessary to promote childcare participation for each group of fathers.

Objectives: This study aimed to determine the issues mothers face in regards to child rearing by analyzing data obtained from mothers at health check-up 3 months after delivery. The factors that constitute effective support provided by local maternal and child health institutions were then examined.<br/>Methods: Health examination data, excluding personal data, and self-reported questionnaire responses about child rearing concerns were analyzed for mothers who attended the health check-up 3 months after delivery in Ward B in Osaka City.<br/>Results: Study subjects comprised 2,552 mothers, 1,213 (47.6%) of whom asked for advice about child rearing-related issues. The most common concern was "skin treatment", followed by "breast-feeding" and "stools." The common factors among the mothers who asked for advice were as follows: "first-time mothers"; "living in an apartment"; "having problems in life"; "feeling mentally and/or physically ill"; and "the feeling of a lack of time for themselves". The influence of these factors was statistically significant. On the other hand, 36.1% of the mothers did not ask for advice, even though they had reported being anxious.<br/>Conclusion: Many of the mothers' concerns pertained to the current situation, and it was found that their backgrounds influenced whether they asked for advice. Some mothers had concerns but neither voiced them or sought advice. These findings suggest that mothers' concerns and feelings of burden related to child rearing cannot be evaluated based on whether they ask for advice or by the number of concerns they report.

Osaka University Center for Twin Research is currently organizing a government-funded, multidisciplinary research project using a large registry of aged twins living in Japan. The purpose of the project is to collect various information as well as biological resources from registered twins, and to establish a biobank and databases for preserving and managing these data and resources. The Center is collecting data from twin pairs, both of whom have agreed to participate in a one-day comprehensive medical examination. The following data are being collected: physical data (e.g., height, body mass, blood pressure, theoretical visceral fat, pulse wave velocity, and bone density), data regarding epidemiology (e.g., medical history, lifestyle, quality of life, mood status, cognitive function, and nutrition), electrocardiogram, ultrasonography (carotid artery and thyroid), dentistry, plastic surgery, positron emission tomography, magnetoencephalogram, and magnetic resonance imaging of brain. These data are then aggregated and systematically stored in specific databases. In addition, peripheral blood is obtained from the participants, and then genomic DNA is purified and sera are stored. A wide variety of studies are ongoing, and more are in the planning stage.

Social competence is one of the most important accomplishments of human development, and this skill in human relationships is learned through communication. Therefore, it is considered that delays in language development could be a barrier to building human relationships and social competence. Although it is well known that there are delays in language development in twins compared with that of singletons, little is known about how these linguistic delays affect the development of social competence. Because twin language is a language that is unique to each pair of twins and cannot be understood by either their mother or others, it may be assumed that the social competence of twins who have a twin language is less than that of twins who don't have a twin language. Therefore, in this prospective longitudinal study we also investigated the relationship between twin language and social competence. A mailed questionnaire survey was conducted in 958 mothers as a follow-up of a study conducted in 2004. As a result, 522 respondents returned the questionnaire (53.9%). In this study, we used only 256 twins aged 6- 12-years-old (school-age children) for analysis, excluding those with missing values. Multiple logistic regression analysis was employed. In the second child of twins, a low birth weight, the appearance of twin language and gestosis of the mother were positively related with social unbalance (OR = 1.846, 2.022 and 1.903). On the other hand, with the first child, however, there was no such link. The present results indicate that twin language might influence social competence in school-age children. It has been believed that linguistic intervention is unnecessary, because most twin language disappears spontaneously. However, early intervention, for example linguistic assistance by public health nurses or psychologists and early enrollment in a preschool may be necessary for twins with a twin language, to avoid adverse consequences in social competence at school-age.

More than 100 pairs of adult twins, reared apart and growing old separately, have participated in the Japanese Study of Adult Twins Reared Apart and Growing Old Separately since it began in 1974. The subjects are 161 pairs of adult twins born between 1910 and 1945 in Japan. The main focus of this study is to investigate the influences of environmental factors and life history on life satisfaction and psychological well-being in later adulthood. A mail survey has been conducted on these twins each year since 1974. To date, the Wechsler Adult Intelligent Scale, Maudsley Personality Inventory, Newgarten Life Satisfaction Index, comprehensive medical examinations and personal interviews have been conducted for 12 twin pairs residing in various areas of Japan.

The Osaka University Aged Twin Registry (OUATR) is the largest adult twin registry in Japan. Since its establishment in 1974, the OUATR has conducted a number of studies with particular focus on the environmental contribution to physical-cognitive-mental aging, longevity and aging-dependent diseases in later adulthood. The registry consists of 12,000 pairs of Japanese twins born between 1900 and 1935. Two hundred and fifty pairs of twins have undergone comprehensive medical examination to date. Follow-up questionnaires have been mailed out on a regular basis, for the purpose of checking current vital statuses, health conditions, and so forth. The main objective of this longitudinal twin study is to contribute to the prevention of lifestyle-related diseases and the promotion of successful aging.

In general, twins have delayed language development early in childhood compared with singletons. The purpose of this study was to clarify the overall linguistic features of twins. A Japanese version of the Illinois Test of Psycholinguistic Abilities (ITPA) was administered in 24 twin pairs (aged 3 to 4 years) at their own homes. The overall language abilities of the twins were in the normal range (based on ITPA normative data: mean scale score 36.0 +/- 6.0 points), and for the ITPA subtests only, Auditory Reception fell within the range of language disorder (mean scale score 24.9 +/- 5.1 points). The findings suggest that in 3- to 4-year-old Japanese twins, overall language abilities are not delayed. However, there may be specific difficulties with auditory reception skills.

The definition and nature of twin language has been a focus of recent studies concerned with the phenomenon. There has been a call for a tighter definition and understanding of the meaning of twin language (Thorpe et al., 2001). This article sought to identify social factors associated with the parent report of twin language and thus provide further understanding of the phenomenon. Data from 583 mothers of twins aged 25 to 59 months were analyzed using multiple logistic regression. Factors included in the modeling of parent-report twin language included social experience factors such as presence of siblings, attendance at preschool education and reports of nonverbal play. It was found that twin pairs who didn't have an older sibling, who showed frequent nonverbal play and who didn't attend preschool were more likely to have a twin language. Moreover, in the group not having an older sibling, the influence of whether twins attended preschool or not was strong and the odds ratio was 0.589 (95% confidence intervals 0.360-0.963). The findings suggest that social experience factors are important predictors of the parent reporting of twin language.

OBJECTIVES: The appearance of 'twin language' has been highlighted as a reason for delayed language development in twins. 'Twin language' is a unique language understandable only within the pair, and not by their mother or others. The purpose of this study was to examine and clarify the factors affecting the appearance of 'twin language'. METHODS: A mailed questionnaires survey was conducted in 2733 mothers of twins. Of them, 1395 mothers returned the questionnaires. The core questionnaire asked for data on birth weight, age at first spoken word, whether the twins were as alike as two peas in a pod, household members and non-verbal play. Logistic regression analysis was used in this study. RESULTS: Out of the 1395 pairs included in this analysis, 598 pairs (42.9%) showed the appearance of a 'twin language'. When the 598 pairs were divided by whether the twin pair was exactly alike or not, there were 112 opposite sex pairs, 105 not-alike male pairs, 106 not-alike female pairs, 129 exactly alike male pairs and 140 exactly alike female pairs. Namely, 38.4% of the opposite sex pairs, 40.4% of the not-alike male pairs, 39.3% of the not-alike female pairs, 47.6% of the exactly alike male pairs and 48.4% in the exactly alike female pairs had a twin language. By multivariate logistic regression analysis controlling for twins' age, it was found that 'twin language' was significantly more frequent in exactly alike twin pairs, pairs with non-verbal play, and pairs with fewer older siblings. CONCLUSIONS: These findings suggest that three factors (whether the twin pair is exactly alike or not, older siblings, non-verbal play) affect the appearance of 'twin language'.

Purpose: This study was conducted in order to better identify the relationship between the psychological empowerment of mothers who have handicapped children and their subsequent involvement with self-help groups.<BR>Methods: Sixteen mothers and one father, who have handicapped children and belong to 2 self-help groups, participated in our semi-structured interviews. Theoretical sampling methods were employed to have a variety of participatory lengths; one year (4 mothers), three to seven years (7 mothers and 1 father), more than ten years (5 mothers) . The data was analyzed using the grounded theory approach (B.Glaser and A.Strauss) .<BR>Results: One core category of the empowerment process was identified, changing an encounter into the power, along with eleven lesser categories. All categories were defined using the following three stages of involvement with self-help groups and the abilities the mothers gained through their involvement. 1) 'from showing interest, concern to motivated into gropely involvement'; ability to identity ones own and others strengths. 2) 'from gropely involvement to exploratory involvement'; ability to recognize and respect differences. 3) 'from exploratory involvement to supportive involvement'; ability to facilitate mothers empowerment, who have a short carrier as a handicapped children's mothers. The following three experiences related to empowerment development; 1) viewing themselves objectively and comparing with other mother participants, 2) awareness of the variety of members, 3) talking and narrating their own experiences as a handicapped children's mothers.