studies reported that slower gait speed was associated with lower prefrontal area
volume, which is related to slower information processing (Rosano et al., 2012) and
lower cerebellar gray matter volume (Nadkarni et al., 2014). Shorter step length was
associated with smaller sensorimotor regions (Rosano et al., 2008) and subclinical
structural damage of the basal ganglia (Rosano, Brach, Longstreth Jr, & Newman,
2006). Degenerative brain lesions may indeed explain the link between lower
trajectories of gait performance and the increased risk of disabling dementia. Individuals in the low gait function trajectory groups had a higher dementia risk that
highlights the importance of maintenance for motor function from younger age, in
addition to among older adults.
4 Trajectories of Aging in Nutritional Biomarkers
(Taniguchi et al., 2019)
Previous studies reported that low albumin levels (Ng, Niti, Feng, Kua, & Yap,
2009; Taniguchi et al., 2014) and low hemoglobin level (Murayama et al., 2017;
Shah, Buchman, Wilson, Leurgans, & Bennett, 2011) were associated with cognitive
deterioration. Initial serum albumin and hemoglobin levels are independent risk
factors for subsequent cognitive deterioration in older adults, which suggests that
incident dementia can be strongly predicted by abnormal age-related trajectory
patterns in albumin and hemoglobin levels as determined by repeated measures
analysis of longitudinal data. However, no longitudinal study had been conducted,
and age trajectories of albumin and hemoglobin levels have not been determined.
This study attempted to identify potential serum albumin and hemoglobin level
trajectories and determine whether these trajectories were associated with incident
disabling dementia among community-dwelling older Japanese.
The data source for this study was 2005 adults (average number of follow-up
assessments, 4.7; total number of observations, 9330) aged 65 through 90 years
during the period from 2002 through 2017 in the Kusatsu Longitudinal Study. There
were 278 (13.9%) cases of incident dementia during the follow-up period, and the
median (SD) duration of follow-up for incident dementia was 2842 (1647) days.
Nutritional biomarkers included albumin (g/dL) and hemoglobin (g/dL). Nonfasting
blood samples were collected by standard procedures. In this study, disabling
dementia was defined as level II or worse dementia in an observer-based rating for
older adults with dementia, as this is the level at which applicants are entitled to
receive LTCI benefits, including institutional, home, respite or day care and loans of
equipment. At baseline, the mean (SD) age of participants was 71.0 (5.7) years,
57.0% were women, 45.0% were never drinkers, and 56.2% were never smokers.
The average number of years of education was 10.3 (2.7), and mean MMSE score
was 27.1 (2.8).
Three trajectory patterns for serum albumin and hemoglobin levels were identified (Fig. 3). All three serum albumin and hemoglobin trajectories showed declines
66
Y. Taniguchi and H. Matsushita
volume, which is related to slower information processing (Rosano et al., 2012) and
lower cerebellar gray matter volume (Nadkarni et al., 2014). Shorter step length was
associated with smaller sensorimotor regions (Rosano et al., 2008) and subclinical
structural damage of the basal ganglia (Rosano, Brach, Longstreth Jr, & Newman,
2006). Degenerative brain lesions may indeed explain the link between lower
trajectories of gait performance and the increased risk of disabling dementia. Individuals in the low gait function trajectory groups had a higher dementia risk that
highlights the importance of maintenance for motor function from younger age, in
addition to among older adults.
4 Trajectories of Aging in Nutritional Biomarkers
(Taniguchi et al., 2019)
Previous studies reported that low albumin levels (Ng, Niti, Feng, Kua, & Yap,
2009; Taniguchi et al., 2014) and low hemoglobin level (Murayama et al., 2017;
Shah, Buchman, Wilson, Leurgans, & Bennett, 2011) were associated with cognitive
deterioration. Initial serum albumin and hemoglobin levels are independent risk
factors for subsequent cognitive deterioration in older adults, which suggests that
incident dementia can be strongly predicted by abnormal age-related trajectory
patterns in albumin and hemoglobin levels as determined by repeated measures
analysis of longitudinal data. However, no longitudinal study had been conducted,
and age trajectories of albumin and hemoglobin levels have not been determined.
This study attempted to identify potential serum albumin and hemoglobin level
trajectories and determine whether these trajectories were associated with incident
disabling dementia among community-dwelling older Japanese.
The data source for this study was 2005 adults (average number of follow-up
assessments, 4.7; total number of observations, 9330) aged 65 through 90 years
during the period from 2002 through 2017 in the Kusatsu Longitudinal Study. There
were 278 (13.9%) cases of incident dementia during the follow-up period, and the
median (SD) duration of follow-up for incident dementia was 2842 (1647) days.
Nutritional biomarkers included albumin (g/dL) and hemoglobin (g/dL). Nonfasting
blood samples were collected by standard procedures. In this study, disabling
dementia was defined as level II or worse dementia in an observer-based rating for
older adults with dementia, as this is the level at which applicants are entitled to
receive LTCI benefits, including institutional, home, respite or day care and loans of
equipment. At baseline, the mean (SD) age of participants was 71.0 (5.7) years,
57.0% were women, 45.0% were never drinkers, and 56.2% were never smokers.
The average number of years of education was 10.3 (2.7), and mean MMSE score
was 27.1 (2.8).
Three trajectory patterns for serum albumin and hemoglobin levels were identified (Fig. 3). All three serum albumin and hemoglobin trajectories showed declines
66
Y. Taniguchi and H. Matsushita