Hunkyung Kim

• Tokyo Metropolitan Institute

While many studies have described the association between cognitive decline and eating habits, little attention has been paid to its association with cheese intake. In this epidemiological study of 1035 community-dwelling women aged ≥ 65, we investigated the association between intake/type of cheese and cognitive function. The anthropometry, functi...

Introduction This longitudinal study aimed to identify aging trajectory patterns of social interaction by sex and determine the association between these patterns and all-cause mortality. Methods Participants were 4,065 community-dwelling older adults (1849 men) in Japan, aged 65–89 years, who responded twice or more to a mail survey conducted bet...

Diet modification may contribute to the prevention of age-related cognitive decline. The association between dairy product consumption and cognitive function in older people remains unknown. We investigated whether cheese intake is associated with lower cognitive function (LCF) in community-dwelling older adults. This cross-sectional study included...

Diet modification may be a potential contributor in the prevention of age-related cognitive decline. The association between dairy product consumption and cognitive function remains unknown in older people. We investigated whether cheese intake is associated with lower cognitive function (LCF) in community-dwelling older adults. This cross-sectiona...

Background This study was aimed to evaluate the hierarchical accumulation of amyloid in the Alzheimer’s brain according to clinical stage using [ ¹⁸ F]flutemetamol positron emission tomography. Method This was a prospective, single‐cohort study of volunteers who lived independently in Itabashi‐ku (Tokyo, Japan). One hundred thirty‐six participants...

Background This study was aimed to evaluate the regional hierarchical brain atrophy among the preclinical to mild cognitive impairment (MCI) stages of Alzheimer’s disease associated with amyloid deposition using [ ¹⁸ F]flutemetamol positron emission tomography and volumetric magnetic resonance imaging. Method This was a prospective, single‐cohort...

Introduction: Since soy isoflavones compensate for age-related estrogen reduction, adequate intake of soy products may prevent the decline in activities of daily living (ADL) due to estrogen reduction in women. However, it is unclear whether regular soy product intake prevents ADL decline. This study examined the effects of soy product consumption...

Background: The influence of neurological or balance dysfunction on cognitive impairment has not been well studied. We compared the results of the balance test, measured by either head or foot sway to consider whole body sway, with those of the cognitive impairment test. Methods: Individuals of either gender, aged over 60 years, underwent a 30 s ba...

Background Few studies have examined the state of oral function in older adults with sarcopenia. We assessed the oral functions of community‐dwelling older adults with sarcopenia from multiple perspectives to clarify their potentially low oral function. Methods A total of 1517 (86.2%; 990 women, 527 men; mean age 76.1 ± 7.6 years) participants wer...

Aim: Radio-Taiso, a traditional exercise program in Japan, may serve as a coping strategy for older adults with frailty during the COVID-19 pandemic. This phase II trial tested program adherence and safety and explored the potential effectiveness of a home-based Radio-Taiso. Methods: This assessor-blind parallel randomized controlled trial inclu...

This study aims to identify the trajectory of psychological well-being during the COVID-19 pandemic among community-dwelling older adults and to clarify the association between coping behavior in the early stage of the pandemic and the trajectory of psychological well-being. The study was based on a cohort study, known as “the Otassha Study.” We ad...

This study examined the impact of disengagement on health status and mortality among community-dwelling older adults in Japan. Disengagement from society was operationally defined as dropping out of a longitudinal survey. A follow-up mail survey was conducted, in 2014, among respondents (n = 3696) of the baseline mail survey. Step-by-step follow-up...

Participation in sports groups has health benefits for older adults, such as preventing functional limitations and social isolation. Encouraging participation in sports groups may be an important means of health promotion in older adults. However, there is insufficient research on the determinants of new participation in sports groups to consider e...

Introduction Few clinical trials have examined the effects of home-based exercise programmes on health-related quality of life (HR-QoL) in older adults with frailty. Radio-Taiso is the most famous exercise programme in Japan. A home-based Radio-Taiso exercise programme may serve as an accessible, scalable and sustainable care intervention for older...

Background Falls and fear of falling (FoF) inhibit healthy longevity and have been suggested to be associated with cognitive function. However, the domains of cognitive function that are associated with them remain controversial. It is speculated that clarifying this will help in the assessment of health status and interventions in the community.Ai...

Inflammatory responses contribute to physical decline in older adults. Clinical studies have shown that the neutrophil-to-lymphocyte ratio (NLR), a marker of inflammation, is associated with physical decline. However, its association with physical function in community-dwelling older people is still unclear. Hence, we used cross-sectional data to i...

Urinary incontinence (UI) among older people is a common problem. Several treatments are available for older people with UI including surgery, drug therapies, and behavioral interventions. Recently, much attention has been placed on the behavioral treatments for UI, including pelvic floor muscle (PFM) exercise, weight loss exercise, and thermal the...

Recently, an occlusal force-measuring device with a capacitive-type pressure-mapping sensor (OFMD-CPS) was developed. We aimed to establish age- and sex-specific standard values for OFMD-CPS-measured occlusal force (OF) and to assess the concurrent validity of the OFMD against another OF measuring system with a pressure-sensitive sheet (Dental Pres...

Background As the population ages, it is important to consider whether older adults tend to have healthier lives. This study examined temporal trends in cognitive function among community-dwelling Japanese older adults. Methods The data source for this study was Integrated Longitudinal Studies on Aging in Japan (ILSA-J). We collected representativ...

Frailty is the state of having a reduced ability to recover from stress. Intervention in frailty is important for fulfilling healthy longevity. Vitamin K is a fat-soluble vitamin contained in vegetables and fermented foods. Although vitamin K is shown to be associated with several age-related diseases, studies on the association of vitamin K intake...

Neurodegenerative changes in the preclinical stage of Alzheimer’s disease (AD) have recently been the focus of attention because they may present a range of treatment opportunities. A total of 134 elderly volunteers who lived in a local community were investigated and grouped into preclinical and mild cognitive impairment stages according to the Cl...

Aim: Identification of modifiable intrinsic factors for occupational falls is required for initiating effective fall prevention strategies for older workers. This study aimed to identify modifiable intrinsic factors related to falls during occupational activities among older workers. Methods: This retrospective study involved 1164 older workers...

Background Ground reaction force during sit-to-stand motion is related to lower extremity strength, and such measurements indicating weak muscle strength may be linked to sarcopenia. We aimed to examine and describe the relationship between sarcopenia and ground reaction force during sit-to-stand motion to develop a diagnostic tool. Research quest...

Background The aim of this study is to explore the prevalence and overlap of physical, cognitive, psychological, and social frailty and their negative-interrelationships. Methods We conducted a survey of people aged ≥75 years in the region with the oldest population in Japan. Results Of the 268 participants (aged 81.5 ± 4.5 years), 48.1% and 8.6% h...

Aim: Community settings often need simple screening, rather than detailed tests, to identify cognitive impairment. This study aimed to develop models to screen older adults with cognitive impairment. Methods: This study used data from the Integrated Research Initiative for Living Well with Dementia Cohort Study and included 5830 older adults. In...

Vitamin K is a fat-soluble vitamin shown to be associated with several age-related diseases. Although a small number of epidemiological studies described the relationship between vitamin K status and cognitive impairment, vitamin K status was estimated by relatively special methods in previous reports. Here, we demonstrated the association of the c...

Aims: To investigate the retinal microvasculature in the elderly persons with prediabetes mellitus (preDM) and type 2 DM. Methods: This cross-sectional study included a total of 452 eyes without retinal pathologies of 301 elderly volunteers aged ≥65 years, and they were categorized into nonDM (225 eyes), preDM (177 eyes), and DM (50 eyes) groups...

One prominent factor associated with malnutrition is poor appetite. In Japan, the number of older adults living alone has increased annually. Those living alone tended to eat alone, which may lead to poor appetite. This study aimed to investigate the association between eating alone and poor appetite using an index called the Simplified Nutritional...

Purpose: The combined treatment effects of nutritional supplementation and exercise on muscle quality (MQ) remain unexamined in individuals at risk for sarcopenia. This secondary analysis aimed to test whether β-hydroxy-β-methylbutyrate (HMB) supplementation enhances the effects of resistance training (RT) on MQ in older women with low muscle mass...

Purpose To the best of our knowledge, the association between xerostomia and physical frailty has not been studied in Asian countries. This prospective cohort study aimed to investigate the longitudinal association between xerostomia and the incidence of physical frailty in Japan. Methods This study included community-dwelling older adults aged ≥6...

Objective To elucidate the relationship between physical frailty and dry mouth among community-dwelling older adults in Japan. Background Oral hypofunction is associated with physical frailty in older adults. Dry mouth, subjectively evaluated as xerostomia and objectively measured as hyposalivation, is highly prevalent in older adults. However, fe...

Objectives Age‐related hearing loss (ARHL) is considered a risk factor for cognitive impairment and falls. The association may be modulated by gait performance because ARHL is related to mobility decline, which strongly contributes to cognitive impairment and falls. We investigated the interactive effects of gait and ARHL on global cognition and fa...

Background The co-occurrence of physical frailty and depressive symptoms is highly prevalent in late life. However, their causal direction remains unclear. This study examined whether frailty and its components (slowness, weakness, exhaustion, low activity, and weight loss) predict the onset of depressive symptoms among older Japanese women. Metho...

This study aimed to examine the prevalence of exercise as a coping strategy among Japanese community-dwelling older adults and its impact on their psychological well-being during the COVID-19 pandemic. In October 2019 (baseline [BL]), 720 community-dwelling older adults living in an urban area in Japan participated in a comprehensive health survey....

Background Individuals with diabetes tend to show decreased muscle volume and motor function compared to those without diabetes. Ultrasound is a non-invasive and potentially safe method to assess muscle function in patients with diabetes; however, the characteristics of muscle thickness and quality, measured by ultrasound, in individuals with diabe...

Aim The coronavirus disease 2019 (COVID-19) pandemic remains a major global public health issue, and it has led to restrictions in physical and social activities among community-dwelling people, including frail older adults. This study aimed to determine the impact of the pandemic on the subjective health status and characteristics of community-dwe...

Aims Although aging is strongly associated with both heart failure and a decline in gait speed, a definition of slowness incorporating an age-related decline has yet to be developed. We aimed to define an event-driven cut-off for the relative decline in gait speed against age-adjusted reference values derived from the general population and evaluat...

Background Walking speed is an important measure associated with health outcomes in older individuals, such as dependency and death. This study aimed to examine whether the walking speed of community-dwelling older adults varies between time periods within a day, as measured outdoors in daily life. We aimed to determine the types of walking speed v...

Background: It is unclear whether motor-cognitive dual tasks predict cognitive decline better than either motor or cognitive tasks alone. Aims: To examine the utility of the novel motor-cognitive dual-task test [Stepping Trail Making Test (S-TMT)], as a predictor of cognitive decline, and compare its predictive performance with single motor or c...

Background: Exercise and essential amino acid supplementation have been separately shown to improve muscle mass in elderly people, however, the combined, added effects of both interventions have yielded inconsistent results on muscle mass, strength, and physical function improvement. Aims: To investigate the additive effects of exercise and esse...

Objective: This study investigated the association between oral hypofunction and malnutrition among community-dwelling older adults. Background: Oral hypofunction, a 7-component phenotype of the clinical features of oral health, has been described in Japan. Data about its association with nutritional status are limited. Materials and methods:...

Oral hypofunction, resulting from a combined decrease in multiple oral functions, may affect systemic-condition deterioration; however, few studies have examined the association between oral hypofunction and general health among older adults. In this cross-sectional study, we examined the relationship between oral hypofunction and sarcopenia in com...

Background: The interaction between exercise and nutritional supplementation is unclear among older adults at risk of sarcopenia. Objectives: We aimed to examine if β-hydroxy-β-methylbutyrate (HMB) supplementation enhances the effects of exercise on muscle mass, strength, and physical performance and observe potential residual effects in older w...

Aim: The oral function-related items of the newly developed "Questionnaire for Latter-stage Elderly People" are based on two items of the Kihon checklist assessing the masticatory and swallowing functions. In this study, we estimated the questionnaire's application rate and investigated the oral function of the respondents. Methods: Included were 6...

Purpose: This cross-sectional study compared gait performance between community-dwelling older adults with and without accumulated deficits in oral health, defined as oral frailty. Methods: A total of 1,082 individuals (439 men and 643 women; mean age, 77.1 years) from the Takashimadaira study were included in the current analysis. Based on a multi...

The association between dietary diversity and frailty remains unknown in older people. We evaluated whether a limited dietary variety is associated with frailty in older adults with diabetes mellitus (DM). This cross-sectional investigation included 1357 adults (median age: 77 years, women: 61.3%). DM was determined by self-reporting, the Dietary V...

Purpose : Deterioration of daily activities increases frailty risk. Most of the previous research has examined the association between frailty and specific activities; nevertheless, the diversity of daily activities is also important. Although the type, frequency, and evenness of daily activities have been proposed as indicators of activity diversi...

Background This study aimed to examine the effects of the consumption frequency of 10 food groups on activities of daily living (ADL) in elderly Japanese women. Methods This was a four-year longitudinal cohort study conducted in Itabashi Ward, Tokyo. Participants were 1,111 community-dwelling elderly women aged 75 to 85 years, without baseline ADL...

Aim: To determine the rate of a decreased oral function using questions from the Kihon checklist corresponding to the Questionnaire for Latter-stage Elderly People and to clarify nutrient intake in older persons. Methods: This study targeted 511 older people (217 men, 294 women, average age 73.1±5.6 years old). Their oral function was evaluated usi...

Background Diet is a modifiable factor affecting sarcopenia, and accumulating evidence links dietary factors to muscle mass, strength, and function in older adults. However, few studies have examined the association of dietary patterns with sarcopenia. This study examined the association of dietary patterns derived by reduced-rank regression (RRR)...

Purpose The incidence of dementia is rapidly increasing worldwide, especially in developed countries. Little is known regarding the effectiveness of dental intervention to prevent dementia or a decline in cognitive functions among community-dwelling older adults, but a few studies have reported a correlation between the lack of regular dental check...

Aim We aimed to investigate whether physical function was associated with urinary incontinence (UI) onset in community‐dwelling older Japanese women. Methods This was a 4‐year prospective cohort study. After excluding participants with UI and missing data in the baseline survey, we included 890 participants in the analyses. Physical function inclu...

In this cross-sectional study including 1150 eyes of 681 volunteers ≧ 65 years old without retinal pathology, factors affecting the progression of posterior vitreous detachment (PVD) were investigated. PVD stages were diagnosed based on swept-source optical coherence tomography (SS-OCT). Linear mixed effect model was used to determine whether age,...

Background Hyposalivation is associated with the nutritional status. Anorexia of ageing, defined as an age-related decrease in appetite and food intake, presents even in healthy adults and is considered an independent predictor of malnutrition, frailty, and mortality. However, the relationship between anorexia and hyposalivation of ageing is unclea...

Background Participation in exercise may be useful for dementia prevention; however, the specific exercise types which may best to reduce the risk of developing cognitive decline have remained unidentified in the literature. Objective To examine the relationships of specific exercise types with the risk of developing cognitive decline in older wom...

This study aimed to examine the concurrent validity of a novel motor-cognitive dual-task test, the Stepping Trail Making Test (S-TMT), as an indicator of cognitive impairment (CI), and compare its screening performance to that of motor or cognitive tests alone. This was a population-based cross-sectional study including 965 Japanese adults aged ≥ 7...

Objectives Ground reaction force (GRF) during sit-to-stand motion is associated with lower extremity strength and balance function. The relationship between GRF and experience of falls has been reported; however, there are no reports on whether GRF can predict the incidence of future falls. We aimed to evaluate the ability of GRF to predict falls a...

BACKGROUND The Computer-Based Cognitive Assessment Tool (CompBased-CAT) has been reported to have concurrent validity with the Mini-Mental State Examination (MMSE) and discriminating ability for dementia, but it was not clear whether it could predict incidence of cognitive impairment. OBJECTIVE This study examined the ability of the CompBased-CAT...

During the last three decades, Japan has become one of the world's top countries for longevity, and the increase in average life expectancy is accompanied by a sharp rise in older population aged 65 years and above to approximately 28%. This study aimed to examine the changes in major health-related measures including physical constitution, physica...

Objectives Oral frailty (OF) has been shown to be a predictor of disability. Therefore, it is important to be able to identify factors associated with OF in order to prevent long-term dependence. The purpose of this study was to clarify the relationships between OF, social frailty (SF), and physical frailty (PF) in community-dwelling older adults,...

Objectives: Eating alone is associated with an increased risk of depression symptoms. This association may be confounded by poor social networks. The present study aimed to determine the role of poor social networks in the association of eating alone with depression symptoms, focusing on cohabitation status. Methods: Seven hundred and ten community...

Although there is evidence on the predictors of adverse health outcomes in older individuals, walking speed has typically been measured in laboratory settings (LWS); LWS may be distinct from individuals’ actual walking speed in their daily lives (DWS). We examined whether DWS differs from LWS among older adults, and its association with physical fr...

Purpose To investigate the association between different stages of posterior vitreous detachment (PVD) and macular microvasculature in the elderly. Methods Swept-source optical coherence tomography (OCT), OCT angiography, and color fundus images of 490 eyes without retinal pathologies of 322 participants aged ≥65 years were evaluated. PVD was clas...

Recent research has suggested that the breadth and evenness of activity and activity diversity contribute to health outcomes among older adults. However, few established assessment tools for activity diversity have been developed. This study developed an Activity Diversity Questionnaire (ADQ) for older adults through expert consultation and a preli...

Sarcopenia is associated with instrumental activities of daily living (IADL) and basic activities of daily living (BADL) disabilities. We developed an index for assessing sarcopenia degree (sarcoscore) and compared it to the Asian Working Group for Sarcopenia (AWGS) criteria. Principal component analyses of walking speed, handgrip strength, and ske...

Aim: This study aimed to examine the reliability and construct validity of the Stepping Trail Making Test (S-TMT) in community-dwelling older adults. Methods: This study comprised a cross-sectional study based on a population sample. Participants comprised 1224 community-dwelling older Japanese women aged 65-81 years without functional disabilit...

Aim: The Mini-Mental State Examination is a widely used cognitive assessment tool. However, it has several limitations, including the learning effect and interrater reliability. Therefore, we developed a Computer-Based Cognitive Assessment Tool (CompBased-CAT), which runs on a tablet or personal computer. In this study, we examined the validity an...

Background: Both hearing loss and mobility decline are well-known risk factors of cognitive impairment among older adults. However, the effects of the accumulation of these functional impairments are still unclear. Thus, the present study examined whether the interactive effects of hearing loss and poor gait performance contribute to cognitive impa...

Background: Although apolipoprotein E polymorphism ε4 allele (ApoE4) and slow gait are well-known risk factors for cognitive impairment, examination of their combined effect on cognitive function is lacking. Our objective was to elucidate whether a combination of ApoE4 phenotyping and slow gait resulted in greater cognitive impairment. Methods: Ove...

Aim: The SARC-F is a useful clinical index for sarcopenia screening; however, this measure has low sensitivity. Furthermore, this tool has never been validated on community-dwelling older Japanese adults. The goal of the present study was to validate a Japanese version of the SARC-F and confirm its suitability for Japanese samples. Methods: Part...

Objectives: To investigate the effects of mold-fermented cheese (MFC) on brain-derived neurotrophic factor (BDNF) in community-dwelling older Japanese women with mild cognitive impairment (MCI). Design: Randomized controlled crossover trial. Intervention: Participants were randomly assigned to 2 groups. The MFC group was provided with 33.4 g M...

Purpose: The SARC-F is a recommended screening tool for sarcopenia; however, its sensitivity is reported to be very low. This study aimed to confirm the diagnostic efficacy of the SARC-F and whether it is affected by population characteristics. Methods: In this study, 2 cohorts of 1060 community-dwelling older adults, who were monitored by the T...

Background Gait measures such as gait speed, stride length, step width, and stance duration change with advanced age and are associated with adverse health outcomes among older adults. The stride-to-stride variabilities of gait measures are also related to falls and cognitive decline in older adults; however, reference values of these gait paramete...

Objective: To investigate the effects of exercise and milk fat globule membrane (MFGM) supplementation on walking ability and walking parameters in community-dwelling elderly Japanese women with declined walking ability. Methods: A randomized placebo controlled trial was performed on 126 elderly community-dwelling women over 79 years old. Partic...

Aim To investigate the prevalence and associated factors of cognitive frailty and cognitive frailty‐related falls in community‐dwelling older people. Methods A total of 25 out of 1192 community‐dwelling older people aged >70 years with cognitive frailty participated in the present cross‐sectional study. Cognitive function was assessed using the Mi...

Objective: Although it has been suggested that living alone is a "social risk factor" for adverse health outcomes, poor social network may confound the association. This study aimed to examine whether the interactive effects of living alone and poor social network contribute to adverse health outcomes. Design: A 4-year prospective observational...

Objectives Recent studies reported that several gait parameters were associated with lower cognitive function or cognitive decline, however, known gait parameters were limited and no study has used large-scale data. We identified the characteristics for gait parameters of community-dwelling elderly Japanese with lower cognitive function. Methods 1...

Objectives: Respiratory muscle strength decreases with advancing age, and respiratory muscle dysfunction may indicate respiratory sarcopenia. However, there is no consensus regarding the definition of respiratory sarcopenia. We aimed to create a definition of respiratory sarcopenia based on the peak expiratory flow rate (PEFR). Design: Cross-sec...

Background Exercise may reduce the risk of disability for activities of daily living (ADL), but the degree of associations between specific exercise types and such a risk remains unclear. This study aimed to examine the longitudinal associations between exercise types and the incidence of ADL disability in older women. Methods This 8‐year populati...

Background: Considering the rate of growth of the older population in several countries, accidental falls in older cyclists are expected to increase. However, the prevalence and correlates of bicycle-related falls (BR-falls) are unknown. The aim of the present study was to explore the characteristics of BR-falls, focusing on the risk factors. Metho...

The cover image, by Yasuhiro Horibe et al., which is designed by Takayuki Ueda, is based on the original article A 2‐year longitudinal study of the relationship between masticatory function and progression to frailty or pre‐frailty among community‐dwelling Japanese aged 65 and older, DOI: 10.1111/joor.12700.

Purpose The purpose of this study was to clarify the reference values of muscle thicknesses by age and to elucidate the association of muscle thickness with physical function in a large group of community-dwelling elderly individuals. Participants and methods The muscle thicknesses of the rectus femoris (RF), vastus intermedius (VI), and quadricep...

Background An association has recently been reported between frailty and reduced masticatory function; however, the causal relationship remains unclear. Objective The aim of this study was to clarify the relationship between masticatory function and frailty progression. Methods Among 6699 individuals aged 65 and older (mean age 72.8±5.2 years) wh...

Aims The association of vascular dysfunction and amyloid beta deposition attracted attentions for its relationship with cognitive decline. Previous studies show the correlation between the declined cardiac function and the cognitive impairment. In the present study, we analysed the association between cognitive functions and cardiac parameters in c...

Objective Clinicians’ evaluations of older adults sometimes reveal inconsistencies between objective and subjective dental status. This study investigated which factors contribute both to good objective masticatory function (OMF) and the poor subjective masticatory function (SMF) that often becomes a clinical issue. Methods Study participants incl...

Exercise can delay the decline of instrumental activities of daily living (IADL), although it remains unclear which specific exercise types are associated with such a delay. This 4-year prospective cohort study in Japan aimed to identify the longitudinal associations between exercise types and the onset of IADL decline in older women. Between 2008...