Ryota Sakurai

• PT, PhD
• Researcher at Tokyo Metropolitan Institute of Gerontology

Although wearable activity trackers (WAT) are considered beneficial for health-management in older adults, their prevalence and impact on health satisfaction are unclear. We limited our study to older Japanese adults who used smartphones, tablets, or personal computers. We categorized the participants into WAT users and non-users. The survey examin...

Introduction: Positive effects of hearing aids (HA) have been suggested. However, their impact on gait performance, which is closely associated with hearing loss and cognition, remains unclear. This pilot study assessed the effect of HA use on gait performance among patients with age-related hearing loss (ARHL). Methods: This single-arm trial co...

Aim Age‐related hearing loss (ARHL) is a common problem among older adults and contributes to adverse health outcomes such as cognitive impairment. However, the neural mechanisms underlying ARHL remain unclear. We aimed to reveal the structural and metabolic (i.e., neural activity) correlates of ARHL using magnetic resonance imaging (MRI) and posit...

BACKGROUND Wearable devices, such as smartwatches (SW) appear to be useful tools for managing lifestyles and health among community-dwelling older adults. However, the detailed health impact of daily SW use on wide-range health outcomes in older adults remains unclear. OBJECTIVE This study aimed to investigate the one-year changes in physical func...

Age-related hearing loss (ARHL) and impaired gait both independently heighten the risk of accidental falls among older adults. However, the combined impact of these factors remains unclear. We analyzed the data of 786 community-dwelling Japanese older adults. Hearing was evaluated at frequencies of 1.0 and 4.0 kHz, with participants categorized int...

In this study, we developed a lightweight shoe sensor system equipped with four high-capacity, compact triaxial force sensors and an inertial measurement unit. Remarkably, this system enabled measurements of localized three-directional ground reaction forces (GRFs) at each sensor position (heel, first and fifth metatarsal heads, and toe) and estima...

In this study, we developed a lightweight shoe sensor system equipped with four high-capacity, compact triaxial force sensors and an inertial measurement unit. Remarkably, this system enabled measurements of localized three-directional ground reaction forces (GRFs) at each sensor position (heel, first and fifth metatarsal heads, and toe) and estima...

INTRODUCTION Apolipoprotein E E4 allele (APOE E4) and slow gait are independently associated with cognitive impairment and dementia. However, it is unknown whether their coexistence is associated with poorer cognitive performance and its underlying mechanism in neurodegenerative diseases. METHODS Gait speed, APOE E4, cognition, and neuroimaging we...

An adequate foot clearance height while stepping over an obstacle is important for safety in daily life. In the present study, we examined whether visual illusions affect foot clearance during a stepping-over action, and whether this is further influenced by gaze behavior. Twelve participants stepped over an obstacle placed four meters away under c...

Abstract Background Whether age-related decline in the musculoskeletal system may contribute to a decline in cognitive performance or vice versa is unclear. Understanding the direction of their associations and the extent to which upper and lower extremities similarly predict subtle changes in high-level cognitive performance will help elucidate th...

Background Research has suggested an association between lower socioeconomic status (SES) and unhealthy dietary habits. However, differences in the effects of different SES indicators and age remain unclear. The current study addressed this research gap by investigating the relationship between SES and unhealthy dietary habits, specifically focusin...

Aim: Working in old age not only solves the labor shortage in Japan, but also benefits the health of the older workers; however, work-related accidents are a major concern. Functional impairment is an important factor in such accidents. The first aim was to examine the association between frailty status and work-related accidents, and the second a...

Objectives Self-employed workers have a higher risk for adverse health outcomes than employed workers. However, the differences in health risk behaviors by employment status are largely unknown. This study examined differences in health risk behaviors between self-employed and employed (permanent/non-permanent) workers by sex and age (20–59 years,...

Background our aim was to assess the effectiveness of medication review and deprescribing interventions as a single intervention in falls prevention. Methods Design systematic review and meta-analysis. Data sources Medline, Embase, Cochrane CENTRAL, PsycINFO until 28 March 2022. Eligibility criteria randomised controlled trials of older partici...

Background : Although inconsistency between objective and subjective hearing loss among older adults has been suggested, a systematic examination of the cognitive and physical functioning among such older adults is lacking. Our objective was to assess the cognitive, physical, and mental profiles associated with the discrepancy. Methods : The audit...

For older adults especially, to perform everyday activities safely, adaptive locomotion that adjusts basic locomotion pattern according to the environmental features is critical. It is unknown, however, whether their locomotor patterns can be modified when there are subtle environmental changes. We examined adaptive limb movements, focusing on obst...

Background As there is a shortage of care staff in elderly care homes, seniors are expected to work as assistants to help the care staff. This study examined the influence of older assistant workers in intermediate elderly care facilities on care staff, specifically focusing on emotional exhaustion which is a sign of burnout. These facilities provi...

Objective During a natural disaster, accessing appropriate information is essential to reduce damage to health. Information and community technology (ICT) devices can help in obtaining information. This study aimed to identify the characteristics of information tools commonly used by ICT device users during a natural disaster, and identify associat...

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...

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: Nordic walking (NW) has been reported as a safe and effective exercise mode. However, the effects of NW on cognitive function are unknown. This study examined the effects of an unsupervised NW intervention on cognitive and physical function among older women engaging in volunteering. Methods: Forty-seven women aged ≥70 years were enroll...

Objective To assess the relationship of serum brain-derived neurotrophic factor (BDNF) levels with the subsequent short-term decline in cognitive functioning in community-dwelling older adults. Design Two-year prospective, observational study. Setting and Participants The study included 405 adults aged 65–84 years, initially free of a dementia di...

An association between cognitive impairment and tripping over obstacles during locomotion in older adults has been suggested. However, owing to its memory-guided movement, whether this is more pronounced in the trailing limb is poorly known. We examined age-related changes in stepping over, focusing on trailing limb movements, and their association...

Background The influence of age-related hearing loss on slow gait has been suggested; however, whether it is associated with increased gait variability, an important predictor of fall risk, remains unclear. Research question Is poor auditory acuity associated with increased gait variability, and does this gait change relate to accidental falls amo...

Background Older adults at risk of falling or who have fear of falling (FoF) present a discrepancy between “imagined” and “performed” actions. Using the gait-related motor imagery (MI) paradigm, we investigated whether prediction accuracy in motor execution is associated with the onset of FoF and with prospective falls among older adults with FoF....

Background Both negative and positive associations between social networking service (SNS) usage and mental health have been suggested by previous studies; however, their differences by type of SNS and age remain unclear. We addressed this issue based on the frequency of traditional communication such as face-to-face and non-face-to-face communicat...

Objective To examine whether co-existing social isolation and homebound status influence medical care utilization and expenditure in older adults. Methods Postal surveys on social isolation and homebound status were performed on older adults aged ≥65 years residing in a Japanese suburban city. Information on medical care utilization and expenditur...

Background: Social contact leads to an increased likelihood of engaging in physical activity (PA). However, the influence of social contact on PA would be different depending on the social contact source. This study aimed to identify the association of changes in social contact with family and non-family members with the change in PA using a paral...

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...

An association between cognitive impairment and tripping over obstacles during locomotion in older adults has been suggested. However, owing to its memory-guided movement, whether this is more pronounced in the trailing limb is poorly known. We examined the age-related changes in stepping-over, focusing on trailing limb movements, and their associa...

Aim Gait impairment implies subtle cognitive impairment (CI) and is associated with severity of white matter hyperintensities (WMHs). However, cognitive differences in such an association are not yet fully understood. This study examined the association between WMHs and gait performance among three cognitively different older groups. Methods Gait...

Objectives There is a growing body of literature examining age-related overestimation of one’s own physical ability, which is a potential risk of falls in older adults, but it is unclear what leads them to overestimate. This study aimed to examine 3-year longitudinal changes in self-estimated step-over ability, along with one key risk factor: low f...

Background Presence of at least one copy of the polymorphic apolipoprotein E ε4 allele (ApoE4) increases the risk of impairments of gait performance, particularly in elderly individuals with cognitive impairment or at risk of dementia; however, its underlying neural mechanism are unclear. This study examined the association among ApoE4, gait perfor...

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: 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...

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...

Psychological problems such as depression and fear of falling are relatively common among community-dwelling older adults. Considerable research has demonstrated that these psychological problems are associated with the incidence of falls among older adults. As indicated in the preceding chapter, cognitive impairment has also been shown to be an in...

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...

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...

Aim The present study explored the interactive effects of willingness to volunteer and actual volunteer engagement on the maintenance of functional health among older Japanese adults, using data from a 3‐year longitudinal study. Methods We used data from the 3‐year longitudinal Tokyo Metropolitan Institute of Gerontology Longitudinal Interdiscipli...

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...

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...

Background: An association between handgrip strength, hand dexterity and global cognition is suggested; however, it is unclear whether both hand motor functions are associated with executive function, which is important for performing daily activities. Understanding this association will help identify motor risk factors for impairment of executive...

Background Social isolation and homebound statuses are possible risk factors for increased mortality among older adults. However, no study has addressed the impact of accumulation of these two factors on mortality. The aim of this study was to examine whether such accumulation increased the risk of all-cause mortality. Methods The analyzed sample...

Background A new paradigm is emerging in which mobility and cognitive impairments, previously studied, diagnosed, and managed separately in older adults, are in fact regulated by shared brain resources. Deterioration in these shared brain mechanisms by normal aging and neurodegeneration increases the risk of developing dementia, falls, and fracture...

Background: Aging is known to be associated with increased risk of lipid disorders related to the development of type 2 diabetes. Recent evidence revealed that change of lipid molecule species in blood is associated with the risk of type 2 diabetes. However, changes in lipid molecular species induced by aging are still unknown. We assessed the eff...

Background Low dual-task gait performance (the slowing of gait speed while performing a demanding cognitive task) is associated with low cognitive performance and an increased risk of progression to dementia in older adults with mild cognitive impairment. However, the reason for this remains unclear. This study aimed to examine the relationship bet...

Background: Deterioration of hand motor function is a possible risk factor of cognitive impairment in older adults. Despite a growing body of research, a lack of clarity exists regarding the relationships. This review offers a synthesis of existing observational studies evaluating the associations of handgrip strength and hand dexterity with cogni...

Objectives: A growing body of literature indicates that social engagements, such as intergenerational programs, are effective strategies to improve a range of cognitive abilities. The present study examined whether the intergenerational program-REPRINTS-prevents age-related hippocampal atrophy. Methods: After comprehensive baseline assessment, p...

Older adults tend to overestimate their step-over ability. However, it is unclear as to whether this is caused by inaccurate self-estimation of physical ability or inaccurate perception of height. We, therefore, measured both visual height perception ability and self-estimation of step-over ability among young and older adults. Forty-seven older an...

Background: Lower dual-task gait performance (the slowing of gait speed while performing a cognitive demanding task) is associated with lower cognitive performance, particularly in MCI older adults. However, the neural mechanism of increased dual-task cost is still unclear. This study aimed to examine the relationship between dual-task cost and reg...

Background: A better understanding of the neural mechanisms that underlie the development of fear of falling (FoF) in seniors may help to detect potential treatable factors and reduce future falls. We therefore investigate the neural correlates of FoF in older adults using ¹⁸F-fluorodeoxyglucose-positron emission tomography (FDG-PET). Methods: This...

Background The apolipoprotein E polymorphism ε4 allele (ApoE4) and gait impairment are both known risk factors for developing cognitive decline and dementia. However, it is unclear the interrelationship between these factors, particularly among older adults with mild cognitive impairment (MCI) who are considered as prodromal for Alzheimer’s disease...

Aim: Understanding the relationship between age-related gait impairment, such as slow gait, and executive functioning in seniors may help identify individuals at higher risk of mobility decline, falls, and progression to dementia at earlier stages. We aim to identify brain regions concomitantly associated with poor gait and executive functioning i...

Objective Understanding of the underlying mechanisms of Fear of Falling (FoF) could help to expand potential treatments. Given the nature of motor performance, the decline in the planning stage of motor execution may be associated with an expression of FoF. The aim of this study was to assess the planning/ prediction accuracy in motor execution in...

A growing body of literature indicates that cognitively intact older adults tend to overestimate their physical functioning (e.g., step-over ability), which may lead to fall risk. However, the neural correlates underlying this phenomenon are still unclear. We therefore investigated the neural basis of older adults’ self-overestimation of stepping-o...

Aim: Understanding the risk factors for developing subjective memory complaints (SMC) could help with early screening and treatment for cognitive impairment. The aim of the present study was to explore the risk factors for developing SMC, by focusing on gait-related variables. Methods: A total of 406 community-dwelling older adults aged 65-85 ye...

Background: Social engagement activities can help older adults maintain mental and physical functioning levels. This study examined the long-term effects of the intergenerational picture-book reading program "REPRINTS" (Research of Productivity by Intergenerational Sympathy) on older adults. Methods: After baseline assessment, participants were all...

Objective: Low frequency of going outdoors (e.g. being homebound) is associated with depressive mood; however, the underlying neural mechanism of this association is unclear. We therefore investigated the neural substrate involved in the relationship between frequency of going outdoors and depressive mood using positron emission tomography (PET),...

Compelling evidence supporting the benefits of social engagement in older adults has been increasingly discussed. However, knowledge regarding an intergenerational program is limited. Herein, we provide a targeted review of intergenerational programs by focusing on our novel interventional program, Research on Productivity through Intergenerational...

Background: The health benefits of bicycling in older adults with mobility limitation (ML) are unclear. We investigated ML and functional capacity of older cyclists by evaluating their instrumental activities of daily living (IADL), intellectual activity, and social function. Methods: On the basis of interviews, 614 community-dwelling older adul...

Objectives This study investigated 1) the incidence of bicycle-related accidents and subsequent injuries and 2) the number of injuries (accidents) reported to the police (i.e., examining the number of potential accidents) among community-dwelling Japanese older adults, after examining the percentage of those who were regular cyclists. Methods Based...

Background: Non-pharmacological interventions are expected to be important strategies for reducing the age-adjusted prevalence of senile dementia, considering that complete medical treatment for cognitive decline has not yet been developed. From the viewpoint of long-term continuity of activity, it is necessary to develop various cognitive stimula...

Background: The objective of this study was to investigate the relationship between normalized regional cerebral metabolic rates of glucose (normalized-rCMRglc) and gait function in physically and mentally high-functioning older women. Methods: One hundred eighty-two community-dwelling older women (mean age [SD], 69.4 [6.6] years) without disabi...

Comparative data on locomotive and non-locomotive physical activity (PA) by age and gender are lacking for Japanese adults. The purpose of this study was to investigate objectively the levels of PA in each intensity in adults and older people by both genders living in Japan with triaxial accelerometry with discrimination between locomotive and non-...

Objective: The objective of this study was to investigate the difference of physical ability depending on the presence or absence of confidence in motor function (CIMF) and fear of falling (FOF) in independently living community-dwelling older adults. Methods: Participants in this study were 368 community-dwelling older adults (mean age±SD, 72.2...

To study the effects of a comprehensive intervention program comprising exercise, diet, and hot bathing in community-dwelling older adults by using a randomized controlled trial. The program included 61 community-dwelling healthy older adults (mean [SD] age, 69.9 [5.3] years) who were using a hot bath facility. The participants were randomly assign...

Background Older adults could not safely step over an obstacle unless they correctly estimated their physical ability to be capable of a successful step over action. Thus, incorrect estimation (overestimation) of ability to step over an obstacle could result in severe accident such as falls in older adults. We investigated whether older adults tend...

抄録 目的：複合健康増進プログラムによる介入が，高齢者の日常の身体活動に反映されるかについて検討した．方法：介入群20名と対照群14名に対して，介入前と介入終了直前の身体活動量を歩・走行とそれ以外を区別する3軸加速度計で評価した．結果：介入群の身体活動は対照群と同程度低下した．結論：介入自体による身体活動量の低下は認められず，本プログラムは身体活動量と独立して心身機能に介入効果をもたらす可能性が示唆された．

Aim: To investigate the manner in which community-dwelling older adults' foot problems affect their history of falls. Methods: This study included 112 community-dwelling older adults. Foot problems (e.g., inflammation, ingrown nails, and pain while walking), self-rated physical ability (e.g., gait, tripping over, and balance), history of falls w...

Aim: The objective of this study was to evaluate the effects of a comprehensive overweight intervention program, which utilizes hot bathing, on overweight, community-dwelling middle-aged and older adults in a randomized controlled trial. Methods: The program was carried out in a hot bath facility and included 66 community-dwelling middle-aged an...

To investigate the influence of the differences in exercise fulfillment on mental and physical functions and the effects of exercise intervention on community-dwelling older adults. Participants in this study included 260 community-dwelling older adults (mean age +/- SD, 70.4 +/- 6.0 years) who participated in the exercise intervention study (inter...

The objective of this study was to evaluate the effects of a comprehensive intervention program named SPRING, which utilizes a hot spring facility, in community-dwelling older adults in a randomized controlled trial. A total of 60 community-dwelling elderly people (mean age, 72.7±6.0 years) participated in this program. After baseline investigation...