Hajime Takechi

Kyoto University, Kioto, Kyōto, Japan

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Publications (36)158.35 Total impact

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    ABSTRACT: Background/aims: Dementia is a priority issue in the public health realm. However, few reports address problems of dementia in the real world or provide comprehensive road maps to solve these problems. Methods: Nine groups of questions covering 4 topics were discussed using the Delphi method, relating to (1) current achievements and challenges regarding inclusive and holistic care in the community, (2) patients who are at a high risk of being excluded from care, (3) suggestions for a road map for the establishment of better and more inclusive medical and social care, and (4) unmet needs of patients with dementia. Results: In total, 477 opinions were obtained. Family issues, psychological/behavioral symptoms, and complications secondary to physical disorders are main factors for being excluded from care. To create a road map for care we have to address the topics of reaffirming care principles, multidisciplinary coalitions, and education for stakeholders. Conclusion: Further effective collaboration to promote dementia care is required.
    No preview · Article · Apr 2014 · Dementia and Geriatric Cognitive Disorders
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    ABSTRACT: AimIt is very important to maintain cognitive function in patients with mild cognitive disorder. The aim of the present study was to determine whether the amount of physical activity is associated with memory function in older adults with mild cognitive disorder.MethodsA total of 47 older adults with mild cognitive disorder were studied; 30 were diagnosed with mild Alzheimer's disease and 17 with mild cognitive impairment. The global cognitive function, memory function, physical performance and amount of physical activity were measured in these patients. We divided these patients according to their walking speed (<1 m/s or >1 m/s). A total of 26 elderly patients were classified as the slow walking group, whereas 21 were classified as the normal walking group.ResultsThe normal walking group was younger and had significantly better scores than the slow walking group in physical performance. Stepwise multiple linear regression analysis showed that only the daily step counts were associated with the Scenery Picture Memory Test in patients of the slow walking group (β = 0.471, P = 0.031), but not other variables. No variable was significantly associated with the Scenery Picture Memory Test in the normal walking group.Conclusions Memory function was strongly associated with the amount of physical activity in patients with mild cognitive disorder who showed slow walking speed. The results show that lower physical activities could be a risk factor for cognitive decline, and that cognitive function in the elderly whose motor function and cognitive function are declining can be improved by increasing the amount of physical activity. Geriatr Gerontol Int 2014; ●●: ●●–●●.
    Full-text · Article · Apr 2014 · Geriatrics & Gerontology International
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    Hiroyuki Umegaki · Hajime Takechi · Hiroko H Dodge

    Full-text · Article · Apr 2013 · International Journal of Alzheimer's Disease
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    ABSTRACT: Aim: Falls are common in patients with cognitive disorder. The purpose of this study was to determine whether global brain atrophy is associated with cognitive function, physical performance and fall incidents in older adults with mild cognitive disorder. Methods: A total of 31 older adults with mild cognitive disorders (mean age 78.9 ± 7.3 years) were studied, and 10 of them had experienced falls and the others had not in the past 1 year. Cognitive function and physical performance were measured in these patients. Global brain atrophy was determined by the Voxel-Based Specific Regional Analysis System for Alzheimer's Disease software. Results: Fallers showed significantly worse scores than the non-fallers in the Global Brain Atrophy Index, Clock Drawing Test (CDT), Verbal Fluency Test (animal), maximum walking time and Timed Up & Go (TUG) Test. The Global Brain Atrophy Index was correlated with the Verbal Fluency Test (animal; r = -0.522), the Verbal Fluency Test with letter (ka; r = -0.337), CDT (r = -0.547), TUG (r = 0.276) and Five Chair Stands Test (r = 0.303) by age-adjusted correlation analyses. Stepwise regression analysis showed that the Global Brain Atrophy Index (β = 1.265, 95% CI 1.022-1.567) was a significant and independent determinant of falls (R(2) = 0.356, P = 0.003). Conclusion: Global brain atrophy might be indicated as one of the risk factors for falls in older adults with mild cognitive disorders.
    No preview · Article · Aug 2012 · Geriatrics & Gerontology International
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    Hajime Takechi · Atsuko Kokuryu · Tomoko Kubota · Hiroko Yamada
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    ABSTRACT: Little is known about the extent to which advanced activities of daily living among patients with dementia are preserved and how family caregivers of these patients support them in the community. In this cross-sectional assessment of pairs of patients with dementia and their family caregivers, we evaluated basic, instrumental, and advanced activities of daily living by comparing past and present status observed by caregivers with subjective estimations by patients with dementia. We also asked about ways in which support was provided by family caregivers. Thirty-nine pairs of patients with dementia and caregivers who presented to our memory clinic were interviewed. The mean age of patients with dementia was 75.3 ± 7.0 years, and Mini-Mental State Examination scores were 22.3 ± 3.4. We found relative preservation of advanced activities of daily living compared with instrumental activities of daily living. Caregivers provided instrumental, informational, and reminding support to patients with dementia. These findings may reinforce the concept of person-centered support of patients with dementia in the community.
    Preview · Article · Jun 2012 · International Journal of Alzheimer's Disease
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    ABSTRACT: Background/PurposeThe aim of this study was to examine the relationship between nurses’ clinical judgment on cognitive function by fall risk assessment and mini-mental state examination (MMSE) scores in elderly inpatients.Methods We studied 61 consecutive hospitalized patients who received both comprehensive geriatric assessment (CGA) and fall risk assessment at the Department of Geriatric Medicine in Kyoto University Hospital from January 2006 to June 2010. During the fall risk assessment at admission, primary nurses evaluated the cognitive function by four items (with or without disorientation, impaired judgment, lack of comprehension, and memory loss), while a trained clinical assistant performed CGA including MMSE. Patients were divided into three groups according to the MMSE scores. The association between the four items of judgment by nurses and MMSE scores was then studied.ResultsThe mean age was 80.1 years and 55.7% of the patients were female. The percentage of patients judged to have impaired judgment, lack of comprehension, and memory loss was higher in patients with lower MMSE scores (impaired judgment, p for trend = 0.001; lack of comprehension, p for trend = 0.043; memory loss, p for trend = 0.001). The percentage of patients judged to have at least one of the four abnormalities was also significantly higher in patients with lower MMSE scores (p for trend <0.001). However, no significant relationship was found between disorientation and the MMSE scores. Further, nurses could not detect impaired cognition by the four items in one-third of the patients with mild impairment determined by MMSE.Conclusion These data indicate that a comprehensive evaluation using all the four items on cognitive impairment is more effective in detecting cognitive impairment in elderly than using individual items, although one-third of cognitively impaired elderly patients may miss detection despite the use of the four items. Better approaches should be developed to identify cognitively impaired elderly patients by nurses.
    Preview · Article · Mar 2012 · Journal of Clinical Gerontology and Geriatrics
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    Izumi Nomura · Hajime Takechi · Nobuo Kato
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    ABSTRACT: Extracellular accumulation of amyloid beta (Aβ) is a hallmark of Alzheimer's disease (AD). It has been reported that extracellular perfusion of Aβ inhibits long-term potentiation (LTP), which is strongly related to memory in animal models. However, it has recently been proposed that intracellular Aβ may be the first pathological change to occur in AD. Here, we have investigated the effect on LTP of intracellular injection of Aβ (Aβ(1-40), Aβ(1-42)) into hippocampal pyramidal cells using patch-clamp technique. We found that injection of 1 nM Aβ(1-42) completely blocked LTP, and extracellular perfusion of a p38 MAPK inhibitor or a metabotropic glutamate receptor blocker reversed these blocking effects on LTP. Furthermore, we have examined the effects of different concentrations of Aβ(1-40) and Aβ(1-42) on LTP and showed that Aβ(1-40) required a 1,000-fold higher concentration to attenuate LTP than 1 nM Aβ(1-42). These results indicate that LTP is impaired by Aβ injected into genetically wild-type neurons in the sliced hippocampus, suggesting an acute action of intracellular Aβ on the intracellular LTP-inducing machinery.
    Preview · Article · Feb 2012 · Journal of Neurophysiology
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    ABSTRACT: Aim: To delineate relationships among cognitive function, frailty and level of care required in the Japanese long-term care insurance program (LTCIP) in outpatient memory clinic patients. Methods: This was a cross-sectional study carried out at an outpatient memory clinic. Participants were 201 cognitively impaired patients. Cognitive function was measured by the Mini-Mental State Examination (MMSE). Frailty was measured by Timed Up & Go (TUG) and grip strength. Waist circumference, body mass index, living arrangement and level of care required in the LTCIP (rank 1 minor disability to rank 7 severe disability) were also assessed. Results: Mean age, MMSE score, TUG score and grip strength were 78.8 ± 6.9 years, 19.6 ± 6.1, 14.6 ± 6.7 s and 16.9 ± 7.5 kg, respectively. A total of 70 patients (34.8%) had not applied for the certification, at least in part because of their younger age and existence of family caregivers. LTCIP rank was correlated both with MMSE score (β: −0.49, P = 0.001), grip strength (β: −0.27, P = 0.005) and living alone (β: −0.18, P = 0.03), but not with TUG score (β: 0.14, P = 0.105). Conclusion: In outpatients of a memory clinic, care ranks, which define the upper limit of monthly benefit in the Japanese LTCIP, were influenced by age, cognitive function, frailty and living arrangements. Understanding the relationship among these parameters would be useful in predicting the needs of cognitively impaired patients and important when comparing the possible services provided by long-term care systems for them worldwide. Geriatr Gerontol Int 2012; ••: ••–••.
    No preview · Article · Feb 2012 · Geriatrics & Gerontology International
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    ABSTRACT: Background The number of elderly hemodialysis (HD) patients is increasing in Japan, and the psychosocial impact of HD to the elderly remains unclear. The main purpose of this study was to evaluate quality of life (QOL) of elderly patients undergoing regular HD.Methods We examined the psychosocial status in elderly HD patients and compared it with that in healthy elderly individuals. The correlations between each item of QOL, laboratory data and comorbidities were explored. This study cohort consisted of 142 people (70 healthy elderly participants and 72 elderly HD patients). We assessed 10 items of QOL, i.e., health condition, appetite, sleep, mood, memory, family relationship, friendship, economical status, satisfaction in daily life, and happiness by visual analog scale (VAS).ResultsOverall, elderly HD patients had lower scores of VAS than healthy elderly participants, especially in sleep, mood, and happiness, but not in family relationship and friendship. Lower VAS scores for sleep were significantly correlated with the duration of HD therapy and the troubles in vascular access for HD. VAS scores for family relationship were also correlated with the duration of HD therapy.Conclusion The QOL of elderly HD patients was poorer than that in healthy elderly individuals, particularly in sleep, mood and happiness. Further study is needed to improve the QOL of elderly HD patients. This is of great importance, since the number of elderly HD patients is estimated to escalate in the future.
    Full-text · Article · Dec 2011 · Journal of Clinical Gerontology and Geriatrics
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    ABSTRACT: The number of hemodialysis (HD) patients is increasing along with their mean age in Japan. The assessment of their psychosocial status and quality of life (QOL) is therefore becoming more and more important along with laboratory data or comorbidities. We examined the psychosocial status of 211 HD patients (72 elderly and 139 non-elderly) and compared the difference between elderly and non-elderly patients using a visual analogue scale (VAS). We then examined how QOL affected mortality rate in 3-year prospective follow up. We assessed 10 items of QOL: health condition, appetite, sleep, mood, memory, family relationships, friendship, economical status, life satisfaction in daily life, and happiness with qualified self-evaluating questionnaires along with laboratory data and comorbidities. Furthermore, we investigated the correlation between the scores of mood and geriatric depression scale (GDS)-15. There was no difference in VAS scores between elderly and non-elderly patients. Lower VAS scores for appetite and mood correlated with higher mortality in HD patients, especially in the non-elderly. VAS scores for mood correlated with GDS-15 in HD patients. More attention should be paid to appetite and the diagnosis and therapy of depressive mood to improve the prognosis of HD patients, especially for the non-elderly.
    No preview · Article · Aug 2011 · Geriatrics & Gerontology International
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    ABSTRACT: Oligomeric amyloid β (Aβ) is currently considered to induce Alzheimer's disease (AD). We examined 2 patients with familial AD who possessed the Osaka (E693Δ) mutation in amyloid precursor protein. To the best of our knowledge, these patients are the first AD cases presumably affected with Aβ oligomers in the absence of senile plaques, and they support the Aβ oligomer hypothesis. We evaluated the clinical course, neuropsychological data, cerebrospinal fluid biomarker levels, magnetic resonance imaging (MRI) scans, fluorodeoxyglucose-positron emission tomography (PET) scans, and Pittsburgh compound B (PiB)-PET images of these patients. In the early stages, these patients developed memory disturbances in a similar rate to patients with sporadic AD. Despite their memory disturbances, both patients showed only limited brain atrophy on MRI and little amyloid accumulation on PiB-PET. Subsequent to the development of memory disturbances, both patients suffered from motor dysfunction, probably due to cerebellar ataxia, and, within a few years, the patients fell into an apallic state. Familial AD patients with Osaka (E693Δ) mutation show severe dementia, cerebellar ataxia, and gait disturbances.
    No preview · Article · Aug 2011 · Dementia and Geriatric Cognitive Disorders
  • Hiroko Yamada · Keiko Aoki · Maiko Nishida · Hajime Takechi

    No preview · Article · Jul 2011 · Alzheimer's and Dementia
  • Atsuko Kokuryu · Hajime Takechi
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    ABSTRACT: We report the case of a 72-year-old man who had been given a diagnosis of semantic dementia (SD) at 64 years of age, and who began to use honorifics in all situations during the later clinical course. His initial clinical features were problems in word comprehension and naming, and some behavioural changes, including clockwatching and aberrant eating behaviours. The most prominent feature in this case was the use of honorifics in all situations, while other aspects of his language ability deteriorated. He even used honorifics with members of his family, including young grandchildren. Although it is difficult to explain the reason why the patient used honorifics in all situations, we considered 2 possibilities. The first is that although he remains able to use honorifics, he is unable to distinguish when the use of honorifics is not required. The second is that a change in emotional state, such as the "taming effect" or "placidity" that has been suggested to accompany frontotemporal lobar degeneration, might have affected his use of honorifics. The regular schedule of daycare services provides him with emotional stability because he does not have to constantly be aware of the time. Since no standard treatment has been established for SD, our experience with this case might be beneficial in caring for patients with SD.
    No preview · Article · Jan 2011 · Nippon Ronen Igakkai Zasshi Japanese Journal of Geriatrics

  • No preview · Article · Jul 2010 · Alzheimer's and Dementia
  • Maiko Nishida · Hiroko Yamada · Hajime Takechi

    No preview · Article · Jul 2010 · Alzheimer's and Dementia
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    Hajime Takechi · Hiroko H Dodge
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    ABSTRACT: It is highly desirable to develop a neuropsychological screening test which is sensitive to the early stage of Alzheimer's disease (AD), and is easy to administer at the primary care physician's (PCP's) office. Participants were 128 AD patients and 54 healthy volunteers. Brief cognitive screening tests were administered to the participants including the Mini-Mental State Examination (MMSE), Clock Drawing Test (CDT), Verbal Fluency Test (VFT), a Verbal Category Cued Memory test (CCMT) and the Scenery Picture Memory Test (SPMT). In the SPMT, a scenery picture of a living room containing 23 familiar objects was used. The administration of the SPMT comprised the first shallow memory session (Pict 1) and the second deep memory session (Pict 2). The area under the receiver-operator curve (AUC) was used to compare the efficacy of SPMT with other cognitive tests. Pict 1, which requires less than 2 min to complete, had the same AUC as Pict 2, and showed significantly larger AUC than MMSE, CDT and VFT for all (MMSE 19-23) and very mild (MMSE > or = 24) AD patients. When we conducted the similar analysis separately for those younger than 75 years and those aged 75 years or older, we obtained the same results as above among the older age group. Pict 1 showed larger AUC than CCMT in overall sample and also in the older age group, although the difference was not statistically significant. The SPMT could be useful for detection of mild and very mild AD in settings even where time is limited.
    Full-text · Article · Apr 2010 · Geriatrics & Gerontology International
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    ABSTRACT: Little is known regarding the normative levels of leisure activities among the oldest old and the factors that explain the age-associated decline in these activities. The sample included 303 cognitively intact community-dwelling elderly persons with no disability in Activities of Daily Living (ADL) and minimal dependency in Instrumental ADL (IADL) in Shiga prefecture, Japan. We examined (i) the nature and frequency of leisure activities, comparing the oldest old versus younger age groups; (ii) factors that explain the age-associated differences in frequencies of engagement in these activities; and (iii) domain-specific cognitive functions associated with these activities, using three summary index scores: physical and nonphysical hobby indexes and social activity index. The oldest old (85 years old or older) showed significantly lower frequency scores in all activity indexes, compared with the youngest old (age 65-74 years). Gait speed or overall mobility consistently explained the age-associated reduction in levels of activities among the oldest old, whereas vision or hearing impairment and depressive symptoms explained only the decline in social activity. Frequency of engagement in nonphysical hobbies was significantly associated with all cognitive domains examined. Knowing the factors that explain age-associated decline in leisure activities can help in planning strategies for maintaining activity levels among elderly persons.
    Full-text · Article · Dec 2008 · The Journals of Gerontology Series A Biological Sciences and Medical Sciences

  • No preview · Article · Jul 2008 · Alzheimer's and Dementia
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    ABSTRACT: During the developmental formation of neuronal circuits, redundant synapses are eliminated and persisting synapses strengthened. In the immature cerebellum, climbing fiber-Purkinje cell synapses undergo a pronounced synaptic rewiring, from a multiple innervation around birth to a mono-innervation in adults. An early stage of this process consists in the differentiation of initially equally strong synapses into one "large" and several "small" synaptic inputs. By performing whole-cell recordings in Purkinje cells of rat cerebellar slices, we found that the coincident activation of a Purkinje cell and one of its afferent climbing fibers induces homosynaptic long-term synaptic potentiation (LTP). This LTP requires postsynaptic Ca2+ signaling and involves an increase in the single channel conductance of the postsynaptic AMPA receptors. Interestingly, LTP occurs exclusively at large synaptic inputs. It is not observed at small inputs that are eventually eliminated. Thus, we identified a new form of LTP that is expressed uniquely and just for a restricted period of early development in the large climbing fiber inputs. Our results suggest that this LTP mediates the activity-dependent maturation of the "winner" climbing fiber.
    Full-text · Article · Feb 2008 · The Journal of Neuroscience : The Official Journal of the Society for Neuroscience
  • Hajime Takechi
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    ABSTRACT: Management of dementia and cognitive decline is a major issue in geriatrics. Since the average age of society is advancing and patients of dementia are increasing, it is important to remove risk factors of dementia and cognitive decline in order to maintain quality of life in the elderly and to save cost of medicine and care. While hypertension has been known to be a risk factor of cerebrovascular events and vascular dementia, recent studies show that midlife hypertension is also a risk factor of cognitive decline and Alzheimer's disease in late life. Clinical trials and retrospective observation studies also show that treatment of hypertension decreases the risk of Alzheimer's disease. These issues are also related with the consideration of vascular factors in Alzheimer's disease. The white matter lesion as a consequence of hypertension and its meaning in Alzheimer's disease are also discussed.
    No preview · Article · Aug 2007 · Nippon Ronen Igakkai Zasshi Japanese Journal of Geriatrics

Publication Stats

703 Citations
158.35 Total Impact Points


  • 2006-2014
    • Kyoto University
      • • Department of Human Health Sciences
      • • Department of Geriatric Medicine
      Kioto, Kyōto, Japan
  • 2010
    • University of New South Wales
      Kensington, New South Wales, Australia
  • 2008
    • Technische Universität München
      • Institute of Neuroscience
      München, Bavaria, Germany
  • 1997-1998
    • Universität des Saarlandes
      Saarbrücken, Saarland, Germany