Development of a system for the assessment of a dual-task performance based on a motion-capture device

The authors produced a dual task (DT) that provided a dynamic balance task and a cognitive task in a game system using motion sensors and virtual images. There had been no DT where a cognitive task needs a dynamic balance task that requires full-body motions. We developed and evaluated a game system to assess the performance of the DT. The DT was to solve a Sudoku puzzle using full-body motions like Tái Chi. An ability to perform a DT is intimately related to risk of falls. To evaluate the developed system, we compared the performance of elderly people and young people. Generally, elderly people are at a higher risk of falls. Twenty elderly community-dwelling adults (mean age, 73.0±6.2 years) and 16 young adults (mean age, 21.8±1.0 years) participated in this study. To compare the two groups, we applied an independent-samples t-test. The time taken for the elderly people was 60.6±43.2 s, whereas the time taken for the young people was 16.0±4.8 s. The difference is statistically significant (p<0.05). This result suggests that the developed game system is useful for the evaluation of the DT performance

Probiotic Bifidobacterium breve Induces IL-10-Producing Tr1 Cells in the Colon

Specific intestinal microbiota has been shown to induce Foxp3+ regulatory T cell development. However, it remains unclear how development of another regulatory T cell subset, Tr1 cells, is regulated in the intestine. Here, we analyzed the role of two probiotic strains of intestinal bacteria, Lactobacillus casei and Bifidobacterium breve in T cell development in the intestine. B. breve, but not L. casei, induced development of IL-10-producing Tr1 cells that express cMaf, IL-21, and Ahr in the large intestine. Intestinal CD103+ dendritic cells (DCs) mediated B. breve-induced development of IL-10-producing T cells. CD103+ DCs from Il10−/−, Tlr2−/−, and Myd88−/− mice showed defective B. breve-induced Tr1 cell development. B. breve-treated CD103+ DCs failed to induce IL-10 production from co-cultured Il27ra−/− T cells. B. breve treatment of Tlr2−/− mice did not increase IL-10-producing T cells in the colonic lamina propria. Thus, B. breve activates intestinal CD103+ DCs to produce IL-10 and IL-27 via the TLR2/MyD88 pathway thereby inducing IL-10-producing Tr1 cells in the large intestine. Oral B. breve administration ameliorated colitis in immunocompromised mice given naïve CD4+ T cells from wild-type mice, but not Il10−/− mice. These findings demonstrate that B. breve prevents intestinal inflammation through the induction of intestinal IL-10-producing Tr1 cells

Effect of a Kinect-based exercise game on improving executive cognitive performance in community-dwelling elderly: case control study.

Background: Decrease of dual-task (DT) ability is known to be one of the risk factors for falls. We developed a new game concept, Dual-Task Tai Chi (DTTC), using Microsoft’s motion-capture device Kinect, and demonstrated that the DTTC test can quantitatively evaluate various functions that are known risk factors for falling in elderly adults. Moreover, DT training has been attracting attention as a way to improve balance and DT ability. However, only a few studies have reported that it improves cognitive performance. Objective: The purpose of this study was to demonstrate whether or not a 12-week program of DTTC training would effectively improve cognitive functions. Methods: This study examined cognitive functions in community-dwelling older adults before and after 12 weeks of DTTC training (training group [TG]) or standardized training (control group [CG]). Primary end points were based on the difference in cognitive functions between the TG and the CG. Cognitive functions were evaluated using the trail-making test (part A and part B) and verbal fluency test. Results: A total of 41 elderly individuals (TG: n=26, CG: n=15) participated in this study and their cognitive functions were assessed before and after DTTC training. Significant differences were observed between the two groups with significant group × time interactions for the executive cognitive function measure, the delta-trail-making test (part B−part A; F1,36=4.94, P=.03; TG: pre mean 48.8 [SD 43.9], post mean 42.2 [SD 29.0]; CG: pre mean 49.5 [SD 51.8], post mean 64.9 [SD 54.7]). Conclusions: The results suggest that DTTC training is effective for improving executive cognitive functions

Concept Software Based on Kinect for Assessing Dual-Task Ability of Elderly People

[Objective]: Assessment of fall risk of elderly people is a critical issue. Dual-task (DT) ability is a criterion for risk assessment. We developed new concept software based on Microsoft (Redmond, WA) Kinect™ for assessing DT ability. The software is named "Dual-Task Tai Chi" (DTTC) and includes Tai Chi and number place (Sudoku) components. The purpose of this study is to validate the DTTC test for assessment of DT ability. [Subjects and Methods]: Forty-five community-dwelling elderly (mean age, 74.1±6.6 years) individuals participated in this study. They performed DTTC, locomotive, cognitive, and DT tests. DT ability was evaluated with a 10-m walk under a cognitive-task condition and a 10-m walk under a manual-task condition. The correlation between the time taken to complete the DTTC test and each function test was determined using Pearson correlation coefficients. Stepwise multiple regression analysis was conducted to assess the relationship between the DTTC test results and results of the other tests. [Results]: The time taken to complete the DTTC test was correlated with DT ability, locomotive functioning, and cognitive functioning. Results of stepwise multiple regression analysis confirmed that DT, balance, and cognitive ability are statistically significant. No statistically significant association was found for the other variables. [Conclusions]: The DTTC test quantitatively evaluates a compound function including DT, balance, and cognitive abilities

Cognitive Decline Predicts Long-Term Care Insurance Requirement Certification in Community-Dwelling Older Japanese Adults: A Prospective Cohort Study

Aim: The purpose of this prospective cohort study is to examine whether cognitive decline is an independent predictor of new long-term care insurance (LTCI) requirement certifications in Japan. Methods: A total of 5,765 community-dwelling older Japanese adults who, at baseline, were independent in terms of their activities of daily living participated in this study and were followed up for 18 months. The outcome measure was the number of new LTCI requirement certifications during the 18-month period of the study. We collected demographic information through questionnaires and assessed cognitive skills with the Cognitive Performance Scale (CPS). The participants were divided into 3 groups according to CPS scores (0, 1, and 2 or greater). Results: During the 18-month period, 399 subjects (6.9%) became newly certified for LTCI services. In a multivariate Cox proportional hazards model, older participants with a CPS score of 1 (adjusted HR: 1.39, 95% CI: 1.08-1.77) and 2 or greater (adjusted HR: 2.27, 95% CI: 1.74-2.96) were significantly more likely to receive an LTCI certification compared to those with a CPS score of 0. Conclusions: Cognitive decline is an independent predictor of new LTCI requirement certifications and the severity of cognitive decline in elderly adults is positively associated with receiving an LTCI requirement certification in Japan

Shoe-fit is correlated with exercise tolerance in community-dwelling elderly people

[Purpose]: Maintenance of physical activity significantly affects quality of life, and the frequency of physical activity depends upon exercise tolerance. However, there is minimal information on the external factors that contribute to exercise tolerance. The aim of this study was to examine the association between exercise tolerance and shoe-fit in community-dwelling elderly people. [Methods]: Subjects were 155 elderly, healthy, community-dwelling Japanese volunteers. Exercise tolerance (Shuttle Walk Test [SWT]), 10-m walking time (10mWT), and forced expiratory volume in 1 second (FEV1) were measured. Shoe-fit was assessed and participants were divided into three groups according to the heel-fit of their shoes (Too Loose, Loose, Fit). Group scores in the above variables were compared. Further, a multivariate logistic regression model using a stepwise method was performed to investigate which shoe-fit factors were independently associated with SWT. [Results]: No significant differences in age, gender, body mass index, 10mWT, FEV1, or presence or absence of pain sites were observed between the three groups. The Fit (p = 0.001) and Loose (p = 0.008) groups had significantly higher SWT score than the Too Loose group. Multivariate logistic regression analysis showed that poor heel-fit was significantly correlated with a low SWT score, even following adjustments for age, gender, 10mWT and FEV1 (odds ratio: 0.25, 95% confidence interval: 0.07–0.95, p = 0.04). [Conclusions]: This study demonstrates that heel-fit is associated with exercise tolerance in community-dwelling elderly people. It is important for elderly people to wear adequate fit shoes in order to enhance physical functions and prevent declining physical functions