Background and Purpose-Increasing attention has been paid to associations between cognitive dysfunction and brain microbleeds (MBs). Because all previous studies have investigated patients with neurological disorders, we examined subjects without neurological disorder in order to clarify pathogenic relationships. Methods-A total of 518 consecutive adults without neurological disorder who had undergone health-screening tests of the brain were studied prospectively. Gradient-echo T2*-weighted MRI using a 1.5-T system was used to detect MBs. The Mini-Mental State Examination (MMSE) was administered to determine cognitive functions. MMSE scores Ͻ27 or Ͼ1.5 SDs below the age-related mean were regarded as subnormal. Results-MBs were found in 35 subjects (6.8%). MMSE score Ͻ27 was found in 25 subjects (4.8%), with MMSE score Ͼ1.5 SDs below the age-related mean in 34 subjects (6.6%). Univariate analysis showed presence and number of MBs, short duration of education, and severe white matter hyperintensities as significantly associated with subnormal scores.

Background and Purpose-Brain microbleeds (MBs) are considered to be associated with cognitive decline and can be pathologically and topographically classified as cerebral amyloid angiopathy-related (located in lobar regions) and hypertensive microangiopathy-related (located in deep regions). We examined whether different effects on global cognitive function might be seen with different distributions of MBs. Methods-A total of 1279 adults without neurological disorders were studied prospectively. Subjects were divided into 4 groups: without-MBs group; lobar group; deep group; and with in both areas (diffuse group). The Mini-Mental State Examination was administered to determine global cognitive functions, with scores Ͻ27 regarded as subnormal. Results-MBs were detected in 98 subjects (8%): 36 subjects (3%) classified as lobar group, 48 subjects (4%) as deep group, and 14 subjects (1%) as diffuse group. Subnormal scores were found in 76 subjects (5.9%), associated with age, education, hypertension, severe white matter hyperintensities, and distribution and number of MBs. In the final model of logistic regression analysis, the deep group (OR, 2.79; 95% CI, 1.14 -6.79) was associated with subnormal scores, whereas the lobar group (OR, 0.77; 95% CI, 0.17-3.44) was not. Trend for the diffuse group did not reach the level of significance (OR, 5.01; 95% CI,). These trends were also seen in analysis using another cut-off point for subnormal score. Scores for total Mini-Mental State Examination and attention and calculation were significantly lower in the deep group and the diffuse groups compared with the without-MBs group. Conclusions-ThisJapanese cross-sectional study demonstrated that MB-related global cognitive dysfunction seems to occur based on hypertensive pathogenesis rather than on cerebral amyloid angiopathy. (Stroke. 2012;43:1800-1805.)Key Words: microbleeds Ⅲ cognitive impairment Ⅲ hypertension Ⅲ cerebral amyloid angiopathy B rain microbleeds (MBs) on gradient-echo T2*-weighted magnetic resonance imaging (MRI), which are characterized histologically by the presence of hemosiderin around small vessels, are now accepted as a manifestation of cerebral small vessel pathologies, including hypertensive small vessel disease and cerebral amyloid angiopathy (CAA). 1,2 MBs are often detected in patients with stroke, 2,3 and are also reportedly associated with dementia disorders such as Alzheimer's disease, 4 and vascular dementia, 5 or memory loss, 6 as well as cognitive decline. 7-11 However, their pathological impacts on cognitive function remain uncertain.The pathological differences in MBs according to distribution is now well-known, with MBs in deep regions (deep MBs) considered to be associated with hypertensive microangiopathy, whereas strictly lobar MBs (lobar MBs) share risk factors with CAA. 12,13 According to this pathological and distributional concept, we assessed whether different effects on global cognitive function might be seen with different topographical distributions of MBs in a sample of independen...

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Aim Previous studies on the association between intraoral conditions and mortality in community‐dwelling older individuals reported that fewer present teeth (PT) are significant risk factors for mortality. However, how the number of PT relative to the number of functional teeth (FT), including both present and rehabilitated teeth, influences mortality has not been investigated fully. This study examined the impact of the number of FT on mortality among community‐dwelling Japanese older adults. Methods This study was a retrospective, observational and population‐based follow‐up study, which examined 1188 older individuals who participated in an annual geriatric health examination from 2009 to 2015. The average follow‐up period was 1697.0 ± 774.5 days. The primary outcome was all‐cause mortality at follow‐up. The numbers of PT and FT of each participant were counted during an oral examination. In addition, demographics, clinical variables, blood nutrient markers, physical functions and perceived masticatory function were measured. Results Kaplan–Meier analysis, followed by a log‐rank test, revealed that fewer PT (P < 0.001) and FT (P = 0.002) were significantly associated with a reduced survival rate. Cox's proportional hazard analysis indicated that the number of FT, but not the number of PT, was a significant independent mortality risk factor after adjusting for demographics, clinical variables, nutrient markers and physical functioning (P = 0.036, hazard ratio: 2.089). Conclusions Current results suggest that the number of FT more strongly predicts all‐cause mortality than the number of PT among community‐dwelling older adults. Further studies are necessary to consider the confounding of socioeconomic status and disability status. Geriatr Gerontol Int 2020; ••: ••–••.

On April 14, the Society of Swallowing and Dysphagia of Japan (SSDJ) proposed its position statement on dysphagia treatment considering the ongoing spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The main routes of transmission of SARS-CoV-2 are physical contact with infected persons and exposure to respiratory droplets. In cases of infection, the nasal cavity and nasopharynx have the highest viral load in the body. Swallowing occurs in the oral cavity and pharynx, which correspond to the sites of viral proliferation. In addition, the possibility of infection by aerosol transmission is also concerning. Dysphagia treatment includes a broad range of clinical assessments and examinations, dysphagia rehabilitation, oral care, nursing care, and surgical treatments. Any of these can lead to the production of droplets and aerosols, as well as contact with viral particles. In terms of proper infection control measures, all healthcare professionals involved in dysphagia treatment must be fully briefed and must appropriately implement all measures. In addition, most patients with dysphagia should be considered to be at a higher risk for severe illness from COVID-19 because they are elderly and have complications including heart diseases, diabetes, respiratory diseases, and cerebrovascular diseases.

Aim To examine the association between a decrease in the frequency of going out and oral function in independent older adults living in the urban area of Tokyo. Methods The participants analyzed were 785 older adults from the “Takashimadaira Study” (344 men and 441 women, age 77.0 ± 4.6 years). This study investigated the following items: decrease in frequency of going out; basic characteristics (sex, age); physical factors, such as oral function (difficulty chewing, difficulty swallowing, dry mouth); body pain; the Japan Science and Technology Agency Index of Competence; physical activities; psychological factors, such as the Geriatric Depression Scale‐15 score; and social and environmental factors, such as the presence or absence of participation in organization activities. Results To investigate the factors associated with a decrease in frequency of going out, logistic regression analysis showed an association with age (OR 1.08, 95% CI 1.03–1.13), difficulty chewing (OR 2.41, 95% CI 1.52–3.83), dry mouth (OR 1.68, 95% CI 1.07–2.64), body pain (OR 1.78, 95% CI 1.14–2.78), Japan Science and Technology Agency Index of Competence scores (OR 0.91, 95% CI 0.84–0.99), physical activities (OR 0.99, 95% CI 0.98–1.00), Geriatric Depression Scale‐15 scores (OR 1.13, 95% CI 1.05–1.21) and organization activities (OR 1.94, 95% CI 1.22–3.07). Covariance structural analyses showed that both “difficulty chewing” and “dry mouth” significantly affected “decrease in frequency of going out.” In addition, decrease in frequency of going out was significantly affected by “ Geriatric Depression Scale‐15 scores” through oral function. Conclusions The relationship between oral function and decrease in frequency of going out was clarified, after the multifaceted factors were adjusted. Geriatr Gerontol Int 2019; 19: 792–797.

The relationship between kidney dysfunction, such as chronic kidney disease (CKD), and brain morphology has attracted increasing attention, but the association between kidney dysfunction and cerebral atrophy has yet to be determined. The purpose of this study was to clarify the relationship between kidney function and a substantial degree of cerebral atrophy. A total of 610 consecutive Japanese adults without neurological disorders who had undergone health screening tests of the brain were studied prospectively. Magnetic resonance imaging was performed using a 1.5-T scanner. Using a computer-assisted processing system, the percentage of cerebrum atrophy (%Cerebrum atrophy) was calculated as an index of cerebral atrophy. Atrophy was defined as 42 s.d.s below the mean %Cerebrum atrophy. The glomerular filtration rate (GFR) was estimated using the revised equations for estimated GFR from serum creatinine in Japan. Kidney function variables included the GFR value and the prevalence of subjects with GFR o60 ml min À1 per 1.73 m 2 . Cerebral atrophy was found in 25 (4.1%) cases. Univariate analysis showed that age, male sex, hypertension, each kidney function variable, white matter hyperintensities and lacunae were associated with cerebral atrophy. On logistic regression analysis, GFR (odds ratio (OR), 0.64; 95% confidence interval (CI), 0.42-0.98) and GFR o60 ml min À1 per 1.73 m 2 (OR, 5.93; 95% CI,) were significantly associated with cerebral atrophy. On subanalysis, GFR o60 ml min À1 per 1.73 m 2 was significantly associated with cortical atrophy (OR, 3.23; 95% CI, 1.15-9.11). Decreased GFR was significantly associated with cerebral atrophy, indicating that treatment of CKD may control age-related degenerative processes of the brain.

The extracts of the flower buds of Magnolia salicifolia showed remarkable anti-allergy effects in passive cutaneous anaphylaxis (PCA) test. The bioactive constituents of this medicinal drug were isolated by monitoring their activities with an in vitro bioassay system measuring inhibitory effects on induced histamine release from rat mast cells. Of the ten isolated compounds magnosalicin is a new compound of neolignan structure. In addition to the isolated compounds samples of coumarins and lignans were evaluated their biological activities with the in vitro bioassay.