Multifa
ifaciOrial lnte:rveritions
バ

f0rprevcntiOnofDemCntia「認知症予防のための多因子介入」

The 17th International
Symposium on Geriatrics
and Gerontology

Saturday, December 3rd, 2022
10:00-18:00
日時12022年12月3日(±)10:00~18:QQ

第 17 回長寿医療研究センター国際シンポジウム開催報告

1. 長寿医療研究センター国際シンポジウム
長寿医療研究センター国際シンポジウム（International Symposium on Geriatrics
and Gerontology, ISGG）は、2004 年に我が国における 6 番目のナショナルセンタ
一としてあらたな活動を開始した国立長寿医療研究センター(National Center for
Geriatrics and Gerontology, NCGG)において、長寿医療の発展と普及を促進し、老化のメカニズムならびに老化関係疾患の病態解明と治療薬開発に関する新しい情報を発信することを目的に開催されている。毎年 NCGG が主催し、公益財団法人長寿科学振興財団（Japan Foundation for Aging and Health）が共催、多くの企業、団体のご後援を得て、センター内からの発表に加え、当該領域を代表する国
内外の著名な研究者ならびに医療関係者を招聘し、広く参加者を求め、定例開催を継続している。2022 年 12 月 3 日に開催した今回のシンポジウムで、開催は 17回を重ね、その評価も定着しつつあるが、今後ますます国際的にも関心の高まる
超高齢社会における健康長寿の延伸に向けたさらなる発展をめざすものである。

2. 第17回開催のねらい第 17 回国際シンポジウムでは、4 年前から国立長寿医療研究センターが総力を挙げて行ってきた「認知症予防のための多因子介入研究（J-MINT 研究）」が終了することを受け、認知症予防に関する世界の英知を結集して、その最新情報を国内外に広く発信することを目的として企画した（タイトル：Multifactorial
Interventions for Prevention of Dementia）。
認知症予防では、運動、食事、社会参画が基本であるが、その神経科学的バッ
クグランドを明らかにすることが重要である。そこでセッション 1 では、脳と身体との臓器連関のメカニズムについて 3 名の研究者に登壇して頂いた。セッション 2 では、認知症予防のための多因子介入研究が進捗している主要 3 か国
から、北欧の FINGER 研究、ドイツの AgeWell.de 研究、日本の J-MINT 研究・
J-MINT PRIME 研究の知見が報告された。セッション 3 では、認知症予防を研究にとどめるのではなく社会実装する試みについて、豪州、日本から 4 題の発表がなされた。全体で女性 5 名を含む 11 人の演者（海外からは 3 名）に発表をお願いした。また、ランチョンセミナーでは、アルツハイマー病のバイオマーカーについての講演を計画した。
COVID-19 の対策のため、第 17 回国際シンポジウムはハイブリッド開催とした。
第 16 回国際シンポジウムもハイブリッド形式の開催であったが、会場の参加者は1限られていた。今回は事前に関係学会などに周知することで、多くのオンサイトの参加者があり、face to face での情報交換が可能であった。オンラインでも過去最大の参加者があり、3 年ぶりに国際学会の雰囲気を再現することができた。
シンポジウム終了後の懇親会では、演者、座長をお勤めいただいた先生、実行委
員会のメンバーが集まり、和やかに食事を共にすることができた。海外からオンサイトで参加された Susanne Röhr 博士には翌日に京都を案内することもできた。
以上のように、第 17 回国際シンポジウムでは、世界の最先端の認知症・老年医学の研究者との交流が可能となり、国立長寿医療研究センターの研究・臨床活
動の活性化に貢献した。

3.

第17回国際シンポジウムの概要

今回のシンポジウムの開催に当たって、主催者である国立長寿医療研究セン
ターの荒井 秀典 理事長、共催者である公益財団法人長寿科学振興財団の大島伸一 理事長、第 17 回国際シンポジウム実行委員会 • 委員長である櫻井 孝 研究所長から、次の挨拶が寄せられた。

2

※国立長寿医療研究センター

荒井 秀典 理事長の挨拶

Welcome, everyone!
We are very pleased to welcome you all to the 17th International Symposium on Geriatrics
and Gerontology (ISGG) hosted by the National Center for Geriatrics and Gerontology(NCGG).
Since 2020 COVID-19 has strongly influenced our society around the globe. Due to the
COVID-19 pandemic, we could not have ISGG in 2020. Although we managed to holdthis symposium virtually in 2021, a face-to-face meeting would be ideal for moreinteractions. Therefore, we did our best to invite domestic and international speakers to
NCGG in person as much as we could this year.
The theme of the 17th symposium is “Multifactorial Interventions for Prevention of
Dementia”. As we all know, dementia is a huge public health issue in all aging societies
and will be a future problem in low to middle income countries. Thus, the effective
measures should be implemented to prevent dementia as early as possible. Our center has
been conducting a multidomain intervention trial for prevention of dementia, J-MINT
since 2019. We are now collaborating with international researchers working on
multidomain interventions for dementia. Therefore, it would be a great opportunity for us
to discuss dementia prevention in this symposium and to promote future research in thisarea.
We wish that we can make a great contribution to the world on dementia prevention
through our knowledge obtained from this symposium.

Hidenori Arai
President
National Center for Geriatrics and Gerontology

3※公益財団法人長寿科学振興財団

大島 伸一 理事長の挨拶

Dear Researchers,
I am delighted to welcome you and have the opportunity to speak at the 17th International
Symposium on Geriatrics and Gerontology.
Today, Japan is one of the leading countries of longevity, called super aging society, inthe world and to live a long life in good health physically and mentally, is one of the top
concerns of most people in our country.
Japanese government had settled a new strategy called “Framework for Promoting
Dementia Care”, ～focusing on inclusion and prevention, much like two wheels of acart, while putting emphasis on the perspectives of the patients and their families～
The theme of the 17th International Symposium is "Multifactorial Interventions forPrevention of Dementia", which is the issue we have to tackle together.
I hope your knowledge exchange and new ideas obtained through the discussion in the
symposium will greatly contribute to solving the issue.
The Japan Foundation for Aging and Health is very happy to support the International
Symposium for Geriatrics and Gerontology and thanks very much for allparticipants in the symposium. Now let us create a society that will enjoy longevity
together!

Yours sincerely,

Shinichi Ohshima
President
The Japan Foundation for Aging and Health4※第 17 回長寿医療研究センター国際シンポジウム
櫻井 孝 研究所長の挨拶

実行委員会・委員長

Greetings
On December 3, 2022, the 17th International Symposium on Geriatrics and Gerontology
will be held. The title of symposium is "Multifactorial Interventions for prevention of
Dementia.
Ten years ago, many people would have asked, "Is it even possible to prevent dementia?".
In recent years, however, many evidences have been reported from around the world thatexercise, diet, social activities, etc. can inhibit the decline of cognitive functions. The
FINGER study, in particular, has had a major impact on the world by demonstrating thata combination of these interventions (Multifactorial Interventions) can significantly
improve cognitive impairment. In Japan, a multifactorial intervention study that is
tailored to the lifestyle of Japanese people, mainly at the National Center for Geriatrics
and Gerontology will soon be completed.
Recently, there was also the wonderful news of the successful development of a diseasemodifying drug for Alzheimer's disease. It is expected that the prevention of dementia
through a combination of pharmacological and non-pharmacological therapies will bringeven greater preventive effects. Therefore, we have planned this symposium to bring
together the world's top researchers in multifactorial intervention for dementia prevention.
They will present their latest research results on large-scale intervention trials fordementia prevention, social implementation, and biological linkage between brain andmulti-organ functions.
We hope that this symposium will contribute to a deeper understanding of dementia andthe realization of new dementia countermeasures. Thank you very much for your kindattention.
Sincerely
Takashi Sakurai, MD, PhD
Director, Research InstituteNational Center for Geriatrics and Gerontology

5

写真 1：座長・講師・国際シンポジウム実行委員会の集合写真

写真 2：シンポジウムの開催風景

6

開催概要
催 事 名：第 17 回長寿医療研究センター国際シンポジウム
The 17th International Symposium on Geriatrics and Gerontology

テ ― マ：Multifactorial Interventions for Prevention of Dementia「認知症予防のための多因子介入」
開催日時：2022 年 12 月 3 日（土）10:00～18:00

開催場所：あいち健康の森プラザ １階プラザホール（愛知県知多郡東浦町大字森岡字源吾山 1 番地の 1）
主催：国立研究開発法人国立長寿医療研究センター

共催：公益財団法人長寿科学振興財団

ランチョンセミナー共催：エーザイ株式会社
後

援：一般社団法人日本老年医学会、公益社団法人日本老年精神医学会、
一般社団法人日本認知症学会、一般社団法人日本神経学会、日本神経科学学会、一般社団法人日本サルコペニア・フレイル学会、国立大学法人東海国立大学機構 名古屋大学、公立大学法人名古屋市立大学、
藤田医科大学病院、愛知医科大学、国立大学法人三重大学、国立大学
法人浜松医科大学、国立大学法人東海国立大学機構 岐阜大学、厚生
労働省、愛知県、名古屋市、大府市、東浦町、朝日新聞社、株式会社
中日新聞社、株式会社毎日新聞社 中部本社、読売新聞社、東海テレ
ビ放送株式会社、中京テレビ放送株式会社、株式会社ＣＢＣテレビ、
名古屋テレビ放送株式会社、テレビ愛知株式会社

使用言語：英語
講 演 者：国内 12 名（うち、内部 5 名）、海外 3 名※ランチョンセミナーも含む
参加人数：会場 66 名、ライブ配信によるオンライン視聴者 308 名（延人数）7プログラム
10:00～10:05 開会の辞
国立長寿医療研究センター 理事長 荒井 秀典

Session Ⅰ：Interaction between the brain and peripheral organs
座長：国立長寿医療研究センター 里 直 行
国立長寿医療研究センター 関谷 倫子
10:10～10:40 Exploring the Association Between Oral Health and Dementia
国立長寿医療研究センター 松下 健二
10:40～11:10

Sarcopenia and NAD-mediated functional connection between
hypothalamus and skeletal muscle
国立長寿医療研究センター 伊藤 尚基

11:10～11:40 Aged human neurons directly converted from urine-derived cells
慶應義塾大学医学部生理学教室 前田 純宏

ランチョンセミナー
座長：国立長寿医療研究センター 佐治 直樹
Digital biomarker と Biofluid biomarker が捉えるアルツハイマー病の Biological subtype
大阪大学大学院医学系研究科 武田 朱公

11:50～12:50

Session Ⅱ：World's Leading Multimodal Intervention Trial for Dementia
Prevention
座長：国立長寿医療研究センター
櫻 井 孝
神戸大学大学院保健学研究科 古和 久朋
13:00～13:45

The AgeWell.de Study: findings and implications from a pragmatic
multidomain trial against cognitive decline in Germany
ライプツィヒ大学（ドイツ） Susanne Röhr

13:45～14:15

The Japan-Multimodal Intervention Trial for Prevention of
Dementia (J-MINT): Study progress8国立長寿医療研究センター 杉本 大貴
14:15～14:55 Social Implementation of Dementia Prevention based on the JMINT PRIME Tamba Study
神戸大学大学院保健学研究科 古和 久朋
15:00～15:40

World-Wide FINGERS Updates: Toward a Personalized andGlobal Strategy for Dementia Prevention
カロリンスカ研究所（スウェーデン） Francesca Mangialasche※Web オンライン講演

Session Ⅲ：Prospects for social implementation of multifactorialinterventions for dementia prevention
座長：国立長寿医療研究センター
島田 裕之
国立がん研究センターがん対策研究所 内富 庸介
15:45～16:30 Population and individual approaches to dementia prevention
ニューサウスウェールズ大学（オーストラリア） Kaarin Anstey※Web オンライン講演
16:30～17:00

Scaling up evidence-based practices for disease prevention using
implementation science
国立がん研究センターがん対策研究所 島津 太一

17:00～17:30

Is a health promotion program using IoT technology effective forolder adults living in the community?
国立長寿医療研究センター 李 相 侖

17:30～17:55

Implementation and challenges of the latest technologies to support

activities of daily living
国立長寿医療研究センター 大高 恵莉
17:55～18:00 閉会の挨拶
国立長寿医療研究センター 櫻 井

9

孝

講演抄録

Exploring the Association Between Oral Health and Dementia
Kenji Matsushita
Department of Oral Disease Research,
National Center for Geriatrics and Gerontology
Summary
Although the establishment of measures against dementia is an urgent issue worldwide, theetiology of dementia, including Alzheimer's disease (AD), which is the most common form ofdementia, has not been fully elucidated and have effective therapies have not been established.
Elucidation of the risk factors for dementia and factors that inhibit its onset and progression as
well as implementation of measures to deal with these factors could be effective for preventing
dementia. The results of previous cohort studies have shown that the smaller number of retained
teeth is, the lower is the cognitive function and the higher is the risk of developing dementia. It isthought that a decrease in the number of teeth retained leads to a decrease in masticatory function.
A decrease in cerebral blood flow due to decreased masticatory function and deterioration ofnutritional status due to decreased masticatory function are thought to be the causes of the decline
in cognitive function. However, the causal relationship between those has not been fully
elucidated. On the other hand, we have recently shown that extraction of the first maxillary upper
molars in aged mice and AD model mice and long-term rearing of aged mice on a soft dietdecreased spontaneous activity, spatial working memory, and motor coordination and enhanced
cellular senescence in the hippocampus and hypothalamus. Recently, a number of
epidemiological and animal studies have shown that periodontal disease and the periodontopathic
bacterium Porphyromonas gingivalis (P.g) are associated with cognitive function and dementia.
In mouse models, P.g infection impairs cognitive function and promotes the deposition ofamyloid-β protein (Aβ) in the brain. Furthermore, inhibition of gingipain has been shown to
improve the pathogenesis of AD in mouse models. Clinical trials (Phase Ⅱ/Ⅲ) for the treatmentof AD with gingipain inhibitors are currently underway in Europe and the United States, and theirefficacy has been partially confirmed. Thus, the importance of oral care as a measure against
dementia is being reaffirmed. Periodontal disease, oral bacteria, oral function, anddementia/Alzheimer's disease are the keywords in this presentation, and their relationships will
be comprehensively explained. The importance of oral health for extending healthy life
expectancy will also be discussed.

10Education
Ph.D. in Kagoshima University Dental School, Kagoshima, Japan, 1993.
Professional Experiences
1993
Assistant Professor, Conservative Dentistry and Endodontology,
Kagoshima University Dental School, Kagoshima, Japan
1997
Instructor, Department of Conservative Dentistry and Endodontology,
Kagoshima University Dental School, Kagoshima, Japan
2002
Research fellow, Department of Cardiology, Johns Hopkins University
School of Medicine
2005-present Head, Department of Oral Disease Research, National Center for
Geriatrics and Gerontology
2007-present Visiting Professor, Tohoku University Graduate School of Dentistry2008-present Visiting Professor, Health Sciences University of Hokkaido School of Dentistry2009-present Visiting Professor, School of Dentistry, Aichi Gakuin University
2010-present Visiting Professor, Hokkaido University Graduate School of Dentistry
2011-present Visiting Professor, Kagoshima University Graduate School of Dentistry2012-present Visiting Professor, Kyusyu University Graduate School of Dentistry
2018-present Visiting Professor, Tokushima University Graduate School of Dentistry
Honors and Awards
1995 Young Investigator Award, The Japanese Society of Conservative Dentistry2003 Young Investigator Prize in Thrombosis, 4th Annual Conference on
Arteriosclerosis, Thrombosis and Vascular Biology
2004 Young Investigator Award, The 3rd International Conference on the Biology, Chemistry
and Therapeutic Applications of Nitric Oxide
2016 Basic Research Award, 100th Annual Meeting of American Academy of Periodontology
2016 Clinical Impact Award, 100th Annual Meeting of American Academy of Periodontology
Major Research Interest❏ Research on the relationship between periodontal disease and the whole body❏ Research on the aging of periodontal tissue❏ Studies on pathogenic factors of periodontal pathogens❏ Research on the decline of masticatory function and brain aging
Recent Publications (Selected)
1. Furukawa M, Tada H, Wang J, Yamada M, Kurosawa M, Satoh A, Ogiso N, Shikama Y,
Matsushita K. Molar loss induces hypothalamic and hippocampal astrogliosis in aged
11

2.

3.

4.

5.

6.

7.

mice. Sci Rep, 18;12(1):6409, 2022.
Furukawa M, Matsuda K, Aoki Y, Yamada M, Wang J, Watanabe M, Kurosawa M,
Shikama Y, Matsushita K. Analysis of senescence in gingival tissues and gingival
fibroblast cultures. Clin Exp Dent Res, 8(4):939-949, 2022.
Shikama Y, Kurosawa M, Furukawa M, Kudo Y, Ishimaru N, Matsushita K. The
Priming Potential of Interferon Lambda-1 for Antiviral Defense in the Oral Mucosa.
Inflammation, 45(3):1348-1361, 2022.
Song LT, Tada H, Nishioka T, Nemoto E, Imamura T, Potempa J, Li CY, Matsushita
K, Sugawara S. Porphyromonas gingivalis Gingipains-Mediated Degradation of
Plasminogen Activator Inhibitor-1 Leads to Delayed Wound Healing Responses in
Human Endothelial Cells. J Innate Immun, 14(4):306-319, 2021.
Kurosawa M, Shikama Y, Furukawa M, Arakaki R, Ishimaru N, Matsushita K:
Chemokines Up-Regulated in Epithelial Cells Control Senescence-Associated T
Cell Accumulation in Salivary Glands of Aged and Sjögren's Syndrome Model Mice.
Int J Mol Sci, 22(5):2302, 2021.
Furukawa M, Wang J, Kurosawa M, Ogiso N, Shikama Y, Kanekura T, Matsushita
K: Effect of green propolis extracts on experimental aged gingival irritation in vivo
and in vitro. J Oral Biosci, 63:58-65, 2021.
Furukawa M, Yamada K, Kurosawa M, Shikama Y, Wang J, Watanabe M, Kanekura

T, Matsushita K: High concentration of glucose induces filaggrin1 expression
through AP-1 in skin keratinocytes. J Dermatol Sci, 98(2):137-140, 2020.
8. Matsushita K, Yamada-Furukawa M, Kurosawa M, Shikama Y: Periodontal Disease
and Periodontal Disease-Related Bacteria Involved in the Pathogenesis of
Alzheimer's Disease. J Inflamm Res, 13:275-283, 2020.
9. Matsushita K: Analysis of Interaction Between Porphyromonas gingivalis andEndothelial Cells In Vitro. Methods Mol Biol, 2210:225-233, 2020.
10. Ishida N, Ishihara Y, Ishida K, Tada H, Funaki-Kato Y, Hagiwara M, Ferdous T,
Abdullah M, Mitan A, Michikawa M, Matsushita K: Periodontitis induced bybacterial infection exacerbates features of Alzheimer's disease in transgenic mice.
npj Aging and Mechanisms of Disease 3(15), 2017.
Contact Information
National Center for Geriatrics and Gerontology,
Institute, Department of Oral Disease Research,
Name: Kenji Matsushita, D.D.S., Ph.D.
Address: 7-430 Morioka-cho, Obu City, Aichi 474-8511, Japan
Phone: +81-562-46-2311(ext.5401)
12

Fax:
+81-562-46-8479
e-mail: kmatsu30@ncgg.go.jp

13Sarcopenia and NAD+-mediated functional connection between
hypothalamus and skeletal muscle
Naoki Ito
Brain-Skeletal Muscle Connection in Aging Project Team, Geroscience ResearchCenter, National Center for Geriatrics and Gerontology
Summary
In rapidly aging societies, sarcopenia is an urgent socio-economic problem. However, theunderlying molecular mechanism of sarcopenia remain unclear. In the past several years,
a number of studies have revealed that the progressive and systemic decreases innicotinamide adenine dinucleotide (NAD+) levels and dysfunctions of NAD+-consuming
enzymes are a driving force of age-associated pathophysiologies. In this study, we
revealed the novel functional connection between the lateral hypothalamus (LH) andskeletal muscle through Slc12α8, a nicotinamide mononucleotide (NMN) transporter(Grozio A et al., Nat Metab, 2019), and its relationship to sarcopenia. We found that
Slc12α8-expressing cells were mainly localized in the LH, compared with otherhypothalamic nuclei. The genetic knockdown of Slc12α8 specifically in the LH of young
mice caused decreases in activity-dependent energy expenditure. LH-specific Slc12α8knockdown mice also showed significant decreases in skeletal muscle functions including
muscle mass, muscle force, intramuscular glycolysis, and protein synthesis, indicating theimportant role of Slc12α8 in the LH for the regulation of whole-body metabolism andskeletal muscle functions. This regulation was mediated by the sympathetic nerve-β2adrenergic receptor axis in skeletal muscle. The expression of Slc12α8 in the LH
decreased over age. Furthermore, LH-specific Slc12α8-knockdown mice recapitulated
the skeletal muscle phenotypes in aged mice. Remarkably, overexpression of Slc12α8 in
the LH of aged mice ameliorated age-related decreases in energy expenditure and skeletal
muscle functions. Thus, our results highlight the novel role of Slc12α8 in the LH for the
regulation of whole-body metabolism and skeletal muscle functions and implicate its
importance in the pathogenesis of sarcopenia during aging (Ito N et al., Cell Reports,
2022).
Education
Department of Biological Information, Graduate School of Bioscience and Biotechnology,
Tokyo institute of Technology, 2013
Professional Experiences
2011-2013,
Research Fellowship for Young Scientists DC2, Japan Society for the
Promotion of Science (JSPS)
2013-2015,
Research fellow, Department of Molecular Therapy, National Instituteof Neuroscience, National Center of Neurology and Psychiatry
14

2015-2016,2016-2018,2018-2019,2019-2022,

Research fellowship for Young Scientists PD, Department ofRheumatology and Allergy, IMSUT Hospital, Institute of Medical
Science, University of Tokyo
Researcher, Pharmaceutical & Healthcare Research Laboratories,
Research & Development Management Headquarters, FUJIFILM
Corporation
Researcher, Laboratory of Molecular Life Science, Institute of
Biomedical Research and Innovation, Foundation for Biomedical
Research and Innovation
Senior Researcher, Laboratory of Molecular Life Science, Institute of

Biomedical Research and Innovation, Foundation for Biomedical
Research and Innovation
2022 April-2022 June, Researcher, Department of Integrative Physiology, Geroscience
Research Center, National Center for Geriatrics and Gerontology
2022 July-present Project reader, Brain-Skeletal Muscle Connection in Aging Project
Team, Geroscience Research Center, National Center for Geriatrics andGerontology
Honors and Awards
2012
2013
2013
2014
2014
2018
2018-2019
2020
2020
2021
2022

Young Investigator Awards, The 67th Japan Society of Physical Fitness andSports Medicine
Akaike Journal Awards, Tokyo Institute of Technology
Dimitris N. Chorafas Foundation Awards, Weizmann Institute of Science
Seiichi Tejima Doctoral Dissertation Awards, Tokyo Institute ofTechnology
The Best Article Awards, National Center of Neurology and Psychiatry
The Best Article Awards, FUJIFILM Corporation
Associated editor of Journal of Alzheimer’s Diseases
Outstanding Reviewer Awards, Nutrients
Young Investigator's Awards, The 6th Annual Meeting of Japan Muscle
Society
The Best Presentation Awards, The 8th Annual Meeting of Japanese
Association on Sarcopenia and Frailty
Presentation Awards, The 9th Annual Meeting of Japanese Association on
Sarcopenia and Frailty

Major research Interest❏ Molecular mechanisms of sarcopenia and physical frailty
15❏ Interaction between hypothalamus and skeletal muscle❏ NAD+ metabolism in hypothalamus and skeletal muscle
Recent Publications (Selected)
1. Naoki Ito et al., Slc12a8 in the lateral hypothalamus maintains energy metabolisms
and skeletal muscle functions during aging. Cell Reports. 2022.
2. Naoki Ito et al., Effects of Composite Supplement Containing Collagen Peptide andOrnithine on Skin Conditions and Plasma IGF-1 Levels—A Randomized, DoubleBlind, Placebo-Controlled Trial. Marine Drugs. 2018.
3. Naoki Ito et al., ATP-induced increase in intracellular calcium levels and subsequent

4.

5.

6.

7.
8.

9.

activation of mTOR as regulators of skeletal muscle hypertrophy. International Journalof Molecular Sciences. 2018.
Naoki Ito et al., The Protective Role of Astaxanthin for UV-Induced Skin
Deterioration in Healthy People—A Randomized, Double-Blind, PlaceboControlled Trial. Nutrients. 2018.
Naoki Ito et al., Effects of composite supplement containing astaxanthin andsesamin on cognitive function in people with mild cognitive impairment: A
randomized, double-blind, placebo-controlled trial. Journal of Alzheimer’s
Diseases. 2018.
Naoki Ito et al., Direct reprogramming of fibroblasts into skeletal muscle progenitor
cells by transcription factors enriched in undifferentiated subpopulation of satellite
cells. Scientific reports. 2017.
Naoki Ito et al., Enhancement of satellite cell transplantation efficiency by leukemia
inhibitory factor. Journal of Neuromuscular Diseases. 2016.
Naoki Ito et al., Capsaicin mimics mechanical load-induced intracellular signaling events:
Involvement of TRPV1-mediated calcium signaling in induction of skeletal muscle
hypertrophy. Channels. 2013.
Naoki Ito et al., Activation of calcium signaling through Trpv1 by nNOS andperoxynitrite as a key trigger of skeletal muscle hypertrophy. Nature Medicine.
2013.

Contact Information
Brain-Skeletal Muscle Connection in Aging Project Team,
Geroscience Research Center,
National Center for Geriatrics and Gerontology
Name: Naoki Ito
Address: 7-430, Morioka-cho, Obu-shi, Aichi 474-8511, Japan
16

Phone: +81-562-44-5651 ext. 7594
e-mail: naoki.ito@ncgg.go.jp

17Aged human neurons directly converted from urine-derived cells

Sumihiro Maeda
Keio University School of Medicine, Department of Physiology
Summary
The intervention of induced pluripotent stem cells (iPSCs) enabled us to modelneurodegenerative diseases using human cells. However, the aging signatures arecanceled in iPSCs, which is a limitation to study aging-dependent diseases like
Alzheimer’s disease (AD) using iPSCs. To circumvent the aging cancellation, conversion
methods of somatic cells directly to neurons were developed mainly for fibroblasts.
However, the collection of fibroblasts is invasive, making it difficult to obtain the donor’s
consent. Thus, we aimed to develop a novel method to convert other somatic cells, urinederived cells (UDCs), to aged neurons not via iPSCs because UDCs can be extracted fromhuman urine samples multiple times in non-invasive ways. After several modifications of
the direct conversion method for fibroblasts, we succeeded to induce neuron-like cells
from UDCs (UDC-iNs). Neuronal markers including microtubule-associated protein tau
were expressed in the UDC-iNs, and the frequency of Ca oscillation of the cells wascomparable level with neurons and much faster than the original UDCs. In addition,transcriptome analysis revealed neuronal profiles of the UDC-iNs. Using this newly
established conversion method, we succeeded to establish UDC-iNs from donors ofvarious ages, 2 to 89 years old. DNA methylation analysis of the UDCs from those donors
illustrated the donor’s age-dependent methylation and the preservation of methylation
status even after the conversion to UDC-iNs. To examine if UDC-iN can reflect diseasephenotypes of neurodegenerative diseases, we obtained UDCs from Niemann-Pick typeC (NPC), a familial neurodegenerative disease with lysosomal dysfunction. The UDC
from NPC proliferated well, but the UDC-iN showed a drastic reduction in the survival
rate with lysosomal dysfunction. In UDC-iNs, we also examined the effect of tau
expression, which is a key protein in several neurodegenerative diseases including AD.
We found that the survival rate of UDC-iNs was increased by tau reduction, indicatingthat tau expression was detrimental to UDC-iNs. These data implied the potential of
UDC-iNs as a disease modeling platform. The accumulation of disease modeling andphenotyping of various donors will enable us to draw a standard curve of neuronal aging
and may enable us to predict one’s onset of neurodegenerative diseases.
18

Education
Tokyo Institute of Technology, Japan
1997-2001 (undergrad), 2001-2003 (Master course), 2003-2006 (Doctor course)• Graduate research with Akihiko Takashima (RIKEN) and Atsushi Ikai (Tokyo
Institute of Technology), Apr 2001–Mar 2006
Professional Experiences
Keio University School of Medicine, Tokyo, Japan• Assistant Professor with Hideyuki Okano, Oct 2018–Present• Instructor with Hideyuki Okano, Dec 2016–Sep 2018
The J. David Gladstone Institute of Neurological Disease; University of California,
San Francisco, CA, USA• Research Scientist with Lennart Mucke, Jan 2014–Nov 2016
• The post-doctoral fellow with Lennart Mucke, Sep 2008–Dec 2013
Brain Science Institute, RIKEN, Saitama, Japan• The post-doctoral fellow with Akihiko Takashima, Apr 2006–Aug 2008
Brain Science Institute, RIKEN, Saitama, Japan and Tokyo Institute of Technology,
Kanagawa, Japan• Graduate research with Akihiko Takashima (RIKEN) and Atsushi Ikai (Tokyo
Institute of Technology), Apr 2001–Mar 2006
• Teaching assistant in Tokyo Institute of Technology, Apr 2003– March 2004
Honors and Awards• Career advancement award at the Gladstone Institute (2014)• Poster presentation award (1st) at 2013 the Gladstone Retreat• Poster presentation award (3rd) at 2012 the Gladstone Retreat• Scientific leadership award 2011-2012 the Gladstone Institute of Neurologicaldiseases• Excellent paper award in Neuroscience research at 2006
Major Research Interest❏ Aggregation-dependent pathogenesis by Tau protein❏ Aggregation-independent pathogenesis by Tau protein❏ Direct conversion of human somatic cells to neuronal cells
Recent Publications (Selected)
1. Supakul, S, Maeda, S#, and Okano, H#. Stem Cell Res. 2022, 62. ＃Corresponding
19

2.
3.
4.

5.
6.

*

Supakul, S, Okano, H, and Maeda, S#. Front. Aging Neurosci. (2021)#Corresponding
Maeda S and Takashima A. Tau oligomer. Tau Biology. Advances inExperimental Medicine and Biology. 2019.
*
Das D, *Maeda S, Hu B, Yu G, Guo W, Lopez I, Yu X, and Mucke L. Neuronallevels and sequence of tau modulate the power of brain rhythms. Neurobiology of
Disease. 2018 June. *Co-first author, equally contributed.
Maeda S*, Y Sato, A Takashima, FTDP-17 mutations enhance tau oligomer
formation. Neurobiology of aging. 2018 May. *Corresponding author.
Maeda S, Djukic B, Taneja P, Yu GQ, Lo I, Davis A, Craft R, Guo W, Wang X, Kim D,

Ponnusamy R, Gill TM, Masliah E, Mucke L. Expression of A152T human tau causes agedependent neuronal dysfunction and loss in transgenic mice. EMBO Rep. 2016
Apr;17(4):530-5.
7. Morris M, Knudsen GM, Maeda S, Trinidad JC, Ioanoviciu A, Burlingame AL,
Mucke L. Tau post-translational modifications in wild-type and human amyloid
precursor protein transgenic mice. Nat Neurosci. 2015 Aug;18(8):1183-9.
8. Morris M, Maeda S, Vossel K, Mucke L. The many faces of tau. Neuron. 2011
May 12: 70 (3): 410-26. Review.
9. Maeda S, Sahara N, Saito Y, Murayama M, Yoshiike Y, Kim H, Miyasaka T,
Murayama S, Ikai A, Takashima A. Granular tau oligomers as intermediates oftau filaments. Biochemistry. 2007 Mar 27; 46 (12): 3856-61.
10. Maeda S, Sahara N, Saito Y, Murayama S, Ikai A, Takashima A. Increased levels of
granular tau oligomers: an early sign of brain aging and Alzheimer's disease. Neurosci Res.
2006 Mar; 54 (3):197-201.
Contact Information
Keio University School of Medicine Department of Physiology
Name: Sumihiro Maeda
Address: 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan, 160-8582
Phone: +81-(0)3-5363-3747
Fax:+81-(0)3-3357-5445
e-mail: sumihiro.maeda@keio.jp20

The AgeWell.de Study: findings and implications from a
pragmatic multidomain trial against cognitive decline in Germany
Associate Professor Susanne Röhr
School of Psychology, Massey University, Palmerston North, New Zealand; Global Brain
Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland; Institute of Social Medicine,
Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig,
Leipzig, Germany
Summary
The potential for dementia risk reduction and prevention is deemed substantial if
modifiable risk factor were addressed. First multidomain interventions thatsimultaneously address several such modifiable risk factors aiming at reducing risk ofcognitive decline and dementia have yielded mixed but promising evidence. In Germany,
AgeWell.de is the first large-scale pragmatic randomized controlled trial investigating theeffectiveness of a multi-component lifestyle intervention against cognitive decline.
Drawing and extending on the successful Finish Geriatric Intervention Study to Prevent
Cognitive Impairment and Disability (FINGER) model, which demonstrated a benefit forcognitive functioning, the AgeWell.de intervention included individualized nutritionalcounselling, physical activity enhancement, cognitive training, monitoring of vascularrisk factors, optimization of medication, social activity enhancement, and, if necessary,interventions targeting depression, bereavement, and grief. Over 1000 older primary carepatients at increased dementia risk underwent the intervention or received general healthadvice/treatment as usual for two years. The lecture will present first findings and discuss
implications for the field of multidomain interventions considering global developments.
Overall, despite the impact of the COVID-19 pandemic on trials conduction, causing
interruptions and delays, the research landscape on multidomain interventions is growing
rapidly with studies underway in more than 40 countries. Lessons learned from
AgeWell.de with regards to study conduction and challenges during COVID-19 will beshared and contrasted against this landscape. Moreover, multidomain interventions will
be framed as part of larger public health strategies for dementia risk reduction anddementia from a social-ecological perspective. Conclusions for future directions will bedrawn that may inform optimizing invention protocols for increased impact.

21

Education
2021
Venia Legendi, Epidemiology & Public Health, University of Leipzig, GER
2017
Cert, Higher Education Didactics, University of Leipzig, GER
2017
PhD, Social Medicine & Public Health, University of Leipzig, GER
2014
MSc, (Clinical) Psychology, Chemnitz Technological University, GER
2012
BSc, Psychology, University of Leipzig, GER
Professional Experiences
2022
Associate Professor, School of Psychology, Massey University
2021
Senior Research Scientist, Institute of Social Medicine, Occupational Healthand Public Health (ISAP), Medical Faculty, University of Leipzig, Germany
2020
Global Atlantic Fellow for Equity in Brain Health, Global Brain Health Institute(GBHI), Trinity College Dublin, Ireland; Atlantic Institute, Oxford, UK
2018-20 Head of Research Group, Epidemiology & Population Brain Health, Universityof Leipzig, Germany
2018
Visiting Postdoctoral Research Fellow, Centre for Healthy Brain Ageing(CHeBA), UNSW Sydney, Australia
2017-18 Postdoctoral Research Fellow, Leipzig Research Center for Civilization
Diseases (LIFE), University of Leipzig, Germany
2015-18 Research Fellow, Doctoral Student, ISAP, Medical Faculty, University ofLeipzig, Germany
2014-15 Research Assistant, ISAP, Medical Faculty, University of Leipzig
2011-13 Student Research Assistant, Polyclinic for Psychosomatic Medicine andPsychotherapy, University Hospital Leipzig, Germany
Honors and Awards
2021
Outstanding Early Career Researcher (ECR) Award, German Association for
Psychiatry, Psychotherapy and Psychosomatics, Berlin, GER
2021
2020
2018
2017
2017
2015
2015

Best Presentation Award, Alzheimer’s Association, Athens, GR (virtual)
Outstanding ECR-Keynote, EU Psychiatric Association, Cambridge, UK
Best Dissertation Prize, Medical Faculty, University of Leipzig, GER
Paper of the Month, International Psychogeriatrics
Poster Award, Intl. Federation of Psychiatric Epidemiology, Melbourne, AUS
Poster Award, Intl. Federation of Psychiatric Epidemiology, Bergen, NO
Best Master Thesis Prize, German Society of Social Medicine & Prevention

Major Research Interest
My professional speciality is epidemiological and public health research on healthy brain
22

ageing, specifically dementia risk reduction and prevention. A key focus is on populationbased cohort studies to identify modifiable health and lifestyle risk factors for cognitive
decline and dementia and their individual and combined contribution to brain health in
old age as well as interventional studies to promote brain health. I am interested in thesocial and environmental determinants of brain health, i.e., which and how contextual
factors (e.g., education, income, social, natural, and built environment, climate) determine
modifiable health and lifestyle for age-related brain health. The overarching aim is toinform equitable public health policy towards creating equitable environments for healthy
ageing as well as developing and evaluating multidomain interventions for individual
brain health promotion and risk reduction of cognitive decline and dementia.
Recent Publications (Selected)
1. Pazan, F., Breunig, H., Weiss, C., Röhr, S., Luppa, M., Pentzek, M., ... Wehling, M.(2022).
Higher FORTA(Fit fOR The Aged)scores are associated with poor functional
outcomes,dementia,and mortality in older people. Eur J Clin Pharmacol, 78(11), 1851-1859.
doi:10.1007/s00228-022-03389-w
2. Samtani, S., Mahalingam, G., Lam, B. C. P., Lipnicki, D. M., Lima-Costa, M. F., Blay, S.
L., ...SHARED consortium for the Cohort Studies of Memory in an International
Consortium (COSMIC). (2022). Associations between social connections and cognition: aglobal collaborative individual participant data meta-analysis. Lancet Healthy Longev.
doi:10.1016/S2666-7568(22)00199-4
3. Röhr, S., Pabst, A. ,Baber, R., Engel, C., Glaesmer, H., Hinz, A., ...Riedel-Heller, S.
G.(2022). Socioeconomic Inequalities in Cognitive Functioning Only to a Small
Extent Attributable to Modifiable Health and Lifestyle Factors in Individuals
Without Dementia. J Alzheimers Dis. doi:10.3233/JAD-220474
4. Kleineidam, L., Wagner, M., Guski, J., Wolfsgruber, S., Miebach, L., Bickel, H., ...
Heser, K.(2022). Disentangling the relationship of subjective cognitive decline anddepressive symptoms in the development of cognitive decline and dementia.
Alzheimers Dement. doi:10.1002/alz.12785
5. Röhr, S., Wittmann, F., Engel, C., Enzenbach, C., Witte, A.V., Villringer, A., ...
Riedel-Heller,S.G.(2022). Social factors and the prevalence of social isolation in a
population-based adult cohort. Soc Psychiatry Psychiatr Epidemiol, 57(10), 19591968. doi:10.1007/s00127-021-02174-x
6. Gühne, U., Jung, F., Röhr, S., Pabst, A., Grochtdreis, T., Dams, J., ... Riedel-Heller,
S. G. (2022). [Occupational Participation of Syrian Refugees with PosttraumaticStress in Germany]. Psychiatr Prax, 49(7), 352-358. doi:10.1055/a-1503-4685
7. Gerhards, S. K., Pabst, A., Röhr, S., Luppa, M., & Riedel-Heller, S. G. (2022).
Coping with stress during the COVID-19 pandemic in the oldest-old population. Eur
23

J Ageing, 1-10. doi:10.1007/s10433-022-00719-w
8. Röhr, S., Pabst, A., Baber, R., Engel, C., Glaesmer, H., Hinz, A.,... Riedel-Heller, S.
G. (2022). Social determinants and lifestyle factors for brain health: implications forrisk reduction of cognitive decline and dementia. Sci Rep, 12(1), 12965.
doi:10.1038/s41598-022-16771-6
9. Röhr, S., Kivipelto, M., Mangialasche, F., Ngandu, T., & Riedel-Heller, S. G. (2022).
Multidomain interventions for risk reduction and prevention of cognitive decline anddementia: current developments. Curr Opin Psychiatry, 35(4), 285-292.
doi:10.1097/YCO.0000000000000792
10. Grothe, J., Röhr, S., Luppa, M., Pabst, A., Kleineidam, L., Heser, K., ... Riedel-Heller,
S. G. (2022). Social Isolation and Incident Dementia in the Oldest-Old-A Competing
Risk Analysis. Front Psychiatry, 13, 834438. doi:10.3389/fpsyt.2022.834438
Contact Information
Massey University
School of Psychology
Health and Ageing Research Team
Name: Dr. Susanne Röhr
Address: Private Bag 11-2222, 4442 Palmerston North, Aotearoa New ZealandPhone: +64 28 8517 5958
E-mail: s.roehr@massey.ac.nz

24

The Japan-Multimodal Intervention Trial for Prevention of
Dementia (J-MINT): Study progress
Taiki Sugimoto
Department of Prevention and Care Science, Research Institute, National Center for
Geriatrics and Gerontology
Summary
Dementia and cognitive decline are key challenges for healthy longevity in aging societies,
because dementia is one of the main causes of disability among older adults and greatly affects
the society, owing to the rising costs of health and social care services. Given the high failure
rate of drug development in Alzheimer’s disease, especially for disease-modifying therapies,
developing successful nonpharmacological strategies to prevent dementia is an urgent priority.
To date, several large multidomain prevention trials, including the FINGER study, haveshown that interventions targeting multiple modifiable risk factors for dementia simultaneously
in older adults, especially in those at increased risk of dementia, could slow cognitive decline
and reduce incident dementia. In addition, the World-Wide FINGERS Network, which is theglobal network of multimodal intervention trials testing and optimizing the FINGER model invarious populations and settings, was launched in 2017. In Japan, the Japan-MultimodalIntervention Trial for Prevention of Dementia (J-MINT) was started in 2019 as a multicenter
clinical trial at five sites across Japan, led by the National Center for Geriatrics and Gerontology.
The J-MINT trial aimed to verify whether an 18-month multidomain intervention, which
consists of the management of vascular risk factors, group-based physical exercise and selfmonitoring of physical activity, nutritional counseling, and cognitive training, could prevent the
progression of cognitive decline among older adults with mild cognitive impairment. In
addition, J-MINT trial aimed to clarify the mechanism of cognitive improvement anddeterioration by using the assessment of blood-based biomarkers, omics analysis, andneuroimaging. Further, the J-MINT trial collaborates with partnering private enterprises in theimplementation of relevant interventional measures for future social implementation.
While COVID-19 pandemic has been affecting J-MINT trial in recruitment andintervention, we successfully recruited 531 older adults in this trial. In area under the declarationof state emergency, J-MINT trial provided on-line group-based physical exercise intervention
programs, which could maintain participant’s adherence and promote physical activity andsocial contacts even in COVID-19 pandemic. The J-MINT trial completed intervention andfinal evaluation in November 2022. The results of the J-MINT trial will not only demonstrate25

efficacy of multidomain interventions for older people at high risk for dementia, but will also
serve as a starting point for social implementation for dementia prevention.
Education
2014

Japanese License of Physical Therapist (No. 127106)

2014–2016

MS. Kobe University Graduate School of Health Sciences, Kobe, Japan

2016–2019

Ph.D. Kobe University Graduate School of Health Sciences, Kobe, Japan

Positions and Employment
2015–2017

Research fellow, Center for Comprehensive Care and Research on Memory
Disorder, National Center for Geriatrics and Gerontology

2017–2019

Research fellowship for Young Scientists (DC2), Japan Society for the
Promotion of Science

2019–present

Research fellow, Center for Comprehensive Care and Research on
Memory Disorder, National Center for Geriatrics and Gerontology

2021–present

Research fellow, Department of Prevention and Care Science, Research Institute,
National Center for Geriatrics and Gerontology

Honors and Awards
2015–2020
2018

The Urakami Award 2015–2020 (5th–10th Meeting of Japan Society for
Dementia Prevention) 2018 KCDS young best award(Kansai Chubu Dementia Seminar)

Major Research Interest❏ Multidomain intervention for prevention of dementia in older adults at high risk ofdeveloping dementia.
❏ Association between diabetes and dementia.
❏ Clinical significance of frailty and sarcopenia in older adults with cognitive impairment.
Recent Publications (Selected)
1. Sugimoto T, Tokuda H, Miura H, Kawashima S, Ando T, Kuroda Y, Matsumoto N,
Fujita K, Uchida K, Kishino Y, Sakurai T. Cross-sectional association of metrics
derived from continuous glucose monitoring with cognitive performance in older
adults with type 2 diabetes. Diabetes Obes Metab. 2022. doi: 10.1111/dom.14866.
Epub ahead of print.
2. Sugimoto T, Noma H, Kuroda Y, Matsumoto N, Uchida K, Kishino Y, Saji N, Niida S,
Sakurai T. Time trends (2012-2020) in glycated hemoglobin and adherence to the26glycemic targets recommended for elderly patients by the Japan Diabetes Society/Japan
Geriatrics Society Joint Committee among memory clinic patients with diabetes mellitus.
J Diabetes Investig. 2022. doi: 10.1111/jdi.13897. Epub ahead of print.
3. Sugimoto T, Kuroda Y, Matsumoto N, Uchida K, Kishino Y, Saji N, Niida S, Sakurai T.
Cross-Sectional Associations of Sarcopenia and Its Components with Neuropsychological
Performance among Memory Clinic Patients with Mild Cognitive Impairment andAlzheimer's Disease. J Frailty Aging. 2022;11(2):182-189.
4. Sugimoto T, Arai H, Sakurai T. An update on cognitive frailty: Its definition, impact,associated factors and underlying mechanisms, and interventions. Geriatr Gerontol
Int. 2022 ;22(2):99-109.
5. Sugimoto T, Araki A, Fujita H, Honda K, Inagaki N, Ishida T, Kato J, Kishi M,
Kobayashi K, Kouyama K, Noma H, Ohishi M, Satoh-Asahara N, Shimada H, Sugimoto
K, Suzuki S, Takeya Y, Tamura Y, Tokuda H, Umegaki H, Watada H, Yamada Y,
Sakurai T. The Multi-Domain Intervention Trial in Older Adults With Diabetes Mellitus
for Prevention of Dementia in Japan: Study Protocol for a Multi-Center, Randomized,
18-Month Controlled Trial. Front. Aging Neurosci. 2021. 13:680341.
6. Sugimoto T, Sakurai T, Akatsu H, Doi T, Fujiwara Y, Hirakawa A, Kinoshita F,
Kuzuya M, Lee S, Matsuo K, Michikawa M, Ogawa S, Otsuka R, Sato K, ShimadaH, Suzuki H, Suzuki H, Takechi H, Takeda S, Umegaki H, Wakayama S, Arai H, JMINT investigators. The Japan-Multimodal Intervention Trial for Prevention of
Dementia (J-MINT): The Study Protocol for an 18-Month, Multicenter, Randomized,
Controlled Trial. J Prev Alzheimers Dis. 2021. doi: 10.14283/jpad.2021.29.
7. Sugimoto T, Ono R, Kimura A, Saji N, Niida S, Sakai T, Rakugi H, Toba K, Sakurai
T. Impact of Cognitive Frailty on Activities of Daily Living, Cognitive Function, andConversion to Dementia Among Memory Clinic Patients with Mild Cognitive
Impairment. J Alzheimers Dis. 2020;76(3):895-903.
8. Sugimoto T, Ono R, Kimura A, Saji N, Niida S, Toba K, Sakurai T. Impact ofGlycemic Control on Daily Living Activities Over 1-Year Follow-up in Memory
Clinic Patients With Diabetes. J Am Med Dir Assoc. 2019; 20:792-794.
9. Sugimoto T, Ono R, Kimura A, Saji N, Niida S, Toba K, Sakurai T. Cross-Sectional
Association Between Cognitive Frailty and White Matter Hyperintensity Among
Memory Clinic Patients. J Alzheimers Dis. 2019; 72:605-612.
10. Sugimoto T, Sakurai T, Ono R, Kimura A, Saji N, Niida S, Toba K, Chen LK, Arai
H. Epidemiological and clinical significance of cognitive frailty: A mini review.
Ageing Res Rev. 2018;44:1-7.
Contact Information
National Center for Geriatrics and Gerontology
27

Department of Prevention and Care Science
Name: Taiki Sugimoto
Address: 7-430 Morioka-cho, Obu, Aichi 474-8511, Japan.
Phone: +81-562-46-2311 (7779)
e-mail: taiki-s@ncgg.go.jp

28

Social Implementation of Dementia Prevention based on the JMINT PRIME Tamba Study
Hisaomo Kowa, M.D.
Kobe University Graduate School of Health Sciences
Summary
Kobe University had the opportunity to participate in the J-MINT PRIME study,
a randomized controlled study of multifocal interventions aimed at dementia
prevention in the citizens of Tamba, Japan. 200 elderly subjects with hypertension or
impaired glucose tolerance who scored 22 to 30 on the DASC-21 questionnaire wererecruited. A 78-week intervention began in October 2020 for 100 randomly assigned
participants in the intervention group. The intervention was almost similar to that in
the J-MINT study, and consisted mainly of a weekly 90-minute intervention class.
Aerobic exercise, dual-task exercise (called “cognicise”), and communication time
were included. Other interventions included home-based brain training using
software, nutrition and lifestyle guidance. Participants in these intervention groups
gave positive feedback, saying that they found the sessions very beneficial and would
like to continue them in the future. The effectiveness of the intervention on cognitive
function is still being verified, and an evaluation using Cogstate's digital evaluation
tool (named Nou-know for the Japanese version) confirmed significant improvement
and maintenance in processing speed and executive function in the intervention group.
In addition to conducting research for establishing evidences for dementia
prevention in Tamba city, Kobe University has also begun to realize social
implementation of dementia prevention. The program is called "CogniCare", which
consists of weekly exercise classes, bi-monthly lectures on dementia prevention andhealth promotion, and an annual health assessment including cognitive function. The
program began in October 2019 at a site in the Kobe area, but had to be interrupted
with the beginning of COVID-19 pandemic in the spring of 2020, and an online
intervention and assessment program called "eCogniCare" began in October 2020.
From October 2021, the service has been integrated with the online service of Moff,
which has the technology to evaluate body movements using wearable sensors, andhas been offered as "eCogniCare powered by Moff".
The issues to be addressed in the social implementation of dementia prevention
through these research and business activities include: securing and training
instructors to support the intervention classes; improving the efficiency of evaluation29

indices and their implementation so that participants can feel the effects of theintervention; cost sharing to ensure continuity; and the selection of high-risk groups
for whom the intervention is expected to have the greatest impact and the means toencourage their participation. Together with the other symposiasts, I would like todiscuss solutions to these issues and seek ways to resolve them.
Education
Faculty of Medicine, University of Tokyo, Japan. 1995
Graduate School of Medicine, University of Tokyo, Japan. (2000-)2004
Professional Experiences
1995-1997
Resident in Internal Medicine, Department of Internal Medicine,
University of Tokyo hospital, Japan.
1997-2000
Senior resident in Neurology, Department of Neurology, University ofTokyo hospital, Japan.
2004-2005
Project Researcher, Center of Excellence for Integrated Brain Medical
Science, Department of Neurology, Graduate School of Medicine,
University of Toyko, Japan
2005-2008
Post-doctoral Fellow, Department of Neurology, Alzheimer Research
Unit, Massachusetts General Hospital
2008-2010
Assistant Professor – Department of Molecular Neuroscience on
Neurodegeneration, University of Tokyo
2010-2011
Lecturer, Department of Neurology, Kobe University Hospital
2012-2016
Associate Professor, Division of Neurology, Kobe University Graduate
School of Medicine
2017-present
Professor, Division of Rehabilitation Science, Kobe University
Graduate School of Health Sciences
2021-present
Director, Dementia Preventing Center
Honors and Awards
2003
2005-2007
2020-present
2022

Awarded Travel Grant from University of Tokyo, Japan
Awarded Research Fellowship from Sankyo Foundation of Life Science.
Associate Editor of the Neurology and Clinical Neuroscience
Presidential Award of Kobe University (as the Director of Dementia
Preventing Center)

Major Research Interest❏ Development of tools to enable screening of elderly people at high risk of dementia
in the community❏ Development of a social system that enables screening of cognitive function in the30

community❏ Prevention of dementia by non-drug intervention for high-risk elderly❏ Employment support for young people with dementia❏ Activities to deepen understanding of dementia
Recent Publications (Selected)
1. Kowa H, Uchimura M, Ohashi A, Hiroe M, Ono R. Self Assessment Memory Scale(SAMS), a new simple method for evaluating memory function. Front. Aging
Neurosci., 22 November 2022 Sec. Neurocognitive Aging and Behavior.
https://doi.org/10.3389/fnagi.2022.1024497
2. Sekiya H, Tsuji A, Hashimoto Y, Takata M, Koga S, Nishida K, Futamura N, Kawamoto
M, Kohara N, Dickson DW, Kowa H, Toda T. Discrepancy between distribution ofalpha-synuclein oligomers and Lewy-related pathology in Parkinson's disease. Acta
Neuropathol Commun. 2022 Sep 6;10(1):133. doi: 10.1186/s40478-022-01440-6.
3. Kumagai R, Osaki T, Oki Y, Murata S, Uchida K, Encho H, Ono R, Kowa H. The
Japan-Multimodal Intervention Trial for Prevention of Dementia PRIME Tamba (JMINT PRIME Tamba): Study protocol of a randomised controlled multi-domainintervention trial. Arch Gerontol Geriatr. 2023 Jan;104:104803. doi:
10.1016/j.archger.2022.104803.
4. Yoshino H, Kowa H, Maeda K, Takechi H. Eight months observation of check-up
system 'Kobe dementia model' of dementia in Kobe City. Psychogeriatrics. 2021
Mar;21(2):246-248. doi: 10.1111/psyg.12649.
5. Murata S, Ono R, Yasuda H, Tanemura R, Kido Y, Kowa H. Effect of a Combined
Exercise and Cognitive Activity Intervention on Cognitive Function in Communitydwelling Older Adults: A Pilot Randomized Controlled Trial. Phys Ther Res. 2021
Feb 24;24(2):112-119. doi: 10.1298/ptr.E10057.
6. Seki T, Kanagawa M, Kobayashi K, Kowa H, Yahata N, Maruyama K, Iwata N, Inoue
H, Toda T. Galectin 3-binding protein suppresses amyloid-β production by modulating
β-cleavage of amyloid precursor protein. J Biol Chem. 2020 Mar 13;295(11):3678-3691.
doi: 10.1074/jbc.RA119.008703.
7. Nagai Y, Kojima S, Kowa H, Yamamoto Y, Kajita H, Osaki T, Kakei Y, Kothari KU,
Kayano R. Kobe project for the exploration of newer strategies to reduce the social
burden of dementia: a study protocol of cohort and intervention studies. BMJ Open.
2021 Jun 18;11(6):e050948. doi: 10.1136/bmjopen-2021-050948.
8. Akatani R, Chihara N, Tachibana H, Koto S, Kowa H, Kanda F, Matsumoto R, Toda T.
Validation of the Guy's Neurological Disability Scale as a screening tool for cognitive
impairment in multiple sclerosis. Mult Scler Relat Disord. 2019 Oct;35:272-275. doi:
10.1016/j.msard.2019.08.012.
9. Fujio H, Inokuchi G, Kuroki S, Tatehara S, Katsunuma S, Kowa H, Nibu KI. Threeyear prospective study on olfaction of patients with Parkinson's disease. Auris Nasus
Larynx. 2020 Oct;47(5):899-904. doi: 10.1016/j.anl.2019.08.008.
31

10. Sekiya H, Kowa H, Koga H, Takata M, Satake W, Futamura N, Funakawa I, Jinnai
K, Takahashi M, Kondo T, Ueno Y, Kanagawa M, Kobayashi K, Toda T. Wide
distribution of alpha-synuclein oligomers in multiple system atrophy brain detectedby proximity ligation. Acta Neuropathol. 2019 Mar;137(3):455-466. doi:
10.1007/s00401-019-01961-w.
Contact Information
Kobe University Graduate School of Health Sciences
Department of Rehabilitation Science
Division of Cognitive and Psychiatric Rehabilitation
Name: Hisatomo Kowa
Address: 7-10-2, Tomogaoka, Suma-ku, Kobe, Hyogo, Japan
Phone: +81-78-796-4502
Fax:+81-78-796-4509
e-mail:kowa@med.kobe-u.ac.jp32

World-Wide FINGERS Updates: Toward a Personalized andGlobal Strategy for Dementia Prevention
Author Francesca Mangialasche, MD, PhD, Assistant Professor, Executive Director of the
Global Scientific Coordinating Center of World-Wide FINGERS
Affiliations: Karolinska Institutet, Department of Clinical Geriatrics, Center for
Alzheimer Research and Theme Inflammation and Aging, Karolinska University
Hospital, and FINGERS Brain Health Institute, Stockholm, Sweden.
Summary
Prevention of cognitive decline and dementia has been highlighted as pivotal to curb theworldwide growing number of cases of Alzheimer´s disease (AD) and dementia. Given
the multifactorial etiology of dementia and late-onset AD, multidomain interventions
targeting several modifiable risk factors and mechanisms simultaneously may be neededfor optimal preventive effects. The landmark Finnish Geriatric Intervention Study toPrevent Cognitive Impairment and Disability (FINGER trial) has shown that a
multidomain intervention combining exercise, nutritional advice, cognitive training,social activities, and vascular and metabolic risk monitoring, can prevent cognitive andfunctional decline in older adults at risk of dementia. Participants with genetic risk fordementia and AD (ApoE4 or high polygenic risk score) had clear beneficial effects on
cognition. New results from the MIND-AD trial among persons with prodromal AD
support the feasibility of a combination approach (multidomain lifestyle + medical food)for increased adherence and efficacy. Ongoing studies based on the FINGER data areunraveling the pathways mediating the beneficial intervention effects, including reduced
occurrence of vascular events, improvement of cholesterol/lipids metabolism,
inflammation, and synaptic plasticity. These findings will be key to the identification of
new therapeutic targets and the definition of personalized prevention approaches. The
FINGER model is currently being adapted, tested and optimized in 45+ countries acrossall continents within the World-Wide FINGERS network (WW-FINGERS,
https://wwfingers.com). As part of this initiative, we are starting the MET-FINGER trial,
which for the first time combines an updated FINGER model with the possible diseasemodifying drug metformin using repurposed drug approach. In addition, since the
COVID-19 pandemic has caused modifications in the mental and physical health of older
adults, with possible detrimental changes on risk profiles for AD and dementia, the WWFINGERS network launched the WW-FINGERS-SARS-CoV-2 survey, to assess direct33

and indirect effects of the pandemic in older adults. Data have been collected from 20+
countries, with 21000+ participants. Findings emerging from various countries show
significant negative changes in modifiable risk factors for AD and dementia. These results
can inform adaptions to ensure successful recruitment and adherence in forthcoming
multidomain trials for dementia prevention in older adults.
Education
2013: Authorized Specialist in Geriatrics in Sweden
2012: PhD in Medical Science Karolinska Institutet (KI), Stockholm, Sweden.
2007: Specialist in Geriatrics, University of Perugia, Perugia, Italy. Full grades withhonors.
2003: Medical Licensure in all Countries of the European Community.
2003: Medical Doctor (MD), University of Perugia, Perugia, Italy. Full grades with honors.
Professional Experiences
CURRENT POSITIONS AND ROLES:• 2018-present: Assistant Professor in Clinical Geriatric Epidemiology, Division ofClinical Geriatrics and ARC, NVS Dept, KI, Stockholm, Sweden. Area of expertise:
Clinical Geriatrics and Geriatric Epidemiology.
•

2020-present: position as Senior Geriatrician at the Medical Unit Aging (former deptof Geriatric Medicine) at Karolinska University Hospital (KUH)• 2021-present: Executive Director of the World-Wide-FINGERS Global Scientific
Coordinating Center at the FINGERS Brain Health Institute. Time devoted for research isaround 70%, clinic 10-15%, and teaching 10-15%.
PRIOR POSITIONS AND PERIODS OF APPOINTMENT:• 2019-2020: Scientific and Clinical Coordinator at the FINGERS Brain Health Institute.
• 2013-2018: Postdoctoral researcher at the ARC, NVS Dept, Karolinska Institutet,
Stockholm, Sweden.
••

2008-2012: PhD student at the Aging Research Center, Karolinska Institutet,
Stockholm, Sweden
2003-2007: resident in the school of Gerontology and Geriatrics, University of
Perugia, Perugia, Italy

Honors and Awards, Commissions of Trust• 2021-present: Alzheimer´s Disease International (ADI) International Advisory Board
Member and Scientific Programme Committee member• 2020-present: Member of the World Health Organization (WHO) “Neurology and
COVID-19 Global Forum”
34

•

•
•
•

2020-2021 Diagnostic study to develop integrated and sustainable model for longterm older adult in Malaysia (National University of Malaysia) – Benchmarking ofolder adults care in Sweden: senior expert
2015: The Lancet Neurology Commission on “Defeating Alzheimer´s disease andother dementias: a priority for European science and society”
2013: EU Meeting on Governmental Experts on Dementia, Ministry of Health, Rome,
Italy
2006 The C.M. Lerici foundation research award, Italienska Kulturinstitutet i Stockholm,
Sweden.

Major Research Interest❏ Community-based and clinical-based intervention research in elderly people in the atrisk spectrum for Alzheimer´s disease and dementia❏ Biological aspects on age-related cognitive impairment, with focus on blood-based
markers of neurodegeneration, inflammation, oxidative/nitrosative stress, lipid andglucose metabolism❏ Age-related brain iron accumulation and changes in cognition
Recent Publications (Selected)
98 publications (web of science). H-Index: 36, 8 901 citations without self-citations.
1. Waterink L, Bakker ED, Visser LNC, Mangialasche F, Kivipelto M, Deckers K,
Köhler S, Sikkes SAM, Prins ND, Scheltens P, van der Flier WM, Zwan MD.
Changes in Brain-Health Related Modifiable Risk Factors in Older Adults After One
Year of COVID-19-Restrictions. Front Psychiatry. 2022 Jun 2;13:877460. doi:
10.3389/fpsyt.2022.877460. eCollection 2022.
2. Röhr S, Kivipelto M, Mangialasche F, Ngandu T, Riedel-Heller SG. Multidomaininterventions for risk reduction and prevention of cognitive decline and dementia:
current developments. Curr Opin Psychiatry. 2022 Jul 1;35(4):285-292. doi:
10.1097/YCO.0000000000000792. Epub 2022 Jun 9.
3. Bellenguez C , …. Mangialasche F, …New insights into the genetic etiology of
Alzheimer's disease and related dementias. Nat Genet. 2022 Apr;54(4):412-436. doi:
10.1038/s41588-022-01024-z. Epub 2022 Apr 4.
4. Crivelli L, Palmer K, Calandri I, Guekht A, Beghi E, Carroll W, Frontera J, García-Azorín
D, Westenberg E, Winkler AS, Mangialasche F, Allegri RF, Kivipelto M. Changes incognitive functioning after COVID-19: A systematic review and meta-analysis.
Alzheimers Dement. 2022 May;18(5):1047-1066. doi: 10.1002/alz.12644. Epub 2022
Mar 17.
5. Goikolea J, Gerenu G, Daniilidou M, Mangialasche F, Mecocci P, Ngandu T, Rinne J,
35

Solomon A, Kivipelto M, Cedazo-Minguez A, Sandebring-Matton A, Maioli S. Serum
Thioredoxin-80 is associated with age, ApoE4, and neuropathological biomarkers in
Alzheimer's disease: a potential early sign of AD. Alzheimers Res Ther. 2022 Feb
24;14(1):37. doi: 10.1186/s13195-022-00979-9.
6. Rydström A, Darin-Mattsson A, Kåreholt I, Ngandu T, Lehtisalo J, Solomon A,
Antikainen R, Bäckman L, Hänninen T, Laatikainen T, Levälahti E, Lindström J, Paajanen
T, Havulinna S, Peltonen M, Sindi S, Soininen H, Neely AS, Strandberg T, Tuomilehto J,
Kivipelto M, Mangialasche F. Occupational complexity and cognition in the FINGER
multidomain intervention trial. Alzheimers Dement. 2022 Feb 9. doi: 10.1002/alz.12561.
7. Sindi S, Thunborg C, Rosenberg A, Andersen P, Andrieu S, Broersen LM, Coley N,
Couderc C, Duval CZ, Faxen-Irving G, Hagman G, Hallikainen M, Håkansson K,
Lehtisalo J, Levak N, Mangialasche F, Pantel J, Kekkonen E, Rydström A, StigsdotterNeely A, Wimo A, Ngandu T, Soininen H, Hartmann T, Solomon A, Kivipelto M.
Multimodal Preventive Trial for Alzheimer's Disease: MIND-ADmini Pilot Trial Study
Design and Progress. J Prev Alzheimers Dis. 2022;9(1):30-39. doi: 10.14283/jpad.2022.4.
8. Kalpouzos G, Mangialasche F, Falahati F, Laukka EJ, Papenberg G. Contributionsof HFE polymorphisms to brain and blood iron load, and their links to cognitive andmotor function in healthy adults. Neuropsychopharmacol Rep. 2021 Sep;41(3):393404. doi: 10.1002/npr2.12197. Epub 2021 Jul 21.
9. De Rojas I, ... Mangialasche F, ... Common variants in Alzheimer's disease and risk
stratification by polygenic risk scores. Nat Commun. 2021 Jun 7;12(1):3417. doi:
10.1038/s41467-021-22491-8.
10. Ponvel P, Shahar S, Singh DKA, Ludin AFM, Rajikan R, Rajab NF, Ai-Vyrn C, Din NC,
Ibrahim N, Subramaniam P, Haron H, Ismail A, Sharif R, Ramasamy K, Majeed ABA,
Ali NM, Mohamad M, Noah SAM, Ibrahim AM, Safien AM, Khalid NM, Fadzil NHM,
Mangialasche F, Kivipelto M. Multidomain Intervention for Reversal of Cognitive
Frailty, Towards a Personalized Approach (AGELESS Trial): Study Design. J Alzheimers
Dis. 2021;82(2):673-687. doi: 10.3233/JAD-201607.
Contact Information
Karolinska Institutet,
Center for Alzheimer research,
Stockholm, Sweden.
Name: Francesca Mangialasche
Address: Center for Alzheimer research, Karolinska Vägen 37 A, QA32, 171 64 Solna,
Sweden.
Phone: +46 (0)70 301 94 66
36

e-mail:francesca.mangialasche@ki.se

37

Population and Individual Approaches to Dementia Prevention
Kaarin Anstey
University of New South Wales and Neuroscience Research Australia
Summary
With population ageing, the projected number of cases of dementia will increase
dramatically, creating unprecedented challenges for care provision and health care costs,
as well as reducing quality of life. Several neurodegenerative and neuropathologicalchanges lead to dementia and there is currently no cure for these. Rather, there is evidence
that a large proportion of cases of dementia are attributable to modifiable risk factors. The
Lancet Commission in 2020 identified twelve potentially modifiable risk factors fordementia which globally account for about 40% of cases. However, there is less evidence
available on the effectiveness of interventions for cognitive decline than there is on therisk factors themselves. The World Health Organization reviewed the intervention
literature using the GRADE methodology and found sufficient evidence to recommend
lifestyle changes and medical advice such as physical activity, a healthy diet, managementof high cholesterol and hypertension in mid-life, smoking cessation and more. Others
studies are focusing on the effect of intervening on multiple risk factors simultaneously
through multi-domain trials. At a broader level, there is currently debate regarding thebest approach to take to dementia risk reduction – with some focusing on individual or
personalized risk reduction interventions, and others focusing on population healthapproaches. In this talk I will describe both approaches and propose where each approach
may be useful as well as challenges for each approach. I will also introduce theInternational Research Network on Dementia Prevention which is a group of researchersand stakeholders with a common interest in global dementia prevention.
Education
1991 BA (Hons 1)
1997 PhD

University of Sydney
University of Queensland

Professional Experiences
Current Appointments and Roles
2020- ARC Laureate Fellow, UNSW
2019- Scientia Professor, UNSW
38

2018- Director, UNSW Ageing Futures Institute2018- Professor of Psychology, UNSW
2018- Senior Principal Research Scientist, NeuRA
2018- Honorary Professor – Australian National University
2017- Deputy Director, ARC Centre of Excellence in Population Ageing
2014- Director, Board of Alzheimer’s Australia Dementia Research Foundation
2021- Fellow of the Australian Academy of Health and Medical Sciences (Elected)
2020 Fellow of the Royal Society of NSW (Elected)
2016- Fellow of the Gerontological Society of America (Elected)
2011- Fellow of the Academy of the Social Sciences in Australia (Elected)
2010- Fellow of the Australian Psychological Society (Elected)
2002- Fellow of the Australian Association of Gerontology (Elected)
Previous Appointments and Roles
2015-2021
Director, Centre of Research Excellence in Cognitive Health2018-2021
Director, NHMRC Dementia Centre for Research Collaboration
2016-2020
NHMRC Principal Research Fellow
2009-2017
Professor, Australian National University
2012-2017
Director, ANU Centre for Research on Ageing, Health and Wellbeing
2010-20142010-2017
2012-2017
2009-20112008-Mar 20102006-2008
2006-20102005-2007

Adjunct Professor, Gerontology Centre, Pennsylvania State University
Director, Dementia Collaborative Research Centre Early Diagnosis
and Prevention
ANU Public Policy Fellow (Inaugural)
Deputy Director, Centre for Mental Health Research
National Convenor, Population Research Strategies Theme,
ARC/NHMRC Research Network in Ageing Well
Associate Professor, Australian National University
NHMRC Senior Research Fellow Level A
Co-convenor, Population Research Strategies Theme, ARC/NHMRC
Research Network in Ageing Well

Honors and Awards
2020 Mental Health and Prevention Senior Career Researcher Award, Mental Health &Prevention Journal, Elsevier
2018 The Distinguished Scientific Contribution to Psychological Science Award 2018,
Australia Psychological Society
2016 Research Team won the best Poster Prize, Australian Injury Prevention Network
Conference for our NHMRC Grant work
39

2016 Research Team won the Australasian College of Road Safety Road Safety Poster
Award for our RCT in cognitive training for driving (Eramudugolla et al)2016 Vice Chancellor’s Award for Advancing the reputation of the ANU through media
2015 ANU High Commended for Media Award for Public Policy
2012 Selected as 1 of 100 Women who have contributed to Canberra for International
Women’s Day Centenary Celebration2010 Advisor to the Governor General of Australia on Priorities in Aged Care2010 Included in ISI database of highly cited scientists
2009 E.W. Busse Award for Research Excellence in the Social and Behavioural
Sciences (presented by the Busse Foundation at the 4-yearly International
2009
2008
2007
2005

2002

Association of Gerontology and Geriatrics Congress)
Exceptional contribution award – Journals of Gerontology Psychological Science
Invited Participant at the Australia 2020 Future Summit
Distinguished Contribution Award from the Australian Association ofGerontology, ACT Division
Margret Baltes Award in Social and Behavioural Sciences from the American
Gerontological Society (international award for Research Excellence in Social
and Behavioural Gerontology up to 10 years Postdoctoral)
Australian Psychological Society Early Career Award

2001 Academy of Social Sciences in Australia Early Career Medal (now the Paul
Bourke Award)
2000 Organon Award 2000 from the Australasian Society for Psychiatric Research (fora mental health researcher under the age of 35)
1999 NHMRC Travelling fellowship for Training Fellows
1998 R.M. Gibson Research Award from the Australian Association of Gerontology
1997 Chinoin Young Investigator Award from the International Association ofGerontology and Geriatrics (IAGG)
1994 University of Queensland Travelling Scholarship for the best applicant from
1994
1992
1991
1991

another university to undertake doctoral study in any field
Offered APA Scholarship (declined in favour of Travelling Scholarship)
The Inaugural Elsie Harwood Award for best psychology honours thesis on ageingin Australia 1988-1992
The Australian Psychological Society Prize for best empirical research thesis
The Dick Thomson Prize for first place in honours year, University of Sydney

Major Research Interest• Cognitive ageing, cognitive resilience over the life course• Dementia prevention, dementia epidemiology40• Older driver safety• Late-life mental health
Recent Publications (Selected)
1. Lang, L., Clifford A., Wei, L., Zhang, D., Leung, D., Augustine, G., Danat, I., Zhou,
W., Copeland, J., Anstey, K.J., Chen, R. (Jan 2017). Prevalence and determinantsof undetected dementia in the community: a systematic literature review and a metaanalysis. BMJ Open. doi:10.1136/bmjopen-2016-011146.
2. Chowdhary N., Barbui C., Anstey K.J., Kivipelto M., Barbera M., Peters R., Zheng
L., Kulmala J., Stephen R., Ferri C.P., Joanette Y., Wang H., Comas-Herrera A.,
Alessi C., Suharya Dy K., Mwangi K.J., Petersen R.C., Motala A.A., Mendis S.,
Prabhakaran D., Bibi Mia Sorefan A., Dias A., Gouider R., Shahar S., AshbyMitchell K., Prince M., Dua T. Reducing the Risk of Cognitive Decline and
Dementia: WHO Recommendations. (2022). Frontiers in Neurology. PMID:
35082745. doi: 10.3389/fneur.2021.765584.
3. Anstey, K.J., Ashby-Mitchell, K., Peters, R., (Jan 2017). Updating the evidence on
the association between serum cholesterol and risk of late-life dementia: Review andmeta-analysis. Journal of Alzheimer’s Disease, 56 (2017) 215–228.
4. Walsh S., Govia I., Wallace L., Richard E., Peters R., Anstey K.J., Brayne C. A wholepopulation approach is required for dementia risk reduction. (2022). The Lancet Healthy
Longevity. doi: 10.1016/S2666-7568(21)00301-9.
5. Anstey KJ., Ee N., Eramudugolla R., Jagger C., Peters R. (2019). A Systematic Review of
Meta-Analyses that Evaluate Risk Factors for Dementia to Evaluate the Quantity, Quality, andGlobal Representativeness of Evidence. Journal of Alzheimers Disease. PMID: 31306123
PMCID: PMC 6700718 70(s1):S165-S186. doi: 10.3233/JAD-190181.
6. Peters R, Ee, N, Peters, J, Beckett, N, Booth, A, Rockwood, K, Anstey K.J., (2019).
Common Risk Factors for Major Noncommunicable Disease, a Systematic Overview ofReviews and Commentary: The Implied Potential for Targeted Risk Reduction.
Therapeutic Advances in Chronic Disease. doi: 10.1177/2040622319880392.
7. Hosking, D.E., Eramudugolla, R, Cherbuin , N, Anstey, K.J., MIND not Mediterranean Diet
Related to 12-year Incidence of Cognitive Impairment in an Australian Longitudinal Cohort
Study. Alzheimers and Dementia. 2019 Apr;15(4):581-589. doi: 10.1016/j.jalz.2018.12.011.
Epub 2019 Feb 28.PMID: 30826160.
8. Anstey K.J., Peters R., Mortby M.E., Kiely K.M., Eramudugolla R., Cherbuin N., Huque
M.H., Dixon R.A., (2021). Association of sex differences in dementia risk factors with
sex differences in memory decline in a population-based cohort spanning 20-76 years.
Scientific Reports. PMID: 33833259. doi: 10.1038/s41598-021-86397-7.
9. Yao Y., Lv X., Qiu C., Li J., Wu X., Zhang H., Yue D., Liu K., Eshak E.S., Lorenz
41

T., Anstey K.J., Livingston G., Xue T., Zhang J., Wang H., Zeng Y. The effect ofChina's Clean Air Act on cognitive function in older adults: a population-based,quasi-experimental study. (2022). The Lancet Healthy Longevity. doi:
10.1016/S2666-7568(22)00004-6.
10. Peters, R, Ee, N, Peters, J, Booth, A, Mudway, I, Anstey, K.J., (2019) Air Pollution
and Dementia: A Systematic Review. J Alzs Dis doi.org10.3233/JAD-180631.
Contact Information
Name:
Address 1:

Professor Kaarin Anstey
Neuroscience Research Australia Level 2/139 Barker Street
Randwick NSW 2031
Address 2:
University of New South Wales Mathews Building 1203/Level
12 Kensington Campus NSW 2052
Division/Department 1: Science/Psychology
Division/Department 2: Deputy Vice-Chancellor/Ageing Futures InstituteContact numbers:
02 9399 1019
0421 935 746
E-mail:k.anstey@unsw.edu.au42

Scaling up evidence-based practices for disease prevention using
implementation science
Taichi Shimazu
Section Head, Implementation Science Section, Division of Behavioral Sciences,
Institute for Cancer Control, National Cancer Center
Summary
Many evidence-based practices (EBPs) aimed at preventing chronic diseases by
inducing a change in behaviors that increase disease risk, such as smoking, low exercise
and unhealthy diet, have been reported. However, it is estimated that it takes 17 years
from the submission of pivotal clinical trials reporting EBPs to their implementation as
routine clinical practices, and only a portion take root in society in a sustainable manner.
Among EBPs related to prevention, those involving medical practice such as
immunization and early detection need to be implemented in healthcare settings. In
contrast, EBPs that change health behavior for disease prevention can be widely
developed in various settings in the community, such as schools, workplaces, community
organizations, and social welfare organizations, along the life course of people living in
the community. Barriers and facilitators in the implementation of EBPs in the community
somewhat differ from those in medical services. Examples include priorities forprevention and health promotion, variations in the skills of EBP providers, and the culture
and values of organizational management. These factors need to be considered whendeveloping implementation strategies for EBPs in community settings.
A number of important points need to be kept in mind in moving forward with theimplementation of EBPs; in particular, an emphasis on the efficient dissemination of
EBPs can contribute to health disparities. To achieve health equity, it is essential that
EBPs be delivered through pre-implementation surveys to fully understand those who aresocially disadvantaged and in need of assistance.
Implementation science in community settings is evolving. Tools such as the Consolidated
Framework for Implementation Research (CFIR) and Expert Recommendations for Implementing
Change (ERIC) - developed primarily in clinical settings - are now available. The accumulation ofknowledge from project results using these tools is creating a solid foundation for implementation.
Lessons learned from the many implementation attempts to date should be used as generalized
knowledge to help the scaling-up of EBP implementation activities for prevention in community
settings. In this presentation, we will introduce examples we have experienced in community settings,
including implementation studies conducted by the research team at the National Cancer Center Japan,
43and discuss strategies for promoting the implementation of EBPs for disease prevention.
Education
Tokushima University Faculty of Medicine, Tokushima, Japan. M.D., 2000
Tohoku University Graduate School of Medicine, Sendai, Japan. Ph.D. in Medical
Sciences (Epidemiology), 2007
Professional Experiences
2000-2003
Resident in General Internal Medicine, Saga Medical School Hospital,
Saga, Japan
2007-20132013-20152016-20172016-2020
2020-2021
2021-Present

Staff Scientist, Division of Prevention, Research Center for Cancer Prevention
and Screening, National Cancer Center
Section Head, Division of Prevention, Research Center for Cancer
Prevention and Screening, National Cancer Center
Guest Researcher, Division of Cancer Epidemiology and Genetics,
National Cancer Institute, National Institutes of Health
Section Head, Division of Prevention, Center for Public Health
Sciences, National Cancer Center
Section Head, Implementation Science Section, Division of Behavioral
Sciences, Center for Public Health Sciences, National Cancer Center
Section Head, Implementation Science Section, Division of Behavioral
Sciences, Institute for Cancer Control, National Cancer Center

Honors and Awards
2007 Presidential Prize for Excellent Student (Tohoku University)
2018 Young Investigator Award (Japan Epidemiological Association)
Major Research Interest❏ Implementation research on evidence-based health promotion interventions in theworkplace❏ Capacity building in implementation science
Recent Publications (Selected)
1. Saito J, Odawara M, Takahashi H, Fujimori M, Yaguchi-Saito A, Inoue M, Uchitomi
Y, Shimazu T (corresponding author). Barriers and facilitative factors in theimplementation of workplace health promotion activities in small and medium-sizedenterprises: a qualitative study. Implement Sci Commun 2022;3:23.
2. Odawara M, Saito J, Yaguchi-Saito A, Fujimori M, Uchitomi Y, Shimazu T
44

(corresponding author). Using implementation mapping to develop strategies forpreventing non-communicable diseases in Japanese small- and medium-sizedenterprises. Front Public Health 2022;10:873769.
3. Lwin KS, Bhandari AKC, Nguyen PT, Saito J, Yaguchi-Saito A, Ota E, Shimazu T.
Factors influencing implementation of health-promoting interventions at workplaces:
Protocol for a scoping review. PLoS One. 2022;17:e0275887.
4. Yuwaki K, Kuchiba A, Otsuki A, Odawara M, Okuhara T, Ishikawa H, Inoue M,
Tsugane S, Shimazu T (corresponding author). Effectiveness of a Cancer Risk
Prediction Tool on Lifestyle Habits: A Randomized Controlled Trial. Cancer
Epidemiol Biomarkers Prev. 2021;30:1063-1071.
5. Otsuki A, Saito J, Yaguchi-Saito A, Odawara M, Fujimori M, Hayakawa M, Katanoda
K, Matsuda T, Matsuoka YJ, Takahashi H, Takahashi M, Inoue M, Yoshimi I, Kreps
GL, Uchitomi Y, Shimazu T (corresponding author). A nationally representative
cross-sectional survey on health information access for consumers in Japan: Aprotocol for the INFORM Study. World Medical and Health Policy. 2022;14:220-270.
6. Yaguchi-Saito A, Kaji Y, Matsuoka A, Okuyama A, Fujimori M, Saito J, Odawara M,
Otsuki A, Uchitomi Y, Zenda S, Shimazu T (corresponding author). Factors
affecting the implementation of guideline-based prophylactic antiemetic therapy forchemotherapy-induced nausea and vomiting in Japan: a protocol for a hospital-based
qualitative study. BMJ Open 2022;12:e055473.
7. Fujiwara M, Yamada Y, Shimazu T, Kodama M, So R, Matsushita T, Yoshimura Y,
Horii S, Fujimori M, Takahashi H, Nakaya N, Kakeda K, Miyaji T, Hinotsu S, Harada
K, Okada H, Uchitomi Y, Yamada N, Inagaki M. Encouraging participation incolorectal cancer screening for people with schizophrenia: A randomized controlled
trial. Acta Psychiatr Scand. 2021;144:318-328.
8. Yamada Y, Fujiwara M, Shimazu T, Etoh T, Kodama M, So R, Matsushita T,
Yoshimura Y, Horii S, Fujimori M, Takahashi H, Nakaya N, Miyaji T, Hinotsu S,
Harada K, Okada H, Uchitomi Y, Yamada N, Inagaki M. Patients' acceptability andimplementation outcomes of a case management approach to encourage participationin colorectal cancer screening for people with schizophrenia: a qualitative secondary
analysis of a mixed-method randomised clinical trial. BMJ Open 2022;12:e060621.
9. Sasaki N, Obikane E, Vedanthan R, Imamura K, Cuijpers P, Shimazu T, Kamada M,
Kawakami N, Nishi D. Implementation Outcome Scales for Digital Mental Health(iOSDMH): Scale Development and Cross-sectional Study. JMIR Form Res.
2021;5:e24332.
10. Akashi H, Kodoi H, Noda S, Tamura T, Baba H, Chinda E, Thandar MM, Naito K,
Watanabe Y, Suzuki Y, Narita T, Shimazu T. Reporting on the implementation to set
up a "care and isolation facility" for mild COVID-19 cases in Tokyo. Glob Health45

Med. 2022;4:71-77.
Contact Information
National Cancer Center, Japan
Division of Behavioral Sciences, Institute for Cancer Control
Name: Taichi Shimazu
Address: 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045 Japane-mail: tshimazu@ncc.go.jp 5946

Is a health promotion program using IoT technolog effective forolder adults living in the community?
Sangyoon Lee
Department of Preventive Gerontology, Center for Gerontology and Social Science,
Research Institute, National Center for Geriatrics and Gerontology
Summary
As a technology that facilitates self-management activities, interest in health promotion
using IoT technology has been growing in recent years. Smartphone applications canrecord daily activities and even health conditions, and this information can be used toachieve health goals and manage chronic diseases and health conditions. They also havethe advantage of easily reaching a large number of people, managing and disseminating
information, and having fewer time and location constraints.
However, compared to other generations, smartphone ownership among the elderly is
considered low. In addition, the use of applications is considered low among the elderly
due to the risks involved in using applications, the accuracy of the information provided,
concerns about operability and data transmission, and the lack of ease of use. On the other
hand, annual trends in the number of smartphones owned show a steady upward trend,
and it is expected that digital literacy will improve as a result of dissemination activities
by various local governments and digital utilization support measures (Ministry ofInternal Affairs and Communications). Against such a background, the use ofsmartphones in future health promotion policies is considered important.
Today, we present a community-based screening model for geriatric syndrome andevaluate the relationship between ICT use and health adverse events using data from the
National Center for Geriatrics and Gerontology-Study of Geriatric Syndromes (NCGGSGS), a very large cohort study among community-dwelling older adults in Japan. In
addition, ongoing intervention studies to prevent cognitive decline and the onset ofdementia in community-dwelling older adults will be reviewed.
Education
Ewha Womans University, Department of Health Convergence, Seoul, Korea Bachelor
1997 Health education
University of Tokyo, Graduate School of Medicine, Department of Social Gerontology,
Japan Master 2002 Health science47

University of Tokyo, Graduate School of Medicine, Department of Social Gerontology,
Japan Ph. D 2012 Health science
Professional Experiences- 2003-2005
Research assistant staff, National Institute of Public Health- 2005-2007
Research resident (Tokyo Metropolitan Institute of Gerontology),
Japan Foundation for Aging and Health- 2007-2009
Researcher, Tokyo Metropolitan Institute of Gerontology- 2009-2012
Senior Lecturer, Oita University- 2012-2014
Researcher, National Center for Geriatrics and Gerontology- 2014-2016- 2016–Present

Postdoctoral Fellowship for Foreign Researchers, Japan Society for
the Promotion of Science
Section chief, Section of Cohort Study for Longevity, Department ofPreventive Gerontology, Center for Gerontology and Social Science,
National Center for Geriatrics and Gerontology

Honors and Awards- Member, The Japan Gerontological Society- Member, Japanese Society of Public Health- Director, Japan Socio-Gerontological Society- Awards, 2014 Prize of President, 49th Congress of Japanese Society of Physical Therapy- Awards, 2020 Prize of President, Congress of The Japanese Society for the Preventionof Dementia- Awards, 2021 Prize of Presentation Award, Congress of Japan Society of Public Health
Major Research Interest❏ Cohort study on community-dwelling older adults to identify factors that contributeto the development of geriatric syndromes❏ Intervention studies to prevent cognitive decline and disability in communitydwelling older adults❏ Intervention research in the prevention of dementia by promoting physical, social,and cognitive activities among community-dwelling older adults
Recent Publications (Selected)
1. Shimada H, Tsutsumimoto K, Doi T, Lee S, Bae S, Nakakubo S, Makino K, Arai H.
Effect of Sarcopenia Status on Disability Incidence Among Japanese Older Adults.
J Am Med Dir Assoc, 22(4): 846-852, 2021.
2.

Chiba I, Lee S, Bae S, Makino K, Shinkai Y, Katayama O, Harada K, Yamashiro Y,48

3.

Takayanagi N, Shimada H. Isotemporal Substitution of Sedentary Behavior With
Moderate to Vigorous Physical Activity Is Associated With Lower Risk of Disability: A
Prospective Longitudinal Cohort Study. Phys Ther, 102(5): pzac002, 2022.
Makino K, Lee S, Bae S, Chiba I, Harada K, Katayama O, Shinkai Y, Shimada H.
Absolute Cardiovascular Disease Risk Assessed in Old Age Predicts Disability andMortality: A Retrospective Cohort Study of Community-Dwelling Older Adults. J
Am Heart Assoc, 10(24): e022004, 2021.

49

Implementation and challenges of the latest technologies tosupport activities of daily living
Eri OtakaSection Chief, Laboratory of Practical Technology in Community Assistive Robot
Center, Research Institute, National Center for Geriatrics and Gerontology
Summary
With the increase in the number of people certified as requiring nursing care and thegrowing shortage of nursing care providers, supporting the independence of the elderly
and improving the quality of nursing care have become pressing issues in Japan. The useof robots, sensors, and information and communication technologies has been attracting
attention as one of the countermeasures, and the development of technology for the
medical and care field has become very active in recent years.
Activity Assistive Technology, which supports people's lives by intervening in theiractivities, can be broadly classified into four areas: exercise assist, independence assist,caregiving assist, and cognitive-emotional assist. Exercise assistive technology is mainly
used in rehabilitation, aiming to recover physical functions more effectively in a shorter
period of time. On the other hand, independence and caregiving assistive technologies areused by the elderly themselves or their caregivers in their daily lives to support basic andinstrumental activities of daily living (ADL), solve problems in daily living, and reducethe burden of caregiving. In addition, cognitive-emotional assistive technologies are
expected to support the creation of psychological stability and a sense of fulfillment or
purpose in life through various forms of communication according to the users’ cognitive
functions.
While many of these assistive technologies are already commercially available,
especially in the areas of independence and caregiving support, their widespread use in
the general public remains limited. Even for technologies with established safety andeffectiveness, social implementation may be hindered by (1) size and cost issues, (2)operational issues during use, and (3) skill issues on the part of the user. Therefore, inorder to introduce and establish technology in clinical settings, it is important to provide
institutional and financial support from local governments, to provide technical support
during initial implementation, and to make a clear sense of purpose and a willingness toreform operations. Also, most of the products currently on the market are designed foruse in so-called elderly care facilities. However, it is desirable to develop and disseminate
more technologies targeting the homebound elderly, who account for a larger proportion50

of the elderly population. Furthermore, it is expected that the activity assistive devices
will evolve into a home-integrated system that makes full use of multi-sensor technology.
Both developers and medical care providers are expected to take an active interest in andgather information about assistive technology in light of these trends.
Education
Keio University School of Medicine, Tokyo (2009)
Doctor of Medicine, Keio University, Tokyo (2016)
Professional Experiences
2009-20112011-2015

Clinical resident, JA Toride Medical Center
Resident, Department of Rehabilitation Medicine, Keio University
School of Medicine-Worked at the following facilities, including during the residency program
2011-2012 Department of Rehabilitation Medicine, Keio University Hospital
2012-2013 Department of Rehabilitation Medicine, Higashisaitama National
Hospital
2013-2017 Department of Rehabilitation Medicine, Eisei Hospital
2017-2020
Chief, Department of Rehabilitation, Kariya Toyota General Hospital
2020-present

Section Chief, Laboratory of Practical Technology in Community,
Assistive Robot Center (ARC), Research Institute, National Center for
Geriatrics and Gerontology

Honors and Awards
2014 Best article award, The Japanese Association of Rehabilitation Medicine
2015 Best resident of the year, Department of Rehabilitation Medicine, Keio University
school of medicine
Major Research Interest❏ Rehabilitation Medicine❏ Implementation of technologies in clinical practice
Recent Publications (Selected)
1. Creation of a list of neuropsychological tests and other assessment methods used inclinical practice and research of dementia. Aiko Osawa, Shinichiro Maeshima, Naoki
Itoh, Ikue Ueda, Takako Yoshimura, Koki Kawamura, Eri Otaka, MasakiKamiya,
Yayoi Sato, Izumi Kondo, Hidenori Arai. Japanese journal of geriatrics, accepted202251

2. Otaka E, Oguchi K, Kondo I, Otaka Y. Effectiveness of Self Monitoring Approach
Using Fitness Trackers to Improve Walking Ability in Rehabilitation Settings: A
Systematic Review. Front Rehabil Sci. 2021 Dec 2;2:752727.
3. Hota S, Inamoto Y, Oguchi K, Kondo T, Otaka E, Mukaino M, Gonzalez Fernandez
M, Saitoh E. Outcomes of Dysphagia Following Stroke: Factors Influencing Oral
Intake at 6 Months After Onset. J Stroke Cerebrovasc Dis 2021 Sep;30(9):105971.
4. Otaka E, Otaka Y, Kasuga S, Nishimoto A, Yamazaki K, Kawakami M, Ushiba J,
Liu M. Reliability of the thumb localizing test and its validity against quantitative
measures with a robotic device in patients with hemiparetic stroke. PLoS One. 2020
Jul 24;15(7):e0236437.
5.

Goto S, Oguchi K, Hoshino T, Ikeuchi T, Asai T, Ota Y, Ogawa T, Ito T, Otaka E.
Effects of Balance Exercise Assist Robot (BEAR) in independently mobile patients bydisease. Japanese Journal of Comprehensive Rehabilitation Science. Vol.10, 18, 20196. Oyama C, Otaka Y, Onitsuka K, Takagi H, Tan E, Otaka E . Reliability and Validityof the Japanese Version of the Mini balance Evaluation Systems Test in Patients with
Subacute Stroke. Prog Rehabil Med. 2018 Jul 6;3:20180015.
7. Nishimoto A, Otaka Y, Kasuga S, Otaka E, Yamazaki K, Ushiba J, Liu M. Robotic
Assessment of Upper Limb Function after Proximal Humeral Fracture: Personal
Experience as A Patient and Occupational Therapist. Keio J Med. 2016;65(3):57 63.
8. Otaka E, Otaka Y, Kasuga S, Nishimoto A, Yamazaki K, Kawakami M, Ushiba J,
Liu M. Clinical usefulness and validity of robotic measures of reaching movement inhemiparetic stroke patients. J Neuroeng Rehabil. 2015 Aug 12;12:66.
9. Otaka E, Otaka Y, Morita M, Yokoyama A, Kondo T, Liu M: Validation of the Japaneseversion of the Mini-Balance Evaluation Systems Test (Mini-BESTest). Jpn J Rehabil
Med 2014;51:673–681. 10.2490/jjrmc.51.673 (Best article award 2014 JARM)
10. Otaka E, Otaka Y, Morita M, Yokoyama A, Kondo T, Liu M: Validation of theJapanese version of the Balance Evaluation Systems Test (BESTest). Jpn J Rehabil
Med 2014;51:565–573. 10.2490/jjrmc.51.565 (Best article award 2014 JARM)
Contact Information
Laboratory of Practical Technology in Community
Assistive Robot Center, Research Institute, National Center for Geriatrics andGerontology
Name: Eri Otaka
Address: 7-430 Morioka, Obu, Aichi 474-8511 Japan
Phone: +81 562-46-2311 (ext.5665 / 7799)
e-mail:eotaka@ncgg.go.jp52

4. 座長の印象記
Session Ⅰ 「Interaction between the brain and peripheral organs」
セッション 1 は「脳と末梢組織の交互作用」ということで 3 人の演者の先生方にお話しを伺った。松下健二先生からは「歯と脳」、伊藤尚基先生からは「筋肉と脳」、前田純宏先生からはすこし違う方向から「尿由来細胞からの神経細胞への誘導」についてのお話であった。座長は関谷倫子先生と里 直行が担当した。
松下先生からは認知症対策としての口腔ケアの重要性のお話があった。歯周病、口腔細菌、口腔機能、認知症・アルツハイマー病(AD)をキーワードに、それらの関係を総合的に解説された。これまでのコホート研究の結果から、保有歯数が少ないほど認知機能が低くなり、認知症を発症するリスクが高くなることが示されているとのことであった。その原因に関する質問では保持歯数の減少は
咀嚼機能の低下、さらには 脳血流の低下や栄養状態の悪化が認知機能低下につながっているのではないかと discussion された。またモデル動物を用いた興味深
いお話があった。高齢マウスおよび AD モデルマウスにおける歯牙の摘出および軟食での長期飼育は自発的活動および攻撃性の亢進や空間的作業記憶の低下を誘発するとともに、細胞老化を亢進させることを示された。 最近、多くの研究により、歯周病原細菌ポルフィロモナス・ジンジバリスが認知機能および認知症に関連していることが示されているとのこと、ジンジバリスが産生するトリ
プシン様プロテアーゼ・ジンジパインの阻害は、マウスモデルにおける AD の病態を改善することが示されているおり、ジンジパイン阻害剤による AD 治療の臨床試験(フェーズ II./III.)は現在欧米で進行中であるとのお話であった。
伊藤先生からは急速に高齢化する社会において社会的問題となっているサル
コペニアの根底にある分子メカニズムについてのお話があった。多くの研究により、加齢に伴うニコチンアミドアデニンジヌクレオチド(NAD+)レベルの低下と NAD+消費酵素の機能不全が加齢に伴う病態生理に重要であることが明らかになっているとのこと。伊藤先生は、この NAD+合成中間体であるニコチンアミ
ドモノヌクレオチド(NMN)のトランスポーターと報告されている Slc12a8 に注
目し、外側視床下部(LH)と骨格筋の間の新しい機能的つながりを明らかにしました。LH 特異的 Slc12a8 ノックダウンマウスは、エネルギー消費および骨格筋機能の有意な低下の結果を示された。逆に、高齢マウスの LH における Slc12a8の過剰発現は、エネルギー消費および骨格筋機能の加齢に伴う減少を改善した
ことから、全身代謝と骨格筋機能の調節に対する LH における Slc12a8 の重要な役割を強調された。
前田先生からはヒトの尿サンプル(UDC, urine-derived cell)からの神経細胞の誘導に関するお話があった。これまで人工多能性幹細胞(iPSC)の導入により、ヒト細胞を用いた神経変性疾患のモデル化が可能になったが、iPS 細胞では老化シグ
53

ネチャが取り消され、iPS 細胞を用いてアルツハイマー病(AD)などの加齢依存性疾患を研究するには限界があるとの問題点から、前田先生はこの研究に取り組まれたとのこと。線維芽細胞からの神経細胞誘導法を何度か改変した後、UDCから神経細胞様細胞(UDC-iN, UDC-induced Neuron)を誘導することに成功された。
この新しく確立した変換法を用いて、様々な年齢のドナーから UDC-iN を確立することに成功し、DNA メチル化分析により、UDC-iN への変換後も加齢依存的なメチル化状態の保存を示したと発表された。次に UDC-iN が神経変性疾患の疾患表現型を反映できるかどうかを調べるために、リソソーム機能障害を伴う家族性神経変性疾患であるニーマンピック C 型(NPC)から UDC を入手し、調査したところ、NPC 由来の UDC は良好に増殖したが、UDC-iN はライソソーム
機能障害により生存率の劇的な低下を示したとのこと。これらの結果から、様々なドナーの疾患モデリングや表現型の蓄積により、神経老化の標準曲線を描く
ことができ、神経変性疾患の発症を予測することができるかもしれません、と締
めくくられた。 会場からは、臨床応用についての多くのコメントや質問があり、今後の研究が期待された。
以上、脳と末梢組織の関係について 2 題、末梢組織を活用した脳疾患の理解のための技術について 1 題のお話を伺った。いずれも分野における最先端の研究であり、会場からも活発な質疑応答がなされた。今後も認知症の病態の解明に重要な領域と考えられ、研究発展が期待される。

（国立長寿医療研究センター研究所

分子基盤研究部長

54

里

直行）

Session Ⅱ「World's Leading Multimodal Intervention Trial for Dementia Prevention」

近年、認知症予防についてのエビデンスの蓄積が進んでいる。身体活動、栄養、社会参画などが中心となるが、それぞれのリスクに個別に介入してもその効果は限られており、複数のリスクに同時に介入を行う多因子介入が主流になりつつある。多因子介入研究の先鞭となった FINGER モデルはグローバルネットワークである World-Wide FINGERS Network に進展している。セッション 2 では、
FINGER 研究はじめ、World-Wide FINGERS の最先端を走る世界のトップ 4 名の演者に講演をしていただいた。座長は、神戸大学の古和久朋教授と櫻井が担当した。
最初に、ドイツの Susanne Röhr 博士（University of Leipzig）が、AgeWell.de 研
究について報告された。AgeWell.de 研究は、個別栄養カウンセリング、身体活動強化、認知トレーニング、血管リスク因子のモニタリング、投薬の最適化、社会
活動強化、さらに必要に応じてうつ、死別、悲しみを対象とした介入などが行われた。認知症リスクの高い高齢プライマリケア患者 1000 人以上を対象に、2 年間の介入を行い、対照群では通常通りの健康アドバイスや治療を行った。
COVID-19 パンデミックのために研究は中断や遅延を引き起こしたが、予定の介入を達成した。主要評価項目では認知機能の有意な改善効果をしめすことはできなかったが、層別化解析においてより多因子介入の効果が示された。
2 番目の演者として国立長寿医療研究センターの杉本大貴博士が、JapanMultimodal Intervention Trial for Prevention of Dementia (J-MINT)について紹介した。
J-MINT 試験は、血管リスク因子の管理、集団での身体運動と身体活動の自己モ
ニタリング、栄養カウンセリング、認知トレーニングからなる 18 カ月間の多領域介入により、軽度認知障害のある高齢者の認知機能低下の進行を予防できるかどうかを検証している。血中バイオマーカー、オミックス解析、神経画像などの評価により、認知機能の改善・悪化のメカニズムを明らかにすることを目的としている。さらに、J-MINT トライアルでは、提携する民間企業と連携し、将来の社会実装に向けた関連施策の実施に取り組んでいる。COVID-19 の流行が JMINT 試験の被験者募集と介入に影響を与えたが、531 人の高齢者の被験者登録を行った。また、非常事態宣言が発令された地域においても、オンラインによるグループベースの身体運動介入プログラムを提供し、参加者のアドヒアランスを維持し、身体活動や社会的接触を促進することが可能であったことを報告した。
3 番目に、J-MINT 研究のシスター研究である、J-MINT PRIME Tamba 研究について、神戸大学の古和久朋教授から報告があった。高血圧または耐糖能異常を有し、DASC-21 質問票のスコアが 22～30 点の高齢者 200 名を登録した。介入内
容は J-MINT 試験とほぼ同様である。介入群の参加者からは、「セッションは非常に有益であり、今後も継続したい」という肯定的なフィードバックが得られて55いる。神戸大学では、丹波市における認知症予防のエビデンスを確立するための研究を行うとともに、認知症予防の社会実装を実現するための取り組みも始めている。週 1 回の運動教室、隔月で認知症予防や健康増進に関する講義、年 1 回の認知機能を含む健康診断からなる「コグニケア」というプログラムである。
2020 年春の COVID-19 の流行開始とともに中断せざるを得ず、2020 年 10 月から「eCogniCare」というオンライン介入・評価プログラムを開始した。2021 年 10月からは、ウェアラブルセンサーによる体動評価技術を持つ Moff のオンラインサービスと統合し、「eCogniCare powered by Moff」として提供されていることが紹介された。
最後に、FINGER 研究から Francesca Mangialasche 博士（カロリンスカ研究所）
が WEB にて講演をされた。FINGER 試験では、認知症や AD の遺伝的リスク（ApoE4 または多因子性リスクスコアが高い）を有する参加者は、認知機能に明らかな有益な効果を示した。FINGER モデルは現在、World-Wide FINGERS
network の中で、すべての大陸の 45 カ国以上で適応、試験、最適化されている。
この取り組みの一環として Mangialasche 博士らは MET-FINGER 試験を開始している。この試験では、最新の FINGER モデルと疾患修飾薬となりうるメトホル
ミンを初めて組み合わせている。さらに、WW-FINGERS ネットワークは、高齢者における COVID-19 の大流行の直接的および間接的影響を評価するため、WWFINGERS-SARS-CoV-2 調査を立ち上げた。20 カ国以上、21000 人以上の参加者からデータが収集された。様々な国から得られた知見は、AD や認知症の修正可
能なリスクファクターに著しいマイナスの変化があることを示している。高齢者の認知症予防のためのマルチドメイン試験の今後の展開について概説された。

（国立長寿医療研究センター

研究所長

56

櫻井

孝）

Session Ⅲ 「 Prospects for social implementation of multifactorial interventions fordementia prevention」
認知症予防に関する研究の実践をどのように社会実装に進めるかについての背景、方法論、そして実践活動について、領域を代表する第一人者の先生方にご講演いただいた。
1 人目の演者である Kaarin Anstey 先生は Neuroscience Research Australia とニューサウスウェールズ大学（オーストラリア）に所属され、認知症をはじめとした
高齢者の社会的課題について広く取り組んでいる。本講演では、認知症予防に関するこれまでの歴史的な流れについて概観し、認知症のリスクが高い個人に対するアプローチと、集団を対象としたアプローチの有用性と課題について説明された。また、認知症予防に共通の関心を持つ研究者や関係者の集まりである認知症予防に関する国際研究ネットワークについての紹介がなされた。
2 人目の演者である島津太一先生は国立がん研究センターに所属され、がん対策の実装研究についてリーダーの一人であり、今回は慢性疾患予防に関するエビデンスに基づく実践について講義がなされた。予防に関する実践のうち、予防接種や早期発見のような医療行為に関わるものは、医療現場で実施される必要があるが、疾病予防のための健康行動を変える実践は、学校、職場、地域組織など、地域社会の様々な場面で、地域住民のライフコースに沿って広く展開することが可能であることが紹介され、地域社会における実装研究の促進戦略について議論された。
3 人目の演者である国立長寿医療研究センターの李相侖先生からは情報通信技術を活用した認知症予防に関する実践が報告された。認知症予防活動を広く実践するためにスマートフォンを活用した自己管理型の健康行動促進の介入研
究や、地域人材を活用した認知症予防介入について紹介され、これまでの成果や研究成果を社会実装する上での課題について討議がなされた。
4 人目の演者である国立長寿医療研究センターの大高恵莉先生からはロボッ
トやセンサー、情報通信技術の活用による医療・介護分野での技術開発について講義がなされた。これらの技術が社会に普及する課題として、コスト、操作性、使用者スキルなどの問題があげられ、その対策についての紹介と議論がなされた。
これらの講義から、認知症予防活動を社会実装する上での戦略や課題が浮き彫りとなり、今後研究開発すべき課題を考える機会となった。

（国立長寿医療研究センター

老年学・社会科学研究センター

57

島田

裕之）

5. 総括第 17 回国際シンポジウムはハイブリッド形式で行なわれ、会場で 68 名（長寿研：NCGG は 57 名）、オンラインでは 150 名（NCGG は 38 名）が参加した。
事前に関係学会などに周知することで、多くの参加者があり、face to face での情報交換が可能であった。オンライン参加者の半数以上は外部からのアクセスであり、認知症の予防に多くの関心が集まっていることが伺われた。
発表者は女性 5 名を含む 11 人の講師（海外からは 3 名）で、ランチョンセミ
ナーでは、アルツハイマー病のバイオマーカーについてご講演をしていただいた。3 年ぶりに国際学会の雰囲気が戻ってきたことを実感することができた。
セッション 1 は「脳と末梢組織の機能連関」について、歯科、筋肉、また、尿由来細胞からの神経細胞への誘導について講演があった。いずれも質の高い研究であった。脳と末梢臓器の連関についてはこれまでも研究は多いが、ヒトでどのように検証できるかは難しい課題である。前田純宏先生（慶応大学 岡野研）
は、細胞を初期化せずに神経細胞に誘導できる手技について紹介され、長寿研の多くのコホート研究でこの技術を導入できれば、“細胞疫学”のような新しい科学を展開する可能性があると思われた。
セッション 2 では、認知症予防のための多因子介入研究、FINGER 研究、
AgeWell.de 研究、J-MINT 研究・J-MINT PRIME 研究の知見が報告された。認知症の非薬物的予防では FINGER 研究は草分け的な研究で、世界に大きなインパクトを与えている。NCGG で行っている J-MINT 研究も解析の段階にある。今後、どのような高齢者において有効であるか、機序についてもデータの蓄積が期待される。FINGER 研究の研究者たちとも交流が深く、今回の国際シンポジウム
でさらに共同研究が発展すると考えられる。
セッション 3 では、認知症予防を研究にとどめるのではなく社会実装する試みについて、豪州、日本から 4 題の発表がなされた。NCGG では多くの実証研究が進行しているが、得られた知見を研究コホートだけではなく社会実装することは NCGG の重要なミッションである。社会実装は単に参加者の人数を増やすことではない。実装科学のマナーを学び実践することで、持続性のある社会貢献が進められるよう期待したい。
以上のように、第 17 回国際シンポジウムでは、3 年ぶりに世界の認知症・老年医学の研究者との交流が可能となり、NCGG の研究・臨床活動の活性化に貢献することができた。
さいごに、公益財団法人長寿科学振興財団（The Japan Foundation for Aging and
Health）様のご共催、多くの企業、団体のご後援、また、センター内外からのご発表者、ご参加の皆様に深く御礼申し上げます。
（国立長寿医療研究センター 研究所長
58

櫻井孝）