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Erschienen in: The journal of nutrition, health & aging 4/2018

15.03.2018

Cognitive Dysfunction in Urban-Community Dwelling Prefrail Older Subjects

verfasst von: Hiroyuki Umegaki, T. Makino, H. Shimada, T. Hayashi, X. Wu Cheng, M. Kuzuya

Erschienen in: The journal of nutrition, health & aging | Ausgabe 4/2018

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Abstract

Objectives

A number of studies have reported that frailty is cross-sectionally associated with cognitive decline and is also a risk for future cognitive decline or dementia; however, there have been only a few studies that focus on the association between prefrailty and cognitive dysfunction. In the current study, we investigated the association between prefrailty and cognition

Design

A cross-sectional study of the data obtained at registration in a randomized control trial.

Setting

Toyota, Japan.

Participants

Community-dwelling older subjects (male 54.6%) who had cognitive complaints.

Measurements

A battery of neuropsychological and physical assessments were performed. Prefrailty was defined as exhibiting one or two of the five Fried criteria (weight loss, exhaustion, weakness, slow gait speed and low physical activity). We performed a multiple regression analysis to investigate the associations of cognitive performance with prefrailty, adjusting for the factors that were significantly different between the robust and prefrailty groups. To assess the cognitive attributes that were significantly associated with prefrailty, logistic analysis was performed to see if one specific criterion of the five frailty criteria was associated with cognitive performance.

Results

The study subjects included 183 prefrail and 264 robust individuals. The prefrail subjects with cognitive complaints were older, less educated, more depressive, and more likely to have diabetes mellitus than the robust subjects. The prefrail subjects had lower performance in a wide-range of cognitive domains, and after adjustments for age, education, depressive mood, and diabetes mellitus, prefrailty was associated with a decline in delayed memory and processing speed. Among the components of the Fried criteria, slow gait speed and loss of activity were significantly associated with slow processing speed as assessed by the digit symbol substitution test.

Conclusion

The current results demonstrated that prefrailty was associated with worse memory and processing speed performance, but not with other cognitive domains.
Literatur
1.
Zurück zum Zitat Ministry of Health, Labour, and Welfare. Number of elderly persons with dementia. 2015. Available at: http://www.mhlw.go.jp/stf/houdou/2r9852000002iau1-att/2r9852000002iavi.pdf. Accessed, July 8 in 2017 (in Japanese). Ministry of Health, Labour, and Welfare. Number of elderly persons with dementia. 2015. Available at: http://​www.​mhlw.​go.​jp/​stf/​houdou/​2r9852000002iau1​-att/​2r9852000002iavi​.​pdf.​ Accessed, July 8 in 2017 (in Japanese).
2.
Zurück zum Zitat Vermeiren S, Vella-Azzopardi R, Beckwée D et al. Frailty and the Prediction of Negative Health Outcomes: A Meta-Analysis. J Am Med Dir Assoc, 2016; 17(12): 1163.e1–1163CrossRef Vermeiren S, Vella-Azzopardi R, Beckwée D et al. Frailty and the Prediction of Negative Health Outcomes: A Meta-Analysis. J Am Med Dir Assoc, 2016; 17(12): 1163.e1–1163CrossRef
3.
Zurück zum Zitat Bauer JM, Sieber CC. Sarcopenia and frailty: a clinician’s controversial point of view. Exp Gerontol, 2008; 43: 674–678.CrossRefPubMed Bauer JM, Sieber CC. Sarcopenia and frailty: a clinician’s controversial point of view. Exp Gerontol, 2008; 43: 674–678.CrossRefPubMed
4.
Zurück zum Zitat Fried LP, Tangen CM, Walston J et al. Frailty in older adults: Evidence for a phenotype. J Gerontol A Biol Sci Med Sci, 2001; 56A: M146–M156.CrossRef Fried LP, Tangen CM, Walston J et al. Frailty in older adults: Evidence for a phenotype. J Gerontol A Biol Sci Med Sci, 2001; 56A: M146–M156.CrossRef
5.
Zurück zum Zitat Blaum CS, Xue QL, Michelon E et al. The association between obesity and the frailty syndrome in older women: the Women’s Health and Aging Studies. J Am Geriatr Soc, 2005; 53: 927–934.CrossRefPubMed Blaum CS, Xue QL, Michelon E et al. The association between obesity and the frailty syndrome in older women: the Women’s Health and Aging Studies. J Am Geriatr Soc, 2005; 53: 927–934.CrossRefPubMed
6.
Zurück zum Zitat Danon-Hersch N, Rodondi N, Spagnoli J, Santos-Eggimann B. Prefrailty and chronic morbidity in the youngest old: an insight from the Lausanne cohort Lc65+. J Am Geriatr Soc, 2012; 60: 1687–1694.CrossRefPubMed Danon-Hersch N, Rodondi N, Spagnoli J, Santos-Eggimann B. Prefrailty and chronic morbidity in the youngest old: an insight from the Lausanne cohort Lc65+. J Am Geriatr Soc, 2012; 60: 1687–1694.CrossRefPubMed
8.
Zurück zum Zitat Robertson DA, Savva GM, Kenny RA. Frailty and cognitive impairment—a review of the evidence and causal mechanisms. Ageing Res Rev, 2013; 12: 840–851.CrossRefPubMed Robertson DA, Savva GM, Kenny RA. Frailty and cognitive impairment—a review of the evidence and causal mechanisms. Ageing Res Rev, 2013; 12: 840–851.CrossRefPubMed
9.
Zurück zum Zitat Nishiguchi S, Yamada M, Fukutani N et al. Differential association of frailty with cognitive decline and sarcopenia in community-dwelling older adults. J Am Med Dir Assoc, 2015; 16: 120–124.CrossRefPubMed Nishiguchi S, Yamada M, Fukutani N et al. Differential association of frailty with cognitive decline and sarcopenia in community-dwelling older adults. J Am Med Dir Assoc, 2015; 16: 120–124.CrossRefPubMed
10.
Zurück zum Zitat Kulmala J, Nykänen I, Mänty M, Hartikainen S. Association between frailty and dementia: a population-based study. Gerontology, 2014; 60: 16–21CrossRefPubMed Kulmala J, Nykänen I, Mänty M, Hartikainen S. Association between frailty and dementia: a population-based study. Gerontology, 2014; 60: 16–21CrossRefPubMed
11.
Zurück zum Zitat Robertson DA, Savva GM, Coen RF, Kenny RA. Cognitive function in the prefrailty and frailty syndrome. J Am Geriatr Soc, 2014; 62: 2118–2124.CrossRefPubMed Robertson DA, Savva GM, Coen RF, Kenny RA. Cognitive function in the prefrailty and frailty syndrome. J Am Geriatr Soc, 2014; 62: 2118–2124.CrossRefPubMed
12.
Zurück zum Zitat Sánchez-García S, Sánchez-Arenas R, García-Peña C et al. Frailty among community-dwelling elderly Mexican people: prevalence and association with sociodemographic characteristics, health state and the use of health services. Geriatr Gerontol Int, 2014; 14: 395–402.CrossRefPubMed Sánchez-García S, Sánchez-Arenas R, García-Peña C et al. Frailty among community-dwelling elderly Mexican people: prevalence and association with sociodemographic characteristics, health state and the use of health services. Geriatr Gerontol Int, 2014; 14: 395–402.CrossRefPubMed
13.
Zurück zum Zitat Umegaki H. Sarcopenia and frailty in older patients with diabetes mellitus. Geriatr Gerontol Int, 2016; 16: 293–299.CrossRefPubMed Umegaki H. Sarcopenia and frailty in older patients with diabetes mellitus. Geriatr Gerontol Int, 2016; 16: 293–299.CrossRefPubMed
14.
Zurück zum Zitat Gill TM, Gahbauer EA, Allore HG, Han L. Transitions between frailty states among community-living older persons. Arch Intern Med, 2006; 166: 418–423.CrossRefPubMed Gill TM, Gahbauer EA, Allore HG, Han L. Transitions between frailty states among community-living older persons. Arch Intern Med, 2006; 166: 418–423.CrossRefPubMed
15.
16.
Zurück zum Zitat Arai H, Satake S. English translation of the Kihon Checklist. Geriatr Gerontol Int, 2015; 15: 518–519.CrossRefPubMed Arai H, Satake S. English translation of the Kihon Checklist. Geriatr Gerontol Int, 2015; 15: 518–519.CrossRefPubMed
17.
Zurück zum Zitat Maki Y, Ura C, Yamaguchi T et al. Effects of intervention using a community-based walking program for prevention of mental decline: a randomized controlled trial. J Am Geriatr Soc, 2012; 60: 505–510.CrossRefPubMed Maki Y, Ura C, Yamaguchi T et al. Effects of intervention using a community-based walking program for prevention of mental decline: a randomized controlled trial. J Am Geriatr Soc, 2012; 60: 505–510.CrossRefPubMed
18.
Zurück zum Zitat American Psychiatric Association Diagnostic and Statistical Manual, 4th ed, APA Press, Washington, DC 1994. American Psychiatric Association Diagnostic and Statistical Manual, 4th ed, APA Press, Washington, DC 1994.
19.
Zurück zum Zitat Aisen PS, Petersen RC, Donohue MC et al. Clinical core of the Alzheimer’s disease neuroimaging initiative: progress and plans. Alzheimers Dement, 2010; 6: 239–246.CrossRefPubMedPubMedCentral Aisen PS, Petersen RC, Donohue MC et al. Clinical core of the Alzheimer’s disease neuroimaging initiative: progress and plans. Alzheimers Dement, 2010; 6: 239–246.CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Guo Q, Zhao Q, Chen M et al. A comparison study of mild cognitive impairment with 3 memory tests among Chinese individuals. Alzheimer Dis Assoc Disord, 2009; 23: 253–259.CrossRefPubMed Guo Q, Zhao Q, Chen M et al. A comparison study of mild cognitive impairment with 3 memory tests among Chinese individuals. Alzheimer Dis Assoc Disord, 2009; 23: 253–259.CrossRefPubMed
21.
Zurück zum Zitat Folstein MF, Folstein SE, McHugh PR: «Mini-mental state». A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res, 1975; 12: 189–198.CrossRefPubMed Folstein MF, Folstein SE, McHugh PR: «Mini-mental state». A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res, 1975; 12: 189–198.CrossRefPubMed
22.
Zurück zum Zitat Wechsler D. Wechsler Memory Scale-Revised Manual. San Antonio, Texas: The Psychological Corporation. 1987. Wechsler D. Wechsler Memory Scale-Revised Manual. San Antonio, Texas: The Psychological Corporation. 1987.
23.
Zurück zum Zitat Wechsler D. Wechsler Adult Intelligence Scale-Third Edition. London: The Psychological Corporation Limited. 1997. Wechsler D. Wechsler Adult Intelligence Scale-Third Edition. London: The Psychological Corporation Limited. 1997.
24.
Zurück zum Zitat Spreen O, Strauss E. A compendium of neuropsychological tests: Administration, norms and commentary (2nd ed.). New York: Oxford University Press. 1998. Spreen O, Strauss E. A compendium of neuropsychological tests: Administration, norms and commentary (2nd ed.). New York: Oxford University Press. 1998.
25.
Zurück zum Zitat Yesavage JA. The use of self-rating depression scales in the elderly, In: Clinical Memory Assessment of Older Adults, Poon LW (ed), Washington, DC, American Psychological Association, 1986; 213–217.CrossRef Yesavage JA. The use of self-rating depression scales in the elderly, In: Clinical Memory Assessment of Older Adults, Poon LW (ed), Washington, DC, American Psychological Association, 1986; 213–217.CrossRef
26.
Zurück zum Zitat Doi T, Shimada H, Makizako H et al. Cognitive function and gait speed under normal and dual-task walking among older adults with mild cognitive impairment. BMC Neurol, 2014; 14: 67–67.CrossRefPubMedPubMedCentral Doi T, Shimada H, Makizako H et al. Cognitive function and gait speed under normal and dual-task walking among older adults with mild cognitive impairment. BMC Neurol, 2014; 14: 67–67.CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat S Chen LK, Liu LK, Woo J et al. Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc, 2014; 15: 95–101.CrossRefPubMed S Chen LK, Liu LK, Woo J et al. Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc, 2014; 15: 95–101.CrossRefPubMed
28.
Zurück zum Zitat Janssen I, Heymsfield SB, Ross R. Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability. J Am Geriatr Soc, 2002;50:889–96.CrossRefPubMed Janssen I, Heymsfield SB, Ross R. Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability. J Am Geriatr Soc, 2002;50:889–96.CrossRefPubMed
29.
Zurück zum Zitat Matsushita E, Okada K, Ito Y et al. Characteristics of physical prefrailty among Japanese healthy older adults. Geriatr Gerontol Int, 2016; doi: 10.1111/ggi.12935. Matsushita E, Okada K, Ito Y et al. Characteristics of physical prefrailty among Japanese healthy older adults. Geriatr Gerontol Int, 2016; doi: 10.1111/ggi.12935.
30.
Zurück zum Zitat Veronese N, Stubbs B, Fontana L et al. Frailty is associated with an increased risk of incident type 2 diabetes in the elderly. J Am Med Dir Assoc, 2016; 17: 902–907. doi: 10.1016/j.jamda.2016.04.021.CrossRefPubMed Veronese N, Stubbs B, Fontana L et al. Frailty is associated with an increased risk of incident type 2 diabetes in the elderly. J Am Med Dir Assoc, 2016; 17: 902–907. doi: 10.1016/j.jamda.2016.04.021.CrossRefPubMed
31.
Zurück zum Zitat Rosano C, Perera S, Inzitari M et al. Digit Symbol Substitution test and future clinical and subclinical disorders of cognition, mobility and mood in older adults. Age Ageing, 2016; 45: 688–695.CrossRefPubMedPubMedCentral Rosano C, Perera S, Inzitari M et al. Digit Symbol Substitution test and future clinical and subclinical disorders of cognition, mobility and mood in older adults. Age Ageing, 2016; 45: 688–695.CrossRefPubMedPubMedCentral
32.
Zurück zum Zitat Best JR, Liu-Ambrose T, Boudreau RM et al. Health, aging and body composition study. An evaluation of the longitudinal, bidirectional associations between gait speed and cognition in older women and men. J Gerontol A Biol Sci Med Sci, 2016; 71: 1616–1623.CrossRefPubMedPubMedCentral Best JR, Liu-Ambrose T, Boudreau RM et al. Health, aging and body composition study. An evaluation of the longitudinal, bidirectional associations between gait speed and cognition in older women and men. J Gerontol A Biol Sci Med Sci, 2016; 71: 1616–1623.CrossRefPubMedPubMedCentral
33.
Zurück zum Zitat Rosano C, Newman AB, Katz R et al. Association between lower digit symbol substitution test score and slower gait and greater risk of mortality and of developing incident disability in well-functioning older adults. J Am Geriatr Soc, 2008; 56: 1618–1625.CrossRefPubMedPubMedCentral Rosano C, Newman AB, Katz R et al. Association between lower digit symbol substitution test score and slower gait and greater risk of mortality and of developing incident disability in well-functioning older adults. J Am Geriatr Soc, 2008; 56: 1618–1625.CrossRefPubMedPubMedCentral
34.
Zurück zum Zitat Weuve J, Kang JH, Manson JE et al. Physical activity, including walking, and cognitive function in older women. JAMA, 2004; 292: 1454–1461.CrossRefPubMed Weuve J, Kang JH, Manson JE et al. Physical activity, including walking, and cognitive function in older women. JAMA, 2004; 292: 1454–1461.CrossRefPubMed
35.
Zurück zum Zitat van Gelder BM, Tijhuis MA, Kalmijn S et al. Physical activity in relation to cognitive decline in elderly men: the FINE Study. Neurology, 2004; 63: 2316–2321.CrossRefPubMed van Gelder BM, Tijhuis MA, Kalmijn S et al. Physical activity in relation to cognitive decline in elderly men: the FINE Study. Neurology, 2004; 63: 2316–2321.CrossRefPubMed
36.
Zurück zum Zitat Abbott RD, White LR, Ross GW et al. Walking and dementia in physically capable elderly men. JAMA, 2004; 292: 1447–1453.CrossRefPubMed Abbott RD, White LR, Ross GW et al. Walking and dementia in physically capable elderly men. JAMA, 2004; 292: 1447–1453.CrossRefPubMed
37.
Zurück zum Zitat Taaffe DR, Irie F, Masaki KH et al. Physical activity, physical function, and incident dementia in elderly men: the Honolulu-Asia Aging Study. J Gerontol A Biol Sci Med Sci, 2008; 63: 529–535.CrossRefPubMed Taaffe DR, Irie F, Masaki KH et al. Physical activity, physical function, and incident dementia in elderly men: the Honolulu-Asia Aging Study. J Gerontol A Biol Sci Med Sci, 2008; 63: 529–535.CrossRefPubMed
38.
Zurück zum Zitat Yaffe K, Barnes D, Nevitt M et al. A prospective study of physical activity and cognitive decline in elderly women: women who walk. Arch Intern Med, 2001; 161: 1703–1708.CrossRefPubMed Yaffe K, Barnes D, Nevitt M et al. A prospective study of physical activity and cognitive decline in elderly women: women who walk. Arch Intern Med, 2001; 161: 1703–1708.CrossRefPubMed
39.
Zurück zum Zitat Kuiper JS, Zuidersma M, Zuidema SU et al. Social relationships and cognitive decline: a systematic review and meta-analysis of longitudinal cohort studies. Int J Epidemiol, 2016; 45: 1169–1206.PubMed Kuiper JS, Zuidersma M, Zuidema SU et al. Social relationships and cognitive decline: a systematic review and meta-analysis of longitudinal cohort studies. Int J Epidemiol, 2016; 45: 1169–1206.PubMed
40.
Zurück zum Zitat Cohen JA, Verghese J, Zwerling JL. Cognition and gait in older people. Maturitas, 2016; 93: 73–77.CrossRefPubMed Cohen JA, Verghese J, Zwerling JL. Cognition and gait in older people. Maturitas, 2016; 93: 73–77.CrossRefPubMed
41.
Zurück zum Zitat Verghese J, Wang C, Lipton RB, Holtzer R. Motoric cognitive risk syndrome and the risk of dementia. J Gerontol A Biol Sci Med Sci, 2013; 68: 412–418.CrossRefPubMed Verghese J, Wang C, Lipton RB, Holtzer R. Motoric cognitive risk syndrome and the risk of dementia. J Gerontol A Biol Sci Med Sci, 2013; 68: 412–418.CrossRefPubMed
42.
Zurück zum Zitat Kelaiditi E, Cesari M, Canevelli M et al. Cognitive frailty: rational and definition from an (I.A.N.A./I.A.G.G.) international consensus group. J Nutr Health Aging, 2013; 17: 726–34.CrossRefPubMed Kelaiditi E, Cesari M, Canevelli M et al. Cognitive frailty: rational and definition from an (I.A.N.A./I.A.G.G.) international consensus group. J Nutr Health Aging, 2013; 17: 726–34.CrossRefPubMed
43.
Zurück zum Zitat Delrieu J, Andrieu S, Pahor M et al. Neuropsychological Profile of «Cognitive Frailty» Subjects in MAPT Study. J Prev Alzheimers Dis, 2016;3:151–159.PubMedPubMedCentral Delrieu J, Andrieu S, Pahor M et al. Neuropsychological Profile of «Cognitive Frailty» Subjects in MAPT Study. J Prev Alzheimers Dis, 2016;3:151–159.PubMedPubMedCentral
44.
Zurück zum Zitat Rosano C, Studenski SA, Aizenstein HJ et al. Slower gait, slower information processing and smaller prefrontal area in older adults. Age Ageing, 2012; 41: 58–64.CrossRefPubMed Rosano C, Studenski SA, Aizenstein HJ et al. Slower gait, slower information processing and smaller prefrontal area in older adults. Age Ageing, 2012; 41: 58–64.CrossRefPubMed
45.
Zurück zum Zitat Janssen HC, Emmelot-Vonk MH, Verhaar HJ, van der Schouw YT. Vitamin D and muscle function: is there a threshold in the relation? J Am Med Dir Assoc, 2013;14:627. e13-8.CrossRefPubMed Janssen HC, Emmelot-Vonk MH, Verhaar HJ, van der Schouw YT. Vitamin D and muscle function: is there a threshold in the relation? J Am Med Dir Assoc, 2013;14:627. e13-8.CrossRefPubMed
46.
Zurück zum Zitat Bruyère O, Cavalier E, Buckinx F, Reginster JY. Relevance of vitamin D in the pathogenesis and therapy of frailty. Curr Opin Clin Nutr Metab Care, 2017; 20: 26–29.CrossRefPubMed Bruyère O, Cavalier E, Buckinx F, Reginster JY. Relevance of vitamin D in the pathogenesis and therapy of frailty. Curr Opin Clin Nutr Metab Care, 2017; 20: 26–29.CrossRefPubMed
47.
Zurück zum Zitat Zhou J, Huang P, Liu P et al. Association of vitamin D deficiency and frailty: A systematic review and meta-analysis. Maturitas, 2016; 94: 70–76.CrossRefPubMed Zhou J, Huang P, Liu P et al. Association of vitamin D deficiency and frailty: A systematic review and meta-analysis. Maturitas, 2016; 94: 70–76.CrossRefPubMed
48.
Zurück zum Zitat Shardell M, D’Adamo C, Alley DE et al. Serum 25-hydroxyvitamin D, transitions between frailty states, and mortality in older adults: the Invecchiare in Chianti Study. J Am Geriatr Soc, 2012; 60: 256–64.CrossRefPubMedPubMedCentral Shardell M, D’Adamo C, Alley DE et al. Serum 25-hydroxyvitamin D, transitions between frailty states, and mortality in older adults: the Invecchiare in Chianti Study. J Am Geriatr Soc, 2012; 60: 256–64.CrossRefPubMedPubMedCentral
49.
Zurück zum Zitat Ensrud KE, Ewing SK, Fredman L et al. Circulating 25-hydroxyvitamin D levels and frailty status in older women. J Clin Endocrinol Metab, 2010; 95: 5266–73.CrossRefPubMedPubMedCentral Ensrud KE, Ewing SK, Fredman L et al. Circulating 25-hydroxyvitamin D levels and frailty status in older women. J Clin Endocrinol Metab, 2010; 95: 5266–73.CrossRefPubMedPubMedCentral
50.
Zurück zum Zitat Chan DD, Tsou HH, Chang CB et al. Integrated care for geriatric frailty and sarcopenia: a randomized control trial. J Cachexia Sarcopenia Muscle, 2016; doi: 10.1002/jcsm.12132. Chan DD, Tsou HH, Chang CB et al. Integrated care for geriatric frailty and sarcopenia: a randomized control trial. J Cachexia Sarcopenia Muscle, 2016; doi: 10.1002/jcsm.12132.
51.
Zurück zum Zitat Luger E, Dorner TE, Haider S et al. Effects of a home-based and volunteeradministered physical training, nutritional, and social support program on malnutrition and frailty in older persons: A randomized controlled trial. J Am Med Dir Assoc, 2016;17:671. e9-671.e16.CrossRefPubMed Luger E, Dorner TE, Haider S et al. Effects of a home-based and volunteeradministered physical training, nutritional, and social support program on malnutrition and frailty in older persons: A randomized controlled trial. J Am Med Dir Assoc, 2016;17:671. e9-671.e16.CrossRefPubMed
52.
Zurück zum Zitat Qualls Cl, Waters DL, Vellas B et al. Reversible States of Physical and/or Cognitive Dysfunction: A 9-Year Longitudinal Study. J Nutr Health Aging. 2017; 21: 271–275.CrossRefPubMed Qualls Cl, Waters DL, Vellas B et al. Reversible States of Physical and/or Cognitive Dysfunction: A 9-Year Longitudinal Study. J Nutr Health Aging. 2017; 21: 271–275.CrossRefPubMed
Metadaten
Titel
Cognitive Dysfunction in Urban-Community Dwelling Prefrail Older Subjects
verfasst von
Hiroyuki Umegaki
T. Makino
H. Shimada
T. Hayashi
X. Wu Cheng
M. Kuzuya
Publikationsdatum
15.03.2018
Verlag
Springer Paris
Erschienen in
The journal of nutrition, health & aging / Ausgabe 4/2018
Print ISSN: 1279-7707
Elektronische ISSN: 1760-4788
DOI
https://doi.org/10.1007/s12603-018-1017-5

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