Although the Internet has been widely used in Japan, the quality of information on mental health-related issues has not been evaluated so far. The purpose of the present study was to investigate the current status of Japanese websites that deal with mental health, mental disorders, and their associated matters. Using a search engine, Google, 37 websites were identified that exclusively contain information on mental health or mental disorders. The characteristics of the sites were then examined, along with variety of mental disorders mentioned, and quality of contents for each of the 37 websites. More than half of the websites were set up, at least in part, for commercial purposes and only 27% of sites were owned by professionals. Mood disorder, panic disorder, and schizophrenia were the three most commonly referred disorders on websites. Aside from some exceptions, the quality of information was inadequate, especially that regarding treatment. Most of the websites on mental health and mental disorders examined in the present study have scope for improvement. The challenge is to establish a system to evaluate the sites and to motivate each webmaster to improve the sites.

Wearable sensors are being applied to real-world motion monitoring and the focus of this work is assessing health status and wellbeing. An extensive literature has documented the effects on gait control of impaired physical health, but in this project, the aim was to determine whether emotional states associated with older people’s mental health are also associated with walking mechanics. If confirmed, wearable sensors could be used to monitor affective responses. Lower limb gait mechanics of 126 healthy individuals (mean age 66.2 ± 8.38 years) were recorded using a high-speed 3D motion sensing system and they also completed a 12-item mental health status questionnaire (GHQ-12). Mean step width and minimum foot-ground clearance (MFC), indicative of tripping risk, were moderately correlated with GHQ-12. Ageing and variability (SD) of gait parameters were not significantly correlated with GHQ-12. GHQ-12 scores were, however, highly correlated with left-right gait control, indicating that greater gait symmetry was associated with better mental health. Maintaining good mental health with ageing may promote safer gait and wearable sensor technologies could be applied to gait asymmetry monitoring, possibly using a single inertial measurement unit attached to each shoe.

目的：認知症予防対策は喫緊の課題であり，軽度の認知機能の異常や軽度認知障害（mild cognitive impairment，MCI）を早期に発見できる簡便な認知機能評価法の開発が求められている．我々はバーチャル・リアリティデバイスを用いた認知機能検査（virtual reality device- examination以下VR-E）を開発した．本研究はその有用性の検証を目的とした．方法：対象は認知機能正常，軽度認知障害，認知症を含む77名（男性29名，女性48名，平均年齢75.1歳）である．基本情報を収集後，Clinical Dementia Rating（CDR）により認知症の重症度を評価した．全対象にVR-EとMini Mental State Examination（MMSE）を実施し，MMSEが20点以上の場合Montreal Cognitive Assessment-Japanese version（MoCA-J）も実施した．結果：全体77名のうちCDR 0群が31名，CDR 0.5が26名，CDR 1が14名，CDR 2が5名，CDR 3が1名であった．VR-Eの得点は，CDR 0；0.77±0.15（平均値±標準偏差），CDR 0.5；0.65±0.19，CDR1；0.24±0.23，CDR2；0.15±0.15であり，CDR 0，0.5，1～3の3群間に有意差を認め，多重比較でもCDR0と0.5，CDR0.5と1～3に有意差を認めた．CDR 0 vs 0.5におけるMMSE/MoCA-J/VR-EのAUCの値は，0.85，0.80，0.70，CDR 0.5 vs 1～3のAUCの値は，0.89，0.92，0.90であり，VR-Eは正常とMCIの鑑別や，MCIと認知症の鑑別に有用なツールであることが示唆された．VR-Eの実施時間はおよそ5分であり，ほとんどの被験者は音声ならびに文字ガイダンスの指示に従って一人で検査の遂行が可能であった．ただし12名は眼疾患，メニエール症候群，認知症による理解度低下のため実施困難だった．結論：VR-Eは簡便に実施でき，また認知機能検査としても有用である可能性が示唆された．

Dementia with Lewy bodies (DLB) is the second most common cause of dementia after Alzheimer's disease. The disease is characterized by many Lewy bodies appearing in the patient's cerebrum. DLB frequently presents with a variety of autonomic symptoms from the early or prodromal stages of the disease, and these are listed as supportive features in the diagnostic criteria. As several useful assessment methods for evaluating autonomic function in DLB have been reported, this review will focus on cardiovascular and respiratory dysfunction and its assessments. Cardiovascular disorders, such as orthostatic hypotension and abnormal heart rate variability, have been reported in DLB patients. Decreased myocardial uptake by metaiodobenzylguanidine myocardial scintigraphy has been added as an indicative biomarker for DLB in the 2017 revision of the diagnostic criteria. We have reported reduced ventilatory response to hypercapnia, abnormal respiratory rhythm, and high frequency of sleep‐disordered breathing as abnormalities of the respiratory regulatory system associated with DLB. Since autonomic dysfunction is highly prevalent in DLB from the early or prodromal phase of the disease and is associated with reduced activities of daily living and quality of life, the evaluation of autonomic dysfunction is also useful in the differential diagnosis of DLB from Alzheimer's disease. There are fewer studies on the respiratory regulatory system than on the cardiovascular system, thus further research is needed to explore its role in DLB.

Globally, we are facing the tendency of aging, and demands for health enhancement among the older population have been steadily increasing. Among various exercise interventions, Pilates has been popularly utilized in rehabilitation; therefore, it is considered suitable for vulnerable populations. In this study, frail late-stage older adults (>75 years) participated in a modified Pilates program (30 min per session, once a week for eight weeks). Age- and condition-matched Controls were also involved as the benchmark to reveal the effect of Pilates. While only the Pilates group participated in the exercise intervention, both groups undertook the health assessments twice (before and after the intervention period). Assessments included: (i) falling risk based on 3D motion capture systems and (ii) overall cognitive functions utilizing Mini-Mental State Examination and executive function with the use of Trail Making Test-A (TMT-A). Two-dimensional mood state was also used to measure changes in mood due to Pilates intervention. An 8-week Pilates intervention was effective in achieving higher and symmetrical swing foot control. Dynamic balance at heel contact was also improved by extending the spatial margin in case of slipping. Despite the trend of positive Pilates effects on executive functions (29% improvement) confirmed by TMT-A, no significant effects were observed for cognitive functions. Positive mood changes were achieved by Pilates intervention, which may be the key for late-stage seniors to continue their participation in exercise programs. While further studies with a larger sample size are essential, Pilates appears to provide adequate exercise for the frail late-stage older population to minimize frailty.