Health-Related Quality of Life With Trastuzumab Monotherapy Versus Trastuzumab Plus Standard Chemotherapy as Adjuvant Therapy in Older Patients With HER2-Positive Breast Cancer

PURPOSE We report findings on quality of life (QoL) in the RESPECT trial, which compared adjuvant trastuzumab monotherapy with trastuzumab plus chemotherapy in older patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC). PATIENTS AND METHODS Patients age 70-80 years with human epidermal growth factor receptor 2-positive surgically treated breast cancer were randomly assigned to receive trastuzumab (T) or trastuzumab plus chemotherapy (T + C). QoL was assessed using the Functional Assessment of Cancer Therapy-General (FACT-G), Philadelphia Geriatric Center Morale Scale, Hospital Anxiety and Depression Scale, Patient Neurotoxicity Questionnaire, and Tokyo Metropolitan Institute of Gerontology Index of Competence at baseline and after 2, 12, and 36 months. Comparisons were based on individual changes from baseline and were performed by Fisher’s test or mixed-model repeated-measures. RESULTS Among 275 patients in the parent study, 231 (84%) (average age: 74 years) were included in the analysis. At 2, 12, and 36 months, 198, 177, and 178 patients completed surveys, and the mean FACT-G scores at each survey point were 78.9, 80.4, 82.7, and 79.1 in group T and 79.5, 74.5, 78.4, and 78.5 in group T + C. Compared with group T + C, the proportion of patients showing QoL deterioration (≥ 5 points decrease from baseline in FACT-G) was significantly lower at 2 months (31% v 48%; P = .016) and 12 months (19% v 38%; P = .009). In group T, the Hospital Anxiety and Depression Scale score ( P = .003) and the proportion of severe sensory peripheral neuropathy ( P = .001) were significantly lower at 2 months, and Philadelphia Geriatric Center Morale Scale and Tokyo Metropolitan Institute of Gerontology Index of Competence scores were significantly higher ( P = .024, .042) at 12 months. At 36 months, there were no significant differences in any QoL items. CONCLUSION Detrimental effects of adjuvant chemotherapy on global QoL, morale, and activity capacity lasted for at least 12 months but were not observed at 36 months.

Reliability and Validity of the Activity Diversity Questionnaire for Older Adults in Japan

Recent research has suggested that the breadth and evenness of activity and activity diversity contribute to health outcomes among older adults. However, few established assessment tools for activity diversity have been developed. This study developed an Activity Diversity Questionnaire (ADQ) for older adults through expert consultation and a preliminary survey among 18 community-dwelling older adults. The diversity score was calculated according to Shannon’s entropy. In study 1, the intraclass correlation coefficients (ICC) of the diversity scores were determined for community-dwelling older adults (n = 30). In study 2, concurrent validity was tested with participants receiving comprehensive health checkups at the Itabashi ward in Japan in 2018 (n = 766). The correlation coefficients of the diversity scores were then calculated in reference to the Tokyo Metropolitan Institute of Gerontology Index of Competence and Japan Science and Technology Agency Index of Competence. The final version of the ADQ consisted of 20 total items with excellent test-retest reliability (ICC = 0.84) and moderate correlations with both the Tokyo Metropolitan Institute of Gerontology Index of Competence and Japan Science and Technology Agency Index of Competence (r = 0.48 and 0.60, respectively). The ADQ was developed through scientific procedures and revealed sufficient reliability and validity. As such, it is a scientifically validated tool for assessing activity diversity among older adults.

Development of a New Product Using Two Distributed Teams

Recent trends in globalization of business operations and education has increased the need for global teams. These teams face a variety of challenges. This paper discusses the experience of distributed teams made up of participants from the Tokyo Metropolitan Institute of Technology and Stanford University in carrying out a design and development assignment. Challenges faced included differences in culture, in time and experience and the use of distributed information to develop a new product. Better product development demanded at least one face-to-face meeting, setting milestone deadlines and heavy use of electronic media, especially telephone and video conferencing.

An Overview of the Tokyo Metropolitan Institute of Gerontology—Longitudinal Interdisciplinary Study on Aging (TMIG-LISA, 1991–2001)

In 1991 the Tokyo Metropolitan Institute of Gerontology launched a new longitudinal interdisciplinary study on aging (TMIG-LISA). The study is designed to run until at least 2001 and includes both an observation and an intervention component. The intervention component was started in 1996 and was designed to assess the extent to which it might be possible to retard the rate of the aging process and prevent geriatric diseases and chronic conditions. In this article, a brief overview of the aims, objectives, and design and some preliminary outcomes from the TMIG-LISA are presented.

Physical Performance Measures for Characterizing High Functioning Older Persons

The goal of this study was to identify methods for characterizing high-functioning older adults living in the community. The subjects were 495 older adults from the Longitudinal Interdisciplinary Study on Aging conducted by the Tokyo Metropolitan Institute of Gerontology. Physical performance measures included grip strength, walking at preferred and maximum speeds, one-leg standing with eyes open, and finger tapping rate. Performance scores were created by summing each categorical score. Consistent differences were found among age groups and genders. Scores were lower in subjects who had stroke or diabetes than in those without these conditions. These results suggest that physical performance measures have both discriminant validity and construct validity, which make them useful methods for characterizing high-functioning older persons.