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This two-year follow-up study aimed to identify factors associated with unhealthy behaviors during the COVID-19 pandemic and examine their impact on functional capacity in older adults.Altogether, 536 adults aged ≥65 years participated in this study. The frequency of going out, exercise habits, face-to-face and non-face-to-face interactions, social participation, and eating habits were examined as behavioral factors before and after the first declaration of a state of emergency in Japan. Functional capacity was assessed using the Tokyo Metropolitan Institute of Gerontology Index of Competence.Using latent class analysis considering changes in the six behaviors, the participants were divided into healthy (n = 289) and unhealthy (n = 247) behavior groups. The male sex was associated with 2.36 times higher odds, diabetes with 2.19 times higher odds, depressive mood with 1.83 times higher odds, poor subjective economic status with 2.62 times higher odds, and living alone with 44% lower odds of being unhealthy. The unhealthy behavior group showed significantly decreased functional capacity (B =-1.56 [-1.98, -1.14]) than the healthy behavior group. For each behavior, negative changes in going out (B =-0.99 [-1.60, -0.37]), face-to-face interaction (B =-0.65 [-1.16, -0.13]), and non-face-to-face interactions (B =-0.80 [-1.36, -0.25]) were associated with a decline in functional capacity.Our results showed four factors associated with engaging in unhealthy lifestyle behaviors and how behavioral changes affect functional capacity decline during the COVID-19 pandemic, which will help to develop public health approaches.

We conducted surveys in older people at a venue and in home-visits, and compared cognitive and health status between the two groups to assess their cognitive and everyday functioning.Among 7,614 persons aged 70 years and older living in an urban area, 5,430 responded to a mail survey for sociodemographic characteristics and self-rated questionnaires including the Geriatric Depression Scale-short form (GDS-15). Of these, 1,360 agreed to attend a venue survey, and 693 agreed to take a home-visit survey. Trained nurses examined participants' blood pressure, medical history, and daily functions using the dementia assessment sheet for community-based integrated care system (DASC-21), and tested their cognitive function using the Mini-Mental State Examination (MMSE).Of 2,053 participants, 2,020 (venue: 1,352; home-visit: 668) completed the MMSE. Median MMSE scores for the venue and home-visit groups were 28 and 26 points, respectively, with 130/1,352 (9.6%) and 205/668 (30.7%) participants below the traditional 23/24 cutoff score. The home-visit group had lower mobility, lower frequency of going out, poorer mental health, and lower independence in instrumental daily activities. Notably, 39.9% and 43.7% of the venue and home-visit groups lived alone, respectively.In this sample of urban older people, the rate of cognitive decline detected using the MMSE was three times higher in the home-visit group than in the venue group. Home-visit participants were more likely to have difficulty in physical, cognitive, and everyday functioning, suggesting they have a greater need for daily living support to continue living in the community.

Social engagement activities can help older adults maintain mental and physical functioning levels. This study examined the long-term effects of the intergenerational picture-book reading program "REPRINTS" (Research of Productivity by Intergenerational Sympathy) on older adults.After baseline assessment, participants were allowed to decide which condition they wanted to participate in: the REPRINTS intervention or control group involving only assessments. REPRINTS participants participated in group activities that involved playing a hand game and reading picture books to children at kindergartens, elementary schools, and public childcare centers, once every one-two weeks. A follow-up assessment, which focused on functional capacity (i.e., instrumental activities of daily living, intellectual activity, and social function), was conducted after seven years. The analysis included responses from 62 REPRINTS (mean age [SD]=66.2 [5.7]) and 100 control-group participants (mean age [SD]=68.0 [4.7]).A logistic regression analysis examining intervention effects revealed that control-group participants were more likely to reduce intellectual activity and interactions with children compared to REPRINTS participants (p=.013 and .003, respectively). Furthermore, the REPRINTS group maintained greater functional reach compared to the control group (p.001). However, the REPRINTS group was likely to stay indoors more often, compared to the control group (p=.045).The present study indicates that the REPRINTS intergenerational program has long-term, positive effects that help maintain and promote intellectual activity, physical functioning, and intergenerational exchange, although the effect of the increasing amount of physical activity is unclear.

Background Japan has the largest aging population in the world, thus, a focus on frailty is important in clinical geriatric practice. Using a nationally representative sample, this study provided national estimates of the prevalence of frailty among community-dwelling older Japanese people. We also examined variations in the prevalence by sociodemographic characteristics, health conditions, and geographical regions. Methods Data came from the National Survey of the Japanese Elderly in 2012. The data were collected using a home visit and face-to-face interviews with trained interviewers. The sample consisted of 2206 adults aged ≥65 years. We used the widely accepted definition of physical frailty phenotype and calculated weighted estimates of the prevalence of frailty. Results Overall estimated prevalence was 8.7 % (7.5 %–9.9 %) for frail, 40.8 % (38.7 %–42.9 %) for prefrail, and 50.5 % (48.4 %–52.6 %) for robust. Frailty was more prevalent in older groups, women, and those with lower socioeconomic status, which was measured by education and household income. Frail people tended to have worse health. We also observed a regional variation: frailty prevalence tended to be higher in eastern than western Japan. Conclusions This study provides important evidence on the prevalence of frailty in older Japanese people and found substantial disparities by sociodemographic characteristics, health conditions, and geographical regions.

Background Because the oral cavity plays an important role as the first digestive organ, thus, decreased oral function such as oral frailty may negatively affect the nutritional status of older adults. However, few studies have examined the relationship between oral frailty and dietary habits. Objective This cross-sectional study aimed to investigate the relationship between oral functions and dietary habits in a general population of older adults. Methods Participants were 722 older adults (mean age, 79.1 ± 4.5 [standard deviation] years) who had participated in the Takashimadaira Study conducted in 2018, in Tokyo, Japan. Oral frailty among them was determined by a modified version of a well-known method originally proposed by other researchers. Dietary habits were evaluated based on two aspects: dietary variety and eating behavior (eating alone or together). The independent association between oral frailty and dietary habits was analyzed with an ordinal logistic regression model, controlling for important covariates. Results Of the participants, 23.5 %, 57.2 % and 19.3 % were determined to have non-oral frailty, pre-oral frailty, and oral frailty, respectively. Eating alone (practiced by 36.0 % of the participants) was significantly associated with oral frailty status (adjusted odds ratio, 1.82 [95 % confidence interval, 1.14–2.90]) even after controlling for potential confounders including age, sex, body mass index, living arrangement, employment, chronic medical conditions, and depressive mood. Conclusions We found a significant association between eating alone and oral frailty in a general population of Japanese older adults. Because of the strong association, further investigation of potential mechanisms is warranted.

Objectives To examine the association of physical performance measures and self-rated health with multimorbidity among older Japanese adults aged ≥60 years using cross-sectional data from a nationwide longitudinal survey. Methods Using respondents’ self-reported data from the 2012 National Survey of the Japanese Elderly, we analyzed multimorbidity involving nine major chronic diseases (heart disease, arthralgia, hypertension, diabetes, stroke, cataract, cancer, respiratory disease, and low back pain). Respondents who reported having two or more of these diseases were identified as having multimorbidity. Multivariate logistic regression analysis was used to examine if physical performance (grip strength and walking speed) and self-rated health were independently associated with multimorbidity after adjusting for potential confounders (e.g., demographic, physiological, and lifestyle-related variables). Results The responses of 2525 participants who responded to the survey by themselves (i.e., without proxies) were analyzed (response rate: 57.9%). Among the chronic diseases examined, hypertension had the highest prevalence (44.1%), followed by low back pain (25.7%) and cataract (24.7%). Approximately 44.4% of the respondents had multimorbidity. The regression analysis revealed that multimorbidity was significantly associated with both poor grip strength (P = 0.006) and self-rated health (P Conclusions Multimorbidity is prevalent in older Japanese adults, and poor grip strength and self-rated health were independently and significantly associated with multimorbidity. Health assessments that include these indicators may provide insight into the health status patterns of older adults with multimorbidity and inform the development of health management strategies.

Self-rated health and physical functioning are recognized as important indicators of health in older persons. Rarely, however, there have been studies done which examine cross-cultural differences in the health of older people using these measures, especially among non-Western countries. The objective of this study was to examine patterns of association of self-rated health and functional disability of Japanese and Korean elderly people living in the community, using nationwide surveys of persons aged 60 years or over. There were striking similarities in the general pattern of associations with covariates. In the multivariate analysis, age, work status, comorbidity, depressive symptoms, life satisfaction, hospitalization, and functional disability were strongly associated with self-rated health in both populations. For functional disability, older age, female, low social contact, depressive symptoms, poor life satisfaction, and poor self-rated health were found to be significantly associated. Some differences in the structure of associations with self-rated health, however, were noted. Women tended to assess their health more favorably than men in Korea, but in the Japanese elderly gender differences disappeared when other variables were taken into account. Health-related variables tended to be more closely associated with functional disability in the Japanese sample. An overall similarity, however, in the pattern of associations of these measures supports their utility in assessing and comparing the health of older populations in this region.

This study examined whether cognitive impairment, falls, and urinary incontinence (UI) were independent predictors of functional decline using a 2-year observation of a non-disabled older Japanese cohort living in a community from 1999 to 2001. A total of 139 men and 214 women aged 70-94 years at the baseline who were independent in both activities of daily living (ADL) and instrumental activities of daily living (IADL) were analyzed in this study. Independent variables, such as cognitive impairment, falls, UI, and other possible factors associated with functional decline were obtained from an interview survey at the baseline. A dependent variable was functional status in ADL and IADL obtained at the time of the 2-year follow-up. During the 2-year follow-up, cognitive function was a significant predictor for both IADL dependence and ADL and/or IADL dependence. Using a group of subjects with Mini Mental State Examination (MMSE) scores of 30-27 points as a reference group, a significant correlation was identified between lower MMSE scores and an increased odds ratio for functional decline. Lower cognitive function was a significant predictor of functional decline, even among those older Japanese whose cognitive function was deemed to be within the normal range.

This study examined the present state and longitudinal changes in higher-level functional capacity in a Japanese urban community. Persons aged 65-84 years living in a suburb of central Tokyo participated in a baseline survey held in 1991 (n = 814) and followed-up for 8 years. Outcome measures were disabilities in: instrumental self-maintenance (IADL), the intellectual activity scale (intellectual activity) and the social role scale (social role), as measured by subscales of the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-index of competence). At baseline among the three subscales, both older men and women had the highest prevalence of disability in social role, followed in turn by intellectual activity and IADL disability. The 8-year longitudinal survey on subjects who had no initial disability (229 men and 235 women) in all three subscales of TMIG-index of competence demonstrated that they were most likely to lose social role function with advancing age, followed in turn by intellectual activity and IADL. The Cox proportional hazard model analysis for all 814 participants revealed that baseline level of social role and intellectual activity significantly predicted the new onset of IADL disability during the 8-year follow-up period even after controlling for gender, age, and chronic medical conditions. In summary, disability in social role and intellectual activity do not only likely precede IADL disability, but also predict significantly the future onset of IADL disability in a Japanese urban community older population.