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Aim: This study aimed to develop and evaluate the Brief Older Adults' Physical Activity Questionnaire (BOPAQ), which was designed to quickly assess moderate-to-vigorous physical activity (MVPA) in community-dwelling older adults., Methods: We used a cross-sectional study design involving 165 older participants. The BOPAQ calculated weekly MVPA duration based on two questions regarding the number of days per week engaged in MVPA and the daily duration of activity. Validity was assessed by correlating the MVPA durations derived from the BOPAQ with those obtained from the ActiGraph and International Physical Activity Questionnaire short form. Reliability was evaluated using the intraclass correlation coefficient, and measurement errors were analyzed using Bland-Altman plots., Results: The BOPAQ reasonably correlated with accelerometer-based MVPA (rho = 0.297) and showed good test-retest reliability (intraclass correlation coefficient of 0.78, 95% CI 0.64-0.87). In contrast, the correlation between the International Physical Activity Questionnaire short form and accelerometer-based MVPA was poor (rho = 0.139). The cut-off value for the BOPAQ was set to identify participants engaging in <150 min of objectively measured physical activity per week, corresponding to the 150-min threshold. However, the area under the curve in the receiver operating characteristic analyses was not significantly high (0.601, 95% CI 0.514-0.688). The Bland-Altman plots showed an underestimation bias of 51.72 min/week (95% CI 1.61-101.84) and showed heteroscedasticity., Conclusion: Despite some measurement errors, the BOPAQ is an available tool for assessing MVPA in community-dwelling older adults. Geriatr Gerontol Int 2024; 24: 1150-1155., (© 2024 The Author(s). Geriatrics & Gerontology International published by John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics Society.)

Aim: We aimed to identify the factors contributing to subjective well-being in community-dwelling older adults in rural Japan. This study explored the relationship among physical and mental health, socioeconomic status, and activity levels with regard to the subjective well-being of older adults., Methods: In the Frail Elderly in the Sasayama-Tamba Area study, a cohort investigation of independent older adults in a rural Japanese community, 541 of 844 participants completed a 2-year follow-up survey. Subjective well-being was assessed as a binary based on three factors - "happiness," "satisfaction with life" and "meaning in life" - using a subset of the World Health Organization's Quality of Life questionnaire. The improvement group transitioned from not having subjective well-being during the baseline survey to having subjective well-being during the follow-up survey. Furthermore, we used multivariable log-Poisson regression models to calculate the prevalence ratios of subjective well-being., Results: The cross-sectional study showed that sleep satisfaction, health services access satisfaction and having a higher-level functional capacity were positively associated with having "happiness" and "satisfaction with life." Furthermore, being aged ≥ 80 years and having financial leeway were positively associated with having "meaning in life." The longitudinal study showed that having a higher-level functional capacity was positively associated with improving "happiness" and "satisfaction with life." Being female was positively associated with improving "happiness" and "meaning in life," and health services access satisfaction and alcohol drinking were positively associated with improving "satisfaction with life" and "meaning in life," respectively., Conclusions: These findings offer promising avenues for enhancing the subjective well-being of older adults. Geriatr Gerontol Int 2024; 24: 311-319., (© 2024 The Authors. Geriatrics & Gerontology International published by John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics Society.)

Aim: We speculated that low back pain, which is the most common ailment in older adults, is associated with frailty and/or sarcopenia and contributes to the progression of either condition. Our objective was to evaluate the relationship between low back pain, sarcopenia and frailty in rural Japanese community-dwelling older adults., Methods: We recruited 730 participants aged ≥65 years who underwent a comprehensive health examination between November 2016 and December 2018. The Oswestry Disability Index (ODI) was used to assess low back pain quantitatively, and scores were compared for the frail groups determined by the Japanese version of Cardiovascular Health Study, and the sarcopenia groups as determined by the Asian Working Group for Sarcopenia 2019., Results: Among 730 participants, the prevalence of low back pain was 57.8%. There were significant differences in the ODI scores between the robust, prefrail and frail groups (P < 0.001). In contrast, there were no significant differences in the ODI scores among the robust, low appendicular skeletal muscle and sarcopenia groups. Logistic regression analysis showed that the prevalence of low back pain and the ODI scores were significantly associated with frailty after adjustment for age, sex and body mass index (odds ratio 3.41, 95% confidence interval 1.39-8.39, P = 0.008, and odds ratio 1.06, 95% confidence interval 1.04-1.09, P < 0.001, respectively)., Conclusions: To the best of our knowledge, this study is the first to show the close association between low back pain and frailty, and suggests that not only the decline in physical function but also neuropsychiatric factors, including chronic pain, constitute a vicious cycle of frailty in community-dwelling older adults. Geriatr Gerontol Int 2021; 21: 54-59., (© 2020 Japan Geriatrics Society.)

Aim: Little is known about the relationship between near falls and substantial falls in older adults. Clarifying this relationship would be helpful to assess fall risk in greater detail. The purpose of the present study was to clarify whether near falls predict future falls., Methods: This was designed to be a prospective cohort study. Participants were recruited from a community apartment for older adults. After a baseline physical assessment, participants were asked to record the incidence of near falls in a diary for 3 months. After the survey period, participants were followed for 6 months by telephone contact every 2 months. Cox proportional hazards regression models were used to analyze the association between near falls and falls., Results: A total of 60 participants were included in the analysis. During the initial 3 months, 23 participants (38%) experienced near falls. Eight participants (13%) experienced substantial falls during the following 6 months. Cox proportional hazards regression models adjusted for age, body mass index, sex and physical frailty showed that experience of near falls (hazards regression 6.0, 95% confidence intervals 1.1-31.7; P < 0.05) was significantly associated with incidence of future falls., Conclusions: Experience of near falls among older adults is an independent predictor of substantial falls irrespective of the physical frailty status. Clinicians might need to focus on near falls to appropriately assess the fall risk in older adults. Geriatr Gerontol Int 2017; 17: 1477-1480., (© 2016 Japan Geriatrics Society.)

Objectives: The aim of the present study was to evaluate whether a complex course obstacle negotiation exercise (CC), a 24-week exercise program, can reduce falls and fractures in older adults, as compared with a simple course obstacle negotiation exercise (SC)., Methods: This trial was carried out on older adults, aged 75 years and above in Japan. In total, 157 participants were randomized into the CC group (n = 78) and the SC group (n = 79). Participants were enrolled in the exercise class using the CC program or the SC program for 24 weeks. The outcome measure was the number of falls and fracture rates in CC and SC groups for 12 months after the completion of the 24-week exercise class., Results: Two participants (2.8%) in the CC group and 19 (26.0%) in the SC group experienced falls during 12 months. During the 12-month follow-up period after the intervention, the incidence rate ratio (IRR) of falls in the SC group against the CC group was 9.37 (95% CI = 2.26-38.77). One participant (1.4%) in the CC group and eight (10.9%) in the SC group had experienced fractures during 12 months after the exercise class. The IRR of fractures in the SC group compared with the CC group was 7.89 (95% CI = 1.01-61.49)., Conclusions: The results of the present trial show that the participants who received individualized obstacle avoidance training under complex tasks combined with a traditional intervention had a lower incidence rate of falls and fractures during the 12 months after the intervention., (© 2011 Japan Geriatrics Society.)

Aim: The purpose of this longitudinal study was to determine whether the rate of decline in community-dwelling older adults varies according to baseline locomotive function levels., Methods: This longitudinal study was conducted in community-dwelling older adults in Kyoto, Japan. In addition to information about falls, physical performance was assessed using a series of tests, including 10-m walking time, timed up and go (TUG) test, functional reach, one-leg stand test, and five chair stand test. The outcomes for each patient were measured once in 2009 and then followed up 1 year later. The change in physical performance was then determined. We divided the participants into tertiles (T1, T2, and T3) according to timed up and go test results, and the differences among the three groups were compared., Results: Of the 252 individuals who were enrolled in the study, 231 (91.6%) completed the 12-month follow-up: 77 in the T1 group; 78 in the T2 group; and 76 in the T3 group. The T1 group showed a significantly larger decrease than the T2 and T3 groups in the 10-m walking time and TUG tests (P < 0.05). However, there were no significant differences in functional reach, one-leg standing test, or five chair stand test among the three groups. In the T1 group, the number of falls and elderly who had developed fear of falling increased during the study period., Conclusions: This study demonstrated that elderly with the highest baseline performances were more likely to show a greater decline in locomotive performance than the other groups. Further study is required to elucidate the mechanism of faster physical functional decline in robust elderly., (© 2011 Japan Geriatrics Society.)

Aim: Maintenance of physical function in the elderly is important. Previous studies have focused mainly on training-center-based interventions, accompanied by training staff or equipped with training machinery. The purpose of this study was to investigate the effects of toe and ankle training for the elderly., Methods: The four facilities were divided into two groups that received the intervention in 8-week shifts. An exercise program, focused mainly on ankle, foot and toe function, was conducted with the subject in a sitting position. Muscle strength, physical function, fear of falling and health-related quality of life were assessed at the beginning of the study and at the end of each 8-week phase. Because subjects were not randomized, significant intergroup differences were present in some baseline measurements. Therefore, the study was conducted with a cross-over design, and ancova was included with the baseline value as an independent covariate., Results: A significant improvement was found in quadriceps strength, functional reach, stepping in sitting and Euro Qol EQ5D score, together with a possible improvement in toe flexor strength., Conclusion: These results suggest that a training program carried out with the subject in a sitting position and focused mainly on ankle, foot and toe functions is effective in improving some aspects of motor function in the elderly. This approach may help elderly individuals maintain their activity level without increasing risks., (© 2011 Japan Geriatrics Society.)