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Aim The coronavirus disease 2019 (COVID-19) pandemic remains a major global public health issue, and it has led to restrictions in physical and social activities among community-dwelling people, including frail older adults. This study aimed to determine the impact of the pandemic on the subjective health status and characteristics of community-dwelling frail older adults by assessing their knowledge of infection, behaviors and negative psychological response. Methods During October 2019, 720 older adults participated in "The Otassha Study." A year after the COVID-19 outbreak, between June 29 and July 31, 2020, a health status questionnaire, comprising questions concerning knowledge about infection, behaviors and psychological responses during the pandemic, was sent to all participants of the health examination in 2019. Respondents were divided into the robust and frail groups, and their responses were compared. Results Although the self-reported health status of the older adults in both groups was worse in 2020 than in 2019, differences were not observed in the degree of deterioration between the groups. Those in the frail group had fewer resources of information related to COVID-19 and had fewer coping behaviors for health maintenance compared with the robust group. Conclusion Information gathering and actions aimed at health maintenance tended to be weaker among older adults with frailty, although the influence of COVID-19 on subjective health status did not differ significantly between robust and frail adults. Therefore, robust and frail older adults may need to adopt different countermeasures to prevent worse health during this pandemic. Geriatr Gerontol Int 2021; ••: ••-••.

Objectives Ground reaction force (GRF) during sit-to-stand motion is associated with lower extremity strength and balance function. The relationship between GRF and experience of falls has been reported; however, there are no reports on whether GRF can predict the incidence of future falls. We aimed to evaluate the ability of GRF to predict falls and compare GRF with existing predictors. Methods This prospective observational cohort study enrolled 456 community-dwelling older adults living in Itabashi ward who participated in health check-ups in 2016 and 2017. Participants’ physical and cognitive functions were assessed, and the maximum GRF (F), F/weight (F/W), rate of force development (RFD), RFD/W (RFD/weight), and time taken to stand up were evaluated. The following year, participants were asked to report the number of falls during the year. Cox proportional hazards regression was conducted to analyze the relationship between the lowest quintile of each GRF parameter as a predictive factor for falling and assess the annual incidence of falls. Results Twenty-three participants reported having two or more falls in the previous year. Of all GRF parameters evaluated, only F/W was lower in the fallers than in the non-fallers. After adjusting for sex, age, lifestyle, and comorbidities, F/W was associated with falls in 1 year, and the lowest F/W group had higher risks of falls than the highest F/W group (hazard ratio 2.72, 95 % confidence interval 1.11–6.68). Other measures were not associated with falls. Conclusions GRF during the sit-to-stand motion might predict the incidence of future falls.

Objective Exercise training has antihypertensive and renoprotective effects in humans and rats. However, the effects of exercise training on renal disorders that occur with salt-sensitive hypertension remains unclear. The study aim was to investigate the effects and mechanisms of exercise training on renal function in a rat model of salt-sensitive hypertension. Methods Six-week-old male Dahl salt-sensitive rats were divided into normal-salt (0.6% NaCl) diet, high-salt (8% NaCl) diet, and high-salt diet with exercise training groups. The high-salt diet with exercise training group underwent daily treadmill running for 8 weeks. Results The high-salt diet induced severe hypertension and renal dysfunction. Exercise training significantly improved high-salt diet-induced urinary protein, albumin, and L-type fatty acid-binding protein excretion, and glomerulosclerosis but not renal interstitial fibrosis without changing blood pressure. Exercise training significantly attenuated high-salt diet-induced oxidative stress in the kidneys and decreased high-salt diet-stimulated xanthine oxidoreductase activity but not nicotinamide adenine dinucleotide phosphate oxidase activity. The high-salt diet did not change urinary excretion of 20-hydroxyeicosatetraenoic acid and decreased cytochrome P450 4A protein expression in the kidneys. Exercise training increased urinary 20-hydoroxyeicosatetraenoic acid excretion and renal cytochrome P450 4A protein expression. Conclusion Exercise training improved renal disorders without lowering blood pressure in Dahl salt-sensitive rats. Exercise training also decreased oxidative stress and increased 20-hydroxyeicosatetraenoic acid production in the kidneys. These results suggest that improvements in oxidative stress and 20-hydroxyeicosatetraenoic acid production may be potential mechanisms by which exercise training improved renal disorders in Dahl salt-sensitive rats.

Deterioration of daily activities increases frailty risk. Most of the previous research has examined the association between frailty and specific activities; nevertheless, the diversity of daily activities is also important. Although the type, frequency, and evenness of daily activities have been proposed as indicators of activity diversity, the association between these indicators and frailty remains unclear. In this study, we examined the association between activity diversity and frailty in community-dwelling older adults.This cross-sectional study comprised 658 community-dwelling older adults aged ≥ 65 years who participated in comprehensive health check-ups in 2018. Frailty was defined using the Japanese version of the Cardiovascular Health Study criteria. Three indicators, type, frequency, and evenness of daily activities, were used to assess activity diversity across one week. Multiple logistic regression analyses were performed, with frailty as the dependent variable and the three activity diversity indicators as independent variables. Socio-demographic, physical, and mental functioning factors were adjusted as covariates.Of the 658 participants (median age: 72 years; age range: 65-91 years; 60.5% women), 27 (4.1%) met the criteria for frailty. The frail group had significantly lower scores for type, frequency, and evenness of daily activities, as well as Mini-Mental State Examination scores (all at p0.01). We found significant independent associations in all activity diversity indicators with frailty, in multiple logistic models.Activity diversity is independently associated with frailty in community-dwelling older adults.

AIM The Mini-Mental State Examination is a widely used cognitive assessment tool. However, it has several limitations, including the learning effect and interrater reliability. Therefore, we developed a Computer-Based Cognitive Assessment Tool (CompBased-CAT), which runs on a tablet or personal computer. In this study, we examined the validity and discrimination ability of the CompBased-CAT. METHODS Participants were recruited from the Otasha-Kenshin study carried out in 2016. We included 773 community-dwelling older individuals in Japan (332 men, 441 women, aged 65-97 years). CompBased-CAT scores were converted to z-scores, and the correlation with Mini-Mental State Examination scores was examined using Pearson's correlation coefficient. Furthermore, the ability to discern cognitive impairment was examined using the receiver operating characteristic curve. RESULTS The Pearson's correlation coefficient for the Mini-Mental State Examination scores and each task component of the CompBased-CAT ranged from 0.24 to 0.41 (P

BACKGROUND Xanthine oxidase (XO) is a source of reactive oxygen species production in the heart. However, pathophysiological role of XO has not been clarified in hypertensive heart disease. Thus, the present study examined the impacts of high salt (HS) intake and febuxostat (Fx), a XO inhibitor in Dahl salt-sensitive (Dahl-S) rats. METHODS Eight-week old, male Dahl-S rats were fed a normal salt diet (0.6% NaCl) or a HS diet (8% NaCl) for 8 weeks. A part of the rats fed the HS diet were simultaneously treated with Fx (3 mg/kg/day). RESULTS HS intake increased blood pressure and heart weight with cardiomyocyte hypertrophy and interstitial fibrosis in the left ventricle (LV), and Fx diminished them. HS increased the XO activity 4.7-fold and nicotinamide-adenine dinucleotide phosphate (NADPH) oxidase activity 1.5-fold, and Fx not only blocked the XO activity but also inhibited the HS-increased NADPH oxidase activity. HS increased the expression of XO, collagen, transforming growth factor-β1 (TGF-β1), angiotensin-converting enzyme, and angiotensin II type 1 receptor and the phosphorylation of extracellular signal-regulated kinase (ERK) in the LV, and Fx reduced the expression and phosphorylation of these proteins except XO. CONCLUSIONS Fx ameliorates the HS intake-induced hypertension, LV hypertrophy, and fibrosis with decreasing the TGF-β1 expression and ERK phosphorylation in Dahl-S rats. Fx also down-regulates cardiac NADPH oxidase and renin–angiotensin system. The XO inhibition may be an effective therapy for hypertensive heart disease.