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BACKGROUND/OBJECTIVE: A driving skill program had positive effects on safe driving performance in older adults, even those with cognitive impairment. However, the long‐term effects of the program remain unclear. The purpose of this study was to examine whether such effects were maintained at 1 year after the intervention in older adults with cognitive impairment who had low driving skills. DESIGN: A secondary analysis of single‐blind randomized controlled trial. SETTING: Community setting in Japan. PARTICIPANTS: Community‐living adults, aged 65 years or older (n = 159), with mild cognitive impairment (MCI). INTERVENTION: The intervention group completed 10 classroom sessions of 1 hour and 10 on‐road sessions of 50 minutes, focusing on common problem areas of older drivers. The control group received one education class about safety driving. MEASUREMENTS: On‐road driving performance was assessed by certified driving school instructors in a driving school at preintervention and postintervention, and 1‐year follow‐up. RESULTS: A total of 159 community‐living older drivers participated in this study and were randomized to either an intervention group (n = 71) or a control group (n = 88). One year after the intervention, 104 of 159 community‐living older drivers completed the follow‐up assessment (intervention group, n = 58). Regarding the safe driving skill score, there was a significant group × time interaction (P <.01), indicating benefits of the intervention over time. Although the intervention group showed a significant decline in the safe driving skill score from postintervention (score = 38.9 ± 46.1) to 1‐year follow‐up (score = −0.3 ± 55.2), there was a significant difference between the groups at 1‐year follow‐up (control group score = −148.5 ± 46.4) (P <.05), and between preintervention (score = −132.0 ± 54.6) and 1‐year follow‐up in the intervention group (P <.05). CONCLUSION: The driving skill program maintained safe driving performance that had been improved by the intervention in older adults with MCI. [ABSTRACT FROM AUTHOR]

Macrolide/fluoroquinolone-resistant Campylobacter jejuni-induced cellulitis in a patient with X-linked agammaglobulinaemia successfully treated with carbapenem *In these cases, macrolide/fluoroquinolone-resistant C. jejuni was detected gl The skin lesion was diagnosed as bacterial cellulitis, and we started antibiotic treatment with cefaclor (750 mg/day). I Streptococcus pyogenes i and I Staphylococcus aureus i are known as major causes of cellulitis.1 I Campylobacter jejuni i is one of the most common causes of foodborne enteric infections in developing countries and may cause refractory cellulitis in immunocompromised patients.2 Here we report a case of multidrug-resistant I C. jejuni i cellulitis in an X-linked agammaglobulinaemia patient. [Extracted from the article]

Background: Bioelectrical impedance analysis (BIA)‐derived phase angle is expected to be an efficient prognostic marker of health adverse events with aging as an alternative of muscle mass. We aimed to examine the predictive ability of phase angle for incident disability in community‐dwelling elderly and determine the optimal cut‐off values. Methods: Community‐dwelling elderly aged ≥65 years (n = 4452; mean age = 71.8 ± 5.3 years, 48.3% women) without disability at baseline participated in this prospective cohort study. Phase angle and appendicular skeletal muscle mass (ASM) were examined using a multi‐frequency BIA at baseline. Other potential confounding factors (demographics, cognitive function, depressive symptoms, medications, and physical performance) were also assessed. Incident disability was monitored on the basis of long‐term care insurance certification. Results: Over a follow‐up of 24 months, 4.0% (n = 174) experienced disability, with an overall incidence rate of 20.6 per 1000 person‐years. The Cox hazard regression analysis showed that phase angle, as a continuous variable, was independently associated with incident disability after adjusting the covariates [male: hazard ratios (HRs) = 0.61, 95% confidence interval (CI) = 0.37–0.98; female: HR = 0.58, 95% CI = 0.37–0.90], although body mass index adjusted ASM was not. Receiver operating characteristic analysis indicated moderate predictive abilities of phase angle for incident disability [male: area under the receiver operating characteristic curve (AUC) = 0.76, 95% CI = 0.70–0.83; female: AUC = 0.71, 95% CI = 0.65–0.76], while those of body mass index adjusted ASM were low (male: AUC = 0.59, 95% CI = 0.521–0.66; female: AUC = 0.58, 95% CI = 0.52–0.63). Multivariate Cox regression analysis showed that low phase angle categorized by cut‐off value (male, ≤4.95°; female, ≤4.35°) was independently related to increased risk of incident disability (HR = 1.95, 95% CI = 1.37–2.78). Conclusions: Lower phase angle independently predicts the incident disability separately from known risk factors. BIA‐derived phase angle can be used as a valuable and simple prognostic tool to identify the elderly at risk of disability as targets of preventive treatment. [ABSTRACT FROM AUTHOR]

Aim: Previous studies have obtained inconsistent results regarding the association between sedentary behavior and cognitive impairment. The present study aimed to examine the association between cognitive activity in a sitting position (CAS) and cognitive impairment among older adults. Methods: Community‐dwelling older adults, from Obu or Nagoya in Japan, participated in a survey in 2013. A total of 5300 participants (mean age 75.0 ± 5.1 years; women 52.9%) met the criteria for the present study. We assessed the frequency and variety of CAS composed of six activities, including reading books or newspapers, writing a diary or letters, solving crossword puzzles, playing board games, using a computer and maintaining housekeeping records. The frequency of engagement in CAS was one or more time(s)/week. The variety of CAS was assessed by the number of engagements in CAS. Cognitive impairment was defined by two or more tests at least 1.5 standard deviations below the reference threshold in four neuropsychological tests. Logistic regression analysis was carried out to examine the associations between the frequency and variety of CAS and cognitive impairment, adjusted for covariates. Results: The proportion of participants engaging in each CAS varied from 12.3% (playing board games) to 93.6% (reading books or newspaper). After adjustment, five CAS were significantly associated with cognitive impairment (OR 0.33–0.65, all P < 0.001). The variety of CAS was significantly associated with the reduced OR of cognitive impairment (OR 0.61, 95% confidence interval 0.55–0.68). Conclusions: Almost every CAS and a greater variety of CAS are associated with cognitive impairment among older people. Geriatr Gerontol Int 2019; 19: 98–102. [ABSTRACT FROM AUTHOR]

Objective: Fear of falling (FOF) is a major health problem for older adults, present not just in fallers, but also nonfallers. This study examined the impact of FOF and fall history on disability incidence among community-dwelling older adults from a prospective cohort study.Methods: A total of 5104 older adults living in community settings participated in baseline assessment and were followed up for about 4 years (median 52 mo, range 49-55 mo). At baseline, participants were assessed the presence of FOF and their fall history, and divided into 4 groups: Fall (-) FOF (-), Fall (+) FOF (-), Fall (-) FOF (+), and Fall (+) FOF (+). Disability incidence was defined as national long-term care insurance certification for personal support or care.Results: During the follow-up period, 429 participants (9.9%) were newly certified as having a disability and needing personal support for long-term care insurance. Fall (-) FOF (+) group and Fall (+) FOF (+) group showed a significantly higher risk of disability incidence than Fall (-) FOF (-) group even after adjusting for covariates (Fall (-) FOF (+): hazard ratio 1.28, 95% confidence interval, 1.01-1.62, Fall (+) FOF (+): hazard ratio 1.44, 95% confidence interval, 1.05-1.98).Conclusions: Fear of falling could be a simple and useful predictor of disability incidence in community-dwelling older adults. Identifying and decreasing fall risk factors may prevent fall-related injuries, but excessive FOF may be associated with increased risk of disability incidence. [ABSTRACT FROM AUTHOR]

Objective: This study examined the association between excessive daytime sleepiness (EDS) and gait characteristics (e.g., speed, variability) in community-dwelling older adults. Method: This cross-sectional study included 3,901 individuals aged ≥65 years. Participants answered questions about EDS, sleep duration, and other sleep-related symptoms. Gait speed, stride length, and the variability in stride length were assessed by using a stopwatch and a WalkWay device. Results: EDS was significantly associated with slower gait speed among younger subjects (<75 years, p = .021) and with both slower gait speed (p = .045) and greater variability in stride length among older subjects (≥75 years, p = .048) in a multivariate analysis adjusted for age, sex, body mass index, medication, number of comorbidities, and education. Discussion: EDS associates with gait ability, particularly in older old adults. Further prospective studies are needed to determine the causal association between gait ability and sleep disturbances, including EDS. [ABSTRACT FROM AUTHOR]

Objective: Although subjective memory complaints (SMCs) are considered a risk factor for incident dementia in older people, the effect might differ based on cognitive function. The aim of the present study was to investigate whether the effect of SMCs on the incidence of dementia in older people differed based on cognitive function.Design: A 24-month follow-up cohort study.Setting: Japanese community.Participants: Prospective, longitudinal data for incident dementia were collected for 3,672 participants (mean age: 71.7 years; 46.5% men) for up to 24 months.Measurements: Baseline measurements included covariates for incident dementia, SMCs, and cognitive function. Associations between SMCs, cognitive impairment, and incident dementia were examined using Cox proportional hazards models.Results: Incidences of dementia in the cognitively intact without SMC, cognitively intact with SMC, cognitive impairment without SMC, and cognitive impairment with SMC groups were 0.3%, 1.8%, 3.4%, and 4.8%, respectively. In the cognitively intact participants, SMCs were associated with a significantly higher risk of dementia (hazard ratio [HR]: 4.95, 95% confidence interval [CI]: 1.52-16.11, p = 0.008). Incident dementia with cognitive impairment was not significantly different based on SMC presence (p = 0.527). Participants with cognitive impairment in multiple domains had a significantly higher risk of incident dementia (HR: 2.07, 95% CI: 1.01-4.24, p = 0.046) CONCLUSION: SMCs were related with dementia in cognitively intact older people, but not in those with cognitive impairment.Multiple domains of cognitive impairment were associated with a higher risk of incident dementia. [ABSTRACT FROM AUTHOR]

Aim The aim of the present study was to evaluate the relationship between sedentary time and declines in kidney function among community-dwelling older adults. Methods Participants comprised 10 242 community-dwelling older adults who were participating in the National Center for Geriatrics and Gerontology - Study of Geriatric Syndromes. Sedentary time was determined by asking participants to record the total amount of hours usually spent sitting each day, with values divided into quartiles of 0 to <4 h (reference), 4 to <6 h, 6 to <8 h and ≥8 h of sitting time per day. The estimated glomerular filtration rate was determined according to creatinine levels, and participants were classified into two categories: ≥60.0 or <60 mL/min/1.73 m2. Results After multivariate adjustment, the highest quartiles of sedentary time showed a higher rate of kidney function decline than those in the lowest quartile (odds ratio 1.42, 95% CI 1.02-1.37). In addition, participants with a history of cancer (odds ratio 1.18, 95% CI 1.01-1.39) or hypertension (odds ratio 1.38; 95% CI 1.07-1.60) had significantly increased risks of kidney function decline in the highest sedentary time group, regardless of multivariate control. Furthermore, analyses showed an increased risk of kidney function decline for a history of both cancer and hypertension (odds ratio 2.02, 95% CI 1.08-3.80). Conclusions A higher level of sedentary time was associated with kidney function decline among community-dwelling older adults. Geriatr Gerontol Int 2017; 17: 730-736. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate whether sitting time, as a form of sedentary behaviour, is related to incident depressive symptoms in older people.Methods: This study included 3503 participants (mean age 71.7 years, 50.1% female) from the 'Obu Study of Health Promotion for the Elderly' cohort study. At baseline and then 15 months later, the participants reported their status of depressive symptoms using the 15-item Geriatric Depression Scale. During the baseline assessment, the participants were also asked about their sedentary behaviour on weekdays over the past 7 days and, from there, categorized into three groups (<240, 240-480, ≥480 min/day). Demographic data and the other health behaviours were also assessed at the baseline.Results: Cross-sectional analysis revealed that 437 participants (12.0%) had depressive symptoms. In a prospective analysis, the logistic regression model revealed that the odds ratio for depressive symptom incidence was higher in participants who, at baseline, spent 480 min or more per day sitting (1.636; 95% confidence interval [CI] 1.015 to 2.636, p = 0.043), and in those who spent 240-480 min (1.605; 95% CI 1.085 to 2.375, p = 0.018) in comparison with those who spent less than 240 min.Conclusions: Sedentary behaviour significantly affects the risk of incident depressive symptoms. Further research is needed to develop an intervention strategy to manage depressive symptoms, as the second most common cause of burden of disease among older adults. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]