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Purpose: To evaluate differences in the incidence of ocular complications among pediatric and young adult patients with non-infectious uveitis receiving immunosuppressive therapy (IMT), according to the time from uveitis onset to IMT initiation in Japan. Methods: Patients aged < 20 years exhibiting uveitis treated with IMT (e.g. methotrexate, cyclosporine, infliximab, or adalimumab) were categorized into three groups according to the time from uveitis onset to IMT initiation: ≤6 months, early IMT group; 7 months to 2 years, intermediate IMT group; and ≥ 2 years, late IMT group. The percentage of ocular complications was compared among these groups. Laser flare values were recorded to evaluate disruption of the blood-aqueous barrier (BAB). Results: Forty-three patients (84 eyes) who received IMT during the follow-up period were included. Among them, 28 patients (65.1%) experienced ≥ 1 ocular complication, with percentage of 56.0% in the early IMT group, 77.8% in the intermediate group, and 77.8% in the late group. Common complications were cataract (27.4%), posterior synechiae (17.9%), and macular edema (10.7%). The early IMT group did not require surgical intervention. The late IMT group experienced a high percentage of ocular complications despite IMT initiation. The mean laser flare value during follow-up was consistently higher in the late group (113.2 pc/ms) than in the early group (14.4 pc/ms) and intermediate group (28.7 pc/ms). Conclusion: In pediatric and young adult patients with chronic non-infectious uveitis, early IMT initiation may prevent permanent breakdown of the BAB, reduce the incidence of ocular complications, and decrease the need for surgical intervention. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusion Nearly half of older adults with frailty experience chronic pain. Chronic pain contributes to activity restrictions. Decreased physical activity with chronic pain is associated not only with physical dysfunction but also with reduced engagement in social activities. We aimed to verify the hypothesis that chronic pain and decreased physical activity are associated with social frailty incidence.The study included 1198 community‐dwelling older adults (aged 70.2 ± 6.3 years) without social frailty at baseline. Chronic pain, physical activity and basic information were assessed at baseline. The participants were divided into two groups based on the presence (yes, n = 167) or absence (no, n = 1031) of chronic low back pain. The incidence of social frailty was investigated during the follow‐up examination after 2.5 years.Binomial logistic regression analysis showed that older adults with chronic low back pain and low step counts had a higher odds ratio for the development of incident social frailty than older adults without chronic low back pain and high step counts (odds ratio 1.89, 95% confidence interval 1.03–3.46).Our results suggest that a combination of chronic low back pain and low step counts is associated with the incidence of social frailty. Further research is required to establish intervention methods for pain and decreased physical activity to prevent social frailty. Geriatr Gerontol Int 2024; ••: ••–••. [ABSTRACT FROM AUTHOR]

Aim: Driving cessation is strongly associated with adverse health outcomes in older adults. Although numerous studies have focused on driving skill interventions for safe driving, the effects of interventions on car accidents remain unclear. We designed a randomized controlled trial to examine the effects of driving skill training on the prevention of car accidents among community‐dwelling older adults using on‐road training. Methods: A total of 1408 community‐dwelling older drivers aged ≥65 years participated in the randomized controlled trial with blinded endpoint assessment. Participants randomized to the intervention group (n = 697) underwent four sessions, with 200 min re‐training focused on the problem of driving in the older people. Controls (n = 697) received one classroom education session. On‐road driving performance was assessed by certified driving school instructors in a driving school. The primary endpoint is an incident car accident, which will be detected based on the Japanese national car accident report data, after 24 months. Discussion: This study has the potential to provide the first evidence of the effectiveness of on‐road driving skill training regarding the prevention of car accidents. If our trial results show a lower number of car accidents due to driving skill training, this kind of intervention will provide an effective method for maintaining safe driving. These results will be disseminated to the appropriate national transportation agencies to improve or modify safe driving policies and possibly extend the validity of driver's licenses for older adults. Trial Registration: UMIN‐CTR (identification number: UMIN000034709). Registered 31 October 2018. Geriatr Gerontol Int 2024; 24: 1218–1222. [ABSTRACT FROM AUTHOR]

Objectives This study aimed to investigate the association between falls and social frailty and its components among older Japanese adults. Methods This is a cross-sectional study. Participants were categorized into 3 groups based on the number of falls in the past year: no fall (none), a single fall (occasional), and more than one fall (recurrent). The participants who met 2 or more of the following criteria were defined as socially frail: living alone, going out less frequently compared with the previous year, rarely visiting friends, feeling unhelpful to friends or family, and not talking with someone daily. Results A total of 4,495 older Japanese adults living in a community analyzed in this study (51.0% women). Of the participants in this study, 3,851 (85.7%) were categorized as none, 443 (9.9%) as occasional, and 201 (4.5%) as recurrent. The proportion of participants considered socially frail was 11.5% in this study. Recurrent falls were associated with social frailty, even after adjusting for covariates (odds ratio [OR]: 1.49; 95% confidence interval [CI]: 1.01–2.19). The experience of recurrent falls was associated with the following components: "feeling unhelpful to friends and family" (OR: 1.62; 95% CI: 1.14–2.31) and "going outside less frequently compared with last year" (OR: 1.57; 95% CI: 1.06–2.31). Discussion Among older Japanese adults, recurrent falls were associated with social frailty and with 2 of its components in particular: social roles and social participation. Future longitudinal studies should be conducted to gain insight into any causal relationships between these variables. [ABSTRACT FROM AUTHOR]

INTRODUCTION: We examined the efficacy of a multidomain intervention in preventing cognitive decline among Japanese older adults with mild cognitive impairment (MCI). METHODS: Participants aged 65‐85 years with MCI were randomized into intervention (management of vascular risk factors, exercise, nutritional counseling, and cognitive training) and control groups. The primary outcome was changes in the cognitive composite score over a period of 18 months. RESULTS: Of 531 participants, 406 completed the trial. The between‐group difference in composite score changes was 0.047 (95% CI: −0.029 to 0.124). Secondary analyses indicated positive impacts of interventions on several secondary health outcomes. The interventions appeared to be particularly effective for individuals with high attendance during exercise sessions and those with the apolipoprotein E ε4 allele and elevated plasma glial fibrillary acidic protein levels. DISCUSSION: The multidomain intervention showed no efficacy in preventing cognitive decline. Further research on more efficient strategies and suitable target populations is required. Highlights: This trial evaluated the efficacy of multidomain intervention in individuals with MCI.The trial did not show a significant difference in preplanned cognitive outcomes.Interventions had positive effects on a wide range of secondary health outcomes.Those with adequate adherence or high risk of dementia benefited from interventions. [ABSTRACT FROM AUTHOR]