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Aim: To examine the effects of employment engagement, classified by frailty and working status, on the incidence of disability in urban community‐dwelling older adults. Methods: We used data from 6386 initially nondisabled residents aged 65–84 years from Ota City, Tokyo, Japan, in 2016. The observation duration was 3.6 years. Self‐administered questionnaires applied the Cox proportional hazard model by assessing the existence of frailty through Check‐List 15 (with a score ≥4 indicating the state of frailty), controlling for age, sex, living situation, education level, equivalent income, chronic conditions, body mass index, instrumental activities of daily living, self‐rated health, drinking and smoking status, and social activities. We evaluated the predictive value of working status (full‐time, part‐time, temporary, or nonworker) at baseline for cause‐specific disability (dementia‐type vs. non–dementia‐type) incidence, identified using the long‐term care insurance system's nationally unified database. Results: Of the 6386 participants, 806 (63/1134 full‐time workers; 58/1001 part‐time workers; 61/547 temporary workers; 624/3704 nonworkers) presented with disabilities during the 3.6‐year‐long duration. Adjustments for conventional covariates showed that nonfrail full‐time and part‐time workers, as well as frail full‐time workers, had significantly lower risks of all‐cause disability incidence. Furthermore, nonfrail and frail full‐time workers had significantly lower risks of dementia‐type and nondementia‐type disabilities, respectively. Conclusions: The incidence of disability in older adults was influenced by working and frailty status. Engaging in full‐time work thus prevents disabilities in older adults, regardless of their frailty status. Meanwhile, nonfrail older adults are able to avoid disabilities even when engaging in part‐time work. Geriatr Gerontol Int 2023; 23: 855–863. [ABSTRACT FROM AUTHOR]

With the topical focus on the prevention of and countermeasures for frailty, scattered studies have subdivided its social elements and aspects as "social frailty." While the concepts and definition of "social frailty" are yet to be established, the purpose of using the term is to capture the attention of professionals using the social aspects of frailty to support older adults. The goal is to increase healthy life expectancy by recognizing that social factors are unlikely to pose a risk of functional decline in isolation, but may increase such a decline when combined with other factors. At feasible scopes of intervention, ways to address these factors should be pursued. Although social aspects are often expressed by frail people, or social factors with complex processes that can cause functional decline, there is no unified definition or indicator of social frailty. Further research and discussion are needed to clarify its academic significance and usefulness for disability prevention. Recognizing this, when the Japanese Socio‐Gerontological Society's Study Committee on "Social Frailty" published its recommendations, it suggested that when using the term "social frailty" we should specify the significance of its use; consider the comprehensiveness of frailty; be mindful of the interrelationship of social activities and other social aspects; and consider environmental conditions such as a person's values, preferences and life course, social norms, systems, and government policies. High‐risk individuals may need multidisciplinary approaches delivered by various professionals, including clinicians, in realizing a life in line with their unique values and preferences. In such cases, it is necessary to understand the background and process that led to frailty, from physical, psychological, and social perspectives, referring to the abovementioned four points. The introduction of social aspects as one of the assessment frameworks can significantly bridge the gap between medical care and the community. Geriatr Gerontol Int 2022; 22: 991–996. [ABSTRACT FROM AUTHOR]

Purpose: Deciding whether or not surgery should be performed for elderly patients is sometimes difficult. This study examined the prognosis of patients ≥ 80 years old with gastric cancer who underwent surgery or not. Methods: The medical records of 111 patients who underwent surgery (surgery group) and 35 who received best supportive care (BSC group) were retrospectively reviewed, excluding those with clinical stage IVB disease, those with a performance status of 4, and those who underwent endoscopic submucosal dissection. The overall survival was compared between the two groups. Results: The patients in the BSC group were significantly older and had worse performance status scores, worse physiological scores, and lower prognostic nutritional indexes than those in the surgery group. The patients in the surgery group showed a significantly better survival than those in the BSC group (median survival time, 38.9 vs. 11.4 months; p = 0.01) even after propensity score matching. In the subgroups of patients ≥ 90 years old and those with a performance status of 3, no marked difference in the survival between the 2 groups was observed. Conclusions: Surgery imbued a survival benefit to elderly gastric cancer patients, except for those ≥ 90 years old and those with a performance status of ≥ 3. The surgical indication of patients ≥ 90 years old and those with a performance status of ≥ 3 requires careful deliberation. [ABSTRACT FROM AUTHOR]

Objectives There is a growing body of literature examining age-related overestimation of one's own physical ability, which is a potential risk of falls in older adults, but it is unclear what leads them to overestimate. This study aimed to examine 3-year longitudinal changes in self-estimated step-over ability, along with one key risk factor: low frequency of going outdoors (FG), which is a measure of poor daily physical activity. Method This cohort study included 116 community-dwelling older adults who participated in baseline and 3-year follow-up assessments. The step-over test was used to measure both the self-estimated step-over bar height (EH) and the actual bar height (AH). Low FG was defined as going outdoors either every few days or less at baseline. Results The number of participants who overestimated their step-over ability (EH > AH) significantly increased from 10.3% to 22.4% over the study period. AH was significantly lower at follow-up than at baseline in both participants with low and high FGs. Conversely, among participants with low FG, EH was significantly higher at follow-up than at baseline, resulting in increased self-estimation error toward overestimation. Regression model showed that low FG was independently associated with increased error in estimation (i.e. tendency to overestimate) at follow-up. Discussion The present study indicated that self-overestimated physical ability in older adults is not only due to decreased physical ability but also due to increased self-estimation of one's ability as a function of low FG. Active lifestyle may be critical for maintaining accurate estimations of one's own physical ability. [ABSTRACT FROM AUTHOR]

Aim: The present study explored the interactive effects of willingness to volunteer and actual volunteer engagement on the maintenance of functional health among older Japanese adults, using data from a 3‐year longitudinal study. Methods: We used data from the 3‐year longitudinal Tokyo Metropolitan Institute of Gerontology Longitudinal Interdisciplinary Study on Aging (1997). We examined 676 older adults aged >65 years from the rural Nangai District who were independent in their basic activities of daily living (BADL). A follow‐up study was carried out in 2000. We categorized participants into four groups: "willing volunteers," "unwilling volunteers," "willing non‐volunteers" and "unwilling non‐volunteers." Logistic regression analyses were carried out to evaluate the interactive effects of willingness to volunteer and actual engagement in volunteering at baseline on BADL decline over a 3‐year period. Results: During the follow‐up period, 6.6% of willing volunteers, 17.4% of unwilling volunteers, 16.3% of willing non‐volunteers and 21.0% of unwilling non‐volunteers experienced a decline in BADL. Unwilling volunteers (odds ratio [OR] 2.88, 95% confidence interval [CI] 1.29–6.43) and both non‐volunteer groups (willing: OR 2.70, 95% CI 1.28–5.72; unwilling: OR 2.48, 95% CI 1.32–4.64) had significantly higher odds of BADL decline than did willing volunteers. When unwilling non‐volunteer was set as the reference, the OR of unwilling volunteers became 1.16 (95% CI 0.55–2.49), suggesting that unwilling volunteers had a similar odds of BADL decline as non‐volunteers. Conclusion: Volunteer activity is effective for preventing BADL decline only for those who willingly engage. Geriatr Gerontol Int 2019; 19: 673–678. [ABSTRACT FROM AUTHOR]

The present study used inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) to compare survival benefits among 112 patients with resectable, stage II–IV esophageal squamous cell carcinoma (SCC) treated between 1996 and 2016 with neoadjuvant chemoradiotherapy (NAC) plus surgery (Group A, n=55) or with surgery alone (Group B, n=57). Their propensity scores (PS) were calculated using a multivariable logistic regression model in which age, sex, cancer site, primary tumor length, cTNM stage, lymph node metastasis and depth of tumor invasion were the independent variables, and used to match Groups A and B according to the IPTW and matching method. After IPTW and PSM, univariate analysis was used to assess overall survival (OS) and disease-free survival (DFS), followed by Cox proportional hazard models for OS using IPTW between the two groups and the subgroups. After PSM, 5-year OS and DFS were significantly higher in Group A (OS: 65.2%, DFS: 65.2%) compared with Group B (OS: 31.2%, DFS: 20.87%). Similarly, after IPTW, OS and DFS were significantly higher in Group A compared with Group B patients. Five-year OS was 73.18% for Group A and 37.69% for Group B (hazard ratio: 0.2899, 95% confidence interval: 0.1167–0.7205). To conclude, treatment was more effective in Group A patients with clinical stage II, N0 and T3 disease involving the mid-esophagus. It was concluded that for patients with esophageal SCC, NAC plus esophagectomy exhibited improved survival compared with surgery alone, as demonstrated by use of IPTW and PSM methods. [ABSTRACT FROM AUTHOR]

Introduction: We examined the relationship between previous fluctuations in Mini-Mental State Examination (MMSE) scores, future changes in MMSE scores, and attrition from follow-up surveys, which helps in a more comprehensive interpretation of repeatedly collected MMSE scores. Methods: This 4-year longitudinal study included 2,073 community-dwelling older adults aged ≥65 years in Japan. The MMSE was administered at baseline (T0), 2 years (T1), and 4 years (T2) follow-up. We performed multinomial logistic regression analysis with the dependent variable, indicating the change in MMSE score from T1 to T2 (categorized as increase, no change [reference category], and decrease) and attrition at T2. The independent variables included the change in MMSE scores from T0 to T1 and MMSE scores at T0 and T1. Results: The mean MMSE score was 29 across the three time points. A one-point decrease in MMSE score from T0 to T1 was associated with 79% (95% confidence interval: 1.62, 1.97) higher odds of an increase in MMSE score from T1 to T2 and 28% (1.17, 1.40) higher odds of attrition at T2. A one-point decrement in the MMSE score at T0 and T1 was also associated with an increase in the MMSE score from T1 to T2 and attrition at T2. Conclusion: Focusing on cognitive fluctuation for 2 years, rather than cognitive function at a point in time, would have no remarkable advantage when focusing on future cognitive function and attrition. Our results emphasize the need for further studies to identify factors that distinguish between those who continue to attend follow-up surveys and show improvements in cognitive test scores and those who drop out. [ABSTRACT FROM AUTHOR]

Older adults tend to overestimate their step-over ability. However, it is unclear as to whether this is caused by inaccurate self-estimation of physical ability or inaccurate perception of height. We, therefore, measured both visual height perception ability and self-estimation of step-over ability among young and older adults. Forty-seven older and 16 young adults performed a height perception test (HPT) and a step-over test (SOT). Participants visually judged the height of vertical bars from distances of 7 and 1 m away in the HPT, then self-estimated and, subsequently, actually performed a step-over action in the SOT. The results showed no significant difference between young and older adults in visual height perception. In the SOT, young adults tended to underestimate their step-over ability, whereas older adults either overestimated their abilities or underestimated them to a lesser extent than did the young adults. Moreover, visual height perception was not correlated with the self-estimation of step-over ability in both young and older adults. These results suggest that the self-overestimation of step-over ability which appeared in some healthy older adults may not be caused by the nature of visual height perception, but by other factor(s), such as the likely age-related nature of self-estimation of physical ability, per se. [ABSTRACT FROM AUTHOR]

Key Clinical Message Granulocyte colony-stimulating factor ( G- CSF)-producing esophageal squamous cell carcinoma ( ESCC) is rare. Esophageal cancer is a highly aggressive disease and often spreads hematogenously; however, choroidal metastases are rarely seen. This report detailed an extremely rare case of G- CSF-producing ESCC with choroidal metastasis. [ABSTRACT FROM AUTHOR]

Aim Decreased frequency of going outside the home and being socially isolated are regarded as predictors of poor health. The object of the present study was to clarify whether these factors have synergistic or independent impacts on future functional decline. Methods We examined a prospective cohort of 2427 community-dwelling persons, aged ≥65 years, who responded to the baseline mail survey in Wako City, in 2008. Participants were asked about the frequency of going outside the home, social isolation status (having contact less than once a week with anyone outside household), functional capacity (Tokyo Metropolitan Institute of Gerontology-Index of Competence), age, sex, annual income, self-rated health, depressive mood and mobility. Results Of 1575 persons (72.1%) who completely responded to the follow-up survey ( T2) in 2012, we defined the groups as follows: group 1, not isolated and going outside the home every day ( n = 897); group 2, not isolated and going outside the home less than every day ( n = 311); group 3, isolated and going outside the home every day ( n = 224); and group 4, isolated and going outside the home less than every day ( n = 143). Multiple logistic regression analyses showed that the variables identifying group 3 for men and group 2 for women with reference to group 1 were predictors of subsequent functional decline even after adjustment for confounders (odds ratios 2.01, 1.63; 95% CI 1.20-3.38, 1.03-2.56, respectively). Conclusion Social isolation regardless of going outside the home every day for men and going outside the home less than every day regardless of being not socially isolated for women might predict functional decline. Geriatr Gerontol Int 2017; 17: 500-508. [ABSTRACT FROM AUTHOR]

Objective: Physical performance measures (PPMs) are good predictors of adverse health outcomes in later life. This prospective study used repeated measures analysis to examine sex-specific age trends in PPMs, identify potential PPM trajectory patterns, and determine whether PPM trajectory patterns were associated with all-cause mortality among older Japanese.Methods: Among 1,524 adults aged 65 years or older who participated in a baseline survey, 1,048 adults (mean [SD] age, 71.6 [5.4] years; women, 57.0%) were followed up at least once. The total number of observations was 4,747, and the average number of follow-up assessments was 4.5 during the period from 2002 through 2011. The PPMs studied were handgrip strength, usual gait speed, and one-leg standing time. We checked local registries to identify deaths from any cause; 89 (8.5%) participants died during follow-up.Results: All PPMs significantly decreased with advancing age, and handgrip strength and usual gait speed showed sex-specific age trends. We identified three distinct trajectory patterns (high, middle, and low trajectory groups) for each PPM in adults aged 65-90 years, and the trajectories for handgrip strength and usual gait speed showed parallel declines in men and women, respectively. After adjusting for important confounders, the trajectory groups for handgrip strength and one-leg standing time were independent predictors of all-cause mortality.Conclusions: Regardless of baseline level, the PPMs tended to show similar age-related changes in later life. However, individuals in low PPM trajectory groups had a higher mortality risk, which highlights the importance of interventions that maintain or improve physical performance, even among older adults with low physical performance. [ABSTRACT FROM AUTHOR]

A growing body of literature indicates that cognitively intact older adults tend to overestimate their physical functioning (e.g., step-over ability), which may lead to fall risk. However, the neural correlates underlying this phenomenon are still unclear. We therefore investigated the neural basis of older adults' self-overestimation of stepping-over ability. A total of 108 well-functioning community dwelling older adults (mean age = 73.9 years) performed step-over tests (SOT) in two ways: self-estimation of step-over ability and an actual step-over task. During the self-estimation task, participants observed a horizontal bar at a distance of 7 m and estimated the maximum height (EH) of successful SOT trials. The actual SOT was then performed to determine the actual maximum height (AH) of successful trials. Participants also underwent positron emission tomography with F-fluorodeoxyglucose at rest to assess cerebral neural activity. The SOT showed that 22.2 % of participants overestimated their step-over ability. A regression analysis adjusted for potential covariates showed that increased self-estimation error (difference between EH and AH) was correlated with lower glucose metabolism in the bilateral orbitofrontal cortex (OFC) and left frontal pole. Only the significant correlation between self-estimation error and OFC activity persisted after correcting for multiple comparisons. For well-functioning healthy older adults, overlooking one's own functional decline may be influenced by reduced metabolic activity in the anterior prefrontal cortex, particularly in the OFC. Our findings also suggest that functional decline in the OFC prevents older adults from updating the qualitative/quantitative values of their impaired physical abilities. [ABSTRACT FROM AUTHOR]

Aim To examine whether engaging in paid work is a predictor of maintaining good functional health among Japanese older adults in both urban and rural communities. Methods We used the 8-year longitudinal Tokyo Metropolitan Institute of Gerontology Longitudinal Interdisciplinary Study on Aging with 306 and 675 persons aged 65-84 years from Koganei City (urban) and Nangai Village (rural), respectively, who are independent in basic activities of daily living ( BADL). In order to examine the declining patterns in BADL and evaluate the predictive value of working status for future BADL disability, we applied the log-rank test of cumulative proportion curves and the Cox proportional hazard model by sex, controlling for age, research fields, years of education, marital state, chronic medical conditions, pain, instrumental activities of daily living ( IADL), smoking status, exercise habits, life satisfaction, usual walking speed and serum albumin for evaluating the predictive value of working status at baseline for future BADL disability. Results In both areas, participants who were not working were more likely to decline in BADL than those working ( P < 0.05), except for women in urban Koganei. Male participants who did not engage in paid work had a higher adjusted hazard ratio of onset of BADL disability, compared with those working, but this was not seen for female participants. Conclusions Working might be protective from a decline in BADL only for men, but not for women. Regarding the difference of sex roles in conventional Japanese society, working would be an effective solution especially for men to participate in social activities. Geriatr Gerontol Int 2016; 16: 126-134. [ABSTRACT FROM AUTHOR]

Purpose: In Japan, the number of distal gastrectomy for patients ≥ 80 years old is increasing, whereas that of total gastrectomy is decreasing. Surgeons seem to avoid total gastrectomy for elderly patients. Total gastrectomy is reported to have a poorer prognosis than distal gastrectomy, and postoperative pneumonia may be involved in the cause. Methods: The medical records of 39 and 108 patients ≥ 80 years old who underwent total and distal gastrectomy, respectively, at 2 affiliated institutions between 2010 and 2019 were retrospectively reviewed. Prognoses were compared between the two groups, focusing on death from pneumonia. Results: The median overall survival time after total and distal gastrectomy was 21.3 and 74.1 months, respectively, with a significantly poorer prognosis after total gastrectomy than after distal gastrectomy (p < 0.01, hazard ratio [HR] 2.20, 95% confidence interval [CI] 1.37–3.53). The gastric cancer-specific survival time was significantly worse after total gastrectomy than after distal gastrectomy (p < 0.01, HR 2.73, 95% CI 1.29–5.79). The pneumonia-specific survival time was also significantly worse after total gastrectomy than after distal gastrectomy (p = 0.01, HR 3.44, 95% CI 1.25–9.48). Conclusions: Patients who underwent total gastrectomy had a poorer prognosis than those who underwent distal gastrectomy, because many patients died of pneumonia early after total gastrectomy. [ABSTRACT FROM AUTHOR]

Background. The objective of this study was to investigate the relationship between normalized regional cerebral metabolic rates of glucose (normalized-rCMRglc) and gait function in physically and mentally high-functioning older women. Methods. One hundred eighty-two community-dwelling older women (mean age [SD], 69.4 [6.6] years) without disability in instrumental activities of daily living and without mobility limitations underwent positron emission tomography with 18F-fluorodeoxyglucose at rest to assess brain activity associated with gait function. We measured normalized-rCMRglc in 16 regions of interest. Within 6 months of the positron emission tomography with 18F-fluorodeoxyglucose scan, gait speed, step length, and step frequency both at comfortable and maximum paces were measured as indices of gait function. Associations between normalized-rCMRglc and gait indices were examined with multiple linear regression analyses adjusted for demographic characteristics, including age, height, body weight, blood pressure, past illness, and education. Results. Slower maximum gait speed even in the range of individual difference was associated with lower normalized-rCMRglc in the prefrontal, posterior cingulate, and parietal cortices. Lower step frequency at the maximum pace was also associated with lower normalized-rCMRglc in these regions. However, there was no significant association between step length at the maximum pace and normalized-rCMRglc or between all gait variables at a comfortable pace and normalized-rCMRglc. Conclusions. The normalized-rCMRglc values in specific regions were associated with individual differences in gait function, even in healthy older women. These regions of the cerebrum could play an important role in gait control. Understanding the cerebral glucose metabolism in these brain regions may enable early detection of mobility limitation. [ABSTRACT FROM PUBLISHER]

Objective Self-overestimation of step-over ability among older adults may result in a potential fall risk. However, the behavioral causal factor(s) of older adults’ self-overestimation is unclear. We examined whether older adults’ overestimation of step-over ability was mediated by an inactive lifestyle and/or poor executive function. Methods A sample of 194 community-dwelling older adults was assigned to either a high (HG, once a day or more) or low (LG, every 2–3 days or less) frequency of going outdoors group. Executive function was determined by the Trail-Making Test (TMT). Both the HG and LG participants performed Step-Over Tests (SOT) in two ways: self-estimation of step-over ability and the actual step-over task. During the self-estimation task, participants observed the horizontal bar at a distance of 7 m and predicted the self-estimated maximum height (EH) of successful SOT trials. The motor task was then performed, determining the actual maximum height (AH) of successful trials. Results A total of 36.1% of LG participants failed to successfully perform SOT trials at their EH (i.e., overestimation), whereas only 11.3% of HG participants failed. A multiple linear regression analysis showed that SOT overestimation was associated with an inactive lifestyle (low frequency of going outdoors) but not with executive function. Analyses of fall experience showed that both executive function and lifestyle significantly correlated with SOT overestimation among fallers, whereas only lifestyle was significantly correlated among non-fallers. Conclusion Our results suggest that an inactive lifestyle is a possible correlate of SOT overestimation among older adults, while executive function further influenced overestimation only among fallers. [ABSTRACT FROM AUTHOR]

Aim The objective of this study was to evaluate the effects of a comprehensive overweight intervention program, which utilizes hot bathing, on overweight, community-dwelling middle-aged and older adults in a randomized controlled trial. Methods The program was carried out in a hot bath facility and included 66 community-dwelling middle-aged and older Japanese adults (mean age 61.6 years, SD 7.5, 77.3% were women). The participants were randomly assigned to an exercise, diet and hot bathing intervention group (group A), exercise and diet intervention group (group B), a hot-bathing intervention group (group C) and a control group (group D). The participants in groups A and B participated in a comprehensive intervention program (including exercise and diet classes) twice a week for 3 months, and groups A and C had hot bathing. Results After 3 months, the participants in group A showed a reduction in weight, abdominal circumference, body mass index and body fat percentage compared with the other intervention groups. And the lower extremity function (i.e. walking speed) had greater improvement in the participants in groups A and B compared with groups C and D. In group C, in which only hot bathing was the intervention, there were no significant improvements in measurement items. Conclusions Our study provides preliminary evidence that a comprehensive intervention program, including hot bathing, is useful for community residents with a tendency toward overweight. Geriatr Gerontol Int 2013; 13: 638-645. [ABSTRACT FROM AUTHOR]

Aim: The Montreal Cognitive Assessment (MoCA), developed by Dr Nasreddine (Nasreddine et al. 2005), is a brief cognitive screening tool for detecting older people with mild cognitive impairment (MCI). We examined the reliability and validity of the Japanese version of the MoCA (MoCA-J) in older Japanese subjects. Methods: Subjects were recruited from the outpatient memory clinic of Tokyo Metropolitan Geriatric Hospital or community-based medical health check-ups in 2008. The MoCA-J, the Mini-Mental State Examination (MMSE), the revised version of Hasegawa's Dementia Scale (HDS-R), Clinical Dementia Rating (CDR) scale, and routine neuropsychological batteries were conducted on 96 older subjects. Mild Alzheimer's disease (AD) was found in 30 subjects and MCI in 30, with 36 normal controls. Results: The Cronbach's alpha of MoCA-J as an index of internal consistency was 0.74. The test–retest reliability of MoCA, using intraclass correlation coefficient between the scores at baseline survey and follow-up survey 8 weeks later was 0.88 ( P < 0.001). MoCA-J score was highly correlated with MMSE ( r = 0.83, P < 0.001), HDS-R ( r = 0.79, P < 0.001) and CDR ( r = −0.79, P < 0.001) scores. The areas under receiver–operator curves (AUC) for predicting MCI and AD groups by the MoCA-J were 0.95 (95% confidence interval [CI] = 0.90–1.00) and 0.99 (95% CI = 0.00–1.00), respectively. The corresponding values for MMSE and HDS-R were 0.85 (95% CI = 0.75–0.95) and 0.97 (95% CI = 0.00–1.00), and 0.86 (95% CI = 0.76–0.95) and 0.97 (95% CI = 0.00–1.00), respectively. Using a cut-off point of 25/26, the MoCA-J demonstrated a sensitivity of 93.0% and a specificity of 87.0% in screening MCI. Conclusion: The MoCA-J could be a useful cognitive test for screening MCI, and could be recommended in a primary clinical setting and for geriatric health screening in the community. Geriatr Gerontol Int 2010; 10: 225–232. [ABSTRACT FROM AUTHOR]

Objective To test the a priori hypothesis that increase or maintenance of the level of cognitive activity would be independently associated with a subsequent beneficial impact (i.e. improvement or maintenance) on instrumental activity of daily living (IADL) functioning. Methods Observational study using 4-year longitudinal data from 1477 community-dwelling Japanese who were 66 years and older and living in Yoita town, a rural community located in the northwest along the Sea of Japan. Baseline assessment occurred in November 2000. Intellectual Activity and IADL were evaluated using the Tokyo Metropolitan Institute of Gerontology (TMIG) Index of Competence. Results Increase or maintenance of exposure to intellectual activities over a period of 2 years was associated with increased likelihood of better IADL functioning trajectory (i.e. improvement or stability) over the subsequent 2 years (OR: 1.63; 95% CI: 1.03–2.56; p = 0.035), even after adjustment for major confounders. Conclusion This study documented a longitudinal, independent association of exposure to intellectual activities with better IADL functioning over time. These findings provide preliminary support for promotion of exposure to intellectual activities among older adults as an opportunity to prevent disability in the older segment of the population. Assessment of public health programs targeting such an opportunity is warranted. Copyright © 2009 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

We launched a new intervention study called REPRINTS in which senior volunteers engaged in reading picture books to children. Sixty-nine volunteers and 72 participants in a control group, all aged 60 years and over, living in three urban locations, participated in a baseline health checkup in June 2004. After completion of a three-month training seminar, volunteers visited public elementary schools and kindergartens in groups of 6 to 10 for an 18 month period. They were assessed again by a follow-up health checkup in March 2006. At the follow-up, social network scores (frequency of contact with grandchildren and others around the neighborhood) and self-rated health improved or was maintained at a significantly higher rate for the 37 individuals volunteering most intensively as compared to those who did not volunteer or volunteered minimally. In conclusion, through intensively being engaged in the intergenerational volunteer programs during 21 months, self-rated health and social networks were more likely to improve or be maintained among senior volunteers than controls. [ABSTRACT FROM AUTHOR]

Background: To explore predictors of functional improvement or decline in instrumental activities of daily living (IADL) among community-dwelling older people. Methods: Of all the residents (≥65 years, n = 1,673) living in Yoita town, Niigata prefecture, Japan, in 2000, 1,544 subjects who participated in the baseline interview survey (T1) were followed up until 2002 (T2). A wide range of variables obtained in T1 was entered into the model predicting functional improvement or decline in IADL. Results: Among 1,274 individuals who participated in both T1 and T2, 105 subjects showed improvement, 194 decline, and the remaining 975 showed stability in IADL. Multiple logistic regression analyses indicated that good self-rated health and cognitive function (MMSE ≥24) at T1 were good predictors of both improvement and protection against decline in IADL. Independence in basic activities of daily living predicted improvement in IADL. Advanced age and poor walking ability predicted decline in IADL. Conclusions: Good self-rated health and cognitive function predicted both improvement and protection against decline in IADL. Thus, intervention programs aiming at maintaining both good self-rated health and cognitive function should be able to improve IADL. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background and Aims: The relationship between gastroesophageal reflux disease and sliding hernia is controversial, especially following distal partial gastrectomy in patients with gastric cancer. The aim of this study was to examine the relationship between gastroesophageal reflux disease and sliding hernia of the esophagus after distal gastrectomy using the gastroesophageal scintigraphy and endoscopy. Methods: Forty-five distal gastrectomy patients diagnosed with cancer of the stomach were studied. Twenty-five patients presented with reflux symptoms, such as heartburn and/or regurgitation and 20 patients exhibited no reflux symptoms. All of the patients were examined by gastroesophageal scintigraphy and their reflux indices were determined. Thirty-eight of the patients underwent upper endoscopy and both sliding hernias and reflux symptoms were classified as mild or severe. Results: Sliding hernias were diagnosed in all of the subjects and 65.8% of the patients exhibited reflux symptoms. Evidence of endoscopic esophagitis was noted in only 39.5% of the patients. The reflux indices for the mild and severe hernia groups were 5.03 ± 2.2 and 10.3 ± 6.4, respectively ( P < 0.05). More severely symptomatic esophagitis was prevalent in the severe hernia group in comparison to the mild group ( P < 0.05). Conclusion: The results suggest that the onset of gastroesophageal reflux after distal gastrectomy is induced by the surgical procedures and that hiatal hernia may be an important factor in the etiology of reflux esophagitis. [ABSTRACT FROM AUTHOR]

Background: Knowledge about potentially modifiable risk factors for cognitive decline is limited at this time. The aim of this study was to determine the cross-sectional relationship between a low level of cognitive function and brachial-ankle pulse wave velocity (baPWV) in a community-dwelling elderly population.Methods: The study population included 352 community-dwelling Japanese persons ages 70 years and older who participated in a comprehensive health examination in April 2003. None had any history of cardiovascular disease. In addition to conventional medical examinations such as blood pressure and routine blood analyses, cognitive function was tested using the Mini-Mental State Examination (MMSE), and baPWV was determined using a recently developed noninvasive and automatic arterial waveform analyzer (AT-Form). This measure, with well-established validity and reproducibility, reflects both central and peripheral arterial flow. A multivariate logistic regression model tested the possible association between poor cognitive function (an MMSE score < 24) and baPWV.Results: Poor cognitive function was independently associated with the middle tertile of baPWV (odds ratio [OR] = 9.66, 95% confidence interval [CI] = 1.15 to 80.93), age (1-year increment; OR = 1.12, 95% CI = 1.04 to 1.22), and the highest tertile of pulse pressure (OR = 4.70, 95% CI = 1.08 to 20.48) even after multivariate adjustment of data for the effects of age, educational level, and hemodynamic and metabolic antecedents of atherosclerosis.Conclusions: A high baPWV may be a potent risk factor for poor cognitive function in an elderly community-dwelling population, and this effect is independent of another marker of arterial stiffness: pulse pressure. [ABSTRACT FROM AUTHOR]

Background. Knowledge about potentially modifiable risk factors for cognitive decline is limited at this time. The aim of this study was to determine the cross-sectional relationship between a low level of cognitive function and brachial-ankle pulse wave velocity (baPWV) in a community-dwelling elderly population. Methods. The study population included 352 community-dwelling Japanese persons ages 711 years and older who participated in a comprehensive health examination in April 2003. None had any history of cardiovascular disease. In addition to conventional medical examinations such as blood pressure and routine blood analyses, cognitive function was tested using the Mini-Mental State Examination (MMSE), and baPWV was determined using a recently developed noninvasive and automatic arterial waveform analyzer (AT-Form). This measure, with well-established validity and reproducibility, reflects both central and peripheral arterial flow. A multivariate logistic regression model tested the possible association between poor cognitive function (an MMSE score <24) and baPWV. Results. Poor cognitive function was independently associated with the middle tertile of baPWV (odds ratio [OR] = 9.66, 95% confidence interval [CI] = 1.15 to 80.93), age (1-year increment; OR = 1.12, 95% CI = 1.04 to 1.22), and the highest tertile of pulse pressure (OR = 4.70, 95% CI = 1.08 to 20.48) even after multivariate adjustment of data for the effects of age, educational level, and hemodynamic and metabolic antecedents of atherosclerosis. Conclusions. A high baPWV may be a potent risk factor for poor cognitive function in an elderly community-dwelling population, and this effect is independent of another marker of arterial stiffness: pulse pressure. [ABSTRACT FROM AUTHOR]

Background. A simple instrument has been developed to measure brachial-ankle pulse wave velocity (baPWV). The aim of the present study was to use this instrument to study the relationship between baPWV and conventional atherosclerotic risk factors.Methods. Community-dwelling Japanese (632) living in a rural area (234 men and 398 women) participated in a municipal medical health survey that included baPWV measurement and a traditional clinical examination, conducted in June, 2002.Results. Men had a significantly higher baPWV than women. No interaction between gender and age on baPWV was identified. Multiple linear regression analysis indicated that age, hemodynamic factors (diastolic blood pressure, pulse pressure, and heart rate), hemoglobinA1c, current drinking and smoking status, and mild retinal changes had significant independent influences on higher baPWV.Conclusions. In this rural population, age, gender, and hemodynamic factors were independently associated with baPWV, along with traditional atherosclerotic risk factors, although no significant associations between baPWV and histories of atherosclerotic diseases or subclinical atherosclerosis except for mild retinal changes were demonstrated. [Copyright &y& Elsevier]

Background: Many studies have examined the impact of chronic medical conditions on the age-related decline in basic activities of daily living (BADL) and the instrumental activities of daily living (IADL), but less is known concerning the influence of chronic disease on physical, cognitive, social, and economic aspects of higher-level functional capacity. Methods: Subjects comprised 793 and 725 persons aged 65-84 years, living in an urban and a rural Japanese community, respectively. A baseline interview established any history of chronic medical conditions. Four years later, a second interview again assessed chronic disease, and higher-level functional capacity was evaluated using the Tokyo Metropolitan Institute of Gerontology (TMIG) Index of Competence. Results: Multiple logistic regression analysis revealed that declines in total score and/or any of three subscales of the TMIG Index of Competence were significantly associated with a history of chronic disease, the onset of visual impairment and the development of hearing impairment, even after controlling for the subject's age, gender, educational attainment, and baseline TMIG Index of Competence. Episodes of stroke were significantly associated with declines in IADL. Hypertension, diabetes mellitus, and heart disease were also significantly associated with a decrease in functional competence, although each affected a different subscale of the TMIG Index of Competence. Conclusions: The present results underline the importance of controlling chronic medical conditions through a physically active lifestyle and an appropriate medical regimen in order to limit the age-related decline in functional capacity. [ABSTRACT FROM AUTHOR]

Objective: To examine the longitudinal changes in higher-level functional 'capacity in Japanese urban and rural community older populations. Design: Population-based cross-sectional, and prospective cohort studies. Setting: Koganei city in a suburb of Tokyo, and Nangai village, Akita Prefecture, Japan. Participants: One thousand, five hundred and six older persons (793 in Koganei and 713 in Nangai) aged 65-83 years living at home. Main outcome measures: Disability in Instrumental Self-Maintenance (IADL), Intellectual Activity or Social Role, measured by the Tokyo Metropolitan Institute of Gerontology Index of Competence. Results: At baseline, older men and women in the rural area, Nangai, had higher prevalence of disability in Intellectual Activity compared with respective counterparts in the urban area, Koganei. By contrast, disability in Social Role was more prevalent among elderly people in Koganei than in Nangai. In both areas older men and women had lowest prevalence of disability in IADL among three subscales. The six-year longitudinal survey on older persons who had initially no disability in all three subscales demonstrated that in urban Koganei older persons were most likely to be disabled in Social Role with advancing age, followed in turn by Intellectual Activity and IADL. By contrast, elderly people in rural Nangai were most likely to be disabled in Intellectual Activity, followed by Social Role and instrumental ADL. The Cox-proportional hazard model analysis for those who had no IADL disability at baseline revealed that the baseline level of Intellectual Activity or Social Role predicted significantly future onset of IADL disability in both areas even after controlling for sex, age, and chronic medical conditions. [ABSTRACT FROM AUTHOR]

Background: Recent studies have suggested that atherosclerosis contributes to the development of dementia of the Alzheimer's type (DAT). Convenient and valid biochemical markers of DAT are needed to control risk factors for this disease. The aims of the present study were thus (1) to determine the distribution of plasma beta-amyloid peptide1-42 (Abeta1-42) levels in an older population and (2) to investigate factors correlating with plasma levels of this amyloid peptide. Our data support the hypothesis that atherosclerosis plays a role in the pathogenesis of DAT.Methods: 759 Japanese community residents participated in a municipal medical health evaluation; a subset of 280 was selected at random for the measurement of physiological, psychosocial and life-style variables, together with the analysis of blood specimens for cell counts, hematocrit, Abeta1-42, and other biochemical markers.Results: Log-transformed plasma Abeta1-42 concentrations showed a Gaussian distribution. Quartiles of log10 (Abeta1-42) concentrations correlated significantly with age categories, but not with other sociopsychological and life-style variables. Plasma Abeta1-42 was significantly correlated with systolic and diastolic blood pressure (DBP; r = 0.19, p = 0.002 and r = 0.16, p = 0.007, respectively), pulse pressure (r = 0.13, p = 0.036), total cholesterol (r = 0.15, p = 0.011), log10 (triacyl glycerol) (r = 0.14, p = 0.021), and log10 (hemoglobin A1c) [log10 (HbA1c)] (r = 0.14, p = 0.020). Stepwise multiple regression analysis showed significant independent effects of DBP, and log(10) (HbA1c) on plasma Abeta1-42 concentrations.Conclusions: Our findings suggest that conventional atherosclerotic risk factors are associated with plasma Abeta1-42 levels. This observation may be important in the detection and prevention of DAT. [ABSTRACT FROM AUTHOR]

Background: Recent studies have suggested that atherosclerosis contributes to the development of dementia of the Alzheimer’s type (DAT). Convenient and valid biochemical markers of DAT are needed to control risk factors for this disease. The aims of the present study were thus (1) to determine the distribution of plasma β-amyloid peptide1–42 (Aβ1–42) levels in an older population and (2) to investigate factors correlating with plasma levels of this amyloid peptide. Our data support the hypothesis that atherosclerosis plays a role in the pathogenesis of DAT. Methods: 759 Japanese community residents participated in a municipal medical health evaluation; a subset of 280 was selected at random for the measurement of physiological, psychosocial and life-style variables, together with the analysis of blood specimens for cell counts, hematocrit, Aβ1–42, and other biochemical markers. Results: Log-transformed plasma Aβ1–42 concentrations showed a Gaussian distribution. Quartiles of log[sub 10] (Aβ1–42) concentrations correlated significantly with age categories, but not with other sociopsychological and life-style variables. Plasma Aβ1–42 was significantly correlated with systolic and diastolic blood pressure (DBP; r = 0.19, p = 0.002 and r = 0.16, p = 0.007, respectively), pulse pressure (r = 0.13, p = 0.036), total cholesterol (r = 0.15, p = 0.011), log[sub 10] (triacyl glycerol) (r = 0.14, p = 0.021), and log[sub 10] (hemoglobin A1c) [log[sub 10] (HbA1c)] (r = 0.14, p = 0.020). Stepwise multiple regression analysis showed significant independent effects of DBP, and log[sub 10] (HbA1c) on plasma Aβ1–42 concentrations. Conclusions: Our findings suggest that conventional atherosclerotic risk factors are associated with plasma Aβ1–42 levels. This observation may be important in the detection and prevention of DAT.Copyright © 2003 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

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. [Copyright &y& Elsevier]

Participation in sports groups has health benefits for older adults, such as preventing functional limitations and social isolation. Encouraging participation in sports groups may be an important means of health promotion in older adults. However, there is insufficient research on the determinants of new participation in sports groups to consider effective interventions to promote participation in these groups. We investigated this using data from a 1-year prospective study. Data were obtained from "The Otassha Study" that assessed a cohort of community-dwelling older adults living in an urban area of Japan. Of 769 older adults who participated in a baseline health survey in 2018, 557 participated in a follow-up survey in 2019. We excluded 184 individuals who already participated in sports groups at baseline and 36 with missing data. Participation in sports groups was defined as that occurring more than once a week. Logistic regression analysis was used to identify the determinants of new participation in sports groups, with sociodemographic factors, lifestyle habits, physical functions, cognitive functions, psychological factors, and social factors as independent variables. Forty-one (12.2%) individuals participated in sports groups at follow-up. In the multiple adjusted logistic regression model, new participation in sports groups was significantly associated with female sex (odds ratio [OR] = 5.57, 95% confidence interval [CI]: 1.61‒19.26), engagement in regular exercise (OR = 2.23, 95%CI: 1.03‒4.84), and having a large social network (OR = 1.12, 95%CI: 1.04‒1.20). Physical functions were not associated with new participation. Determinants of new participation were lifestyle habits and social factors, rather than physical functions. Intervention through social networks may be effective in encouraging new participation in sports groups, which, in turn, may facilitate healthy aging. [ABSTRACT FROM AUTHOR]

Background: As gastric cancer patients aged ≥ 85 years have a short life expectancy and often die from other diseases such as pneumonia, indications for surgery are controversial. In this study, we retrospectively analyzed the prognostic factors of elderly patients with gastric cancer who are candidates for curative gastrectomy. Methods: Among 114 patients aged ≥ 85 years with gastric cancer at our hospital between 2010 and 2019, prognostic factors were examined using the Cox proportional hazards model in 76 patients excluding those with cStage IVB or endoscopic submucosal dissection. We also analyzed the factors of pneumonia death. Results: cStage was I/IIA/IIB/III/IVA in 37/6/14/14/5 patients, respectively. Treatment included distal gastrectomy in 28 patients, total gastrectomy in 6, local resection in 9, others in 3, and no surgery in 30. In univariate analyses of overall survival, Eastern Cooperative Oncology Group Performance Status, physiological score of Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM), Onodera's prognostic nutritional index, cStage, and treatment were prognostic factors. In a multivariate analysis, POSSUM physiological score, cStage, treatment method {no surgery vs. distal gastrectomy: hazard ratio (HR) 5.78, 95% confidence interval (CI) 2.33–14.3}, (total gastrectomy vs. distal gastrectomy: HR 4.26, 95% CI 1.22–14.9) were independent prognostic factors. In univariate analyses of pneumonia-specific survival, treatment (total gastrectomy vs. distal gastrectomy: HR 6.98, 95% CI 1.18–41.3) was the only prognostic factor. Conclusions: The prognosis of distal gastrectomy was better than that of non-surgery even in patients aged ≥ 85 years. However, total gastrectomy was considered to be avoidable due to the high rate of postoperative pneumonia death. [ABSTRACT FROM AUTHOR]

Introduction: Frailty is a crucial health issue among older adults. Growth differentiation factor 15 (GDF15) is associated with inflammation, oxidative stress, insulin resistance, and mitochondrial dysfunction, which are possible pathogeneses of frailty. However, few longitudinal studies have investigated the association between GDF15 and the incidence of frailty. Therefore, we investigated whether high serum GDF15 levels are associated with the incidence of frailty. Methods: A total of 175 older adults (mean age: 77 ± 6 years; 63% women) with cardiometabolic diseases and no frailty out of the two criteria at baseline participated. Individuals with severe renal impairment or severe cognitive impairment were excluded. Serum GDF15 levels were measured at baseline. Patients were asked to assess frailty status at baseline and annually during follow-up using the modified version of the Cardiovascular Health Study (mCHS) and the Kihon Checklist (KCL). We examined the association between GDF15 tertiles and each frailty measure during follow-up (median 38–39 months). In the multivariate Cox regression analysis, with the GDF15 tertile groups as the explanatory variables, hazard ratios (HRs) and 95% confidence intervals (CIs) for incident frailty were calculated after adjusting for covariates and using the lowest tertile group as the reference. Results: During the follow-up period, 25.6% and 34.0% of patients developed frailty, as defined by the mCHS and KCL, respectively. The highest GDF15 tertile group had a significantly higher incidence of mCHS- or KCL-defined frailty than the lowest GDF15 tertile group. Multivariate Cox regression analysis revealed that the adjusted HRs for incident mCHS- and KCL-defined frailty in the highest GDF15 tertile group were 3.9 (95% CI: 1.3–12.0) and 2.7 (95% CI: 1.1–6.9), respectively. Conclusion: High serum GDF15 levels predicted the incidence of frailty among older adults with cardiometabolic diseases and could be an effective marker of the risk for frailty in interventions aimed at preventing frailty, such as exercise and nutrition. [ABSTRACT FROM AUTHOR]

Background: Patients with gastric cancer are aging in Japan. It is not clear which patients and which surgical procedures have survival benefits after gastrectomy. A multivariate analysis was performed. Methods: The medical records of 166 patients aged ≥ 80 years who underwent gastrectomy without macroscopic residual tumors were retrospectively reviewed. Univariate and multivariate analyses using Cox proportional hazard models were performed to detect prognostic factors for overall survival. Results: In univariate analyses, age (≥ 90 vs. ≥ 80, < 85), performance status (3 vs. 0), American Society of Anesthesiologists physical status (ASA-PS) (3, 4 vs. 1, 2), Onodera's prognostic nutritional index (< 40 vs. ≥ 45), the physiological score of the Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) (≥ 40 vs. ≥ 20, ≤ 29), surgical approach (laparoscopic vs. open), extent of gastrectomy (total, proximal vs. distal), extent of lymphadenectomy (D1 vs. ≥ D2), pathological stage (II–IV vs. I), and residual tumor (R1 vs. R0) were significantly correlated with worse overall survival. Multivariate analysis revealed that ASA-PS [3, 4 vs. 1, 2, hazard ratio (HR) 2.30, 95% confidence interval (CI) 1.24–4.24], extent of gastrectomy (total vs. distal, HR 2.17, 95% CI 1.10–4.31) (proximal vs. distal, HR 4.05, 95% CI 1.45–11.3), extent of lymphadenectomy (D0 vs. ≥ D2, HR 12.4, 95% CI 1.58–97.7), and pathological stage were independent risk factors for mortality. Conclusions: ASA-PS was a useful predictor for postoperative mortality. Gastrectomy including cardia is best avoided. [ABSTRACT FROM AUTHOR]

Aim: This study examined the effects of fear of COVID‐19 on older volunteers' willingness to continue activities that required face‐to‐face interactions. Methods: From September to November 2020, a self‐administered questionnaire survey was conducted with 481 older adult volunteers. A total of 423 responses were collected; 343 had no missing items and were included in the analysis. Analysis items included willingness to continue volunteer activities, fear of COVID‐19, mental and physical health, and a group of items related to factors influencing the continuation of volunteer activities. Results: The structural analysis of covariance indicated that volunteer orientation, which included items considered to be factors for continuing volunteer activities, had a significant positive influence on the willingness to continue activities. Fear of COVID‐19 had a significant negative effect on the latent variable mental and physical health, which consisted of a subjective sense of health, but fear of COVID‐19 and physical and mental health had no significant effect on the willingness to continue volunteering. Conclusions: Our results suggest that the willingness of older adults to continue volunteer activities during the COVID‐19 pandemic is influenced by their volunteer orientation and is not affected by their fear of COVID‐19. Geriatr Gerontol Int 2024; 24: 370–376. [ABSTRACT FROM AUTHOR]

Aim: Muscle mass and strength correlate with cognitive function; however, it remains unclear whether dynapenia (i.e., muscle weakness with preserved muscle mass) is relevant. This study aimed to explore whether dynapenia is associated with global cognitive function in community‐dwelling older Japanese adults. Methods: This cross‐sectional study used data from the Integrated Research Initiative for Living Well with Dementia Cohort Study, which pooled data from five community‐based geriatric cohorts. Dynapenia was defined as muscle weakness without muscle mass loss according to the Asian Working Group for Sarcopenia criteria. Cognitive function was assessed using the Mini‐Mental State Examination (MMSE). An ordered logistic regression analysis was conducted with dynapenia as the exposure and with cognitive decline stages, defined as an MMSE score of 27–30 for normal cognition, 24–26 for possible cognitive decline, and <24 for cognitive decline, as the outcome, stratified by sex and adjusted for age, muscle mass, education, alcohol consumption, smoking habits, living alone, and non‐communicable diseases. Results: We analyzed data for 3338 participants (2162 female) with preserved muscle mass. Of these, 449 (13.5%) had dynapenia, and 79 (2.4%) exhibited cognitive decline. Multivariate odds ratios (95% confidence interval) for cognitive decline among those with dynapenia, compared with those without dynapenia, were 1.51 (1.02–2.24) for males and 2.08 (1.51–2.86) for females. Conclusions: Muscle weakness is associated with cognitive decline, even in individuals with preserved muscle mass. Further studies are needed to better understand the association between muscle weakness and cognitive decline over time in order to develop dementia prevention strategies for those with dynapenia. Geriatr Gerontol Int 2024; 24: 123–129. [ABSTRACT FROM AUTHOR]

Volunteering older adults plays a role in maintaining well‐being through facilitation of face‐to‐face communication. However, the COVID‐19 pandemic reduced volunteer opportunities involving physical interaction among seniors. While studies have reported that indirect communication such as non‐face‐to‐face can support and improve mental health, it remains unclear whether it can substitute face‐to‐face communication among older volunteers accustomed to frequent interpersonal interactions. Therefore, the current study aimed to examine the relationship between communication forms and well‐being during the pandemic by communication partner, among volunteers aged 65 years and above. Participants engaged in REPRINTS, which are volunteer who read picture books to children. At questionnaire survey was completed to investigate changes in the frequency of face‐to‐face and non‐face‐to‐face communication before and during the pandemic, and well‐being using the WHO‐5. The results showed that maintaining or increasing the frequency of face‐to‐face communication with friends and neighbours before to during the pandemic was associated with a lower risk of being determined poor well‐being (ORs: 0.465, 95% CI: 0.274–0.789, p =.004). This study demonstrated the significance of creating opportunities for face‐to‐face communication to maintain the well‐being of older volunteers during the pandemic. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to develop a patient‐centred handbook that integrates information on lifestyle modifications and psychological support strategies for individuals with mild cognitive impairment (MCI). This article provides a comprehensive record of the development process. Methods: We adopted a participatory research model for the methodology, which comprised five phases and involved an interdisciplinary team specializing in dementia and health literacy. Data were initially collected via interviews conducted among patients with MCI (n = 5) and their families (n = 5). Given the study's preliminary nature, depth and richness of the qualitative data were the key concerns for determining the sample size, rather than broad generalizability. We ensured the inclusion of diverse experiences and perspectives by facilitating the creation of patient questions (PQs) that merged scientific evidence with patient perspectives. To enhance the handbook's accessibility and utility, we continuously evaluated the same using patient interviews, health literacy tool assessments and team discussions. This comprehensive approach harmonized scientific knowledge and patient experience, leading to the development of a personalized MCI management guide. Results: The handbook comprises nine domains, encompassing 38 selected PQs: MCI, lifestyle, lifestyle‐related diseases, exercise, nutrition, social participation, cognitive training, psychological care and family support. The health literacy handbook was evaluated based on Clear Communication Index scores. The results revealed that 73.7% of the PQs were deemed difficult prerevision, whereas only 5.3% remained challenging postrevision. The formative evaluation underscored the need for more detailed explanations prerevision, whereas postrevision comments focused primarily on editorial suggestions. Conclusion: The inclusion of patients' perspectives right from the outset ensured that the handbook met their specific needs. The final version, which reflects all stakeholders' inputs, is now slated for imminent publication. Patient or Public Contribution: Patients and the public participated extensively throughout the project, from initial interviews to material evaluation and refinement. [ABSTRACT FROM AUTHOR]

Background Preoperative chemoradiotherapy(CRT) for advanced resectable esophageal cancer patients is controversial in Japan, and it is different from other countries. We examine the clinical significance of it using propensity score(PS). Methods 142 patients in resectable cStageII/III/IV(TNM 6th edition) esophageal cancer patients were studied. There were 55 preoperative CRT cases (Group A), 87 patients with surgery alone(Group B). The survival was analyzed between the two groups. PS was calculated by Logistic analysis and the background factor was adjusted by the PS matching and IPTW(Inverse probability of treatment weighting) method for the preoperative CRT (Group A) vs surgery alone group (GroupB), Cox model was used to analyzed the prognostic factors. Results 1, Unmatched situation: In OS(Overall survival), no difference was found between the two groups. In DFS(Disease free survival), the prognosis of group A was better than that of group B (5 years DFS: 52.2% vs 34.55%, P  < 0.05). 2, After PS matching: OS, GroupA was tended to be better(P  = 0.097). DFS: the prognosis of the Group A was better (5 years DFS: 57.2 vs 28.1%, P  < 0.01). With Cox analysis, the presence or absence of preoperative CRT was a significant prognostic factor. 3, After IPTW : Prognosis of group A in both OS and DFS was better (5 years OS: 77.25 vs 41.13%, P  < 0.05, 5 years DFS: 76.7 vs 32.14%, P  < 0.01). In Cox analysis, preoperative CRT and TNM stages were independent prognostic factors. Conclusion 1, Preoperative CRT for resectable advanced esophageal cancer is a recommended treatment by analyzing the PS. 2, IPTW and PS matching are different methods for evaluating PS, and since there is a possibility that different results may be occurred when evaluated between two groups by PS, the evaluation of it should be done more carefully. Disclosure All authors have declared no conflicts of interest. [ABSTRACT FROM AUTHOR]

This study examined the ability of a computer-based cognitive assessment tool (CompBased-CAT) to predict mild cognitive impairment (MCI) in community-dwelling older adults. A two-year longitudinal study was conducted using data from 2016 to 2018 from the Otassha study cohort of community-dwelling older adults. MCI was defined as a Mini-Mental Status Examination (MMSE) score of <27. The CompBased-CAT was used at baseline, with each subtest score converted into a Z-score. Subsequently, the total Z-scores were calculated. Participants were divided into robust and MCI groups, and all variables were compared using the t-test or χ2 test. Receiver operating characteristic (ROC) curves and logistic regression analyses were conducted, with MCI and total Z-scores as dependent and independent variables, respectively. Among the 455 participants (median age, 72 years; range, 65–89 years; 282 women and 173 men), 32 developed MCI after two years. The participants in the MCI group were significantly older. They had lower maximal gait speed, baseline MMSE scores, subtest Z-scores, and total Z-scores than those in the robust group. The area under the ROC curve was 0.79 (95% confidence interval: 0.70–0.87; P <0.01). The sensitivity was 0.76, and the specificity was 0.75. The logistic regression analysis showed an odds ratio of 1.34 (95% confidence interval: 1.18–1.52; P <0.01). This study showed that CompBased-CAT can detect MCI, which is an early stage of dementia. Thus, CompBased-CAT can be used in future community health checkups and events for older adults. [ABSTRACT FROM AUTHOR]

Aim: To develop a rapid and easy screening tool to detect sarcopenia. Methods: In total, 683 community‐dwelling older adults who participated in our cohort study, the "Otassha Study," in 2019, completely responded to a questionnaire, and were diagnosed with sarcopenia were included. Participants responded to a nine‐item questionnaire, including candidate items for a new sarcopenia screening tool named rapid sarcopenia screening, based on items of the Strength, Assistance with walking, Rising from a chair, Climbing stairs, and Falls (SARC‐F) questionnaire. To select appropriate items for the new screeening tool, multiple logistic regression analyses were performed, with sarcopenia as the dependent variable and questionnaire responses as independent variables. The area under the curve using 10 000 bootstraps was used to assess the rapid sarcopenia screening diagnostic ability for detecting sarcopenia. Results: Responses to question nos 2 (how much can you squeeze a wet towel?), 5 (how much muscle strength do you think you have compared with that of people of your age and sex?), 7 (how fast do you usually walk?), and 9 (age‐related item) were related to sarcopenia in multiple logistic regression analysis. The area under the curve of the total score of rapid sarcopenia screening was 0.82, 0.80, and 0.81 for men, women, and overall, respectively. At a cut‐off value of 14/15, the sensitivity and specificity for sarcopenia detection were 0.73 and 0.73, respectively. Conclusions: The newly developed sarcopenia screening tool has a better diagnostic ability for sarcopenia than the SARC‐F. Rapid sarcopenia screening does not require physical function measurements, making it a useful and accessible tool among older adults to detect sarcopenia. Geriatr Gerontol Int 2023; 23: 945–950. [ABSTRACT FROM AUTHOR]

Objective: The consumption of various foods is internationally recommended in healthy diet although the association between dietary variety and incident dementia is unknown. We aimed to examine the association between dietary variety and the incidence of disabling dementia in older Japanese adults. Design: We conducted a prospective cohort study. Dietary variety was assessed based on the Dietary Variety Score (DVS). DVS was assessed by counting the number of ten food components (meat, fish/shellfish, eggs, milk, soyabean products, green/yellow vegetables, potatoes, fruit, seaweed and fats/oils) that were consumed almost daily using a FFQ. Participants were categorised into low (0–2 points), middle (3–4 points) and high (5–10 points) groups based on the DVS. Data on newly diagnosed disabling dementia were retrieved from the public long-term care insurance database. Cox proportional hazards regression was used to estimate hazard ratios (HR) with 95 % CI. Setting: Yabu cohort study, Japan. Participants: A total of 4972 community-dwelling adults aged 65 years or older. Results: During the median follow-up of 6·8 years, 884 participants were newly diagnosed with disabling dementia. After adjusting for confounders, the multivariable-adjusted HR for incident disabling dementia was 0·82 (95 % CI, 0·69, 0·97) for participants in the highest DVS category compared with those in the lowest DVS category (P for trend = 0·019). Conclusions: A higher dietary variety is associated with a reduced risk of disabling dementia in older Japanese adults. These results have potential implications for the development of effective public nutritional approaches to prevent dementia in older adults. [ABSTRACT FROM AUTHOR]

The article investigates whether individuals with mild cognitive impairment (MCI) exhibit impaired memory monitoring, which refers to the accuracy of judging one's own memory, using a memory monitoring task. Through a study involving older Japanese adults, it was found that those with MCI showed reduced accuracy in memory monitoring compared to healthy older adults, suggesting a potential impairment in their ability to assess their own memory performance accurately.

The article examines the role of older assistant care workers in addressing the shortage of caregiving resources in Japan, particularly focusing on their mental health benefits. Through a nationwide survey, it was found that these workers perceive various benefits from their employment, including contributing to society, income generation, and health promotion.

Objectives: Social isolation is a particular problem among older people and social participation may reduce future isolation. However, it is unclear which types of activities and which level of participation are effective. This study examines the relationship between social participation and isolation among Japanese older people by employing a 3-year longitudinal study. Methods: A mail survey was sent to 3,518 community-dwelling older people in an urban area in 2014 (baseline: BL). We then conducted follow-up mail survey on respondents who were non-isolated at BL in 2017 (follow-up: FL), with isolation being defined as being in contact with others less than once a week. An analysis was carried out on 1,070 subjects (398 men and 672 women). Social participation is defined by participation in group activities (community, senior club, hobbies, sports, volunteering, politics, industry, and religion). A logistic regression analysis was conducted to determine the association between the types of social participation and the number of organization types at BL, and isolation at FL. Results: At FL, 75 men (18.8%) and 59 women (8.8%) were considered to be isolated. Among the men, participation in a hobby group and sports group both significantly reduced the degree of isolation. Moreover, participation in two organizations and three or more organizations significantly lowered the risk of isolation when compared to non-participants. Among women, there were no significant associations among particular types of social activities and isolation. On the other hand, participation in one organization and three or more organizations significantly reduced their isolation when compared to non-participants. There was a significant linear trend between the number of types of organizations and isolation, regardless of gender. Conclusions: Participation in social activities reduces future isolation in older people. Encouraging participation in social activities could help reduce negative health outcomes associated with social isolation later in life. [ABSTRACT FROM AUTHOR]

Stress management activities that older adults can efficiently perform at home are needed. We therefore created a home-based expressive writing for older adults focusing on habituation and conducted a randomized controlled trial. Participants were randomly assigned to the expressive writing group (n = 42) and the active control group (n = 40). The expressive writing group wrote about stressful events for 15 to 30 minutes 3 times each day at home. The active control group wrote about what they bought the previous day on three different days. Twenty six participants were included in the final analysis. The results showed that rumination, a risk factor for depression, decreased in the active control group compared to the expressive writing group. Our findings suggest that older adults can efficiently perform writing sessions at home. Also, a task such as cognitive training, rather than writing about stressful events, decreased rumination in older adults concerned about their forgetfulness. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the association between vitamin D status and periodontal inflammation as determined by the periodontal inflamed surface area (PISA) in community‐dwelling older adults. Materials and Methods: This cross‐sectional study included 467 Japanese adults (mean age = 73.1 years) who underwent full‐mouth periodontal examinations and measurements of serum levels of 25‐hydroxyvitamin D (25(OH)D). We used linear regression and restricted cubic spline models to analyse the association between exposure (serum 25(OH)D) and outcome (PISA). Results: The linear regression model showed that, after adjusting for potential confounders, participants in the lowest quartile of serum 25(OH)D had 41.0 mm2 more PISA (95% confidence interval [CI]: 4.6–77.5) than the reference group (the highest quartile of serum 25(OH)D). The spline model showed that the association between serum 25(OH)D and PISA was non‐linear and restricted to the low 25(OH)D range. PISA initially sharply decreased as serum 25(OH)D increased, and then the decreasing trend slowed and plateaued. The inflection point with the minimum PISA value was a serum 25(OH)D level of 27.1 ng/mL, above which there was no decreasing trend in PISA with increasing serum 25(OH)D levels. Conclusions: Low vitamin D status had an L‐shaped association with periodontal inflammation in this cohort of Japanese adults. [ABSTRACT FROM AUTHOR]

Background: As the older population increases, the need for early detection of cognitive decline is also increasing. In this study, we examined whether our paper–pencil type group examination for cognitive assessment (PAPLICA) could detect the effects of years of education and aging. Methods: PAPLICA was conducted on 829 older people. The inclusion criteria were age 60 years or older and the ability to come to the event site alone. The exclusion criteria were participants with a medical or psychiatric disorder or dementia.One examiner conducted the test on a group of approximately 10–20 people in approximately 25 min. Participants were instructed on tackling the issues projected on the projector, and their answers were recorded in a response booklet. Results: An independent sample t-test was performed for years of education, and ANCOVA was performed for aging. Among the test items included in PAPLICA, the Speed I and Letter fluency tests were unable to detect the effects of aging. Furthermore, the age at which the effect of aging manifests varies depending on the test item. For instance, a decline in scores in the Speed I and Picture ECR Free recall tests was observed in the 70–74 age group; for that of Word DRT, Picture ECR cued recall, and Similarity, in the 75–79 age group; for CFT, in the 80–84 age group, and for CLOX, the decline was observed in the 85 ≤ age group. Conclusions: PAPLICA, similar to other neuropsychological tests, was able to detect the effects of years of education and aging. Future testing should be conducted on different demographics to identify the differences in patterns of cognitive decline. [ABSTRACT FROM AUTHOR]