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Aim Methods Results Conclusion Few studies have investigated the relationship between low dietary variety and clearly defined social isolation by gender. This study explored the association between dietary variety and social isolation, classified by operational definition, separately by gender in community‐dwelling older adults.This cross‐sectional study recruited respondents via mail. A total of 4798 participants aged ≥65 years participated in the on‐site assessment. Social isolation was assessed by “lack of conversation,” “lack of passive support,” “lack of offering support,” and “lack of social participation.” Dietary variety was evaluated using the Dietary Variety Score (DVS).The participants' median age was 73 (interquartile range 25–75: 69–77) years, and 2147 (44.7%) were male. After adjusting for covariates, with regard to male participants, a lack of offering support (β = −0.051, P = 0.019) and a lack of social participation (β = −0.089, P < 0.001) were associated with a low DVS. For female participants, only a lack of social participation was related to a low DVS (β = −0.067, P < 0.001). A lack of conversation and passive support were not associated with a low DVS for both genders (P >0.05).The results indicate that encouraging social participation, regardless of gender, as well as preventing a lack of offering support for others among men, may contribute to improving individuals’ DVS. Geriatr Gerontol Int 2024; ••: ••–••. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Social participation is recommended for older adults to remain actively involved in daily life. Social participation is a broad concept, ranging from ‘interacting with others without doing a specific activity with them’ to ‘actively contributing to society.’ However, previous studies have not taken into account the components of social participation. Depressive symptoms are significant outcomes in older adults. Social participation mitigates these risks owing to its association with reduced mortality and enhanced quality of life. This study aimed to examine the association between the level of social participation and depressive symptoms in community‐dwelling older adults.We included 17 040 individuals aged ≥65 years. Social participation was categorised into Level 3, interacting with others without doing a specific activity with them; Level 4, engaging in an activity with others; Level 5, helping others; and Level 6, contributing to society, based on a previous study by Levasseur et al. Depressive symptoms were assessed using the 15‐item Geriatric Depression Scale. Logistic regression models were used to examine the association between the level of social participation and depressive symptoms.Overall, 15 069 older adults met the inclusion criteria. A higher level of social participation was associated with lower odds ratios (ORs) for depressive symptoms (Level 6 = OR: 0.43, 95% confidence interval (CI): 0.37–0.50; Level 5 = OR: 0.50, 95% CI: 0.41–0.60; and Level 4 = OR: 0.60, 95% CI: 0.52–0.69). Subgroup analyses based on age and sex yielded similar results across all participants.Among older adults in Japan, a higher level of social participation was associated with lower rates of depressive symptoms. The relationship between depressive symptoms and the levels of social participation may help develop measures to reduce or prevent depressive symptoms in older adults. [ABSTRACT FROM AUTHOR]

The purpose of this study was to conduct a cross-sectional analysis of the association between hearing aid use and cognitive decline in community-dwelling older adults with hearing impairment, stratified by cardiovascular risk level. This cross-sectional study covers 1857 hearing-impaired individuals selected among 10,674 community-dwelling older adults (≥65 years of age) in Japan. We investigate the association between hearing aid use and cognitive decline stratified by cardiovascular risk level, by assessing self-reported hearing impairment and hearing aid use, absolute cardiovascular risk, cognitive function, and potential confounding factors. The association between hearing impairment severity and increased cardiovascular risk, and the benefit of hearing aid use in preventing cognitive decline, were examined in a binomial logistic regression analysis, with the presence of cognitive decline as the objective variable. In the low cardiovascular risk group, hearing aid users had a lower odds ratio for decline in executive function than non-users (odds ratio = 0.61, 95% confidence interval: 0.39–0.98). However, there was no significant association between hearing aid use and cognitive decline in the high cardiovascular risk group (p > 0.05). Among older adults with hearing impairment, hearing aid use was associated with the maintenance of executive function in individuals of low cardiovascular risk. [ABSTRACT FROM AUTHOR]

INTRODUCTION: This study aimed to determine whether the concomitance of hearing impairment and isolation with lack of conversation, which is considered self‐evident but has not been investigated extensively, is associated with the occurrence of dementia. METHODS: A total of 2745 participants were divided into four groups according to the presence/absence of hearing impairment and isolation with lack of conversation. The association of dementia with hearing impairment and isolation with lack of conversation was analyzed using Cox proportional hazards regression. RESULTS: The combined hearing impairment and isolation with lack of conversation (hazard ratio: 1.69, 95% confidence interval: 1.09‐2.61) and non‐hearing impairment and isolation with lack of conversation (hazard ratio: 1.60, 95% confidence: 1.07‐2.39) were associated with the development of dementia. DISCUSSION: These findings emphasize the importance of promoting high‐quality social relationships throughout life by adopting preventive measures against isolation with lack of conversation from the early stage of awareness of hearing impairment. Highlights: Dementia affects 12.9% of those with hearing impairment and isolation.Hearing impairment and isolation are associated with increased risk of dementia.Addressing these risk factors may help reduce the risk of developing dementia.Preventing isolation and promoting quality social relationships is important. [ABSTRACT FROM AUTHOR]

Background: Social networks and social participation have protective effects on cognitive function maintenance and Alzheimer's disease and general dementia development. Objective: We aimed to investigate the association between conversations and dementia incidence in older adults. Methods: This longitudinal prospective cohort study used population data from the National Center for Geriatric and Gerontology–Study of Geriatric Syndromes (NCGG–SGS) from September 2015 to February 2017. The database included 4,167 individuals in Japan aged ≥60 years who were generally healthy and without major cognitive impairment. Participants were classified into two groups according to six daily conversation measures at baseline. The conversation index was calculated as a composite score for these measures. Participants were tracked monthly over 60 months for new-onset dementia. Results: Data from 2,531 participants were analyzed (72.7±6.7 years; range: 60–96 years). Dementia incidence per 1,000 person-years was 15.7 (95% confidence interval, 13.6–18.1). The Youden index determined the cut-off point for dementia incidence, with a conversation index of 16/17 points. The low conversation group included more participants with new-onset dementia. Cox proportional hazards regression crude models showed remarkable relationships between dementia onset and specific conversation measurements, including conversation index. According to the Cox regression adjusted model, the cut-off point of the conversation index showed only a remarkable relationship with dementia onset. Conclusions: Dementia risk was extensively associated with low daily conversation statuses. The assessment of conversational factors may be useful as a risk indicator for the development of Alzheimer's disease and general dementia. [ABSTRACT FROM AUTHOR]

Background: Physical frailty accelerates the timing of both subsequent disability and death; however, evidence regarding the impact of frailty on the period from disability onset to death and sex differences of this impact is lacking. The aim of this study was to examine the relationship among physical frailty, disability, death, and sex differences. Methods: This Japanese cohort study included 10,524 community‐dwelling people aged ≥65 years. Physical frailty was operationalized by key phenotypes as per Fried's criteria (slowness, weakness, exhaustion, weight loss, and low activity) at baseline. We calculated hazard ratios (HRs) with 95% confidence intervals (CIs) for disability onset and post‐disability survival according to the frailty status. Results: During a 5‐year follow‐up, the risk of disability onset for pre‐frailty (HR: 1.74, 95% CI: 1.51–2.00) and frailty (HR: 3.27, 95% CI: 2.77–3.87) were significantly higher than that for robust people. Furthermore, among participants who developed disabilities within 5 years (n = 1481), the risk of post‐disability death for pre‐frailty was not different from that for robust (HR: 1.49, 95% CI: 0.99–2.24), but frailty showed a higher risk of post‐disability death than did robust people. (HR: 1.75, 95% CI: 1.13–2.72). In the sex‐stratified analysis, although the female group showed no association between frailty status and post‐disability death (HR: 1.21, 95% CI: 0.63–2.33 in pre‐frailty; HR: 1.24, 95% CI: 0.60–2.57 in frailty), the male group showed higher risk of post‐disability death in both pre‐frailty (HR: 1.74, 95% CI: 1.03–2.96) and frailty (HR: 2.32, 95% CI: 1.32–4.09). Conclusions: Physical frailty shortens the period from disability onset to death. Additionally, the impact of frailty on post‐disability death is greater for males than for females. Our findings suggest that physical frailty is an important clinical indicator distinct from disability and that interventions to prevent and address frailty in men need further investigation. [ABSTRACT FROM AUTHOR]

Background: The current study examines the negative impact of the coronavirus disease 2019 (COVID-19) emergency declarations on physical activity among the community-dwelling older adults, the participants of a physical activity measurement program, in Japan. Methods: This retrospective observational study included 1,773 community-dwelling older adults (aged 74.6 ± 6.3 years, 53.9% women) who had participated in the physical activity measurement project from February 2020 to July 2021. We measured physical activity using a tri-axial accelerometer during 547 consecutive days. Three emergency declarations, requesting people to avoid going outside, occurred during the observational period. We multiply-imputed missing values for daily physical activity, such as steps, light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) for several patterns of datasets according to the maximum missing rates on a person level. We mainly report the results based on less than 50% of the maximum missing rate (n = 1,056). Other results are reported in the supplemental file. Changes in physical activity before and after the start of each emergency declaration were examined by the regression discontinuity design (RDD) within 14-, 28-, and 56-day bandwidths. Results: For all the participants in the multiply-imputed data with the 14-day bandwidth, steps (coefficients [ γ ^ 1 ] , 964.3 steps), LPA ( γ ^ 1 , 5.5 min), and MVPA ( γ ^ 1 , 4.9 min) increased after the first emergency declaration. However, the effects were attenuated as the RDD bandwidths were widened. No consistent negative impact was observed after the second and third declarations. After the second declaration, steps ( γ ^ 1 , -609.7 steps), LPA ( γ ^ 1 , -4.6 min), and MVPA ( γ ^ 1 , -2.8 min) decreased with the 14-day bandwidth. On the other hand, steps ( γ ^ 1 , 143.8 steps) and MVPA ( γ ^ 1 , 1.3 min) increased with the 56-day bandwidth. For the third declaration, LPA consistently decreased with all the bandwidths ( γ ^ 1 , -2.1, -3.0, -0.8 min for the 14, 28, 56-day bandwidth), whereas steps ( γ ^ 1 , -529 steps) and MVPA ( γ ^ 1 , -2.6 min) decreased only with the 28-day bandwidth. Conclusions: For the community-dwelling older adults who regularly self-monitor their physical activity, the current study concludes that there is no evidence of consistently negative impacts of the emergency declarations by the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Introduction: Delaying the onset of disability is important for maintaining independence and quality of life in community-dwelling older adults. Given that social isolation is a significant risk factor for disability, effective means associated with social isolation are needed to alleviate disability. Although information and communication technology (ICT) may be a reasonable measure considering the recent social contexts due to the coronavirus disease 2019 pandemic, further insights are required. This study aimed to investigate whether ICT use can alleviate the onset of disability in community-dwelling older adults with and without social isolation. Methods: This longitudinal cohort study on 4,346 community-dwelling independent Japanese older adults (mean age, 73.5 ± 5.3 years) was conducted between 2017 and 2018. Participants were classified into four groups based on social isolation (the condition where two or more of the following measures were met: domestic isolation, less social contact, and social disengagement) and ICT users (those who had recently used a computer or a smartphone) and followed up to assess disability incidence for 24 months after baseline assessments. Cox proportional-hazards regression models were used to identify the effect of social isolation and ICT use on the risk of disability onset by adjusting for age, sex, education history, number of medications, eye disease, level of annual income, Mini-Mental State Examination, Geriatric Depression Scale 15, and gait speed. Results: The group comprised nonsocial isolation and ICT users (44.7%), social isolation and ICT users (5.4%), nonsocial isolation and ICT nonusers (41.7%), and social isolation and ICT nonusers (8.2%). At the follow-up, 2.2%, 2.4%, 5.5%, and 12.4% of the participants in the above order developed disability (p < 0.01). Cox regression models revealed a significantly higher risk of disability onset in the social isolation and ICT nonusers group than in the social isolation and ICT users group (HR = 2.939; 95% confidence interval (CI) 1.029–8.397; p = 0.044). In the subgroup analysis stratified by social isolation, ICT use significantly reduced the risk of disability onset in the socially isolated group (HR = 0.320; 95% CI 0.109–0.943; p = 0.039), although the same association was not observed in the nonsocially isolated group (HR = 0.845; 95% CI 0.565–1.264; p = 0.411). Conclusion: ICT use can alleviate the onset of disability in socially isolated older adults in a community setting. Considering ICT-applied methods for alleviating disability is beneficial for older adults in social isolation. [ABSTRACT FROM AUTHOR]

Background: Subjective cognitive decline (SCD) in older adults has been identified as a risk factor for dementia, although the literature is inconsistent, and the factors that contribute to this inconsistency are not fully understood. We focused on the protective factors for dementia risk and aimed to determine whether SCD has more protective factors for dementia risk and whether they reduce the association with future objective cognitive decline (OCD) from a 4‐year longitudinal study. Method: We included 4,363 older adults (age: 71.7±5.3 [mean ± standard deviation] years; 2,239 women) from the National Center for Geriatrics and Gerontology–Study of Geriatric Syndromes. SCD, OCD, and protective factors such as lifestyle and activity for dementia risk were assessed using a face‐to‐face interviews and objective cognitive assessment tools. Participants were categorized into cognitive status: normal cognition (neither SCD nor OCD), SCD only, OCD only, and SCD and OCD (both SCD and OCD) groups. Four years later, participants were classified as having or not having mild cognitive impairment or global cognitive impairment. Binomial logistic regression analysis was performed with follow‐up on the cognitive status and at the baseline cognitive status groups as the dependent and independent variables, respectively. Result: Potential confounding factors‐adjusted odds ratios for SCD only, OCD only, and SCD and OCD groups for developing OCD at follow‐up were 1.08 (95% CI, 0.80‐1.45; p = 0.608), 4.00 (95% CI, 2.64‐6.07; p<0.001), and 3.12 (95% CI, 2.22‐4.37; p<0.001), respectively. The SCD only group had more protective factors for dementia risk than the OCD only group. Conclusion: Community‐dwelling elderlies with SCD had more protective factors for dementia risk at the baseline and a lower association with OCD in the 4‐year follow‐up. Our results suggest that the presence of protective factors for dementia risk may be a contributing factor to the inconsistent literature on the SCD outcomes. [ABSTRACT FROM AUTHOR]

Background and Objectives: Cognitive reserve (CR) is a property of the brain that allows for better-than-expected cognitive performance relative to the degree of brain change over the course of life. However, neurophysiological markers of CR remain under-investigated. Electroencephalography (EEG) features may function as suitable neurophysiological markers of CR. To assess this, we investigated whether the dorsal attention network (DAN) and ventral attention network (VAN) activities, as measured during resting-state EEG, moderate the relationship between hippocampal volume and episodic memory., Methods: Participants were recruited as part of the National Center for Geriatrics and Gerontology-Study of Geriatric Syndromes. Hippocampal volume was determined using magnetic MRI, and episodic memory was measured using word lists. After testing the effect of hippocampal volume on memory performance using multiple regression analysis, we evaluated the interactions between hippocampal volume and DAN and VAN network activities. We further used the Johnson-Neyman technique to quantify the moderating effects of DAN and VAN network activities on the relationship between hippocampal volume and word list memory, as well as to identify specific ranges of DAN and VAN network activity with significant hippocampal-memory association., Results: A total of 449 participants were included in this study. Our analysis revealed significant moderation of DAN with a slope of β = -0.00012 (95% CI: -0.00024; -0.00001, p = 0.040), and VAN with a slope of β = 0.00014 (95% CI: 0.00001; 0.00026, p = 0.031). Further, we found that a larger hippocampal volume was associated with improved memory performance, and that this association became stronger as the DAN activity decreased until a limit of DAN activity of 944.9, after which the hippocampal volume was no longer significantly related to word-list memory performance. For the VAN, we found that a higher hippocampal volume was more strongly associated with better memory performance when VAN activity was higher. However, when VAN activity extended beyond -914.6, the hippocampal volume was no longer significantly associated with word-list memory., Discussion: Our results suggest that attentional networks help to maintain memory performance in the face of age-related structural decline, meeting the criteria for the neural implementation of cognitive reserve., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Katayama, Stern, Habeck, Coors, Lee, Harada, Makino, Tomida, Morikawa, Yamaguchi, Nishijima, Misu, Fujii, Kodama and Shimada.)

Importance: Loneliness is suggested to negatively affect physical and mental health and influence the development of disability; however, a consensus on the relationship between loneliness and disability has not been reached. Age-related hearing impairment worsens the daily-life activities of older adults, and the association between loneliness and the incidence of disability may be influenced by hearing impairment., Objective: To examine the association between loneliness and the incidence of disability among older adults stratified by hearing impairment., Design, Setting, and Participants: This prospective observational cohort study included 5563 community-dwelling adults 65 years or older who participated in functional health examinations in Tokai City, Aichi Prefecture, Japan, between September 2017 and June 2018. Data analysis was conducted from August 2022 to February 2023., Main Outcomes and Measures: Cox proportional hazards regression models were used to examine the association between loneliness and the incidence of disability stratified by hearing impairment., Results: Among the 4739 participants who met the inclusion criteria (mean [SD] age, 73.8 [5.5] years; 2622 [55.3%] female), 3792 (80.0%) were without hearing impairment and 947 (20.0%) were with hearing impairment. Of those who reported experiencing loneliness, 1215 (32.0%) were without hearing impairment, and 441 (46.6%) were with hearing impairment. After 2 years, the number of individuals with disabilities was 172 (4.5%) without hearing impairment and 79 (8.3%) with hearing impairment. Cox proportional hazards regression analysis showed no statistically significant association between loneliness and the incidence of disability in a model adjusted for potential confounding factors among community-dwelling older adults without hearing impairment (hazard ratio, 1.10; 95% CI, 0.80-1.52). Among community-dwelling older adults with hearing impairment, a model adjusted for potential confounding factors showed a statistically significant association between loneliness and the incidence of disability (hazard ratio, 1.71; 95% CI, 1.04-2.81)., Conclusions and Relevance: This cohort study found that the association between loneliness and the incidence of disability was moderated by the presence or absence of hearing impairment. Hearing impairment is the most common symptom of geriatric syndromes, showing that among the various risk factors, loneliness may require special attention in the prevention of disability in people with hearing impairment.