Biopsychosocial Consideration of Ikigai in Older Adults in Japan through a Cross-Sectional Study.

Ikigai-a Japanese concept that includes elements such as life's purpose and meaning-has been reported to be associated with various systemic health conditions, such as the risk of developing physical dysfunction or death in older adults. However, there are no reports that comprehensively examine the psychological and social aspects of Ikigai. We attempted to clarify the characteristics of Ikigai by examining it from a biopsychosocial model using physical, psychological, and social perspectives through a cross-sectional study on sarcopenia, frailty and healthy life expectancy in a hilly and mountainous area of Japan. Koyadaira in Mima City, which is located in a hilly and mountainous region on Shikoku Island in Japan, was targeted. This cross-sectional study included 105 outpatients aged 65 and over, with an average age of 79.02 ± 6.91 years. Ikigai (self-rating score on a scale of 0 (no Ikigai) to 5 (the highest Ikigai)) participants' level of physical activity (the Physical Activity Scale for the Elderly, PASE), degree of depression (the Geriatric Depression-15 Scale, GDS-15), cognitive function (the Mini-Mental State Examination, MMSE) and social isolation (the abbreviated Lubben Social Network Scale, LSNS-6) was assessed. Significant positive correlations were found between PASE and MMSE. The LSNS-6 significantly correlated with the MMSE and GDS-15. In a path model, out of four paths from PASE, GDS-15, MMSE, and LSNS-6 to Ikigai, the path from the GDS-15 alone was significant (correlation coefficient -0.271, p < 0.01). The adaptability of this model was good. This study indicates that depressive status has a large impact on Ikigai, along with physical, cognitive, and social conditions; thus, it is appropriate to consider that an affective psychological status, such as depressive symptoms, is a fundamental condition for having Ikigai.

[Association between working in small-scale cultivated land as a daily-life task and the physical and cognitive functions among elderly people in hilly and mountainous areas].

AIM: This study aimed to verify whether working in cultivated land as a daily-life task contributes to the maintenance and improvement of physical and cognitive functions. METHODS: The participants were 91 elderly people of ≥65 years of age who owned cultivated land in the mountainous Koyadaira district in Tokushima Prefecture. Sex, age, body mass index (BMI), walking speed as a physical function, and the mini-mental status examination (MMSE) score as a cognitive function were measured and analyzed in addition to the total working hours per week (WH) in cultivated land. RESULTS: The participants were 31 males and 60 females (mean age 78.5±6.6 years). The average values of the evaluated variables were as follows: WH, 18.0±13.2; BMI, 23.4±3.0 kg/m2; walking speed, 0.95±0.28 m/s; and MMSE score, 26.6±3.1 points. In addition, the Mann-Whitney U test and the Chi-square test showed no significant differences between sexes for each item. A logistic regression analysis showed that WH was significantly associated with MMSE (1, ≥28 points; 0, <28 points), and the odds ratio was 1.054 (p=0.010) in the model adjusted for age and BMI, while it was not significantly associated with walking speed (1, ≥1 m/s; 0, <1 m/s). CONCLUSIONS: Working on small-scale cultivated land was significantly associated with the cognitive function but not the physical function. Routine work on small-scale cultivated land as a daily-life task would contribute to the suppression of cognitive decline in older people living in hilly and mountainous areas.

Did "Kayoinoba" Prevent the Decline of Mental and Physical Functions and Frailty for the Home-Based Elderly during the COVID-19 Pandemic?

The purpose of this study is to grasp the management situation of "Kayoinoba" under the conditions of self-quarantine due to the COVID-19 pandemic. It is also to clarify the efficacy of "Kayoinoba" using the Kihon Checklist (KCL) for the assessment of mental and physical functions in the elderly. The respondents were 136 elderly people aged 65 years and over who lived in A City, a standard rural area in Japan. The age, gender, living style, affluence for living, and the frequency of participation in "Kayoinoba" were examined by using the KCL as a self-completed questionnaire. Finally, 101 respondents were included in the final analysis. There was no difference in the participation status before and after the spread of COVID-19. The frailty ratio tended to decrease from 23.8% to 19.8% between the two periods, but there was no difference in the frailty ratio. It is suggested that the participants in "Kayoinoba" may have suppressed the deterioration of mental and physical conditions, excluding physical activity. This would prevent the frailty of the elderly, even during self-quarantine due to the spread of COVID-19.

[The application and usefulness of virtual reality aimed at encouraging an understanding of and reducing and eliminating prejudice towards dementia patients among local residents].

AIM: To demonstrate the usefulness of a virtual reality device that authentically portrays the emotions of dementia patients and their families (VR Dementia Experience) for encouraging an understanding of and reducing and eliminating prejudice towards dementia patients among local residents. METHOD: In Prefecture T, Town N, 85 residents of Neighborhood A were chosen as the intervention group, and 95 residents of Neighborhood B were chosen as the non-intervention group. The VR Dementia Experience was provided only to the residents of Neighborhood A. Residents of both neighborhoods completed a 35-item questionnaire regarding their degree of understanding and prejudice towards dementia patients before and after the intervention. RESULTS: Seventy-seven residents of Neighborhood A and 82 residents of Neighborhood B were analyzed. Their gender, age, and pre-intervention test baseline values were equivalent in the degree of understanding and prejudice. Significant increases were observed in 9 of 35 items for Neighborhood A residents (7 understanding-related, 2 prejudice-related) and 2 items for Neighborhood B residents (1 understanding-related, 1 prejudice-related). To ascertain the usefulness of the VR Dementia Experience, we compared the number of items with a significant increase: 9/35 (25.7%) in Neighborhood A and 2/35 (5.7%) in Neighborhood B. An effect (≥ 20%) was observed among the residents of Neighborhood A. Furthermore, after exposure to the VR Dementia Experience, the connection between understanding, prejudice, and dementia was strengthened among the residents of Neighborhood A compared to the residents of Neighborhood B. CONCLUSION: The VR Dementia Experience is a useful tool for encouraging an understanding of and reducing and eliminating prejudice towards dementia patients among local residents. However, to encourage the widespread usage of the technology, we should compare results with other public awareness campaigns as well as make improvements to the device and its VR content.

[Histopathological examination and analysis of mortality in DBA/2 mouse vasculitis induced with CAWS, a water-soluble extracellular polysaccharide fraction obtained from Candida albicans].

CAWS, a water-soluble extracellular polysaccharide fraction obtained from the culture supernatant of Candida albicans, is one of the fungal pathogen-associated molecular patterns (PAMPs). It has been reported to show potent activity inducing arteritis and coronaritis in mice. Especially, CAWS-induced arteritis has a 100% incidence and severe mortality in the DBA/2 mouse strain. This artificial vasculitis was reported to provide a good murine model of Kawasaki disease and other inflammatory vascular disease. However, severe mortality was observed only in DBA/2 mice, which is a CAWS-sensitive strain. In this study, to clarify the mechanisms of CAWS-induced arteritis and mortality, we investigated microscopic histopathological changes in cardiovascular tissues in DBA/2 mice. Severe inflammatory infiltration was observed from the external elastic lamina in the aorta and proximal coronary arteries within 1 week after CAWS administration. Severe stenosis of the aorta and coronary arteries was observed more than 3 weeks after CAWS administration. Fibrinoid necrosis was observed in these vessel walls. All CAWS-treated mice died between the fifth and twelfth week after administration. Severe inflammatory change with aortic valve transformation suggested that CAWS-treated mice died of valvular endocarditis or cardiac dysfunction. Based on the simple induction method and complete incidence, these data suggest that CAWS-induced arteritis is a good model of not only Kawasaki disease but also other cardiovascular diseases such as valvular endocarditis.