Development of the Self-Assessment Self-Disclosure Questionnaire to Examine the Association between Self-Disclosure and Frailty among Community-Dwelling Older Adults in Japan.

Self-disclosure is the attitude of communicating one's experiences and condition to others and is an indicator of mental health and an open personality. Frailty, characterized by reduced physical and psychological resistance, predicts the incidence of dependency and mortality. Although low self-disclosure may be associated with frailty, there is no scale to measure older adults' self-disclosure. This cross-sectional study assessed the validity of a self-assessment self-disclosure questionnaire and examined the association between the content of self-disclosures to friends and acquaintances and frailty among community-dwelling older adults. A total of 237 adults aged ≥65 in Japan were surveyed using a mailed self-administered questionnaire in 2021. The self-disclosure scale consisted of 10 items and showed adequate validity. Participants were classified into a robust group (n = 117, women 57.3%) and a frailty group (n = 120, women 73.3%) using the Kihon Checklist. After adjusting for covariates, multivariate-adjusted logistic regression models revealed frailty was associated with lower self-disclosure of recent positive events, motivation and strengths (indicating strong points) in life, relationships with family and relatives, experiences of work and social activities, and financial status. The proposed questionnaire must still be further tested in other populations, but our initial results may contribute to preventing frailty and improving mental health among community-dwelling older adults.

Associations of fall history and fear of falling with multidimensional cognitive function in independent community-dwelling older adults: findings from ORANGE study.

BACKGROUND: Falls and fear of falling (FoF) inhibit healthy longevity and have been suggested to be associated with cognitive function. However, the domains of cognitive function that are associated with them remain controversial. It is speculated that clarifying this will help in the assessment of health status and interventions in the community. AIM: To analyse the associations between fall history and FoF and multidimensional cognitive function in independent community-dwelling older adults. METHODS: The data from 9759 (73.3 ± 5.4 years, 59.9% women) older individuals enrolled in the cross-sectional ORANGE study were analysed. Simple questions were used to assess fall history in the past year and current FoF. Assessments of multidimensional cognitive function were performed using the National Center for Geriatrics and Gerontology-Functional Assessment Tool (NCGG-FAT) to evaluate memory, attention, executive function, and processing speed. The independent associations of fall history and FoF with multidimensional cognitive function were assessed using multivariate linear regressions adjusted for potential confounding variables. RESULTS: A total of 18.3% and 35.4% of participants presented with fall history and FoF, respectively. Fall history (p = 0.008) and FoF (p = 0.002) were significantly associated with memory. FoF, but not fall history was associated with attention (p = 0.004), executive function (p < 0.01), and processing speed (p < 0.01). CONCLUSION: In independent community-dwelling older adults, fall history was associated only with the memory domain; in contrast, fear of falling was associated with multidimensional cognitive function. This study provides weak evidence suggesting the need to assess falls and FoF in all situations involving independent community-dwelling older adults.

Association between Productive Roles and Frailty Factors among Community-Dwelling Older Adults: A Cross-Sectional Analysis.

The employment rate of older people in Japan is expected to increase in the future owing to the increase in the retirement age. Preventing frailty is imperative to maintaining productive roles of older adults. Therefore, this study aimed to examine the association between productive roles and frailty factors among community-dwelling older adults. A total of 135 older adults, enrolled in 2017, participated in the study. Productive roles and domains related to frailty were measured. We measured usual gait speed and grip strength for the physical domain; Mini-Mental State Examination (MMSE) and Geriatric Depression Scale (GDS-15) scores for the cognitive and mental domains; and social role and group activity for the social domain. Multivariate-adjusted logistic regression models revealed that having productive roles was associated with faster usual gait speed (odds ratios [OR] = 1.05; 95% confidence interval [CI], 1.01-1.08; p = 0.005) and lower GDS-15 score (OR = 0.79; 95% CI, 0.64-0.97; p = 0.023). These results suggest that health promotion to maintain gait speed and prevent depressive symptoms may contribute to maintaining productivity in community-dwelling older adults.

Association between Kihon check list score and geriatric depression among older adults from ORANGE registry.

OBJECTIVE: Older adults in Japan are tackling health-related challenges brought by comprehensive geriatric symptoms, such as physical and cognitive problems and social-psychological issues. In this nationwide study, we mainly focused on the Kihon checklist (KCL) as certificated necessity of long-term care for Japanese older adults and investigated whether the KCL score was associated with geriatric depression. In addition, we aimed to identify critical factors that influence the relationship between the KCL score and geriatric depression. METHODS: This survey was a cross-sectional observational study design, performed from 2013 to 2019. A total of 8,760 participants aged 65 years and over were recruited from five cohorts in Japan, consisting of 6,755 persons in Chubu, 1,328 in Kanto, 481 in Kyushu, 49 in Shikoku and 147 in Tohoku. After obtaining informed consent from each participant, assessments were conducted, and outcomes were evaluated according to the ORANGE protocol. We collected data on demographics, KCL, physical, cognitive and mental evaluations. To clarify the relationship between the KCL and geriatric depression or critical factors, a random intercept model of multi-level models was estimated using individual and provincial variables depending on five cohorts. RESULTS: The KCL score was correlated with depression status. Moreover, the results of a random intercept model showed that the KCL score and geriatric depression were associated, and its association was affected by provincial factors of slow walking speed, polypharmacy and sex difference. CONCLUSIONS: These results suggest that provincial factors of low walking performance, polypharmacy and sex difference (female) might be clinically targeted to improve the KCL score in older adults.

Association of Health Literacy with the Implementation of Exercise during the Declaration of COVID-19 State of Emergency among Japanese Community-Dwelling Old-Old Adults.

Health literacy is important for promoting and maintaining good health in old-old adults. It may influence the implementation of exercise in the coronavirus disease epidemic. The present cross-sectional study investigated the association of each dimension of health literacy with the implementation of exercise during the declaration of a state of emergency due to coronavirus disease in community-dwelling old-old adults. We collected data from 483 community-dwelling old-old adults (52.8% women) aged between 77 and 99 years who participated in a mail survey. Participants were divided into exercise or nonexercise groups based on the implementation of exercise during the declaration of a state of emergency. Health literacy was assessed using a 14-item health literacy scale. There were 327 (67.7%) participants in the exercise group and 156 (32.3%) in the nonexercise group. A significantly higher score of health literacy was observed in the exercise group than in the nonexercise group (communicative health literacy score = 14.0 ± 3.6 vs. 12.7 ± 3.8, p = 0.001). In a multivariate logistic regression model adjusted for potential confounders, high communicative health literacy scores were significantly associated with the implementation of exercise during the declaration of a state of emergency (odds ratio = 1.88, 95% confidence interval = 1.20-2.93). Approximately two-thirds of community-dwelling old-old adults implement exercise during the declaration of a state of emergency. High communicative health literacy was associated with the implementation of exercise during this period.

Perceived declining physical and cognitive fitness during the COVID-19 state of emergency among community-dwelling Japanese old-old adults.

AIM: Perceived health status, including physical and cognitive fitness, will be negatively associated with future health conditions among old-old adults. The coronavirus disease 2019 (COVID-19) pandemic has caused sudden changes in lifestyle. Thus, this study examined the associations of participation in an exercise class before the COVID-19 pandemic and the exercise habits and disruption to the rhythms of daily life during the COVID-19 state of emergency with perceived declining physical and cognitive fitness among community-dwelling old-old adults. METHODS: In July 2020, we carried out a mail survey of community-dwelling old-old adults aged between 77 and 99 years in Bibai, Hokkaido, Japan, to determine their perceived declining physical and cognitive fitness during the COVID-19 state of emergency. RESULTS: Of the 774 responders, 339 (43.8%) participants reported a decline in physical fitness, whereas 259 (33.5%) perceived declining cognitive fitness during the COVID-19 state of emergency. In a multivariate logistic regression model adjusted for potential confounders, exercise habits during the COVID-19 state of emergency were significantly associated with a lower perception of declining physical fitness. Disruption to the rhythms of daily life during the COVID-19 state of emergency was significantly associated with a higher perception of declining physical and cognitive fitness. CONCLUSIONS: Approximately half and more than one-third of community-dwelling old-old adults perceived declining physical and cognitive fitness, respectively, during the COVID-19 state of emergency. During this period, exercise habits were positively correlated with perceived health status among old-old adults, whereas disruption to the rhythms of daily life was negatively correlated. Geriatr Gerontol Int 2021; 21: 364-369.