Diversity in productive activities enhances life satisfaction among Japanese community-dwelling older adults: A cross-sectional study.

Few studies have reported an association between diversity in productive activities and life satisfaction; hence, this cross-sectional study conducted in Japan aimed to clarify this association. We assessed the life satisfaction of 4,498 Japanese community-dwelling older adults engaged in productive activities (e.g., paid work, volunteering, taking care of children, and supporting others) using the Life Satisfaction Scale. We took the sum of the number of engaging productive activities as the diversity in productive activities score. A dose-response relationship was observed for each additional productive activity on life satisfaction. Participants who engaged in one, two, three, or four productive activities were more likely to have higher life satisfaction than those who did not engage; the odds ratios (95 % confidence intervals) were 1.19 (1.02-1.39), 1.19 (1.00-1.42), 1.71 (1.37-2.13), and 2.27 (1.58-3.27), respectively. Diversity in productive activities may enhance higher life satisfaction likelihood among Japanese community-dwelling older adults.

Association between Hearing Aid Use and Cognitive Function in Persons with Hearing Impairment Stratified by Cardiovascular Risk.

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.

Association between perceived value of adopting new behaviors and incident disability among Japanese community-dwelling older adults.

OBJECTIVES: This longitudinal observational cohort study aimed to clarify the relationship between perceived value (PV) to adopt new behaviors and incident disability in community-dwelling older adults. METHOD: Participants were 5073 community-dwelling older adults aged ≥65 years in Japan (Mage = 74.0 ± 5.6 years; female = 55.1%). The mean follow-up time was 34.5 months. Baseline data were collected during health checkups in a prospective cohort study. Measurements included engagement in physical activity (PA), cognitive activity (CA), and social activity (SA), PV, health and physical conditions, and demographic characteristics. PV was assessed by asking whether participants thought it was valuable to adopt new behaviors related to PA, CA, and SA. Participants were classified as having higher/lower PV, PA, CA, and SA. Cox proportional hazard models were used to analyze the association between PV and incident disability. PV was examined both as an independent variable and in combination as follows: higher PV and higher PA/CA/SA (high/high); lower PV and higher PA/CA/SA (low/high); higher PV and lower PA/CA/SA (high/low); and lower PV and lower PA/CA/SA (low/low). RESULTS: Higher PV was significantly associated with a lower hazard ratio (HR) for incident disability. The low/high, high/low, and low/low significantly increased the HR compared to high/high in the analyses of PV & PA and CA. The analysis of PV & SA showed that only low/low increased the HR compared to high/high. CONCLUSION: Having both higher PV and higher activity engagement may contribute to preventing disability development. Both support for activities and value education in older adults may be needed.

Social participation in the neighborhood community prevents onset of disability in community-dwelling older adults whose life space with activities is limited: A 2-year prospective cohort study.

AIMS: For older adults with limited life space and activity, social participation in the neighborhood community is essential to ensure social interaction and activity levels. This study examined the association between social participation in the neighborhood community and the onset of disability in older adults with different life spaces and activities. METHODS: The participants were 9513 older adults from a cohort study conducted at the National Center for Geriatrics and Gerontology Study of Geriatric Syndromes (NCGG-SGS). Social participation in the neighborhood community was assessed by participating in the community meetings. Life space with activities was evaluated using the Activity Mobility Index (AMI) developed in the NCGG-SGS, with higher scores indicating better mobility and movement. The participants were divided into four groups based on the quartiles of their AMI scores (Q1-Q4). Cox proportional hazard models were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for disability incidence by social participation in each quartile. RESULTS: Over the 2-year follow-up period, disability occurred in 4.3% of the participants (n = 409). In the Q1 group, participants who participated in the neighborhood community had a significantly lower risk of developing a disability than those who did not (HR, 0.47; 95% CI, 0.28-0.76). There were no significant differences in onset of disability between the presence and absence of social participation for groups Q2, Q3, and Q4. CONCLUSIONS: Social participation in the neighborhood community was associated with the onset of disability in the lowest life space group. Social participation within a limited life space with activities may prevent disability onset. Geriatr Gerontol Int 2024; 24: 609-618.

Estimating the Effect of Engagement in Community-Based Going-Out Program on Incidence Disability in Older Adults.

OBJECTIVES: Although going out has been reported to be associated with the incidence of disability, few studies have investigated the effect of community-based programs to promote going out on the incidence of disability. This study aimed to estimate the effects of a program fostering going-out on the incidence of disability in community-dwelling older adults. DESIGN: Longitudinal, observational study. SETTING AND PARTICIPANTS: Nonengaged (n = 1086) and engaged older adults (n = 1086) enrolled in the National Center for Geriatrics and Gerontology Study of Geriatric Syndrome by using a one-to-one nearest neighbor propensity score-matching scheme. METHODS: After the baseline assessments, participants in the community-based going-out program received a specialized physical activity tracker, monitored their daily physical activity, and received personalized feedback on going out to community facilities with a system for reading the device for 12 months. Disability onset was defined as a new case of long-term care under the public insurance certification in Japan within 48 months of program completion. The absolute risk reduction and the number needed to treat for the incidence of disability were calculated for the nonengaged and engaged groups. Cox proportional hazard regression analysis, using inverse probability weighting was used to obtain the hazard ratio. RESULTS: Disabilities occurred in 112 individuals in the matched nonengaged group and 51 individuals in the engaged group. The absolute risk reduction was 5.67% (95% CI 3.46%-7.88%). The number needed to treat was 18 (95% CI 13-29). The hazard ratio, with the nonengaged group as the reference, was 0.49 (95% CI 0.36-0.67). CONCLUSIONS AND IMPLICATIONS: This longitudinal observational study suggested that a community-based program could prevent 1 disability in every 18 participants. This program does not require a professional instructor, only the distribution of devices and system installation, and it could be beneficial as a population-based approach to preventing disabilities.

First tarsometatarsal joint mobility in hallux valgus during gait: A synchronized ultrasound and three-dimensional motion capture analysis.

PURPOSE: To quantify the vertical translation between the first metatarsal and medial cuneiform during the stance phase of gait in young individuals with and without hallux valgus. DESIGN: This cross-sectional observational study included 34 young adults (male, n = 4; female, n = 30) who were divided into three groups according to the hallux valgus angle: control (< 20°, n = 13), mild hallux valgus (≥ 20° to < 30°, n = 12), and moderate hallux valgus (≥ 30°, n = 9). The mobility of the first tarsometatarsal joint was evaluated during the stance phase using B-mode ultrasound synchronized with a motion analysis system. RESULTS: The medial cuneiform shifted more plantar during the early phase in mild hallux valgus and during the middle and terminal phases in moderate hallux valgus than in control. The severity of the hallux valgus was correlated with a trend toward plantar shift of the medial cuneiform. The first metatarsal was located more dorsal than the medial cuneiform; however, there was no significant variation. No significant differences in the peak ankle plantarflexion angle and moment were noted between the groups. CONCLUSION: The hypermobility of the first tarsometatarsal joint, especially plantar displacement of the medial cuneiform in the sagittal plane, was found in young individuals with hallux valgus during the stance phase of gait, and the mobility increased with the severity of hallux valgus. Our findings suggest the significance of preventing hallux valgus deformity early in life.

Association between the perceived value of adopting new behaviors and depressive symptoms among older adults.

Early preventive measures against depression have become important with unprecedented global aging. Increase in one's perceived value (PV) may correspond to better mental health outcomes. This cross-sectional observation study aimed to clarify whether the PV of adopting new behaviors is associated with depressive symptoms. The participants were 5266 community-dwelling older adults aged ≥ 65 years. We developed a questionnaire to measure the PV of adopting new behaviors, specifically activities beneficial for preventing depressive symptoms (physical, cognitive, and social activities) in older adults. The questionnaire asked whether adopting the ten selected behaviors was valuable. The scores were added, and the total score ranged from - 20 to 20. The odds ratios (OR) of depressive symptoms were calculated using binomial logistic regression according to the PV score quartiles. Depressive symptoms were reported by 595 (11.3%) participants. After adjusting for potential confounders, higher quartiles of PV scores were significantly associated with lower prevalence of depressive symptoms: vs Q1; Q2 OR 0.76 (95% confidence interval: 0.59-0.97); Q3 0.67 (0.51-0.87); Q4 0.54 (0.40-0.73) (P for trend < .001). Having a higher PV of adopting new behaviors may prevent depressive symptoms among older adults. Healthcare professionals need to pay attention to poor value orientation among older adults.

Lifetime Physical Activity and Late-Life Mild Cognitive Impairment in Community-Dwelling Older Adults.

OBJECTIVES: Regular physical activity throughout life is generally recommended to prevent dementia; however, there is little evidence regarding the association between lifetime physical activity and mild cognitive impairment (MCI), which often precedes dementia. This study aimed to examine the association of lifetime physical activity and their transitions with late-life MCI. DESIGN: A population-based case-control study. SETTING AND PARTICIPANTS: A total of 2968 Japanese community-dwelling older adults aged ≥70 years without dementia. METHODS: We evaluated the participants' early-, mid-, and late-life physical activity habits and categorized their transitions across life stages. Cognitive functions in late life were assessed for memory, attention, executive function, and processing speed; functional impairment in one or more cognitive domains was defined as MCI. RESULTS: Regular physical activity in early life was not significantly associated with late-life MCI [odds ratio (OR), 0.80; 95% CI, 0.63-1.02], although those in mid-life (OR, 0.64; 95% CI, 0.51-0.81) and late-life (OR, 0.74; 95% CI, 0.59-0.91) were associated with lower odds of late-life MCI. Compared with nonexercisers, participants who acquired new habits of physical activity during mid- or late-life (OR, 0.71; 95% CI, 0.55-0.91) and those who maintained physical activity throughout their life span (OR, 0.61; 95% CI, 0.42-0.87) had lower odds of late-life MCI; those who stopped regular activity during mid- or late-life did not (OR, 0.79; 95% CI, 0.58-1.06). CONCLUSIONS AND IMPLICATIONS: While physical activity throughout the life span is associated with the lowest odds of MCI, starting regular physical activity, even later in life, confers a benefit and should be encouraged as a "lifelong approach" to MCI risk reduction.

Combined impact of physical frailty and social isolation on use of long-term care insurance in Japan: A longitudinal observational study.

OBJECTIVES: The combined effect of physical frailty and social isolation on the need to make use of long-term care insurance (LTCI) among older adults remains unknown. Thus this study investigates the association between physical frailty, social isolation, and the use of LTCI among older adults in Japan. STUDY DESIGN: This is a prospective observational study. MAIN OUTCOME MEASURES: Physical frailty is defined as limitations in strength, mobility, and physical activity, as well as exhaustion and weight loss. People with one or two indicators were categorized as pre-frail. Participants with a score of 1 point or more on the social isolation scale were defined as being socially isolated. Participants were followed up monthly for two years to check whether incident certification of care had been required. RESULTS: Data on 4576 community-dwelling independent older adults (mean age, 73.9 ± 5.5 years, 2032 men, 2544 women) were analyzed. A time-dependent Cox proportional hazards regression model showed that individuals with pre-frailty without social isolation (hazard ratio [HR] 2.02, 95 % confidence interval [CI] 1.40-2.91), pre-frailty with social isolation (HR 2.36, 95 % CI 1.62-3.43), frailty without social isolation (HR 2.98, 95 % CI 1.83-4.85), and frailty with social isolation (HR 3.19, 95 % CI 2.07-4.91) had significantly higher risks of needing to make use of LTCI than those with no frailty and without social isolation. This higher risk was non-significant among individuals with no frailty and social isolation (HR 1.28, 95 % CI 0.78-2.10). CONCLUSION: Combined frailty and social isolation among older adults should be addressed to prevent adverse health outcomes, including use of LTCI.

Association of objectively measured physical activity with incidence disability in older adults with/without social isolation.

PURPOSE: This study aimed to investigate association between objectively measured physical activities with incidence disability in older adults with and without social isolation. METHODS: This 5-year longitudinal observational study used a population-based study from a sub-cohort of the National Center for Geriatrics and Gerontology Study of Geriatric Syndrome. In Japan, Incident disability is defined as a new case of public insurance certification for long-term care. As participants, we enrolled 5,257 community-dwelling older adults aged ≥ 70 years. The Participants on whom incomplete baseline physical activity assessments were performed; who required long-term care; had a history of dementia, Parkinson's disease, stroke, or depression; who lacked independence in basic ADL; who had Mini-Mental State Examination scores; or who had missing measurements; were excluded. Thus, 2,071 participants were included. RESULTS: Of the participants, 1,183 non-socially isolated participants had 151 (4.3%) cases of disability, while socially isolated participants had 150 (13%) cases. Cox proportional-hazards regression analysis presented the adjusted hazard ratio (HR) and 95% confidence interval (95%CI) of daily steps and low-intensity and moderate-to-vigorous physical activities-0.62(0.43-0.89), 0.84(0.60-1.18), 0.62(0.43-0.89) in participants with social isolation, and 0.58(0.40-0.85), 0.86(0.60-1.24), 0.70(0.49-1.01) in those with social isolation. CONCLUSIONS: Daily steps were significantly associated with a decreased risk of incidence disability, regardless of social isolation. These results suggest the greater importance of daily physical activity than its specific intensity in socially isolated older adults.

Physical frailty and survival time after the onset of functional disability: Is there a sex difference?

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.

Neurophysiological markers in community-dwelling older adults with mild cognitive impairment: an EEG study.

BACKGROUND: Neurodegeneration and structural changes in the brain due to amyloid deposition have been observed even in individuals with mild cognitive impairment (MCI). EEG measurement is considered an effective tool because it is noninvasive, has few restrictions on the measurement environment, and is simple and easy to use. In this study, we investigated the neurophysiological characteristics of community-dwelling older adults with MCI using EEG. METHODS: Demographic characteristics, cognitive function, physical function, resting-state MRI and electroencephalogram (rs-EEG), event-related potentials (ERPs) during Simon tasks, and task proportion of correct responses and reaction times (RTs) were obtained from 402 healthy controls (HC) and 47 MCI participants. We introduced exact low-resolution brain electromagnetic tomography-independent component analysis (eLORETA-ICA) to assess the rs-EEG network in community-dwelling older adults with MCI. RESULTS: A lower proportion of correct responses to the Simon task and slower RTs were observed in the MCI group (p < 0.01). Despite no difference in brain volume between the HC and MCI groups, significant decreases in dorsal attention network (DAN) activity (p < 0.05) and N2 amplitude of ERP (p < 0.001) were observed in the MCI group. Moreover, DAN activity demonstrated a correlation with education (Rs = 0.32, p = 0.027), global cognitive function (Rs = 0.32, p = 0.030), and processing speed (Rs = 0.37, p = 0.010) in the MCI group. The discrimination accuracy for MCI with the addition of the eLORETA-ICA network ranged from 0.7817 to 0.7929, and the area under the curve ranged from 0.8492 to 0.8495. CONCLUSIONS: The eLORETA-ICA approach of rs-EEG using noninvasive and relatively inexpensive EEG demonstrates specific changes in elders with MCI. It may provide a simple and valid assessment method with few restrictions on the measurement environment and may be useful for early detection of MCI in community-dwelling older adults.

The Features of Foot Morphology and Intrinsic Foot Muscle Property in Adolescent Swimmers: An Ultrasound-Based Study.

This cross-sectional study aimed to investigate the relationship between foot shape and intrinsic foot muscles (IFMs) in adolescent swimmers compared with other athletes. Foot morphology of swimmers was compared with other athletes of comparable age and a competition level (n = 32 [64 feet]; a total of 64 feet; 128 feet in two groups). Foot morphology and variables of IFMs were measured using a three-dimensional foot scanner and an ultrasound imaging system, respectively. Multiple linear regression analysis with forced entry was performed to clarify the association of the thickness and the cross-sectional area (CSA) of IMFs with the navicular height in both sitting and standing positions. Navicular height in a standing position, the thickness of the abductor hallucis (AbH) and the flexor digitorum brevis (FDB), as well as the CSA were significantly lower in swimmers compared with other athletes (p < 0.05). A larger CSA for the flexor hallucis brevis (FHB) was observed in swimmers than in other athletes (p < 0.01). The navicular height of swimmers in sitting and standing positions was positively correlated with the thickness and the CSA of the FHB and the FDB (p < 0.05). Multiple regression analysis showed that navicular height was associated with the CSA of the FDB in both sitting and standing positions (ß = 0.395; p < 0.002, ß = 0.201; p < 0.018). This study showed that the navicular height of elite adolescent swimmers was lower than that of other athletes. Furthermore, the swimmers' high navicular height was associated with the CSA of the FDB, suggesting that the FDB might be more involved in the formation of the medial longitudinal arch than the AbH.

Motoric Cognitive Risk Syndrome and Traffic Incidents in Older Drivers in Japan.

Importance: To prevent motor vehicle collisions by older drivers, the increased risk of collisions should be considered early. Cognitive decline increases the risk of car collisions. Motoric cognitive risk syndrome (MCR), characterized by the presence of cognitive concerns and slow gait, can be assessed conveniently and is useful to assess the risk of dementia. Objective: To examine the association between MCR assessment findings and car collisions among older drivers in Japan. Design, Setting, and Participants: This cross-sectional study used data from a community-based cohort study, the National Center for Geriatrics and Gerontology-Study of Geriatric Syndromes, conducted in Japan from 2015 to 2018. Participants were community-dwelling older adults aged at least 65 years. Data were analyzed from February to March 2023. Exposure: MCR was defined as having subjective memory concerns (SMC) and slow gait. Participants were classified into 4 groups: no SMC or slow gait, only SMC, only slow gait, and MCR. Main Outcomes and Measures: Participants were asked about the experience of car collisions during the last 2 years and near-miss traffic incidents during the previous year through face-to-face interviews. Odds of experiencing a collision or near-miss traffic incident were assessed using logistic regression. Results: Among a total of 12 475 participants, the mean (SD) age was 72.6 (5.2) years, and 7093 (56.9%) were male. The group with only SMC and the group with MCR showed a higher proportion of both car collisions and near-miss traffic incidents than the other groups (adjusted standardized residuals > 1.96; P < .001). Logistic regression analysis showed the only SMC and MCR groups had increased odds of car collisions (only SMC group: odds ratio [OR], 1.48; 95% CI, 1.27-1.72; MCR group: OR, 1.73; 95% CI, 1.39-2.16) and near-miss traffic incidents (only SMC group: OR, 2.07; 95% CI, 1.91-2.25; MCR group: OR, 2.13; 95% CI, 1.85-2.45) after adjusting for confounding factors. After stratifying MCR assessments by objective cognitive impairment, significant associations were still observed. In the only slow gait group, objective cognitive impairment was associated with increased odds of car collisions (OR, 1.96; 95% CI, 1.17-3.28). Conclusions and Relevance: In this cross-sectional study of community-dwelling older drivers in Japan, SMC and MCR were associated with car collisions and near-miss traffic incidents independent from objective cognitive impairment. Future studies should examine the mechanism of these associations in more detail.

Difference in employment status and onset of disability among Japanese community-dwelling older adults: a prospective cohort study.

OBJECTIVE: This prospective cohort study investigates the relationship between the onset of disability and employment status. METHODS: We investigated 3,741 community-dwelling adults aged 70 or older, who participated in a population-based cohort study in Japan. Their onset of disability was monitored monthly using the long-term care insurance certification registration system, for five years from baseline. Based on an employment status questionnaire, we categorized participants into three groups: (1) employee, (2) self-employed, and (3) not working. Covariates included demographic information, medical history, number of medications, educational level, living alone, social group engagement, smoking status, walking speed, instrumental activities of daily living, global cognitive function, and depressive symptoms. Missing values were managed using multiple imputation. Cox proportional hazard models were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for incident disability risk by employment status. RESULTS: The disability incidence rates were 15.3/1,000 (95% CIs: 10.7-22.0) person-years among employees, and 33.0/1000 (95% CIs: 24.4-44.6) and 39.6/1000 (95% CIs: 36.5-43.0) person-years among self-employed and non-working participants, respectively. The adjusted HRs for the onset of disability among non-working and self-employed participants were 1.69 (95% CIs: 1.16-2.46, p = 0.007) and 1.63 (95% CIs: 1.01-2.62, p = 0.044) compared with employees, respectively. Similar results were found among men. Among women, disability onset was not associated with employment status. CONCLUSIONS: Older adults' risk of disability onset differed according to their employment status. Older employees had a lower risk of disability onset than those not working or self-employed.

Effects of Rearfoot Eversion on Foot Plantar Pressure and Spatiotemporal Gait Parameters in Adolescent Athletes.

BACKGROUND: Foot malalignment can augment the risk of lower-extremity injuries and lead to musculoskeletal disorders. This study aimed to clarify the contribution of rearfoot alignment to plantar pressure distribution and spatiotemporal parameters during gait in healthy adolescent athletes. METHODS: This retrospective study included 39 adolescent athletes who were divided into the rearfoot eversion and control groups according to a leg heel angle of 7°. A total of 78 legs were analyzed (45 and 33 legs in the rearfoot eversion [women, 53.3%] and control groups [women, 48.5%], respectively). Gait was assessed using an in-shoe plantar pressure measuring system and a wearable inertial sensor. RESULTS: The foot plantar pressure distribution in the hallux was higher in the rearfoot eversion group than that in the control group (p = 0.034). Spatiotemporal parameters showed that the foot pitch angle at heel strike was significantly larger in the rearfoot eversion group than that in the control group (24.5° vs. 21.7°; p = 0.015). Total sagittal range of motion of the ankle during the stance phase of gait was significantly larger in the rearfoot eversion group than that in the control group (102.5 ± 7.1° vs. 95.6 ± 15.8°; p = 0.020). Logistic regression analysis revealed that plantar pressure at the hallux and medial heel and foot pitch angle at heel strike were significantly associated with rearfoot eversion. CONCLUSIONS: Our findings suggest that rearfoot eversion affects the gait patterns of adolescent athletes. Notably, leg heel angle assessment, which is a simple and quick procedure, should be considered as an alternative screening tool for estimating plantar pressure and spatiotemporal gait parameters to prevent sports-related and overuse injuries in adolescent athletes.

Differences in Center of Pressure Displacement and Lower Limb Muscle Activity During Relevé Descending Phase Comparing Flat Shoes and Pointe Shoes.

AIMS: In classical ballet, dancers may wear flat shoes and pointe shoes. To consider the kinematic changes between flat shoes and pointe shoes to prevent injuries, it is essential to focus on the fundamental ballet movement of standing on pointe. This study aimed to clarify the differences in the center of pressure (COP) displacement and lower limb muscle activity during the descending phase of a relevé when wearing pointe shoes versus flat shoes. METHODS: Ten amateur ballet dancers volunteered for this study and performed a reléve wearing flat shoes and pointe shoes. We measured the COP displacement by using a footplate and electromyographies of the tibialis anterior, soleus, lateral gastrocnemius, and peroneus longus muscles during the relevé descending phase. These data were compared using a paired t-test or Wilcoxon signed-rank sum test. RESULTS: The COP significantly shifted to the lateral side when dancers were wearing pointe shoes compared to wearing flat shoes (p<0.05). The muscle activity of the tibialis anterior and soleus muscles was significantly higher by 5.7% and 5.3%, respectively, when ballet dancers were wearing pointe shoes compared to flat shoes (p<0.05). However, there were no differences in both lateral gastrocnemius and peroneus longus. CONCLUSION: Greater muscle activities in the tibialis anterior and soleus muscles when wearing pointe shoes than when wearing flat shoes were associated with a larger lateral displacement of the COP. To control the COP displacement during the descending phase of a relevé, the muscle activity of the peroneus longus, which is antagonist of tibialis anterior muscle, and soleus muscles should be increased.

Association between COVID-19 emergency declarations and physical activity among community-dwelling older adults enrolled in a physical activity measurement program: Evidence from a retrospective observational study using the regression discontinuity design.

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 [[Formula: see text]][Formula: see text] 964.3 steps), LPA ([Formula: see text] 5.5 min), and MVPA ([Formula: see text] 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 ([Formula: see text]-609.7 steps), LPA ([Formula: see text]-4.6 min), and MVPA ([Formula: see text]-2.8 min) decreased with the 14-day bandwidth. On the other hand, steps ([Formula: see text] 143.8 steps) and MVPA ([Formula: see text] 1.3 min) increased with the 56-day bandwidth. For the third declaration, LPA consistently decreased with all the bandwidths ([Formula: see text]-2.1, -3.0, -0.8 min for the 14, 28, 56-day bandwidth), whereas steps ([Formula: see text]-529 steps) and MVPA ([Formula: see text]-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.

Reciprocal relationship between physical and social frailty among community-dwelling older adults.

OBJECTIVE: Both physical and social frailty are risk factors for major adverse health-related outcomes and influence each other. However, the longitudinal causal relationship between physical and social frailty has not been clarified. This study aimed to determine the reciprocal relationship between physical and social frailty by age group. METHODS: This study analyzed longitudinal data from a cohort study of older adults aged 65 years or older living in Obu City, Aichi Prefecture, Japan. The study included 2568 participants who participated in both a baseline assessment in 2011 and a follow-up assessment four years later. Participants participated in assessments of physical and cognitive function. Physical frailty was assessed using the Japanese version of the Cardiovascular Health Study criteria. Social frailty was assessed with five questions about daily social activities, social roles, and social relationships. A total frailty score was calculated for each frailty type and used in the cross-lagged panel analysis. The reciprocal relationship between physical and social frailty status was analyzed using a cross-lagged panel model in each of the young-old (n = 2006) and old-old (n = 562) groups. RESULTS: In the old-old group, baseline physical frailty status predicted social frailty status four years later, and social frailty status at baseline predicted physical frailty status four years later. In the young-old group, the effect of social frailty status at baseline on physical frailty at four years was significant; however, the cross-lag effect from baseline physical frailty status to social frailty status at four years was insignificant, indicating that social frailty preceded physical frailty. CONCLUSION: The reciprocal relationship between physical and social frailty differed by age group. The results of this study suggest the importance of considering age when planning strategies to prevent frailty. Although a causal relationship between both physical and social frailty was observed in old-old, social frailty preceded physical frailty in the young-old, suggesting that early prevention of social frailty is important for the prevention of physical frailty.

Association of Loneliness With the Incidence of Disability in Older Adults With Hearing Impairment in Japan.

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.