[A longitudinal study of the association between physical activity and apathy among community-dwelling older adults].

AIM: This study clarified the association between the amount of physical activity and apathy after one year among community-dwelling older adults. METHODS: Two hundred community-dwelling older adults (mean age: 74.3±5.0 years old, female: 52.5%) who participated in the 2018 and 2019 "Kasama Longevity Health Examination" were included. Apathy was assessed using the Apathy Scale (0-42 points; the higher the score, the lower the motivation), physical activity by Physical Activity Scale for the Elderly (PASE), and Geriatric Depression Scale-15 (GDS). The 2018 PASE data were grouped into tertiles. A multiple regression analysis was performed with the 2019 Apathy Scale as the dependent variable and the 2018 PASE as the independent variable, and the sex, age, years of education, economic situation, body mass index, chronic illness, smoking history, alcohol drinking habits, physical function, cognitive function, GDS, and the 2018 Apathy Scale as adjustment variables. The PASE subcategories (leisure-time, household, and work-related activities) were examined using a similar method. RESULTS: The mean Apathy Scale in 2019 was 14.0±6.2 for the low physical activity group, 12.8±6.0 for the medium physical activity group, and 10.1±5.9 for the high physical activity group. The high physical activity group showed a significant negative association with the Apathy Scale (B=-1.56, 95% confidence interval=-2.91 to -0.21, p=0.023). No association was found for any activity of the PASE sub-items. CONCLUSIONS: A high level of physical activity may protect against apathy among community-dwelling older adults.

Association between comorbidities associated with diabetes and higher-level functional status in older patients with type 2 diabetes mellitus: a cross sectional study.

PURPOSE: To investigate the association between comorbidities associated with diabetes and higher-level functional status as well as the relationship between comorbidities associated with diabetes and higher-level functional status in older patients with type 2 diabetes mellitus who have better social networks. METHODS: Participants were outpatients with type 2 diabetes aged ≥ 65 years, excluding individuals with severe cardiovascular or respiratory illness, hyperglycaemic crisis, type 1 diabetes, or diabetic foot. The Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) was used to evaluate the higher-level functional status. A TMIG-IC score of ≤ 9, instrumental activities of daily living (IADL) ≤ 4, intellectual activity or social role ≤ 3 were defined as decline in higher-level functional status. The comorbidities investigated included peripheral neuropathy, retinopathy, nephropathy, cognitive impairment, depression, frailty, sarcopenia, low muscle strength, stroke, heart disease, and arthritis. RESULTS: The analysis included 198 patients (mean age 75.9 ± 5.7 years, male 60.1%). After adjusting for potential confounders, depression was associated with TMIG-IC (Prevalence ratio (PR) 2.34, 95% confidence interval (CI) 1.44-3.82), low muscle strength was associated with IADL (PR 2.85, 95% CI 1.30-6.27), and frailty was associated with intellectual activity (PR 1.38, 95% CI 1.10-1.74). In the model with social networks added as a confounder, the relationship between depression or low muscle strength and higher-level functional status was not statistically significant. CONCLUSION: Comorbidities of depression and low muscle strength for older patients with type 2 diabetes mellitus increase the risk of malfunctioning of higher-level functional status. Increased interactions with family, friends and neighbours may reduce this event.

The relationship between acceleration in sit-to-stand and falls in community-dwelling older adults: cross-sectional study.

[Purpose] This study aimed to determine the relationship between acceleration parameters in the sit-to-stand (STS) movement and falls, and the strength of the association between acceleration in STS movements and falls in older adults. [Participants and Methods] In total, 330 older adults were included. Four acceleration parameters were measured in STS movement: maximum acceleration (MA), velocity (MV), power (MP), and stand-up time (ST). For the conventional STS tests, 5 times STS test (5xSTS) and ground reaction force (maximal rate of force development per body weight: RFD/w, peak reaction force per body weight: F/w, chair-rise time: T) were measured. Poisson regression analysis adjusted for confounding factors was used. [Results] In the model adjusted for confounders, significant associations were observed among MV (Prevalence ratio (PR): 0.75; 95% confidence interval (CI): 0.58-0.98), MP (PR: 0.67; 95% Cl: 0.68-0.93), RFD/w (PR: 0.70; 95% Cl: 0.56-0.87), and T (PR: 1.14; 95% Cl: 1.05-1.24). [Conclusion] Among the acceleration parameters, MP was most strongly associated with falls and was considered the most useful parameter for evaluation. In addition, comparisons with the conventional chair rise tests suggested that MP was stronger than the 5xSTS test and may be equally related to the RFD/w.

Relationship between Acceleration in a Sit-To-Stand Movement and Physical Function in Older Adults.

Acceleration parameters in sit-to-stand (STS) movements are useful for measuring lower-limb function in older adults. The purpose of this study was to examine the relationship between acceleration in STS movements and physical function and the test-retest reliability of acceleration parameters in older adults. We performed cross-sectional analyses on 244 older adults including 107 men (mean age: 77.4 ± 4.7) and 137 women (mean age: 75.6 ± 5.3). Four acceleration parameters were measured in STS movements: maximum acceleration (MA), maximum velocity (MV), maximum power (MP), and stand-up time (ST). Good intraclass correlation coefficients (ICC > 0.70) were observed for all parameters. For the acceleration parameters, MA, MV, and MP were relatively strongly associated with the 5-time STS test (men: r = -0.36~-0.47; women: r = -0.37~-0.45) and the timed up and go test (men: r = -0.39~0.47, women: r = -0.43~-0.51): MP was also strongly associated with grip strength (men: r = 0.48, women: r = 0.43). All acceleration parameters were poorer in participants reporting mobility limitations than in those reporting no mobility limitations. These findings support the usefulness of sensor-based STS measurement. The system is expected to be useful in various settings where care prevention is addressed.

Evaluation of Cognitive and Physical Function Among Older Adults by Their Physical Activity: A Cross-Sectional Kasama Study, Japan.

BACKGROUND: The amyloid-ß1-42 (Aß42) level is a biomarker that is widely used to evaluate individual cognitive dysfunction early in neurodegenerative diseases, as well as differentiate between normal cognitive function, mild cognitive impairment, Alzheimer's disease, and vascular cognitive impairment. OBJECTIVE: Our cross-sectional study evaluated the association between daily exercise and physical and cognitive function and Aß42 levels among a subsample of 325 older adults from the Kasama Study. METHODS: Participants (age: 74.5 [range 65-90] years) were classified into three exercise groups: the dual-task (DEG, n = 128), single-task (SEG, n = 122), and non-exercise (NEG, n = 75) groups. The main outcomes were the plasma Aß42 levels and the scores of the five cognitive (5-COG) tests and five cognition-related physical function (5-PHYS) tests. RESULTS: The Aß42 levels and 5-COG and 5-PHYS scores were higher in the SEG and DEG than in the NEG. The Aß42 levels were higher in the DEG than in the NEG (p = 0.008). CONCLUSIONS: Physical activities such as regular exercise may benefit older adults, improving their cognitive and physical function.

Cross-sectional and longitudinal study of the relationship between phase angle and physical function in older adults.

AIM: Although the validity of the assessment in older adults has been supported by several studies, cross-sectional and longitudinal relationships between phase angle (PhA) and physical function by sex have not been clarified. This study aimed to examine (i) cross-sectional relationships and (ii) longitudinal relationships between PhA and physical function in older adults. METHODS: A total of 816 and 445 community-dwelling older adults were included in cross-sectional and longitudinal analyses, respectively. We evaluated their physical function using grip strength, 5-repetition sit-to-stand test (5-STS), 5-meter habitual walk, Timed Up and Go test (TUG), single-leg balance with eyes open, and sit-and-reach test. A multifrequency bioelectrical impedance analyzer was used to determine the PhA at 50 kHz as well as the participants' body composition. RESULTS: In the cross-sectional analysis, a higher PhA was significantly associated with higher grip strength, sit-and-reach, single-leg balance with eyes open, 5-STS and lower TUG in women, as well as higher grip strength, single-leg balance with eyes open, lower 5-STS and TUG in men, adjusting for age, body mass index and muscle mass. In the longitudinal analysis, there was a significant interaction between PhA and year in the TUG test (B = -0.08; 95% CI, -0.136 to -0.025; P = 0.005) in men. There was no significant interaction between the PhA value and year for the other physical functions. CONCLUSIONS: The PhA is a useful indicator for assessing physical function in both older men and women. Furthermore, the PhA may be able to predict mobility limitation in older men. Geriatr Gerontol Int 2023; 23: 141-147.

Frail Older Adults without Occupational Dysfunction Maintain Good Subjective Well-Being: A Cross-Sectional Study.

The purpose of this cross-sectional study was to clarify the relationship between frailty/occupational dysfunction (OD), both with and without, and subjective well-being among community-dwelling older adults. A total of 2308 (average age: 72.2 ± 5.1, female: 47.0%) independently living older adults in Kasama City, Japan, completed a self-administered questionnaire in November 2019. OD, frailty, and subjective well-being were assessed. Participants were classified into six groups: robust and healthy occupational function (HOF), robust and OD, pre-frail and HOF, pre-frail and OD, frail and HOF, and frail and OD. To examine the relationship between frailty/OD and subjective well-being, we performed an analysis of variance with subjective well-being as the dependent variable and with and without frailty/OD (six groups) as the independent variables. The results showed a significant association between with and without frailty/OD and subjective well-being in community-dwelling older adults. The subjective well-being of the pre-frail and HOF group was significantly better than that of the robust and OD group. Furthermore, the subjective well-being of the frail and HOF group was significantly better than that of the pre-frail and OD group. These results can be used to develop a new support method for frailty.

[Relationship between performance on the Digital Trail Making Peg test and cognitive function in older adults].

AIM: To determine the relationship between performance on the Digital Trail Making Peg test (DTMP) and cognitive function in older adults. METHODS: A total of 203 community-dwelling older adults (mean age: 76.4±5.1 years old) participated in this study. The five-cog test was used to assess the cognitive function. The DTMP measured completion time, number of errors and intra-individual variability for performance variability (coefficient of variation, CV; inter-elemental variability, IEV). Spearman's rank correlation coefficient (ρ) was calculated to examine the association between each variable. In addition, a multiple regression analysis was performed with the cognitive function score as the dependent variable and the DTMP completion time, number of errors, CV, and IEV as the independent variables, with adjusting for the sex, age, years of education, body mass index, medical history, depression, and physical function. RESULTS: The rank correlation coefficients with cognitive function scores were as follows: completion time, ρ = -0.479 (P < 0.01), number of errors, ρ = -0.068 (P = 0.332), CV, ρ = 0.085 (P = 0.225), IEV, ρ = -0.316 (P < 0.01). The results of the multiple regression analysis showed that completion time (ß = -0.566), CV (ß = 0.164), IEV (ß = 2.736) were significantly associated with cognitive function scores. CONCLUSIONS: The shorter the DTMP completion time, the better the overall cognitive function. However, the intra-individual variability of CV and IEV did not show consistent results, with smaller values indicating less intra-individual variability.

The association of the Japan Science and Technology Agency Index of Competence with physical and cognitive function in community-dwelling older adults.

AIM: To investigate the association of the Japan Science and Technology Agency Index of Competence with physical and cognitive functions in community-dwelling older adults. METHODS: This study used the data of 565 community-dwelling adults aged ≥65 years (mean age: 74.3 ± 5.2 years) from the Kasama Health Checkup for Longevity survey in Japan. The Japan Science and Technology Agency Index of Competence was used to comprehensively evaluate the higher-level functional capacity and subscale functional capacity: technology usage, information practice, life management and social engagement. Physical functions were assessed using grip strength, the five-repetition sit-to-stand test, 5-m habitual walking test, one-leg standing test and hand working test with a pegboard. Cognitive functions were evaluated using the Five-Cog test consisting of attention, memory ability, visuospatial function, language ability and reasoning ability. Multiple regression analysis was conducted to examine the associations between total Japan Science and Technology Agency Index of Competence score and physical and cognitive functions. RESULTS: After adjusting for potential confounders, the total Japan Science and Technology Agency Index of Competence score was favorably associated with static balance ability (ß = 0.09; B = 0.01; 95% confidence interval: 0.00-0.02), lower limb strength (ß = -0.19; B = -0.29; 95% confidence interval: -0.41 to -0.16), walking ability (ß = -0.15; B = -0.67; 95% confidence interval: -1.05 to -0.30), hand dexterity (ß = -0.13; B = -0.08; 95% confidence interval: -0.14 to -0.03) and overall cognitive function (ß = 0.28; B = 0.04; 95% confidence interval: 0.03-0.05). CONCLUSIONS: Physical and cognitive functions are important for maintaining higher-level functional capacity. Geriatr Gerontol Int 2022; 22: 753-758.

Pre-frailty associated with traffic crashes in Japanese community-dwelling older drivers.

Objectives: Frailty might be useful to identify older drivers who are at risk for traffic crashes. We aim to examine the association between pre-frailty/frailty defined by the Kihon Checklist (KCL) and the involvement of traffic crashes and clarify whether some domains of the KCL are associated with traffic crashes.Methods: This cross-sectional study analyzed data from 2,208 Japanese community-dwelling older drivers aged ≥ 65 years in Kasama City, who participated in our postal survey in November 2019. A self-reported history of traffic crashes was used to divide participants into non-crash-involved and crash-involved groups.Results: A total of 192 (8.7%) participants had been involved in traffic crashes in the past year. The crash-involved group was found to have gained more body mass index, driven more frequently, and scored higher on the total KCL score than the non-crash-involved group (all P < .05). Binary logistic regression analyses showed that after adjusting for age, sex, education, driving frequency, and driving distance, pre-frailty (OR = 1.52, 95% CI: 1.10-2.10) was more significantly associated with traffic crashes as compared to robustness. Those who had impairment in the oral domain (OR = 1.57, 95% CI: 1.09-2.27) and memory domain (OR = 1.38, 95% CI: 1.01-1.90) were also more likely to be involved in traffic crashes.Conclusion: The results suggest that identifying pre-frailty may play an important pole in crash prevention. Additionally, more attention should be given to older drivers with oral dysfunction and cognitive impairment.

Combined effect of daily physical activity and social relationships on sleep disorder among older adults: cross-sectional and longitudinal study based on data from the Kasama study.

BACKGROUND: This study investigated whether daily physical activity of older adults, combined with social relationships, is associated with the risk of sleep disorder. Further, it determined whether a high level of one variable with a low level of the other, leads to a significantly lower risk of sleep disorder than low levels of both. METHODS: The sample comprised 1339 community-dwelling older Japanese adults: 988 in Study 1 and 351 in Study 2. The level of daily physical activity and range of social relationships were assessed using the Physical Activity Scale for the Elderly and the Lubben Social Network Scale, respectively. The Pittsburgh Sleep Quality Index was used to assess sleep disorder. To test the combined relationships and effects in Studies 1 and 2, the medians for the respective scores of each of the following four groups that the participants were categorized into, were calculated: (1) low activity group with low social relationships, (2) low activity group with high social relationships, (3) high activity group with low social relationships, and (4) high activity group with high social relationships. After adjusting for potential confounders, a logistic regression analysis was conducted in Study 1. After adjusting for potential confounders, a Cox proportional hazards regression analysis was conducted in Study 2. RESULTS: Study 1 revealed that the high activity group with high social relationships showed a significantly lower risk of sleep disorder (ORs: 0.585, 95% CI: 0.404-0.847) than the low activity group with low social relationships. Study 2 also revealed that the high activity group with high social relationships showed a significantly lower prevalence of sleep disorder (HRs: 0.564, 95% CI: 0.327-0.974) than the low activity group with low social relationships. CONCLUSIONS: Our findings suggest that for older adults with high social relationships, being physically active is favorably associated with sleep quality. However, a high level of one variable with a low level of the other has not been confirmed in improving sleep quality among older adults.

Association between Occupational Dysfunction and Social Isolation in Japanese Older Adults: A Cross-Sectional Study.

We clarified the relationship between occupational dysfunction and social isolation among community-dwelling adults. We used a self-administered questionnaire with a cross-sectional study for 2879 independently living older adults in Kasama City, Japan. Participants responded to a self-reported questionnaire in November 2019. Occupational dysfunction and social isolation were assessed. The participants were classified into two groups: healthy occupational function group, and occupational dysfunction group. To examine the relationship between occupational dysfunction and social isolation, we performed a logistic regression analysis with social isolation as a dependent variable and occupational dysfunction as an independent variable. In the crude model, the occupational dysfunction group had a higher risk of social isolation than the healthy occupational function group (odds ratio (OR) = 2.04; 95% confidence interval (CI), 1.63-2.55; p < 0.001). In the adjusted model, the occupational dysfunction group had a higher risk of social isolation than the healthy occupational function group (OR = 1.51; 95% CI, 1.17-1.94; p = 0.001). The results showed that occupational dysfunction was significantly associated with social isolation. These results can be used in constructing a support method for social isolation from a new perspective.