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BACKGROUND: Radio-Taiso could be a sustainable public health strategy for maintaining quality of life (QoL) in older adults with frailty. This study aimed to investigate whether Radio-Taiso provided greater benefits for health-related quality of life (HR-QoL) and to identify the mechanisms underlying the effectiveness in this population. METHODS: A 12-week randomized controlled trial enrolled 226 older Japanese adults with pre-frailty or frailty, assessed using the modified frailty phenotype. Participants were randomly allocated to the intervention (Radio-Taiso + nutrition program) or control (nutrition program) groups. The Radio-Taiso program comprised five 60-min group sessions and daily practice at the participants' homes. The primary outcome was the change in the mental domain of HR-QoL, assessed using the SF-36®. The secondary outcomes included six physical fitness items and exercise self-efficacy. RESULTS: Overall, 104 and 105 participants in the intervention and control groups, respectively, were analyzed based on the intention-to-treat principle. The median (interquartile range) daily practice rate of Radio-Taiso was 94.1% (73.2-98.8%). Although general linear models adjusted for baseline values and allocation stratification factors showed that the intervention group obtained greater benefits (adjusted mean differences [95% confidence intervals]) in the up-and-go (0.3 [0.1, 0.6] s), 2-min step-in-place (-3.2 [-6.2, -0.2] steps) tests, and exercise self-efficacy scale (-1.4 [-2.6, -0.1] points) than the control group, there were no group differences in changes in the mental domain score of HR-QoL. CONCLUSIONS: Radio-Taiso provided greater benefits for agility/dynamic balance, aerobic endurance, and exercise self-efficacy in older adults with frailty; however, these changes do not improve HR-QoL.
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INTRODUCTION: Vitamin K is a fat-soluble vitamin discovered as an essential factor for blood coagulation. It is suggested that vitamin K can benefit several aging-related diseases, including osteoporosis, osteoarthritis, and dementia. We previously reported the cross-sectional association of vitamin K insufficiency with frailty in community-dwelling older adults. MATERIALS AND METHODS: In October 2020, a health examination of community-dwelling older adults (The Otassha Study) was performed, including frailty evaluation and blood tests. We used a ucOC and OC ratio (ucOC/OC) to indicate vitamin K insufficiency. One year later, we conducted a follow-up evaluation of frailty on 518 people who were not frail at baseline. The serum ucOC/OC at the baseline examination was divided into quartiles (Q1, Q2, Q3, and Q4). Odds ratio (OR) and 95% confidence interval (CI) were calculated using multivariate binary logistic regression for each quartile of ucOC/OC to determine the risk of incident frailty in the follow-up study, with the lowest quartile (Q1) as the reference. RESULTS: Among the 518 older adults who were not frail at baseline, 66 people (12.7%) became frail in the follow-up study. In the multivariate binary logistic regression analysis, setting the lowest quartile of ucOC/OC (Q1) as a reference, the OR of the incident frailty in the highest quartile (Q4) was 2.53 (95% CI 1.07, 4.92) which was significantly different from Q1. CONCLUSION: The findings of this longitudinal study suggest that vitamin K insufficiency has nutritional importance in predicting the future incidence of frailty in the Japanese older adult population.
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Fragilidade , Vitamina K , Humanos , Idoso , Estudos Longitudinais , Incidência , Seguimentos , Fragilidade/epidemiologia , Vida Independente , Estudos Transversais , OsteocalcinaRESUMO
BACKGROUND: To clarify the association between psychosocial problems and frailty in the areas affected by the Great East Japan Earthquake, and to develop strategies for preventive long-term care in the community, we launched the Kesennuma Study in 2019. This report describes the study design and the participants' profiles at baseline. METHODS: The prospective study comprised 9,754 people (4,548 men and 5,206 women) randomly selected from community-dwelling independent adults aged 65 to 84 who were living in Kesennuma City, Miyagi. The baseline survey was conducted in October 2019. It included information on general health, socio-economic status, frailty, lifestyle, psychological factors (eg, personality, depressive moods), and social factors (eg, social isolation, social capital). A follow-up questionnaire survey is planned. Mortality, incident disability, and long-term care insurance certifications will also be collected. RESULTS: A total of 8,150 questionnaires were returned (83.6% response rate), and 7,845 were included in the analysis (80.4%; mean age 73.6 [standard deviation, 5.5] years; 44.7% male). About 23.5% were considered frail. Regarding psychological and social functions, 42.7% had depressive moods, 29.1% were socially isolated, and only 37.0% participated in social activities at least once a month. However, 82.5% trusted their neighbors. CONCLUSION: While local ties were strong, low social activity and poor mental health were revealed as issues in the affected area. Focusing on the association between psychological and social factors and frailty, we aim to delay the need for long-term care for as long as possible, through exercise, nutrition, social participation, and improvement of mental health.
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Terremotos , Fragilidade , Humanos , Masculino , Feminino , Idoso , Fragilidade/prevenção & controle , Estudos Prospectivos , Japão/epidemiologia , Vida Independente , Idoso FragilizadoRESUMO
BACKGROUND: Exercise and essential amino acid supplementation have been separately shown to improve muscle mass in elderly people, however, the combined, added effects of both interventions have yielded inconsistent results on muscle mass, strength, and physical function improvement. AIMS: To investigate the additive effects of exercise and essential amino acid supplementation on muscle mass, strength, and walking ability in older Japanese women with muscle mass decline, but not weakness and slowness. METHODS: One hundred thirty women over 65 years of age were defined as having muscle decline and randomly assigned into two groups; exercise and amino acid supplementation (n = 65) or exercise and placebo supplementation (n = 65). The exercise group attended a 60-min comprehensive training program once a week and were encouraged to perform a home-based exercise program. The amino acid or placebo group ingested a 3 g supplement daily for 3-month. Body composition was determined by bioelectrical impedance analysis. Interview data and functional fitness measurements, such as muscle strength and walking ability were collected at baseline and after the 3-month intervention. RESULTS: There were no significant group × time interactions in primary outcomes such as muscle mass and strength. However, interactions were observed in the degree of low back discomfort (P = 0.014). Percent change of low back discomfort was significantly greater in exercise + amino acid group compared with exercise + placebo group. CONCLUSIONS: The combination of exercise and amino acid supplementation had a beneficial effect on low back discomfort. However, additional effects were not observed in primary outcomes including muscle mass and strength in this population.
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Vida Independente , Sarcopenia , Idoso , Aminoácidos Essenciais , Composição Corporal , Suplementos Nutricionais , Feminino , Humanos , Japão , Força Muscular , Músculo Esquelético , MúsculosRESUMO
BACKGROUND: It is unclear whether motor-cognitive dual tasks predict cognitive decline better than either motor or cognitive tasks alone. AIMS: To examine the utility of the novel motor-cognitive dual-task test [Stepping Trail Making Test (S-TMT)], as a predictor of cognitive decline, and compare its predictive performance with single motor or cognitive tests. METHODS: This 2-year population-based prospective study included 626 adults aged ≥ 70 years from Takashimadaira, Itabashi, Tokyo. The S-TMT measured the time taken to step on 16 numbers in order. Gait speed and TMT-A were assessed with standardized methods as single motor and cognitive tasks, respectively. A decline in the Mini-Mental State Examination score by ≥ 3 points over 2 years was defined as a significant cognitive decline. RESULTS: Over 2 years, 97 (15.5%) experienced cognitive decline. After adjusting for confounders, binary logistic regression models showed no significant associations between gait speed, TMT-A time tertiles, and risk of cognitive decline, but participants in the longest tertile of S-TMT time were more likely to develop cognitive decline than those of the shortest tertile (odds ratio 2.14; 95% confidence interval 1.17-3.90). Only the addition of the S-TMT time to the covariates model significantly improved the reclassification indices for predicting cognitive decline (net reclassification improvement: 0.31, P < 0.01; integrated discrimination improvement: 0.01, P = 0.02). DISCUSSION AND CONCLUSION: Only the S-TMT was significantly associated with cognitive decline and improved reclassification indices, indicating that it is more useful for predicting cognitive decline than individual gait speed or visual tracking tests alone.
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Disfunção Cognitiva , Marcha , Idoso , Cognição , Humanos , Estudos Prospectivos , Desempenho Psicomotor , Teste de Sequência AlfanuméricaRESUMO
BACKGROUND: Physical inactivity and sedentary behaviour (too much sitting) can contribute to renal dysfunction. However, the potential benefits of behavioural change (e.g. replacing sedentary behaviour with physical activity) on renal function are not well understood. We used isotemporal substitution to model potential impacts of behaviours on renal function by replacing time spent in one behaviour to another. METHODS: In 174 older Japanese adults (age, 50-83 years; females, 76%), the time spent in sedentary behaviour, light-intensity physical activity (LPA), and moderate- to vigorous-intensity physical activity (MVPA) were assessed using an uniaxial accelerometer. Renal function was evaluated by the estimated glomerular filtration rate (eGFR) from serum creatinine and cystatin C levels. RESULTS: In univariate analyses, eGFR was significantly, albeit weakly, correlated with time spent in sedentary behaviour (rs = - 0.229), LPA (rs = 0.265), and MVPA (rs = 0.353). In the isotemporal substitution models, replacement of 30 min/day of sedentary behaviour with an equivalent LPA time was not significantly associated with eGFR (ß = 2.26, p = 0.112); however, replacement with an equivalent time of MVPA was beneficially associated with eGFR (ß = 5.49, p < 0.05). CONCLUSIONS: These cross-sectional findings suggest that sedentary behaviour (detrimentally) and physical activity (beneficially) may affect renal function and that replacing sedentary behaviour with MVPA may benefit renal health in older adults.
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Exercício Físico/fisiologia , Rim/fisiologia , Comportamento Sedentário , Acelerometria , Idoso , Idoso de 80 Anos ou mais , Creatinina/sangue , Estudos Transversais , Cistatina C/sangue , Feminino , Taxa de Filtração Glomerular , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de TempoRESUMO
BACKGROUND: Exercise may reduce the risk of disability for activities of daily living (ADL), but the degree of associations between specific exercise types and such a risk remains unclear. This study aimed to examine the longitudinal associations between exercise types and the incidence of ADL disability in older women. METHODS: This 8-year population-based prospective cohort study enrolled 1003 community-dwelling older Japanese women without ADL disability in the baseline surveys. In the baseline surveys, all participants were asked whether or not they participated in any of 16 exercise types through a face-to-face interview. ADL were assessed using a modified form of the Katz index that comprised five ADL tasks. ADL disability was defined as dependence in at least one ADL task during the 8-year follow-up period. Binary logistic regression analyses were applied to obtain adjusted odds ratios (ORs) and 95% confident intervals (CIs) for the incidence of ADL disability based on participation or non-participation in each exercise type. RESULTS: Activities of daily living disability was noted in 130 participants (13.0%) over the 8-year follow-up period. After adjustment for confounders and other exercise types, participation in dancing, compared to non-participation, was associated with a significantly lower OR (0.27; 95% CI: 0.09-0.75) for incident ADL disability. There were no significant associations between other exercise types and incident ADL disability. CONCLUSION: Dancing was significantly and independently associated with a lower incidence of ADL disability. Thus, dancing may solely contribute to a reduced risk of ADL disability in older women.
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Atividades Cotidianas , Avaliação da Deficiência , Exercício Físico , Idoso , Idoso de 80 Anos ou mais , Dança , Feminino , Humanos , Incidência , Estudos Prospectivos , Inquéritos e QuestionáriosRESUMO
Exercise can delay the decline of instrumental activities of daily living (IADL), although it remains unclear which specific exercise types are associated with such a delay. This 4-year prospective cohort study in Japan aimed to identify the longitudinal associations between exercise types and the onset of IADL decline in older women. Between 2008 and 2012, 1082 community-dwelling older women aged ≥75â¯years participated in this study. Participations in 16 exercise types based on a face-to-face interview at baseline were used as independent variables. The primary study outcome was a decline in IADL as assessed using the instrumental self-maintenance subscale of the Tokyo Metropolitan Institute of Gerontology index of competence. An IADL decline was defined as a decrease of ≥1 point over the 4-year follow-up period and was used as the dependent variable. Adjusted odds ratios (ORs) and 95% confident intervals (CIs) for IADL decline based on participation or non-participation in each exercise type were obtained using logistic regression analyses. An IADL decline was observed in 151 participants (13.9%) over the 4-year follow-up period. After adjustment for potential confounders, participation in calisthenics had a significantly lower OR (0.62; 95% CI 0.42-0.90) for IADL decline. There were no significant associations between other specific exercise types and IADL decline. In conclusion, participation in calisthenics was significantly and independently associated with delayed IADL decline in older women aged ≥75â¯years. Thus, calisthenics may be a useful exercise to slow IADL decline in this age group.
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Atividades Cotidianas , Exercício Físico/fisiologia , Vida Independente , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Japão , Estudos Longitudinais , Estudos Prospectivos , TóquioRESUMO
BACKGROUND: To identify one of the physiological underlying mechanisms of the predictive effects of urinary liver-type fatty acid-binding protein (L-FABP) for the onset of cardiovascular disease (CVD), we investigated the relationship between urinary L-FABP levels and subendocardial viability ratio (SEVR), a marker of myocardial perfusion, in middle- and older-aged adults. METHODS: This was a cross-sectional study of 249 middle- and older-aged adults (aged 46-83 years). We measured urinary L-FABP levels and central hemodynamic parameters, including SEVR, calculated by pulse wave analysis using an applanation tonometry. RESULTS: In the participants stratified in accordance with the tertiles of urinary L-FABP levels, SEVR decreased in a stepwise fashion with increasing tertiles (p < 0.001). Furthermore, this association remains significant after the consideration of various confounders. On the contrary, urinary albumin levels were not independently related with SEVR. CONCLUSION: Our results demonstrated that urinary L-FABP levels were independently associated with the SEVR of the middle- and older-aged adults. This result suggests that the increase in urinary L-FABP levels even within the normal range might be related to the decrease in myocardial perfusion (SEVR).
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Doenças Cardiovasculares/urina , Circulação Coronária , Proteínas de Ligação a Ácido Graxo/urina , Hemodinâmica , Idoso , Idoso de 80 Anos ou mais , Albuminúria/urina , Biomarcadores/urina , Doenças Cardiovasculares/fisiopatologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Onda de PulsoRESUMO
BACKGROUND: Family support can help older adults better adhere to exercise routine, but it remains unclear whether an exercise program targeting older married couples would have stronger effects on exercise adherence than would a program for individuals. The purpose of this study was to determine the effects of an exercise program on the exercise adherence of older married couples over a 24-week follow-up period. METHODS: Thirty-four older married couples and 59 older adults participated in this study as couple and non-couple groups (CG and NCG, respectively). All participants attended an 8-week supervised program (once a week and a home-based exercise program comprising walking and strength exercises) and then participated in a follow-up measurement (24 weeks after post-intervention measurement). Exercise adherence was prospectively measured via an exercise habituation diary during the follow-up period-specifically, we asked them to record practice rates for walking (≥2 days/week) and strength exercises (≥6 items for 2 days/week). A multivariate logistic regression analysis was conducted to obtain the CG's odds ratios (ORs) and 95% confidence intervals (CIs) for adherence to walking and strength exercise adjusted for potential confounders (with NCG as the reference). RESULTS: Although the adherence rate of walking exercise in the CG was significantly higher than that in the NCG (29.2%; P < 0.001), there was no significant difference in the adherence rate of strength exercise between the two groups (P = 0.199). The multivariate logistic regression analysis showed that CG had significantly higher odds of adherence to walking exercise compared with the NCG (3.68 [1.57-8.60]). However, the odds of adherence to strength exercise did not significantly differ between the two groups (1.30 [0.52-3.26]). CONCLUSIONS: These results suggest that an exercise program targeting older married couples may be a useful strategy for maintaining walking adherence, even six months after the supervised program has ceased. A blinded randomized controlled trial will be needed to confirm this conclusion. TRIAL REGISTRATION: Retrospectively registered. UMIN Clinical Trials Registry (Registered: 02/11/16) UMIN000024689 .
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Terapia por Exercício/métodos , Cooperação do Paciente , Apoio Social , Cônjuges , Idoso , Idoso de 80 Anos ou mais , Exercício Físico , Terapia por Exercício/psicologia , Feminino , Seguimentos , Pesquisas sobre Atenção à Saúde , Humanos , Masculino , Cooperação do Paciente/psicologia , Estudos Prospectivos , Treinamento Resistido , Estudos Retrospectivos , Autoeficácia , Cônjuges/psicologia , Fatores de Tempo , Caminhada/psicologiaRESUMO
BACKGROUND: Research has shown that engaging in leisure-time physical activity (LTPA) and consuming dairy foods can lead to better sleep. Combining these two non-invasive prescriptions may be more effective for helping people fall asleep. This study investigates whether participating in LTPA in conjunction with consuming milk and milk products has a beneficial association with difficulty initiating sleep (DIS) among older adults. METHODS: The present study looked at 421 community-dwelling older people aged 65 years and older living in Ibaraki prefecture, Japan (mean age 74.9 ± 5.5 years, male 43.7%). We measured LTPA and sleep latency with the Physical Activity Scale for the Elderly and the Pittsburgh Sleep Quality Index, respectively. Participants who needed 30 minutes or more to fall asleep were defined as having DIS. We assessed dairy consumption as participants' habitual intake of milk, yogurt and cheese. RESULTS: After adjusting for covariates, participants who engaged in sufficient levels of LTPA as well as consumed milk (OR = 0.27, 95% CI = 0.10-0.73) or cheese (OR = 0.34, 95% CI = 0.14-0.85) were less likely to complain of DIS compared with people who neither engaged in LTPA nor ingested milk or cheese. CONCLUSIONS: Our findings suggest that the combination of engaging in LTPA and consuming milk or cheese is necessary as a prescription to improve falling asleep for older adults suffering from DIS. Additionally, engaging in LTPA along with dairy consumption may effectively improve a problem with falling asleep.
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Laticínios/estatística & dados numéricos , Nível de Saúde , Atividades de Lazer/psicologia , Leite/estatística & dados numéricos , Atividade Motora/fisiologia , Qualidade de Vida , Distúrbios do Início e da Manutenção do Sono/etiologia , Idoso , Animais , Estudos Transversais , Feminino , Seguimentos , Humanos , Incidência , Japão , Masculino , Estudos Retrospectivos , Comportamento Sedentário , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Inquéritos e QuestionáriosRESUMO
We examined whether knee extensor muscle strength can predict the onset of depressive symptoms in older Japanese women living in Tokyo. A baseline comprehensive geriatric examination was conducted to evaluate isometric knee extensor muscle strength and depressive symptoms (using Geriatric Depression Scale [GDS]) in 2017-2019. A free of neurological disease participants received a series of follow-up examinations following an initial evaluation. A GDS score of ≥5 during follow-up marked the onset of depressive symptoms. A logistic regression model was established after adjustment of baseline GDS score for variables including age, body mass index, smoking, alcohol consumption, comorbidities, working status, hobbies, volunteering, years of education, and dietary variety. Of the 1845 recruited individuals, 1409 were eligible to be targeted for follow-up. Among them, 768 women provided two-year follow-up data and contributed the final analysis. After covariate adjustments, the odds ratios (95% confidence interval) for depressive symptoms were 0.68 (0.39, 1.20) and 0.48 (0.26, 0.91) for the middle and highest tertiles of muscle strength, respectively, using the lowest tertile as reference. A dose-response association between muscle strength and depression (p = 0.022) was identified. This study suggests an inverse dose-response relationship between knee extensor muscle strength and the onset of depressive symptoms in older Japanese women.
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Depressão , Joelho , Força Muscular , Humanos , Feminino , Idoso , Depressão/epidemiologia , Japão/epidemiologia , Avaliação Geriátrica/métodos , Idoso de 80 Anos ou mais , Modelos Logísticos , Tóquio/epidemiologia , População do Leste AsiáticoRESUMO
BACKGROUND: Physical frailty and cognitive decline are common issues in geriatrics within an aging society, yet the association between them remains controversial. This study aims to evaluate the association between physical frailty and cognitive decline among community-dwelling older Japanese women. METHODS: A prospective cohort study was conducted in an urban area of Tokyo, Japan, involving community-dwelling older adults 65 years or older. Physical frailty was evaluated using the Japanese version of the Cardiovascular Health Study criteria, consisting of five components: shrinking, weakness, exhaustion, slowness, and low activity. Participants were classified as robust, pre-frail, or frail based on the presence of one or more criteria. Cognitive decline was defined as at least a three-point decrease in the Mini-Mental State Examination score from baseline. The association between physical frailty and cognitive decline was examined using binomial logistic regression, adjusting for potential confounders. The analysis yielded multivariable odds ratios (ORs) and 95 % confidence intervals (CIs), with robust participants using as the reference group. RESULTS: A total of 2,122 individuals participated in the baseline survey, with 805 included in the analysis (mean age: 72.9 ± 5.1 years). At baseline, 363 participants were classified as pre-frail, while 32 were classified as frail. During the two-year follow-up period, 68 participants experienced cognitive decline. The multivariable OR (95 % CI) for frailty, using robust as the reference, was 3.50 (1.13, 10.80). Furthermore, a linear relationship was observed between physical frailty and cognitive decline. CONCLUSION: Among older Japanese women, there exists a dose-response relationship between physical frailty status and cognitive decline.
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Disfunção Cognitiva , Idoso Fragilizado , Fragilidade , Avaliação Geriátrica , Vida Independente , Humanos , Feminino , Idoso , Estudos Prospectivos , Disfunção Cognitiva/epidemiologia , Vida Independente/estatística & dados numéricos , Fragilidade/epidemiologia , Idoso Fragilizado/estatística & dados numéricos , Idoso Fragilizado/psicologia , Japão/epidemiologia , Avaliação Geriátrica/métodos , Idoso de 80 Anos ou mais , Fatores de Risco , Estudos de Coortes , População do Leste AsiáticoRESUMO
PURPOSE: This pilot study compared serum metabolites in participants with and without sarcopenia. METHODS: Metabolomic techniques were applied to identify serum metabolites and novel biomarkers specific to patients with sarcopenia. In accordance with AWGS2019 criteria, sarcopenia was defined as low muscle mass plus either low muscle strength/low physical function, and severe sarcopenia was defined as low muscle mass, low muscle strength, and low physical function all together. RESULTS: The sarcopenia group had higher hypoxanthine, galactose, and mannose levels but lower triethanolamine and homogentisic acid levels than the non-sarcopenia group. The severe sarcopenia group had lower levels of alpha-tocopherol than the mild and moderate sarcopenia groups. CONCLUSION: This study is the first to identify hypoxanthine as a potential biomarker for sarcopenia in humans and provides new insights into the pathophysiology of sarcopenia. Furthermore, the identified metabolites may be useful for the early detection of sarcopenia.
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Sarcopenia , Humanos , Sarcopenia/diagnóstico , Projetos Piloto , Força Muscular/fisiologia , Biomarcadores , HipoxantinaRESUMO
OBJECTIVES: Digital gait biomarkers collected from body-worn devices can remotely and continuously collect movement types, quantity, and quality in real life. This study assessed whether digital gait biomarkers from a wrist-worn device could identify people with frailty in a large sample of middle-aged and older adults. DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: A total of 5822 middle-aged (43-64 years) and 4344 older adults (65-81 years) who participated in the UK Biobank study. MEASURES: Frailty was assessed using a modified Fried's frailty assessment and was defined as having ≥3 of the 5 frailty criteria (weakness, low activity levels, slowness, exhaustion, and weight loss). Fourteen digital gait biomarkers were extracted from accelerometry data collected from wrist-worn sensors worn continuously by participants for up to 7 days. RESULTS: A total of 238 (4.1%) of the middle-aged group and 196 (4.5%) of the older group were categorized as frail. Multivariable logistic regression analysis revealed that less daily walking (as assessed by step counts), slower maximum walking speed, and increased step time variability best-identified people with frailty in the middle-aged group [area under the curve (95% CI): 0.70 (0.66-0.73)]. Less daily walking, slower maximum walking speed, increased step time variability, and a lower proportion of walks undertaken with a manual task best-identified people with frailty in the older group [0.73 (0.69-0.76)]. CONCLUSIONS AND IMPLICATIONS: Our findings indicate that measures obtained from wrist-worn wearable devices worn in everyday life can identify individuals with frailty in both middle-aged and older people. These digital gait biomarkers may facilitate screening programs and the timely implementation of frailty-prevention interventions.
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AIM: The Questionnaire for Medical Checkup of Old-Old (QMCOO) is a 15-item dichotomous questionnaire developed for the early detection and intervention of frailty in a nationwide health checkup program targeting the old-old (i.e. aged ≥75 years). The Kihon Checklist (KCL) is a 25-item questionnaire widely used for screening and self-monitoring frailty status in administrative settings. With fewer items than the KCL, the QMCOO might expedite the frailty screening process. This study tested whether the QMCOO shows noninferiority in detecting frailty compared with the KCL. METHODS: Overall, 645 participants aged ≥75 years in the Itabashi Longitudinal Study on Aging were assessed for their frailty status according to the revised Japanese version of the Cardiovascular Health Study criteria. They also completed the QMCOO and the KCL simultaneously. We compared the discriminative performance of the two questionnaires using non-inferiority testing with an operationally defined non-inferiority margin of 10% of the area under the receiver operating characteristic curve computed from the KCL. RESULTS: The prevalence of frailty was 8.8%. The area under the receiver operating characteristic curve for the QMCOO in determining frailty was 0.76 (95% CI 0.70, 0.82), and the corresponding area under the receiver operating characteristic curve for the KCL was 0.77 (95% CI 0.69, 0.84). The QMCOO was not inferior to the KCL for frailty discrimination (P for non-inferiority = 0.006). CONCLUSIONS: The accuracy of the QMCOO for determining frailty was not inferior to that of the KCL. The QMCOO might be more acceptable and useful, as it can be applied in a shorter time with fewer questions than the KCL. Geriatr Gerontol Int 2024; 24: 176-181.
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Fragilidade , Idoso , Humanos , Envelhecimento , Lista de Checagem , Idoso Fragilizado , Fragilidade/diagnóstico , Fragilidade/epidemiologia , Avaliação Geriátrica , Japão/epidemiologia , Estudos Longitudinais , Inquéritos e Questionários , Idoso de 80 Anos ou maisRESUMO
AIM: Although polypharmacy and frailty are concerns in older adults, there is limited understanding of their association, particularly regarding frailty severity and its phenotypes within this population. This study aimed to examine the association between polypharmacy and frailty severity or frailty phenotypes in community-dwelling older Japanese adults. METHODS: This cross-sectional study included 1021 older adults from the Itabashi Longitudinal Study on Aging. Men accounted for 45.4%, and the mean age (standard deviation) was 77.9 (5.1) years. Participants were classified into frail (n = 67), pre-frail (n = 543), and robust (n = 411) groups using the revised Japanese Cardiovascular Health Study criteria. Polypharmacy was defined as using five or more self-reported prescription drugs. Ordinal and binomial logistic regression analyses examined the association between polypharmacy and frailty severity or frailty phenotypes (weight loss, weakness, exhaustion, slowness, and low activity). These models were adjusted for age, sex, body mass index, number of comorbidities, living status, employment status, years of education, as well as drinking and smoking habits. RESULTS: The prevalence of frailty in participants with and without polypharmacy was 10.1% and 5.0%, respectively. Participants with polypharmacy were more likely to have frailty (adjusted odds ratio [95% confidence interval], 1.89 [1.40-2.57]), weight loss (1.81 [1.00-3.27]), weakness (1.50 [1.08-2.09]), and slowness (2.25 [1.29-3.94]) compared with the no-polypharmacy group. CONCLUSIONS: Polypharmacy was associated with frailty severity and three frailty phenotypes. Longitudinal studies are required to investigate whether polypharmacy can predict the development and progression of frailty. Geriatr Gerontol Int 2024; 24: 196-201.
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Fragilidade , Masculino , Humanos , Idoso , Fragilidade/epidemiologia , Estudos Longitudinais , Vida Independente , Polimedicação , Estudos Transversais , Envelhecimento , Fenótipo , Redução de Peso , Idoso FragilizadoRESUMO
Smartphone applications aimed at enhancing physical, cognitive, and social activities through mobile health (mHealth) technology are of increasing interest. Their feasibility and acceptability, alongside impacts on frailty phenotype scores and step counts among older adults with frailty, remain to be fully validated. This study presents a 13-week preliminary intervention trial assessing an mHealth app's feasibility in a cohort of 34 eligible older adults, including 5 frail and 29 pre-frail participants. The intervention entailed a 6-week course on app usage, followed by 7 weeks of observation, with four participants withdrawing early. Feasibility was determined by login and active use rates, with a target login rate of 60% or higher. Post-intervention, 100% session attendance and a median login rate of 88.4% were observed. Acceptability was high, with 73% affirming the app's health benefits. Notably, frailty scores and step counts improved post-intervention, underscoring the app's potential for supporting older adults with frailty.
Assuntos
Estudos de Viabilidade , Idoso Fragilizado , Fragilidade , Vida Independente , Aplicativos Móveis , Telemedicina , Humanos , Projetos Piloto , Idoso , Masculino , Feminino , Idoso de 80 Anos ou mais , Telemedicina/métodos , Smartphone , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Avaliação Geriátrica/métodosRESUMO
OBJECTIVE: This study aimed to develop a simpler approach for diagnosing sarcopenia by using only bioelectrical impedance vector analysis parameters. METHODS: The study design was a cross-sectional study. The research was conducted based on the Itabashi Longitudinal Study on Aging, a community-based cohort study, with data collected from the 2022 and 2023 surveys in Itabashi Ward, Tokyo, Japan. The development cohort consisted of 1146 participants from the 2022 survey, and the validation cohort included 656 participants from the 2023 survey. Both cohorts were comprised of community-dwelling older adults with similar inclusion criteria. Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019 criteria. The logistic model utilized height divided by impedance at 50 kHz and phase angle to establish a new regression equation to identify sarcopenia. Regression equations were generated for the development cohort and validated for the validation cohort. Discriminatory ability was assessed using the area under the receiver operating characteristic curve (AUC) for men and women. RESULTS: The prevalence of sarcopenia was 20.7% and 14.8% in the development and validation cohort, respectively. The AUC (95% confidence interval) of the logistic model in discriminating sarcopenia was 0.92 (0.88, 0.95) for men and 0.82 (0.78, 0.86) for women in the development cohort and 0.85 (0.78, 0.91) for men and 0.90 (0.86, 0.95) for women in the validation cohort. CONCLUSION: The study demonstrated that a simple formula using bioelectrical parameters at 50 kHz proved useful in identifying sarcopenia in the older adult population.