Importance of Lifestyle Activities for Older Adults' Psychosomatic Functions After Driving Cessation: Interpretation by a Mixed-Methods Study.

Older adults who cease driving are more likely to experience psychosomatic decline than those who continue driving. This mixed-methods study was intended to examine differences in psychosomatic functions depending on driving status and lifestyle activities, and factors affecting engagement in additional lifestyle activities after driving cessation. The quantitative analysis included individuals aged 60 and above. Driving status, lifestyle activities, and psychosomatic functions were assessed. For qualitative analysis, semi-structured interviews were conducted with the driving-cessation group to determine the factors affecting involvement in various lifestyle activities after driving cessation. Analysis of covariance was used for quantitative data, while text mining and qualitative inductive analysis were used for qualitative data. Older adults who engaged in more lifestyle activities walked faster than those who engaged in fewer lifestyle activities, even after driving cessation. Actively using local and personal resources may increase engagement in lifestyle activities after driving cessation.

Averting older adults' memory function decline via meaningful activities: a follow-up longitudinal study.

PURPOSE: The purpose of the study was to investigate the effects of satisfaction with meaningful activities and their performance on the memory function among community-dwelling older adults 3 years later. METHODS: A longitudinal analysis was conducted on 288 community-dwelling older adults aged 65 years and more who had completed the survey in 2019 and 2022 as participants in the Tarumizu Study. Meaningful activities were assessed in 2019 using the Aid for Decision-Making in Occupation Choice for activities. Satisfaction with and performance of meaningful activities were assessed, and the bottom 25% were classified into two groups: low satisfaction and low performance. Memory function was assessed using the National Center for Geriatrics and Gerontology-Functional Assessment Tool in 2019 and 2022. Changes in memory function over 3 years were analyzed by satisfaction and performance of meaningful activities. RESULTS: Two-way analysis of variance with group (satisfaction with and performance of meaningful activities) and time (2019 and 2022) as factors showed no statistically significant group-time interaction for memory in the satisfaction with meaningful activities group (F = 1.4, p = 0.24). Meanwhile, a statistically significant group-time interaction was observed for memory in the meaningful activity performance group, indicating that high performance of meaningful activities may play a protective role against memory decline (F = 7.4, p = 0.007). CONCLUSION: Higher performance of meaningful activities may protect against age-related changes in memory. A careful assessment of meaningful activities, and engagement that enhances performance may be useful in designing health support against memory decline.

Associations between driving status, frequency of transport use after driving cessation, and social frailty among middle-aged and older people aged 60 years and older.

Background: The use of transport other than cars is a modifiable factor in the association between driving cessation and social frailty. Clarifying this relationship may serve as a new preventive measure against social frailty among current non-drivers. This study examined the potential association of driving status and transport use with social frailty, as well as between the frequency of transport use and social frailty, among current non-drivers. Methods: This study included 977 middle-aged and older adults (average age 65.3 ± 4.8 years). The participants were classified as transport users (more than a few times a week) and transport non-users (less than a few times a month). Based on driving status and transport use, the groups were further classified into current driver, current non-driver/transport user, and current non-driver/transport non-user groups. We performed statistical analyses to examine the relationships between driving status, transport use, and social frailty. Results: The current non-driver/transport non-user group showed a significant association with a higher social frailty. The current non-driver/transport user group showed no association with social frailty compared with the current driver group. The current non-driver/transport non-user group showed a significant association with a higher social frailty rate (OR 2.14, 95%CI 1.25-3.73). Conclusions: Participants who did not drive or take transport showed significant associations with increased social frailty. Compared with current driver/transport use, current non-driver/transport non-use was associated with social frailty.

Association of combined low physical activity and low dietary diversity with mild cognitive impairment among community-dwelling Japanese older adults.

Objective: This study aimed to investigate the potential association between the combination of low physical activity and low dietary diversity with mild cognitive impairment (MCI) in older Japanese adults. Methods: Data from 600 older adults (mean age 74.1 ± 6.4 years; 62.0% women) were analyzed. We evaluated dietary variety based on the Food Frequency Score (FFS) (maximum 30 points) by assessing the one-week consumption frequencies of ten foods. An FFS of ≤ 16 indicated low dietary diversity. We assessed MCI using the National Center for Geriatrics and Gerontology (NCGG) Functional Assessment Tool. Physical activity levels was determined based on participant responses to two questions: "Do you engage in moderate levels of physical exercise or sports aimed at health?" and "Do you engage in low levels of physical exercise aimed at health?". Participants who responded "No" to both questions were classified as having low physical activity levels. We classified the participants into robust, low-dietary diversity, low-physical activity, and coexistence groups. Results: The overall prevalence of MCI was 20.7%, with rates in the robust, low dietary diversity, low physical activity, and coexistence groups of 17.7%, 24.7%, 25.0%, and 41.9%, respectively. Multiple logistic regression analysis revealed that low dietary diversity and physical activity were associated with MCI in older adults (odds ratio [OR] 2.80, 95% confidence interval [CI] 1.22-6.28). Conclusions: The results of the present study demonstrated the association of the co-occurrence of low dietary diversity and low physical activity with MCI. Older adults with both risk factors may require early detection, as well as physical activity and dietary interventions.

Associations between information and communication technology use and frailty in community-dwelling old-old adults: results from the ILSA-J.

OBJECTIVES: Frailty is a significant cause of adverse health events including long-term care and hospitalization. Although information and communication technology (ICT) has become an integral part of modern life, it remains unclear whether ICT use is associated with frailty. DESIGN: A cross-sectional study (Integrated Longitudinal Studies on Aging in Japan, ILSA-J). SETTING AND PARTICIPANTS: Aged 75 and older data from the ILSA-J in 2017 (n = 2893). METHODS: ICT use was measured using the technology usage sub-items of the Japan Science and Technology Agency Index of Competence. Specifically, the use of mobile phones, ATMs, DVD players, and sending e-mails were rated as "yes" (able to do) or "no" (unable to do), with the first quintile (≤1 point) defined as ICT non-users. Frailty was assessed using the Japanese version of the Cardiovascular Health Study criteria based on the phenotype model (e.g., weight loss, slowness, weakness, exhaustion, and low activity). Further, multivariate logistic regression analysis analyzed its association with ICT use. Subgroup analyses were stratified according to gender, years of education, and living arrangements. RESULTS: Higher ICT use was not associated with frailty after adjusting for covariates (odds ratio [OR]: 0.53; 95%CI 0.39-0.73). Similar associations were found in the sub-groups of women (OR 0.45, 95%CI 0.30-0.66), <13 years of education (OR 0.48, 95%CI 0.34-0.67), living alone (OR 0.46, 95%CI 0.27-0.79), and living together (OR 0.57, 95%CI 0.38-0.85). No association existed between using ICT and frailty in the sub-groups of men and ≥13 years of education. CONCLUSIONS AND IMPLICATIONS: Higher ICT use is associated with the absence of frailty in individuals 75 years and older. Such benefits may be particularly pronounced in women, those with lower levels of education, and older adults living alone or with others.

Are middle-aged and older adult users of physical activity monitors more physically active and at a lower risk of locomotive syndrome? Cross-sectional Web-based Online Survey.

Background: Physical inactivity is a risk factor for locomotive syndromes and functional limitations in middle-aged and older adults. Therefore, strategies to promote physical activity should be considered. This study investigated whether users of physical activity monitors were more physically active and exhibited a lower risk of locomotive syndrome, compared with non-users. Methods: We analyzed data from 742 Japanese adults aged 60-79 years. The participants were surveyed for their use of physical activity monitors in their daily lives. We also assessed the prevalence of locomotive syndrome. Results: We observed significantly higher physical activity levels in users compared with non-users. Moreover, the use of a physical activity monitor was significantly associated with decreased odds of locomotive syndrome (adjusted odds ratio [aOR] = 0.48). Significantly lower risk of locomotive syndrome were observed in individuals who had used a monitor for >2 years (aOR = 0.42) or had set a personal step goal (aOR = 0.32). Conclusion: Physical activity monitoring may increase engagement in physical activity-associated behavior. Therefore, monitoring could serve as a useful tool to promote physical health in middle-aged and older adults.

Associations of eating out and dietary diversity with mild cognitive impairment among in community-dwelling older adults.

Background: Dementia is a critical later life health issue that occurs among members of aging societies. This study examined the relationships between eating out, dietary diversity, and mild cognitive impairment (MCI) among community-dwelling older adults. Methods: We analyzed data from 597 older adults (median age 73.0 years [interquartile range 69.0-78.0] and 62.6% females). We applied the Food Frequency Score (FFS) to evaluate diet variety and the weekly consumption frequencies of ten food items were determined. The Functional Assessment Tool from the National Center for Geriatrics and Gerontology was used to evaluate MCI. Finally, we asked the participants how often they ate out each month; those who replied 'none' were categorized into the "non-eating out" group. Results: The overall prevalence of MCI was 122 (20.4%), with a higher prevalence in the low dietary diversity group than in the high dietary diversity group (28.6% vs. 18.6%). After adjusting for covariates, the participants who self-described as not eating out were independently associated with low dietary diversity (odds ratio [OR]: 1.97, 95% confidence interval [CI]: 1.20-3.20), while low dietary diversity was associated with MCI (OR: 1.72, 95% CI: 1.02-2.87). Structural equation models revealed that not eating out had no direct effect on MCI but was associated with MCI via low dietary diversity (root mean square error of approximation = 0.030, goodness-of-fit index=0.999, and adjusted goodness-of-fit index = 0.984). Conclusions: Although non-eating out may not have a direct effect on MCI, an indirect relationship may exist between eating-out habits and MCI via dietary diversity status.

Association of Olfactory and Gustatory Function with Memory among Community-Dwelling Independent Older Adults.

BACKGROUND: This study examined the association between memory function and reduced olfactory and gustatory function among independent community-dwelling older adults. METHODS: This cross-sectional study included 127 older adults (65.4% women). We assessed their memory, odor, and taste identification skills. Open essence (OE) test and taste strips (TS) were used to identify hyposmia (OE test ≤6) and hypogeusia (TS test ≤8), respectively. RESULTS: Participants with severe hyposmia had significantly poorer memory functions compared to participants without severe hyposmia. After adjusting for covariates, multivariate logistic regression models revealed a significant association between immediate recognition performance and a decreased likelihood of severe hyposmia (odds ratio=0.65; 95% confidence interval 0.47-0.90). We observed no significant association between taste function and memory. CONCLUSION: Memory function may be associated with olfactory impairment in older adults.

Independent Association between Cognitive Frailty and Cardio-Ankle Vascular Index in Community-Dwelling Older Adults.

INTRODUCTION: Although arterial stiffness has been suggested to be associated with poor physical function and mild cognitive impairment (MCI), its association with cognitive frailty (CF), a comorbidity of both, is unclear. This study aims to examine the association between CF and arterial stiffness in community-dwelling older adults. METHODS: A cross-sectional analysis of 511 community-dwelling older adults aged 65 years or older (mean age 73.6 ± 6.2 years, 63.6% women), who participated in a community cohort study (Tarumizu Study, 2019), was conducted. Poor physical function was defined as either slowness (walking speed <1.0 m/s) or weakness (grip strength <28 kg for men and <18 kg for women). MCI was defined by the National Center for Geriatrics and Gerontology Functional Assessment Tool as a decline of at least 1.5 standard deviation from age- and education-adjusted baseline values in any one of the four cognitive domains (memory, attention, executive, and information processing). CF was defined as the combination of poor physical function and MCI. Arterial stiffness was measured using the Cardio-Ankle Vascular Index (CAVI), and the average of the left and right sides (mean CAVI) was used. RESULTS: Multinomial logistic regression analysis adjusted for covariates was performed with the four groups of robust, poor physical function, MCI, and CF as dependent variables and mean CAVI as an independent variable. Using the robust group as reference, the poor physical function and MCI groups showed no significant relationship with the mean CAVI. The mean CAVI was significantly higher in the CF group (odds ratio 1.62, 95% confidence interval: 1.14-2.29). CONCLUSION: A significant association was found between CF and the higher CAVI (progression of arterial stiffness). Careful observation and control of CAVI, which is also an indicator of arterial stiffness, may be a potential target for preventive interventions for CF.

Associations of the Alpha-Actinin Three Genotype with Bone and Muscle Mass Loss among Middle-Aged and Older Adults.

Bone and muscle mass loss are known to occur simultaneously. The alpha-actinin three (ACTN3) genotype has been shown to potentially affect bone and muscle mass. In this study, we investigated the association between the ACTN3 genotype and bone and muscle mass loss in community-dwelling adults aged ≥ 60 years. This study was a cross-sectional analysis of data from 295 participants who participated in a community health checkup. The ACTN3 genotypes were classified as RR, RX, or XX types. Bone mass loss was defined as a calcaneal speed of sound T-score of <−1.32 and <−1.37, and muscle mass loss was defined as an appendicular skeletal muscle index of <7.0 kg/m2 and <5.7 kg/m2 in men and women, respectively. The percentages of XX, RX, and RR in the combined bone and muscle mass loss group were 33.8%, 30.8%, and 16.7%, respectively, with a significantly higher trend for XX. Multinomial logistic regression analysis showed that XX had an odds ratio of 3.00 (95% confidence interval 1.05−8.54) of being in the combined bone and muscle mass loss group compared to the RR group (covariates: age, sex, grip strength, and medications). The ACTN3 genotype of XX is associated with a higher rate of comorbid bone and muscle mass loss. Therefore, ACTN3 genotyping should be considered for preventing combined bone and muscle mass loss.

Association of self-rated health with type and frequency of social interaction during the declaration of COVID-19 state of emergency among Japanese community-dwelling oldest-old adults.

AIM: To investigate whether the type and frequency of social interaction during the state of emergency due to coronavirus disease were associated with self-rated health (SRH) after the state of emergency. METHODS: Data from a cross-sectional study were collected for 889 oldest-old adults in Bibai City, Hokkaido, Japan. In total, 612 participants (mean age: 83.0 ± 4.3 years; women: 51.8%) were included in the analysis, taking biological sex into account. The self-reported questionnaire included questions about demographic variables, SRH (July 2020, after the emergency), and the type and frequency of social interaction (March 2020, during the state of emergency). RESULTS: There was no significant association between social interaction and SRH in men (P > 0.05). Women who had social interactions (both face-to-face and non-face-to-face) more than once a week during the state of emergency reported higher SRH after the emergency than those who did not (odds ratio 2.17, 95% confidence interval 1.07-4.41). CONCLUSIONS: Having both types of interaction more than once a week during the state of emergency was related to higher SRH after the emergency among oldest-old women. It is suggested that having opportunities for both types of interaction at least once a week would potentially be beneficial for high SRH in women, even in situations where the declaration of a state of emergency restricts face-to-face interaction. Geriatr Gerontol Int 2022; 22: 405-411.

Association of Sleep Quality Status With Worsening Low Back or Knee Pain During The COVID-19 State of Emergency Among Old-Old Adults.

BACKGROUND: Poor sleep quality has a negative effect on pain among older adults. During the coronavirus disease 2019 (COVID-19) state of emergency, lifestyle changes can cause psychologic stressors and lead to poor sleep quality. AIM: This study examined whether sleep quality status was associated with low back or knee pain changes during the COVID-19 state of emergency among community-dwelling Japanese old-old adults. DESIGN: Cross-sectional investigation. METHODS: In July 2020, during the COVID-19 epidemic, we conducted a postal survey for old-old adults aged ≥77 years and collected data on 597 participants. For those who had low back or knee pain at the time of the survey (in July), characteristics such as low back pain, knee pain, changes in pain status, and sleep quality status during the COVID-19 state of emergency (in March) were assessed. RESULTS: Data from 597 participants showed the prevalence of low back pain (50.6%) and knee pain (40.7%) in July. Of those with low back or knee pain, 374 had pain changes during the state of emergency, with 12.3% worsening. Of these, 23.9% had poor sleep quality in March compared to non-change (p = .008). In a multivariate logistic regression model adjusted for potential confounders, poor sleep quality was significantly associated with pain worsening (odds ratio 2.80, 95% confidence interval 1.26-6.22). CONCLUSIONS: During the COVID-19 state of emergency, poor sleep quality was associated with worsening low back or knee pain. This may indicate the need to pay attention to poor sleep quality to prevent the exacerbation of pain among old-old adults.

Association between satisfaction with meaningful activities and social frailty in community-dwelling Japanese older adults.

OBJECTIVES: This cross-sectional study investigates the associations among satisfaction with meaningful activities, and social frailty in community-dwelling Japanese older adults. METHODS: We analyzed data from 596 older adults (mean age 74.2 ± 6.4 years, female 63.6%) who participated in the Tarumizu Study 2019, a community-based health survey. Participants selected meaningful activities from 95 activities using the Aid for Decision-Making in Occupation Choice (ADOC) tool. Satisfaction was evaluated from 1 to 5, and those who were assigned a rating of 4 or 5 were operationally classified as the high satisfaction group (n = 487), with others occupying the low satisfaction group (n = 109). Both groups were evaluated based on the ADOC, social frailty (Makizako's five items), physical function, depressive symptoms, cognitive function, and higher-level competence. RESULTS: Of the 596 participants, 18.7% showed prevalence of social frailty. The low satisfaction group had a significantly higher prevalence of social frailty (low satisfaction 28.4% vs. high satisfaction 16.4%, P = 0.004) and depressive symptoms (low satisfaction 30.3% vs. high satisfaction 17.9%, P<0.01), and poor higher-level competence (P = 0.026) than the high satisfaction group. Logistic regression analysis showed that social frailty (Odds Ratio 1.78, 95% Confidence Interval 1.068-2.990, P = 0.027) was significantly associated with satisfaction with meaningful activity after adjusting for covariates. We found no significant differences in categories of meaningful activities between the low and high satisfaction groups (P = 0.549). CONCLUSIONS: This study suggested that social frailty was associated with satisfaction with meaningful activities, regardless of the degree or category of satisfaction.

Characteristics of meaningful activities in community-dwelling Japanese older adults with pre-frailty and frailty.

OBJECTIVES: This cross-sectional study aimed to clarify the association between physical and social frailty, cognitive impairment, and meaningful activity in older adults. METHODS: Data were obtained from 747 older adults (mean age, 74.7 ± 6.2 years; women, 63.9%) who participated in a community-based health check survey (Tarumizu Study 2018). Physical frailty, cognitive impairment, and social frailty were evaluated using the Fried phenotype model (exhibiting one or more of the criteria, including having a pre-frailty status); computerized cognitive test including memory, attention, executive functions, and processing speed (having a score below an age-education adjusted reference threshold in one or more domains); and Makizako's 5 items (exhibiting one or more of the criteria, including having a pre-frailty status), respectively. Participants selected meaningful activities from the 95 activities included in the Aid for Decision-Making in Occupation Choice, after which their satisfaction and performance were evaluated. Meaningful activities were categorized into physical activity, cognitive activity, social activity, and other daily activity. RESULTS: The physical frailty group was significantly less likely to choose physical activity over other activities (p < 0.05). The cognitive impairment group was significantly less likely to choose cognitive activity over other activities (p < 0.01). The multi-domain frailty group (including cognitive impairment) was significantly less likely to choose social activity over other activities (p < 0.05). No significant differences in satisfaction and performance were observed according to frailty status. CONCLUSIONS: Our findings indicated that physical and social frailty and cognitive impairment may affect participation in meaningful activities corresponding to these domains.

Pain and physical activity changes during the COVID-19 state of emergency among Japanese adults aged 40 years or older: A cross-sectional study.

ABSTRACT: Understanding the relationship between pain and physical activity (PA) levels is beneficial for maintaining good health status. However, the impact of pain on changes in PA during the coronavirus disease 2019 (COVID-19) pandemic is unknown. The purpose of this study was to examine whether PA levels pre-, during, and post-COVID-19 state of emergency differ between Japanese adults who had pain after the COVID-19 state of emergency and those who did not.Data were collected from a cross-sectional online survey conducted between October 19 and 28, 2020. The analytic sample consisted of 1967 Japanese adults aged ≥40 years who completed the online survey. Participants completed questionnaires on the presence of pain and duration of PA, defined as the total PA time per week based on activity frequency and time. Participants were asked to report their PA at 3 time points: October 2019 (before the COVID-19 pandemic), April 2020 (during the COVID-19 state of emergency), and October 2020 (after the COVID-19 state of emergency).Among participants aged ≥60 years who reported pain in October 2020, the total PA time was significantly lower than participants who did not report having pain. Furthermore, the total PA time in April 2020 was significantly lower than that in October 2019; however, no significant difference in total PA time was observed between April and October 2020. Among participants aged 40 to 59 years, no significant differences were observed in total PA times at the 3 time points between those with and without pain. In addition, the total PA time in October 2020 significantly increased compared to that in April 2020, although it significantly decreased in April 2020 compared to October 2019.This study suggests that older adults with pain have lower PA levels after the COVID-19 state of emergency.

Physical Activity and Perceived Physical Fitness during the COVID-19 Epidemic: A Population of 40- to 69-Year-Olds in Japan.

The COVID-19 pandemic has caused an abrupt change in lifestyle for many people with restrictions, often leading to a decrease in physical activity (PA), and thus contributing to a negative perception of health status. The purpose of this study was to examine the effects of the COVID-19 epidemic on physical activity and perceived physical fitness in Japanese adults aged 40 to 69 years. Data were collected from an online survey conducted between October 19 and 28, 2020. The analytic sample consisted of 1989 Japanese adults (mean age, 50.1 ± 6.9 years; women, 38.9%) who were aged between 40 and 69 years and completed the online survey. Overall, the PA time per week decreased by 32.4% between October 2019 and April 2020. A decrease in PA time was recorded in October 2020; however, a decline of 15.5% was observed. Compared to individuals who did not perceive a decline in physical fitness, individuals who perceived declining physical fitness during the COVID-19 state of emergency demonstrated a greater decrease in PA time in April 2020 (-50.5%), and this trend continued into October 2020 (-25.0%). These findings may indicate that Japanese adults aged 40 to 69 years who perceived declining physical fitness experienced a greater decrease in physical activity.