Frailty and social isolation before and during the coronavirus disease 2019 pandemic among older adults: A path analysis.

AIM: To explore the prevalence of social isolation among Japanese community-dwelling older adults before and during the COVID-19 pandemic as well as determine how family and friend connections before and during the pandemic affected frail older adults during the pandemic. DESIGN: A cross-sectional study. METHODS: A total of 852 community-dwelling older adults in Hokkaido and Tokyo, Japan were surveyed conducted between April and November 2021 using convenience sampling. The Lubben social network scale-6, frailty screening index, and geriatric depression scale were used to assess social isolation, frailty and depression, respectively. A path analysis was conducted to evaluate the effect of social isolation on frailty. RESULTS: Participants had a mean age of 76.8 ± 6.6 years. Overall, 46% and 59% of participants were socially isolated before and during the COVID-19 pandemic, respectively. Frailty was found in 19% of participants during the pandemic. Friends and family connectedness before the pandemic had no direct relationship with frailty; only friend connectedness affected frailty indirectly via depression. Family connectedness during the pandemic had a significant, negative and direct relationship with frailty. CONCLUSION: The findings show that connectedness with family and friends is critical for older people's physical and mental health. IMPACT: Nurses in the community should consider these findings to reduce mental health problems and physical decline among older adults. It is important to identify older adults who are socially isolated from their families or friends and provide resources to help them build relationships within their communities. PATIENT OR PUBLIC CONTRIBUTION: Community centre staff and community volunteers assisted in data collection. The public was not involved in data analysis, interpretation or manuscript preparation.

Sarcopenia and risk factors among Japanese community-dwelling older adults during the COVID-19 pandemic: A cross-sectional study.

The COVID-19 pandemic exposed older adults to high risk of sarcopenia. This study aimed to investigate the prevalence of sarcopenia and its risk factors among Japanese community-dwelling older adults during the COVID-19 pandemic. We collected data through questionnaires and physical measurements among 242 older adults. Sarcopenia was assessed using the Asian Working Group for Sarcopenia 2019 criteria. The results revealed that 14.5% had sarcopenia, which was significantly associated with age, nutritional status, number of prescription medications, body mass index, and self-rated health. On multivariate analysis, the risk of malnutrition was independently significantly associated with sarcopenia. Approximately 70% of participants reported decreased social interaction and going outside, but with no significant association with sarcopenia. In addition, approximately 65% of the participants had an exercise habit and went outside at least once a week, thus maintaining a good level of activity. These findings suggest that prevention of sarcopenia during the pandemic required provision of opportunities for older adults to remain active and positive assessment of nutritional status and well-being.

Association of visceral fat area with pre-frailty in Japanese community-dwelling older adults: a cross-sectional study.

BACKGROUND: Screening and intervention in pre-frailty can help prevent or delay frailty among older adults. Being overweight has shown associated with pre-frailty, and overweight is highly prevalent among community-dwelling older adults during COVID-19. However, the impact of visceral fat accumulation remains unclear. This study aimed to explore the association between visceral fat area and pre-frailty in community-dwelling older adults. METHODS: The participants of this study included community-dwelling older adults from three elderly welfare centers. The frailty phenotype was assessed using the frailty screening index. The body composition was measured using bioelectrical impedance analysis. RESULTS: A total of 214 community-dwelling older adults completed the questionnaire and measurements. After excluding 16 frail participants, 149 (75.3%) were pre-frailty. The mean age of participants was 75.4 ± 5.4 years, and 69.7% (138) of participants were women. There were 54 (27.3%) participants with high visceral fat area. The multivariable model showed that participants with high visceral fat area were at increased risk for pre-frailty (adjusted OR, 3.15; 95% CI, 1.26 - 7.87; P = 0.014), even after adjusted for age, sex, health status, and impact of COVID-19 pandemic. CONCLUSIONS: This study suggests that the association between visceral fat accumulation and pre-frailty may help to identify a new target for prevention. Further longitudinal studies are needed to determine their mechanisms in older adults.

Nursing skills required across natural and man-made disasters: A scoping review.

AIMS: To map the nursing skills required for different types of disasters. DESIGN: This was a scoping review of research studies conducted between July and August 2021. We conducted a systematic literature search of nine electronic databases from inception till July 2021, and an updated search was done in April 2022. This review is based on the methodological framework of Arksey and O'Malley (2005), which was further refined by the Joanna Briggs Institute. DATA SOURCES: A range of electronic databases was searched systematically, including CINAHL, Cochrane, Embase, MEDLINE, PsycINFO, PubMed, Web of Science, CNKI and Ichushi-Web. Articles published in Chinese, English and Japanese were selected for the review. REVIEW METHODS: The PCC model was used to frame the inclusion criteria. Studies were screened, appraised and extracted by two reviewers, and the study findings were narratively synthesized. RESULTS: We identified nursing skills for five types of natural disasters including (1) earthquakes, (2) typhoons, (3) tsunamis, (4) marine disasters and (5) infectious diseases and three man-made disasters: (1) radiation disasters, (2) bioterrorism and (3) war. Among these, there are five types of common professional skills nurses are required to possess including casualty triage, observation and monitoring, basic first aid techniques, psychological care and communication skills. In addition, it was shown that different disasters require different specific professional skills. CONCLUSION: This scoping review explored the disaster nursing skills required for eight types of disasters and provides evidence for future education and training. Further research is needed to build more accurate scenario-based simulation training programs to provide more insights into future disaster precision nursing. IMPACT: This scoping review provides evidence for future education and training in disaster nursing to improve nurses' knowledge and competencies in dealing with the different types of disaster situations.

Clinicopathological features of radiological early malignant pleural mesothelioma with no apparent tumor or pleural thickening.

BACKGROUND: We occasionally encounter malignant pleural mesothelioma (MPM) of no apparent tumor or pleural thickening that is radiological early MPM. This study aimed to examine the clinicopathological outcomes of radiological early MPM. METHODS: Patients with MPM treated with neoadjuvant chemotherapy and planned surgery at the time of diagnosis between July 2004 and December 2019 were retrospectively examined. Pretreatment maximal pleural thickness of all patients was measured on chest computed tomography. We extracted and investigated the patients who exhibited a lack of pleural thickening or visible tumor, which was defined as radiological early MPM. Survival was analyzed by the Kaplan-Meier method. RESULTS: Of 296treated patients, 16 (5.4%) exhibited radiological early MPM. Fourteen (87.5%) of these patients underwent pleurectomy/decortication and 2 (12.5%) underwent extrapleural pneumonectomy. Pathological stage T1 disease was diagnosed in 14 (87.5%) patients; 2 (12.5%) exhibited pulmonary parenchymal invasion (pathological stage T2). Lymphatic invasion was detected in only 1 patient. Lymph node metastases and vascular invasion were not detected. Median follow-up was 42 months. Median progression-free survival and median overall survival were 40.7 and 56.1 months, respectively. The 3-year progression-free survival and overall survival rates were 84.8% and 83.6%, respectively. CONCLUSIONS: Radiological early MPM occurs in approximately 1 of every 20 patients treated with neoadjuvant chemotherapy and surgery planned at the time of diagnosis in an experienced center. Radiological early MPM was associated with early pathological stage and long-term survival.

Predictors and short-term outcomes of post-stroke fatigue in initial phase of transition from hospital to home: A prospective observational study.

AIM: To analyse the interactions of associated factors with post stroke fatigue (PSF) after discharge home and determine the predictors of PSF and their impact on stroke survivors. DESIGN: A prospective observational study. METHODS: A total of 94 patients with acute stroke were recruited between May 2019 -July 2020. The main outcomes were fatigue, depression, insomnia, sarcopenia, and health-related quality of life (HRQOL) and were assessed at admission and 1 month after discharge. Fatigue was measured using the Fatigue Assessment Scale. Depression and Insomnia were assessed using the Hospital Anxiety and Depression Scale-Depression and Insomnia Severity Index, respectively. Sarcopenia was measured using the SARC-F questionnaire, and HRQOL was assessed using the Short Form-8. RESULTS: Acute phase PSF was an independent predictor of PSF after discharge home. Moreover the path analysis revealed that this effect is mediated through both the direct effect of acute-phase PSF on PSF after discharge home and through the indirect effect of interaction with pre-stroke SARC-F, acute phase depression, and acute phase insomnia, which remains a separate predictor of acute-phase PSF. In total, 17% of the survivors had persistent PSF. Persistent PSF was significantly associated with depression, insomnia, sarcopenia, and a lower quality of life scores. CONCLUSIONS: Post-stroke fatigue may occur in the acute phase and persists after discharge, it will not only affect later depression, insomnia, and quality of life, but also sarcopenia. IMPACT: Acute phase PSF was found to be an independent predictor of PSF after discharge home. In addition, the interaction with pre-stroke SARC-F, acute phase depression and insomnia had an indirect connection with PSF after discharge home, which remains a separate predictor of acute-phase PSF. Thus, early assessment and management of mental status, sleep problems, and sarcopenia during hospitalization might be an important step in post-stroke rehabilitation and home transition.

Development and Internal Validation of a Nomogram to Predict Post-Stroke Fatigue After Discharge.

OBJECTIVES: We aimed to develop and validate a nomogram for the individualized prediction of the risk of post-stroke fatigue (PSF) after discharge. MATERIALS AND METHODS: Fatigue was measured using the Fatigue Assessment Scale. Multivariable logistic regression analysis was applied to build a prediction model incorporating the feature selected in the least absolute shrinkage and selection operator regression model. Discrimination, calibration, and clinical usefulness of the predictive model were assessed using the C-index, calibration plot, and decision curve analysis. Internal validation was conducted using bootstrapping validation. Finally, a web application was developed to facilitate the use of the nomogram. RESULTS: We developed a nomogram based on 95 stroke patients. The predictors included in the nomogram were sex, pre-stroke sarcopenia, acute phase fatigue, dysphagia, and depression. The model displayed good discrimination, with a C-index of 0.801 (95% confidence interval: 0.700-0.902) and good calibration. A high C-index value of 0.762 could still be reached in the interval validation. Decision curve analysis showed that the risk of PSF after discharge was clinically useful when the intervention was decided at the PSF risk possibility threshold of 10% to 90%. CONCLUSION: This nomogram could be conveniently used to provide an individual, visual, and precise prediction of the risk probability of PSF after being discharged home. Thus, as an aid in decision-making, physicians and other healthcare professionals can use this predictive method to provide early intervention or a discharge plan for stroke patients during the hospitalization period.

Prevalence of stroke-related sarcopenia: A systematic review and meta-analysis.

OBJECTIVES: Although the skeletal muscle is the main effector of disability in stroke, evidence on post-stroke skeletal muscle is scarce; especially, the prevalence of stroke-related sarcopenia remains unclear. Thus, we aimed to systematically search the prevalence of sarcopenia in stroke survivors and synthesize pooled estimates of overall prevalence of stroke-related sarcopenia and prevalence stratified by sex, country, time since stroke onset, and diagnostic criteria of sarcopenia. METHODS: We performed systematic searches in the MEDLINE, CINAHL, Embase, and Cochrane Library databases. English-language searches to identify included studies were completed August 25, 2019. Meta-analysis of data collected from cross-sectional or observational studies which were reported the prevalence of sarcopenia among stroke participants. All statistical analyses were performed using R version 3.5.2. RESULTS: A total of 855 articles were initially identified. Seven articles were included in this study. Total sample size across all included studies was 1695. Three studies were conducted in Japan, 2 in South Korea, 1 in Taiwan, and 1 in the U.S. Four included studies had a cross-sectional design, and 3 were retrospective cohort studies. Four and 3 studies included participants at <1 month and ≥6 months since stroke onset, respectively. The pooled prevalence estimate was 42% (95% confidence interval: 33%-52%), with a substantial heterogeneity (I2=91%). CONCLUSIONS AND IMPLICATIONS: Sarcopenia is frequently observed in stroke survivors, and a higher prevalence of sarcopenia is noted during the early phase after stroke. This study would be useful for researchers to design sarcopenia studies in this population. Further prospective longitudinal studies for sarcopenia and their prognostic outcomes in stroke survivors are urgently needed to propose appropriate physical and nutritional strategies in geriatric rehabilitation.

Green tea extract attenuates MNU-induced photoreceptor cell apoptosis via suppression of heme oxygenase-1.

The effects of green tea extract (GTE) on N-methyl-N-nitrosourea (MNU)-induced photoreceptor cell apoptosis were examined, and the possible mechanisms of action of GTE were assessed. Alterations in the retinal morphological architecture were determined by hematoxylin-eosin staining, vimentin immunoreactivity, and photoreceptor cell apoptosis (TUNEL labeling). Expression of oxidant marker, heme oxygenase (HO)-1, mRNA levels in outer nuclear cells was assessed by laser capture microdissection (LCM). Sprague-Dawley rats were given 40 mg/kg MNU at 7 weeks of age in the absence and presence of 250 mg/kg GTE treatment (once daily from 3 days prior to MNU for a maximum 10 days). Although photoreceptor cell degeneration began 24 hr after MNU, the morphological effects of GTE at the time point were not definitive. However, GTE lowered TUNEL labeling and HO-1 mRNA expression. At 7 days after MNU, photoreceptor damage was attenuated by GTE treatment. Therefore, the ability of GTE to reduce MNU-induced photoreceptor cell apoptosis may be due to its antioxidant properties.

Susceptibility to N-methyl-N-nitrosourea-induced retinal degeneration in different rat strains.

To evaluate the potential role of genetic background in the susceptibility to retinal degeneration induced by N-methyl-N-nitrosourea (MNU), female rats of the Sprague-Dawley (SD), Long-Evans (LE) and Copenhagen (CH) strains were administered 50 mg/kg MNU or saline at 7 weeks of age. Retina morphology and morphometric analysis of all rats was performed 7 days after MNU administration. Atrophy of both the peripheral and central outer retina occurred in all rat strains exposed to MNU. Decreased photoreceptor cell ratio and increased retinal damage ratio were observed. The severities of the retinal atrophy were similar among all three rat strains. In conclusion, MNU-induced photoreceptor degeneration developed consistently in all three strains regardless of the absence (SD rats) or presence (LE and CH rats) of melanin in the retina, suggesting that genetic and melanin factors did not affect photoreceptor cell death after MNU.

A spontaneously occurring malignant ovarian Sertoli cell tumor in a young Sprague Dawley rat.

Primary ovarian tumors are generally uncommon in rats used in toxicologic studies. A malignant Sertoli cell tumor was present in the ovary of a 19-week-old female Sprague Dawley rat. Macroscopically, the mass was white and firm, 10 × 13 × 17 mm in size, and located in the right ovary. Histopathologically, the mass was composed of nests of pleomorphic cells, which formed seminiferous-like tubules separated by a thin fibrovascular stroma. The tubules were lined by tumor cells, which had basally located nuclei and abundant eosinophilic and vacuolated cytoplasm. In some areas, the tumor cells were arranged in a retiform growth pattern, mimicking a rete testis/ovarii. Disseminated metastases to the surfaces of the mesentery, spleen and liver were also present. Immunohistochemically, many tumor cells were strongly positive for vimentin, estrogen receptor α and Ki 67. Some tumor cells were positive for pancytokeratin and inhibin α. These findings closely resemble those of an ovarian-derived human malignant Sertoli cell tumor. From our review of the literature, we believe this is the first report of a spontaneous malignant Sertoli cell tumor in the ovary of a young laboratory rat. This case might provide useful historical control information for rat toxicity studies.

[Association between evacuation condition and habitual physical activity in Great East Japan Earthquake evacuees: The Fukushima Health Management Survey].

Objectives: Prevalence of life-style disease has increased dramatically in evacuees due to the Great East Japan Earthquake. One reason may be that physical activity level decreased from life environment changes due to evacuation. However, associations between evacuation condition and habitual physical activity have not been studied. We examined this association in Fukushima residents who participated in the Fukushima Health Management Survey. Methods: In this study, 37,843 evacuees from 13 municipal evacuation zones from the nuclear-power accident caused by the Great East Japan Earthquake, born before April 1, 1995, were included in the analysis. Evacuation condition was defined by disaster living place (13 zones), evacuation place (inside or outside the prefecture), and current living status (evacuation shelter or temporary housing, rental housing/ apartment, and relative's home or own home). Habitual physical activity was defined from self-administered questionnaires as participants who responded "almost every day" and "2-4 times/week" of regular exercise. In the analysis, habitual physical activity prevalence was aggregated by gender and variables (living place in the disaster, evacuation place, and current living status). Prevalence was adjusted for age, disaster living place, evacuation place, and current living status by standard analysis of covariance methods. Results: Adjusted prevalences of habitual physical activity were: men, 27.9-46.5%; women, 27.0-43.7% in each disaster living place. The differences were 18.6% point in men and 16.7% point in women. For evacuation place, physical activity outside the prefecture for men (37.7%) and inside the prefecture for women (32.1%) were higher, but those differences were only 2.2% point and 1.8% point in men and women, respectively. For current living status, physical activity of those in rental housing/ apartment was the lowest; evacuation shelter or temporary housing was the highest in both genders (men: 38.9%, women: 36.7%). Compared with residents in evacuation shelter or temporary housing, those in rental housing/apartment were 5.4% point and 7.1% point lower and those in relative's home or own home were 2.0% point and 4.2% point lower in men and women. Conclusion: Habitual physical activity in residents who lived in 13 municipal evacuation zone differed by disaster living place and current living status, while it was similar regardless of placement in the prefecture. In particular, prevalence was the lowest in participants who lived in rental housing/ apartment. We need to plan and perform additional life-style disease prevention strategies for participants who become isolated.

Mead acid supplementation does not rescue rats from cataract and retinal degeneration induced by N-methyl-N-nitrosourea.

Fatty acids and their derivatives play a role in the response to ocular disease. Our current study investigated the effects of dietary mead acid (MA, 5,8,11-eicosatrienoic acid) supplementation on N-methyl-N-nitrosourea (MNU)-induced cataract and retinal degeneration in Sprague-Dawley rats. Experiment 1 was designed to inhibit cataract formation, with the dams fed a 2.4% MA or basal (<0.01% MA) diet during lactational periods. On postnatal day 7, male pups received a single intraperitoneal (ip) injection of 50 mg/kg MNU or vehicle. Lens opacity and morphology were examined 7 and 14 days after the MNU injection. Experiment 2 was designed to inhibit retinal degeneration and was performed with female postweaning rats. In this experiment, dams were fed the 2.4% MA or basal diet during the lactational periods. Thereafter, the female pups were continuously fed the same diets during their postweaning periods. On postnatal day 21 (at weaning), pups received a single ip injection of 50 mg/kg MNU. Retinal morphology was examined 7 days after the MNU injection. In experiment 3, six-week-old female rats were fed the 2.4% MA or basal diet starting at one week before the MNU injection and were then continuously fed the same diets until sacrifice. Rats at 7 weeks of age were given a single ip injection of 40 mg/kg MNU, and the retina was then examined morphologically one week after the MNU injection. In experiment 1, mature cataract was found in all of the MNU-treated groups, with or without MA supplementation. In experiments 2 and 3, atrophy of both the peripheral and central outer retina occurred in all rats exposed to MNU, with or without MA supplementation, respectively. The severities of the cataracts and retinal atrophy in the rats were similar regardless of MA supplementation. Dietary mead acid, which is used as a substitute in essential fatty acid deficiency in the body, does not modify MNU-induced cataract and retinal degeneration in rat models.

Green tea extract suppresses N-methyl-N-nitrosourea-induced photoreceptor apoptosis in Sprague-Dawley rats.

BACKGROUND: Retinitis pigmentosa (RP) is a group of inherited neurodegenerative human diseases characterized by the loss of photoreceptor cells by apoptosis and eventual blindness. A single intraperitoneal (ip) injection of N-methyl-N-nitrosourea (MNU) causes photoreceptor cell apoptosis within 7 days in rats. Green tea extract (THEA-FLAN 90S; GTE) is a common herbal supplement with pluripotent properties including antioxidant activity. The purpose of the present study was to evaluate the efficacy of GTE against photoreceptor apoptosis in 7-week-old female Sprague-Dawley rats that received a single ip injection of 40 mg/kg MNU. METHODS: The oral administration of 250 mg/kg/day GTE was initiated 3 days prior to MNU injection and continued once daily throughout the experiment. Rats were sacrificed at 12, 24, and 72 h and 7 days after MNU injection, and the eyes were examined morphologically and morphometrically. The photoreceptor cell ratio, retinal damage ratio, and retinal preservation ratio were used to determine the structural and functional alterations. The number of apoptotic photoreceptor cells per mm(2) was determined in situ by TdT-mediated dUTP-digoxigenin nick end labeling (TUNEL). Our results indicated that oral administration of GTE significantly suppressed the loss of photoreceptor cells morphometrically 7 days after MNU injection. The number of TUNEL-positive cells per mm(2) in MNU-exposed rat central retina with or without GTE administration was 981 vs. 2056 at 24 h after MNU injection. CONCLUSIONS: GTE structurally and functionally suppressed MNU-induced photoreceptor cell apoptosis. These findings indicate that GTE may help to ameliorate the onset and progression of human RP.

Green Tea Extract-induced Acute Hepatotoxicity in Rats.

Although green tea is considered to be a healthy beverage, hepatotoxicity associated with the consumption of green tea extract has been reported. In the present study, we characterized the hepatotoxicity of green tea extract in rats and explored the responsible mechanism. Six-week-old IGS rats received a single intraperitoneal (ip) injection of 200 mg/kg green tea extract (THEA-FLAN 90S). At 8, 24, 48 and 72 hrs and 1 and 3 months after exposure, liver damage was assessed by using blood-chemistry, histopathology, and immunohistochemistry to detect cell death (TUNEL and caspase-3) and proliferative activity (PCNA). Analyses of malondialdehyde (MDA) in serum and the liver and of MDA and thymidine glycol (TG) by immunohistochemistry, as oxidative stress markers, were performed. Placental glutathione S-transferase (GST-P), which is a marker of hepatocarcinogenesis, was also immunohistochemically stained. To examine toxicity at older ages, 200 mg/kg green tea extract was administered to 18-wk-old female rats. In 6-wk-old rats, 12% of males and 50% of females died within 72 hrs. In 18-wk-old rats, 88% died within 72 hrs. The serum levels of aspartate aminotransferase, alanine aminotransferase and/or total bilirubin increased in both males and females. Single-cell necrosis with positive signs of TUNEL and caspase-3 was seen in perilobular hepatocytes from 8 hrs onward in all lobular areas. PCNA-positive hepatocytes increased at 48 hrs. MDA levels in the serum and liver tended to increase, and MDA- and TG-positive hepatocytes were seen immunohistochemically. GST-P-positive hepatocellular altered foci were detected in one female rat at the 3-month time point. In conclusion, a single injection of green tea extract induced acute and severe hepatotoxicity, which might be associated with lipid peroxidation and DNA oxidative stress in hepatocytes.

Similarity of GATA-3 Expression between Rat and Human Mammary Glands.

The GATA family members are zinc finger transcription factors involved in cell differentiation and proliferation. In particular, GATA-3 is necessary for mammary gland maturation and is a useful marker in the characterization of mammary carcinoma in humans. The expression of GATA-3 protein in normal mammary glands, fibroadenomas and carcinomas was immunohistochemically compared in female rats and humans. In normal mammary glands of rats and humans, scattered luminal cells in the acini and whole ductal epithelial cells were positive for GATA-3 in the nuclei. No positive cells were detected in rat or human fibroadenomas. In rat and human mammary carcinomas, the nuclei of proliferating luminal-derived cancer cells expressed GATA-3. Therefore, GATA-3 protein is a candidate marker for mammary carcinoma in rats as well as humans.

Health-related QOL and self-efficacy for activities of daily living in elderly residents of mountainous areas with kyphosis: a one-year longitudinal study.

AIM: The purpose of this study was to investigate changes over one year in the prevalence of kyphosis, the ability to perform activities of daily living and self-efficacy among elderly residents of mountainous areas. METHODS: The subjects included 155 elderly residents of mountainous areas (68 males, 87 females) aged 65 or older who participated in both our initial and follow-up investigations. The investigations were conducted via interviews using questionnaires and the index of kyphosis (I/K). The subjects were divided into three groups (non-kyphosis, kyphosis without changes, kyphosis with worsening) according to the change in I/K. RESULTS: The average patient age was 74.9±6.2 years. The average I/K on the initial investigation was 10.0±3.7 (2.4-20.0). On the follow-up investigation, the average I/K increased slightly to 10.2±3.6 (3.0-22.9). A particularly large number of females 65 to 69 years of age exhibited an increase in the I/K. The percentage of subjects with an I/K of 13.0 or above was 20.6%. The male kyphosis sufferers demonstrated a significant decrease in the health-related QOL categories of "able to fulfill everyday life roles (physical)" and "able to fulfill everyday life roles (mental)." There were no significant differences between the females with and without kyphosis. One year later, there were significant differences between the three groups in terms of the health-related QOL categories of "vitality" and "ability to live in society." CONCLUSIONS: Female kyphosis sufferers are affected by psychological factors. Kyphosis should be detected early and carefully followed up in elderly patients in order to prevent the need for nursing care, and appropriately estimating the patient's physical condition is required to prevent a decline in the lower limb function.

Association between dynapenia and multimorbidity: A systematic review.

Dynapenia and multimorbidity are common health problems affecting older adults. However, few studies have systematically reviewed the association between dynapenia and multimorbidity. Therefore, this systematic review aimed to provide a comprehensive overview of studies on the association between these conditions. We searched four electronic databases for relevant articles published in July 2023. The main inclusion criteria were the following: (1) a description of dynapenia, which indicates loss of muscle strength and (2) a description of multimorbidity with two or more chronic diseases. Five studies met these inclusion criteria. In all five of these studies, the participants were community-dwelling older adults. All the studies showed an association between dynapenia and multimorbidity. The prevalence of dynapenia and multimorbidity ranged from 16% to 25.9%. The results of our systematic review demonstrated that dynapenia in older adults increases the risk of multimorbidity. We propose that interventions and reversible changes in dynapenia can prevent multimorbidity.

Depressive symptoms associated with infection prevention measures and daily lifestyle habit characteristics among Japanese community-dwelling older adults during the COVID-19 pandemic.

AIM: This study aimed to clarify the relationship between depressive symptoms and infection prevention measures and daily lifestyle habits during the coronavirus disease 2019 pandemic among community-dwelling Japanese older adults. METHODS: This cross-sectional study was conducted on older residents (age ≥65 years) living in the Tama area of Tokyo and Sapporo, Hokkaido, in 2021. A self-administered questionnaire survey was conducted to collect data on demographics, the impact of the pandemic on physical condition, and depressive symptoms, infection prevention measures, and daily lifestyle habits during the pandemic. The Geriatric Depression Scale was used to assess depressive symptoms. RESULTS: In total, 554 respondents were included in the analysis. The results of multiple logistic regression analyses revealed that refraining from going out and visiting medical institutions were associated with depressive symptoms. Furthermore, those who went out almost every day were less likely to have depressive symptoms than the others, those who exercised almost every day were less likely to have depressive symptoms than were those who almost never exercised, and those who slept 6-7 h were less likely to have depressive symptoms than were those who slept ≤5 h. CONCLUSIONS: The findings of the present study suggest the necessity of having a place where older adults with physical and lifestyle concerns can consult with healthcare providers in a location other than a medical institution, even during infectious disease outbreaks. In addition, increasing the frequencies of going out and independent exercise and sleeping 6-7 h may help prevent depression among older adults.

Development of a Screening Tool for Oral Frailty in Community-Dwelling Older Adults: A Cross-Sectional Study.

OBJECTIVES: To develop a Screening for Oral Frailty Tool (SOFT) and evaluate its reliability and validity among Chinese community-dwelling older adults. DESIGN: Cross-sectional analysis. SETTING AND PARTICIPANTS: The study was conducted as part of an ongoing community-based prospective study in Shanghai. A total of 307 older adults, aged between 60 and 96 years, participated in the study. METHODS: This study was conducted in 3 stages: item development, scale development, and scale evaluation. This study was based on a visual model depicting the deterioration of oral function, and a draft scale was generated based on a literature review, existing scales, expert consultations, and cognitive interviews. Between December 2023 and February 2024, the validity and reliability of the SOFT were evaluated using a questionnaire administered to 307 community-dwelling older adults. Data including demographics, frailty, and sarcopenia were collected. RESULTS: The oral frailty scale comprises 6 items, including number of teeth, difficulty in swallowing, difficulty in chewing, difficulty in articulatory oral motor, dry mouth, and oral pain, and is assessed using a yes or no question. The correlations ranged from 0.40 to 0.66 when correlating each item with the total score of the scale. Using frailty and sarcopenia as criteria, the area under the curve for the SOFT was 0.71. The optimal cutoff for the SOFT was 2, using frailty as a criterion, with a higher Youden index and a high negative predictive value (94.9%), but a low positive predictive value (19.3%). The SOFT showed low internal consistency (Kuder-Richardson formula 20 coefficients 0.50) and good test-retest reliability (intraclass correlation coefficients 0.86). CONCLUSIONS AND IMPLICATIONS: The SOFT does not require specialized equipment and is not affected by cultural differences. It can be used for oral frailty screening in Chinese community-dwelling older adults and is simple and rapid.