Predicting the incidence of mild cognitive impairment with a computer-based cognitive assessment tool in community-dwelling older adults: The Otassha study.

This study examined the ability of a computer-based cognitive assessment tool (CompBased-CAT) to predict mild cognitive impairment (MCI) in community-dwelling older adults. A two-year longitudinal study was conducted using data from 2016 to 2018 from the Otassha study cohort of community-dwelling older adults. MCI was defined as a Mini-Mental Status Examination (MMSE) score of <27. The CompBased-CAT was used at baseline, with each subtest score converted into a Z-score. Subsequently, the total Z-scores were calculated. Participants were divided into robust and MCI groups, and all variables were compared using the t-test or χ2 test. Receiver operating characteristic (ROC) curves and logistic regression analyses were conducted, with MCI and total Z-scores as dependent and independent variables, respectively. Among the 455 participants (median age, 72 years; range, 65-89 years; 282 women and 173 men), 32 developed MCI after two years. The participants in the MCI group were significantly older. They had lower maximal gait speed, baseline MMSE scores, subtest Z-scores, and total Z-scores than those in the robust group. The area under the ROC curve was 0.79 (95% confidence interval: 0.70-0.87; P <0.01). The sensitivity was 0.76, and the specificity was 0.75. The logistic regression analysis showed an odds ratio of 1.34 (95% confidence interval: 1.18-1.52; P <0.01). This study showed that CompBased-CAT can detect MCI, which is an early stage of dementia. Thus, CompBased-CAT can be used in future community health checkups and events for older adults.

Determinants of new participation in sports groups among community-dwelling older adults: Analysis of a prospective cohort from The Otassha Study.

Participation in sports groups has health benefits for older adults, such as preventing functional limitations and social isolation. Encouraging participation in sports groups may be an important means of health promotion in older adults. However, there is insufficient research on the determinants of new participation in sports groups to consider effective interventions to promote participation in these groups. We investigated this using data from a 1-year prospective study. Data were obtained from "The Otassha Study" that assessed a cohort of community-dwelling older adults living in an urban area of Japan. Of 769 older adults who participated in a baseline health survey in 2018, 557 participated in a follow-up survey in 2019. We excluded 184 individuals who already participated in sports groups at baseline and 36 with missing data. Participation in sports groups was defined as that occurring more than once a week. Logistic regression analysis was used to identify the determinants of new participation in sports groups, with sociodemographic factors, lifestyle habits, physical functions, cognitive functions, psychological factors, and social factors as independent variables. Forty-one (12.2%) individuals participated in sports groups at follow-up. In the multiple adjusted logistic regression model, new participation in sports groups was significantly associated with female sex (odds ratio [OR] = 5.57, 95% confidence interval [CI]: 1.61‒19.26), engagement in regular exercise (OR = 2.23, 95%CI: 1.03‒4.84), and having a large social network (OR = 1.12, 95%CI: 1.04‒1.20). Physical functions were not associated with new participation. Determinants of new participation were lifestyle habits and social factors, rather than physical functions. Intervention through social networks may be effective in encouraging new participation in sports groups, which, in turn, may facilitate healthy aging.

[Association between issues in activities and psychosocial health status in the social positions of older residents' community-based activities: a cross-sectional study].

Objectives　When local governments and community nurses provide support for community-based activities led by older residents, it is imperative to reduce the burden of participants in leadership positions. This study aimed to identify the issues associated with the activities by social position, such as leadership, support, and regular participation, to discuss effective support for community-based activities and to examine the association between social position, relating issues, and psychosocial health.Methods　Participants in community-based activities were recruited by the local government in Tokyo, Japan. Overall, 2,367 people from 155 activity groups from 40 municipalities responded. Social positions in the groups were defined as leaders who manage activities; supporters who support leaders; and regular members who do not have any specific role. The participants chose the issues of community-based activities from 10 items. Psychosocial health was measured by the WHO-5 well-being index (WHO-5) and Lubben social network scale-6 (LSNS-6). The relationship between recognition of issues and social positions were examined by the chi-square test. Interaction effects of social positions and issues (with or without) on the WHO-5 and LSNS-6 were investigated using a two-way analysis of covariance.Results　The final sample comprised 2,096 respondents: 174 leaders, 296 supporters, and 1,626 regular members. There was a significant association between recognition of social positions and issues in the groups: respondents who reported no issues in the activities comprised 8.6% of the leaders, 27.7% of the supporters, and 53.6% of the regular members (P<0.001). There was a large difference in recognition between roles for issues related to group management, such as the lack of management members. There was no significant interaction between these issues and social positions in either WHO-5 or LSNS-6 (P=0.729, P=0.171, respectively). The main effect of the social positions was significant in both analyses (P<0.001). The leaders and supporters showed significantly higher WHO-5 and LSNS-6 scores than regular members.Conclusion　The issues that the participants reported differed by social positions in activities. It may be effective to provide support according to the difficulty of sharing issues within the group. Regardless of whether or not the participants report issues, leaders and supporters had improved psychosocial health than regular members. The study concludes that organizational position in community-based activities may offer health benefits for older adults.

[Factors associated with participation in community activities after receiving long-term care preventive services].

Objectives　Since amending the long-term care insurance system to cover community-based services in 2015, community activities led by older residents have become increasingly important in Japan. It is necessary for local governments to effectively promote participation in community activities during long-term care prevention services. This study aimed to identify the factors associated with participation in community activities and the contents of intervention after long-term care prevention services in which interventions were conducted to promote older residents' participation in community activities.Methods　A secondary analysis of data collected in two classes of long-term care preventive services of a local government in Tokyo was conducted. This service provided not only interventions to improve physical function but also initiatives to promote participation in community activities after the service, such as learning and group-work activities. We analyzed participants' responses to self-administered questionnaires in 2016 and 2017; three months after the service started (T1) and six months after the service ended (T2). A total of 216 people (51 men and 165 women; age range: 65-95 years) responded to the questionnaires. Types of intervention, self-rated health, responses to the Kihon Checklist, and social capital, which was measured through items such as "Interaction with neighbors (SC1)," "Participation in groups other than preventive activity (SC2)," "Strength of trust for neighbors (SC3)," and "Mutual trust with neighbors (SC4)," were assessed at T1. Engaging in community activities was assessed to determine whether they participated in the self-motivating group for preventive activity at T2. Logistic regression analyses were conducted to examine the factors associated with participation in community activities by adjusting for each variable.Results　Totally, 113 respondents participated in community activities (participation rate=52.3%), and 103 did not participate (47.7%). Univariate logistic regression analyses revealed that types of intervention was significantly associated with participation in community activities (OR: 0.31, 95% CI: 0.15-0.63, P=0.001). Multivariate logistic regression models adjusted for all independent variables also indicated that types of intervention was significantly associated with participation in community activities (OR: 0.29, 95% CI: 0.14-0.62, P=0.001).Conclusion　The results showed that approximately 50% of the participants were involved in community activities because participation in such activities was promoted in long-term care preventive services. Types of intervention was a significant factor associated with participation in community activities. These findings highlight the importance of program contents in community activities during preventive services.

[Effectiveness of a program promoting community activities for the prevention of frailty using a community assessment].

AIM: We developed a program to promote community activities for preventing frailty using the Community-as-Partner model. We aimed to clarify whether or not participants' extent of practice relating to frailty prevention activities increased after the classroom, as well as the effectiveness of the program for preventing frailty. METHODS: The participants were recruited from among pre-frailty and frailty individuals in a cohort study of community-dwelling older adults. Thirty-two participants completed the classroom intervention. Thereafter, every three months, through a telephone survey, the participants were asked about the extent of practice regarding their frailty prevention activities. The Kihon Checklist and Japanese version of the Cardiovascular Health Study (J-CHS) frailty index were surveyed as outcome measures during the cohort study conducted six months before the classroom (baseline [BL]) as well as approximately one year after this intervention (follow-up [FL]). The changes in the outcome measures between the BL and FL in the intervention group were compared to those in the control group matched by the propensity score. RESULTS: The frailty prevention activities saw a maximum increase around six to nine months after the classroom. The J-CHS frailty index showed a group × time-of-survey significant interaction (F = 6.531, p=0.012) and significantly decreased from 1.3 at BL to 0.8 at FL in the intervention group (p=0.009). CONCLUSIONS: The practice of activities relating to frailty prevention increased after the classroom, and the participants also showed improvements in their physical frailty. The present program seems likely to be effective preventing frailty.

Factors associated with follow-up difficulty in longitudinal studies involving community-dwelling older adults.

This study aims to clarify the factors associated with the gradual withdrawal from society in older adults. We defined the stages of follow-up difficulty based on four follow-up surveys on non-respondents of longitudinal mail surveys in community-dwelling older adults to examine the main factors associated with the stages of follow-up difficulty. We conducted a follow-up mail survey (FL1) with respondents of a baseline survey, and three more follow-up surveys with the non-respondents of each previous survey: simplified mail (FL2), postcard (FL3), and home visit surveys (FL4). The respondents of each follow-up survey were defined as a stage of follow-up difficulty; their characteristics concerning social participation and interaction at baseline in each stage were analyzed. The number of respondents in the FL1, FL2, FL3, and FL4 stages and non-respondents (NR) were as follows: 2,361; 462; 234; 84; and 101, respectively. Participation in hobby groups in FL2 and FL3, sports groups in FL4, and neighborhood association and social isolation in NR were significantly associated with the stage of follow-up difficulty. Based on these results, we conclude that the following factors are associated with each stage of follow-up difficulty: 1) a decline in instrumental activities of daily living in the FL2 and FL3 stages, 2) dislike for participating in physical activity such as sports in the FL4 stage, and 3) social isolation, not even belonging to a neighborhood association due to low social interaction in the NR group.

Social participation reduces isolation among Japanese older people in urban area: A 3-year longitudinal study.

OBJECTIVES: Social isolation is a particular problem among older people and social participation may reduce future isolation. However, it is unclear which types of activities and which level of participation are effective. This study examines the relationship between social participation and isolation among Japanese older people by employing a 3-year longitudinal study. METHODS: A mail survey was sent to 3,518 community-dwelling older people in an urban area in 2014 (baseline: BL). We then conducted follow-up mail survey on respondents who were non-isolated at BL in 2017 (follow-up: FL), with isolation being defined as being in contact with others less than once a week. An analysis was carried out on 1,070 subjects (398 men and 672 women). Social participation is defined by participation in group activities (community, senior club, hobbies, sports, volunteering, politics, industry, and religion). A logistic regression analysis was conducted to determine the association between the types of social participation and the number of organization types at BL, and isolation at FL. RESULTS: At FL, 75 men (18.8%) and 59 women (8.8%) were considered to be isolated. Among the men, participation in a hobby group and sports group both significantly reduced the degree of isolation. Moreover, participation in two organizations and three or more organizations significantly lowered the risk of isolation when compared to non-participants. Among women, there were no significant associations among particular types of social activities and isolation. On the other hand, participation in one organization and three or more organizations significantly reduced their isolation when compared to non-participants. There was a significant linear trend between the number of types of organizations and isolation, regardless of gender. CONCLUSIONS: Participation in social activities reduces future isolation in older people. Encouraging participation in social activities could help reduce negative health outcomes associated with social isolation later in life.