Criterion validity of the health assessment questionnaire for the national screening program for older adults in Japan: The SONIC study.

AIM: In our previous study, we proposed that the total score of the 12 frailty-related items in the health assessment questionnaire for the national screening program for older adults could be used as an indicator of frailty. We aim to examine the criterion validity of the 12 frailty-related items for frailty. METHODS: The data used in this study were from older Japanese individuals aged 78-81 years (n = 461) who participated in the in-venue (2019) and mailed questionnaire (2020) surveys of the Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians study. A receiver operator characteristic (ROC) curve analysis was used to evaluate the criterion validity of the 12 frailty-related items for frailty defined based on the Japanese version of the Cardiovascular Health Study criteria. A multivariable logistic regression model was used to examine the independent association of the 12 frailty-related items with frailty. RESULTS: The area under the ROC curve of the scores of the 12 frailty-related items for frailty was 0.79 (95% confidence interval [CI] = 0.73-0.85, P < 0.001). The cut-off value for frailty was 3 and 4 points, and the sensitivity and specificity were 55.9% and 85.8%, respectively. The multivariable logistic regression model showed that four or more scores of the 12 frailty-related items were significantly associated with frailty (adjusted odds ratio = 7.75, 95% CI = 4.10-14.65, P < 0.001). CONCLUSIONS: The results of this study suggest that the 12 frailty-related items in the health assessment questionnaire for older adults may be useful for assessing frailty in community-dwelling older adults in a simplified manner. Geriatr Gerontol Int 2023; 23: 437-443.

Construct Validity of a New Health Assessment Questionnaire for the National Screening Program of Older Adults in Japan: The SONIC Study.

The Japanese government has implemented a new screening program to promote measures to avoid worsening lifestyle-related diseases and frailty among the older population. In this effort, the government formulated a new health assessment questionnaire for the screening program of old-old adults aged ≥75 years. The questionnaire comprises 15 items, of which 12 address frailty, two address general health status, and one addresses smoking habits. This study examined the construct validity of this questionnaire, using the explanatory factor analysis (EFA) and confirmatory factor analysis (CFA). The data used in this study were drawn from a mail-in survey conducted in 2020 as part of the Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians study. A total of 1576 respondents (range, 78-99 years of age) were included in the study. Although the EFA did not show an interpretable factor structure of the questionnaire with 15 items, the CFA using only 12 frailty-related items showed the goodness of fit for a higher-order factor "frailty", and the five frailty-related sub-factors model was acceptable. These results suggest that the total score of the 12 frailty-related items in the questionnaire can be used as an indicator of the degree of "frailty".

Examination of important life experiences of the oldest-old: cross-cultural comparisons of U.S. and Japanese centenarians.

The purpose of this study was to compare the most important life events reported by U.S. and Japanese centenarians. This study included a population-based sample of 239 U.S. centenarians from the Georgia Centenarian Study and 304 Japanese centenarians from the Tokyo Centenarian Study. Two open-ended life events questions were categorized and grouped into different life event domains. Several cross-tabulations were computed to investigate culture and gender differences in most important life event domains. Next, four configural frequency analyses were conducted using Neuroticism, Extraversion, and the first most often mentioned life event domain for each sample (i.e., marriage and historical life events). Results suggest that events related to marriage were the most frequent important event domains mentioned by U.S. centenarians. The Japanese sample was more likely to report historical events. Men from the U.S. were more likely to report events related to work and retirement compared to U.S. women, and U.S. women reported events related to family as the most important life events when compared to U.S. men. Japanese women considered events related to marriage, death and grief as the most important life events when compared to Japanese men. In addition, Japanese men reported events related to work and retirement as the most important life events. A cross-cultural difference was found in life events: U.S. centenarians were more likely to mention positive experiences related to marriage and children, whereas Japanese centenarians reported mostly negative and traumatic experiences such as historical, death/grief, and work/retirement events.

[Development of a Japanese version of the Valuation of Life (VOL) scale].

This study developed a Japanese version of the Valuation of Life (VOL) scale, to measure psychological wellbeing among older adults. In Analysis 1, we conducted a factor analysis of 13 items, and identified two factors: positive VOL and spiritual well-being. These factors had adequate degrees of internal consistency, and were related to positive mental health. In Analysis 2, we examined sociodemographic, social, and health predictors for VOL. The role of social factors was stronger than the role of health factors, and spiritual well-being was more related to moral or religious activities than positive VOL. These results suggest that predictors for VOL vary by culture. In Analysis 3, we investigated the relationship between VOL and desired years of life. Positive VOL significantly predicted more desired years of life, whereas spiritual well-being did not. Positive VOL had acceptable reliability and validity. Future research is required to investigate whether VOL predicts survival duration or end-of-life decisions.