[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.

A comparison of colorimetric and visual methods for the assessment of masticatory performance with color-changeable chewing gum in older persons.

BACKGROUND/PURPOSE: Color-changeable chewing gum is used for the evaluation of masticatory performance. However, it is currently unclear whether colorimetric and visual assessment methods yield consistent results. This study aimed to clarify the consistency between colorimetric and visual methods used for the evaluation of color changes in color-changeable chewing gum. MATERIALS AND METHODS: The sample comprised 644 older persons (mean age, 75.4 ± 6.4 years). The chewing gum was masticated 60 times at the participant's own chewing rate and then expectorated. The color of the chewing gum was evaluated with the ΔE values and a∗ values, measured using a colorimeter, and the 10 Color Shades (10CSh) and 5 Color Scales (5CSc), using visual evaluation. Spearman's correlation analysis was performed to examine the correlation between the results obtained by the four methods. The significance level was set at α = 0.05. RESULTS: The ΔE values, a∗ values, 10CSh scores, and 5CSc scores were all significantly correlated. The highest correlation coefficient (0.979) was between the ΔE values and a∗ values. The lowest correlation coefficient (0.847) was between the a∗ values and 5CSc scores. Decreased masticatory performance was observed with increased age. CONCLUSION: Significant correlations were found for all four methods used in the assessment of masticatory performance with color-changeable chewing gum. While visually based assessments are valid, colorimetric methods are more sensitive to smaller changes in masticatory performance.

The Mini Nutritional Assessment-Short Form as a predictor of nursing home mortality in Japan: A 30-month longitudinal study.

OBJECTIVES: We examined whether the Mini Nutritional Assessment-Short Form (MNA®-SF) predicted mortality in 367 nursing home residents (82% women; mean age = 84.4 ± 8.5 years) in Japan. MEASUREMENTS: We examined participants' basic characteristics (sex, age, height, weight, and medical history), the Barthel index (BI), clinical dementia rating (CDR), and six items of the MNA®-SF. The association between the MNA®-SF and 30-month mortality was assessed using a Cox proportional regression analysis. RESULTS: During the study, 157 (42.8%) participants died. MNA®-SF scores in the Survival group were significantly higher than in the Death group (9.4 ± 2.1 vs. 8.4 ± 2.3, respectively; p < .001). After adjusting for age, sex, history of aspiration pneumonia, BI, and CDR, MNA®-SF scores were significantly associated with 30-month mortality (hazard ratio: 0.89, 95% confidence interval: 0.82-0.97, p = .005). CONCLUSION: The MNA®-SF was an effective predictor of mortality among nursing home residents in Japan, even after adjusting for potential confounders. These results indicate that periodically evaluating nutritional status using the MNA®-SF, and nutritional interventions according to status, may result in maintenance and improvement of nutritional status, as well as lead to reduced mortality.

A 2-year longitudinal study of the relationship between masticatory function and progression to frailty or pre-frailty among community-dwelling Japanese aged 65 and older.

BACKGROUND: An association has recently been reported between frailty and reduced masticatory function; however, the causal relationship remains unclear. OBJECTIVE: The aim of this study was to clarify the relationship between masticatory function and frailty progression. METHODS: Among 6699 individuals aged 65 and older (mean age 72.8 ± 5.2 years) who were invited to participate in comprehensive medical check-ups, 418 who underwent examinations at the Tokyo Metropolitan Institute of Gerontology in both 2013 and 2015 and who met inclusion criteria were included in this study. Frailty was determined with the Kihon Checklist developed by the Japanese Ministry of Health, Labour and Welfare. The following three masticatory functions were evaluated: occlusal force, mixing ability and subjective chewing ability. The following confounding factors were investigated: age, sex, grip strength, comfortable walking speed, Mini-Mental State Examination (MMSE) score, Self-Rating Depression Scale (SDS) score, skeletal mass index (SMI), number of medications taken and number of remaining teeth. Statistical analysis was performed with binomial logistic regression analysis. RESULTS: Logistic regression analysis revealed that comfortable walking speed, SDS score, MMSE score and masticatory function were significantly related to progression to frailty or pre-frailty. Of the three masticatory function items evaluated, mixing ability and subjective chewing ability were related to frailty progression. CONCLUSION: Our results confirm that masticatory function was associated with the progression to pre-frailty or frailty among community-dwelling individuals 65 years and older over the 2-year period of this longitudinal study. Of the masticatory function items evaluated, mixing ability and subjective chewing ability were associated with frailty progression.