Participation Patterns and Associated Factors in Japanese Children With Autism.

BACKGROUND: Children's participation is an important outcome for children, families, and rehabilitation. OBJECTIVES: We compared participation patterns (home and community) of 6- to 12-year-old Japanese children with autism and children with typical development (TD) and explored the associations of participation with familial, environmental, and child-related factors. METHOD: Twenty-five mothers of children with autism and 21 mothers of TD children completed a survey covering their child's participation and environment, family empowerment, autism symptoms, sensory processing, behavior, and demographic characteristics. RESULTS: Children with autism showed restricted home and community participation. Home involvement was associated with family empowerment and the children's age, whereas home frequency was linked to environmental supportiveness and household income. CONCLUSION: Japanese children with autism need appropriate support to address decreased participation. Occupational therapists may focus on family empowerment and the child's environment to facilitate the home participation of children with autism.

Participation Patterns and Associated Factors in Japanese Children with AutismParticipation in daily activities is essential for children's health and well-being. We investigated the characteristics of and factors associated with home and community participation among Japanese children with autism without intellectual disability. The degree of environmental support at home, maternal perceptions of family empowerment, annual household income, and the age of the children were all associated with home participation in children with autism. These findings may be useful for professionals who support the daily lives of Japanese children with autism. They also suggest the importance of professionals focusing on children's environment and family when effectively supporting their home lives.

Age-specific comparisons in the rate of force development of toe pressure strength and its association with the timed up and go test.

PURPOSE: It has recently been recommended that Rate of Force Development (RFD) be evaluated in addition to maximal muscle strength. There are no studies on RFD of toe pressure strength, and its importance in older adults and the extent to which it is associated with aging needs to be clarified. This study purpose was to examine the association between the RFD of toe pressure strength and timed up and go test (TUG) in an age-specific study. METHODS: This study is a cross-sectional study. Participants in the study included 159 younger adults (26.3 ± 13.1 years, 52% male) and 88 older adults (75.0 ± 6.2 years, 26% male). The RFD of toe pressure strength was determined from the force-time curve obtained during the toe pressure strength assessment, and the ability to exert maximum muscle force in the shortest possible time was assessed. Regression analysis was performed for each group to test the association between RFD of toe pressure strength and TUG by age. RESULTS: Younger adults showed no association between TUG and RFD of toe pressure strength, and significant association between TUG and RFD of toe pressure strength was found only in the older adults (standard regression coefficient = - 0.19, p = 0.048). CONCLUSION: This study showed a significant association between TUG and RFD of toe pressure strength in older adults. These findings show that RFD is one of the functions that should be assessed, particularly in older adults. Furthermore, it was suggested that approaching RFD could improve gait, standing, and sitting movements.

Effect of Occupation-Based Intervention Using the ADOC-H Combined With Physical Function-Based Intervention on Patients With Distal Radius Fractures: A Retrospective Case-Control Study.

Objectives: Occupation-based intervention (OBI) involves daily and meaningful activities for evaluation and intervention. Recently, the "aid for decision-making in occupation choice for hand" (ADOC-H) was developed to facilitate OBI in patients with hand injuries. We aimed to examine the efficacy of OBI using the ADOC-H combined with physical function-based interventions (PBI) for patients with distal radius fractures (DRF). Material and methods: Patients with DRF were retrospectively allocated to two groups, ADOC-H group (n = 14) and PBI group (n = 14), and compared. Results: Improvements in the Pain Catastrophizing Scale magnification and Hospital Anxiety and Depression Scale and Disabilities of the Arm, Shoulder, and Hand questionnaire scores were significantly higher in the ADOC-H group than in the PBI group (p < .05). The groups showed no differences in measure of physical function, such as range of motion and grip strength. Conclusion: OBI using the ADOC-H combined with PBI is clinically useful for patients with DRF as it promotes use of the injured hand for daily activities in a step-by-step approach, improving psychological difficulties in using the hand.

Real-World Navigation With Application: Characteristics of Gaze Behavior and Associated Factors in Older Adults.

Background and Objectives: Advancing age might impair real-world navigation ability. The use of mobile devices by older adults has grown rapidly in recent years. Navigation applications (apps) in mobile devices may facilitate the freedom of outings for older adults. Our aim is to investigate age-related differences in real-world app-based navigation walking in terms of accuracy, efficiency, and gaze behavior; and to explore clinical factors associated with navigation walking in older adults. Research Design and Methods: A total of 20 community-dwelling older adults and 16 young adults completed a route navigation task using a navigation app while recording their gaze behavior. Outcomes were compared in both groups and a general linear regression was used to explore clinical factors associated with app-based navigation walk in older adults. Results: Compared with young participants, older participants had more stops and root errors and less fixation time, smaller amplitude of saccades. Additionally, older adults were more likely to glance at their smartphones while app-based navigation walking. Furthermore, gait speed and the following assessment scores were significantly associated with navigation walking in older adults: Mini-Mental State Examination, Life-Space Assessment, and the short version of the Mobile Device Proficiency Questionnaire. Discussion and Implications: For app-based navigation walks, differences in accuracy and gaze behavior were found to exist with age. Additionally, efficient real-world navigation walks in older adults require the extent of life space and proficiency with mobile devices, along with walking speed and cognitive function. It is possible that age-related functional decline, such as the visual field and shifting attention between mobile devices and the real world, may have influenced the results. The study also suggests the need to understand the level of proficiency with mobile devices so that older adults can continue to go out freely. These findings give the basis for providing older adults with appropriate navigation assistance.

Association between Toe Pressure Strength in the Standing Position and Maximum Walking Speed in Older Adults.

BACKGROUND: Considering concerns about conventional toe grip strength, we devised a method to measure toe pressure strength in the standing position, which is close to the actual motion. This study examined the association between toe pressure strength in the standing position and walking speed among older adults. METHODS: This cross-sectional study included 150 community-dwelling older adults (81±8 years, 73% female) who participated in the physical fitness test. We analyzed the correlation between the participants' maximum walking speed and physical function. Furthermore, we performed regression analysis with the maximum walking speed as the dependent variable to examine the association with toe pressure strength in the standing position. We also examined the association between maximum walking speed and toe pressure strength in the standing position by introducing a covariate. RESULTS: Correlation analysis revealed a significant positive correlation between maximum walking speed and toe pressure strength in the standing position, with a moderate effect size (r=0.48, p<0.001). Moreover, multiple regression analysis with covariates showed an association between maximum walking speed and toe pressure strength in the standing position (standardization factor=0.13, p<0.026). CONCLUSION: Toe pressure strength in the standing position was associated with maximum walking speed. This finding clarifies the significance of assessing toe pressure strength in the standing position and suggests that enhanced toe pressure strength in the standing position may increase maximum walking speed.

Domains of the Kihon Checklist Associated with Prefrailty among Community-Dwelling Older Adults.

BACKGROUND: Various functions are involved in prefrailty. However, no studies have examined more relevant functions. Therefore, this study examined the domains of the Kihon Checklist (KCL) associated with prefrailty by comparing them to robustness measures, using the KCL to comprehensively assess life-related functions in community-dwelling older adults. METHODS: The 194 (mean age, 75±6 years) participants were community-dwelling older adults. Their robustness and preferences were assessed using the Japanese Cardiovascular Health Study criteria. Comprehensive life-related functions were assessed using the KCL, and each physical function was measured. RESULTS: The main KCL characteristics associated with robustness and prefrailty were physical function (odds ratio [OR]=1.83; 95% confidence interval [CI], 1.17-2.88), nutritional status (OR=8.16; 95% CI, 2.96-22.48), and depressed mood (OR=3.46; 95% CI, 1.76-6.79). In particular, older adults had difficulty moving, including climbing stairs and getting up from a chair, which suggested a strong fear of falling. The participants also reported psychological characteristics such as low life fulfillment, a low sense of self-usefulness, and a strong sense of boredom. CONCLUSIONS: Prefrail individuals were characterized by poor physical function and nutritional status, as well as depressive mood. Prefrailty may be prevented or improved by approaches to improve physical function and fear of falling in addition to psychological interventions that encourage activity and a sense of self-usefulness.

Association between toe pressure strength in the standing position and postural control capability in healthy adults.

BACKGROUND: A method has been developed to assess toe pressure strength in the standing position, taking into account concerns about toe grip strength. RESEARCH QUESTION: Which is more associated to postural control capability, the conventional toe grip strength or the newly devised toe pressure strength in the standing position, which is close to the actual movement? METHODS: This study is a cross-sectional study. This study included 67 healthy adults (mean age, 19 ± 1 years; 64% male). The postural control capability was measured using the center-of-pressure shift distance in the anterior-posterior axis. Toe pressure strength in the standing position was assessed using a toe pressure measuring device to evaluate the force of pressure on the floor surface by all toes. During measurement, care is taken to ensure that the toes do not flex. However, toe grip strength in the sitting position was measured using muscle strength for toe flexion in a conventional manner. Statistical analysis was conducted by performing a correlation analysis between each of the measured items. Additionally, multiple regression analysis was used to examine the functions associated with postural control capability. RESULT: Pearson's correlation analysis revealed that the postural control capability was correlated with toe pressure strength in the standing position (r = 0.36, p = 0.003). Multiple regression analysis demonstrated that only toe pressure strength in the standing position was significantly associated with the postural control capability, even after adjusting for covariates (standard regression coefficient: 0.42, p = 0.005). SIGNIFICANCE: The results of this study indicated that toe pressure strength in the standing position was more strongly associated with the postural control capability in healthy adults than toe grip strength in the sitting position. It has been suggested that a rehabilitation program for toe pressure strength in the standing position would help improve postural control capability.

Changes in Satisfaction with Meaningful Activities and Onset of Depressive Symptoms among Community-Dwelling Japanese Older Adults: A Population-Based Study Before and During the COVID-19 Pandemic.

OBJECTIVES: This study aimed to clarify the association between changes in satisfaction with meaningful activities and the occurrence of depressive symptoms before and during the coronavirus disease 2019 (COVID-19) pandemic. DESIGN: A population-based prospective cohort study (Tarumizu Study). SETTING AND PARTICIPANTS: A total of 231 community-dwelling older adults aged ≥65 years without depressive symptoms at baseline. METHODS: The participants completed baseline (June to December 2018, before the COVID-19 pandemic) and follow-up (September to December 2021, during the COVID-19 pandemic) assessments. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale (GDS-15) and defined by a GDS-15 score of ≥5. Participants selected meaningful activities from the 95 activities included in the Aid for Decision-Making in Occupation Choice, and their satisfaction levels were evaluated. Satisfaction with the most meaningful activities was assessed as to whether it was maintained/improved or decreased at follow-up. RESULTS: In the follow-up survey, 31 (14.3%) participants reported the occurrence of depressive symptoms. Compared with before the COVID-19 pandemic, the rates of meaningful activities during the COVID-19 pandemic decreased for interpersonal interaction and social life and increased for leisure, sports, self-care, and domestic life. Logistic regression analysis revealed that changes in satisfaction with meaningful activity were associated with the occurrence of depressive symptoms after adjusting for demographic variables, baseline GDS scores, cognitive and physical status, and instrumental activities of daily living (odds ratio, 2.78; 95% confidence interval, 1.17-6.59, P = .020). CONCLUSIONS AND IMPLICATIONS: To avoid decreasing satisfaction with meaningful activities, supporting older adults may be protective against the occurrence of depressive symptoms. Our findings highlight the need for health care professionals to not only encourage older adults to participate in activities for their mental health but also consider whether the activities are meaningful or satisfying for them.

Comparison of toe pressure strength in the standing position and toe grip strength in association with the presence of assistance in standing up: a cross-sectional study in community-dwelling older adults.

PURPOSE: We believe that toe pressure strength in the standing position, which is closer to the actual movement, is more associated with standing up in the older adults than the conventional toe grip strength. Therefore, the purpose of this study is to examine the association between toe pressure strength in the standing position and the presence of assistance in standing up in the older adults. METHODS: Ninety-five community-dwelling older adults (82 ± 8 years old, 72% female) were included in this study. The patients were evaluated based on their need for assistance in standing up. Physical functions, including toe pressure strength in the standing position, toe grip strength, hand grip strength, knee extension strength, one-leg standing time with eyes open, and maximal walking speed, were measured. RESULTS: When compared with and without assistance to stand up, the group requiring assistance had weaker toe pressure strength in the standing position than the group without assistance (p = 0.015, ES = 0.53). After adjusting for confounding factors, the final model revealed that toe pressure strength in the standing position was associated with the use of assistance in standing up (odds ratio 0.94 [0.88-0.99, p = 0.025]). CONCLUSION: Toe pressure strength in the standing position was associated with the use of assistance in standing up in older adults. Improving toe pressure strength in the standing position may facilitate the ability of older adults to stand up.

Factors influencing postpartum depression among Japanese parents: A prospective longitudinal study.

AIM: Postpartum depression (PPD) may have negative effects on the parents and lead to impaired cognitive, socioemotional, and behavioral development in their children. The purpose of this study was to examine factors associated with PPD in parents during the first year after delivery. METHODS: This study used a self-administered questionnaire. Questionnaires were mailed at 5 days, 3 months, 6 months, and 1 year after delivery, respectively. The particpants were 107 pairs of mothers and fathers. PPD was assessed using the Edinburgh Postnatal Depression Scale (EPDS). Data on sense of coherence (SOC), Quality Marriage Index, Social Support Scale, Mother-to-Infant Bonding Scale, and sociodemographic variables were collected. Multiple regression analysis was performed to examine the strength of the association between several variables and the EPDS at each survey period for fathers and mothers, respectively. RESULTS: The prevalence of PPD in the first-year postpartum ranged from 12.1%-23.4% to 7.5%-8.4% for fathers and mothers, respectively. SOC had the strongest impact on EPDS scores for both fathers and mothers at all four survey periods. CONCLUSIONS: Our findings suggest that stress coping skills are an important factor affecting PPD throughout the first-year postpartum for both fathers and mothers.

Relationship between grave visitation and apathy among community-dwelling older adults.

BACKGROUND: It has been shown that involvement in religious activities has a positive impact on psychological aspects. In this study, the relationship between grave visitation, a standard religious activity in Japan, and depression and apathy symptoms was investigated among older adults in Japan. METHODS: A total of 638 older adults who participated in a community-based health check survey (Tarumizu Study 2019) were interviewed regarding the presence or absence of grave visitation, frequency, travel time, means of transportation, and flower offerings. Apathy and depressive symptoms were measured using the 15-item Geriatric Depression Scale (GDS-15). The participants were categorised into three grave visitation groups, namely, frequent (more than once per week), occasional (less than once per week), and non-visiting. Outcomes were compared between the frequency groups, and Poisson regression analysis was used to investigate the relationship between grave visitation frequency and apathy and depression. RESULTS: Of the participants, 91.8% reported regular grave visitation. The non-visiting group had a significantly higher prevalence of apathy symptoms (44.2%) than the visiting groups. Furthermore, using the frequent group as the reference, Poisson regression analysis adjusted for potential covariates demonstrated that no grave visitation was significantly related to apathy (prevalence ratio, 1.43; 95% confidence interval, 1.00-2.05, P = 0.049). CONCLUSIONS: Not practising grave visitation was significantly related to apathy among older adults. Helping older adults to visit graves may prevent apathy by facilitating motivation and increasing activity.

Associations between Optimism and Attentional Biases as Measured by Threat-Avoidance and Positive-Search Tasks.

Evidence suggests that optimism has a positive impact on health status. Attentional bias modification (ABM) may be beneficial for enhancing optimism, but its effective application requires a detailed investigation of the association between attentional bias and optimism. This study aimed to determine the association between attentional bias and optimism based on different task types. Eighty-four participants completed the attentional bias measures using the dot-probe task (DPT), emotional visual search task (EVST) paradigms, and psychological assessments. Optimism was assessed using the Life Orientation Test-Revised with subscales for optimism and pessimism. Pearson's correlation coefficient and multivariate linear regression analysis were applied to investigate the association between optimism and attentional bias. Neither the attentional bias derived from DPT nor EVST was significantly correlated with optimism total score or subscales. Regression analysis also showed no association between attentional bias and optimism (DPT, ß = 0.12; EVST, ß = 0.09), optimism subscales (DPT, ß = 0.09; EVST, ß = 0.17), or pessimism subscales (DPT, ß = -0.10; EVST, ß = 0.02). Our findings showed no evidence that attentional biases derived from either the DPT or EVST measures are associated with optimism or pessimism. Further studies are needed to effectively adapt the ABM to enhance optimism.

Risk factors for nursing home admission among older adults: Analysis of basic movements and activities of daily living.

This retrospective study aimed to clarify the risk of older adults' nursing home placement in terms of basic movements and activities of daily living (ADLs) by analyzing data from a long-term care insurance certification survey in 2016‒2018 in City A. Of the 21,520 people certified as needing care, 16,865 could be followed up until 2018. Data on sex, age, household structure, and level of care required were obtained. Those who lived at home and at nursing homes were categorized as the "Unchanged group" and the "Changed group," respectively. Multivariate binomial logistic regression analysis was performed, with group type as the dependent variable and basic movement and ADL scores as the independent variables. For factor analysis according to care level, participants were classified into support need levels 1 and 2, care need levels 1 and 2, and care need levels 3, 4, and 5. For those categorized into support need levels 1 and 2, standing on one leg and transferring (basic movements) and urination and face cleaning (ADLs) were associated with nursing home placement. For those in care need levels 1 and 2, getting up and transferring (basic movements) and bathing, urination, face cleaning, and hair styling (ADL) were significantly associated with nursing home placement. For those in care need levels 3, 4, and 5, sitting and transferring (basic movements) and self-feeding and defecation (ADL) were significant. Occupational therapists must focus on older adults' declining ADLs and basic movements and relay the necessary information to patients, families, and other healthcare professionals to ensure appropriate and prompt care delivery.

Implications of refrigerator management on subjective memory complaints among Japanese community-dwelling older adults.

AIM: Older adults with subjective memory complaints (SMC) may experience very minor difficulties in daily activities. Although caregivers and occupational therapists who support community-dwelling older adults are aware of the existence of characteristic behaviours related to refrigerator management, no specific studies have been conducted. This study aimed to examine the implications of refrigerator management for older adults with SMC. METHODS: A self-administered questionnaire was sent to 3000 randomly selected members of Consumer's Co-operative Kagoshima. Of the returned responses, a total of 282 older adults were analyzed. Analyzed subjects were divided into two groups: SMC (+) group (n = 74) and SMC (-) group (n = 192). A questionnaire was created by four occupational therapists and used to assess the characteristics of analyzed subjects and their abilities to manage the refrigerator. The observation list for early signs of dementia was also utilised. A multiple logistic analysis was performed to examine the association between SMC and refrigerator management. RESULTS: The SMC (+) group had a significantly higher number of refrigerator management errors than the SMC (-) group (P = 0.008). The SMC (+) group had more errors than the SMC (-) group in the following four items regarding refrigerator management; the refrigerator has a lot of the same foods / expired food, the person does not know what's in the refrigerator, the person cannot find what he/she needs in the refrigerator. Moreover, SMC was associated with the item 'the person does not know what is in the refrigerator' (odds ratio 7.44, 95% CI 1.51-43.8, P = 0.02). CONCLUSIONS: Our results showed that older adults with SMC had several problems regarding refrigerator management. Evaluating refrigerator management among older adults with SMC may help consider multifaceted support.

Usefulness of navigation application for outdoor mobility guides in community-dwelling older adults: a preliminary study.

PURPOSE: This study aimed to examine a mobile device navigation application's (apps) usefulness as a guide based on the required time and accuracy of moving to a destination for community-dwelling older adults. METHODS: Twelve older adults, aged ≥65 years (mean age 77.0 ± 8.0, 62% female) who used the day-care centre for older adults, based on the long-term care insurance system in Kagoshima Prefecture, participated in this study. Study participants performed a Route Navigation Task (RNT), which is a simple real-world navigation test based on the actual living environment, after a brief assessment of physical function, cognitive function, and daily living routine. RNT required that participants arrive at a destination for the shortest time, under three tasks: map-, app-, and photo-language. The order of implementation of each task, determined by one of the tasks, was randomized, with a span of a minimum 1 month between tasks. RESULTS: The app-task resulted in a significantly shorter amount of travel time than did the other tasks (p < 0.05). The factors considerably correlating with travel time in the app-task were walking speed, mobile device proficiency, years of mobile device use, and higher-order activities of daily living. CONCLUSION: Our findings suggested the possibility that the navigation app was useful as efficient outdoor mobility support, and healthcare providers should encourage the use of mobile devices for improving the active lifestyle of the community-dwelling older adults.IMPLICATIONS FOR REHABILITATIONThe navigation apps in mobile devices are expected to be useful for community-dwelling older adults.We examined the effect of navigation app use on path execution using three tasks in RNT and what factors are associated with the ability of route navigation.A significant reduction in travel time when RNT was performed using a navigation app compared to the other two tasks (map, photo-language).Regardless of cognitive function, mobile device proficiency, and mobile device usage were associated with navigation app use.This study suggests the usefulness of a navigation application in providing route assistance to community-dwelling older adults.

Social Frailty and Meaningful Activities among Community-Dwelling Older Adults with Heart Disease.

Patients with heart disease are more likely to experience social frailty due to physical inactivity, which may affect meaningful activities such as hobbies. This study aimed to investigate (1) the association between heart disease and social frailty in community-dwelling older adults and (2) the characteristics of meaningful activities in community-dwelling older adults with heart disease. Data from 630 older adults who participated in a community-based health survey were obtained, including clinical history, meaningful activities, social frailty and psychosomatic functions. Participants were divided into two groups: those with heart disease (n = 79) and those without (n = 551), and comparisons were made. Social frailty was observed in 23.7% of participants with heart disease, and logistic regression revealed significant associations with heart disease and social frailty after adjusting for potential covariates (OR, 1.97; 95% CI, 1.06 3.67; p = 0.032). Participants with heart disease did not differ significantly in terms of satisfaction or performance; their frequency of engagement in meaningful activities was significantly lower than without heart disease (p = 0.041). These results suggest that heart disease and social frailty are associated in community-dwelling older adults, and that this demographic is inclined to engage in meaningful activities less frequently.

Differences by cognitive impairment in detailed processes for basic activities of daily living in older adults with dementia.

BACKGROUND: Impairment of activities of daily living in patients with dementia has a fundamental and lasting impact on their quality of life and requires a detailed assessment. This study investigated to clarify characteristic of basic activities of daily living (BADL) processes with the severity of cognitive impairment in community-dwelling older adults with dementia using the Process Analysis of Daily Activity for Dementia (PADA-D). METHODS: Participants were recruited from outpatient departments of 24 hospitals, daycare centres, and home rehabilitation services in Japan. The severity of cognitive impairment was determined using the Mini-mental State Examination (mild: score ≥ 20; moderate: 10 ≤ score < 20; severe: score < 10). Patient's BADL were assessed according to the PADA-D by observation of the occupational therapist and interviews with family members. Basic information and the scores of BADL items of the PADA-D were compared between the three groups. Subsequently, we compared the percentage of independent or non-independent processes included in the sub-items of BADL in the PADA-D. RESULTS: A total of 143 patients were included in the analysis. Performance on BADL was shown to decrease significantly with increasing severity of cognitive impairment. The percentage of all BADL processes performed ranged from 58% to 100% in mild, 38% to 97% in moderate, and 0% to 88% in severe. Some of the processes included in BADL of PADA-D showed no significant differences in independence between the three groups. DISCUSSION/CONCLUSION: Most BADL processes differed with respect to different independence rates depending on the severity of cognitive impairment of the older adults with dementia. However, some BADL processes were not associated with the severity of cognitive impairment. Our findings may suggest that a detailed BADL assessment of patients with dementia is useful in terms of caregiver education to avoid excessive caregiving and in predicting BADL impairment.

Characteristic of process analysis on instrumental activities of daily living according to the severity of cognitive impairment in community-dwelling older adults with Alzheimer's disease.

OBJECTIVES: To clarify the characteristic of impaired and unimpaired Instrumental Activities of daily living (IADL) processes with the severity of cognitive impairment in community-dwelling older adults with Alzheimer's disease (AD) using the Process Analysis of Daily Activity for Dementia (PADA-D). DESIGN: Cross-sectional study. SETTING: 13 medical and care centers in Japan. PARTICIPANTS: 115 community-dwelling older adults with AD. METHODS: The severity of cognitive impairment was classified by Mini-Mental State Examination (20 ≥ mild group, 20 < moderate group ≥ 10, 10 < severe group), and IADL scores and eight IADL items in PADA-D were compared among three groups after adjusting for covariates. Rate of five feasible processes included in each IADL of PADA-D was compared. RESULTS: IADL score showed a decrease in independence with the severity of AD except for Use modes of transportation and Managing finances, which was especially pronounced in Shopping (F = 25.58), Ability to use the telephone (F = 16.75), and Managing medication (F = 13.1). However, when the PADA-D was examined by process, some processes that were impaired and unimpaired with the severity of cognitive impairment were clear. For example, Plan a meal was impaired (ES = 0.29) with the severity, but Prepare the food was not in Cooking performance. CONCLUSIONS: We suggested that detailed process analysis in IADLs can clarify the characteristic of processes that are impaired and unimpaired with the severity of cognitive impairment in older adults with AD living in the community. Our findings may be useful for rehabilitation and care in IADL to continue living at home.

Associations between apathy and comprehensive frailty as assessed by the Kihon Checklist among community-dwelling Japanese older adults.

BACKGROUND: Frailty is a multidimensional condition characterised by reduced physical and psychological resilience. Older adults also frequently demonstrate apathy, suggesting that it shares similar neuro-physiological pathways with frailty. This cross-sectional study aimed to investigate the association between apathy and frailty as defined by a comprehensive assessment. METHODS: We analyzed 882 older adults (mean age: 74.4 ± 6.4 years; 62.1% female) who participated in a community-based health check survey (Tarumizu Study). Apathy was measured by the Geriatric Depression Scale-3A, a three-item subset of the Geriatric Depression Scale-15, and frailty by the Kihon Checklist of physical, psychological, functional, and social status. Associations were examined by multinomial logistic regression with frailty status (robust, pre-frailty, frailty) as the dependent variable, apathy as the independent variable, and sociodemographic factors, medications, cognitive function, functional capacity, and mood symptoms as potential confounders. RESULTS: Apathy was observed in 23.7% of individuals, and logistic regression revealed significant associations with both pre-frailty and frailty after confounder adjustment (pre-frailty: odds ratio (OR) 1.80, 95% CI 1.22-2.64; frailty: OR 3.24, 95% CI 1.63-6.42). Participants with apathy also exhibited greater deficits in the Kihon Checklist subdomains instrumental activities of daily living (P = 0.022), physical function (P < 0.001), oral function (P < 0.001), and cognitive function (P = 0.001). CONCLUSIONS: Our findings underscore the importance of comprehensive frailty assessment and demonstrate that apathy can have pervasive deleterious effects on geriatric health.