Community activities predict disability and mortality in community-dwelling older adults.

AIM: With aging, it is important to maintain older community dwellers' regular engagement with familiar community activities (CA) engaged in close to home to protect them from frailty. Thus, the present study aimed to examine whether CA items or CA score were associated with mortality or the need for care under the new long-term care insurance service requirements over 3 years among community-dwelling older Japanese adults. METHODS: We analyzed cohort data for older adults from a prospective cohort study in Kami town, Japan. The response rate to the self-reported questionnaire was 94.3% (n = 5094), and we followed these participants for 3 years. Our final sample comprised 5076 older adults. Missing data were filled in using multiple imputation. We used seven items to assess CA: (i) volunteer activity; (ii) regional activity related to the neighborhood; (iii) visiting friends; (iv) hobbies or favorite lessons; (v) earning an income; (vi) farm work and growing vegetables; and (vii) shopping daily by oneself. The Kihon Checklist and new long-term care insurance service certifications were used as the frailty screening and disability indices, respectively. RESULTS: During the follow-up survey, 705 participants obtained new long-term care insurance service certifications and 262 died. Using the receiver operating characteristic curve, the desirable cut-off of the CA score to predict disability and mortality was at least two items for all elderly age groups in rural areas. CONCLUSIONS: CA items and CA score could predict disability and mortality in community-dwelling older adults in Japanese rural areas. Therefore, it is recommended that older adults from all age groups participate in CA. Geriatr Gerontol Int 2018; 18: 1114-1124.

Health checkup behavior and individual health beliefs in older adults.

AIM: Despite Japan being a developed nation, half of its older population does not attend regular health checkups. The aim of the present study was to examine the individual health beliefs and personal recommendations that strongly influence health checkup attendance among community-dwelling older adults. METHODS: In 2013, questionnaires were sent to 5401 community-dwelling older adults who were not receiving long-term institutionalized care. The response rate was 94.3%. We analyzed response data from 4984 older adults using multiple imputation to manage missing data. Participation in health checkups was defined as having undergone at least one checkup in the past 3 years, and non-participation as having attended no checkups in this period. RESULTS: The participants' mean age was 75.8 years, and 57.9% were women. The adjusted odds ratio of health checkup participation ranged from 1.35 (95% confidence interval [CI] 1.13-1.61) to 1.62 (95% CI 1.34-1.95) for positive individual health beliefs about health checkups, and was 2.21 (95% CI: 1.51-3.24) and 1.28 (95% CI: 1.17-2.08) for recommendations to participate from family and neighbors, respectively. All odds ratios were adjusted for age, sex, driving by oneself to daily shopping or clinic, paid work, method of response, internal medical therapy, polypharmacy, serious disease, periodic blood test, frailty and neighborly relationships. CONCLUSIONS: The present findings suggest that both individual and community approaches might be effective in promoting participation in health checkups among community-dwelling older adults. Geriatr Gerontol Int 2018; 18: 338-351.

Self-Assessed Kyphosis and Chewing Disorders Predict Disability and Mortality in Community-Dwelling Older Adults.

OBJECTIVE: It is clear that each trend of kyphosis with increased age and the ability to eat firm foods with the back teeth (chewing ability) has a strong influence on both the physical and mental condition of older people. Thus, this study aimed to examine whether the combination of kyphosis and chewing disorders was associated with mortality or the need for care under the new long-term care insurance (LTCI) service requirement, over 3 years in community-dwelling older Japanese adults. DESIGN: A prospective cohort study. SETTING AND PARTICIPANTS: We analyzed the cohort data for older adults (65 years or older) from a prospective study in Kami town. The response rate was 94.3%, and we followed 5094 older individuals for 3 years. Thus, we analyzed 5083 older adults using multiple imputation to manage missing data. OUTCOME: The outcomes were mortality or new certifications for LTCI services in a 3-year period. MEASUREMENTS: We developed 3 groups by asking 2 self-reported questions on both "no kyphosis" and "good chewing ability." The groups were no kyphosis and good chewing ability (GG), kyphosis and poor chewing ability (BB), and kyphosis and good chewing ability or no kyphosis and poor chewing ability (GB/BG). RESULTS: The prevalence of BB, BG/GB, and GG were 8.9%, 40.3%, and 50.8%, respectively, in our survey. During the 3-year follow-up period, 5.2% (n = 262) died and 13.9% (n = 708) individuals were newly certified as needing LTCI services. As determined by multivariate analyses, BG/GB older adults (adjusted hazard ratio: 1.3 [95% CI 1.1-1.6]) and BB older adults (adjusted hazard ratio: 2.0 [95% CI 1.5-2.4]) had a significantly higher risk of needing LTCI services than GG older adults. Similarly, BG/GB older adults (adjusted hazard ratio: 1.5 [95% CI 1.1-2.0]) and BB older adults (adjusted hazard ratio: 2.3 [95% CI 1.5-3.3]) had a significantly higher risk of mortality than GG older adults did. CONCLUSION: The presence of kyphosis or poor chewing ability was related to mortality and new certifications for LTCI services, and we found an additive effect of these 2 factors related to frailty.

The relationship of community activities with cognitive impairment and depressive mood independent of mobility disorder in Japanese older adults.

AIM: This study aimed to examine the relationship of participating in community activities (CA) with cognitive impairment and depressive mood independent of mobility disorder (MD) among older Japanese people. METHODS: Elderly residents in institutions or those requiring long-term care insurance services were excluded; questionnaires were mailed to 5401 older adults in 2013. The response rate was 94.3% (n=5094). We used multiple imputation to manage missing data. The questionnaire addressed physical fitness, memory, mood, and CA. Participants were divided into two groups (good and bad) based on the median scores for physical fitness, memory, and mood. We identified items related to periodically performed CA, cognitive impairment, and depressive mood, and examined correlations between scores on these sets of items. RESULTS: The mean age was 75.9 years; 58.4% of participants were women. The following CA significantly predicted reduced cognitive impairment and depressive mood independent of MD: volunteer activity, community activity, visiting friends at home, pursuing hobbies, paid work, farm work, and daily shopping. These results were corrected for age, sex, and response method (mail or home-visit). Higher CA scores were associated with lower cognitive impairment and lower depressive mood independent of MD. CONCLUSIONS: CA is negatively associated with cognitive impairment and depressive mood among community-dwelling elderly independent of MD; promoting CA may protect against cognitive impairment and depressive mood in this population. However, MD, cognitive impairment, and depressive mood may lead to reduced CA.

Effect of self-reported quality of sleep on mobility in older adults.

AIM: Quality of sleep (QOS) has been shown to have an affect on mental and physical well-being, and quality of life. However, few studies have investigated how sleep affects mobility in older adults. The aim of the present study was to examine the relationship between QOS and mobility disorder (MD) in community-dwelling older adults. METHODS: Data collected through self-administered questionnaires was analyzed for 4564 Japanese older adults. Sleep outcomes included two self-reported questions regarding QOS. Logistic regression analysis was used to analyze the association between sleep and MD both by the QOS questions independently and grouped together by the two QOS questions into three groups: often sleeps well and good awakening (GG), does not often sleep well and bad awakening (BB) and a group with one of each (GB/BG). RESULTS: After adjustment for age, sex and depression, both those who did not often sleep well and those with poor awakening were more likely to show MD (OR 1.45, 95% CI 1.29-1.75), (OR 1.77, 95% CI 1.50-2.08), respectively. When grouped by both questions, those in the BB group had the least favorable outcome with increased odds ratio for possessing a MD (OR 1.95, 95% CI 1.61-2.37), compared with GB group (OR 1.40, 95% CI 1.18-1.67). CONCLUSIONS: Often sleeping well and good morning awakening were both associated with MD, suggesting that self reported QOS is associated with MD. Further research is required to investigate whether improving sleep quality could be a possible means of preventing and reversing MD in older adults.