Prevalence and characteristics of frailty in older adults in Japan: a cross-sectional study using data from the long-term care insurance system.

[Purpose] Owing to rapid population aging, prevention of frailty in older adults and minimizing the burden on the long-term care insurance system are priorities for the Japanese government. However, limited data are available regarding the prevalence and characteristics of frailty among older adults requiring support in Japan. In this study, we investigated the prevalence and characteristics of frailty in older adults requiring support in Japan. [Participants and Methods] The study included 695 new users of preventive long-term care services certified as "requiring support" between 2011 and 2019. In this cross-sectional investigation, we used data obtained from a community comprehensive support center. Frailty prevalence was assessed using the Kihon Checklist, followed by a χ2 test. Logistic regression analysis was performed to identify the characteristics (basic information and service type) associated with frailty. [Results] A significantly large percentage of robust/pre-frail participants (72.7%) belonged to urban areas, although we observed no significant difference in robust participants with regard to residence. Furthermore, we observed significant intergroup differences in age and orthopedic conditions. [Conclusion] It is important to encourage older adults to access the long-term care insurance system and seek support at an early stage.

Association between regional phase angle and level of locomotion among older females requiring long-term care in a health facility.

[Purpose] This study aimed to determine the characteristics of regional phase angles based on locomotion level among older Japanese females requiring long-term care in a health facility. [Participants and Methods] This was a cross-sectional observational study. The participants included 91 residents (mean age ± standard deviation: 90.2 ± 5.6 years) admitted to an older health facility. Based on their indoor locomotion status, the participants were divided into three groups: group I, able to walk with or without walking aids; group II, able to move in a wheelchair without assistance; and group III, able to move in a wheelchair with assistance. The regional phase angle was measured using a bioimpedance device. [Results] Significant differences were observed in the regional phase angle of the upper limbs between groups I and III and between groups II and III; in that of the lower limbs among all groups; and in that of the trunk between groups I and II and between groups I and III. [Conclusion] The level of locomotion may be explained by the regional phase angles of the lower limbs.

Comparison of body composition and muscle mass by age in amateur soccer players.

[Purpose] This study aimed to elucidate the changes in body composition components associated with aging in amateur male soccer players. Specifically, we investigated the alterations in the phase angle and regional muscle mass distribution. [Participants and Methods] The study included a cohort of 163 male participants categorized into three age groups: U15 (12-15 years), U18 (16-18 years), and O19 (≥19 years). Precise body composition assessments were performed, employing the InBodyS10 body composition scale. [Results] The findings revealed substantial age-related disparities in various body composition parameters. Data revealed a consistent trend of increasing basic body composition metrics with age. Notably, the body fat percentage progressively increased with age. Muscle mass and phase angle exhibited age-related increases with nuanced variations in different anatomical regions. [Conclusion] In the general Japanese population, muscle mass tends to decrease with age after 18 years. However, in this study on amateur soccer players, we observed a plateau in the height and lower limb phase angle around the age of 18 years, whereas muscle mass exhibited an increasing trend.

Students' level of satisfaction with graduation research during the COVID-19 pandemic.

[Purpose] We investigated the effects of the state of emergency declared following the spread of coronavirus disease on the level of satisfaction with graduation research. [Participants and Methods] The study included 320 students who graduated from a university in northern Tochigi Prefecture between March 2019 and 2022. Participants were categorized into the non-coronavirus group (graduation in 2019 and 2020) and the coronavirus group (graduation in 2021 and 2022). Levels of satisfaction with the content and rewards of graduation research were assessed using a visual analog scale. [Results] Levels of satisfaction with the content and rewards of graduation research were >70 mm in both groups and were significantly higher in females in the coronavirus group than in the non-coronavirus group. [Conclusion] The study highlights that despite the pandemic, educational engagement can improve students' satisfaction with graduation research.

Improvement of frailty prevalence: difference in factors affecting frailty prevalence among 75 year-old individuals between 2006 and 2019.

[Purpose] This study aimed to examine and compare the prevalence of frailty in 75 year-old people sampled in two remote years, namely 2006 and 2019. [Participants and Methods] A total of 910 participants aged 75 years were included (502 people in 2006 and 408 people in 2019). We compared the total score of the Kihon checklist and each question for males and females between the two years. [Results] The prevalence of frailty decreased from 24.3% in 2006 to 15.2% in 2019. The comparison of the 2006 and 2019 Kihon checklists revealed significant differences in activities of daily living, physical function, oral function, outdoor activities, and cognitive function. [Conclusion] Frailty among 75 year-old individuals improved in 2019 compared to that in 2006. Improved activities of daily living, physical function, outdoor activities, and cognitive function were major causes of improved frailty in 2019.

Effect of interferential current on deep abdominal muscle thickness.

[Purpose] We aimed to investigate the effects of various modulated interferential currents on deep abdominal muscle thicknesses of healthy participants using ultrasound imaging. [Participants and Methods] We recruited twenty-two healthy male participants for this study. We compared the rate of change in muscle thickness of the abdominal muscles under different stimulation interferential current conditions. [Results] The change in interclass correlation coefficient of muscle thickness for each electrical stimulation by attached electrode altering was 0.738-0.998, indicating normal to good reliability. The rate of change for all muscle thicknesses under interferential current at 2.5 kHz and 20 Hz was significantly greater than that under the other conditions. [Conclusion] An interferential current at 2.5 kHz and 20 Hz is a feasible and reproducible way to train the abdominal muscles.

Effects of truncal taping on center of gravity sway: comparison of different trunk muscle masses.

[Purpose] Taping is a therapeutic technique used to prevent and treat sporting injuries and other conditions. This study aimed to clarify how kinesio taping versus non-elastic taping of the trunk affects postural control. [Participants and Methods] Thirty-three healthy male participants were included in this study. Participants were assigned to low or high trunk skeletal muscle mass groups. Main outcomes of path length and area representing the center of gravity sway were measured using a Zebris FDM-S system in three conditions: control, kinesio taping, and non-elastic taping. Tapes were applied to the rectus abdominis, external oblique, and erector spinae muscles. The measured limb position was seated on a balance cushion. [Results] The area of the low trunk mass group differed significantly between kinesio and non-elastic taping. However, the path length of the low trunk mass group and path length and area of participants with high trunk mass did not differ significantly between groups. [Conclusion] This study's findings indicated that two types of taping methods affected the area of gravitational sway in healthy adult males with a low trunk muscle mass.

Changes in physical function in older females over a 5†year period.

[Purpose] The quality of physical functions was evaluated prospectively in older females over a 5 year period to identify the physical functions that are more likely to consistently decline or be maintained in females aged 65‒74 years and more than 75 years. [Participants and Methods] Physical functions, including grip strength, walking speed, and balance, were measured for older females aged 65-74 years group and more than 75 years group from 2015 to 2019. T-scores of the physical performances were calculated to analyze the changes in the physical functions over 5 years. [Results] Based on the T-scores, physical functions in terms of the 5-m walking speed, timed up-and-go test, and functional reach test, improved from 2015 to 2019 in the 65-74 group, whereas all physical functions consistently deteriorated in the older than 75 group. [Conclusion] There was no significant decline of the physical functions in both groups; however, the T-score variations for physical functions during the 5 year observation period differed in each group.

Student satisfaction with initiatives for the national examination during the COVID-19 pandemic.

[Purpose] To examine the impact of the state of emergency declared with the spread of coronavirus disease (COVID) on the initiatives for the national examination. [Participants and Methods] The participants were 257 students who graduated from the International University of Health and Welfare, in March of the years 2019-2021 (non-COVID group; graduation in 2019 and 2020, COVID group; graduation in 2021). The levels of satisfaction with the department's initiatives, test scores, and frequency of mock examinations were assessed using a visual analog scale. [Results] The COVID group was significantly more satisfied with the department's initiatives and frequency of mock examinations than the non-COVID group. [Conclusion] The results suggest that despite the pandemic, it is possible to improve student satisfaction through measures to familiarize students with the examination.

Intraclass correlation coefficient of trunk muscle thicknesses in different positions measured using ultrasonography.

[Purpose] This study aimed to clarify the required number of measurements to calculate trunk muscle thickness at each position. [Participants and Methods] The participants were 30 elderly males aged >65 years. The right lumbar multifidus (L2), lumbar multifidus (L5), erector spinae, transversus abdominis, internal oblique, and external oblique muscle thicknesses were measured on longitudinal images obtained using ultrasonography in the lying, sitting, and standing positions. Two measurement values for each muscle thickness was used to calculate the intraclass correlation coefficient (1.1-1.5). [Results] The intraclass correlation coefficients of the abdominal muscle thickness measurements with "great reliabilities" were as follows: 1.3-1.5 for the external oblique muscle and 1.2-1.5 for the internal oblique and transversus abdominis muscles in the lying position; 1.3-1.5 for the external oblique and transversus abdominis muscles and 1.2-1.5 for the internal oblique muscle in the sitting position; the intraclass correlation coefficient in the standing position was 1.5 for the external oblique muscle 1.1-1.5 for the internal oblique muscle and 1.3-1.5 for the transversus abdominis muscle. In all the positions, the intraclass correlation coefficient of the measurements of the back-muscle thicknesses ranged from 1.1 to 1.5 for the right lumbar multifidus (L2), lumbar multifidus (L5), and erector spinae. [Conclusion] Depending on the posture, the abdominal muscles require multiple measurements, whereas the back muscles only require a single measurement.

One-year longitudinal study on spinal kyphosis and respiratory function in community-dwelling older Japanese adults who require long-term care or support.

[Purpose] To clarify the effects of longitudinal changes in older adults by evaluating the relationship between changes in spinal kyphosis and respiratory function over time in patients with certified need of care in the long-term care insurance system. [Participants and Methods] We included 57 older adults (28 males and 29 females) aged ≥65 years who were identified as requiring long-term care or support. The participants were community-dwelling individuals undergoing ambulatory rehabilitation. We assessed the longitudinal changes in spinal kyphosis index, respiratory function and muscle strength, and body composition over 1 year. [Results] The spinal kyphosis index was 10.5 at the first measurement and 14.6 at 1 year after the first measurement, showing a significant increase. We did not detect any significant differences in respiratory function and muscle strength, or body composition. [Conclusion] This 1 year longitudinal comparison suggests that the spinal kyphosis indexes were high, and the respiratory function and trunk muscle mass remained unchanged. Therefore, the relationships were negligible.

Changes in muscle strength and endurance of professional cyclists due to PycnoRacerTM.

[Purpose] Changes in the muscle performance of professional motorized athletes using pycnogenol-containing supplements have not been clarified. The purpose of this study was to evaluate the changes in muscle strength and endurance of professional cyclists during 4 weeks of training with the use of PycnoRacerTM. [Participants and Methods] Eight professional cyclists were requested to consume PycnoRacerTM twice/day for 4 weeks. The muscle endurance test consisted of 50 consecutive knee flexion and extension exercises at 180°/sec using an isokinetic torque machine before and after PycnoRacerTM administration. The athletes' body composition, including leg muscle mass, was also measured. [Results] The maximum flexor muscle torque and 41st-50th flexion muscle torque values significantly improved after supplement consumption (average improvement of 8.5%; range, 13.3-67.2%). The leg muscle mass and body composition did not differ significantly between the two conditions. The participants showed an average improvement of 31.8% (range, 0.9-67.8%) in their total work with cycling training. No adverse events were observed. [Conclusion] The use of PycnoRacerTM may improve training, muscle strength, and endurance, but not muscle mass.

Changes in the screening efficacy of lower calf circumference, SARC-F score, and SARC-CalF score following update from AWGS 2014 to 2019 sarcopenia diagnostic criteria in community-dwelling older adults.

[Purpose] To identify changes in the efficacy of the Asia Working Group for Sarcopenia (AWGS) screening tools and the differences between the different screening tools following the updates from the AWGS 2014 to 2019 criteria for community-dwelling older adults. [Participants and Methods] We included 139 community-dwelling older adults aged ≥65 years. We assessed the lower calf circumference, SARC-F score, SARC-CalF score, skeletal muscle mass, grip strength, and gait speed. Moreover, we investigated the sensitivity, specificity, likelihood ratios, and area under the ROC curve of the lower calf circumference, SARC-F score, and SARC-CalF score using the AWGS 2014 and 2019 criteria for sarcopenia diagnosis. [Results] The prevalences of sarcopenia were 10.8% and 12.9%, and 5.0% using the AWGS 2014 and 2019, and 2019 severe sarcopenia diagnostic criteria, respectively. Using AWGS 2014 criteria, the sensitivity and specificity of lower calf circumference, SARC-F score, and SARC-CalF score, were 86.7% and 62.1%, 13.3% and 91.9%, and 66.7% and 80.6%, respectively. Using AWGS 2019 criteria, the sensitivity and specificity of lower calf circumference, SARC-F score, and SARC-CalF score were 83.3% and 62.8%, 11.1% and 91.7%, and 66.7% and 81.8%, respectively. Using AWGS 2019 severe sarcopenia criteria, the sensitivity and specificity of lower calf circumference, SARC-F score, and SARC-CalF score were 100% and 59.8%, 14.3% and 91.7%, and 71.4% and 78.0%, respectively. [Conclusion] All screening tools used in AWGS 2014 and 2019 were similar in terms of efficacy; however, the AWGS 2019 severe sarcopenia criteria had different characteristics.

Correlation between skeletal muscle mass index and parameters of respiratory function and muscle strength in young healthy adults according to gender.

[Purpose] The purpose was to determine the correlation between the skeletal muscle mass index and parameters of respiratory function and muscle strength in young healthy adults as predictors of sarcopenia in association with aging and respiratory diseases. [Participants and Methods] Participants were 41 males and 37 females with a mean age of 19.5 ± 1.5 years. The following were measured: body composition (skeletal muscle mass index), respiratory function (vital capacity, inspiratory reserve volume, expiratory reserve volume, inspiratory capacity, forced vital capacity, one-second forced expiratory volume, peak expiratory flow rate), and respiratory muscle strength (maximum inspiratory pressure, maximum expiratory pressure). Correlations between the skeletal muscle mass index and parameters of respiratory function and respiratory muscle strength were assessed using Pearson's coefficient. [Results] The total skeletal muscle mass index showed a positive correlation with all items. The male skeletal muscle mass index showed a positive correlation with respiratory function excluding inspiratory reserve volume, expiratory reserve volume, maximum inspiratory pressure, and maximum expiratory pressure. The female skeletal muscle mass index showed a positive correlation with all respiratory functions including inspiratory reserve volume and expiratory reserve volume, but was not associated with respiratory muscle strength. [Conclusion] The skeletal muscle mass index showed a positive correlation with respiratory function and respiratory muscle strength. Gender-based features were correlated with respiratory muscle strength in males and lung capacity in females.

Characteristics of Japanese Older Adults Whose Trunk Muscle Mass Decreased during the COVID-19 Pandemic.

The coronavirus (COVID-19) pandemic significantly affected the physical and mental functions in older adults, resulting in "corona-frailty". This 2-year prospective study characterized changes in quantitative measures and corona-frailty among a cohort of community-dwelling older women. Changes were evaluated using face-to-face interactions with 39 Japanese women (mean age: 76.1 ± 5.9) in 2019 (pre-pandemic baseline) and 2021 (follow-up during the pandemic). Quantitative measurements of handgrip strength, walking speed, calf circumference, body composition, and background factors were evaluated. Body weight and trunk muscle mass significantly decreased at follow-up. Multiple regression analysis, using change in trunk muscle mass as the dependent variable and background factors as independent variables, identified that decrease in trunk muscle mass was associated with "being robust at baseline" and answering "Yes" to the question of "Do you go out less frequently compared with last year"? The 2-year trunk muscle mass change for each baseline frailty stage showed a significant decrease only in the robust group (-8.0%). The decrease in trunk muscle mass might be related to pandemic-induced lifestyle restraint, suggesting that robust older adults who are healthy and active should take measures that focus on trunk muscles to avoid "corona-frailty".

Relationship between Eye Frailty and Physical, Social, and Psychological/Cognitive Weaknesses among Community-Dwelling Older Adults in Japan.

This study investigated the relationship between eye frailty and physical, social, and psychological/cognitive weaknesses among older adults in Japan. The participants were 192 community-dwelling older adult women. We measured handgrip strength, walking speed, and skeletal muscle mass; additionally, their physical, social, and psychological/cognitive frailties were surveyed using questionnaires. Eye frailty self-checks were used to assess eye frailty. Exploratory and confirmatory factor analyses were employed to verify the validity of the eye frailty self-checks. Eye frailty prevalence and related factors were investigated by conducting a binomial logistic regression analysis, with eye frailty as the dependent variable. The factor analysis results showed that a model could be constructed with the two factors of visual acuity or contrast and visual field. The model's goodness of fit was acceptable, supporting the validity of the self-checking construct. The Kihon checklist was the only variable with a significant relationship to eye frailty. Regarding the relationship between eye frailty and subordinate items of the Kihon checklist, social withdrawal [odds ratio (OR) 2.437, 95% confidence interval 1.145-5.188], cognitive function (OR 2.047, 95%CI 1.051-3.984), and depressed mood (OR 1.820, 95%CI 1.163-2.848) were significant. Eye frailty can be considered a factor reflecting the existence of social and psychological/cognitive frailties.

Rejuvenation of standing and gait balance in community-dwelling older individuals: A comparative study between 2006 and 2019.

AIM: The present study investigated the rejuvenation of physical function in terms of walking speed and grip strength. Specifically, it examined the rejuvenation of physical functions in community-dwelling older individuals between 2006 and 2019. The study is novel, because it analyzes this by focusing on gait balance. METHODS: Data were collected from 339 participants (52 men, 287 women) in 2006, and 382 participants (83 men, 299 women) in 2019. They were categorized according to age: early-stage and late-stage groups for men, and early-stage, late-stage and latest-stage groups for women. These groups were analyzed by participants' walking speed, grip strength, Timed Up and Go test, Functional Reach test and One-Leg Standing test. The results were compared based on two factors: time (2006 to 2019) and age group. RESULTS: The scores for the Timed Up and Go and One-Leg Standing tests were better in 2019 than in 2006 for all age groups in both older men and women. However, improvement in walking speed was observed only in women. Additionally, the decline in physical function with age was slower for walking speed among men, and Functional Reach and One-Leg Standing tests among women. CONCLUSIONS: The changes over this 13-year period showed that the physical function of community-dwelling older individuals was rejuvenated in terms of improved standing and walking balance. These rejuvenations will aid in preventing falls among community-dwelling older individuals. Geriatr Gerontol Int 2021; 21: 975-980.