Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.14283/jfa.2024.51

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Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVES: Frailty is a significant cause of adverse health events including long-term care and hospitalization. Although information and communication technology (ICT) has become an integral part of modern life, it remains unclear whether ICT use is associated with frailty. DESIGN: A cross-sectional study (Integrated Longitudinal Studies on Aging in Japan, ILSA-J). SETTING AND PARTICIPANTS: Aged 75 and older data from the ILSA-J in 2017 (n = 2893). METHODS: ICT use was measured using the technology usage sub-items of the Japan Science and Technology Agency Index of Competence. Specifically, the use of mobile phones, ATMs, DVD players, and sending e-mails were rated as "yes" (able to do) or "no" (unable to do), with the first quintile (≤1 point) defined as ICT non-users. Frailty was assessed using the Japanese version of the Cardiovascular Health Study criteria based on the phenotype model (e.g., weight loss, slowness, weakness, exhaustion, and low activity). Further, multivariate logistic regression analysis analyzed its association with ICT use. Subgroup analyses were stratified according to gender, years of education, and living arrangements. RESULTS: Higher ICT use was not associated with frailty after adjusting for covariates (odds ratio [OR]: 0.53; 95%CI 0.39-0.73). Similar associations were found in the sub-groups of women (OR 0.45, 95%CI 0.30-0.66), <13 years of education (OR 0.48, 95%CI 0.34-0.67), living alone (OR 0.46, 95%CI 0.27-0.79), and living together (OR 0.57, 95%CI 0.38-0.85). No association existed between using ICT and frailty in the sub-groups of men and ≥13 years of education. CONCLUSIONS AND IMPLICATIONS: Higher ICT use is associated with the absence of frailty in individuals 75 years and older. Such benefits may be particularly pronounced in women, those with lower levels of education, and older adults living alone or with others.

DOI： 10.1007/s41999-024-00979-y

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Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.jth.2024.101807

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Language：English   Publishing type：Research paper (scientific journal)  

AIM: This study aimed to examine the relationships between levels of competence and impaired physical and cognitive functions in older adults. METHODS: We used a data set of the Integrated Longitudinal Studies on Aging in Japan for 2017 including 5475 community-dwelling older adults. Levels of competence were assessed using the Japan Science and Technology Agency Index of Competence (JST-IC). Grip strength (low grip strength: <28 kg for men and <18 kg for women) and gait speed (slow gait speed: <1.0 m/s for both sexes) were evaluated as physical function measurements, and the Mini-Mental State Examination (cognitive decline: <24 on the Mini-Mental State Examination) was used to assess cognitive function. RESULTS: The JST-IC had areas under the curve estimated from receiver operating characteristic analysis ranging from 0.65 to 0.73 for detecting low function as assessed by these tests. Restricted cubic spline curves showed that the shape of the association between the JST-IC and impaired function depended on sex and the test used. The comparison between perfect and imperfect JST-IC scores showed significant differences in the prevalence of low grip strength in both sexes, slow gait speed in women, and cognitive decline in men. CONCLUSIONS: It may be insufficient to identify those with impaired physical or cognitive function using the JST-IC. The shape of the association with the JST-IC varies across their measurements. Our findings can help interpret JST-IC scores in the context of low physical and cognitive functions. Geriatr Gerontol Int 2024; 24: 352-358.

DOI： 10.1111/ggi.14839

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AIM: Muscle mass and strength correlate with cognitive function; however, it remains unclear whether dynapenia (i.e., muscle weakness with preserved muscle mass) is relevant. This study aimed to explore whether dynapenia is associated with global cognitive function in community-dwelling older Japanese adults. METHODS: This cross-sectional study used data from the Integrated Research Initiative for Living Well with Dementia Cohort Study, which pooled data from five community-based geriatric cohorts. Dynapenia was defined as muscle weakness without muscle mass loss according to the Asian Working Group for Sarcopenia criteria. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). An ordered logistic regression analysis was conducted with dynapenia as the exposure and with cognitive decline stages, defined as an MMSE score of 27-30 for normal cognition, 24-26 for possible cognitive decline, and <24 for cognitive decline, as the outcome, stratified by sex and adjusted for age, muscle mass, education, alcohol consumption, smoking habits, living alone, and non-communicable diseases. RESULTS: We analyzed data for 3338 participants (2162 female) with preserved muscle mass. Of these, 449 (13.5%) had dynapenia, and 79 (2.4%) exhibited cognitive decline. Multivariate odds ratios (95% confidence interval) for cognitive decline among those with dynapenia, compared with those without dynapenia, were 1.51 (1.02-2.24) for males and 2.08 (1.51-2.86) for females. CONCLUSIONS: Muscle weakness is associated with cognitive decline, even in individuals with preserved muscle mass. Further studies are needed to better understand the association between muscle weakness and cognitive decline over time in order to develop dementia prevention strategies for those with dynapenia. Geriatr Gerontol Int 2024; 24: 123-129.

DOI： 10.1111/ggi.14749

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PURPOSE: Although examining the dose-response curves of physical activity (PA) and sitting time with health-related outcomes is an important research agenda, the results for older Japanese adults are extremely limited. We examined the dose-response associations of PA and sitting time with all-cause mortality among older Japanese. METHODS: Initially, 8,069 non-disabled residents (4,073 men; 3,996 women) aged 65-84 years of Ota City, Japan, were recruited. Moderate-to-vigorous PA (MVPA) and sitting time were evaluated using the International Physical Activity Questionnaire-Short Form. Multivariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of MVPA and sitting time for all-cause mortality were calculated, and the dose-response curves were examined using restricted cubic splines (RCS). RESULTS: During 4.1 years of follow-up, 458 participants (5.7%; 331 men and 127 women) died. Compared with the low MVPA (<600 metabolic equivalents [METs]·minutes/week) group, HR for mortality gradually reduced in moderate (600-3000 METs·minutes/week) and high (>3000 METs·minutes/week) MVPA groups (moderate: HR 0.66; 95% CI, 0.54-0.82; high: HR 0.58; 95% CI, 0.45-0.75; P <0.001 for trend). RCS showed that the HR for mortality reduced linearly up to approximately 2000 METs·minutes/week of MVPA, and maximal risk reduction was seen at approximately 3000-4500 METs·minutes/week of MVPA. No significant dose-response association of sitting time with mortality was observed. CONCLUSIONS: Higher MVPA levels reduced all-cause mortality risk, in a significant inverse non-linear dose-response manner. Sitting time was not significantly associated with all-cause mortality. It is important to disseminate the significance of even a slight increase in the MVPA.

DOI： 10.2188/jea.JE20220246

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PURPOSE: Evidence regarding the dose-response curve shapes of physical activity (PA) and sedentary time (ST) in older adults with functional disability (FD) is extremely limited. Moreover, these associations may differ depending on with/without frailty. We examined the dose-response associations between moderate-to-vigorous PA (MVPA) and ST with FD among older adults with/without frailty. METHODS: We included 7,480 initially nondisabled adults (3,795 men and 3,685 women) aged 65-84 years in Ota City, Tokyo, Japan. MVPA and ST were evaluated using the International Physical Activity Questionnaire-Short Form. FD was prospectively identified using a nationally unified database of the long-term care insurance system. Frailty was determined using Check-List 15, validated against Fried's frailty criteria. Multivariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of MVPA and ST for FD were calculated, and dose-response curves were examined using restricted cubic splines. RESULTS: During 3.6 years of follow-up, 1,001 (13.4%) participants had FD. Among all participants, compared with no MVPA, the HRs for FD reduced linearly up to approximately 2000 metabolic equivalents (METs)■min/week of MVPA, and the lowest HR (HR: 0.61, 95% CI: 0.51-0.74) was reached at around 3,000-4,000 METs■min/week. Although the shape of this association was consistent regardless of with/without frailty, the magnitude of the association tended to be stronger in frail older adults than in non-frail older adults. Compared with those for the median (300 min/day) of ST, the HRs for FD increased linearly as ST reached approximately 600 min/day or more, independent of MVPA, with a maximum HR of 1.31 (95% CI: 1.01-1.71) for 1,080 min/day among all participants. This association was more pronounced among non-frail older adults but not statistically significant among frail older adults. CONCLUSION: Higher MVPA levels consistently reduced the incidence of FD regardless of frailty in a significant inverse nonlinear dose-response manner. A significant positive nonlinear dose-response association between ST and FD risk was identified among non-frail older adults but not among frail older adults. Increasing MVPA and reducing prolonged ST are important for preventing FD among non-frail older adults. However, reducing ST alone may be insufficient; increasing MVPA, even if by only small increments, is highly recommended for frail older adults.

DOI： 10.3389/fpubh.2024.1357618

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Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1007/s12603-023-2029-3

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Other Link： https://link.springer.com/article/10.1007/s12603-023-2029-3/fulltext.html

Language：English   Publishing type：Research paper (scientific journal)  

AIM: To examine the effects of employment engagement, classified by frailty and working status, on the incidence of disability in urban community-dwelling older adults. METHODS: We used data from 6386 initially nondisabled residents aged 65-84 years from Ota City, Tokyo, Japan, in 2016. The observation duration was 3.6 years. Self-administered questionnaires applied the Cox proportional hazard model by assessing the existence of frailty through Check-List 15 (with a score ≥4 indicating the state of frailty), controlling for age, sex, living situation, education level, equivalent income, chronic conditions, body mass index, instrumental activities of daily living, self-rated health, drinking and smoking status, and social activities. We evaluated the predictive value of working status (full-time, part-time, temporary, or nonworker) at baseline for cause-specific disability (dementia-type vs. non-dementia-type) incidence, identified using the long-term care insurance system's nationally unified database. RESULTS: Of the 6386 participants, 806 (63/1134 full-time workers; 58/1001 part-time workers; 61/547 temporary workers; 624/3704 nonworkers) presented with disabilities during the 3.6-year-long duration. Adjustments for conventional covariates showed that nonfrail full-time and part-time workers, as well as frail full-time workers, had significantly lower risks of all-cause disability incidence. Furthermore, nonfrail and frail full-time workers had significantly lower risks of dementia-type and nondementia-type disabilities, respectively. CONCLUSIONS: The incidence of disability in older adults was influenced by working and frailty status. Engaging in full-time work thus prevents disabilities in older adults, regardless of their frailty status. Meanwhile, nonfrail older adults are able to avoid disabilities even when engaging in part-time work. Geriatr Gerontol Int 2023; 23: 855-863.

DOI： 10.1111/ggi.14686

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND AND OBJECTIVES: Neighborhood places that facilitate older residents to meet and interact (third places) receive an increasing research interest as studies have consistently shown the benefits of social engagement for older adults' health. This scoping review synthesized the findings of studies examining the role of third places in older adults' social engagement. RESEARCH DESIGN AND METHODS: Searching 5 databases (CINAHL, Medline, PsycInfo, Scopus, and Web of Science) in October 2021, this study identified quantitative and qualitative studies that examined the relationships between third places and social engagement (interaction and network) among older adults. RESULTS: A total of 32 studies (12 quantitative and 20 qualitative studies) met the eligibility criteria. These studies examined 4 types of third place, namely, community facilities, local businesses, open/green spaces, and transition spaces. More than two thirds of the studies reviewed found that access to community facilities, local businesses, and open/green spaces were related to older adults' social interaction. For the relationships between third places and social networks, the importance of accessible local businesses and the quality of open/green spaces was supported by fewer studies. DISCUSSION AND IMPLICATIONS: The findings of quantitative and qualitative studies suggest that local places that are convenient to visit and comfortable to stay in for older adults are likely to enhance their social interaction and network. However, more specific evidence is needed to inform the planning and design of third places. The review discusses future research topics that address the gaps identified in the current literature.

DOI： 10.1093/geront/gnac180

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INTRODUCTION: We examined the relationship between previous fluctuations in Mini-Mental State Examination (MMSE) scores, future changes in MMSE scores, and attrition from follow-up surveys, which helps a more comprehensive interpretation of repeatedly collected MMSE scores. METHODS: This 4-year longitudinal study included 2,073 community-dwelling older adults aged ≥65 years in Japan. The MMSE was administered at baseline (T0), 2-yeas' (T1), and 4-years' (T2) follow-up. We performed multinomial logistic regression analysis with the dependent variable, indicating the change in MMSE score from T1 to T2 (categorized as increase, no change [reference category], and decrease) and attrition at T2. The independent variables included the change in MMSE scores from T0 to T1 and MMSE scores at T0 and T1. RESULTS: The mean MMSE score was 29 across the three time points. A one-point decrease in MMSE score from T0 to T1 was associated with 79% (95% CI:1.62, 1.97) higher odds of an increase in MMSE score from T1 to T2 and 28% (1.17, 1.40) higher odds of attrition at T2. A one-point decrement in the MMSE score at T0 and T1 was also associated with an increase in the MMSE score from T1 to T2 and attrition at T2. CONCLUSION: Focusing on cognitive fluctuation for 2 years, rather than cognitive function at a point in time, would have no remarkable advantage when focusing on future cognitive function and attrition. Our results emphasize the need for further studies to identify factors that distinguish between those who continue to attend follow-up surveys and show improvements in cognitive test scores and those who drop out.

DOI： 10.1159/000531764

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Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: The consumption of various foods is internationally recommended in healthy diet although the association between dietary variety and incident dementia is unknown. We aimed to examine the association between dietary variety and the incidence of disabling dementia in older Japanese adults. DESIGN: We conducted a prospective cohort study. Dietary variety was assessed based on the Dietary Variety Score (DVS). DVS was assessed by counting the number of ten food components (meat, fish/shellfish, eggs, milk, soyabean products, green/yellow vegetables, potatoes, fruit, seaweed and fats/oils) that were consumed almost daily using a FFQ. Participants were categorised into low (0-2 points), middle (3-4 points) and high (5-10 points) groups based on the DVS. Data on newly diagnosed disabling dementia were retrieved from the public long-term care insurance database. Cox proportional hazards regression was used to estimate hazard ratios (HR) with 95 % CI. SETTING: Yabu cohort study, Japan. PARTICIPANTS: A total of 4972 community-dwelling adults aged 65 years or older. RESULTS: During the median follow-up of 6·8 years, 884 participants were newly diagnosed with disabling dementia. After adjusting for confounders, the multivariable-adjusted HR for incident disabling dementia was 0·82 (95 % CI, 0·69, 0·97) for participants in the highest DVS category compared with those in the lowest DVS category (Pfor trend = 0·019). CONCLUSIONS: A higher dietary variety is associated with a reduced risk of disabling dementia in older Japanese adults. These results have potential implications for the development of effective public nutritional approaches to prevent dementia in older adults.

DOI： 10.1017/S1368980023000824

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Authorship：Lead author   Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.jtrangeo.2023.103598

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Language：English   Publishing type：Research paper (scientific journal)  

Preventing frailty is crucial in aging societies. We examined the effectiveness of a community-based frailty-prevention program for delaying the onset of functional disability among community-dwelling older adults. From 2014 to 2019, 48 community-based frailty prevention classes (FPC, 60 min/session, once a week), comprising resistance exercise and nutritional or psychosocial programs, were established in Yabu City, Japan. We conducted a baseline survey in 2012 and followed up with participants for up to 6.8 years (4.8 years from establishing the first FPC). We analyzed data from 3350 older people. The primary and secondary outcomes were the onset of functional disability and cause-specific functional disability (including dementia and cardiovascular and orthopedic diseases), respectively. In addition to crude Cox proportional hazard regression, inverse probability of treatment weighting (IPTW) and propensity score matching (PSM; 918 nonparticipants and 459 participants) were used to adjust for confounders. Participants were more likely to be female and have a healthy lifestyle than nonparticipants. During the follow-up, 690 individuals developed a functional disability. The hazard ratio of incident functional disability in the participants was significantly lower than that in nonparticipants in the IPTW (hazard ratio 0.53, 95% confidential interval 0.38-0.75) and PSM (0.52, 0.37-0.71) analyses. In age-stratified analysis, significant associations were observed only in the ≥75-year-old subgroup. In a cause-specific analysis, participation significantly and consistently reduced incident functional disability caused by dementia (IPTW 0.47, 0.25-0.86; PSM 0.45, 0.25-0.83). Community-based FPC may be effective for preventing functional disability, especially caused by dementia, in this population.

DOI： 10.1016/j.ypmed.2023.107449

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Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.trd.2023.103643

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Language：English   Publishing type：Research paper (scientific journal)  

The association between the urinary sodium (Na)/potassium (K) ratio and hypertension is well recognized. We investigated whether the urinary Na/K ratio might be associated with hypertension in community-dwelling older adults and whether the association was influenced by habitual dietary patterns. We enrolled a total of 684 older adults (mean age, 76.8 years) and conducted health examinations at Kusatsu, Japan, in 2021. The urinary Na/K ratio was found to be independently associated with systolic blood pressure (SBP) (p < 0.0001), years of education (p = 0.0027), number of cohabitants (p = 0.0175), estimated glomerular filtrate rate (eGFR) (p = 0.0244), and Geriatric Depression Scale short-version (GDS15) score (p = 0.0366). In addition, an unsupervised hierarchical clustering analysis revealed a spectrum of habitual dietary patterns for higher and lower values of the urinary Na/K ratio. The decision tree indicated that the urinary Na/K ratio was associated with the history of milk consumption. A positive history of daily milk consumption predicted a mean urinary Na/K ratio of 2.8, and a negative history of daily milk consumption predicted a mean urinary Na/K ratio of 3.3. Furthermore, the frequency of fruit and vegetable consumption also predicted the urinary Na/K ratio. The relationship between the urinary Na/K ratio and hypertension was influenced by the frequency of consumption of milk, fruits, and vegetables in the subjects. This finding might be due to the influence of education and/or depression. The results suggested the importance of nutritional education in the development of hypertension.

DOI： 10.1038/s41440-022-01135-4

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Language：English   Publishing type：Research paper (scientific journal)  

Healthy behaviours reduce the risk of incident disability; however, their components require further consideration. Specifically, little evidence exists on healthy behaviours that comprise modifiable factors, including social aspects, and their effects on those who do not engage in them. This study aimed to examine the association between engaging in healthy behaviours with modifiable factors and incident disability among community-dwelling older adults; as well as identify factors associated with nonengagement in healthy behaviours. We analysed data obtained from 1357 older adults aged 65 years and more without disabilities at baseline. The outcome was incident disability, which was defined based on the long-term care insurance certification in Japan. This study included regular exercise (≥1 day/week), favourable eating habits (≥4 dietary variety score), and social participation (engaging in two or more social activities) as components of healthy behaviours. We used the Cox proportional hazards model to calculate hazard ratios (HR) for incident disabilities. The proportion of those who satisfied all healthy behaviours was 21 %. During the follow-up period (median: 6.3 years), 282 incident disabilities were confirmed. Compared to those who engaged in one healthy behaviour, those who satisfied all healthy behaviours showed a 31 % (95 % confidence interval: 0.48, 0.98) lower HR of incident disability after adjusting for covariates. Current smoking and depressive mood were associated with non-engagement in healthy behaviours. This study found that having physically and socially active lifestyles and favourable eating habits are effective in reducing the risk of incident disability. Meanwhile, several older adults lack the components of a healthy lifestyle. Approaches that focus on multiple healthy behaviours are necessary to enhance the benefits of healthy lifestyles.

DOI： 10.1016/j.exger.2023.112094

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Language：English   Publishing type：Research paper (scientific journal)  

AIM: Working in old age not only solves the labor shortage in Japan, but also benefits the health of the older workers; however, work-related accidents are a major concern. Functional impairment is an important factor in such accidents. The first aim was to examine the association between frailty status and work-related accidents, and the second aim was to identify those who utilize the opportunity to learn about safe work. METHODS: The participants were 7265 members of the Silver Human Resource Center in Tokyo, engaged in non-regular and indeterminate paid work. The frailty status (robust, pre-frail and frail) was assessed using the frailty screening index. We obtained data on self-reported work-related accidents that occurred in the past year, and the experience of participation in workshops and reading brochures for safe work. Modified Poisson regression analysis was carried out to calculate the prevalence ratio. RESULTS: The prevalence of robust, pre-frailty and frailty were 26.3%, 63.3% and 10.4%, respectively. The percentage of participants who reported work-related accidents was 9.4%. Relative to robust participants, pre-frail and frail participants showed 1.57-fold (95% confidence interval [CI] 1.28-1.93) and 2.31-fold (95% CI 1.79-2.98) higher prevalence ratios of work-related accidents, respectively. The prevalence ratio in pre-frail and frail participants were 1.08 (95% CI 1.04-1.11) and 1.14 (95% CI 1.09-1.20), respectively, for non-participation in workshops, and 1.17 (95% CI 1.06-1.29) and 1.39 (95% CI 1.20-1.61), respectively, for not reading brochures. CONCLUSIONS: These findings suggest the importance of support for older workers with functional impairment, as well as those without to continue to work safely. Geriatr Gerontol Int 2023; 23: 234-238.

DOI： 10.1111/ggi.14557

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Publishing type：Research paper (scientific journal)   Publisher：Japan Prosthodontic Society  

DOI： 10.2186/jpr.jpr_d_21_00272

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Language：English   Publishing type：Research paper (scientific journal)  

INTRODUCTION: This study examined whether the association between sarcopenia severity and cognitive function differed according to sex and age in community-dwelling older adults in Japan. METHODS: This is a cross-sectional study of older adults (age ≥ 65 years) consisting of five regional cohorts integrated as the Integrated Research Initiative for Living Well with Dementia (IRIDE) Cohort Study. Sarcopenia severity was determined based on the Asian Working Group for Sarcopenia 2019, which assessed grip strength, walking speed, and skeletal muscle mass index. Poor cognitive function was defined as a Mini-Mental State Examination score of ≤ 23. Odds ratios (ORs) and 95% confidence intervals (CIs) for poor cognitive function were calculated by sex and age group (65-74 and ≥75 years) using binomial logistic regression models, which were adjusted for age, educational attainment, history of non-communicable diseases, smoking and drinking habits, living alone, frequency of going outdoors, exercise habits, and depressive symptom. RESULTS: Of the 8,180 participants, 6,426 (1,157 men aged 65-74 and 1,063 men aged 75 or older; 2,281 women aged 65-74 and 1,925 women aged 75 or older) were analyzed. The prevalence ratio of sarcopenia and severe sarcopenia were 309 (13.9%) and 92 (4.1%) among men and 559 (13.3%) and 166 (3.7%) among women, respectively. A total of 127 (5.8%) men and 161 (3.9%) women had a poor cognitive function. Setting non-sarcopenia as a reference, the adjusted ORs (95% CI) of poor cognitive function were 2.20 (1.54, 3.15) for sarcopenia and 3.56 (2.20, 5.71) for severe sarcopenia. A similar trend was observed in analyses stratified by sex and age, with linear associations (P for trend <0.05) in both categories. Furthermore, there was a significant interaction (P < 0.05) between sex and sarcopenia severity, indicating a stronger linear association of sarcopenia severity with poor cognitive function in women compared with men. DISCUSSION AND CONCLUSION: Sarcopenia severity was linearly associated with poor cognitive function in adults aged ≥ 65 years, with a stronger association in women compared with men.

DOI： 10.3389/fpubh.2023.1148404

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Language：Japanese   Publisher：Japanese Society of Test and Measurement in Health and Physical Education  

This study determined how many days of data were needed to predict weekly travel behavior in older adults. Seven days of travel behavior data were collected from 142 older adults aged ≥ 65 years, who participated in health promotion classes conducted in Shizuoka, Japan. Using these data, we calculated the time spent walking, cycling, and using cars and public transportation each day. We then assessed intraclass correlations among the combinations of days with regard to travel behavior and conducted multiple regression analysis to examine the extent to which these data explained weekly travel behavior based on the estimated adjusted coefficients of determination. To ensure values ≥ 0.80 of the intra-class correlations, information on car use and other travel behaviors (walking, cycling, and public transportation use) was needed for at least four and three days, respectively. The range of adjusted R2 was 0.77–0.89 for walking, 0.76–0.94 for cycling, and 0.74–0.93 for public transportation use based on travel data for three days, and 0.76–0.93 for car use based on data for four days. Our results suggest that the specific single-day or twoday data collection that Japanese travel surveys commonly administered may be not sufficient to predict the weekly travel behavior of older adults, whereas information about travel behaviors over three-four days would greatly enhance the predictability of such behavior with an acceptable level of accuracy.

DOI： 10.14859/jjtehpe.hpm202304

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This study examined the differences in medical and long-term care costs over 18 months between pet owners and non-owners among community-dwelling older Japanese. Pet ownership data were collected from 460 community-dwelling adults age 65 years and older. These data were matched with data from the National Health Insurance, health insurance for older people, and Long-Term Care Insurance beneficiaries for 17 months back from the survey on pet ownership. Pet-ownership group-specific trajectories in monthly medical and long-term care costs were modeled by a generalized estimating equation. Among pet owners (n = 96, 20.9%) and non-pet owners (n = 364, 79.1%) there were no significant differences in baseline demographic or health characteristics including chronic disease and self-reported long-term care level. At baseline, pet owners had estimated monthly medical costs of \48,054 (SE = 0.11; $418), compared to \42,260 (SE = 0.06; $367) for non-pet owners. The monthly medical costs did not differ significantly between the two groups during the 18-month follow-up period. At baseline, estimated monthly long-term care costs of pet owners and non-pet owners were \676 (SE = 0.75; $6) and \1,420 (SE = 0.52; $12), respectively. During the follow-up period, the non-pet owner to owner ratio of monthly long-term care costs was 1.2 at minimum and 2.3 at maximum. This study showed that monthly long-term care costs for pet owners were approximately half those of non-pet owners. Pet owners might use long-term care services less frequently, or use lighter care services.

DOI： 10.1371/journal.pone.0277049

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Publishing type：Research paper (scientific journal)   Publisher：Wiley  

DOI： 10.1002/jcsm.13145

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Other Link： https://onlinelibrary.wiley.com/doi/full-xml/10.1002/jcsm.13145

Authorship：Lead author   Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.cities.2022.103964

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Publishing type：Research paper (scientific journal)   Publisher：Hogrefe Publishing Group  

Abstract. Time perspectives may change as people age and become more aware of their limited time remaining in life. A research question is whether awareness of one’s limited time remaining associates with pet ownership among older adults. Although owning pets in old age involves both benefits and risks, the association between pet ownership and subjective remaining time in life remains understudied. The present study examines the associations between pet ownership and the subjective perception of time remaining in life among older adults. We assessed the experience of pet ownership (dog or cat) and age-related future time perspectives of 329 community-dwelling older adults in Japan. By adopting three constructs of the Future Time Perspective scale, we found that current dog ownership was associated with more limited future opportunities but not with limited time left or future constraints. Older dog owners may focus on the present rather than new future opportunities, yet they may see the future of their dogs that require care. Yet no such association was observed among current cat owners. The present findings extend the previous research of age-related future time perspectives by suggesting that pet ownership in late adulthood may be another contributing factor that needs to be better understood.

DOI： 10.1024/1662-9647/a000298

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Language：Japanese   Publisher：(一社)日本応用老年学会  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2022&ichushi_jid=J05647&link_issn=&doc_id=20220831150003&doc_link_id=%2Feh0ohrou%2F2022%2F001601%2F005%2F0030-0039%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Feh0ohrou%2F2022%2F001601%2F005%2F0030-0039%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Authorship：Lead author   Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.archger.2022.104708

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Publishing type：Research paper (scientific journal)   Publisher：SAGE Publications  

The role of personality in determining the association between social participation and mental health was examined by a cross-sectional study. We analyzed data from 4981 older adults aged 65–84 years who were recruited via a mail survey in one region of Japan. We defined poor mental health using a score ≤12 points on the World Health Organization-Five Well-Being Index-Japanese. Personality traits were measured by 10 Item Personality Inventory-Japanese. In women, higher openness positively moderated the association between private group participation (volunteering, sports, hobby, and learning) and mental health, while higher neuroticism negatively moderated it. This study contributes to knowledge about mental health, personality, and participation. The findings provide provisional evidence about recommending private group participation for women with high openness but not those with high neuroticism.

DOI： 10.1177/13591053221105350

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Other Link： http://journals.sagepub.com/doi/full-xml/10.1177/13591053221105350

Authorship：Lead author   Publishing type：Research paper (scientific journal)   Publisher：Wiley  

DOI： 10.1111/ggi.14360

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Other Link： https://onlinelibrary.wiley.com/doi/full-xml/10.1111/ggi.14360

Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.jth.2021.101318

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Publishing type：Research paper (scientific journal)   Publisher：Public Library of Science (PLoS)  

Objectives

This study examined the association between dog and cat ownership, the onset of disability and all-cause mortality in an older population. Dog and cat owners take more regular exercise and have closer social relationships than non-owners. We further assess the beneficial effects of these moderating variables on the onset of disability and mortality.

Methods

Dog and cat ownership data were collected from 11233 community-dwelling adults age 65 years and older. These data were matched with data about the onset of disability held by the Japanese long-term care insurance system. Local registry data were used to ascertain all-cause mortality.

Results

During the approximately 3.5 year follow-up period, 17.1% of the sample suffered onset of disability, and 5.2% died. Logistic regression analysis indicated that, compared with a reference group of those who had never owned a dog (odds ratio fixed at 1.0), older adults who were currently dog owners had a significantly lower odds ratio of onset of disability (OR = 0.54 95% CI: 0.37–0.79). Our results further show that regular exercise interacts with dog ownership to reduce the risk of disability. The association of dog and/or cat ownership with all-cause mortality was not statistically significant.

Conclusions

Dog ownership appears to protect against incident disability among older Japanese adults. Additional benefits are gained from ownership combined with regular exercise. Daily dog care may have an important role to play in health promotion and successful aging.

DOI： 10.1371/journal.pone.0263791

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DOI： 10.11236/jph.21-022

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Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.maturitas.2021.10.003

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Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.ypmed.2021.106768

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Publishing type：Research paper (scientific journal)   Publisher：MDPI AG  

This study aimed to examine the factors related to participation in volunteer-managed preventive care exercises by focusing on the distance to exercise facilities and interpersonal social networks. A postal mail survey was conducted in 2013 in Kasama City in a rural region of Japan. Older adults (aged ≥ 65 years) who were living independently (n = 16,870) were targeted. Potential participants who were aware of silver-rehabili taisou exercise (SRTE) and/or square-stepping exercise (SSE) were included in the analysis (n = 4005). A multiple logistic regression analysis revealed that social and environmental factors were associated with participation in SRTE and SSE. After adjusting for confounding variables, exercise participation was negatively associated with an extensive distance from an exercise facility in both sexes for SRTE and SSE. Among women, participation in SRTE was negatively associated with weak interpersonal social networks (odds ratio (OR) = 0.57), and participation in SRTE and SSE was negatively associated with being a car passenger (SRTE, OR = 0.76; SSE, OR = 0.60). However, there were no significant interactions between sex and social and environmental factors. Our findings suggest the importance of considering location and transportation to promote participation in preventive care exercise.

DOI： 10.3390/ijerph182211944

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Publishing type：Research paper (scientific journal)   Publisher：Wiley  

DOI： 10.1111/ggi.14253

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Other Link： https://onlinelibrary.wiley.com/doi/full-xml/10.1111/ggi.14253

Publishing type：Research paper (scientific journal)   Publisher：MDPI AG  

Our study examined the associations between neighborhood walkability, frailty, and the incidence of long-term care insurance (LTCI) service needs using a prospective cohort survey in a suburban town in Japan. The final sample for analyses comprised 2867 community-dwelling older adults (mean age: 73.0 years). Neighborhood walkability was measured using the Walk Score®. A total of 387 participants (13.5%) exhibited frailty. The odds of frailty, adjusted for the covariates (sex, age, educational status, marital status, residential status, employment status, subjective economic status) among participants who lived in somewhat walkable/very walkable areas, was 0.750 (95% Confidence Interval, CI: 0.597–0.943) versus those who lived in car-dependent areas. During the 23-month follow-up, 102 participants needed LTCI services (19.0 per 1000 person-years), 41 of whom (21.0 per 1000 person-years) lived in car-dependent areas, and 61 of whom (17.9 per 1000 person-years) lived in somewhat walkable/very walkable areas. As compared with participants who lived in car-dependent areas, the incidence of LTCI service needs was not significantly lower than that of those who lived in somewhat walkable/very walkable areas. Walk Score® can provide the critical information for the strategies to improve walkability and prevent older adults’ frailty in less walkable areas, contributing to achieving the United Nation’s Sustainable Development Goals (SDGs).

DOI： 10.3390/su13105632

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Publishing type：Research paper (scientific journal)   Publisher：MDPI AG  

The psychological health effects of pet ownership have been widely studied, but only a few studies investigated its impact among socially isolated older adults. The present study aims to investigate the psychological health of older adults with or without the experience of pet (i.e., dog or cat) ownership who are socially isolated or not socially isolated. This study used cross-sectional data from 9856 community-dwelling older adults in a metropolitan area of Japan. Social and non-social isolation and type of pet ownership (i.e., dog or cat) were stratified to examine the psychological health. Logistic regression models indicated that, after adjusting for demographic and potential confounders, socially isolated older adults who never owned a dog were 1.22 times more likely to report lower psychological health in comparison to socially isolated current or past dog owners. No such difference was observed among cat owners. The results suggest that the experience of dog ownership may be effective to improve the psychological health among socially isolated older adult.

DOI： 10.3390/ani11030595

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Publishing type：Research paper (scientific journal)   Publisher：Wiley  

DOI： 10.1002/jcsm.12651

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Other Link： https://onlinelibrary.wiley.com/doi/full-xml/10.1002/jcsm.12651

Publishing type：Research paper (scientific journal)   Publisher：Japan Epidemiological Association  

DOI： 10.2188/jea.je20210392

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Publishing type：Research paper (scientific journal)   Publisher：Wiley  

DOI： 10.1111/ggi.14049

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Other Link： https://onlinelibrary.wiley.com/doi/full-xml/10.1111/ggi.14049

Publishing type：Research paper (scientific journal)   Publisher：MDPI AG  

This study examined differences in older adults’ travel behaviours by frailty status in metropolitan, suburban, and rural areas of Japan. Data were collected from 9104 older adults (73.5 ± 5.7 years; 51% women; 19% frail) living in metropolitan (n = 5032), suburban (n = 2853), and rural areas (n = 1219) of Japan. Participants reported if they walked, cycled, drove a car, rode a car as a passenger, and used public transportation (PT) once per week or more. A standardised questionnaire was used to assess frailty status. We conducted logistic regression analysis to calculate the odds ratios of using each travel mode by frailty status stratified by locality. Relative to non-frail participants, frail participants were less likely to walk and drive a car in all three areas. Frail participants had significantly higher odds of being a car passenger in the suburban (OR = 1.73 (95% CI: 1.32, 2.25)) and rural areas (OR = 1.61 (1.10, 2.35)) but not in the metropolitan area (OR = 1.08 (0.87, 1.33)). This study found that frail older adults living in suburban and rural areas tended to rely more on cars driven by someone else, suggesting that transport disadvantage is more pronounced in suburban and rural areas than in metropolitan areas.

DOI： 10.3390/ijerph17176367

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Language：English   Publishing type：Research paper (scientific journal)  

Frailty is a dynamic condition that can worsen or improve. Although previous studies have identified demographic and intrinsic factors associated with transitions in frailty status, less evidence is available regarding associations with daily activities. This longitudinal study examined associations of behavioral factors with incident frailty, adverse events (e.g. residence in a nursing home, hospitalization, and death), and frailty improvement among older adults. The analysis included data from 3,769 independent older adults aged 65 years or more (mean age, 76.3 ± 7.2years; proportion of frail participants, 30.1%) from the Yabu cohort study (baseline, 2012; follow-up, 2017). The Kaigo-Yobo Checklist, a standardized questionnaire, was used to assess frailty status (non-frail or frail) and seven behavioral factors: farming, shopping, exercise, eating habit, intellectual activity, social participation, and smoking. At the 5-year follow-up survey, the proportions of participants transitioning from non-frail to frail, from non-frail to incident adverse events, from frail to non-frail, and from frail to incident adverse events were 16.8%, 13.9%, 15.2%, and 50.1%, respectively. In the analysis of non-frail participants, farming, exercise, intellectual activity, and social participation were associated with lower odds of becoming frail and experiencing adverse events. In the analysis for frail participants, farming, intellectual activity, and social participation were significantly associated with improvement in frailty status, and farming, shopping, and social participation were associated with lower odds of incident adverse events. These findings suggest that farming, healthy daily activities, and social participation help improve and prevent frailty/adverse events.

DOI： 10.1016/j.maturitas.2020.04.007

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Language：English  

The aim of this cross-sectional study was to investigate the influence of replacing sedentary time with time engaged in one of two levels of physical activity on sleep quality using an isotemporal substitution model. The participants were 70 community-dwelling older Japanese adults (approximately 70% female). Physical activity types were measured using a triaxial accelerometer and categorized based on intensity as sedentary, light-intensity, and vigorous-intensity. The Pittsburgh Sleep Quality Index assessed subjective sleep quality. Objective sleep parameters were assessed using an actigraph. A series of multi-linear regression models analyzed the statistical relationships. Our findings showed that replacing 30 min of sedentary activity per day with an equal period of light-intensity physical activity significantly influenced sleep quality parameters. However, there was no significant difference in sleep quality when light-intensity activity was replaced with vigorous-intensity activity. Engaging in one activity type means less available time for other types of activity; habitual replacement of sedentary activity with light-intensity physical activity might have long-term benefits on the sleep quality of older people.

DOI： 10.1111/nhs.12647

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OBJECTIVES: We examined the dose-response relationships of body composition indices with mortality and identified the best predictor. DESIGN AND SETTING: Kusatsu Longitudinal Study and Hatoyama Cohort Study, Japan. PARTICIPANTS: In total, 1977 community-dwelling Japanese adults age ≥65 years (966 men and 1011 women) participated. MEASUREMENTS: Body mass index (BMI), fat mass index (FMI), fat-free mass index (FFMI), and skeletal muscle mass index (SMI) were determined by segmental multifrequency bioelectrical impedance analysis. The main outcome was all-cause mortality. We determined multivariate-adjusted hazard ratios for mortality relative to sex-specific medians of each body composition index and examined the association shapes. RESULTS: During the median follow-up of 5.3 years, 128 (13.3%) men and 75 (7.4%) women died. Compared with median BMIs (23.3 kg/m2 in men and 22.8 kg/m2 in women), a BMI >23.3 and ≤26.1 kg/m2 was associated with significantly lower mortality risk in men, and a BMI <22.8 kg/m2 was associated with significantly higher mortality risk in women. The inverse dose-response relationship with mortality was clearer for FFMI [hazard ratios (95% confidence interval) of 10th and 90th percentiles: 1.58 (1.23-2.03) and 0.58 (0.44-0.79), respectively, in men and 1.56 (1.12-2.16) and 0.68 (0.51-0.91), respectively, in women] and SMI [1.57 (1.22-2.01) and 0.60 (0.45-0.80), respectively, in men and 1.45 (1.05-2.01) and 0.77 (0.61-0.96), respectively, in women] than for BMI [1.30 (0.92-1.83) and 0.65 (0.41-1.03), respectively, in men and 1.87 (1.18-2.95) and 0.88 (0.54-1.42), respectively, in women]. FMI was not associated with mortality in either sex. CONCLUSIONS AND IMPLICATIONS: FFMI and SMI were more definitive predictors of mortality than were BMI and FMI. The lower mortality risk with higher FFMI, regardless of FMI, may explain the age-related weakening of the association between higher BMI and mortality (the "obesity paradox"). FFMI and SMI evaluation should be introduced to clinical assessments of older adults because mortality risk might be reduced by maintaining muscle mass.

DOI： 10.1016/j.jamda.2019.11.018

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Language：Japanese  

Objectives This study aimed to determine risk factors for frailty and lifestyle-related diseases impacting the incidence of loss of independence among Japanese community-dwelling older adults, and to measure the magnitude of these associations.Methods We conducted an 8.1-year prospective study involving 1,214 residents of the town of Kusatsu, aged 65 years and over, who were initially free of disability and underwent the comprehensive geriatric assessment between 2002 and 2011. Loss of independence was defined as the incidence of disability or having died before the occurrence of disability was certified by the Long-Term Care Insurance program in Japan. Risk factors for lifestyle-related diseases and health status comprised hypertension, diabetes mellitus, overweight, chronic kidney disease, current smoking, past history of stroke, heart disease and cancer, frailty, underweight, anemia, hypoalbuminemia, and cognitive decline. Frailty was defined as the presence of three or more of the following criteria: Weight loss, weakness, exhaustion, slowness, and low levels of physical activity. Prefrailty was defined as the presence of one or two of these same criteria. Cox proportional-hazard regression model was used to estimate hazard ratios (HR) and the population attributable fraction (PAF) of loss of independence.Results During the follow-up, 475 cases, including 372 disabilities and 103 deaths, were identified as having experienced loss of independence. The multivariable HRs for the loss of independence were 1.3 to 2.2-fold higher for the presence of frailty, past history of stroke, cognitive decline, prefrailty, and smoking. The PAF of loss of independence was the greatest for prefrailty (19%), followed by frailty (12%). The PAF was relatively large for prefrailty (19%) and smoking (11%) in men, and frailty (18%), prefrailty (18%), and chronic kidney disease (11%) in women. Stratified by age category, participants aged 65-74 years having frailty and several lifestyle-related diseases showed significantly higher HRs for loss of independence and greater PAFs for prefrailty (18%), frailty (13%), and smoking (11%).Conclusions Loss of independence among Japanese community-dwelling older adults who underwent screening examinations was largely attributed to frailty and prefrailty. Our findings suggest that the screening and the intervention for frailty and lifestyle-related diseases in the early stages of old age might be beneficial in prolonging healthy life expectancy of Japanese community-dwelling older adults.

DOI： 10.11236/jph.67.2_134

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Language：English  

AIM: Cognitive decline increases mortality risk through dementia-related pathways and might be associated with increased healthcare costs. Using up to 12 years of repeated measures data, we identified trajectories in cognitive function among community-dwelling older Japanese adults. We then examined whether these trajectories were associated with all-cause and cause-specific mortality, and differences in healthcare costs. METHODS: A total of 1736 adults aged ≥65 years who were free of disabling dementia completed annual assessments during 2002-2014. Cognitive function was assessed with the Mini-Mental State Examination. The average number of follow-up assessments was 3.9, and the total number of observations was 6824 during the follow-up period. RESULTS: We identified five trajectory patterns in cognitive function (high, second, third, fourth, and low) during the 12-year follow-up period. The low (2.0%) and fourth (2.2%) trajectory groups had higher hazard ratios for cardiovascular disease mortality, and hazard ratios for other cause mortality were significantly higher for the third (16.8%) and second (38.8%) trajectory groups than for the high trajectory group (40.3%). Until 5 years of follow up, participants in the two lower-trajectory groups had higher mean combined monthly medical and long-term care costs. After 8 years of follow up, mean costs were highest for the third trajectory. CONCLUSIONS: The risk of death from cardiovascular disease was higher in the two lower-trajectory groups in cognitive function, and they showed higher healthcare costs during the first 5 years of follow up. After 8 years of follow up, the third trajectory had the highest healthcare costs, perhaps because of hospitalizations attributable to gradual cognitive decline. Geriatr Gerontol Int 2019; 19: 1236-1242.

DOI： 10.1111/ggi.13802

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This study aimed to examine area differences in the prevalence of and factors associated with frailty. This cross-sectional study included metropolitan (eastern and western areas), suburban (districts A and B), and rural areas of Japan (n = 9182, woman 50.9%). Frailty was defined by using a standardized questionnaire comprising three subcategories (fall, nutritional status, and social activities). The prevalence of frailty in the five areas was 14.2% to 30.6% for men and 11.5% to 21.4% for women. The areas with a high frailty prevalence had a significantly lower nutritional status or social activity, or both. Compared to the western metropolitan area, among men, the multivariable-adjusted prevalence ratio (APR) of frailty was significantly higher in the eastern metropolitan area and lower in suburban district A, and among women, the eastern metropolitan and rural areas had significantly higher APRs. Area-stratified multiple Poisson regression analysis showed that age, bone and joint disease, and a subjective economic status were associated with frailty in most areas and that some factors were area-specific, i.e., living alone (for men living in metropolitan areas) and underweight (for women living in suburban areas). The frailty prevalence differed by area, even after multivariable adjustment. Area-specific characteristics and factors associated with frailty may result in area differences.

DOI： 10.3390/ijerph16203974

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OBJECTIVES: To determine whether physical activity mediates the association of gait speed with incident disability and mortality in older adults. STUDY DESIGN: Prospective cohort data from 782 community-dwelling Japanese older adults were analyzed. The median follow-up periods for incident disability and mortality were 4.4 and 4.5 years, respectively. MAIN OUTCOME MEASURES: Physical activity was assessed with the Japan Arteriosclerosis Longitudinal Study Physical Activity Questionnaire, gait speed was calculated from 5-m walking time, and incident disability was defined as long-term care insurance certification during follow-up. RESULTS: There were 247 cases of incident disability and 202 deaths during follow-up. After adjusting for potential confounders, faster gait speed was associated with decreased risk of incident disability (hazard ratio [HR] = 0.87, 95% confidence interval [CI] = 0.82-0.93), but physical activity level was not associated with incident disability (HR = 0.98, 95% CI = 0.95-1.01). Gait speed was associated with mortality risk in the model without physical activity (HR = 0.93, 95% CI = 0.88-1.00). When gait speed and physical activity were both included in the model, gait speed was not associated with mortality (HR = 0.95, 95% CI = 0.89-1.02) but physical activity was associated with mortality (HR = 0.95, 95% CI = 0.92-0.99). Physical activity was a mediating factor in the association between gait speed and mortality (Sobel test p = .025). CONCLUSIONS: Gait speed is directly associated with incident disability and is indirectly related to mortality through physical activity in older adults.

DOI： 10.1016/j.maturitas.2019.02.002

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Language：Japanese  

CiNii Research

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DOI： 10.1016/j.jth.2018.05.002

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DOI： 10.1016/j.jth.2018.01.010

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DOI： 10.1589/jpts.30.609

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DOI： 10.1589/jpts.29.1737

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Language：English  

[Purpose] The purpose of this study was to investigate which of the four chair-rising methods has low-load and the highest success rate, and whether the GRF parameters in that method are useful for measuring lower extremity function among physically frail Japanese older adults. [Subjects and Methods] Fifty-two individuals participated in this study. The participants voluntarily attempted four types of Sit-to-stand test (one variation without and three variations with the use of their arms). The following parameters were measured: peak reaction force (F/w), two force development rate parameters (RFD1.25/w, RFD8.75/w) and two time-related parameters (T1, T2). Three additional commonly employed clinical tests (One-leg balance with eyes open, Timed up and go and 5-meter walk test) were also conducted. [Results] "Hands on a chair" chair-rising method produced the highest success rate among the four methods. All parameters were highly reliable between testing occasions. T2 showed strongly significant associations with Timed up and go and 5-meter walk test in males. RFD8.75/w showed significant associations with Timed up and go and 5-meter walk test in females. [Conclusion] Ground reaction force parameters in the Sit-to-stand test are a reliable and useful method for assessment of lower extremity function in physically frail Japanese older adults.

DOI： 10.1589/jpts.29.1561

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DOI： 10.7600/jpfsm.6.49

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Language：Japanese   Publisher：Japanese Association of Exercise Epidemiology  

<p>This study protocol introduces the Kasama Study, a mid-sized longitudinal study of health, fitness, and physical activity in older people. The study is a challenging research project that discusses the future of the system for preventive nursing care and for supporting successful aging in Japan. In May 2008, we began the Kasama Study with an exercise program of preventive nursing care for community-dwelling older adults. As of March 2016, we have conducted six study projects: 1) the Kasama health checkup for longevity, 2) an all-round exercise class, 3) the volunteer and the circle, 4) an exercise class for men only, 5) an exercise class for improving cognitive and physical function, and 6) the Kasama Iki-iki checklist survey. We describe each project in detail in the present study protocol.</p>

DOI： 10.24804/ree.19.118

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Language：Japanese   Publisher：The Society of Physical Therapy Science  

[Purpose] The aim of this study was to investigate the usefulness of ground reaction force (GRF) parameters in a modified chair-rising method for the elderly using long-term care insurance services (LTCI) and its relationship with lower limb strength and activities of daily living (ADL). [Subjects and Methods] Thirty-two subjects (13 males and 19 females) using the LTCI were recruited. GRF parameters, lower limb strength, and functional independence measures&ndash;motor domain (FIM-M) and each of its component items were evaluated to examine the relationships among the items. [Results] Among males, the maximal rate of force development parameters showed significant relationships with lower limb strength, and the time parameters showed significant relationships with self-care and locomotion. Among females, peak reaction force showed a significant relationship with self-care. [Conclusion] The results suggest that measurement of GRF parameters is a simple and useful assessment method for lower limb function that can be used for elderly males using the LTCI.

DOI： 10.1589/rika.32.881

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Language：Japanese   Publisher：(一社)日本体力医学会  

DOI： 10.7600/jspfsm.65.491

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Language：Japanese   Publisher：日本認知症予防学会  

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DOI： 10.7600/jpfsm.5.257

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Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1519/JPT.0000000000000054

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Language：Japanese   Publisher：(一社)日本老年医学会  

DOI： 10.3143/geriatrics.52.162

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Language：Japanese   Publisher：(一社)日本老年医学会  

DOI： 10.3143/geriatrics.52.71

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Authorship：Lead author  

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Language：Japanese   Publisher：日本介護福祉・健康づくり学会  

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Language：Japanese   Publisher：(公財)明治安田厚生事業団  

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