Background The association between health-related quality of life (HRQoL) and oral health remains unclear, especially in physically active adults. This study aimed to examine the association between HRQoL and oral frailty in middle-aged and older Japanese master athletes. Methods In this cross-sectional study, 197 Japanese master athletes aged >= 35 years participated. HRQoL was assessed using the Short Form-8, from which physical (PCS) and mental (MCS) component summary scores were derived. Oral frailty was assessed using the Oral Frailty 5-Item Checklist. Multivariate regression analyses were conducted to adjust for potential confounders. Results Of the participants, 195 individuals (median age: 59.0 years [interquartile range: 53.8-68.0], 41.0% women) were included in the analysis. The prevalence of oral frailty was 37.5% in PCS Tertile 1, compared with 16.9% in Tertile 2 and 16.7% in Tertile 3, while the prevalence was similar across MCS tertiles. Multivariate regression analysis revealed that oral frailty was independently and inversely associated with PCS (standardized beta = -0.20, p = 0.006), but not MCS (standardized beta = -0.12, p = 0.090). In the sub-analysis, difficulty chewing (standardized beta = -0.15, p = 0.034) and swallowing (standardized beta = -0.26, p < 0.001) were associated with PCS, whereas fewer teeth (standardized beta = -0.15, p = 0.035) and dry mouth (standardized beta = -0.21, p = 0.004) were associated with MCS. Conclusion Oral frailty was significantly associated with physical HRQoL in Japanese master athletes. These findings suggest that incorporating oral frailty assessment into health promotion strategies may enhance HRQoL in physically active adults.
ABSTRACT Introduction We examined whether age identity moderates the associations between depressive symptoms and cognitive function, as well as the dementia risk among Korean older adults. Methods A nationally representative sample ( N = 8529) of Korean adults aged 65 years or older was drawn from the 2020 National Survey of Older Koreans. We conducted linear and logistic regression analyses using R. Results Linear regression model revealed that higher depressive symptoms were associated with lower cognitive function among older adults. Older adults who perceived themselves as having reached or exceeded the onset of old age (subjective old‐age group) reported lower cognitive function than those who did not (subjective non‐old‐age group). In the subjective old‐age group, a stronger tendency was observed for the association between higher depressive symptoms and lower cognitive function, although it did not reach statistical significance. The Johnson–Neyman technique indicated that group differences in cognitive function became statistically significant only when older adults experienced a certain threshold of depressive symptoms. The logistic regression model yielded similar results. Each unit increase in depressive symptoms was associated with 1.10 times higher dementia risk. Moreover, dementia risk was 1.45 times higher in the subjective old‐age group than in the subjective non‐old‐age group. Conclusions Our findings suggest that higher depressive symptoms and perceiving oneself as old may be associated with poorer cognitive function and greater dementia risk among Korean older adults. Further investigation is needed to understand the meaning of avoiding identification with the old‐age peer group among Korean older adults.
ABSTRACT Aim To compare Emergency Severity Index (ESI) discrimination, level‐specific risk, and under‐triage for a critical outcome between emergency department (ED) stays aged 80 years and older and 18–64 years. Methods Retrospective cohort of 418 025 ED stays of 201 214 adults with an ESI level at one US academic center, 2011–2019 (MIMIC‐IV‐ED). The critical outcome was death in the ED or hospital, or intensive care admission within 24 h. Measures were the ESI C statistic, transportability of each level's risk from 18 to 64 years, under‐triage odds (ESI 3–5 in an outcome stay), and differences after case‐mix stratification and reweighting. Results The C statistic was 0.818 at 18–64 and 0.754 at 80 and older (difference, −0.065; 95% CI, −0.072 to −0.058). The difference was −0.040 (95% CI, −0.048 to −0.033) pooled within arrival‐mode strata and −0.058 (95% CI, −0.071 to −0.046) after case‐mix reweighting. At 80 and older, observed risk was 1.96 times that carried by the same levels at 18 to 64. Specificity of ESI 1 or 2 was 48.8% versus 69.0%. Under‐triage occurred in 11.1% of outcome stays at 80 and older and 14.0% at 18–64 (adjusted odds ratio, 0.81; 95% CI, 0.73–0.90), but in 1.42 versus 0.55 per 100 stays. Conclusions At 80 years and older, ESI levels ranked critical‐outcome risk less well, a difference smaller within arrival‐mode strata, and levels 1–3 carried more risk than in younger adults. Age‐specific triage rules need prospective study.
ABSTRACT Background How urinary incontinence (UI) subtypes relate to other geriatric syndromes remains unclear. We evaluated the prevalence of UI and its subtypes and their associations with sarcopenia, frailty, malnutrition, and functional status in older adults. Methods This retrospective cross‐sectional study included 1042 patients aged ≥ 60 years undergoing comprehensive geriatric assessment (CGA) at a tertiary geriatric clinic (May 2023–January 2026). UI status and subtype were obtained from medical records. Sarcopenia was evaluated using SARC‐F, handgrip strength (HGS), physical performance tests, and dual‐energy X‐ray absorptiometry (EWGSOP2). Binary and multinomial logistic regression, sex‐stratified, and sensitivity analyses were performed. Results The median age was 79 years; 66.0% were women. UI was present in 62.4% of patients (61.5% of women and 64.1% of men, p = 0.404), and urge UI was the most common subtype. After adjustment, UI was associated with impaired physical performance, slower gait speed, lower HGS, higher SARC‐F and Clinical Frailty Scale scores, and lower Mini Nutritional Assessment–Short Form and instrumental activities of daily living scores. Urge, mixed and functional UI were each associated with most of these parameters, whereas stress UI was not associated with any. Mixed UI was the only subtype associated with confirmed sarcopenia (OR 2.259, 95% CI 1.029–4.956). Most associations were observed in both sexes, although the association with gait speed was stronger in women. Conclusion UI is highly prevalent among older adults undergoing CGA and is associated with frailty, sarcopenia‐related parameters, malnutrition risk, and functional decline in both sexes, with subtype‐specific differences.
ABSTRACT Aim To examine nonlinear associations of circulating insulin‐like growth factor‐1 (IGF‐1) with dementia risk and longitudinal changes in cognitive subdomains in the UK Biobank. Methods We analyzed 66 535 participants for all‐cause dementia and dementia subtypes and a nested cohort of 12 582 participants with repeated cognitive assessments. Cox proportional hazards models and restricted cubic splines assessed dementia risk, while linear mixed‐effects models evaluated longitudinal changes in global cognition, fluid intelligence, paired matching, reaction time, and prospective memory. Results In the fully adjusted linear Cox model, a 1‐SD increase in IGF‐1 was not linearly associated with all‐cause dementia (HR = 1.01, 95% CI: 1.00–1.01; p = 0.290). RCS analysis yielded p = 0.060 for the overall association and p = 0.048 for nonlinearity. AD risk was elevated only in Q3 (HR = 1.52, 95% CI: 1.08–2.13), and VaD risk was higher in Q5 (HR = 1.93, 95% CI: 1.01–3.69); nonlinear tests for AD, VaD, and FTD were not significant. For the other‐dementia category, the nonlinearity test was nominally significant ( p = 0.048), but continuous and quintile analyses were not. Paired matching showed an IGF‐1‐by‐time interaction ( p = 0.008), with a nominally significant test for nonlinearity ( p = 0.049). Other cognitive domains showed no significant nonlinear longitudinal associations. Conclusions Overall, circulating IGF‐1 showed no clear association with all‐cause dementia risk, while exploratory analyses suggested possible nonlinear patterns and a domain‐specific longitudinal signal in paired matching. These observational findings are hypothesis‐generating and do not establish a clinical target range.
