OBJECTIVE:Approaching the "population that is indifferent to health" is important for reducing health disparities. This also applies to individuals with mild cognitive impairment (MCI). Raising health awareness is essential for preventing further cognitive decline and the onset of various diseases, including dementia. This study examined the association between MCI and interest in health among community-dwelling older adults. METHODS:We performed a cross-sectional analysis using baseline data from the Wako Cohort Study conducted in Wako City, Saitama Prefecture. A community survey was conducted in September-October 2023, and 1,004 individuals aged 65 years or older participated. Among them, 1,000 participants who completed the cognitive assessments were included in the analysis. The cognitive function of the participants was assessed using the Japanese version of the Montreal Cognitive Assessment, with scores ≤25 classified as MCI. Interest in health was measured using the 12-item Interest in Health Scale (score range: 12-48). The covariates included sex, age, marital status, household composition, work status, years of education, economic status, self-rated health, number of chronic diseases, and depressive symptoms. We analyzed the data of the total sample and subsamples stratified by sex and age. Moreover, we also conducted the analyses by setting three subscales ("health consciousness," "health motivation," and "health value") as the outcomes. RESULTS:Of the participants, 48.2% were men, and the mean age was 75.3±6.4 years. The prevalence of MCI was 65.0%. The mean scores of the Interest in Health Scale were 38.4±4.6 in the non-MCI group and 38.1±4.9 in the MCI group. A multiple regression analysis with adjustment for covariates indicated that MCI was significantly associated with a lower interest in health (b=-0.67, 95% confidence interval: -1.31, -0.04). Stratified analyses showed that this association was evident among men and those aged 75 years or older. In subscale analyses, a significant difference between groups was observed only in "health value" (b=-0.45, 95% confidence interval: -0.75, -0.15). CONCLUSIONS:Older adults with MCI showed a lower interest in health than their cognitively normal peers, and this tendency was more pronounced among men and those aged 75 years or older. Moreover, a significant difference was found only in the "health value" subscale, suggesting that a diminished valuation of health may be a characteristic of MCI. Strategies to enhance health interests in this population are therefore needed to support preventive behaviors.
AIM:The tongue function is a key factor associated with the nutritional status. However, in which specific stages of malnutrition the tongue function becomes significantly involved remains unclear. This study examined the association between tongue pressure and indicators of nutritional status among community-dwelling older adults. METHODS:A total of 109 participants ≥65 years old were included in the analysis. The maximum tongue pressure was measured, and values below 30 kPa were defined as a decreased tongue pressure. Being at risk of malnutrition was evaluated using the Mini Nutritional Assessment Short-Form (MNA-SF). A low body mass index (BMI; <20) was considered to indicate a trend toward malnutrition, and the appendicular skeletal muscle mass (ASM) adjusted for the BMI (ASMBMI) was used to assess a low skeletal muscle mass, defined as <0.789 kg/BMI for men and <0.512 kg/BMI for women. RESULTS:The mean age of participants was 78.1±6.9 years old, and 79.8% were female. The prevalence of being at risk of malnutrition was 16.4% in the normal tongue pressure group and 33.3% in the low tongue pressure group. The prevalence of a low BMI was 13.1% and 25.0%, and that of low ASMBMI was 11.5% and 35.4% in the normal and low tongue pressure groups, respectively. The adjusted odds ratios (95% confidence intervals [CIs]) were 2.88 (95% CI: 1.06-7.87) for at risk of malnutrition, 3.03 (95% CI: 1.01-9.08) for a low BMI, and 1.93 (95% CI: 0.62-5.99) for a low ASMBMI. CONCLUSION:Decreased tongue pressure was associated with nutritional risk and a low BMI, whereas no significant association was found with a low ASMBMI.
PURPOSE:This study aimed to investigate the relationship between 2-year changes in physical function and the progression of locomotive syndrome (LS) in community-dwelling older adults, focusing on the utility of the 30-second chair stand test (CS-30) as an indicator of muscular endurance. METHODS:Among those who participated in the 2021 preventive care classes, 58 older adults who completed follow-up assessments after 2 years were included. The LS stage was assessed using the 25-question Geriatric Locomotive Function Scale (GLFS-25) and a two-step test, and participants were classified into either progression or non-progression (maintenance/improvement) groups. Changes in eight physical function indicators, including grip strength, sit-and-reach test, and the CS-30 score, were calculated. Group comparisons and receiver operating characteristic (ROC) analyses were also performed. A logistic regression analysis was conducted with LS progression as the dependent variable and age as a covariate to evaluate the independent association of the CS-30 changes. The minimal detectable change (MDC) and minimal clinically important difference (MCID) for the CS-30 score were also calculated. RESULTS:Sixteen participants (27.6%) experienced LS progression. Significant group differences were observed in age, grip strength, sit-and-reach test results, and CS-30 change (p < 0.05). CS-30 showed a moderate predictive ability (AUC = 0.705), with a cutoff of+1 repetitions (sensitivity, 81.2%, specificity, 61.9%). Logistic regression revealed a significant association between the CS-30 change and LS maintenance/improvement (OR 1.24, p = 0.04) after adjusting for age. CS-30 MDC and MCID were 5.64 and 4.00, respectively. CONCLUSION:Even a minimal increase in the CS-30 score was associated with LS maintenance and improvement. The CS-30 score may therefore serve as an early predictor of LS progression, independent of age.
The prevalence of dementia and mild cognitive impairment (MCI) is projected to increase further in Japan, underscoring the urgent need for effective non-pharmacological prevention strategies. Multidomain interventions targeting multiple risk factors simultaneously have gained increasing attention. In Japan, the J-MINT study evaluated the efficacy of a lifestyle-tailored multidomain intervention.J-MINT was an 18-month randomized controlled trial in older adults with MCI, combining exercise, nutrition, cognitive training, and management of lifestyle-related diseases. Although no significant difference was observed in the primary outcome (composite cognitive score) between intervention and control groups, participants with high adherence to exercise showed significant cognitive improvement. Subgroup analyses further demonstrated greater benefits among APOE ε4 carriers, individuals with elevated GFAP levels, and those with untreated or poorly controlled vascular risk factors, suggesting that intervention effects depend on target populations. Cost-effectiveness analysis indicated that J-MINT simultaneously reduced healthcare and long-term care costs while improving quality-adjusted life years.However, challenges for real-world implementation include the lack of evidence-based programs, shortage of trained personnel, difficulties in recruitment and retention, and the absence of sustainable business models. To address these issues, a 6-month community-based J-MINT Brain Health program, instructor certification systems, and a business framework have been developed. A cluster randomized trial across 20 municipalities is currently underway. Future efforts should focus on optimizing target populations, leveraging blood biomarkers, refining delivery methods, and elucidating mechanisms, with an emphasis on early detection and intervention.
AIM:To examine the relationship between the frequency of participation in a preventive care exercise program and the physical and mental health of community-dwelling older adults. METHODS:This study targeted participants of the "Ikiiki Hyakusai Taiso" program in Nose Town, Osaka.•Analysis (1): The physical fitness measures of 530 participants in 2018 were compared according to their participation frequency.•Analysis (2): For the 391 individuals who continued in 2019, year-over-year changes in fitness were similarly analyzed.The participants were divided into high- and low-frequency groups based on quartiles. Physical assessments and questionnaire data were compared between the groups. RESULTS:In Analysis (1), no significant differences were found among the men (average session: 27.5). In contrast, among women (average sessions: 28.2), the high-participation group had significantly faster 5-meter walking speeds, greater muscle strength, more social interactions, higher engagement in hobbies, and fewer depressive tendencies (p < 0.05). Older women (75+) also showed better Timed Up and Go (TUG) scores.In Analysis (2), similar trends were observed: no significant differences were found among men, whereas women in the high-participation group showed improved mobility, more social interaction, and lower rates of motor decline (p < 0.05). CONCLUSIONS:No significant associations were found in men, possibly because of external activities or exercise intensity. In contrast, among frail women, higher participation was linked to physical improvement, thereby supporting the promotion of continued involvement in such programs.
AIM:To develop a dementia and delirium nursing education program for nurses in acute care hospitals with the aim of enhancing their practical competencies. The program, based on person-centered care, included a 60-minute workshop and regular case conferences held two to three times per week. This study aimed to evaluate the effects of the program by examining changes in nurses' knowledge and self-efficacy regarding dementia and delirium nursing, as well as patient outcomes, including falls, self-removal of tubes or catheters, and the use of physical restraints. METHODS:The program was conducted over a three-month period from November 2023 to January 2024 in a gastrointestinal surgical ward of an acute care hospital with a 7:1 nurse-to-patient ratio. Twenty-five nurses participated in this study. Questionnaires assessing knowledge and self-efficacy were administered before and after intervention. Patient outcome data, including falls, self-removal of tubes or catheters, and use of physical restraints, were collected from the medical records and compared before and after the intervention. RESULTS:Nurses' knowledge and self-efficacy significantly improved after the intervention. Although the total number of patients with dementia and delirium increased significantly, the incidents of self-removal of tubes or catheters and the use of physical restraints significantly decreased. Falls decreased from two to zero, although this difference was not statistically significant. CONCLUSIONS:The program was effective in improving nurses' knowledge and self-efficacy in dementia and delirium care and in reducing self-removal of tubes or catheters, as well as reducing the use of physical restraints.
AIM:This study investigated the association between frailty awareness-defined as understanding the term "frailty" and its meaning-and actual frailty status as well as oral frailty among community-dwelling older adults. METHODS:This cross-sectional study was conducted among adults ≥65 years old residing in the community. Data were collected via a postal survey assessing frailty awareness, status (using a health assessment questionnaire for the national screening program for older adults in Japan), and oral frailty (using the Oral Frail Index-8). Frailty awareness was divided into three categories: Awareness I (aware of both the term and its meaning), Awareness II (aware of the term only), and Awareness III (unaware of both). Associations between frailty awareness and frailty outcomes were analyzed using the chi-square test and multivariate logistic regression. RESULTS:A total of 1,758 respondents (age 77.0±6.9 years old) were included. The prevalence of frailty was 32.6%, while that of oral frailty was 55.5%. Among the participants, 38.4% were classified as Awareness I, 18.3% as Awareness II, and 43.3% as Awareness III, respectively. Lower frailty awareness was significantly associated with higher rates of frailty and oral frailty (p < 0.001). In logistic regression analyses, compared with Awareness I, the odds ratios (ORs) for frailty were 1.57 (95% confidence interval [CI], 1.16-2.13, p = 0.004) for Awareness II and 2.06 (95% CI, 1.60-2.64, p < 0.001) for Awareness III. Compared with Awareness I, the ORs for oral frailty were 1.58 (95% CI, 1.20-2.08, p = 0.001) for Awareness II and 1.91 (95% CI, 1.53-2.40, p < 0.001) for Awareness III. CONCLUSIONS:Lower frailty awareness was associated with an increased likelihood of both frailty and oral frailty among community-dwelling older adults, suggesting that improving frailty knowledge may contribute to effective frailty prevention and management.
