INTRODUCTION:Walking speed is widely recognized as an informative indicator of physical capability in later life and is frequently used to evaluate mobility and functional health in older adults. Although the measurement of community walking speed (CWS) has been made possible using accelerometers, it is unclear whether discrepancies between laboratory walking speed (LWS) and CWS make a difference in predicting the incidence of future disabilities in older adults. Using data from the National Center for Geriatrics and Gerontology-Study of Geriatric Syndromes (NCGG-SGS), we examined whether LWS and CWS each independently predict incident disability. The discrepancy was defined as the difference between LWS and CWS, and we further analyzed the characteristics of older adults who exhibited such discrepancies. METHODS:Participants comprised 1,631 older adults (mean age = 70 years; 62.7% women). LWS was measured using a WalkWay device that measures the distribution of foot pressure during walking. CWS was derived using a model that estimated gait speed based on composite acceleration calculated from the mean triaxial acceleration within a single gait cycle. Participants were instructed to wear a triaxial accelerometer for at least 14 days. The incidence of disability was prospectively determined for 5 years. RESULTS:The Cox proportional hazards regression models revealed a statistically significant association between the z scores of LWS (hazard ratio [HR], 0.54; 95% confidence interval [CI], 0.41-0.72) and CWS (HR, 0.59; 95% CI, 0.41-0.83) and disability incidence. There were no statistically significant interactions between LWS and CWS for disability (HR, 1.00; 95% CI, 0.76-1.31). The area under the receiver operating characteristics curve of the LWS and CWS was 0.752 and 0.709, respectively. Regarding discrepancies between the fast LWS group and the fast CWS group, residual analysis showed that the fast LWS group had a higher proportion of women than the fast CWS group. CONCLUSION:LWS and CWS were found to be independently associated with disability. Further research must determine how CWS should be interpreted because participants who showed discrepancies between CWS and LWS did not exhibit a significant association with incident disability. Healthcare providers could use either CWS and LWS as a significant indicator in healthcare practice for older populations.

BACKGROUND:Given that the relationship between the duration and content of golf and cognitive function remains unclear, this study determined the relationship between golf and cognitive decline among older adults. METHODS:Overall, 4575 older participants were analyzed cross-sectionally. Participants were divided into three groups based on their current golf status: golf players, golf cessation, and no golf experience. Participants who scored below the threshold on one or more of four cognitive tests were classified as having cognitive decline. RESULTS:There were 72 (14.1%), 115 (20.1%), and 755 (21.6%) golfers with cognitive decline in the golf player, golf cessation, and no golf experience groups, respectively. The golf player group exhibited significantly lower odds ratios (ORs) for cognitive decline than the no golf experience group. A significantly lower OR was noted for cognitive decline with a longer golf history (p < 0.01) but without association between the number of rounds and practice sessions. The golf cessation and golf player groups had significantly lower ORs for memory decline compared with the no golf experience group. The golf player group had significantly lower ORs for executive functional decline than the non-golf group. CONCLUSIONS:Continuing to play golf during older age was associated with lower odds of cognitive decline. This association was not observed among older adults who had ceased playing golf. Longer golfing history was associated with lower odds of cognitive decline, whereas the number of rounds or practice sessions was not clearly associated with cognitive status. These findings suggest that continued golf participation, rather than a higher frequency of play or practice, may be related to cognitive function in older adults.

OBJECTIVES:Life satisfaction is a key indicator of health outcomes among older adults. This study examined whether mild cognitive impairment (MCI) modified the relationship between life satisfaction and life-space mobility. DESIGN:Cross-sectional study. SETTING AND PARTICIPANTS:This study included 14,009 community-dwelling older adults (mean age, 71.9 ± 6.2 years; 54.8% women) who participated in the National Center for Geriatrics and Gerontology-Study of Geriatric Syndromes. METHODS:Life satisfaction was assessed using the Life Satisfaction Scale, and life-space mobility was evaluated using the activity mobility index (AMI). To examine whether MCI status modified the association between life-space mobility and life satisfaction, multiple regression analyses were performed using the Life Satisfaction Scale score as the dependent variable. The model included an interaction term between AMI and MCI and was adjusted for relevant potential covariates. RESULTS:In total, 2737 participants (19.5%) met the criteria for MCI. MCI was significantly associated with lower life satisfaction compared with participants without MCI (B = -0.257; 95% CI, -0.470 to -0.044; P = .018). AMI was significantly associated with life satisfaction (B = 0.026; 95% CI, 0.023-0.029; P < .001). However, the MCI × AMI interaction term was not significantly associated with life satisfaction (B = 0.006; 95% CI, -0.001-0.013; P = .084). CONCLUSIONS AND IMPLICATIONS:Greater life-space mobility was associated with higher life satisfaction regardless of MCI status. These findings suggest that maintaining and expanding life-space mobility may support well-being among community-dwelling older adults, including those with cognitive decline. Interventions aimed at preserving life-space mobility may have practical implications for promoting healthy aging and quality of life in older populations.

INTRODUCTION:LIFE is a Japanese digital database introduced by the Ministry of Health, Labour and Welfare to promote evidence-based care for older adults. Training sessions to promote the dissemination of the Long-term care Information system For Evidence (LIFE) commenced in 2021 in Japan. However, participants' subsequent understanding of the system and their self-efficacy in using it remained unclear. AIM:This study aimed to clarify the participants' understanding and self-efficacy regarding LIFE on the day of training and 3 months after the training. METHODS:A "LIFE Workshop (Basic)" was held in 2024 in Japan in the cities of Hakata, Sapporo, and Sendai. An online survey was administered to participants directly after the workshop, on the same day of the training session, and again, 3 months later. The survey included 12 items to gauge the participants' (and by extension, their work colleagues') understanding in self-efficacy and engagement with LIFE. An analysis was conducted of 42 matched data using a paired t -test, with the effect size calculated using Hedges' g. RESULTS:Three months after training, participants' understanding of the LIFE outline improved significantly (from 5.12 (2.43) to 6.19 (1.71), p   <  .001, Hedges' g = -0.471, 95% confidence interval [CI] [-0.736 to -0.206]). Significant improvements were observed in the following areas: performing the tests and measurements used in LIFE; interpreting and using the tests and measurements; planning and submitting LIFE data; and using the system within the organization. From the respondents' perspective, no significant improvement was found in their colleagues' understanding, practices, or use of the system. CONCLUSIONS:When introducing new initiatives to existing services, support must be provided for the organizational structure and the personnel who will take on leadership roles.

ObjectivesThis study examined whether sleep duration and physical inactivity were associated with incident disability among community-dwelling older adults.MethodsA total of 4,372 adults aged ≥70 years participated in a baseline assessment. We assessed self-reported sleep duration and physical activity using the International Physical Activity Questionnaire - Short Form. We measured monthly incident disability over 5 years.ResultsThe Cox proportional hazards regression analysis showed long sleep duration (≥9 h, HR 1.32, 95% CI 1.05-1.67) and physical inactivity (HR 1.33, 95% CI 1.13-1.57) were associated with incident disability in multivariate analyses. Coexistence of long sleep duration and physical inactivity had higher risk of incident disability than each factor individually (HR 1.69, 95% CI 1.11-2.58), even though the synergistic interaction was mildly effective.DiscussionThis study demonstrated that long sleep duration and physical inactivity were independently associated with the risk of incident disability among older adults.

Chronic low back pain affects 20–30

OBJECTIVES:Although several studies have shown that long sleep duration is associated with sarcopenia, there has been insufficient analysis of the involvement of physical activity patterns in this association. The purpose of the present study was to examine whether long sleep duration was associated with sarcopenia while considering physical activity. METHODS:A total of 2855 older community-dwelling people (mean age: 75.6 ± 4.1 years, 52.2% female) from the National Center for Geriatrics and Gerontology Study of Geriatric Syndromes were analyzed. Sleep duration was assessed using a self-reported questionnaire, and the participants with sleep duration of ≥ 9 h were assigned to the group with long sleep duration. Physical activity was measured using a triaxial accelerometer and each participant's duration (min/day) of moderate- to vigorous-intensity physical activity (MVPA) was calculated. Logistic regression analysis was used to estimate the odds ratio (OR) and 95% confidence interval (CI) of sarcopenia. RESULTS:Of the 2855 participants, 118 (4.1%) were classified as having sarcopenia. Long sleep duration was significantly associated with sarcopenia after adjusting for covariates (OR: 2.09, 95% CI: 1.01-4.29, Model 1). In Model 2, in which MVPA was also adjusted for, this association was weaker (OR: 2.02, 95% CI: 0.98-4.18). After dividing the participants according to MVPA, while long sleep duration was not associated with sarcopenia in participants with higher physical activity (OR: 1.37, 95% CI: 0.47-3.99), it was in those with lower physical activity (OR: 3.34, 95% CI: 1.21-9.21). CONCLUSIONS:This study suggests that the association between long sleep duration and sarcopenia appeared to be stronger among older adults with lower physical activity.

OBJECTIVES:Chronic pain significantly reduces life satisfaction in older adults, but the moderating role of leisure activities is unclear. We examined the association between chronic pain and life satisfaction and whether leisure activity participation moderates this relationship. DESIGN:Cross-sectional study. SETTINGS AND PARTICIPANTS:We analyzed cross-sectional data from 5594 community-dwelling adults aged 60 to 95 years, including 2558 men (45.7%). METHODS:Assessments included demographics, Mini-Mental State Examination, chronic pain status, life satisfaction, and physical and cognitive leisure activities. Multiple linear regression models tested chronic pain, leisure activity scores, and their interactions, adjusting for sociodemographic, health, and lifestyle factors. RESULTS:Chronic pain was associated with lower life satisfaction (β = -0.67; 95% CI, -0.92 to -0.42; P < .001). Higher physical (β = 0.04; 95% CI, 0.02-0.06; P < .001) and cognitive (β = 0.07; 95% CI, 0.04-0.09; P < .001) leisure activity scores were independently associated with higher life satisfaction. A significant interaction indicated that physical leisure activities attenuated the negative association of chronic pain with life satisfaction (β = 0.04; 95% CI, 0.004-0.07; P = .03). CONCLUSIONS AND IMPLICATIONS:Engagement in physical leisure activities may help preserve life satisfaction among older adults with chronic pain. These results highlight the importance of incorporating leisure activity promotion into community-based programs and geriatric care initiatives aimed to improve life satisfaction.

INTRODUCTION:Cardiovascular disease (CVD) is associated with disability, highlighting the need for prevention strategies that assess and mitigate CVD risk. This study aimed to examine the relationship between participation in lifestyle activities and incident disability among older individuals at high risk of CVD. METHODS:This prospective cohort study included 3,217 older adults (mean age 70.7 years, standard deviation ± 6.8; 1,843 women [57.3%]). Absolute CVD risk was estimated using the revised World Health Organization charts, categorizing individuals' risk levels as either low (<10%) or high (≥10%). The incidence of disability was monitored for 60 months. Baseline assessments included the frequency of participation in 36 lifestyle activities spanning physical, cognitive, and social domains, measured by annual participation frequency. A total score was calculated and categorized into three tertiles based on the frequency of participation (low, moderate, and high groups). An adjusted Cox proportional hazard analysis assessed disability risk based on baseline participation in lifestyle activities stratified by CVD risk level. RESULTS:Over 60 months, 326 (10.2%) participants experienced disability. Older adults who were highly active in cognitive and social activities had a lower risk of disability than those who were less active. Stratified analysis based on CVD risk level showed that engagement in lifestyle activities was linked to disability risk among older adults at high risk of CVD, whereas no such association was observed in those at low risk. CONCLUSION:Among older adults at high CVD risk, greater engagement in lifestyle activities was associated with a reduced risk of disability after 60 months.

BACKGROUND:Going outdoors is crucial in promoting older adults' health. This study examined the association between incident disability and the frequency of going outdoors in certain life spaces. METHODS:This prospective study included 19,822 older adults (mean age ± standard deviation: 73.5 ± 5.8 years; 53.6 % women). The frequency of going outdoors within the past month was collected based on life space, categorized by distance from home (up to 1 km; 1-10 km; and >10 km). Participants were classified into three groups (called "Rarely": less than 1 day, "Sometimes": 1 to 3 days, and "Often": 4 days or more) for each life space. Incident disability was defined using the Long-Term Care Insurance system data (mean follow-up: 23.3 months). A Cox proportional hazards model was used to examine the association between incident disability and the frequency of going outdoors for each life space, adjusted for covariates. RESULTS:A total of 1038 (5.2 %) participants had an incident disability. Within the "up to 1 km" category, no frequency group was associated with disability; within "1-10 km," two frequency groups were associated with disability ("Sometimes" group: hazard ratio [HR] 0.85, [95 % confidence interval [CI]: 0.73-0.99]; "Often" group: HR 0.68, [95 % CI: 0.57-0.81]); within ">10 km," similar results were observed ("Sometimes" group: HR 0.84, [95 % CI: 0.72-0.98]; "Often" group: HR 0.75, [95 % CI: 0.53-1.07]). CONCLUSIONS:The frequency of going outdoors at specific distances from home is associated with disability.

BackgroundMotoric cognitive risk (MCR) syndrome is characterized by subjective cognitive complaints and slow gait and confers a higher risk of dementia. Cerebral small vessel disease (CSVD) is associated with poor cognitive, functional, and survival outcomes in aging. Markers of CSVD seen on magnetic resonance imaging (MRI) include white matter hyperintensities (WMHs) and lacunes.ObjectiveTo examine associations between imaging markers of CSVD and the MCR syndrome.MethodsCross-sectional data from 4 cohorts in 4 countries were examined. WMHs and lacunes were quantified from brain MRIs manually, using a standardized grading scale. Regression models examined the associations between WMH and lacunes and MCR, gait speed, slow gait, and cognitive complaints. We also compared the prevalence of the outcomes of interest between participants with "confluent or diffuse" or "no or mild" WMH. Statistical models were adjusted for age, sex, study site, and vascular risk factors.ResultsData from 1772 participants (M Age = 71.1 years, 49.9% female) was analyzed. Higher global WMH scores were associated with MCR (aOR = 1.07, p = 0.015). Frontal and basal ganglia WMH scores were associated with MCR (aOR = 1.23, p = 0.007, aOR = 1.31, p = 0.023, respectively). Participants with "confluent-diffuse" WMH had significantly higher prevalence of MCR (30.2% versus 19.2%, p = 0.003). Basal ganglia lacunes were associated with MCR (aOR = 1.57, p = 0.018).ConclusionsIn this multi-cohort study of older adults without cognitive impairment, we show that WMH and lacunes independently predict increased risk of MCR, after adjusting for key confounders. Our findings, based on a large multi-ethnic cohort, reveal region-specific CSVD patterns linked to MCR and related outcomes.

OBJECTIVES:Social isolation is a critical public health issue that increases pain sensitivity and exacerbates chronic pain, leading to further social limitations. However, the risk of disability when these factors overlap remains unclear. This study hypothesized that the coexistence of social isolation and chronic pain would elevate disability incidence among community-dwelling older adults. DESIGN:A prospective cohort study. SETTINGS AND PARTICIPANTS:This study included 4709 community-dwelling older adults (73.8 ± 5.4 years of age, male: n = 2053) without baseline disability. METHODS:Chronic pain, isolation due to lack of social support, and isolation due to lack of social participation were assessed at baseline. Disability incidence was examined during a 24-month follow-up. RESULTS:In the adjusted Cox proportional hazards model, participants experiencing both chronic pain and isolation due to lack of social support provision had a significantly higher risk of disability incidence than those without chronic pain or isolation [hazard ratio (HR), 2.69; 95% CI, 1.78-4.05; P < .001]. Similarly, participants experiencing both chronic pain and isolation due to lack of social participation had a significantly higher risk of disability incidence than those without chronic pain or isolation (HR, 2.97; 95% CI, 2.00-4.40; P < .001). In addition, chronic pain and isolation due to lack of social participation had an additive effect after adjustment (relative excess risk due to interaction, 0.68; 95% CI, 0.00-1.36). CONCLUSION AND IMPLICATIONS:The overlap of chronic pain and isolation due to lack of social participation had an additive effect on disability incidence over 24 months. These findings highlight the importance of preventing the combination of chronic pain and social isolation to mitigate disability risk.

OBJECTIVES:Identifying the factors that contribute to the incidence of disability in older adults and the activities that can be engaged in to reduce the risk of disability is critical to the health of older adults. This study aimed to assess the impact of social activities on the incidence of disability during follow-up examinations in older adults with chronic pain. DESIGN:A prospective cohort study. SETTINGS AND PARTICIPANTS:The study included 4692 community-dwelling older adults (aged 73.8 ± 5.5 years, male: n = 2043) without disability at baseline. METHODS:Chronic pain and social activity data were assessed at baseline and the incidence of disability was investigated during the follow-up examination after 24 months from baseline. RESULTS:In total, 1587 (33.8%) participants reported chronic pain at baseline, and 206 (4.4%) reported disability at follow-up examination. The Cox proportional hazards model showed that the chronic pain group had a higher hazard ratio (HR) for disability incidence compared with the group without chronic pain [HR, 1.77; 95% confidence interval (CI), 1.33-2.35; P < .001]. High social activity significantly prevented the incidence of disability compared with low social activity in the chronic pain group (HR, 0.57; 95% CI, 0.39-0.84; P = .005). Event participation had a protective effect on disability incidence in the chronic pain group (HR, 0.60; 95% CI, 0.40-0.91; P = .02). CONCLUSION AND IMPLICATIONS:This study shows that chronic pain at baseline increases the risk of developing disability, whereas high social activity reduces that risk compared with low social activities. These results suggest the important role of social activities regarding the incidence of disability in community-dwelling older adults with chronic pain.

BackgroundThe emergence of disease-modifying treatment options for Alzheimer disease is creating a paradigm shift in strategies to identify patients with mild symptoms in primary care settings. Systematic reviews on digital cognitive tests reported that most showed diagnostic performance comparable with that of paper-and-pencil tests for mild cognitive impairment and dementia. However, most studies have small sample sizes, with fewer than 100 individuals, and are based on case-control or cross-sectional designs. ObjectiveThis study aimed to examine the predictive validity of the Japanese Cognitive Function Test (J-Cog), a new computerized cognitive battery test, for dementia development. MethodsWe randomly assigned 2520 older adults (average age 72.7, SD 6.7 years) to derivation and validation groups to determine and validate cutoff points for the onset of dementia. The Mini-Mental State Examination (MMSE) was used for comparison purposes. The J-Cog consists of 12 tasks that assess orientation, designation, attention and calculation, mental rotation, verbal fluency, sentence completion, working memory, logical reasoning, attention, common knowledge, word memory recall, and episodic memory recall. The onset of dementia was monitored for 60 months. In the derivation group, receiver operating characteristic curves were plotted to determine the MMSE and J-Cog cutoff points that best discriminated between the groups with and without dementia. In the validation group, Cox proportional regression models were developed to predict the associations of the group classified using the cutoff points of the J-Cog or MMSE with dementia incidence. Harrell C-statistic was estimated to summarize how well a predicted risk score described an observed sequence of events. The Akaike information criterion was calculated for relative goodness of fit, where lower absolute values indicate a better model fit. ResultsSignificant hazard ratios (HRs) for dementia incidence were found using the MMSE cutoff between 23 and 24 point (HR 1.93, 95% CI 1.13-3.27) and the J-Cog cutoff between 43 and 44 points (HR 2.42, 95% CI 1.50-3.93). In the total validation group, the C-statistic was above 0.8 for all cutoff points. Akaike information criterion with MMSE cutoff between 23 and 24 points as a reference showed a poor fit for MMSE cutoff between 28 and 29 points, and a good fit for the J-Cog cutoff between 43 and 44 points. ConclusionsThe J-Cog has higher accuracy in predicting the development of dementia than the MMSE and has advantages for use in the community as a test of cognitive function, which can be administered by nonprofessionals.

While previous literature suggests that multimorbidity is linked to a higher risk of mortality, evidence is scarce among individuals in middle adulthood. We aimed to examine the association between physical multimorbidity and all-cause mortality among individuals aged 40–64 years at baseline in Japan. Data were obtained from two cohort studies, the Japan Public Health Center-based Prospective Study (JPHC) and the Japan Epidemiology Collaboration on Occupational Health Study (J-ECOH). The study participants were 144,774 individuals aged 40–64 years at baseline who were followed up for a maximum of 29 and 10 years in the JPHC and J-ECOH, respectively. Multimorbidity was defined as the presence of ≥ 2 of 10 morbidities or conditions based on self-reported information. A Cox proportional hazards model was used to examine the association in relation to all-cause mortality. We calculated pooled hazard ratios (HR) and corresponding 95

BACKGROUND:Loneliness is a growing public health concern due to its association with adverse health outcomes in older adults. Research on the relationship between participation in cognitive activities and the alleviation of loneliness remains limited. This study examined longitudinal associations between engagement in cognitive activities and the onset of loneliness among community-dwelling older adults in Japan. METHODS:The prospective cohort initially included 5563 older adults. After excluding participants with baseline loneliness or missing data, 2317 participants (mean age 73.5 ± 5.4 years; 58.1 % women) were analyzed and followed for 36.7 ± 2.3 months. Loneliness was assessed using the UCLA Loneliness Scale. Six cognitive activities were evaluated: reading, keeping a diary, solving crossword puzzles, playing board games, participating in group discussions, and playing musical instruments. Logistic regression, adjusted for demographic, lifestyle, health, and cognitive covariates, examined associations of individual activities and total activity frequency with the onset of loneliness. RESULTS:During follow-up, 574 participants (24.8 %) developed loneliness. Reading (OR = 0.61, 95 % CI = 0.41-0.91, p = .01) and participating in group discussions (OR = 0.63, 95 % CI = 0.51-0.77, p < .001) were significantly associated with a reduced risk of loneliness. Frequent engagement in other cognitive activities was not associated with lower loneliness. CONCLUSIONS AND IMPLICATIONS:Engagement in specific cognitive activities was associated with lower odds of loneliness. These findings suggest that it may be important to consider not only the frequency of cognitive activities but also their specific characteristics and qualities.

AIM:To investigate whether lifestyle activities reduce the risk of depressive symptoms among older adults who have ceased driving. METHODS:This longitudinal, community-based study included 1654 community-dwelling older adults aged ≥60 years, excluding individuals with baseline depressive symptoms or without driver's licenses. Participants recruited from Takahama City, Aichi Prefecture, Japan, between September 2015 and February 2019 were categorized into driving and driving-cessation groups at baseline. Follow-up postal surveys were conducted over an average of 30.7 (standard deviation: 2.4) months. Depressive symptoms at 30 months were assessed using the Geriatric Depression Scale-15. Lifestyle activities were assessed using the 36-item Lifestyle Activities Questionnaire (LAQ), comprising 12 items each for physical, cognitive and social activities. Logistic regression analysis for each activity and the total LAQ score adjusted for potential covariates identified activities that had a protective role against depressive symptom development. RESULTS:During the follow-up period, 213 participants (13.6%) from the driving group (n = 1564) and 16 participants (17.8%) from the driving-cessation group (n = 90) developed depressive symptoms. Logistic regression analysis adjusted for covariates indicated that a higher total LAQ score was associated with depressive symptoms. Engagement in all activities reduced the risk of depressive symptoms in the driving group, whereas only engagement in cognitive activities reduced the risk in the driving-cessation group. CONCLUSIONS:High engagement in lifestyle activities was associated with a decreased risk of developing depressive symptoms. Hence, a conducive environment and support system are required to enhance engagement in lifestyle activities before older adults cease driving. Geriatr Gerontol Int 2025; 25: 1316-1322.

BackgroundFemales are twice as likely to be diagnosed with Alzheimer's disease (AD) as males, but the underlying mechanisms of this sex difference are not well-understood. The motoric cognitive risk (MCR) syndrome is characterized by slow gait and subjective cognitive concerns and predicts both AD and vascular dementia (VaD). The prevalence of MCR is typically similar in females and males. We have previously shown that MCR is associated with cortical atrophy in frontal, parietal, and temporal regions.ObjectiveThe current study examined sex-specific, cortical (frontal), and subcortical (hippocampal) atrophy patterns associated with MCR.MethodsFrontal cortical thicknesses (in 11 frontal regions) and hippocampal volumes (in 12 hippocampal subfields) were quantified in 940 females (M Age = 71.03 years) and 1108 males (M Age = 71.07 years). Sex-stratified linear models were used to examine frontal cortical thicknesses and hippocampal volumes as a function of MCR-after adjusting for age, education, total intracranial volume, study site, vascular comorbidities, white matter lesion burden, and multiple comparisons (with the false discovery rate).ResultsMCR-related frontal atrophy was observed (in pars orbitalis and caudal middle frontal) in males but not in females. MCR-related hippocampal atrophy (in CA1, molecular layer, GCMLDG, and Fimbria) was observed in females but not in males.ConclusionsThere are sex-specific patterns of atrophy associated with MCR. Females with MCR display brain atrophy patterns more consistent with early AD, while males with MCR display atrophy patterns more consistent with VaD.

Aim Fatigue is a common health problem in older adults. Chronic pain is associated with fatigue. However, the longitudinal association between chronic pain and the incidence of subjective fatigue among community‐dwelling older adults remains unclear. Therefore, this study aimed to investigate the association between chronic pain and subjective fatigue using prospective data. Methods The study included 2060 community‐dwelling older adults (age 70.5 ± 6.4 years; male: n = 944) without subjective fatigue at baseline. Chronic pain and other data were assessed at baseline. Subjective fatigue incidence was investigated at the follow‐up examination 2.5 years from baseline. Results In total, 389 (18.9%) reported chronic low back pain, 322 (15.6%) reported chronic knee pain at baseline, and 342 (16.6%) reported subjective fatigue at follow‐up examination. A logistic regression analysis showed that the odds ratio for the incidence of subjective fatigue in participants with chronic low back pain had a higher odds ratio for the incidence of subjective fatigue compared to participants without chronic low back pain (odds ratio = 1.71, 95% confidence interval = 1.29–2.26). Chronic knee pain had a higher odds ratio for the incidence of subjective fatigue compared to participants without chronic knee pain (odds ratio = 1.63, 95% confidence interval = 1.21–2.20). Conclusions These results suggest that chronic low back pain and knee pain increase the risk of subjective fatigue incidence. These findings emphasize the contribution of chronic pain to fatigue among older adults. Therefore, intervention studies are required to prevent subjective fatigue in participants with chronic pain. Geriatr Gerontol Int 2025; ••: ••–•• .

Objectives Relationships among social isolation, loneliness, and disability onset remain unclear. We investigated the distinct patterns of disability development among Japanese older adults who experience social isolation and loneliness. Design This study applied a prospective observational approach. Participants Data from 4,716 community-dwelling independent older adults were analyzed. Measurements The Japanese version of the University of California, Los Angeles Loneliness Scale Version 3 and the Social Isolation Scale were used to measure loneliness and social isolation, respectively. The long-term care insurer conducted monthly follow-ups with participants over two years to determine their care needs. Disability onset was defined as the point at which participants were certified by a care manager as requiring long-term care. Results During the follow-up period, 265 participants (5.6%) required long-term care insurance certification due to disability onset. The incidence of disability in the lonely and not lonely groups was 8.0% and 4.5%, respectively. In the socially isolated and not socially isolated groups, it was 7.1% and 4.4%, respectively. The Cox proportional hazards regression model revealed a significantly higher risk of disability incidence in the lonely and socially isolated groups. The high-risk group experiencing both loneliness and social isolation exhibited significantly higher hazard ratios than the low-risk group without these symptoms. Conclusions The results indicated that older adults experiencing both social isolation and loneliness were at high-risk for future disability incidence. This finding provides insight into the complex interplay between social factors and disability, which can contribute to the development of effective interventions to promote healthy aging and prevent disability.