The COVID-19 pandemic caused occupational disruption and adverse health outcomes in community-dwelling older adults. This study aimed to investigate the extent of occupational disruption in older adults and its relationship to health-related quality of life (QOL), depression, and frailty. In this cross-sectional study, retention rates in four activity domains and relationships with health outcomes were examined in Japanese older adults aged ≥65 years (n=163) using canonical correlation analysis (CCA) and mixed linear models. More than 25% of activities were restricted compared with the pre-pandemic period. CCA demonstrated correlations between four retention rates and health outcomes (canonical correlation = .42, p = .0003). Retention in instrumental and social activities independently predicted QOL and depression (p < .05). This study highlights that different activities may have different effects on health outcomes and can provide community occupational therapy practitioners with a perspective to assess occupational disruption and identify activities for intervention.

ObjectivesThe aim of this study was to investigate the stronger correlate of appetite—family or friend networks—in community-dwelling older adults, given that undernutrition can impair physical function, increase mortality, and be influenced by social networks. MethodsA cross-sectional study was conducted in Kasugai City, Aichi Prefecture, and Nara City, Nara Prefecture, Japan, between August 2019 and March 2023. The analysis included 119 participants (women: 79%, mean age: 76.5 ± 5.6 y). A multiple regression analysis was performed, using the scores from the Japanese version of the Simplified Nutritional Appetite Questionnaire (SNAQ-J) as the dependent variable and family network and friend network as the independent variables. The analysis included social participation, living alone status, sex, age, body mass index, skeletal muscle mass index, grip strength, walking speed, and the Japanese version of the 15 Geriatric Depression Scale score as covariates to examine their relationship with appetite. ResultsThe mean value of the SNAQ-J score of the participants was 15.4 ± 1.2. Seven participants (6%) had a loss of appetite. Family network was significantly associated with appetite (B = 0.121, β = 0.266, P <0.05; 95% condidence interval [CI], 0.030–0.212). In the single regression analysis, the friend network was significantly associated with the total score of the SNAQ-J (B = 0.115, P <0.001; 95% CI, 0.052–0.177); however, this association was not observed in the multiple regression analysis (B = 0.002, β = 0.006, P = 0.954; 95% CI, –0.074–0.078). ConclusionAppetite was associated with family networks. Among social networks, focusing on family networks may help prevent the loss of appetite in older adults in Japan.

The quadriceps muscle is one of the human body's largest and most clinically important muscles and is evaluated using mid-thigh computed tomography (CT); however, its relationship with motor function and sarcopenia remains unclear. Herein, we investigated the relationship between the cross-sectional area (CSA) of the quadriceps muscle, CT attenuation value (CTV), dual-energy X-ray absorptiometry muscle mass measurements, and muscle strength and motor function to evaluate the relationship between muscle mass loss and motor function decline, determine the diagnostic ability for sarcopenia, and confirm the usefulness of quadriceps muscle CT evaluation. A total of 472 middle-aged and older community dwellers (254 men and 218 women) aged ≥40 years (mean age: 62.3 years) were included in this study. The quantity and quality of the quadriceps muscle were assessed using CSA and CTV (CSA×CTV) as a composite index multiplied by quality and quantity. Age-adjusted partial correlations by sex with eight motor functions (knee extension muscle strength, power, normal walking speed, fast walking speed, grip strength, sit-up ability, balance ability, and reaction time) were evaluated, including correction methods for height, weight, and body mass index (BMI). Further, the accuracy of sarcopenia diagnosis was evaluated using appendicular muscle mass with dual-energy X-ray absorptiometry measurements, grip strength, and walking speed as the gold standard, and receiver operating characteristic curves were plotted to evaluate diagnostic performance. In men, CSA and CSA×CTV were significantly associated with seven of the eight motor functions (p<0.05), excluding only balance ability. BMI-corrected CSA was significantly correlated with all eight motor functions in men and women (p<0.05). In the diagnosis of sarcopenia based on skeletal muscle index, CSA (area under the curve (AUC) 0.935) and CSA×CTV (AUC 0.936) and their correction by height (CSA/height (AUC 0.917) and CSA×CTV/height (AUC 0.920)) were highly accurate and useful for diagnosis in men but moderately accurate in women (CSA (AUC 0.809), CSA×CTV (AUC 0.824), CSA/height (AUC 0.799), CSA×CTV/height (AUC 0.814)). The present results showed that a single CT image of the quadriceps muscle at the mid-thigh is useful for diagnosing sarcopenic changes, such as loss of muscle mass, muscle weakness, and muscle function.

BackgroundIndividual-level social capital prevents cognitive decline. However, a few studies have focused on the effects of community-level social capital on dementia. Therefore, we investigated the association between community-level social capital and dementia onset based on longitudinal study data on older adults in Japan. MethodsWe used longitudinal data from the Japan Gerontological Evaluation Study, obtained over nine years (2010–2019). In total, 35,921 physically and cognitively independent individuals (16,848 males and 19,073 females) aged ≥65 years and nested within 308 communities in seven municipalities participated in the study. Dementia onset was assessed using the public long-term care insurance registration. Social capital was assessed using three dimensions: civic participation, social cohesion, and reciprocity. We performed a two-level multilevel survival analysis stratified by sex, calculated hazard ratios (HRs), and 95% confidence intervals (CIs). ResultsDuring the follow-up, 6245 (17.4%) dementia onset cases were identified. The cumulative incidence of dementia was 16.2% in males and 18.4% in females. After adjusting for covariates, individual-level civic participation was associated with a lower incidence of dementia in both males and females (HR, 0.84; 95% CI, 0.77–0.92; HR, 0.78; 95% CI, 0.73–0.84). Community-level civic participation and social cohesion were associated with a lower incidence of dementia among females (HR, 0.96; 95% CI, 0.93–0.99; HR, 0.93; 95% CI, 0.88–0.98) and cross-level interaction on social cohesion among females (HR, 0.95; 95% CI, 0.90–0.99). ConclusionsLiving in a community with high civic participation and social cohesion is associated with a lower incidence of dementia among older females. Therefore, promoting civic participation and social cohesion in the community may be a useful population-based strategy to delay or prevent the onset of dementia.

ABSTRACT This study aimed to identify the social care support provided by life story work and children’s family relationships for children with disabilities in medical-type residential care facilities for children in Japan and the challenges thereof. The participants were 12 staff from residential care facilities for children with disabilities experienced in providing ongoing support to children admitted for social care purposes. Semi-constructive interviews on the life story work and support for family relationships practiced with children admitted to a residential care facility for children with disabilities for social care were conducted with the participants. The interviews were recorded and analyzed using thematic analysis. The analysis resulted in 32 codes, 10 sub-themes, and four main themes. The main themes were family form, children’s thoughts on their family, support for family relationships, and readiness for life story work. In some cases, children were not informed about their negative situation, that is, the reason for admission or their family situation. This was due to the lack of a unified view on life story work among staff and insufficient organizational readiness. The results suggest the need for a unified understanding throughout the organization, as well as the need to disseminate the methodology of life story work for children with disabilities.

Abstract Background Digital welfare technologies are increasingly expected to perform a broader set of functions and roles. The worldwide COVID-19 pandemic further underscored use of technology, as it heightened the need for security and safety in care settings, with cleanliness and infection control becoming an even more important aspect of care delivery. While there are great expectations for digitalization and automation of care work, bringing new technologies such as robots into a workplace remains a challenge in terms of acceptance and usability, as well as a reflection of user preferences and needs. Methods An original air-disinfection ‘robot’ was developed for a cross-cultural research project, and was introduced to a residential nursing home in Japan. Prior to its instalment, seven main users (physiotherapists, nurses and social care professionals) were trained by the developer. Semi-structured interviews and focus groups were conducted before, during and after the trial in order to understand care professionals’ needs regarding and impressions of the device. The System Usability Scale (SUS) was also used to test professionals’ experience with the device. Results Overall, the users had a positive experience of using the robot (SUS score of 74.3/100). During the trial, the team of users changed the inorganic appearance of the robot by adding a face, hair, hands and music to it. The qualitative data reveal how additional efforts were made to transform a piece of air-disinfection equipment into an interactive and accessible robot for older adults. The appropriate size and the level of automation were also raised as essential points for design consideration. Conclusion There is great potential for a variety of care robots to be deployed and evaluated beyond cultural boundaries, but local knowledge and professional expertise are crucial to smooth implementation. The study ‘Harmonisation towards the establishment of Person-centred, Robotics-aided Care System’ was supported by the Toyota Foundation (D18-ST-0005, 2019–2022).

Abstract Background An integrated model of health and social care in the community has been considered to be the gold standard, although many obstacles and challenges still exist. Living at one’s private home for as long as one wishes requires highly personalised arrangements, and therefore is costly, but assistive technologies can potentially facilitate this. In order to test the concept, a remote monitoring and care delivery system was developed. The usability and efficacy of the model were examined. Methods Sensor devices (biometric, temperature sensor and infrared camera sensor) were set up in the homes of five older people (aged 70 years and over), and the information was sent online to each older person, plus his/her family and caregivers. Using these devices, fifteen care professionals delivered home care and remotely supported the home life of the older adults between December 2022 and January 2023. A pre-post study design was adopted, collecting the System Usability Score (SUS), the International Classification of Functioning, Disability and Health (ICF) and the InterRAI assessments. The participating older adults and family members all consented to the research, which involved being observed or watched (all images are silhouettes only) when the system was in operation. Results Remote monitoring with alerts and two-way communication functions was highly valued by caregivers, as it provided an alternative model of care delivery, particularly for those living alone. While the device usability was not highly rated (D), several improvements in ICF and InterRAI scores were recorded (e.g. interpersonal communication, self-care, depressive tendencies). Conclusion While more research is necessary to increase the sample size and the duration of the data collection period, there is great potential for this model, embedding the use of assistive technologies into home care delivery. The study was funded in part by the Japan Agency for Medical Research and Development (22he2002023j0002).

Activation of the unaffected hemisphere contributes to motor function recovery post stroke in patients with severe upper limb motor paralysis. Transcranial direct current stimulation (tDCS) has been used in stroke rehabilitation to increase the excitability of motor-related areas. tDCS has been reported to improve upper limb motor function; nonetheless, its effects on corticospinal tract excitability and muscle activity patterns during upper limb exercise remain unclear. Additionally, it is unclear whether simultaneously applied bihemispheric tDCS is more effective than anodal tDCS, which stimulates only one hemisphere. This study examined the effects of bihemispheric tDCS training on corticospinal tract excitability and muscle activity patterns during upper limb movements in a patient with subacute stroke. In this single-case retrospective study, the Fugl-Meyer Assessment, Box and Block Test, electromyography, and intermuscular coherence measurement were performed. Intermuscular coherence was calculated at 15-30 Hz, which reflects corticospinal tract excitability. The results indicated that bihemispheric tDCS improved the Fugl-Meyer Assessment, Box and Block Test, co-contraction, and intermuscular coherence results, as compared with anodal tDCS. Discussion: These results reveal that upper limb training with bihemispheric tDCS improves corticospinal tract excitability and muscle activity patterns in patients with subacute stroke.

Abstract Background and Objectives Evidence remains inadequate regarding the benefits of participation in community gathering places, which is Japan’s primary strategy for preventing functional disability in older adults, in other domains of health and well-being. This longitudinal study examined the associations of participation in community gathering places with an array of subsequent health and well-being outcomes among older adults. Research Design and Methods We used 3-wave data (2013, 2016, and 2019) from Japan Gerontological Evaluation Study (n = 5 879 or 4 232 depending on the outcome). Our exposure was participation in community gathering places in 2016. We assessed 34 health/well-being outcomes in 2019 across 6 domains. We adjusted for pre-baseline covariates including prior outcome values in 2013. Results Compared with nonparticipation, participation in community gathering places was associated with some outcomes in the following 3 domains: physical/cognitive health (better higher-level functional capacity), social well-being (more frequent participation in hobby groups, senior citizens clubs, learning or cultural groups, and seeing more friends within a month), and prosocial/altruistic behaviors (more frequent participation in volunteering; after Bonferroni correction as p &amp;lt; .0015, .05/34). Discussion and Implications Evidence was mixed and more modest for the outcomes in three other domains, mental health, psychological well-being, and health behaviors. Promoting participation in community gathering places may not only fulfill its original goal (ie, preventing functional disability) but also enhance other domains of human well-being, potentially by increasing social interactions.

Abstract This study investigated whether non-native English speakers showed a processing advantage for high-frequency multiword units (multiword frequency effects), and whether the effects differed between native and non-native speakers. Such a difference has been identified in relation to single-word processing. Native English speakers and intermediate learners of English with languages of different scripts (native speakers of Japanese and German) judged whether English multiword units were grammatical. A significant processing advantage was identified for both native and non-native participants. More importantly, the multiword frequency effects were stronger among non-native than native speakers. The discrepancy persisted even after including individual vocabulary knowledge as a predictor in the mixed-effect models. Furthermore, there was no significant different impact of the effects between two non-native groups, even though German participants responded quicker than Japanese participants. This indicates that the varying influence between L1 and L2 could be explained by within-language, not between-language, variables.