Community-dwelling Elders Research Articles

Predictors of Dependency in Instrumental Activities of Daily Living Among Community Dwelling Elderly in A Rural Field Practice Area of a Tertiary Care Hospital in Chengalpattu District, Tamilnadu, India- A Cross Sectional Study

Background: Longer lifespans of elderly are associated with chronic illnesses that impair functioning, making it harder to carry out daily activities and making assistance necessary. The aim was to estimate the prevalence of dependence in Instrumental Activities of Daily Living (IADL) among elderly and to determine its sociodemographic and health related predictors. Methodology: This cross-sectional study was conducted among elderly in Chengalpattu district from December 2023 to May 2024. Sample size was determined by multistage random sampling. A semi-structured questionnaire consisting of sociodemographic details and Lawton scale to assess dependence were used to collect data. Data was entered in Ms Excel and analysed using SPSS version 26. Results: Mean age of participants was 67.4 ± 7.4 years. 131 (43.7%) of them were at risk of malnutrition and 83 (27.7%) were malnourished. Majority (n=178,59.3%) experienced increased IADL dependency. Binary logistic regression analysis showed increasing age, lower socioeconomic status, Divorced/Widowed/Unmarried, smoking and tobacco use, hospitalizations within previous year were significant predictors of IADL dependency. Conclusions: The study concluded that a considerable proportion of our study population was suffering from IADL dependency (59.3%), with majority demonstrating mild to moderate degree of dependency. To prevent disease in its early stages, arrangements can be made for community-based extensive geriatric health assessments.

Sex-Specific Association Between Urinary Metal and Serum Homocysteine Levels in Chinese Older Adults: A Study Based on the Yinchuan Community-Dwelling Elderly Cohort

Sex-Specific Association Between Urinary Metal and Serum Homocysteine Levels in Chinese Older Adults: A Study Based on the Yinchuan Community-Dwelling Elderly Cohort

A Practice Combining Exercise and Social Interaction for Community-Dwelling Elderly People and Its Outcomes

A Practice Combining Exercise and Social Interaction for Community-Dwelling Elderly People and Its Outcomes

Malnutrition and Handgrip Strength are Correlated in Community Dwelling Elderly

Malnutrition and Handgrip Strength are Correlated in Community Dwelling Elderly

Intrinsic Capacity and Instrumental Activity of Daily Living Among Community Dwelling Elderly in China: The Mediating Effect of Two‐Way Social Support and Sense of Coherence

ABSTRACTObjectivesTo explore the influence of intrinsic capacity (IC) on instrumental activities of daily living (IADL) among community‐dwelling elderly and to analyze the chain‐mediated effects of two‐way social support, and sense of coherence (SOC).DesignThis study was a cross‐sectional research design. Participants were recruited from September 2023 to December 2023 from Hangzhou City, Zhejiang Province, China, using a multistage sampling method.SampleParticipants in this study were at least 60 years old and had been currently living in the community for at least 1 year (n = 458).MeasurementsThe Integrated Care for Older People screening tool, the Brief Two‐Way Social Support Scale, the Sense of Coherence Scale‐13, and the Functional Activities Questionnaire were used to collect relevant data, which were statistically tested using structural equation modeling and multiple mediation effects.ResultsThere were correlations between IC, two‐way social support, SOC and IADL in community‐dwelling elderly (all p < 0.01). IC predicted two‐way social support (β = 0.570, p < 0.001), SOC (β = 0.544, p < 0.001) and IADL (β = −0.492, p < 0.001); two‐way social support had a positive predictive effect on SOC (β = 0.363, p < 0.001) but a negative predictive effect on IADL (β = −0.193, p < 0.001); SOC negatively predicted IADL (β = −0.150, p < 0.05).ConclusionsTo mitigate the impact of declining IC on IADL among community‐dwelling elderly, to sustain independent living, and to reduce the risk of progression to illness and disability, this study proposes two‐way social support and SOC as potential effective intervention targets. This conclusion holds implications for the assessment and intervention of elderly health, as well as the formulation of public health policies.

Noradrenergic Modulation and a Treatment Algorithm for Behavioral Symptoms in Patients with Late Life Dementia

Introduction: Patients affected by neurodegeneration disorders (NDD) often experience difficult to treat disruptive neuropsychiatric symptoms (NPS) i.e. verbal disruption, aggression, psychomotor hyperactivity, sleep difficulties, hallucinations, delusions. The existing treatment algorithms include antipsychotics, gabapentin, trazodone, prazosin, memantine, cholinesterase inhibitors.1,2 Some NPS i.e. anxiety, agitation, aggression, disturbed sleep have been linked to overactivity of the brain noradrenergic system (NAS). The current report suggests a treatment algorithm which includes a method of noradrenergic modulation (NAM). Aims of the study: A. To evaluate a new treatment algorithm for patients with NPS and late life dementia. B. To evaluate the method of NAM in treatment of NPS. Participants and Methods: Nine elderly community dwelling patients (3 males and 6 females) with probable Alzheimer’s dementia and NPS. Age of the patients 71-104 years (86.9, SD 9.4), 4 patients with moderate and 5 patients with severe dementia. Treatment algorithm includes 5 steps and two pathways. Each step is evaluated on the clinical global impression of change (CGI-C) scale. The psychosis pathway (4 patients) begins with an antipsychotic, the alternative pathway (5 patients), with low dose gabapentin (GBP). The psychosis pathway, if ineffective, can switch to the alternative pathway with the add-on of GBP. The alternative pathway proceeds with addition of NAM which includes alpha-1 receptor antagonists (prazosin, doxazosin) and alpha-2 receptor agonists (transdermal clonidine, guanfacine). Results: Treatment was well tolerated. Substantial (7 patients) and moderate (2 patients) improvement in disruptive behaviors such as agitation, aggression, sleep was reflected on the CGI-C scale (score 1.2, SD 0.4), on the Cohen-Mansfeld Agitation Inventory (the score decreased from 52.6, SD 27.0 to 18.6, SD 7.9) and on the de novo introduced VAPS scale (from 8.7, SD 0.4 to 2.7, SD 0.8). The final step of the algorithm, method of NAM was the “game changer” in both psychosis and nonpsychosis alternative pathways. Conclusion: The case series provides preliminary evidence supporting the suggested approach to treatment of NPS in patients with late life dementia.

Factors Influencing Perceived Health Status among Community-dwelling Elderly Individuals with Fear of Falling: An Analysis Based on Data from the Ninth Korean Longitudinal Study of Aging 2022

Factors Influencing Perceived Health Status among Community-dwelling Elderly Individuals with Fear of Falling: An Analysis Based on Data from the Ninth Korean Longitudinal Study of Aging 2022

Development and Validation of a Frailty Risk Prediction Model for Community-Dwelling Elderly in Shanghai

Background: China is rapidly aging, increasing the burden on families, society, and public health services. The health of elderly individuals tends to deteriorate with age, and chronic conditions like frailty become more prevalent, driving up the use of healthcare services. Early screening and intervention for frailty are crucial in managing this demographic shift. While tools like the Fried Frailty Phenotype and Frailty Index assess frailty in communities, they are resource-intensive and only indicate frailty status without predicting risk or providing management recommendations. This study aims to develop a risk prediction model for frailty using real-world data, which can support the early detection of high-risk individuals in community settings. Objectives: To analyze the prevalence of frailty and its influencing factors in community-dwelling elderly, to construct a frailty risk prediction model and develop a nomogram, and to validate the model and assess its clinical utility. Methods: A cross-sectional survey of 420 elderly individuals in a Shanghai community health center was conducted (August 2022–March 2023). Data from various assessment tools were used to build a frailty prediction model through logistic regression, with validation conducted on 180 additional participants. The model’s predictive performance was evaluated using the ROC, AUC, calibration curves, and decision curve analysis (DCA). Results: The frailty prevalence was 7.4%. Independent risk factors included social support, malnutrition, fatigue, sarcopenia, reduced grip strength, and sleep duration. The prediction model achieved an AUC of 0.968 in the training set and 0.939 in the validation set, indicating high discrimination and calibration. DCA confirmed the model’s clinical utility. Conclusion: This study highlights a frailty prevalence rate of 7.4% among elderly individuals in Shanghai, with key risk factors identified. The validated frailty risk prediction model provides accurate and clinically effective frailty risk assessment, supporting targeted early interventions to prevent frailty in community settings.

Predictors of care home resident conveyance to hospital or referral to community pathways by a regional ambulance service attending medical emergencies: a retrospective cross sectional study

BackgroundCare home residents are at higher risk compared with community dwelling elders for medical emergencies, often resulting in ambulance attendance and conveyance to hospital. We aimed to determine the factors predicting care home resident conveyance to hospital or referral to community pathways by an ambulance service.MethodsWe used a retrospective cross-sectional study design analysing routine data from electronic clinical records from East Midlands Ambulance Service NHS Trust (EMAS). Data comprised all patients including care home residents attended by ambulance from 2018 to 2021. A multivariable logistic regression model was used to identify the main predictors of conveyance to hospital or referral to community services.ResultsData included 170,612 attendances to care homes representing 7.5% of the total number of EMAS attendances between 2018 and 2021. The main predictors of conveyance to hospital were being male (Relative Risk Ratio [RRR] 1.07, 95% Confidence Interval [CI] 1.03–1.10, p < 0.001), aged 70–79 years (RRR 1.09, 95%CI 1.03–1.17, p < 0.001) or 80–89 years (RRR 1.10, 95%CI 1.03–1.17, p < 0.001), situated in an area of higher deprivation (RRR 1.06, 95%CI 1.03–1.09, p < 0.001), or having dispatch categories which included cardiovascular (RRR 11.29, 95%CI 10.43–12.22, p < 0,001), trauma such as falls (RRR 9.50, 95%CI 8.97–10.05, p < 0,001) or neurological conditions (RRR 9.06, 95%CI 8.42–9.75, p < 0,001). Calls made by health care professionals (HCPs) (RRR 15.37, 95%CI 13.41–17.62, p < 0,001) or where patients had a higher National Early Warning Score (NEWS2) (RRR 1.23, 95%CI 1.22–1.24, p < 0,001) resulted in significantly increased conveyance.ConclusionsVarious factors significantly predicted conveyance of care home residents to hospital by ambulance. These included HCP referral and a higher NEWS2 score confirming that severity of clinical condition of the patient significantly increased conveyance. Future interventions to prevent or address certain conditions such as falls or provide enhanced care in care homes may prevent some emergencies or reduce the likelihood of conveyance to hospital.

Detecting muscle fatigue among community-dwelling senior adults with shape features of the probability density function of sEMG

BackgroundPhysical exercise is an important method for both the physical and mental health of the senior population. However, excessive exertion can lead to increased risks of falls, severe injuries, and diminished quality of life. Therefore, simple and effective methods for fatigue monitoring during exercise are highly desirable, particularly in community settings. The purpose of this study was to explore the possibility of real-time detection of exercise-induced fatigue using surface Electromyogram (sEMG) features, including the kurtosis and skewness of the Probability Density Function (PDF) in the community settings to solve the issues of low sensitivity and high computational complexity of commonly used sEMG features.MethodssEMG signals from six forearm muscles were recorded during hand grip tasks at 20% maximal voluntary contraction (MVC) task-to-failure contractions from 30 healthy community-dwelling elders at their respective community centers. PDF shape features of the sEMG, namely kurtosis and skewness, were computed from 25 s of non-fatigue stable phase and 25 s of fatigue data for comparison. Statistical tests were conducted to compare and test for the significance of these features. We further proposed a novel fatigue indicator, Temporal-Mean-Kurtosis (TMK) of channel-averaged kurtosis, to detect fatigue with relatively low computational complexity and adequate sensitivity in community settings. ANOVA and post-hoc analyses were performed to examine the performance of TMK.ResultsStatistically significant differences were found between the non-fatigue period and the fatigue period for both kurtosis and skewness, with increasing values when approaching fatigue. TMK was shown to be sensitive in detecting fatigue with respect to time with lower computational complexity than the Sample Entropy.ConclusionThis study investigated PDF shape features of sEMG signals during a handgrip exercise to identify muscle fatigue in older adults in community experiments. Results revealed significant changes in kurtosis upon fatigue, indicating that PDF shape features were suitable convenient detectors of muscle fatigue in community experiments. The proposed indicator, TMK, showed potential sensitivity in tracking muscle fatigue over time in community-based settings with limited computational complexity, highlighting the promise of sEMG’s PDF features in detecting muscle fatigue among the elderly.

Intergenic Interactions of ESR1, GSTO1 and AGER and Risk of Dementia in Community-Dwelling Elderly (SADEM Study).

Dementia causes the loss of functional independence, resulting in a decrease in the quality of life of those who suffer from it. This study aimed to investigate the interactions influencing susceptibility to the development of dementia through multifactor dimensionality reduction (MDR). the study population was made up of 221 cases and 534 controls. We performed an MDR analysis as well as a bioinformatic analysis to identify interactions between the genes GSTO1_rs4925, AGER_rs2070600, and ESR1_rs3844508 associated with susceptibility to dementia. We observed associations between the polymorphism of GSTO1 and risk of dementia for the site rs4925 with the recessive model (OR = 1.720, 95% CI = 1.166-2.537 p = 0.006). Similarly, the site AGER rs2070600 showed risk of dementia with an additive model of inheritance (OR = 7.278, 95% CI = 3.140-16.868; p < 0.001). Furthermore, we identified the best risk model with a high precision of 79.6% that, when combined with three environmental risk factors, did not give an OR = 26.662 95%CI (16.164-43.979) with p < 0.001. The MDR and bioinformatics results provide new information on the molecular pathogenesis of dementia, allowing identification of possible diagnostic markers and new therapeutic targets.

Effect of an Exercise Intervention Based on General Adaptation Syndrome Model on Psychological Experience in Community-Dwelling Elderly.

With the intensification of population aging globally, the mental health of the elderly is not only related to their personal well-being but also directly affects family harmony and social stability. However, few studies have been conducted on interventions for mental health issues in the elderly. From September to December 2023, a total of 164 elderly individuals were recruited from Ronghui Shanshui community in Fuzhou City of China through random cluster sampling and randomly divided into the control and experiment groups. The experiment group was given a three-month intervention based on general adaptation syndrome model, whereas the control group was given no intervention. At the end of the intervention period, an effect comparison was conducted between the two groups using the Physical Activity Rating Scale, University of California at Los Angels (UCLA) Loneliness Scale, and Memorial University of Newfoundland Scale of Happiness. After the intervention, the well-being of the experiment group increases significantly and is significantly higher than that of the control group (P < 0.05). After the intervention, the loneliness of the experiment group decreases significantly and is significantly lower than that of the control group (P < 0.05). Exercise participation significantly mediates the relationship between the intervention and psychological experience (P < 0.001). This intervention model is not only beneficial for improving positive psychological experience in the elderly but can also effectively reduce their negative psychological experience. This study provides valuable reference for scientific intervention in the mental health of the elderly.

Positive association between constipation and mild cognitive impairment in elders: A cross-sectional study.

This study aimed to examine the association between constipation and mild cognitive impairment (MCI); and further elucidate the possible mechanisms involved. A cross-sectional study was conducted among community-dwelling elders (N = 789) in Nanning, China. Trained research staffs collected detailed information through questionnaires and physical examinations. A Bayesian network model was used to explore the hypothesized causal path. Synergistic effects of constipation with infrequent fruit consumption, inactive physical exercise, or history of stroke were observed in the risks of MCI occurrence. The Bayesian network model analyses showed 3 hypothesized causal-association paths leading to MCI occurrence. Among these, constipation, history of stroke, and years of schooling were directly related to the occurrence of MCI. Years of schooling indirectly affected MCI through infrequent fruit consumption and constipation; or through inactive physical exercises and history of stroke. This study demonstrates a direct association between constipation and increased risks of MCI.

The Impact of the COVID-19 Pandemic on Suicidal Ideation and Depression in Community-Dwelling Elderly.

This study examined the effects of the coronavirus disease 2019 (COVID-19) pandemic on depression and suicidal ideation in community-dwelling elderly in Korea. Data were employed from a survey on elderly mental health in Jeollanam-do (southwest province in Korea), conducted by the Jeollanam-do Provincial Mental Health and Welfare Center. A total of 2423 people were recruited from all 22 cities in Jeollanam-do from April to October, 2021. We used self-reported questionnaires including sociodemographic factors, COVID-19-related stress, the Geriatric Depression Scale-Short Form Korean Version, the Multidimensional Scale of Perceived Social Support, the Satisfaction With Life Scale and the Brief Resilience Scale. Logistic regression was performed to examine the factors of depression and suicidal ideation. Of the 2423 subjects, 622 (25.7%) reported depressive symptoms and 518 (21.4%) reported suicidal ideation. The multivariate logistic regression analysis revealed that living alone, poor perceived health status, worry of COVID-19 infection, and restriction of daily activities due to COVID-19 pandemic are significantly associated with depression. Female gender, poor perceived health status, inability to perform household chores, and depressive symptom are risk factors of suicidal ideation. These findings show that old age, negative perception of health, and restriction of daily activities due to COVID-19 are risk factors of depression in community-dwelling elderly in the context of the COVID-19 pandemic. Female gender, poor self-perceived health status, and depression increase the risk of suicidal ideation among the elderly. Social support and life satisfaction are protecting factors of both depression and suicidal ideation. Resilience decreased risk of depression but not in suicidal ideation.

Derivation of Indices of Cognitive Change Among Hispanic Adults and Elders.

Determining the influence of race and ethnicity on change in cognitive test performance has significant implications for clinical practice and research in populations at risk for Alzheimer disease. To evaluate the significance of race and ethnicity in predicting longitudinal cognitive test performance and to develop models to support evidence-based practice. This prognostic study included baseline and 24-month follow-up data that were obtained from the Health and Aging Brain Study-Health Disparities (HABS-HD) study, an ongoing longitudinal observational study of aging and dementia in a multiracial, multiethnic cohort. Participants included community-dwelling adults and elders living in the Dallas and Fort Worth metropolitan area who were Hispanic and non-Hispanic adults older than the age of 50 years and were cognitively unimpaired. The primary exposure of interest was time, measured in months. Demographic variables included age, sex, education, and race and ethnicity. Cognitive domains included attention and working memory, processing speed, language, memory, and executive functioning. Linear regression models predicted follow-up performance from baseline performance and demographic variables for 13 commonly used neuropsychological tests. Follow-up testing was the primary outcome for all domains. Raw scores from 13 standardized tests were used for analyses. This study included 799 adults who were cognitively unimpaired (352 Hispanic individuals [44.1%]; 447 non-Hispanic individuals [55.9%]; 524 female [65.6%]; mean [SD] age, 65.4 [8.1] years). In the regression models, all 13 follow-up scores were significantly predicted from their respective baseline scores and demographic variables. Baseline performance and education were the most consistent predictors of follow-up scores, contributing to all 13 models. Age was significantly associated with follow-up in 11 models, and sex was significant in 5 models. Race and ethnicity contributed to 10 of 13 models, with Hispanic participants predicted to have poorer follow-up scores than their non-Hispanic White counterparts on each test. In this longitudinal study of cognitive change in Hispanic and non-Hispanic older adults who were cognitively unimpaired, standardized regression-based models were influenced by multiple demographic variables, including race and ethnicity. These findings highlight the importance of including race and ethnicity in such cognitive change models. This ability to accurately predict cognitive change is expected to become increasingly important as clinical practice and clinical trials need to become more diverse and culturally appropriate in this burgeoning global medical and societal crisis.

Gender Differences in the Association between BMI and Depression Status among Community-dwelling Middle-aged and Elderly Population in Taiwan

&lt;p&gt;目的：本研究旨在探討台灣社區居住的中老年人群中BMI與憂鬱狀態之間的性別差異。&lt;/p&gt; &lt;p&gt;方法：這是一個在台灣北部進行的橫斷面研究。年齡介於50至80歲的243名男性和607名女性納入統計。依照不同的性別，參與者根據問卷分數被分類為不同的憂鬱狀態。我們採用了流行病學研究中心憂鬱量表10項版本(CESD-10)問卷來評估參與者的憂鬱狀態。並探討了憂鬱症與教育水平、婚姻狀況、BMI、自覺健康量表、吸菸習慣、飲酒習慣、運動、就業、收入、高血壓、糖尿病和高血脂的相關性。我們使用卡方檢定來比較類別變項之間的關係，而多元邏輯斯迴歸分析則使用來探討BMI與憂鬱狀態(CESD-10 &amp;ge; 8分)之間的關聯性。&lt;/p&gt; &lt;p&gt;結果：將參與者根據性別與CESD-10切點8分分析。結果在男性組中，BMI與憂鬱狀態之間沒有顯著關聯(p=0.06)在女性，BMI和自覺健康量表與憂鬱狀態則存在顯著相關性(p&lt;0.01)。我們使用多元邏輯斯迴歸分析，發現在女性組中BMI&lt;18.5的族群與憂鬱狀態有顯著關聯(p=0.02, OR 3.76, 95% CI 1.23-11.46)。&lt;br /&gt;結論：研究表明BMI低於18.5是女性憂鬱症的一個獨立風險因素。因此，我們建議對於BMI低於18.5體型瘦弱的中老年女性應進行憂鬱症篩檢。也強調維持適當的體重有助於改善心理健康，尤其是中老年女性。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;Purpose: The purpose of this study was to investigate the gender differences in the association between body mass index (BMI) and depression status among middle-aged and elderly people living in the community in Taiwan. &lt;/p&gt; &lt;p&gt; Methods: This is a cross-sectional study in northern Taiwan. 243 males and 607 females, aged 50-80 years were eligible for analysis. The participants were categorized in different depression status base on questionnaire according to gender. We applied Center for Epidemiologic Studies Depression Scale 10-item version (CESD-10) questionnaire to evaluate participant&amp;rsquo;s depression status. The statistical methods of Chi-square test were used to explored the correlation between depression status and categorical variables, including education level, marital status, BMI, self-reported health status, current smoking, alcohol consumption, exercise, employment status, income, hypertension, diabetes, and hyperlipidemia. Furthermore, we also applied multivariate logistic regression analysis. &lt;/p&gt; &lt;p&gt; Results: A total of 850 participants, 243 men and 607 women, were included in the analysis. They were classified into 2 categories by CESD-10 score with cut-off point of 8 in male and female group respectively. There is a significant difference between BMI and depression status in women (p&lt;0.01). However, no significant relationship (p=0.06) between BMI and depression status was found in male group. Multivariate logistic regression analysis indicated that BMI&lt;18.5 subclass has a significant relationship (p=0.02, OR 3.76, 95% CI 1.23-11.46) with depression status in female group. &lt;/p&gt; &lt;p&gt; Conclusions: Our study suggests that BMI below 18.5 is an independent risk factor for depression in females. Thus, when we visit thin middle-aged and elderly female patient, performing depression screening method should be taken into account in our clinical practice, especially those BMI below 18.5.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

The Development and Application of the “Outcome Measurement of Health-Promotion Program for Community-Dwelling Elderly”

&lt;p&gt;我國自2018年老年人口超過14%，正式邁入「高齡社會」，並即將於2025年達到超過21%，並進入「超高齡社會」。為因應人口結構改變，預防及延緩失能更加重要。自2017年起，衛福部推出了「長期照顧十年計畫2.0-預防及延緩失能照護計畫」，徵求介入方案，在社區據點展開長者健康促進活動。然計畫執行上，仍缺乏一個適當的方案成效評估工具，評量長者的健康狀態，同時評估各據點的執行成效，作為政府品質控管的參考。&lt;br /&gt;本文將介紹於2022年1月2日國民健康署公告的社區長者健康促進方案之成效評估工具（以下簡稱「方案成效評估工具」）之發展背景、目標、特性及過程、信效度驗證等內容與應用，及未來展望，最後將比較此評估工具與目前國健署更新公告之前後測工具--ICOPE (Integrated Care for Older People)長者功能評估量表，以協助讀者更清楚了解方案成效評估工具的使用時機。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;Since 2018, Taiwan has transitioned into an &amp;ldquo;aged society,&amp;rdquo; with more than 14% of Taiwanese aged over 65. By 2025, Taiwan is predicted to turn into a &amp;ldquo;super-aged society,&amp;rdquo; with the weight of her elderly populating reaching 21%. In response, the Ministry of Health and Welfare has launched the national &amp;ldquo;Ten-year Long-term Care Plan 2.0&amp;rdquo; to prevent or delay disability among the elderly since 2017. While the plan calls for the implementation of health-promotion interventions for elderly community-dwellers, there has not been an appropriate outcome measure for the government to evaluate participants&amp;rsquo; health status and improvement before and after participating in the interventions, as well as to assess the strength and quality of implementation in individual communities. &lt;/p&gt; &lt;p&gt; This article introduces the development, goal, characteristics, validity, application, and limitation of the &amp;ldquo;Outcome Measure of Health-Promotion Program for Community-Dwelling Elderly&amp;rdquo; announced on January 1, 2023 by the Health Promotion Administration. We have also compared the new outcome measure with ICOPE (Integrated Care for Older People) so as to clarify the differences.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Improvement of social frailty is associated with stability of nonparametric characteristics of the rest-activity rhythm and improvement of the usual walking ability in the elderly

ABSTRACT Our study, conducted between April 2022 and January 2024, was aimed at clarifying components of the rest-activity rhythm (RAR) involved in improvement of social frailty state before or after a 3-month multi-component exercise intervention in the elderly. Participants were recruited from the general population in Akita prefecture, Japan. We administered a four-item social frailty screening questionnaire to classify the severity of social frailty in each participant before and after the 3-month intervention. The RAR parameters were measured on an Actiwatch Spectrum Plus device worn by the subjects for 7 continuous days. As the final sample, 65 participants classified into the improved/maintained group (n = 36) or the deteriorated group (n = 29) according to the change in the social frailty classification after the intervention were included in the analysis. The results of a binomial logistic regression analysis showed significantly higher values of interdaily stability (IS) and usual walking speed at the post-test after the intervention. Based on our findings, we propose that stability of the rest-activity rhythm related to synchronization with external stimuli (such as social effect and physical activity) might have clinical impact on improvement of social frailty state in elderly community-dwellers.

Effects of board games on balance in association with cognition in community-dwelling older adults

Objectives: Falls among the elderly are a prevalent concern. Maintaining balance and preventing falls necessitate cognitive processes, such as information processing speed and executive functions. The objective was to determine the impacts of board games on cognition, balance, and risk of falls among community-dwelling elders. Methods: Sixty-four elders aged 65 years and above, with mini–mental state examination (MMSE), scores above 26 and Berg balance scale (BBS) scores between 41 and 52, were recruited with a sample size of 64 divided into two groups, 32 in each group. Participants were randomized through the sealed envelope technique into experimental (engaging in board games) and control groups (not involved in board game activity). The BBS, MMSE, timed upand-go test (TUGT), and dynamic gait index (DGI) were assessed at baseline, four weeks, and eight weeks. Results: Participants engaging in board games (mean age 69.93 ± 4.77) demonstrated significant improvements in cognition, with MMSE scores increasing from 26.8 ± 0.83 at baseline to 28.6 ± 0.74 after eight weeks (P &lt; 0.001). BBS scores enhanced from 47.2 ± 1.84 to 49.8 ± 5.15 (P &lt; 0.001), DGI scores improved from 19.65 ± 1.49 to 21.37 ± 1.47 (P &lt; 0.001), and TUGT scores decreased from 10.40 ± 0.69 to 10.22 ± 0.67 (P &lt; 0.001). Mixed analysis of variance revealed significant differences between experimental and control groups for MMSE (P &lt; 0.001), BBS (P &lt; 0.001), DGI (P &lt; 0.001), and TUGT (P &lt; 0.001). Conclusion: The eight-week interactive physical-cognitive training program involving board games was found to enhance cognitive performance, mobility, and balance and decrease fall risk among the elderly.

Relationship between health-related quality of life and swallowing function in community-dwelling independent older adults

The purpose of this study was to examine the relationship between health-related quality of life (QOL) and swallowing function among independent community-dwelling older Japanese adults aged 65 years or older. A total of 500 participants (250 males and 250 females) were surveyed about BMI, dysphagia and eating disorders (Dysphagia Risk Assessment for the Community-dwelling Elderly [DRACE]), quality of life (QOL; SF-8 Physical and Mental Summary Score), sleep (Pittsburgh Sleep Questionnaire Japanese version [PSQI-J]), and depression (Geriatric Depression Scale [GDS]). Participants were divided into two groups based on risk of aspiration and data between the groups were compared. Logistic regression analysis revealed that the SF-8 physical component summary score (PCS) and mental component summary score (MCS) were associated with aspiration risk. In the multiple regression analysis, the SF-8 related to eating and swallowing function and PSQI-J were extracted. The risk of aspiration among the older adults in this study was found to be associated with health-related QOL, sleep quality, revealing a wide-ranging impact on physical, mental, and social functioning. These associated factors may pose a risk for community-dwelling independent older adults, suggesting the need to focus on eating and swallowing function for frailty.