Community-dwelling Elderly Individuals Research Articles

Effects of continuous supplementation of Acanthopanax senticosus Harms on the cardiac autonomic function of community-dwelling elderly individuals during resting and standing tests: a randomized controlled trial.

Cardiac autonomic function (CAF) decreases with aging, and Acanthopanax senticosus Harms (ASH) consumption reportedly induces anti-stress effects. This study aimed to assess the effect of continuous supplementation of ASH on CAF during resting and standing tests in the elderly population. This double-blind, randomized controlled trial was conducted in the morning in a laboratory setting and was carried out between June 2017 and July 2017 at Kambaikan, Doshisha University (Karasuma-higashi-iru, Imadegawa-dori, Kamigyo-ku, Kyoto 602-8580, Japan). In total, 28 community-dwelling elderly individuals (mean ± standard deviation = 72.5 ± 4.5 years) were included. Each subject was instructed to consume ASH or placebo supplements twice daily for 4 weeks. An autonomic reflex orthostatic tolerance recorder was used to measure CAF in pre- and post-intervention phases. Parameters were measured in a seated position and included coefficient of variation of R-R intervals (CVRR), low frequency (LF), high frequency (HF), LF/HF ratio, blood pressure, and heart rate (HR). Changes in each parameter were evaluated before and after standing. All parameters were defined as the difference between the mean value obtained in a standing position for 2 min and that obtained in a 2-min seated position. A two-way analysis of variance revealed a significant group-time interaction effect on CVRR, HF, and ΔLF/HF ratio. Following the intervention, CVRR, HF, LF/HF ratio, systolic blood pressure (SBP), HR, ΔLF/HF ratio, ΔSBP, and ΔHR improved significantly in the ASH group only. Four-week supplementation of ASH improved CAF in community-dwelling elderly individuals during resting and standing tests. https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000031218, UMIN Clinical Trials Registry (UMIN000027251).

GAIT SPEED AND MOBILITY PERFORMANCE AMONG FALLERS AND NON-FALLERS COMMUNITYDWELLING ELDERLY FILIPINOS: A COMPARATIVE CROSS-SECTIONAL STUDY

Introduction: Southeast Asia is experiencing a significant rise in the population of elderly individuals, particularly in the Philippines. Thus, screening and monitoring mobility restrictions in elderly people are critical in order to provide effective measures as well as prompt and timely interventions. Methods: The study used a quantitative, non-experimental, comparative, and cross-sectional design. Filipino community-dwelling elderly individuals who were aged 60-79 years old, had no significant disability, and residing in a municipality of the National Capital Region (n=152), participated in the study. Researchers measured mobility performance using Timed Up-and-Go Test (TUGT). While, gait speed was measured using iWalkAssess application to administer 10-Meter Walk Test (10MWT). Preliminary reference values for the mobility-specific tests were presented as means, standard deviations, and 95% confidence intervals. Findings were compared between Faller and Non-Faller groups. Results: Fallers demonstrated consistently higher scores compared to their non-Faller counterparts on the TUGT (P-value < 0.05). While there are significantly lower scores in 10MWT among Fallers than in Non-Fallers (P-value < 0.05). Furthermore, the Faller group revealed to have a Timed Up and Go Test mean (SD) score of 13.32 ± 1.41, while there is a reported 0.92 ± 0.15 mean (SD) score in 10-Meter Walk Test. Discussion: The study provides preliminary evidence on the differences in gait speed and mobility performance among community-dwelling elderly individuals who are Fallers and Non-Fallers. Hence, Filipino community-dwelling elderly individuals who are classified as Fallers revealed to have a slower gait speed than Non-Faller community-dwelling older adults. Also, results suggested that Non-Fallers have a better mobility performance than the Faller population.

Develop and Validate a Prognostic Index With Laboratory Tests to Predict Mortality in Middle-Aged and Older Adults Using Machine Learning Models: A Prospective Cohort Study.

Prognostic indices can enhance personalized predictions of health burdens. However, a simple, practical, and reproducible tool is lacking for clinical use. This study aimed to develop a machine learning-based prognostic index for predicting all-cause mortality in community-dwelling older individuals. We utilized the Healthy Aging Longitudinal Study in Taiwan (HALST) cohort, encompassing data from 5663 participants. Over the 5-year follow-up, 447 deaths were confirmed. A machine learning-based routine blood examination prognostic index (MARBE-PI) was developed using common laboratory tests based on machine learning techniques. Participants were grouped into multiple risk categories by stratum-specific likelihood ratio analysis based on their MARBE-PI scores. The MARBE-PI was subsequently externally validated with an independent population-based cohort from Japan. Beyond age, sex, education level, and BMI, 6 laboratory tests (low-density lipoprotein, albumin, aspartate aminotransferase, lymphocyte count, high-sensitivity C-reactive protein, and creatinine) emerged as pivotal predictors via stepwise logistic regression (LR) for 5-year mortality. The area under curves of MARBE-PI constructed by LR were 0.799 (95% confidence interval [95% CI]: 0.778-0.819) and 0.756 (95% CI: 0.694-0.814) for the internal and external validation data sets, and were 0.801 (95% CI: 0.790-0.811) and 0.809 (95% CI: 0.774-0.845) for the extended 10-year mortality in both data sets, respectively. Risk categories stratified by MARBE-PI showed a consistent dose-response association with mortality. The MARBE-PI also performed comparably with indices constructed with clinical health deficits and/or laboratory results. The MARBE-PI is considered the most applicable measure for risk stratification in busy clinical settings. It holds potential to pinpoint older individuals at elevated mortality risk, thereby aiding clinical decision-making.

The association between time-restricted eating and arterial stiffness status in community-dwelling elderly Chinese individuals

Background and aimsEmerging studies indicate that time-restricted eating (TRE) may protect against cardiovascular disease (CVD); however, studies performed in elderly adults are limited. This study aimed to analyze the association of TRE with arterial stiffness (AS) in community-dwelling elderly Chinese individuals. Methods and resultsThis cross-sectional study recruited 3487 participants aged ≥60 y from Shanghai, China. TRE was determined by calculating the end time of the last meal minus the start time of the first meal of the average day. Participants were then categorized into those with a time-restricted window lasting ≤11 h (TRE) and >11 h (non-TRE). The mean age of the sample was 71.78 ± 5.75 y, and 41.2 % were men. Having a TRE pattern was 72.2 %. In the logistic analysis, TRE was associated with borderline arterial stiffness (OR = 1.419; 95 % CI = 1.077–1.869) and elevated arterial stiffness (OR = 1.699; 95 % CI = 1.276–2.263). In a subgroup analysis, the significance remained in the group at risk of malnutrition (with borderline arterial stiffness: OR = 2.270; 95 % CI = 1.229–4.190; with elevated arterial stiffness: OR = 2.459; 95 % CI = 1.287–4.700), while in well-nourished participants, the association only remained with elevated arterial stiffness (OR = 1.530; 95 % CI = 1.107–2.115) and not with borderline arterial stiffness. ConclusionsTRE is a risk factor for both borderline and elevated arterial stiffness in community-dwelling Chinese individuals and varies by nutritional status. (Protocol code 2019-WJWXM-04-310108196508064467.)

Association between timed up-and-go test and subsequent pneumonia: A cohort study.

Sarcopenia is a risk factor for pneumonia in the elderly, and the timed up-and-go test (TUG) can be used as a screening tool for sarcopenia in this population. This study aimed to evaluate the association between TUG test results and future pneumonia or ventilator care. From the National Health Insurance Service-Senior Cohort database, we identified 19,804 people without neurological diseases who underwent the TUG test in the National Screening Program for Transitional Ages at the age of 66 years during 2007-2008. Gait abnormality was defined as taking 10 s or longer to perform the TUG test. Pneumonia occurrence was defined using the International Classification of Diseases 10th Revision (ICD-10) code for pneumonia (J12-J18, J69), and ventilator care was defined by procedure codes (M5830, M5850, M5867, M5858, M5860, M5859) according to the Healthcare Common Procedure Coding system codes from 2007 to 2015. The mean follow-up period was 7.4 years (standard error, SE 0.02). The incidence rates of pneumonia in the normal and slow TUG groups were 38 and 39.5/1000 person-years, respectively. The slow TUG group did not show a higher risk of pneumonia (adjusted hazard ratio [aHR], 1.042; 95% confidence interval [95% CI], 0.988-1.107]). Regarding ventilator care, the incidence was 4.7 and 5.2 cases per 1,000 person-years in the normal and slow TUG groups, respectively. Slow TUG groups also did not show an increased risk of ventilator occurrence (aHR, 1.136, [95% CI = 0.947-1.363]). The TUG test result was not associated with future pneumonia or ventilator care and may not be useful for predicting pneumonia in community-dwelling elderly individuals. Further studies are needed to identify additional functional tools for sarcopenia associated with future pneumonia occurrences.

Classification and comparison of the physical characteristics and functions of various age groups of community-dwelling elderly individuals participating in the Kayoi-no-ba program.

[Purpose] To classify and compare the physical characteristics and functions of community-dwelling elderly individuals of various age groups participating in the Kayoi-no-ba program. [Participants and Methods] A total of 176 community-dwelling elderly individuals living in six cities and towns in the Niigata Prefecture who participated in the Kayoi-no-ba program between 2018 and 2020 were recruited in this study. Physical characteristics, such as strength, balance, and mobility, were assessed. [Results] Among elderly females and males who participated in the Kayoi-no-ba program, those >80 years of age showed shorter height, lighter weight, and lower body muscle mass than the other age groups. Strength, balance, and mobility functions, including grip strength, sit-to-stand test, single-leg-stand test, and timed up-and-go test, were significantly decreased, especially in patients aged >80 years. [Conclusion] Among community-dwelling elderly individuals participating in the Kayoi-no-ba program, physical characteristics and functions were affected by aging, with significant decline particularly in those aged >80 years old. These findings suggest that early intervention is necessary to maintain muscle mass, strength, balance, and mobility in the elderly.

Risk factors for oral frailty among community-dwelling pre-frail older adults in Japan: A cross-sectional analysis.

Oral frailty is a well-established risk factor for frailty and plays a significant role in progression to frailty. However, the association between oral frailty and pre-frailty in elderly individuals remains unclear. This cross-sectional study aimed to clarify the characteristics and risk factors of pre-frailty in elderly individuals with oral frailty. A total of 377 elderly individuals participated. Oral examinations comprised simple and non-invasive measures of chewing function, self-reported swallowing function, and oral moisture. The frailty screening index was used to assess frailty phenotypes. The overall prevalence of pre-frailty was 63.1%, after excluding 40 frail and 99 robust individuals. The mean age of the pre-frail participants was 76.6 ± 5.8 years; 70.6% were women. 10.5% of the pre-frail elderly participants had oral frailty. In multivariate analysis diabetes mellitus, history of cancer, denture wearing, and malnutrition were independently associated with oral frailty among pre-frail elderly individuals (adjusted odds ratio (OR) 3.8, 95% confidence interval (CI) 1.06-13.54; OR 4.5, CI 1.32-15.36; OR 8.8, CI 1.76-43.78; and OR 3.6, CI 1.30-9.67; respectively). The prevalence of oral frailty was low among community-dwelling pre-frail elderly individuals. Early interventions involving oral, nutritional, and disease management may prevent or improve oral frailty in pre-frail elderly individuals and may prevent progression to frailty. Further studies are required to elucidate the underlying mechanisms.

Path analysis of current status and influencing factors of nutritional literacy among community-dwelling older adults

The aim of this study is to investigate the current status of nutritional literacy among community-dwelling elderly individuals in Hangzhou, Zhejiang Province, China, as well as the associated influencing factors and pathways. The Nutritional Literacy Assessment Scale for community-dwelling older adults and a questionnaire on factors influencing nutritional literacy were utilized. Descriptive statistics, stratified linear regression, and path analysis were employed to determine the influencing factors and pathways of nutritional literacy. The nutritional literacy rate among community-dwelling older adults in Hangzhou was moderate, with functional nutritional literacy being the highest and critical nutritional literacy being the lowest. Factors such as gender, education level, self-efficacy, healthy lifestyles, family and social networks, living environment, and policies were found to influence nutritional literacy. There is scope for improvement in the nutritional literacy level among older adults in the community in Hangzhou, particularly in terms of critical and interactive nutritional literacy.

Feasibility of Health and Fitness Data Collection in Online Behavioral Intervention of Elderly

Abstract The global increase in life expectancy has led to a growing elderly population, which necessitates novel strategies to promote healthy ageing and maintain optimal quality of life. Lifestyle coaching has emerged as a promising intervention to address these challenges by offering tailored guidance and support for seniors to make sustainable lifestyle changes. This study investigates the feasibility of collecting health and fitness data reported by the elderly population participating in an online behavioural intervention. We recruited 60 community-dwelling elderly individuals between the ages of 55-80 (including both men and women) for a 14-week online intervention promoting healthy lifestyles using coaching principles. The main criteria for inclusion were a diagnosis of arterial hypertension with or without medication and/or overweight or obesity as defined by BMI. We collected health-related data (arterial blood pressure, weight, waist circumference, quality of life using EQ-5D-5L questionnaire) and fitness-related data (30-second chair test, 2-minute step test). All data were self-recorded by the participants and reported via an online system with the help of a health coach. Forty-seven participants were able to complete the entire 14-week intervention. The initial data set resulted in only 51% (24 out of 47) of the participants having reported the full dataset. We then used written and spoken reminders to notify participants to submit the collected data, which brought the percentage up to 70% (33 out of 47). The main obstacle in health and fitness-related data collection was the forgetfulness of participants to do the self-reported measurements and tests. Among other factors affecting the amount of collected data, we experienced a lack of understanding of the process of the fitness tests, as well as a low questionnaire completion ratio. Almost 80% of participants managed to report all of the health-related data which was also considered the least complicated to collect. Key messages • Elderly people with higher cardiovascular risk are able to self-report health and fitness data in online behavioral intervention but thorough guidance and reminders need to be applied. • Elderly people are willing to participate on the online lifestyle behavioural interventions.

Application of the mild behavioral impairment checklist in Chinese patients with the behavioral variant of frontotemporal dementia.

The mild behavioral impairment checklist (MBI-C) designed to capture neuropsychiatric symptoms in the whole spectrum of elder with or without dementia, have been verified in mild behavioral impairment, mild cognitive impairment and Alzheimer's Disease, but never used in the behavioral variant of frontotemporal dementia (bvFTD). Fifty-two patients with bvFTD (mild, n = 30; moderate-severe, n = 22) and 82 community-dwelling elderly individuals (HCs) were enrolled. All subjects were assessed with a full neuropsychological scale including the MBI-C, Neuropsychiatric Inventory Questionnaire (NPI-Q), and Frontal Behavioral Inventory (FBI). Receiver operating characteristic curves were drawn to analyze the sensitivity and specificity of the MBI-C, NPI-Q, and FBI, and cutoff points were determined using the Youden index. The MBI-C and domain scores in all patients with bvFTD were significantly higher than those in HCs. The most common symptoms of bvFTD were apathy (82.7%) and impulse dyscontrol (80.8%). The MBI-C score was positively correlated with the NPI-Q, FBI, and Activities of Daily Living. For differentiating patients with both bvFTD and mild bvFTD from HCs, the optimal MBI-C cutoff point was 5.5 with a sensitivity of 100% and specificity of 82%, and its sensitivity was higher than that of the NPI-Q and FBI. The MBI-C is a sensitive tool for screening behavioral and psychological symptoms in patients with bvFTD, even in the early stages of the disease.

Selenium and coenzyme Q10 improve the systemic redox status while reducing cardiovascular mortality in elderly population-based individuals.

Serum sulfhydryl groups (R-SH, free thiols) reflect the systemic redox status in health and disease, and may be amenable to therapeutic modulation. Since R-SH are readily oxidized by reactive species, oxidative stress is characterized by reduced serum R-SH levels. Selenium and coenzyme Q10 supplementation may improve the systemic redox status. This study aimed to evaluate the effect of supplementation with selenium and coenzyme Q10 on serum free thiols and to study associations with the risk of cardiovascular mortality in elderly community-dwelling individuals. In this randomized, double-blind, placebo-controlled trial, serum R-SH were measured colorimetrically and adjusted for albumin in 434 individuals at baseline and after 48 months of intervention. Selenium yeast (200 μg/day) and coenzyme Q10 (200 mg/day) or placebo were provided as dietary supplements. After 48 months of intervention, participants receiving combined selenium and coenzyme Q10 supplementation demonstrated increased levels of serum R-SH compared to placebo (P = 0.002). In prospective association analysis, the highest rate of cardiovascular mortality after a median follow-up of 10 years (IQR: 6.8-10.5) was observed in the lowest quartile (Q1) of R-SH levels. Baseline albumin-adjusted serum R-SH were significantly associated with the risk of cardiovascular mortality, even after adjustment for potential confounding factors (hazard ratio [HR] 1.98 per SD, 95% CI: 1.34-2.91, P < 0.001). Supplementation with selenium and coenzyme Q10 to an elderly community-dwelling population low on the two substances, significantly improved serum R-SH levels, supporting a reduction in systemic oxidative stress. Low serum R-SH levels were significantly associated with an increased risk of cardiovascular mortality in elderly individuals.

Telemedicine for Monitoring Nutritional Intake in Malnourished Community-Dwelling Elderly: A Scoping Review of Clinical Trials

Malnutrition is part of the geriatric giant and a major concern among community-dwelling elderly individuals. Improper intervention of this problem can have detrimental effects on the elderly. Monitoring nutritional intake plays a vital role in managing malnutrition. Telemedicine has been widely applied for managing chronic diseases and gained prominence during the COVID-19 pandemic as a remote health monitoring method. This scoping review aims to identify the advantages and limitations of implementing telemedicine for addressing malnutrition in community-dwelling elderly. This study reviewed the literature obtained through a systematic search of PubMed and ScienceDirect databases, supplemented by manual searches based on specific inclusion criteria.  Two randomized controlled trials (RCTs) assessing the application of telemedicine for malnutrition were identified. The forms of telemedicine used were telecare and set-top boxes on television. The interventions included nutritional monitoring and specific interventions for each patient. However, high patient dropout rates indicated low patient compliance. Nevertheless, the application of telemedicine demonstrated improved patient compliance with nutritional intake guidelines. Limitations of telemedicine implementation included low motivation, technological constraints, and physiological constraints. Telemedicine may be used as a tool for monitoring nutritional intake among malnourished geriatric populations.

Salivary Microbiota Associated with Peripheral Microvascular Endothelial Dysfunction

Oral health is associated with atherosclerotic cardiovascular disease (ACVD). We previously identified the salivary microbiota characteristics of patients with ACVD. However, whether salivary microbiota is characteristic under impaired vascular endothelial function before ACVD onset remains unclear. Therefore, we aimed to evaluate the characteristics of salivary microbiota associated with peripheral microvascular endothelial dysfunction. We collected saliva samples from 172 community-dwelling elderly individuals without a history of ACVD and performed 16S rRNA metagenomic analysis. We assessed the peripheral microvascular endothelial function using reactive hyperemia index (RHI) and compared the salivary microbiota in the groups with normal (RHI ≥ 2.10), borderline, and abnormal (RHI ＜1.67) peripheral endothelial function. Furthermore, we applied machine learning techniques to evaluate whether salivary microbiota could discriminate between individuals with normal and abnormal endothelial function. The number of operational taxonomic units (OTUs) was higher in the abnormal group than in the normal group (p=0.037), and differences were found in the overall salivary microbiota structure (unweighted UniFrac distances, p=0.038). The linear discriminant analysis (LDA) effect size (LEfSe) algorithm revealed several significantly differentially abundant bacterial genera between the two groups. An Extra Trees classifier model was built to discriminate between groups with normal and abnormal vascular endothelial function based on the microbial composition at the genus level (AUC=0.810). The salivary microbiota in individuals with endothelial dysfunction was distinct from that in individuals with normal endothelial function, indicating that the salivary microbiota may be related to endothelial function.

Ultrasound evaluation of vagus nerve cross-sectional area in a community-dwelling elderly Japanese cohort.

Although the vagus nerve (VN) is easily observed by ultrasonography, few studies have evaluated the cross-sectional area (CSA) of the VN in healthy older individuals from East Asia. In this study, we aimed to report reference values for the CSA of the VN in community-dwelling elderly Japanese individuals and to identify any associated medical history and/or lifestyle factors. The present study included 336 participants aged ≥ 70 years from a prospective cohort study conducted in Yahaba, Japan from October 2021 to February 2022. The CSA of the VN was measured bilaterally at the level of the thyroid gland by ultrasonography. Simple linear regression analysis and generalized estimating equation were conducted to identify the associations between clinical and background factors and the CSA of the VN. In our cohort, the median CSA of the VN was 1.3 mm2 (interquartile range [IQR] 1.1-1.6) on the right side and 1.2 mm2 (IQR 1.0-1.4) on the left side. Generalized estimating equation showed that history of head injury (β = 0.19, p < .01), current smoking habit (β = -0.09, p = .03), and BMI (β = 0.02, p < .01) were independently associated with the CSA of the VN. We have reported reference VN CSA values for community-dwelling elderly Japanese individuals. In addition, we showed that the CSA of the VN was positively associated with a history of head injury and BMI and inversely associated with current smoking habit.

Association of Glycated Hemoglobin Level with Self-Reported Chewing Problems in Elderly Community-Dwelling Individuals in Japan.

Chewing problems are associated with increased mortality, geriatric syndromes and poor activities of daily living. Starting in 2018, in Japan, a self-reported questionnaire investigating chewing status was implemented in the annual health checkup program. Considering the bidirectional association between hyperglycemia and poor oral health, it is hypothesized that people with self-reported chewing problems will have relatively poor glycemic profiles. We investigated the metabolic characteristics of elderly community dwellers with self-reported chewing problems, as well as the association between the problems and HbA1c levels. This was a retrospective, cross-sectional study. We reviewed the data of 1018 adults ≥ 65 years of age who had undergone an annual health checkup at Nihon University Hospital during the period from January 2019 through December 2019. The presence of chewing problems was investigated using a self-reported questionnaire constructed based on guidance provided by the Japanese government. In the 1018 participants, the overall prevalence of chewing problems was 10.4%. Participants with chewing problems showed significantly higher levels and worse categories of HbA1c than those without such problems (HbA1c < 6.0%, 42.5% vs 54.8%; HbA1c 6.0-6.9%, 41.5% vs 37.0%; HbA1c ≥ 7.0%, 16.0% vs 8.2%, p = 0.008). Participants with HbA1c ≥ 7.0% have a significantly increased risk of chewing problems as compared to those with HbA1c < 6.0% (odds ratio 2.76, p = 0.002), even after adjusting for the effects of age, sex, body mass index, eating behaviors, and history of diabetes mellitus. HbA1c ≥ 7.0% is associated with self-reported chewing problems in elderly Japanese community-dwellers. We thus recommend a proactive assessment of oral conditions for this population.

Effects of advance care planning on end-of-life decisions among community-dwelling elderly people and their relatives: a systematic review and meta-analysis.

Currently, more and more older people are inevitably facing the final stages of life and their need for end-of-life care is becoming more prominent. It is therefore important to understand in advance what older people expect from their approaching end-of-life care and attention. We conducted a meta-analysis to explore the influence of advance care planning (ACP) on end-of-life decision-making among older adults living in community settings and their family members. We searched databases including PubMed, Embase, Cochrane Library, and Web of Science through 10 August 2022, to locate randomized controlled trials (RCTs) that investigated the effects of ACP on the end-of-life decision-making of community-dwelling elderly individuals and their family members. Studies we obtained from the databases were screened based on specific inclusion and exclusion criteria. The software Stata 15.0 was used for combining and analyzing data. A total of 8 RCTs were eligible for meta-analysis. They involved 1,292 community-dwelling elderly people. The meta-analysis results revealed the incidence of the following items among participants after the intervention of the ACP: cardiopulmonary resuscitation (CPR) [rate =26%, 95% confidence interval (CI): 11-41%], life-sustaining treatment (rate =12%, 95% CI: 6-18%), gastric gavage (rate =34%, 95% CI: 18-50%), mechanical ventilation (rate =34%, 95% CI: 14-54%), death at home (rate =7%, 95% CI: 3-12%), and death in hospital (rate =6%, 95% CI: 3-10%). The systematic review protocol was prespecified and registered in the international prospective register of systematic reviews (PROSPERO; CRD42022348900). According to current research, ACP is a promising treatment that can improve the end of life of elderly people living in the community and their families. However, considering the heterogeneity of the included studies, multi-center RCTs with high quality and larger sample sizes need to be conducted to confirm our conclusions.

Possible predictors for sarcopenia in community-dwelling elderly: neck and calf circumferences.

The aim of this study was to determine the relationship between sarcopenia and calf and neck circumferences. One hundred seventy-seven community-dwelling elderly individuals (over 65years old) were recruited. A questionnaire was applied via face-to-face interview and the MNA-SF was used to assess nutritional status. In addition, some anthropometric measurements and handgrip strength were assessed by dieticians to determine sarcopenia. Sarcopenia was defined according to the European consensus definition of the EWGSOP-2 criteria. Neck (p<0.001), calf (p=0.001), and waist circumference (p<0.001) were significantly higher in nonsarcopenic elderly women but in men. According to ROC analyses, neck (AUC: 74.7%), calf circumferences (AUC: 74.3%), and BMI (AUC: 80.4%) are possible predictors of sarcopenia in elderly women. This is the first study to demonstrate that neck circumference can be useful for predicting sarcopenia in community-dwelling women over 65 years old. These findings may contribute to the development of new strategies to screen for sarcopenia.

Relationships among Depressive Symptoms, Body Weight, and Chronic Pain: A Cross-Sectional Analysis of the Shika Study.

Although depression and body weight have individually been associated with chronic pain (CP), it currently remains unclear whether the combination of depressive symptoms (DS) and being underweight/overweight is related to CP. Therefore, we herein investigated the relationships among depression, body mass index (BMI), and CP in community-dwelling middle-aged and elderly individuals. Participants comprised 2216 inhabitants of Shika town in Ishikawa prefecture, Japan, including 1003 males (mean age of 68.72 years, standard deviation (SD) of 8.36) and 1213 females (mean age of 69.65 years, SD of 9.36). CP and DS were assessed using a CP questionnaire and Geriatric Depression Scale-15, respectively. The Breslow-Day test indicated that DS positively correlated with lumbar/knee pain in the BMI < 25 group, but not in the BMI ≥ 25 group. Furthermore, lumber/knee pain was related to a higher BMI. These results were confirmed by a logistic analysis with age, sex, BMI, solitary living, the duration of education, no exercise/hobbies, smoking history, alcohol intake, and medical treatment for diabetes, hyperlipidemia, or hypertension as confounding factors. The present study indicates the importance of considering DS and BMI in the prevention of CP. Further studies are needed to clarify the causal relationships among depression, BMI, and CP.

Reliability and validity of the Chinese version of the Walsh Family Resilience Questionnaire among community-dwelling disabled elderly individuals (WFRQ-CE).

To test the reliability and validity of the Chinese version of the Walsh Family Resilience Questionnaire among community-dwelling disabled elderly individuals (WFRQ-CE). Convenience sampling was used to select 566 dyads of disabled elderly individuals and their caregivers. The Walsh Family Resilience Questionnaire Chinese Version (WFRQ-C) was tested among elderly individuals. The Family Care Capacity Scale for Elderly Patients (FCCSE) was used as a concurrent validation tool for the caregivers, and the Psychological Resilience Scale (CD-RISC-10), and the Social Support Assessment (SSRS-10) were used as concurrent validation tools for both the elderly individuals and the caregivers. Exploratory factor analysis (EFA) revealed four common factors-"Family belief," "Organization and problem solving," "Family communication," and "Utilization of external resources"-with a cumulative variance contribution rate of 56.94%. Confirmatory factor analysis (CFA) yielded the following fit indices: chi-square/freedom degree (χ2/df) = 2.007, Tucker Lewis index (TLI) = 0.900, incremental fit index (IFI) = 0.917, comparative fit index (CFI) = 0.916, parsimony goodness-of-fit index (PGFI) = 0.681, and root-mean-square error of approximation (RMSEA) = 0.060. The concurrent scales were significantly correlated with the WFRQ-C total score and the scores for each factor (r values between 0.23 and 0.60, P < 0.01). The Cronbach's alpha coefficient was 0.93 for the WFRQ-CE and 0.87, 0.83, 0.89, and 0.65 for the four factors; the retest reliability was 0.96 for the total scale and 0.95, 0.92, 0.92, and 0.95 for the four factors; the split-half reliability was 0.85 for the total scale, and 0.81, 0.78, 0.79, and 0.68 for the four factors. The WFRQ-CE has good reliability and validity among community-dwelling disabled elderly individuals and can be used to evaluate the level of family resilience.

A Fall Risk Assessment Model for Community-Dwelling Elderly Individuals Based on Gait Parameters

A Fall Risk Assessment Model for Community-Dwelling Elderly Individuals Based on Gait Parameters