Super-aged Society Research Articles

Contemporary use of beta-blockers in the outpatient treatment of heart failure with atrial fibrillation

Abstract Background Evidence of the effectiveness of β-blockers in heart failure (HF) and atrial fibrillation (AF) in a contemporary cohort is controversial. This study investigated the association between the use of β-blockers and prognosis in outpatients across a broad spectrum of HF with AF. Methods Patients hospitalized with the first episode of acute HF were identified from the National Database of Health Insurance Claims and Specific Health Checkups of Japan between 2014 and 2021. Associations of β-blocker use at discharge and prognosis were compared by propensity score matching among the AF or non-AF group. A multilevel mixed-effects survival model was used with hazard ratio (HR) and 95% confidence interval (CI). Results Among 428,650 patients discharged with HF in 4,433 hospitals, 175,174 (40.9%) were ≥85 years old, 151,873 (35.4%) had complicated AF, and 236,457 (55.2%) were β-blocker users. In a matched AF group, β-blocker use was associated with a lower composite outcome of all-cause mortality or HF rehospitalization (HR [95% CI], 0.95 [0.93–0.97]). A similar result was obtained in a matched non-AF group (0.95 [0.94–0.96]). In addition, the HRs in patients aged ≥85 years and female patients were 1.00 [0.98–1.02] and 1.01 [0.98–1.03] in the AF group and 1.03 [1.01–1.05] and 0.98 [0.97–1.00] in the non-AF group, respectively (Figure). Conclusions The favorable prognostic associations of β-blocker use were observed regardless of AF in outpatients across a broad spectrum of HF in a superaged society. However, β-blocker use may not be effective in older or female patients.

Health-Promoting Behaviors, Physical Self-Efficacy, Exercise Adherence, and Sports Commitment Among Older Adults Who Participate in Sports Activities

Objectives: The Republic of Korea is progressively becoming a super-aged society, emphasizing the need for regular physical activity among older adults because it has physical, psychological, and social benefits. Recently, increasing depression and suicide rates have been reported among older adults living alone. However, research that considers older adults’ living situations is limited. Therefore, this study aimed to analyze the relationship between health-promoting behaviors (HPB), physical self-efficacy (PSE), exercise adherence, and sports commitment among older adults aged ≥ 65 years who participated in sports activities and investigate the influence of their living situation. Methods: The participants were 452 individuals aged ≥ 65 who lived in the metropolitan areas of Chungcheong-do, Jeolla-do, and Gwangju Provinces, Republic of Korea, and who regularly participated in sports activities (men = 283, women = 169). This study was conducted from January to May 2024. Data were collected using a structured and validated questionnaire, and the collected data were analyzed using descriptive statistics, correlation analysis, structural equation modeling, and multi-group analysis. Results: Structural equation modeling showed that the research model was appropriate, and all five paths showed statistical significance. The identity of the model was verified in the multi-group analysis, but path coefficients differed between older adults living alone and those living with family members. HPB significantly affected PSE, exercise adherence, and sports commitment among both groups of older adults. However, the impact of PSE on exercise adherence and sports commitment was not statistically significant among older adults living alone. Conclusions: The results highlight the need to consider older adults’ living situations when establishing regular physical activity. Efforts should also be made to promote regular exercise participation among older adults living alone.

End-of-Life Decision Making in Patients with Advanced Dementia: The Perspectives of the Korean General Population and Clinicians.

Korea's transition into a super-aged society brings to the forefront the escalating dementia prevalence and the consequent rise in mortality, highlighting the need for effective end-of-life (EOL) care strategies. Despite legislative advancements, gaps remain in addressing the medical and ethical challenges of EOL care for patients with advanced dementia, particularly in evaluating treatment options like nasogastric tube (NGT) use and mechanical ventilation (MV). This study investigates the attitudes of the general population (GP) and clinicians in Korea towards EOL treatment decisions. A cross-sectional, web-based survey was conducted among 500 members of the GP and 200 clinicians from a university hospital. Case vignettes were used to assess attitudes towards EOL treatment decisions, specifically focusing on NGT and MV use, and to explore the influencing factors. There was a notable difference in favorable attitudes toward NGT withdrawal between the GP (62.2%) and clinicians (39.0%). Otherwise, both groups showed higher acceptance of MV withholding (82.2% [GPs] and 82.5% [clinicians]) when informed of the patient's verbal intention regarding life-sustaining treatment (LST), and attitudes were more positive with written advance directives. Also, it was decreased when patient intentions were unclear. The results suggested the need to consider NGT as a medical intervention requiring a risk-benefit analysis. Although LST decision-making in patients with advanced dementia is still limited in Korea, this study showed the shared recognition among the GP and clinicians of the importance of EOL treatment decisions that consider patient wishes and quality of life for patients with advanced dementia.

Disaster response and older adult cancer care in super-aged societies: insights from the 2024 Noto Peninsula Earthquake in Oku-Noto, Japan

Disaster response and older adult cancer care in super-aged societies: insights from the 2024 Noto Peninsula Earthquake in Oku-Noto, Japan

Multimorbidity and Multiple Disabilities: Present Status and the Roles of Rehabilitation

The world is aging, and an increasing number of countries are becoming aged or super-aged societies. Japan has already become the world’s first super-aged society, with an aging rate of 29.1% of the entire population of the country. As of 15 September 2021, there were approximately 36.40 million people aged 65 years and over. The advent of the super-aged society has increased the possibility of multimorbidity and multiple disabilities (MMDs) in the elderly population. According to a survey by the Ministry of Health, Labour and Welfare, the percentage of people with multiple disabilities of all people with physical disabilities has fluctuated between 4.0 and 7.0%, but rapidly increased to 8.9% in 2006 and 17.7% in 2016. This review aimed to establish the present status of MMDs and the rehabilitation for MMDs. In rehabilitation settings, patients with MMDs are more common than patients with a single disease or disability; however, evidence on MMD rehabilitation is insufficient. Inexperienced and unconfident medical professionals are overly cautious in providing rehabilitation; therefore, adequate rehabilitation is not provided. Furthermore, to respond to the rehabilitation needs of patients with MMDs, human resources need to be cultivated, and a scientific basis needs to be built. It is expected that MMD guidelines will soon be developed based on various case studies and surveys. In MMD rehabilitation, it is important to provide “wider, earlier, more intimate, and more connected rehabilitation”; for this, the training and cooperation of rehabilitation medical professionals is necessary.

Heat impacts on an aging society: a spatio-temporal analysis of heatstroke deaths in Japan

Abstract Climate change, especially through heatwaves, significantly affects human health and is a growing global concern. Concurrently, population aging is occurring worldwide, with many countries experiencing an increase in their elderly populations. As the elderly are particularly susceptible to extreme temperatures and unevenly distributed due to internal migration of younger populations, a spatio-temporal analysis integrating temperature changes and demographic data is essential. This study focuses on Japan, a super-aged society where over 25% of the total population is 65 years or older. We examined the effects of climate and the proportion of the elderly population on heatstroke deaths through spatio-temporal analysis within a Bayesian framework. We estimated the annual relative risk of heatstroke-related deaths at the prefecture level from 2008 to 2019. The results indicate a strong spatial autocorrelation in heatstroke deaths across Japan. The spatio-temporal interaction model was the best-performing, showing that regional and temporal variations significantly impact heatstroke mortality. In this model, a one-degree increase in temperature anomaly was linked to a 0.35 (95% CI 0.25 to 0.46) times higher odds of heatstroke deaths, while a 1% increase in the population aged 65 years or older was associated with 4.85 (95% CI 0.92 to 8.65) times higher odds. We found that not only metropolitan areas but also rural areas, such as the Tohoku and Shikoku regions, face a high risk of heatstroke, emphasizing the need to address the challenges in rural communities. Our study highlights the necessity of integrating temperature changes and demographic data in a spatio-temporal context for heatstroke risk assessment. It demonstrates the profound effects of temperature anomalies and the proportion of the elderly population on heatstroke mortality. This research framework could be applicable to other countries experiencing aging and heatwave issues, aiding in the development of targeted public health interventions.

Satisfaction with the Exercise Program and Successful Aging Among Older Adults Who Exercise Regularly: The Multiple Mediation of Physical Self-Efficacy and Exercise Adherence.

As the Republic of Korea transitions towards a super-aged society, the health and mental well-being of older adults are emerging as critical issues. While many researchers are focusing on successful aging among older adults who participate in exercise, there is a research gap in the Korean literature regarding the preconditions that foster this outcome. Therefore, this study analyzed the relationship between satisfaction and exercise, physical self-efficacy (PSE), exercise adherence, and successful aging among Korean older adults who exercise regularly. The participants were 369 (234 male and 135 female) older adults aged 65 or older living in the Republic of Korea, with an average age of 69.91 years. Data were collected from March 2024 to June 2024 and analyzed using descriptive statistics, correlation analysis, and structural equation modeling. There was no problem with the model fit. Satisfaction with exercise positively affected PSE (β = 0.317, p < 0.001), exercise adherence (β = 0.487, p < 0.001), and successful aging (β = 0.669, p < 0.001). PSE positively affected exercise adherence (β = 0.356, p < 0.001), and exercise adherence positively affected successful aging (β = 0.190, p < 0.05). Furthermore, PSE (β = 0.019, p < 0.01) and exercise adherence (β = 0.081, p < 0.05) mediated the relationship between satisfaction with exercise and successful aging. Satisfaction with exercise is important for promoting successful aging among Korean older adults who exercise. Satisfaction with exercise can increase their efficacy for performing physical activities and encourage them to continue exercising. This can ultimately lead to a happy life in old age.

Digital competency among the aged entrepreneurs under the silver economy with soft power in Thailand

The rise of the elderly in Thailand experiencing a significant demographic transformation resulted in a growing senior population to become a super-aged society by 2030. This affacted the demand for “silver economy in Thailand. The objectives are to study (1) the overview of digital competency among the aged entrepreneurs under the silver economy with soft power; and (2) the mechanism for digital competency empowerment among the aged entrepreneurs under the silver economy with soft power in Thailand. Mixed-research method was employed by quantitative (survey questionnaire) and qualitative (Focus group discussion and interview) with a total of 100 samples and 15 key informants involved: the government workers, the aged entrepreneurs, the private &amp; industrial workers, the digital competency expertise, the elderly expertise, and the community leaders. Two main results reflected the objectives accordingly: 1) the overview of digital competency summarized from survey questionnaire found most of the positive factors as follow; 1.1) positive attitude toward digital competency even of their quite low educational background; 1.2) their positive practical existing skilled in digital competency : digital communication, digital media production, privacy, security, analytic thinking skills that can be well applied with their silver economy’s activities. 2) the mechanism for digital competency empowerment among the aged entrepreneurs found most urgent needs in more closed collaboration among all relevant sectors, starting from the lead government sector, private sector, and the local sectors to help expanding all kinds of empowerment activities. Deepen links by driving more inter-sectoral mechanism, resources sharing, regular consultation for internship, apprenticeship, on-site training, employment, market outlet and other schemes with equity, quality and sustainable practices.

Characteristic features of late-onset systemic lupus erythematosus: An observational study of data from the Lupus Registry of Nationwide Institutions.

Late-onset systemic lupus erythematosus (LoSLE) is known to possess characteristics different from those of early-onset SLE (EoSLE), thereby making their diagnosis difficult. This study aimed to assess the characteristic features of LoSLE in Japan, a model country with a super-aged society. Data were obtained from the Lupus Registry of Nationwide Institutions, which includes a multicenter cohort of patients with SLE in Japan who satisfied the 1997 American College of Rheumatology revised classification criteria for SLE. Data were compared between patients with LoSLE (≥50years old at onset) and EoSLE (<50years old at onset). To identify factors associated with LoSLE, binary logistic regression was used for the multivariate analysis, and missing values were complemented by multiple imputations. We also conducted a sub-analysis for patients diagnosed within 5years of onset. Out of 929 enrolled patients, 34 were excluded owing to a lack of data regarding onset age. Among the 895 remaining patients, 100 had LoSLE, whereas 795 had EoSLE. The male-to-female ratio was significantly higher in the LoSLE group than in the EoSLE group (0.32 vs 0.11, p < 0.001). With respect to SLEDAI components at onset, patients with LoSLE exhibited a higher frequency of myositis (11.9% vs 3.75%, p = 0.031), lower frequency of skin rash (33.3% vs 67.7%, p < 0.001), and lower frequency of alopecia (7.32% vs 24.7%, p = 0.012). No significant differences in overall disease activity at onset were observed between the two groups. Regarding medical history, immunosuppressants were more commonly used in EoSLE. A multivariate analysis revealed that a higher male proportion and a lower proportion of new rash at onset were independent characteristic features of LoSLE. We also identified late onset as an independent risk factor for a high SDI score at enrollment and replicated the result in a sub-analysis for the population with a shorter time since onset. We clarified that LoSLE was characterized by a higher male proportion, a lower frequency of skin rash and a tendency to organ damage. Now that the world is faced with aging, our results may be helpful at diagnosis of LoSLE.

Securing human resources for Japan’s aging population: a mixed methods study of job satisfaction and well-being among Southeast Asian long-term care workers in Japan

BackgroundJapan is one of the countries experiencing a “super-aged society.” The government has looked to Southeast Asia for recruiting workers to fill the demand for long-term care (LTC) workers. However, migrant LTC workers have faced many job-related stressors. This study aimed to examine the factors associated with job satisfaction and subjective well-being among Filipino, Indonesian, and Vietnamese LTC workers in Japan and explore the specific factors behind what makes them satisfied in their jobs.MethodsA convergent mixed methods study was conducted. The workers were recruited through snowball and convenience sampling and completed a self-administered questionnaire for the quantitative part. The association of the work environment with the workers’ job satisfaction and subjective well-being were analyzed using multiple linear regression analysis. An interpretive phenomenological approach was used to conduct in-depth interviews of the workers, which were analyzed using a deductive and inductive approach for the qualitative part. Quantitative and qualitative results were integrated and interpreted to expand on the findings with new insights.ResultsIn the final analysis, 122 workers were included (20 Filipino, 43 Indonesian, and 59 Vietnamese). In the quantitative part, having the necessary tools/equipment (Unstandardized Coefficient [B] = 16.1, 95% Confidence Interval [CI] = 6.8, 25.3) and support from work (B = 18.1, 95% CI = 8.6, 27.6) were associated with a higher level of job satisfaction. Having experienced harassment on the job was associated with a lower level of job satisfaction (B = -18.2, p = 0.007, 95% CI = -28.5, -7.8). There is no strong evidence for the association with subjective well-being. In the qualitative part, prominent themes emerged related to cultural sensitivity and an inadequate knowledge of caring for older adults living with dementia. The integrated findings suggested inadequate and unequal Japanese language training across the facilities. Moreover, the importance of human relations in the workplace emerged, with some workers desiring a deeper connection with their Japanese coworkers.ConclusionsA supportive and culturally sensitive work environment may bring about more motivated employees and increase employee retention from migrant LTC workers. Government and facilities should consider policies supporting a culturally sensitive work environment and more equitable Japanese language training across all facilities.

Does Vitamin B6 Act as an Exercise Mimetic in Skeletal Muscle?

Marginal vitamin B6 (B6) deficiency is common in various segments worldwide. In a super-aged society, sarcopenia is a major concern and has gained significant research attention focused on healthy aging. To date, the primary interventions for sarcopenia have been physical exercise therapy. Recent evidence suggests that inadequate B6 status is associated with an increased risk of sarcopenia and mortality among older adults. Our previous study showed that B6 supplementation to a marginal B6-deficient diet up-regulated the expression of various exercise-induced genes in the skeletal muscle of rodents. Notably, a supplemental B6-to-B6-deficient diet stimulates satellite cell-mediated myogenesis in rodents, mirroring the effects of physical exercise. These findings suggest the potential role of B6 as an exercise-mimetic nutrient in skeletal muscle. To test this hypothesis, we reviewed relevant literature and compared the roles of B6 and exercise in muscles. Here, we provide several pieces of evidence supporting this hypothesis and discuss the potential mechanisms behind the similarities between the effects of B6 and exercise on muscle. This research, for the first time, provides insight into the exercise-mimetic roles of B6 in skeletal muscle.

A Study on the Leisure Sports Participation Behavior of the Elderly through Comparative Analyses by Age: Focusing on Leisure Participation Constraints and Price Sensitivity.

Worldwide, interest in healthy living has been increasing as people's lifespans have lengthened, owing to interest in health and the development of the medical industry. The need for research on healthy lifestyles aided by sports activities for older adults is greater than before. This study aimed to compare and analyze constraints on participation in leisure sports and participation price sensitivity based on age groups in a super-aging society. From 22 May to 10 July 2024, in three community and sports centers, Korean adults over the age of 20 who regularly participated in leisure sports voluntarily responded to a questionnaire. Based on a quantitative research design using a survey with a convenience sampling technique, 305 collected survey responses were analyzed for validity, reliability, and exploratory factor analysis through SPSS 28. Additionally, one-way multivariate analysis of variance and the price sensitivity meter technique allowed us to analyze the differences in leisure participation constraints and price sensitivity among the groups. No statistically significant group differences were found in the health and social factors of leisure sports participation constraints. However, statistically significant differences were found for the cost and time factors. Finally, the price sensitivity meter technique found differences in price sensitivity in participating in leisure sports among the three age groups. This scientific analysis, aiming to expand older adults' participation in leisure sports, provides objective data for the future.

Analysis of anticholinergic drugs associated with aspiration pneumonia using the Japanese adverse drug event report database: Supplementary insights from a scoping review

BackgroundJapan's super-aged society presents significant challenges, particularly with regard to managing aspiration pneumonia among older adults. We aimed to investigate the link between anticholinergic drug use and the incidence of aspiration pneumonia, primarily utilizing data from the Japanese Adverse Drug Event Report (JADER) database. MethodsThe primarily analysis included JADER data from the first quarter of 2004 through the third quarter of 2023, focusing on 2367 cases of aspiration pneumonia in individuals aged ≥60 years. The study examined the association of aspiration pneumonia with 49 drugs listed in the Anticholinergic Risk Scale, using the Reporting Odds Ratio for signal detection. A scoping review incorporating findings from MEDLINE and the Cochrane Library was conducted to validate these associations. ResultsThe primary analysis identified an increased risk of aspiration pneumonia associated with specific drugs, including clozapine, haloperidol, risperidone, quetiapine, and olanzapine. A total of 20 drugs were significantly associated with an increased risk of aspiration pneumonia. Our results emphasize the importance of considering the dopamine-blocking effects of these drugs, particularly in at-risk populations, such as older adults, and those with conditions, such as schizophrenia or Parkinson's disease. ConclusionsThe study highlights the importance of careful monitoring of anticholinergic drugs with potent dopamine-blocking effects, such as clozapine, haloperidol, risperidone, quetiapine, and olanzapine, to reduce the risk of aspiration pneumonia. Future research should include observational and interventional studies to further investigate these findings. Ethics and disseminationAs this study utilized pre-existing anonymized information, approval from an ethics committee was not required.

580. ESTABLISHMENT OF A RAT MODEL OF GASTROESOPHAGEAL REFLUX DISEASE INDUCED CHRONIC MICROASPIRATION

Abstract Background Gastroesophageal reflux disease (GERD) is a common gastrointestinal disorder in Japan, the world’s first super-aging society. Occult microaspiration due to GERD can cause respiratory infections especially in frail elderly individuals. The aim of the study was to establish an experimental in vivo model of GERD induced chronic microaspiration. Methods GERD was induced in 8-week-old male Wistar rats. A 2-cm midline incision was made in the upper abdomen. The border between the forestomach and the glandular portion (limiting ridge) was ligated with a 2–0 silk tie, and the duodenum near the pyloric ring was covered with a 2-mm-wide piece of an 18-Fr Nélaton catheter. CT scan and histopathological evaluation of the bilateral lungs were performed at 3 weeks after surgery. Results The 3-week survival rate was 80% (n=4/5). CT scan showed diffuse dilatation of the esophagus due to the reflux of gastric contents; however, there was no consolidation in the lungs similar to the healthy control. Based on macroscopic evaluation, the lungs had multiple spotted redness. Histopathological evaluation of hematoxylin and eosin staining showed multiple spotted aspiration pneumonia with peribronchiolar inflammatory cells, granuloma formation, goblet cell hyperplasia. Conclusions This model mimics human occult chronic microaspiration due to GERD, and may be useful in the investigation of drug efficacy and the evaluation for pathophysiology of GERD induced pulmonary disorders.

디지털 헬스케어를 활용한 수원특례시 노인복지시스템 구축 연구

The pace of aging in Korea is the highest in the world, and Suwon City is also expected to enter a super-aged society in 2030, so preparations for the medical and welfare sectors for the elderly are urgent. In addition, interest in digital healthcare, which focuses on non-face-to-face treatment, has increased due to the COVID-19 pandemic crisis in 2019. In this study aimed to propose a plan to build an elderly welfare system for Suwon based on previous studies through literature review and expert focus group interviews As a result of literature survey, in developed countries, digital healthcare services have been developed mainly in the U.S., Japan, and Israel. In particular, the U.S., which has been promoting non-face-to-face telemedicine since early on due to its large land area, has developed a business centered on private companies, but has also been able to grow into a digital health powerhouse due to government support such as deregulation. In Korea, the development of the digital healthcare industry has been limited due to problems such as the regulation of telemedicine practices and unclear core. In addition, according to the results of the expert group interviews, those involved in the mobile healthcare project at the Suwon City Health Center pointed out errors in the system app and difficult input methods as the main factors for negative participation in the project. Therefore, it is expected that for self-healthcare through digital healthcare to be actively implemented, it is necessary not only for the right understanding and participation of the project targets, but also for the active cooperation of the government and private companies.

고령사회 노인문화정책의 변화 고찰 및 과제

In 2025, South Korea is projected to enter a super-aged society with 20.6% of its population aged 65 and older. The Baby Boomer generation, which will constitute a significant portion of this aged society, values cultural needs, independence, and the identity of being a free and active participant in society. Thus, understanding the characteristics of an aging society and the new senior is essential, and policy responses based on this understanding are necessary. This study explains the policy lag phenomenon in cultural policies for an aging society, based on Thomas Kuhn's paradigm theory and the path dependency theory of new institutionalism. It demonstrates that the cultural policies for an aging society have not adequately responded to the aging population, using the low birth rate and aging society policies and senior cultural programs as case studies. The study found that society has shifted to an aging society centered on the Baby Boomer generation, which has high cultural activity demands. Despite the shift in social paradigms, the transition from senior policies to the “Basic Plan for Low Fertility and Aging Society” did not prioritize the fulfillment of cultural needs, but rather continued to focus primarily on employment policies, as seen in previous welfare policies. It was difficult to find policies implemented from the perspective of cultural activities for seniors in the first Basic Plan, and even in the second and third supplementary plans, the emphasis was predominantly on senior employment. Additionally, the budget for the representative senior cultural policy, the Senior Culture Program, decreased steadily from approximately 4.6 billion KRW in 2016 to 2.5 billion KRW in 2022, with the number of programs reducing from 391 in 2016 to 163 in 2023. This study, which highlights the changes in an aging society and the current state of senior cultural policies, can be used to develop policies that enhance the quality of life in an aging society. Moreover, it suggests the need for more detailed research to create more segmented cultural policies that address specific age groups and genders, rather than policies targeting everyone aged 65 and older as a single group.

The Challenges of Entrance to Super-Aged Society and Apartment Housing Legislation

The Challenges of Entrance to Super-Aged Society and Apartment Housing Legislation

Premature senescence is regulated by crosstalk among TFEB, the autophagy lysosomal pathway and ROS derived from damaged mitochondria in NaAsO2-exposed auditory cells

Age-related hearing loss (ARHL) is one of the most prevalent types of sensory decline in a superaging society. Although various studies have focused on the effect of oxidative stress on the inner ear as an inducer of ARHL, there are no effective preventive approaches for ARHL. Recent studies have suggested that oxidative stress-induced DNA damage responses (oxidative DDRs) drive cochlear cell senescence and contribute to accelerated ARHL, and autophagy could function as a defense mechanism against cellular senescence in auditory cells. However, the underlying mechanism remains unclear. Sodium arsenite (NaAsO2) is a unique oxidative stress inducer associated with reactive oxygen species (ROS) that causes high-tone hearing loss similar to ARHL. Transcription factor EB (TFEB) functions as a master regulator of the autophagy‒lysosome pathway (ALP), which is a potential target during aging and the pathogenesis of various age-related diseases. Here, we focused on the function of TFEB and the impact of intracellular ROS as a potential target for ARHL treatment in a NaAsO2-induced auditory premature senescence model. Our results suggested that short exposure to NaAsO2 leads to DNA damage, lysosomal damage and mitochondrial damage in auditory cells, triggering temporary signals for TFEB transport into the nucleus and, as a result, causing insufficient autophagic flux and declines in lysosomal function and biogenesis and mitochondrial quality. Then, intracellular ROS derived from damaged mitochondria play a role as a second messenger to induce premature senescence in auditory cells. These findings suggest that TFEB activation via transport into the nucleus contributes to anti-senescence activity in auditory cells and represents a new therapeutic target for ARHL. We have revealed the potential function of TFEB as a master regulator of the induction of oxidative stress-induced premature senescence and the senescence-associated secretion phenotype (SASP) in auditory cells, which regulates ALP and controls mitochondrial quality through ROS production.

Contribution of kelp dashi liquid to sustainable maintenance of taste sensation and promotion of healthy eating in older adults throughout the umami-taste salivary reflex.

Taste decline, including taste loss in older adults, leads to malnutrition and frailty. In a super-aging society, improving taste decline and maintaining taste sensation are crucial for the wellbeing of older adults. Hyposalivation frequently affects older individuals and is the leading cause of taste decline in older adults. Treating taste decline, including taste loss, in older adults presents challenges due to the limited sustainable methods for increasing saliva production, except for drug therapy, which may lead to adverse effects. Umami-taste stimulation results in a prolonged increase in both the whole salivary flow rate (WF), more than 90% of which is secreted from the major salivary glands, and the minor salivary gland flow rate (MF) in healthy volunteers through the umami-taste salivary reflex. We hypothesized that umami-rich kelp dashi liquid (KDL), commonly used in Japanese cuisine, may alleviate taste decline and sustain normal taste sensation in older adults with hyposalivation. This study investigated whether KDL stimulation could improve taste decline. A non-randomized controlled trial was conducted at the dental department of a university hospital, involving those who presented with dry mouth between May 2017 and December 2021. Before and after repeated KDL stimulation, characteristics like changes in WF and MF, the recognition thresholds (RTs) for five basic tastes, and subjective eating and swallowing difficulties were assessed. Statistical comparisons were performed between the values measured before and after KDL stimulation. A total of 35 older patients were included. Patients with reduced MF and with or without reduced WF exhibited umami-taste loss. Repeated stimulation with KDL increased MF and WF and improved taste loss, including umami, decreased RTs, and normalized each taste. Furthermore, subjective taste impairment, subjective eating and swallowing difficulties, and burning sensations in the oral mucosa were alleviated. These findings indicate that KDL stimulation improved umami-taste loss and normalized each taste sensation, further alleviating eating difficulties via the umami-taste salivary reflex. Importantly, umami-taste loss was also observed in patients with normal WF but decreased MF, who are typically not diagnosed with hyposalivation. Therefore, KDL has the potential to sustain taste sensations and promote healthy eating habits in older individuals.

Effect of Silicon Nitride Coating on Titanium Surface: Biocompatibility and Antibacterial Properties.

In recent years, with the advent of a super-aged society, lifelong dental care has gained increasing emphasis, and implant therapy for patients with an edentulous jaw has become a significant option. However, for implant therapy to be suitable for elderly patients with reduced regenerative and immunological capabilities, higher osteoconductive and antimicrobial properties are required on the implant surfaces. Silicon nitride, a non-oxide ceramic known for its excellent mechanical properties and biocompatibility, has demonstrated high potential for inducing hard tissue differentiation and exhibiting antibacterial properties. In this study, silicon nitride was deposited on pure titanium metal surfaces and evaluated for its biocompatibility and antibacterial properties. The findings indicate that silicon nitride improves the hydrophilicity of the material surface, enhancing the initial adhesion of rat bone marrow cells and promoting hard tissue differentiation. Additionally, the antibacterial properties were assessed using Staphylococcus aureus, revealing that the silicon nitride-coated surfaces exhibited significant antibacterial activity. Importantly, no cytotoxicity was observed, suggesting that silicon nitride-coated titanium could serve as a novel implant material.