Geriatrics & Gerontology International最新文献

Aim: Weight loss is among the diagnostic criteria for frailty and is associated with increased mortality among older people. This study aimed to identify factors associated with future weight loss among community-dwelling older people.

Methods: A multidimensional questionnaire-based prospective cohort study was carried out. The questionnaire included the Kihon Checklist, instrumental activities of daily living (IADL) scale, Activity Scale for the Elderly, Fall Risk Index-21 and Dietary Variety Score. The associations among the scores of the scales and the 3-year weight change from study entry were assessed. The participants were categorized into the non-weight loss group, <4.5-kg weight loss group and >4.5-kg weight loss group.

Results: In total, 982 participants completed the follow up. Their mean age was 73.4 ± 5.1 years, and 545 (55.5%) participants were women. Among the IADL questionnaire subitems, depositing and withdrawing money from the bank, walking, interacting with people, taking medication, and cooking were associated with 3-year weight loss. Furthermore, cooking was strongly associated with weight loss. However, there was no association between eating frequency and weight loss. Finally, low IADL and physical function scores were associated with a doubled risk of future weight loss.

Conclusions: An association was found between 3-year weight loss and physical fitness and IADL, such as walking, among community-dwelling older people. Future weight loss in older people can be caused by a decline in IADL and physical fitness before a decline in dietary intake. Furthermore, maintaining IADL and physical fitness can prevent future weight loss and frailty. Geriatr Gerontol Int 2025; ••: ••-••.

Aim: Among the many screening tools developed to detect frailty and disability in older adults, the Clinical Frailty Scale (CFS) is a valid, reliable, and easy-to-use tool and has been translated into several languages. The aim of this study was to demonstrate the validity of the Japanese version of the CFS (CFS-J).

Methods: The necessary permissions were obtained from Rockwood and colleagues. The Japanese version was prepared by translation (English to Japanese) and verified by back translation (Japanese to English). Concurrent criterion validity was assessed by evaluating the extent to which CFS relates to the Frailty Index (FI), the Frailty Index based on a Comprehensive Geriatric Assessment (FI-CGA), and Performance Status (PS), using Kendall's tau.

Results: In total, 223 patients admitted to the geriatric ward of an acute hospital between June 2021 and March 2023 were analyzed in the validation study. Mean age was 84.9 ± 5.9 years (range, 67-101 years), 128 (57.4%) were women, and the mean body mass index was 20.9 ± 4.0 kg/m². In a correlation analysis, significantly positive associations were found between the CFS-J and the FI (r = 0.713, P < 0.001), the FI-CGA (r = 0.691, P < 0.001), and PS (r = 0.669, P < 0.001) for numerical variables. Significant positive associations were also found between the CFS-J and the FI (r = 0.567, P < 0.001) and the FI-CGA (r = 0.591, P < 0.001) for categorical valuables.

Conclusion: The CFS-J was found to be a valid instrument for identifying frailty in Japanese inpatients. Geriatr Gerontol Int 2025; ••: ••-••.

Aim: Alzheimer's disease (AD) is a chronic, progressive cognitive disorder characterized by prominent episodic memory impairment. The contribution of neuronal damage and neuroinflammation to this process has been investigated by measuring various substances. Two of the most promising substances in serum and plasma studies are visinin-like protein 1 (VILIP-1) and tyrosine (Y), lysine (K), leucine (L)-40 (YKL-40). These markers may lead to early diagnosis and new treatment options.

Methods: Serum VILIP-1 and YKL-40 levels were analyzed in 33 probable AD patients and 23 healthy controls. Cranial magnetic resonance imaging (MRI) was used for volumetric measurements. The results were compared with the control group and then the correlation analyze between markers and volumetric measurements of the patient group was achieved.

Results: The right and left hippocampus and amygdala, left medial temporal, right rostral anterior cingulate, total brain, cortex, white matter, gray matter, subcortical gray matter, right and left total cortex volumes of the probable AD group were significantly lower than those of the control group. In the correlation analysis, the YKL-40 level and left posterior cingulate volume and the VILIP-1 level and left amygdala volume were negatively correlated.

Conclusions: In AD, there is atrophy of the limbic structures, cortex, and white matter. While the relationship between these regions and neurodegenerative markers remains unclear, our findings highlight a notable correlation between YKL-40 and VILIP-1 levels and the left amygdala and left posterior cingulate cortex, respectively. Geriatr Gerontol Int 2025; ••: ••-••.

Aim: Few studies have longitudinally assessed the determinants of limitations in activities of daily living (LADL) among persons aged ≥80 years. The aim of this study was to estimate the determinants of LADL among persons aged ≥80 years based on 4-wave national longitudinal data from Thailand.

Methods: Data from the Health, Aging and Retirement in Thailand study from 2015, 2017, 2020 and 2022 were utilized. The sample was restricted to community-dwelling persons aged ≥80 years (analytic sample: n = 3113 observations). For the pooled sample, the average age was 85.4 years (range 80-117 years). Established measurements were used to assess LADL. Linear fixed effects regression was applied to assess the time-varying determinants and outcomes.

Results: Linear fixed effects regressions showed that increasing age, an increase in the number of chronic conditions, an increase in depressive symptoms, higher religious involvement and being underweight increased LADL, whereas increases in exercise frequency and increases in subjective life expectancy decreased LADL. In addition, in subgroup analysis among 60-79-year-olds, transitioning to widowhood and work status decreased LADL. Further differences between ≥80-year-olds and 60-79-year-olds include that an increase in depressive symptoms and increase in chronic conditions only increased LADL among ≥80-year-olds and not among 60-79-year-olds.

Conclusions: This longitudinal study enhances our understanding of the determinants of LADL among persons aged ≥80 years. Strategies to delay or decrease depressive symptoms and chronic conditions, proper weight management and increasing physical activity might help in reducing LADL. Geriatr Gerontol Int 2025; ••: ••-••.

Aim: Hearing loss is a public health issue; further studies are warranted to elucidate preventable factors. This study aimed to explore the associations of bilateral high-frequency hearing loss (HFHL) with examination data and lifestyle behaviors, using the Comprehensive Health Checkup System (Ningen Dock) data in Japan.

Methods: This cross-sectional study used Ningen Dock data obtained from the Seirei Health Care Division for 2020. HFHL was defined as inaudibility of 40 dB at 4 kHz. The Areal Deprivation Index (ADI) in Japan was used as an indicator of socioeconomic status. Binomial logistic regression analysis by sex was performed to evaluate the association of bilateral HFHL with each binarized examination data and lifestyle behavior, with age and the ADI as covariates.

Results: This study included 36,137 participants (60% male; mean age, approximately 60 years in both sexes). The odds ratios (ORs) for high uric acid (UA) levels in the examination data and current regular smoking in lifestyle behaviors were statistically significantly the highest (males: 1.27, 1.57; females: 3.56, 2.41, respectively). The OR for excessive alcohol consumption, especially large amounts consumed per occasion, was also statistically significant (males: 1.25; females: 2.15). Additionally, the ORs for high aminotransferase and γ-glutamyl transpeptidase levels in females were statistically significant.

Conclusions: High UA levels, current regular smoking, and excessive alcohol consumption were associated with bilateral HFHL in both sexes. Especially, the findings regarding high UA levels and the large amount of alcohol consumption per occasion are novel, warranting longitudinal studies. Geriatr Gerontol Int 2025; ••: ••-••.

Aim: Standardized quality indicators for long-term care (QIs-LTC) were previously developed to ensure high-quality holistic nursing care for older adults. This research aimed to assess the feasibility and reliability of unfavorable health outcomes measured by the QIs-LTC and proposed strategies for improvement.

Methods: Thirty-nine pairs of home care nurses assessed 53 clients. We evaluated 20 of the 21 items of feasibility to calculate scores for the "I do not know" answer and test the interrater reliability using bias-adjusted and prevalence-adjusted kappa (PABAK). We then conducted interviews with 16 home care nurses to collect feedback on the implementation of QIs-LTC. Based on this feedback, we developed the QIs-LTC assessment manual and reassessed the QIs-LTC when used with the manual.

Results: The mean for the "I do not know" answer was 13.8%, and the mean PABAK was 0.75 (±0.28). Overall, the reliability was good for physical assessment but inadequate for social aspects. Using the assessment manual, the mean for the "I do not know" answers decreased to 10.4%. The mean PABAK was 0.77 (±0.32) and increased for 12 unfavorable health outcomes.

Conclusions: The feasibility and reliability of most unfavorable health outcomes were ensured by using the newly developed assessment manual. Challenges in education and practice of social aspects were identified. QIs-LTC support individual and agency evaluations, nursing interventions and quality evaluations, which are a priority for long-term care in Japan. Geriatr Gerontol Int 2025; ••: ••-••.

Aim: This study aimed to reestimate the prevalence of hearing loss based on the updated World Health Organization hearing loss classification and investigate whether existing hearing screening criteria could efficiently screen for frailty or cognitive deficit.

Methods: Data collected from community dwellers aged 40-91 years included 2325 samples. Health checkup hearing screening used were as follows: (A) 30 dB both at 1 and 4 kHz and (B) 30 dB at 1 kHz and 40 dB at 4 kHz were used. For participants aged ≥60 years, frailty according to the modified Cardiovascular Health Study criteria and cognitive deficit defined by a Mini-Mental State Examination score <28 were assessed. Logistic regression was performed to obtain odds ratios for frailty and cognitive deficit.

Results: The rates of hearing loss using the updated World Health Organization classification in men were 8.6, 24.1, 54.2, 79.0 and 96.0% in their 40s, 50s, 60s, 70s and 80s and 3.7, 12.7, 36.4, 72.1 and 90.4% in women, respectively. Failing hearing screening using criterion A was associated with an increased risk of frailty, a sex-adjusted odds ratio of 4.136 (95% confidence interval, 2.182-7.838) and an increased risk of cognitive deficit: 1.753 (95% confidence interval, 1.346-2.283). After adjusting for age and sex, the effects on frailty and cognitive deficit were no longer significant. The results were similar when criterion B was used.

Conclusion: Because of the high prevalence of hearing loss and the ability to utilize existing devices and methodologies, hearing screening for the elderly should be reviewed. Geriatr Gerontol Int 2025; ••: ••-••.