Japanese Journal of Geriatrics最新文献

Objective: To examine the relationship between the type, number, and frequency of social participation and higher life functions in elderly patients with diabetes.

Methods: The subjects were outpatients with diabetes ≥60 years old at Ise Red Cross Hospital. The Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC), a self-administered questionnaire, was used to assess the higher life function. The frequency and number of the six types of social participation activities were investigated. Standardized regression coefficients (β) for the higher life functions of social participation were calculated using a multiple regression analysis, with TMIG-IC scores as the dependent variable, social participation as the explanatory variable, and adjustment variables.

Results: A total of 447 patients were included in the analysis. Volunteer activities, sports/exercise clubs, and hobbies were significantly related to higher life functioning among men who participated in these activities several times a year, at least once a month, or at least once a week. For men, study circles (several times a year, β=0.184; p=0.003), activities to share skills and experiences (at least once a week, β=0.178; p=0.004), and work (at least once a month, β=0.144; p=0.022) were also significantly associated with higher life functioning. For women, only volunteer activities (at least once a week, β=0.164; p=0.017), sports/exercise clubs (at least once a week, β=0.149; p=0.032), and hobbies (at least once a week, β=0.147; p=0.036) were significantly related to higher life functions. Social participation was significantly associated with better life functioning. Social participation was significantly related to higher life functions.

Conclusion: The types and frequency of social participation related to higher life functions were clarified in elderly patients with diabetes.

Objective: This study aimed to evaluate the impact of the regular provision of information on the oral function and nutrition to members of senior citizens clubs, with the goal of promoting voluntary health behaviors and examining their effects on the oral function and dietary intake status.

Subjects and methods: Information on the oral function and nutrition was provided biannually to members of senior citizens clubs. The study included 60 participants who attended the measurement events in March 2022 and February 2024. Pre- and post-comparisons were conducted for awareness of oral frailty (OF), risk of OF, implementation of oral exercises, and tongue pressure. Participants were categorized into groups based on whether their oral function was maintained or improved or whether it deteriorated, and factors associated with the risk of OF were analyzed. The dietary intake status was assessed using a food frequency questionnaire comparing intake across 17 food groups and 23 nutrients before and after the intervention. A two-sided significance level of < 5% was set for all the analyses.

Results: The participants included 36 men and 24 women, with a mean age of 78.0±4.2 years and a mean BMI of 23.8±2.7 kg/m². No significant differences were observed between the sexes. While no significant differences were observed in the risk classification of OF before and after the intervention (p=0.359), significant increases were noted in awareness of OF (40% to 98%, p<0.001), the proportion of participants performing oral exercises (13% to 40%, p=0.002), and tongue pressure (31.6±7.2 kPa to 33.1±7.3 kPa, p=0.020). Age category and number of event participants were associated with the risk of OF. Conversely, significant increases or decreases were observed in 16 food groups and nutrients, but no clear improvements in dietary intake status were detected.

Conclusions: Providing information to a relatively health-conscious group of senior citizens club members improved their oral function. However, no improvement in dietary intake was observed. These findings suggest that while voluntary health behaviors can be promoted by providing information, the modification of daily dietary habits may be more challenging than incorporating oral exercises into daily routines.

This study aimed to identify the characteristics of elderly individuals in need of nursing care who would require a walking aid after two years and to examine the factors that make it challenging for them to walk alone. This study involved 179 elderly individuals in need of care, whose grip strength, balance, lower limb muscle strength, and walking ability were assessed. Participants were divided into two groups based on whether they were using walking aids after two years, and their physical function was compared.A logistic regression analysis was conducted with the use of a walking aid as the dependent variable and the items showing significant differences between the two groups as independent variables. Knee extension muscle strength was a significant factor. Furthermore, the incidence curves of walking aid use were compared between the two groups based on the presence or absence of knee extensor muscle weakness.The findings indicated that individuals who required a walking aid after two years had reduced knee extensor muscle strength, highlighting the importance of using a walking aid at an earlier stage.

Aim: We have developed a quality indicator for long-term care (LTC) that can be applied across various care settings, advancing the "Visualizing Effectiveness of Nursing & Long-term Care (VENUS) indicators." This study assessed the feasibility and reliability of the VENUS indicators in LTC hospitals and revised the evaluation forms and guides based on these findings.

Methods: This study included 24 nurses and 12 care workers employed in two LTC hospitals in the Tokyo metropolitan area. Each group, consisting of two nurses and one care worker, was asked to evaluate VENUS indicators for the same patient. The missing data rate and inter-rater reliability between the two nurses and between the nurses and care workers were calculated. Interviews were conducted to gather feedback on the use of VENUS indicators, followed by revisions to the evaluation forms and guides. The revised forms were re-evaluated, and opinions on re-evaluation were collected.

Results: The average missing data rate for evaluations was 20.0%, with particularly high missing rates for the following indicators: "Poor family wellbeing," "Neglecting the client's desired way of life," "Lack of social interaction," and "Social isolation." On the other hand, the inter-rater reliability was high, with an average of 89.4% between nurses and 92.0% between nurses and care workers. After the revision of the evaluation forms and guides, it was reported that the criteria for evaluating patients with communication difficulties and their families were clarified, making it easier for them to evaluate.

Conclusions: In LTC hospitals, the VENUS indicators showed high overall feasibility and reliability, although there were challenges in the feasibility of some items. The revision of the evaluation forms and guides allowed for clearer criteria based on which patients' conditions could be assessed. This research has the potential to contribute to maintaining consistency in quality evaluation across various LTC settings and to improve the quality of LTC.