Japanese Journal of Geriatrics最新文献

Purpose: This study investigated the factors associated with oral frailty among community-dwelling older adults. In particular, we compared the factors between individuals in the young-old and old-old groups and clarified the differences between the two groups.

Methods: We measured the basic attributes, body composition, grip strength, gait function, oral function, cognitive function, and daily living function using the Kihon checklist in older people living independently in T City, Aichi Prefecture. The risk of oral frailty was assessed using the Oral Frailty Screening and Evaluation Form (OFI-8), and the measurement results were compared between two groups: those with and those without risk. To identify the factors associated with oral frailty, we performed a multivariate analysis with the risk of oral frailty as the dependent variable and a univariate analysis separately for the young-old and old-old groups.

Results: The mean age of the 100 subjects was 76.6±4.6 years old. Forty-four subjects were at risk of oral frailty, and 55 subjects were not at risk. The high-risk group had significantly higher rates of polypharmacy, depression, and a slow walking speed than the no-risk group. The risk factors associated with oral frailty were living alone, polypharmacy, and depression. The risk factors for oral frailty were a poor ambulatory function in the young-old and a poor ambulatory function, decline in the cognitive function, and depression in the old-old.

Conclusions: The results of this study suggest that the risk factors for oral frailty differ between older individuals in the young-old and old-old groups and that age-appropriate support is necessary to prevent oral frailty in older people.

Aim: This study aimed to examine the statuses of sacral pressure ulcer and treatment strategies for 135 elderly patients who were long-term hospital patients.

Methods: Patients with sacral pressure ulcers were divided into two groups, the cured or non-cured, and the discharged or deceased.The mean age, length of hospital stay, diagnosis, bedridden degree, nutritional status pre and post ulcer development, nutritional administration method, presence on admission or development, depth on National Pressure Ulcer Advisory Panel and treatment duration were examined.The serum albumin levels, lymphocyte counts and hemoglobin levels were calculated, and malnutrition levels were categorized into normal, mild, moderate or severe according to the Controlling Nutritional Status variant scores.

Results: The mean age of men (n=62) and women (n=73) was 80.8±4.9 and 86.2±1.2 years, and the mean length of hospital-stay was 25.1±9.6 and 27.3±4.9 months, respectively, indicating a significant difference.The diagnoses did not vary significantly between the cured (n=43) or non-cured (n=92) patients, or in those discharged (n=53) or deceased (n=82) patients.Comparison of the groups revealed that pressure ulcers were difficult to heal in patients with advanced age, those brought to hospital, bedridden degree C2 (unable to turn over), depth level III, moderate to severe malnutrition and those whose Gr did not improve.The effectiveness of gastrostomy management and the ineffectiveness of central venous nutrition were determined.

Conclusions: Bedridden degree C2, depth level III, presence on admission, malnutrition on admission and no improvement were the factors for interruption of the healing.

Objective: To examine the relationship between vegetable-first eating habits and the cognitive function in elderly patients with diabetes.

Methods: The subjects were outpatients with diabetes ≥60 years old at Ise Red Cross Hospital. A self-administered dementia checklist was used to assess mild cognitive impairment and dementia. The participants were asked to fill out a questionnaire on their vegetable-first eating habits and were classified into 4 groups: 0, 1, 2, and 3 times a day. The dependent variables were mild cognitive impairment and dementia, and the explanatory variable was vegetable-first eating habits (0 as a reference).

Results: In total, 358 patients were included in the analysis. The number of vegetable-first meals was 0 in 153 (42.7%), 1 in 48 (13.4%), 2 in 46 (12.8%), and 3 in 111 (31.1%) patients. The adjusted odds ratios for 1, 2, and 3 times of mild cognitive impairment were 0.83 (95% confidence interval [CI], 0.35-1.94; P=0.680), 0.81 (95% CI, 0.32-2.00; P=0.653), and 0.37 (95% CI, 0.17-0.81; P=0.014), respectively. However, there was no significant association between vegetable-first eating habits and dementia.

Conclusion: In elderly patients with diabetes, a vegetable-first eating habit at each meal was associated with a decreased risk of mild cognitive impairment.

Objective: To examine the relationship between difficulties experienced by family in supporting elderly patients with diabetes and these patients' higher-level functions.

Methods: The subjects were outpatients with diabetes ≥65 years old at Ise Red Cross Hospital and their family members. The Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) was used to assess patients' higher-level functions. The Japanese version of the Diabetes Caregiver Activity and Support Scale (D-CASS-J) was used to measure difficulties experienced by family in supporting elderly patients with diabetes. Using a multiple regression analysis with TMIG-IC scores (instrumental ADL, intellectual activity, and social participation) as the dependent variable and D-CASS-J scores (based on the highest scoring Q1 group among the three quartiles of D-CASS-J scores) as the explanatory variables, standardized regression coefficients (β) for higher-level functions on the family's perceived support difficulties were calculated.

Results: In total, 429 patients (254 male patients and 175 female patients) were included in the analysis. For male patients, the adjusted beta values for TMIG-IC scores in Q2 and Q3 were -0.039 (P=0.649) and -0.352 (P<0.001), respectively, and the adjusted beta values for the instrumental ADL scores were -0.064 (P=0.455), -0.192 (P=0.047), -0.090 (P=0.375), and -0.360 (P=0.002) for the Intellectually Active scores, respectively, and the adjusted beta for social role scores were 0.054 (P=0.581) and -0.261 (P=0.019), respectively. However, there was no association between the patients' higher-level functions and family support difficulties among female patients.

Conclusions: Difficulty experienced by the family in supporting elderly male patients with diabetes is associated with reduced higher-level functioning.

Aim: Some studies have reported a higher incidence of falls during winter with similar proportions of indoor and outdoor falls. We investigated the relationship between indoor temperature during winter and falls at home in the past year among community-dwelling older adults.

Methods: This cross-sectional study enrolled 964 individuals of ≥65 years of age in Japan. Participants answered questions about falls (including trips) at home within the past year, and the living room temperature was measured for 2 weeks during winter. Participants were divided into those living in cold (mean temperature near the floor <12°C), slightly cold (12-17.9°C), and warm (≥18°C) houses. The association between indoor temperature (cold vs. slightly cold vs. warm houses) and falls at home in the past year was examined using a logistic regression analysis adjusted for potential confounding factors.

Results: Valid data were obtained from 907 participants (mean age: 72.0±6.3 years), of whom 265,553, and 89 lived in cold, slightly cold, and warm houses, respectively. In the past year, falls occurred once in 325 (35.8%) participants and multiple times in 148 (16.3%) participants. In warm houses, the odds ratio of falling once and multiple times in the past year was 0.49 (p=0.032) and 0.34 (p=0.035), respectively, in comparison to cold houses.

Conclusions: Living in cold houses may be associated with an increased risk of falling at home among older adults. Maintaining an appropriate indoor thermal environment during winter may reduce the risk of falling among individuals who spend most of their time at home.