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Aim To present practical predictors for the difficulty of carrying out basic activities of daily living ( ADL) among the old-old during a 2-year period. Methods Assessment was carried out using data obtained from the Tosa Longitudinal Aging Study, a community-based cohort survey on geriatric functions in the elderly. Predictor variables measured at baseline included age; sex; height; weight; blood pressure; oxygen saturation; neurobehavioral functions, such as Mini-Mental State Examination, Kohs Block Design test, Timed Up and Go test, button score, functional reach test, geriatric depression scale, cardio-ankle vascular index, ankle brachial pressure index; and blood chemical results, such as hemoglobin, fasting blood sugar, hemoglobin A1c, serum lipids, serum albumin and serum creatinine. The outcome variable was the presence of difficulties while carrying out basic ADL after 2 years. Results Age of ≥85 years, Timed Up and Go test of ≥15 s, button score of >17 s and presence of knee pain were independent predictors of difficulty in carrying out basic ADL after 2 years. Elderly individuals who have had at least two positive findings out of these four variables were likely to have impaired basic ADL during a 2-year period with a positive predictive value of 52.0%, negative predictive value of 90.2%, sensitivity of 70.3% and specificity of 80.8%. Conclusions Assessment of age, Timed Up and Go test, manual dexterity, and presence of knee pain is a useful and relevant way to identify patients who should be informed about their likelihood of developing difficulties in carrying out basic ADL. Geriatr Gerontol Int 2016; 16: 214-222. [ABSTRACT FROM AUTHOR]

Aim To investigate whether positive affect independently predicts a lower risk of functional decline among community-dwelling older Japanese. Methods A 2-year prospective study was carried out among 505 residents of Tosa Town aged 65 years and older without disability in carrying out basic activities of daily living ( B ADL) at baseline. Positive and negative affect was measured using the 15-item Geriatric Depression Scale, which includes items that reflect positive affect, as well as items that reflect negative affect. Information on functional ability, sociodemographic factors and medical conditions was obtained using a self-administered questionnaire. Results A total of 72 (14.3%) participants reported a decline in B ADL at the 2-year follow up. The sum-score of the positive items was significantly associated with a lower risk of functional decline ( OR 0.78, 95% CI 0.64-0.97), after controlling for potential confounding factors. Of the five positive items, three items (feeling satisfied with life OR 0.49, 95% CI 0.25-0.95; feeling happy most of the time OR 0.50, 95% CI 0.25-0.99; and feeling full of energy OR 0.46, 95% CI 0.22-0.95) were significantly associated with functional decline after adjusting for confounders. These associations were also independent of negative affect. In contrast, none of the negative items predicted functional decline after controlling for confounding factors. Conclusions Positive psychological well-being, specifically the feeling of satisfaction with life, happiness and energy, might have a favorable effect on the maintenance of functional ability, regardless of negative affect. Geriatr Gerontol Int 2013; 13: 1051-1058. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to assess chewing ability using color-changeable chewing gum and to show the association between chewing ability and geriatric functions, as well as dietary status in the community-dwelling elderly. Methods The study population consisted of 269 community-dwelling elderly aged ≥75 living in Tosa, Japan. Assessment of chewing ability was carried out by a dentist using color-changeable chewing gum. Activities of daily living ( ADL), depression and subjective quality of life ( QOL) were assessed by questionnaire. Cognitive status was assessed by; Mini- Mental State Examination ( MMSE), Hasegawa Dementia Scale- Revised ( HDS-R) and Frontal Assessment Battery ( FAB) during the check-up. Food diversity was assessed using the 11-item Food Diversity Score Kyoto ( FDSK-11). Results Number of teeth was significantly related to chewing ability ( P < 0.001). The participants with low chewing ability had significantly lower ADL scores in the items of self-maintenance ( P = 0.029) and intellectual activity ( P = 0.021). There was a significant association between low chewing ability and depression ( P < 0.001). Lower cognitive functions were significantly related to low chewing ability; MMSE ( P = 0.022), HDSR ( P = 0.017) and FAB ( P = 0.002). The participants with low chewing ability had lower food variety ( P < 0.001), and less frequent intake of beans, vegetables, seaweed and nuts, than the participants with high chewing ability. Conclusion Low chewing ability evaluated by color-changeable gum was associated with lower ADL, lower cognitive functioning, depression and food insufficiency in the community-dwelling elderly. More attention should be paid to assessing chewing ability of elderly persons in community settings. Geriatr Gerontol Int 2013; 13: 718-725. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to show which dimensions of functions differ among community-dwelling elderly participants in four different certification levels of the current long-term care insurance system (LTCI) in a rural, depopulated and aging town in Japan, with special consideration for strengths and weaknesses of the LTCI. Methods: The study population consisted of 1077 community-dwelling elderly participants aged 65 years and older, with LTCI certification comprising 542 uncertified elderly (Ippan-Koureisya), 437 specified elderly ( Tokutei-Koreisha), 57 support-level elderly ( Youshien-Koureisha) and 41 care-level elderly ( Youkaigo-Ninteisha). Each participant was rated regarding their health status, with question topics including basic activities of daily living (ADL), the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC), the 15-item Geriatric Depression Scale (GDS-15), 21-item Fall Risk Index (FRI-21), the quantitative subjective quality of life (QOL), current medical situation, past medical histories and social backgrounds. Results: The scores in basic ADL, each item of the TMIG-IC and five items of the quantitative subjective QOL were significantly lower, and the scores in GDS-15 and in FRI-21 were significantly higher according to certification level, in order of uncertified, specified, support-level and care-level elderly in a dose-response manner. Exercise and drinking habits were significantly less common in support- or care-level elderly than in specified or uncertified elderly. The prevalence of taking antihypertensive, antihyperlipidemia, antidepressant or sleeping medications was significantly higher in the support- or care-level elderly than in uncertified or specified elderly people. Support- or care-level elderly also had a significantly higher prevalence of past medical histories of stroke, bone fractures, osteoarthropathy, heart disease and cancer than uncertified or specified elderly people. Conclusion: Actual standardized quantitative and qualitative geriatric functions of the elderly among four categories in newly revised LTCI system were shown in a depopulated and aging town in Japan. Based on the actual situation of functions of the elderly, the strengths and weaknesses of the current LTCI system were reconsidered. Further research on the measures to prevent future dependency among the specified and support-level elderly is required. Geriatr Gerontol Int 2013; 13: 63-69. [ABSTRACT FROM AUTHOR]