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Since the 2011 Fukushima nuclear power plant accident, multiple social network disruptions have been reported among the community in Fukushima, while posttraumatic stress symptoms among the residents have persisted. In this study, we aimed to explore the influence of time and social networks on the recovery of posttraumatic stress symptoms based on longitudinal data from community residents in Fukushima, following up five to ten years after the nuclear power plant accident. We conducted five questionnaire surveys quasi-annually, the targets of which were randomly sampled 4900 non-evacuee community residents. In this study, the data of 1809 respondents who participated in at least one survey were used (36.9% of the initial target). Setting posttraumatic stress symptoms as the outcome, we examined the interaction between time and social network size using a mixed model, adjusting for sociodemographic characteristics and disaster-related events. Their interaction was statistically significant, and the posttraumatic stress symptoms of those with small social networks persisted, while those with larger social networks recovered. Maintaining and promoting social networks may contribute to mental health recovery after a nuclear disaster. • Posttraumatic stress symptoms remained 10 years after the Fukushima nuclear disaster. • Posttraumatic stress symptoms persisted among those with small social networks. • Posttraumatic stress symptoms decreased among those with not-small social networks. [ABSTRACT FROM AUTHOR]

This study aimed to examine the impact of prefracture cognitive impairment (CI) severity and postoperative delirium on recovery after hip fracture surgery in older patients. Prospective study with a 1-year follow-up. We included 355 patients aged ≥80 years from 2 acute hospitals in Japan. Barthel Index (BI) ambulation scores were assessed prefracture and at 1, 3, 6, and 12 months postoperatively. The score at each time point minus the prefracture score was used as the ambulation recovery variable. The 21-item Dementia Assessment Sheet for the Community-based Care System (DASC-21) and Confusion Assessment Method were used to assess CI severity and delirium, respectively. The impacts of CI severity and delirium on recovery at 1 month and by 12 months postoperatively were examined. Linear multiple regression and linear mixed effects models were used. BI ambulation scores remained the same or improved from prefracture levels in 26.8%, 34.4%, 33.0%, and 30.4% of patients at 1, 3, 6, and 12 months, respectively. Ten patients (2.8%) had fall-related hip fractures, 20 (5.6%) were rehospitalized, and 43 (12.1%) died during this period. Although DASC-21 CI severity significantly affected the recovery both at 1 month and by 12 months postoperatively [standardized β (Stdβ) = −0.39, P <.0001, and Stdβ = −0.37, P <.0001, respectively], delirium did not. Other variables affecting recovery by 12 months postoperatively included prefracture BI ambulation scores, Mini Mental State Examination scores, age, fracture type, place of residence, and time. Postoperative ambulation recovery, excluding the effect of death and other poor outcomes, is influenced by prefracture CI severity, and the presence of delirium itself may not be the moderating variable. These results emphasize the importance of treatment planning based on prefracture CI severity and indicate that assessments such as the DASC-21 may be useful in implementing such a plan. [ABSTRACT FROM AUTHOR]

Background: Postoperative exercise is effective for improving activities of daily living (ADL) in patients undergoing total knee arthroplasty (TKA), and exercise has been included in standard care after surgery provided in Japan. However, it is unknown whether standard care has room to develop for improving ADL. The goal of this study was to investigate the effect of an intensive functional rehabilitation (IFR) program in addition to standard care on the recovery of ADL following surgery.Methods: A total of 104 inpatients with knee osteoarthritis undergoing TKA were randomly assigned to either the experimental or the control group. The experimental group (n = 57) were given standard care and participated in the IFR program immediately after surgery (e.g., stand up and sit down, strengthen the knee extensor muscle, climbing onto a platform, and walking laterally). The control group (n = 47) were given standard care only. Primary outcomes were the score of Functional Independence Measure (FIM) and the Barthel Index (BI) at 2 weeks postoperatively. Matching using the propensity score was performed to control the influence of the patient characteristic on the outcome.Results: As a result of matching, 42 patients were extracted. The averages (standard deviation) of the FIM motor score were 79.0 (10.8) for the experimental group and 80.5 (9.4) for the control group. The BI scores were 88.1 (13.3) for the experimental group and 91.0 (10.1) for the control group. The experimental and control groups did not show significant intergroup differences in either score.Conclusions: Our study shows that as compared to standard care, IFR program for 2 weeks in addition to standard care after surgery did not significantly improve ADL in patients undergoing TKA. [ABSTRACT FROM AUTHOR]

Background Several studies have suggested that malnutrition impedes functional recovery in patients with hip fracture, but there are few reports on improvement in nutritional status and return to activities of daily living (ADL) in these patients. Objective This study was conducted to evaluate the relationship between change in nutritional status and recovery of ADL in malnourished patients after hip fracture and to identify predictors of functional recovery among the characteristic features of undernutrition. Design This was a retrospective observational cohort study. Participants/setting Data for patients aged ≥65 years with hip fracture and malnutrition (Mini Nutritional Assessment–Short Form [MNA-SF] score ≤7) at the time of admission to convalescent rehabilitation units were obtained from the Japan Rehabilitation Nutrition Database between November 2015 and August 2017. Main outcome measures The main outcome measures were Functional Independence Measure (FIM) at discharge and the proportion of patients discharged home. Statistical analyses performed Patients were divided into two groups based on MNA-SF scores at discharge: improvement in nutritional status (>7, IN group) and non-improvement in nutritional status (≤7, NN group). Clinical characteristics and outcomes were compared between the groups. Multivariable regression analysis was performed to adjust for confounders including age, sex, comorbidity, pre-fracture ADL level, and FIM score on admission. Results Of 876 patients, 110 met the eligibility criteria (mean age, 85 years; 78.2% female); 77 of the patients were assigned to the IN group and 33 to the NN group. The patients in the IN group were younger and had higher FIM and MNA-SF scores on admission than those in the NN group. At discharge, the median FIM score was significantly higher in the IN group than in the NN group (110 vs 83, P <0.001). Multivariable analysis revealed a significant association between improvement in nutritional status and higher FIM score at discharge (B=7.377 [B=partial regression coefficient], P =0.036) but no association with discharge to home. Mobility, neuropsychological impairment, and weight loss subscores of MNA-SF were independently associated with discharge FIM score ( R 2 =0.659). Conclusions In older patients with hip fracture and malnutrition, improvement in nutritional status was independently associated with improved performance of ADL during inpatient rehabilitation. Weight loss may be an important nutritional indicator for these patients. [ABSTRACT FROM AUTHOR]

Background: Despite the introduction of plasmapheresis and immunoglobulin therapy, many patients with Guillain-Barré syndrome still have an incomplete recovery. Evidence from pathogenesis studies suggests the involvement of complement-mediated peripheral nerve damage. We aimed to investigate the safety and efficacy of eculizumab, a humanised monoclonal antibody against the complement protein C5, in patients with severe Guillain-Barré syndrome.Methods: This study was a 24 week, multicentre, double-blind, placebo-controlled, randomised phase 2 trial done at 13 hospitals in Japan. Eligible patients with Guillain-Barré syndrome were aged 18 years or older and could not walk independently (Guillain-Barré syndrome functional grade 3-5). Patients were randomly assigned (2:1) to receive 4 weeks of intravenous immunoglobulin plus either eculizumab (900 mg) or placebo; randomisation was done via a computer-generated process and web response system with minimisation for functional grade and age. The study had a parallel non-comparative single-arm outcome measure. The primary outcomes were efficacy (the proportion of patients with restored ability to walk independently [functional grade ≤2] at week 4) in the eculizumab group and safety in the full analysis set. For the efficacy endpoint, we predefined a response rate threshold of the lower 90% CI boundary exceeding 50%. This trial is registered with ClinicalTrials.gov, number, NCT02493725.Findings: Between Aug 10, 2015, and April 21, 2016, 34 patients were assigned to receive either eculizumab (n=23) or placebo (n=11). At week 4, the proportion of the patients able to walk independently (functional grade ≤2) was 61% (90% CI 42-78; n=14) in the eculizumab group, and 45% (20-73; n=5) in the placebo group. Adverse events occurred in all 34 patients. Three patients had serious adverse events: two in the eculizumab group (anaphylaxis in one patient and intracranial haemorrhage and abscess in another patient) and one in the placebo group (depression). The possibility that anaphylaxis and intracranial abscess were related to eculizumab could not be excluded. No deaths or meningococcal infections occurred.Interpretation: The primary outcome measure did not reach the predefined response rate. However, because this is a small study without statistical comparison with the placebo group, the efficacy and safety of eculizumab could be investigated in larger, randomised controlled trials.Funding: The Japan Agency for Medical Research and Development, Ministry of Health, Labor and Welfare, and Alexion Pharmaceuticals. [ABSTRACT FROM AUTHOR]

Background: It is generally recognized that the main thoracic curve Cobb angle threshold for surgical correction is approximately 50 degrees in patients with adolescent idiopathic scoliosis (AIS). Although AIS with a Cobb angle of <50 degrees is sometimes treated surgically to improve cosmesis, the precise outcomes are unclear. This study analyzed the postoperative results for AIS with a main thoracic curve of 50 degrees.Methods: Thirty-nine consecutive patients with Lenke type 1-2 curves underwent posterior spinal fusion for AIS. These subjects were divided into the <50 degrees of main thoracic curve group (n = 14) and the ≥50 degrees group (n = 25). Clinical and radiographic data were compared.Results: The mean Cobb angle of the main thoracic curve before and at 2 years after surgery for the <50 degrees and ≥50 degrees groups was 44.5 and 60.3 degrees (p < 0.001) and 14.0 and 19.5 degrees (p = 0.016), respectively. Preoperatively, both groups had comparable Scoliosis Research Society-22 (SRS-22) scores (all p > 0.05). Patients with a Cobb angle of <50 degrees displayed significantly milder postoperative pain (4.7 vs. 4.3, p = 0.031), with no remarkable differences in other SRS-22 domain scores. These patients also had a significantly shorter operative time (194 vs. 235 min, p = 0.021) and fused level (9.2 vs. 10.8 vertebrae, p = 0.006) along with similar correction rate (68.1 vs. 65.8%, p = 0.622) and blood loss volume (932 vs. 1009 ml, p = 0.715).Conclusions: Surgical correction of AIS with <50 degrees of main thoracic curve may less invasively achieve results that are comparable with those for AIS with 50 degrees or more, including improvements in self-image. [ABSTRACT FROM AUTHOR]

Background: Fukuyama congenital muscular dystrophy (FCMD) is one of the most common congenital progressive muscular dystrophies in Japan. Some patients develop a severe spinal deformity that leads to an unstable sitting position or pain. Since 2008, we have treated FCMD using posterior spinal fusion. This study reports the short-term clinical and radiographic results of posterior spinal correction and fusion in FCMD.Methods: We retrospectively reviewed 11 consecutive FCMD patients, average age 13 years old, treated with posterior spinal instrumentation and fusion between 2008 and 2015. All patients were non-ambulatory and complained about difficulty sitting and/or buttock pain. Posterior spinal correction was performed to halt progression of spinal deformity and improve their sitting balance. Assessment was performed clinically and with radiological measurements at a mean follow up period of 34.5 months. To evaluate functional status of patients after surgery objectively, a Muscular Dystrophy Spine Questionnaire (MDSQ) was obtained at the final follow up.Results: The mean height, weight and body mass index of the patients were 144.1 ± 11.8 cm, 26.5 ± 8.7 kg and 12.5 ± 2.6 kg/m2. The average intensive care unit stay was 1.3 days. Five patients had complications related to surgery. The mean preoperative major Cobb angle and pelvic obliquity (PO) were 65.5 ± 41.7° and 31.4 ± 28.9°, respectively, were corrected to 34.4 ± 29.7° and 20.0 ± 18.7° just after the surgery, and were maintained at 35.1 ± 29.9° and 20.5 ± 21.1° at the final follow up. The average MDSQ score was 35.8 ± 13.2 at the final follow up.Conclusion: Posterior spinal correction and fusion in FCMD achieved good radiographic results and clinical improvement with acceptable perioperative complications. FCMD patients are mentally impaired and physically small, so post-operative observation and close attention to perioperative complications are critical. [ABSTRACT FROM AUTHOR]

Background: The Japanese Orthopaedic Association shoulder score cutoff values were calculated in patients with rotator cuff repair using the University of California at Los Angeles shoulder score.Methods: Overall, 175 patients with rotator cuff repair were subjects in this study. The University of California at Los Angeles and Japanese Orthopaedic Association shoulder scores were evaluated before surgery and at 3, 6, 9, and 12 months after surgery. The cutoff value of the Japanese Orthopaedic Association shoulder score was determined using the 4-stage criteria of the University of California at Los Angeles shoulder score and a University of California at Los Angeles shoulder score of 28 points, which is the boundary between an excellent/good group and a fair/poor group.Results: Both the JOA shoulder and UCLA shoulder scores showed significant improvement at 6, 9, and 12 months from the preoperative scores (p < 0.0001). There was a strong correlation between the total values of the two scores (r = 0.85, p < 0.0001). The cutoff value of the Japanese Orthopaedic Association shoulder score based on the highest accuracy from receiver operating characteristic curve analysis was 83 points.Conclusion: A Japanese Orthopaedic Association shoulder score cutoff value of 83 was equivalent to a University of California at Los Angeles shoulder score cutoff value of 28 for distinguishing between excellent/good and fair/poor outcomes after rotator cuff repair. [ABSTRACT FROM AUTHOR]

Background: Ossification of the posterior longitudinal ligament (OPLL) can cause myelopathy that is often managed surgically. Knowledge of predictors of surgical outcomes can provide decision support to surgeons. The aims of this study were to investigate the relationships between preoperative physical signs and postoperative functional outcomes in patients with OPLL and to clarify whether physical signs could predict functional outcomes.Methods: Fifty-five patients with OPLL who had undergone cervical laminoplasty were included in this study. Six physical signs including hyperreflexia, Babinski sign, sensory disturbance, grip strength, 10-s grip and release test, and bladder dysfunction, and four other factors including age, duration of symptoms, history of minor trauma and preoperative Japanese Orthopaedic Association (JOA) score were investigated as potential predictive prognostic factors using both univariate and multivariate analyses.Results: The mean recovery rate of JOA score was 62.5 ± 32.5%. The neurological recovery rate was negatively associated with age (P = 0.002), the duration of symptoms (P = 0.002) and Babinski sign (P = 0.007), whereas it was positively correlated with grip strength (P = 0.011). Multiple logistic regression analyses revealed that age (Odds ratio: 0.89, 95% CI: 0.81-0.99) and Babinski sign (Odds ratio: 0.18, 95% CI: 0.04-0.89) were factors associated with functional outcomes.Conclusions: Satisfactory functional outcomes could be expected for patients who are young and do not exhibit the Babinski sign, showing that the Babinski sign could be useful as an indicator of the window of opportunity for achieving satisfactory functional outcomes. [ABSTRACT FROM AUTHOR]

• Empirical analysis of practitioner perspectives in Japan using Q method. • Identification of 3 groups: recovery supporters, moral guardians, crime bureaucrats. • Commonalities around the theme of 'autonomous drug-free lives'. • Competing interpretations about why this matters and the journey to this. • Conflicts may result in erosion of cooperation and differences in implementation. In Japan, responses to people with drug dependency problems and who frequently re-enter the criminal justice system have undergone significant change in recent years, resulting in a heavier emphasis placed on non-criminal justice interventions and greater diversification of practitioners. To better understand how different practitioners are negotiating and adapting to their changing environments, this paper examines the goals of practitioners who work with individuals who are on probation, parole or have received a suspended sentence for an illegal drug offence. Q methodology was utilised, with participation of 89 practitioners from across the fields of criminal justice, health, social welfare, and local government. Participants ranked 64 goals in drug policy according to their perceived importance in a Q-sort activity, before reflecting on their decision-making during a post-sort questionnaire. Principal components analysis was conducted, along with an iterative and holistic approach that considered the Q-sort and questionnaire data as a whole, to extract and interpret groups of practitioners that shared similar perspectives. Three groups of practitioner perspectives were identified, termed as recovery supporters, moral guardians , and crime bureaucrats. Overall, there are a number of commonalities which revolve around facilitating 'autonomous drug-free lives', but groups are distinguished in important ways, not least in terms of goals relating to the nature and role of criminal justice and treatment services. Although the notion of 'autonomous drug-free lives' binds together different perspectives, there are competing interpretations about why this matters and the preferred 'journey' to this social state. These findings show that the embracing of more welfare and health-based approaches in drug policy in Japan is also being largely reflected in practitioner perspectives, but the conflicts that exist have the potential to erode multi-agency co-operation and lead to variation in policy implementation. [ABSTRACT FROM AUTHOR]

Background: In non-Western countries including Japan, activities requiring deep flexion of the hip joint, such as seiza (kneeling with calves tucked under the thighs and buttocks resting on the heels) and using squat toilets are commonly practiced. The purpose of this study was to assess longitudinal changes in traditional health-related quality of life measures and measures of physical functions associated with lifestyle for Japanese patients pre-surgery and after total hip arthroplasty.Methods: Consecutive primary total hip arthroplasty patients between July 2003 and November 2006 were eligible. Patients were measured preoperatively and at 6 weeks, 1 year and 3 years postoperatively. Patients completed the EuroQol 5D, the Western Ontario and McMaster Universities Osteoarthritis Index and items related to Japanese lifestyle activities such as squatting. Changes in these scale scores across the four time points were tested, and we examined predictive factors of EuroQol 5D score at 3-year follow-up using multiple linear regression.Results: Of 1103 eligible patients, 576 completed questionnaires at all four time points. By 6 weeks post-surgery, reductions in pain and improvements in physical function and stiffness became highly significant, and improvements continued to 3 years postoperative. In contrast, improvements were far more limited for items related to Japanese lifestyle functions such as seiza and use of a Japanese squat toilet, even 3 years after surgery. Predictive factors of EQ5D at 3-year post THA were WOMAC pain and physical function, seiza, age and comorbidity measured at 3-year post THA.Conclusion: The rate of improvement in QOL requiring deep flexion of the hip joint was much slower than that in QOL related to Western lifestyle. Our study suggests a need for lifestyle modification for THA patients in the other countries where kneeling and squatting are commonly performed. [ABSTRACT FROM AUTHOR]

Background: Achievement of very deep knee flexion after total knee arthroplasty (TKA) can play a critical role in the satisfaction of patients who demand a floor-sitting lifestyle and engage in high-flexion daily activities (e.g., seiza-sitting). Seiza-sitting is characterized by the knees flexed >145º and feet turned sole upwards underneath the buttocks with the tibia internally rotated. The present study investigated factors affecting the achievement of seiza-sitting after TKA using posterior-stabilized total knee prosthesis with high-flex knee design.Methods: Subjects comprised 32 patients who underwent TKA with high-flex knee prosthesis and achieved seiza-sitting (knee flexion >145º) postoperatively. Another 32 patients served as controls who were capable of knee flexion >145º preoperatively, but failed to achieve seiza-sitting postoperatively. Accuracy of femoral and tibial component positions was assessed in terms of deviation from the ideal position using a two-dimensional to three-dimensional matching technique. Accuracies of the component position, posterior condylar offset ratio and intraoperative gap length were compared between the two groups.Results: The proportion of patients with >3º internally rotated tibial component was significantly higher in patients who failed at seiza-sitting (41 %) than among patients who achieved it (13 %, p = 0.021). Comparison of intraoperative gap length between patient groups revealed that gap length at 135º flexion was significantly larger in patients who achieved seiza-sitting (4.2 ± 0.4 mm) than in patients who failed at it (2.7 ± 0.4 mm, p = 0.007). Conversely, no significant differences in gap inclination were seen between the groups.Conclusions: From the perspective of surgical factors, accurate implant positioning, particularly rotational alignment of the tibial component, and maintenance of a sufficient joint gap at 135º flexion appear to represent critical factors for achieving >145º of deep knee flexion after TKA. [ABSTRACT FROM AUTHOR]

Unequal distribution of access to resources would often be highlighted after disasters, and may have impact on child mental health. We aimed to elucidate the association between perception of recovery process (dissatisfaction and perceived inequality) and child mental health. Data from the Great East Japan Earthquake Follow-up for Children (GEJE-FC) study targeting children (aged 4–6 years at the time of the disaster) and their siblings and parents from three affected prefectures (Miyagi, Fukushima and Iwate) in Japan, from August 2012 to January 2018, were analyzed. Dissatisfaction and perceived inequality of recovery process, parental mental health (Kessler Psychological Distress Scale (K6) and happiness) and social capital, and child mental health (Depression Self-Rating Scale for Children) were assessed via self-rated questionnaires. Longitudinal associations of dissatisfaction and perceived inequality and mental health were examined with the linear mixed modeling and structural equation modeling (n = 168 parent-child dyads). Dissatisfaction and perceived inequality predicted lower parental happiness and more child depressive symptoms. Structural equation modeling revealed that parental mental health was associated with perceived inequality via lower social capital. Interestingly, perceived inequality was associated with child depressive symptom directly and indirectly through parental mental health and social capital. Dissatisfaction and perceived inequality of post-disaster recovery process were important predictors of child mental health. To mitigate the impact of disaster and to avoid damage on child mental health in the recovery process, policy makers should take into account survivors' dissatisfaction and perceived inequality of recovery process. • Negative evaluation on recovery was tied with the nuclear power plant explosion. • Parental perceived inequality and dissatisfaction predicted child depression. • The association was mediated by parental social capital and mental health. • Post-disaster reconstruction needs to consider the assessment of the survivors. [ABSTRACT FROM AUTHOR]

In order to obtain better range of motion in knees with osteoarthritis, medial and lateral parapatellar retinaculo-capsular release operations were performed at the time of high tibial osteotomy, with fixation using dual plating on medial compartmental knee osteoarthritis (29 knees) or spontaneous osteonecrosis of the medial femoral condyle (15 knees). At removal of the blade plate, 1 to 2 years after the initial osteotomy, the same release procedures were performed together with resection of adhesive soft tissue and resection of osteophytes, which were obstacles to full flexion. A grading system (Grade 0–3) was proposed to evaluate the duration (min) of formal floor sitting. After these procedures, the patients were able to sit on the floor with 155–165° of flexion for more than 30 min (Grade 3) in 20 knees, for 10–29 min (Grade 2) in seven, for less than 10 min (Grade 1) in nine and were unable to sit on the floor (Grade 0) in eight knees. Maximum knee flexion and total range of motion were 142±8.4° and 137±11° before and 152±6.6° and 151±7.4° after surgery, respectively. The American Knee Society Knee Score and Function Score were 61±17 and 46±16 before, and 97±5 (P<0.0001) and 91±13 (P<0.0001) after surgery at the final follow-up, respectively. The femoro-tibial angle in standing with one leg was 183±6° (3° of anatomical varus angulation) before and 170±3° (P<0.0001) (10° of anatomical valgus angulation) after surgery. [Copyright &y& Elsevier]

• Effects of BMI on ADL in older Asian patients with femoral fracture were examined. • Underweight was associated with poor recovery of ADL after femoral fracture. • Underweight patients had more complications and a lower rate of return to home. • Overweight/obesity may positively affect functional recovery after femoral fracture. To evaluate the effects of body mass index (BMI) on recovery of activities of daily living (ADL) in older Asian patients with femoral fracture registered in a nationwide inpatient database in Japan. We retrospectively analyzed data of patients aged ≥65 years with acute femoral fracture between April 2014 and November 2017 in the Diagnosis Procedure Combination database. Patients were classified into the following categories based on BMI (kg/m2): underweight (<18.5); normal weight (18.5–22.9); overweight (23–27.4); obese (≥27.5); and missing data. Demographic data included age, sex, type of fracture, comorbidities, and Barthel Index (BI). The primary outcome was BI at discharge and secondary outcomes were the overall complication rate and discharge to home. In total, data for 13,348 patients were extracted from the database, of whom 80.3 % were female. At discharge, underweight patients had lower BI than overweight or obese patients. In multivariable analysis, underweight and missing BMI data were associated with lower BI at discharge (partial regression coefficients −2.324 and −5.763, respectively). In contrast, overweight and obese were correlated with higher BI (3.080 and 5.732, respectively). Underweight was independently associated with a higher overall complication rate (odds ratio 1.195) and a lower rate of discharge to home (odds ratio 0.865). Underweight was associated with poorer performance in ADL, higher risk of complications, and lower rate of discharge to home in older Asian patients with femoral fracture. Overweight and obese had positive effects on ADL. [ABSTRACT FROM AUTHOR]

• We examined the social, mental and physical factors relating to social isolation. • We found factors relating to the onset of social isolation in older people. • We also found factors relating to recovery from social isolation in older people. We analyzed the data from a 2-year prospective-cohort survey to identify factors relating to new incidences of social isolation and recovery from social isolation in community-dwelling older people. We conducted a longitudinal study (2013–2015) involving 2657 older residents of Iriarai, Japan. A chi-square test, an independent t -test, and logistic regression analysis with imputed data were conducted to examine categorical data, continuous variables, and factors relating to social isolation, respectively. The results suggested that the factors that predicted future social isolation included being a man, being older, living with others, having a decline in mental health, having a lower frequency of going out, and not participating in community groups. On the other hand, being younger, having a higher level of mental health, having a higher frequency of going out, and participating in community groups were identified as factors that predicted participants' recovery from social isolation. Some demographic, mental, and social factors could relate to new incidences of social isolation and recovery from social isolation in community-dwelling older people. As aging is an irreversible phenomenon, and there is a limit to preventing all disorders, either building a safety net or introducing exchange programs to prevent social isolation are important interventions for older people. [ABSTRACT FROM AUTHOR]