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Aim: Muscle mass and strength correlate with cognitive function; however, it remains unclear whether dynapenia (i.e., muscle weakness with preserved muscle mass) is relevant. This study aimed to explore whether dynapenia is associated with global cognitive function in community‐dwelling older Japanese adults. Methods: This cross‐sectional study used data from the Integrated Research Initiative for Living Well with Dementia Cohort Study, which pooled data from five community‐based geriatric cohorts. Dynapenia was defined as muscle weakness without muscle mass loss according to the Asian Working Group for Sarcopenia criteria. Cognitive function was assessed using the Mini‐Mental State Examination (MMSE). An ordered logistic regression analysis was conducted with dynapenia as the exposure and with cognitive decline stages, defined as an MMSE score of 27–30 for normal cognition, 24–26 for possible cognitive decline, and <24 for cognitive decline, as the outcome, stratified by sex and adjusted for age, muscle mass, education, alcohol consumption, smoking habits, living alone, and non‐communicable diseases. Results: We analyzed data for 3338 participants (2162 female) with preserved muscle mass. Of these, 449 (13.5%) had dynapenia, and 79 (2.4%) exhibited cognitive decline. Multivariate odds ratios (95% confidence interval) for cognitive decline among those with dynapenia, compared with those without dynapenia, were 1.51 (1.02–2.24) for males and 2.08 (1.51–2.86) for females. Conclusions: Muscle weakness is associated with cognitive decline, even in individuals with preserved muscle mass. Further studies are needed to better understand the association between muscle weakness and cognitive decline over time in order to develop dementia prevention strategies for those with dynapenia. Geriatr Gerontol Int 2024; 24: 123–129. [ABSTRACT FROM AUTHOR]

Introduction: We examined the relationship between previous fluctuations in Mini-Mental State Examination (MMSE) scores, future changes in MMSE scores, and attrition from follow-up surveys, which helps in a more comprehensive interpretation of repeatedly collected MMSE scores. Methods: This 4-year longitudinal study included 2,073 community-dwelling older adults aged ≥65 years in Japan. The MMSE was administered at baseline (T0), 2 years (T1), and 4 years (T2) follow-up. We performed multinomial logistic regression analysis with the dependent variable, indicating the change in MMSE score from T1 to T2 (categorized as increase, no change [reference category], and decrease) and attrition at T2. The independent variables included the change in MMSE scores from T0 to T1 and MMSE scores at T0 and T1. Results: The mean MMSE score was 29 across the three time points. A one-point decrease in MMSE score from T0 to T1 was associated with 79% (95% confidence interval: 1.62, 1.97) higher odds of an increase in MMSE score from T1 to T2 and 28% (1.17, 1.40) higher odds of attrition at T2. A one-point decrement in the MMSE score at T0 and T1 was also associated with an increase in the MMSE score from T1 to T2 and attrition at T2. Conclusion: Focusing on cognitive fluctuation for 2 years, rather than cognitive function at a point in time, would have no remarkable advantage when focusing on future cognitive function and attrition. Our results emphasize the need for further studies to identify factors that distinguish between those who continue to attend follow-up surveys and show improvements in cognitive test scores and those who drop out. [ABSTRACT FROM AUTHOR]

Background and Objectives Neighborhood places that facilitate older residents to meet and interact (third places) receive an increasing research interest as studies have consistently shown the benefits of social engagement for older adults' health. This scoping review synthesized the findings of studies examining the role of third places in older adults' social engagement. Research Design and Methods Searching 5 databases (CINAHL, Medline, PsycInfo, Scopus, and Web of Science) in October 2021, this study identified quantitative and qualitative studies that examined the relationships between third places and social engagement (interaction and network) among older adults. Results A total of 32 studies (12 quantitative and 20 qualitative studies) met the eligibility criteria. These studies examined 4 types of third place, namely, community facilities, local businesses, open/green spaces, and transition spaces. More than two thirds of the studies reviewed found that access to community facilities, local businesses, and open/green spaces were related to older adults' social interaction. For the relationships between third places and social networks, the importance of accessible local businesses and the quality of open/green spaces was supported by fewer studies. Discussion and Implications The findings of quantitative and qualitative studies suggest that local places that are convenient to visit and comfortable to stay in for older adults are likely to enhance their social interaction and network. However, more specific evidence is needed to inform the planning and design of third places. The review discusses future research topics that address the gaps identified in the current literature. [ABSTRACT FROM AUTHOR]

Aim: Community settings often need simple screening, rather than detailed tests, to identify cognitive impairment. This study aimed to develop models to screen older adults with cognitive impairment. Methods: This study used data from the Integrated Research Initiative for Living Well with Dementia Cohort Study and included 5830 older adults. Individuals were considered cognitively impaired if their Mini‐Mental State Examination score was less than 24. Three screening models were developed: the simple model (age, sex, and education), the base model comprising 13 candidate variables available in the questionnaire, and the enhanced model, where grip strength and gait speed were added to the base model. We performed binary logistic regression analysis with stepwise backward elimination (P < 0.1 for retention in the model) to develop each model. Then, we calculated integer scores from coefficients to develop score‐based models. The area under the receiver operating characteristic curve (AUC) was used to evaluate discrimination. Results: Participants with cognitive impairment accounted for 4.0% (n = 233) of the total. The score‐based simple model comprised three variables (AUC = 0.72, sensitivity: 72%, specificity: 61%). The score‐based base model included nine variables (AUC = 0.76, sensitivity: 70%, specificity: 67%). The score‐based enhanced model comprised eight variables, including grip strength and gait speed (AUC = 0.79, sensitivity: 73%, specificity: 70%). Conclusions: This study developed three screening models with acceptable discriminant validity for cognitive impairment. These models comprised simple questionnaire‐based items and common physical performance measurements. These models could enable screening of older adults suspected of cognitive impairment without the need to conduct cognitive tests in community settings. Geriatr Gerontol Int 2022; 22: 292–297. [ABSTRACT FROM AUTHOR]

The article explores the need for cognitive assessments in Community General Support Centers (CGSCs) among older adults and the rarity of standardized cognitive evaluation. Topics include cognitive assessment needs, methods used, and identified barriers, emphasizing the applicability of a screening model for dementia. .

The aim of this cross‐sectional study was to investigate the influence of replacing sedentary time with time engaged in one of two levels of physical activity on sleep quality using an isotemporal substitution model. The participants were 70 community‐dwelling older Japanese adults (approximately 70% female). Physical activity types were measured using a triaxial accelerometer and categorized based on intensity as sedentary, light‐intensity, and vigorous‐intensity. The Pittsburgh Sleep Quality Index assessed subjective sleep quality. Objective sleep parameters were assessed using an actigraph. A series of multi‐linear regression models analyzed the statistical relationships. Our findings showed that replacing 30 min of sedentary activity per day with an equal period of light‐intensity physical activity significantly influenced sleep quality parameters. However, there was no significant difference in sleep quality when light‐intensity activity was replaced with vigorous‐intensity activity. Engaging in one activity type means less available time for other types of activity; habitual replacement of sedentary activity with light‐intensity physical activity might have long‐term benefits on the sleep quality of older people. [ABSTRACT FROM AUTHOR]

Aim: Cognitive decline increases mortality risk through dementia‐related pathways and might be associated with increased healthcare costs. Using up to 12 years of repeated measures data, we identified trajectories in cognitive function among community‐dwelling older Japanese adults. We then examined whether these trajectories were associated with all‐cause and cause‐specific mortality, and differences in healthcare costs. Methods: A total of 1736 adults aged ≥65 years who were free of disabling dementia completed annual assessments during 2002–2014. Cognitive function was assessed with the Mini‐Mental State Examination. The average number of follow‐up assessments was 3.9, and the total number of observations was 6824 during the follow‐up period. Results: We identified five trajectory patterns in cognitive function (high, second, third, fourth, and low) during the 12‐year follow‐up period. The low (2.0%) and fourth (2.2%) trajectory groups had higher hazard ratios for cardiovascular disease mortality, and hazard ratios for other cause mortality were significantly higher for the third (16.8%) and second (38.8%) trajectory groups than for the high trajectory group (40.3%). Until 5 years of follow up, participants in the two lower‐trajectory groups had higher mean combined monthly medical and long‐term care costs. After 8 years of follow up, mean costs were highest for the third trajectory. Conclusions: The risk of death from cardiovascular disease was higher in the two lower‐trajectory groups in cognitive function, and they showed higher healthcare costs during the first 5 years of follow up. After 8 years of follow up, the third trajectory had the highest healthcare costs, perhaps because of hospitalizations attributable to gradual cognitive decline. Geriatr Gerontol Int 2019; 19: 1236–1242. [ABSTRACT FROM AUTHOR]

• Social behavioral changes were highlighted rather than physical behavioral ones. • Using latent class analysis, we identified healthy and unhealthy behavioral groups. • We extracted four factors associated with being the unhealthy behavioral group. • The unhealthy behavioral group was associated with a decline in functional capacity. • Negative behavioral changes were associated with a decline in functional capacity. This two-year follow-up study aimed to identify factors associated with unhealthy behaviors during the COVID-19 pandemic and examine their impact on functional capacity in older adults. Altogether, 536 adults aged ≥65 years participated in this study. The frequency of going out, exercise habits, face-to-face and non-face-to-face interactions, social participation, and eating habits were examined as behavioral factors before and after the first declaration of a state of emergency in Japan. Functional capacity was assessed using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Using latent class analysis considering changes in the six behaviors, the participants were divided into healthy (n = 289) and unhealthy (n = 247) behavior groups. The male sex was associated with 2.36 times higher odds, diabetes with 2.19 times higher odds, depressive mood with 1.83 times higher odds, poor subjective economic status with 2.62 times higher odds, and living alone with 44% lower odds of being unhealthy. The unhealthy behavior group showed significantly decreased functional capacity (B =−1.56 [−1.98, −1.14]) than the healthy behavior group. For each behavior, negative changes in going out (B =−0.99 [−1.60, −0.37]), face-to-face interaction (B =−0.65 [−1.16, −0.13]), and non-face-to-face interactions (B =−0.80 [−1.36, −0.25]) were associated with a decline in functional capacity. Our results showed four factors associated with engaging in unhealthy lifestyle behaviors and how behavioral changes affect functional capacity decline during the COVID-19 pandemic, which will help to develop public health approaches [ABSTRACT FROM AUTHOR]

We examined the dose-response relationships of body composition indices with mortality and identified the best predictor. Kusatsu Longitudinal Study and Hatoyama Cohort Study, Japan. In total, 1977 community-dwelling Japanese adults age ≥65 years (966 men and 1011 women) participated. Body mass index (BMI), fat mass index (FMI), fat-free mass index (FFMI), and skeletal muscle mass index (SMI) were determined by segmental multifrequency bioelectrical impedance analysis. The main outcome was all-cause mortality. We determined multivariate-adjusted hazard ratios for mortality relative to sex-specific medians of each body composition index and examined the association shapes. During the median follow-up of 5.3 years, 128 (13.3%) men and 75 (7.4%) women died. Compared with median BMIs (23.3 kg/m2 in men and 22.8 kg/m2 in women), a BMI >23.3 and ≤26.1 kg/m2 was associated with significantly lower mortality risk in men, and a BMI <22.8 kg/m2 was associated with significantly higher mortality risk in women. The inverse dose-response relationship with mortality was clearer for FFMI [hazard ratios (95% confidence interval) of 10th and 90th percentiles: 1.58 (1.23–2.03) and 0.58 (0.44–0.79), respectively, in men and 1.56 (1.12–2.16) and 0.68 (0.51–0.91), respectively, in women] and SMI [1.57 (1.22–2.01) and 0.60 (0.45–0.80), respectively, in men and 1.45 (1.05–2.01) and 0.77 (0.61–0.96), respectively, in women] than for BMI [1.30 (0.92–1.83) and 0.65 (0.41–1.03), respectively, in men and 1.87 (1.18–2.95) and 0.88 (0.54–1.42), respectively, in women]. FMI was not associated with mortality in either sex. FFMI and SMI were more definitive predictors of mortality than were BMI and FMI. The lower mortality risk with higher FFMI, regardless of FMI, may explain the age-related weakening of the association between higher BMI and mortality (the "obesity paradox"). FFMI and SMI evaluation should be introduced to clinical assessments of older adults because mortality risk might be reduced by maintaining muscle mass. [ABSTRACT FROM AUTHOR]