Search

Aim: Aging is a major cause of cognitive dysfunction. It has also been reported that respiratory function may influence cognitive dysfunction. However, few studies have examined the relationship between cognitive function and respiratory function among community‐dwelling older adults. This study aims to determine the relationship between respiratory function, assessed using spirometry, and mild cognitive impairment (MCI) in community‐dwelling older adults. Methods: This study included 419 participants aged 73 ± 1 years and 348 participants aged 83 ± 1 years from the SONIC cohort study (Septuagenarians Octogenarians Nonagenarians Investigation with Centenarians Study). Respiratory function was evaluated using %Vital Capacity (%VC), Forced Expiratory Volume 1 s (FEV1)/Forced Vital Capacity (FVC), and %Peak Expiratory Flow (%PEF). Airflow‐limitation presence and stages were classified using FEV1/FVC. Cognitive function and MCI were assessed using the Japanese version of the Montreal Cognitive Assessment (MoCA‐J). Results: The MoCA‐J score exhibited a declining trend as the airflow‐limitation stage increased among study participants in the 83 ± 1 age group. The presence of airflow limitation was associated with MCI in the 83 ± 1 age group. Among the indicators of each respiratory function, low %PEF was found to be associated with an increased rate of MCI. Furthermore, low %VC has also been suggested to be associated with an increased rate of MCI in the 83 ± 1 age female group. Conclusions: Advanced airflow‐limitation stages may exacerbate cognitive dysfunction in community‐dwelling older adults. The presence of airflow limitation and low %VC may also be associated with cognitive dysfunction in older women. Consequently, reduced respiratory function may potentially be associated with MCI in community‐dwelling older adults. Geriatr Gerontol Int 2024; 24: 1001–1007. [ABSTRACT FROM AUTHOR]

Aim: Vitamin D (VD) affects skeletal muscles. The high prevalence of VD deficiency in Japan may lead to decreased skeletal muscle mass and strength, increasing the prevalence of sarcopenia. Therefore, we aimed to investigate the association between serum VD levels and skeletal muscle indices in a Japanese community‐dwelling older population. Methods: We extracted data from the Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians (SONIC) study. We analyzed the data for participants in the 70s and 90s age groups. Skeletal mass index (SMI) using bioimpedance analysis, grip strength, walking speed, and serum VD levels using 25‐hydroxyvitamin D [25(OH)D] were measured. Results: We analyzed the data of 310 participants in their 70s and 48 in their 90s. Mean serum 25(OH)D levels were 21.6 ± 5.0 ng/mL in the 70s group and 23.4 ± 9.1 ng/mL in the 90s group. In the 70s group, serum 25(OH)D levels correlated with SMI (r = 0.21, P < 0.0001) and grip strength (r = 0.30, P < 0.0001). Serum 25(OH)D levels were independently associated with SMI after adjusting for sex, body mass index, and serum albumin levels. In the 90s group, serum 25(OH)D levels were correlated with SMI (r = 0.29, P = 0.049) and grip strength (r = 0.34, P = 0.018). However, the multivariate analysis showed no independent association between SMI, grip strength, and serum 25(OH)D levels. Conclusion: In a cross‐sectional analysis of an older population, serum VD levels were associated with SMI and grip strength, and this association was more pronounced in the 70s group than in the 90s group. Our results suggest that serum VD levels maintain skeletal muscle mass and grip strength. Geriatr Gerontol Int 2024; 24: 898–903. [ABSTRACT FROM AUTHOR]

Since assessing aerobic capacity is key to enhancing swimming performance, a simple and widely applicable technology should be developed. Therefore, we aimed to noninvasively visualize real‐time changes in sweat lactate (sLA) levels during swimming and investigate the relationship between lactate thresholds in sweat (sLT) and blood (bLT). This prospective study included 24 university swimmers (age: 20.7 s ± 1.8 years, 58% male) who underwent exercise tests at incremental speeds with or without breaks in a swimming flume to measure heart rate (HR), bLT, and sLT based on sLA levels using a waterproof wearable lactate sensor attached to the dorsal upper arm on two different days. The correlation coefficient and Bland–Altman methods were used to verify the similarities of the sLT with bLT and personal performance. In all tests, dynamic changes in sLA levels were continuously measured and projected onto the wearable device without delay, artifacts, or contamination. Following an initial minimal current response, with increasing speed the sLA levels increased substantially, coinciding with a continuous rise in HR. The speed at sLT strongly correlated with that at bLT (p < 0.01 and r = 0.824). The Bland–Altman plot showed a strong agreement (mean difference: 0.08 ± 0.1 m/s). This prospective study achieved real‐time sLA monitoring during swimming, even with vigorous movement. The sLT closely approximated bLT; both were subsequently validated for their relevance to performance. Highlights: A new technique using a wearable device can measure sweat lactate (sLA) levels during swimming without artifacts or contamination.Lactate threshold assessed using sLA dynamics is consistent with that calculated from blood samples.The current novel measurement method is expected to promote a personalized training regimen and simultaneous multi‐person measurements. [ABSTRACT FROM AUTHOR]

Aim: This study aims to identify the key risk factors that lead to subtypes of physical frailty assessed by walking speed and grip strength among community‐dwelling Japanese individuals, stratified by the presence of musculoskeletal diseases (MSDs) and age group. Methods: We included 302 participants aged 70 or 80 years who did not exhibit subtypes of physical frailty at baseline through the Septuagenarians, Octogenarians, Nonagenarians, Investigation with Centenarians (SONIC) study. Our study was a longitudinal study. The outcome was the incidence of subtypes of physical frailty after 3 years. Subtypes of physical frailty were defined as a weak grip strength or slow walking speed, or both, based on the Japanese version of the Cardiovascular Health Study Index. The risk factors for subtypes of physical frailty incidence were examined by age group and MSD, using multivariate logistic regressions. Results: Of the 302 participants, 110 (36.4%) had MSD. Those with MSD were significantly more likely to have subtypes of physical frailty after 3 years compared with those without MSD. Among all participants, older age was a risk factor of subtypes of physical frailty (P < 0.05). Without MSD, older age and dissatisfied financial status were risk factors (P < 0.05). With MSD, older age was a risk factor (P < 0.05). By age group, in individuals aged 70 years old, a dissatisfied financial status was a risk factor for those without MSD (P < 0.05), and a higher BMI was one for those with MSD (P < 0.05). Conclusions: Older age was a risk factor for subtypes of physical frailty, but other risk factors differed according to the presence of MSD and age. Geriatr Gerontol Int 2024; 24: 797–805. [ABSTRACT FROM AUTHOR]

Genetic characteristics of North Pacific loggerhead turtles captured as bycatch in pound nets operating inMuroto, Kochi, Japan were sampled to identify and estimate stock structure of coastal foraging aggregations. Tissue samples were obtained from juvenile, subadult and adult turtles from 2005-2006 and 2008-2010. For each of the years, 100 samples were processed and approximately 820 bp of mitochondrial DNA control region were sequenced. Straight carapace length of the turtles ranged from 56.3-99.1 cmand their life stages were identified based on previous estimates of the size at puberty (66.0cm) and maturity (82.1cm). A total of 487 out of the 500 samples yielded sequences of sufficient quality to identify five different haplotypes. We conducted mixed stock analysis (MSA) using Bayesian approaches to estimate the contributions of three potential source nesting Management Units (MU) to the Muroto foraging aggregation. There were no significant differences between haplotype frequencies among the different size classes and life stages, nor among the different years, thus the haplotype frequencies were combined for the MSA. The MSA was runwith and without consideration of MUsize and distance, which resulted in similar MSA estimates. A >50% contribution was estimated from the Yakushima MU, and 40% from the Mainland MU, with only minor contribution from the Ryukyu MU. The estimated contribution from Mainland MU and Yakushima MU were disproportionately larger than the relative abundance of nesting at these MUs compared with Ryukyu MU, demonstrating that closer MUs had a greater contribution than those from further away. The lack of differences found in haplotype frequency among life stages, suggests that both juvenile and mature loggerhead turtles that remigrate to Japanese waters have the tendency to utilize foraging grounds and migration routes near their natal waters. [ABSTRACT FROM AUTHOR]

Aim: The serum creatinine/cystatin C ratio (CCR) or sarcopenia index is considered a useful marker of muscle mass. However, its usefulness in late‐stage older adults remains unclear. We aimed to determine the usefulness of CCR as an indicator of sarcopenia in community‐dwelling Japanese adults aged >75 years. Methods: Our study recruited participants aged 70, 80, and 90 ± 1 years during the baseline years, and included a 3‐year follow‐up in the Septuagenarians, Octogenarians, Nonagenarians, Investigation with Centenarians study. From 2015 to 2018, 955 participants were eligible: 367 in their 70s, 304 in their 80s, and 284 in their 90s. The diagnostic components of sarcopenia, including "low muscle mass, plus low muscle strength, and/or low physical performance," were evaluated using the bioelectrical impedance analysis‐measured skeletal muscle mass index (SMI), handgrip strength, and short physical performance battery (SPPB) score, respectively, in accordance with the Asia Working Group for Sarcopenia 2019 criteria. Separate analyses were performed between each component and CCR, adjusting for sex, body mass index, and other blood biomarkers in each group. Results: The relationship between CCR and sarcopenia components was significant for handgrip strength (β = 0.21, 0.13, 0.19, and P < 0.0001, =0.0088, <0.0001, for the 70s, 80s, and 90s age groups, respectively); however, it was limited for SMI (β = 0.14; P = 0.0022, only for the 90s) and not significant for the SPPB score. Conclusion: CCR is a limited indicator of sarcopenia in late‐stage older adults. Although its association with muscle strength was significant, its relationship with muscle mass and physical performance was less pronounced. Geriatr Gerontol Int 2024; 24: 529–536. [ABSTRACT FROM AUTHOR]

Objective: The purpose of the study is to assess if daily use of hypnotics increases mortality, aspiration pneumonia and hip fracture among relatively healthy individuals aged 75 years or older who lead independent lives in the community. Method and Patients: Of the adults aged 75 years or older residing in Hokkaido prefecture of Japan (n = 705,538), those who did not meet several exclusion criteria were eligible for generating propensity score‐matched cohorts (n = 214,723). Exclusion criteria included co‐prescribed medications acting on the central nervous system, diagnoses of malignant neoplasm, dementia, depression, etc. We compared 33,095 participants who were prescribed hypnotics for daily use (hypnotic group) with a propensity score‐matched cohort without a prescription (control group). Participants were followed for more than 42 months. Results: During the 42‐month follow‐up period, the incidence of the three outcome measures in the hypnotics group was significantly higher than that in the control group (aspiration pneumonia p < 0.001, hip fracture p = 0.007, and all‐cause mortality p < 0.001). Sensitivity analyses utilizing inverse probability weighting demonstrated hazard ratios of 1.083 [1.023–1.146] for mortality, 1.117 [1.014–1.230] for aspiration pneumonia, and 1.720 [1.559–1.897] for hip fracture. Meanwhile, the attribute risk differences were 2.7, 1.5, and 1.0 per 1000 patient‐years, respectively. Conclusions: Although daily use of hypnotics increased the risk of three events, their attribute risk differences were fewer than 3.0 per 1000 patient‐years. The results will help provide guidance on whether it is reasonable to prescribe hypnotics to geriatric population aged 75 or older leading independent lives in the community. Clinical trial registration: UMIN‐CTR UMIN000048398. Key points: It is controversial if daily use of hypnotics increases mortality, aspiration pneumonia and hip fracture in individuals aged 75 years or older leading independent lives in the community.We compared 33,095 participants who were prescribed hypnotics for daily use (hypnotic group) with a propensity score‐matched cohort without a prescription (control group).The incidence of the three adverse events in the hypnotics group was significantly higher than that in the control group, although the attribute risk differences were 2.7, 1.5, and 1.0 per 1000 patient‐years, respectively.The results will help provide guidance on whether it is reasonable to prescribe hypnotics to geriatric population aged 75 or older leading independent lives in the community. [ABSTRACT FROM AUTHOR]

Tenofovir alafenamide (TAF), a prodrug of tenofovir, delivers high levels of active drug to hepatocytes and is given in a lower dose than tenofovir disoproxil fumarate (TDF). TAF reduces viral replication in patients with chronic hepatitis B (CHB) similar to TDF and has shown a lower risk of the renal and bone toxicities associated with TDF use. This post‐marketing surveillance study examined the safety and effectiveness of TAF in treatment‐naïve and ‐experienced CHB patients who received TAF for 144 weeks at real‐world clinical sites in Japan. Safety assessments included the incidence of adverse drug reactions (ADRs), renal and bone events, and changes in selected laboratory parameters. Effectiveness was based on the proportion of patients with HBV DNA levels below the lower limit of quantitation or <29 IU/mL. This analysis included 580 patients; 18.4% of whom were treatment‐naïve. The cumulative incidence of ADRs was 0.21 per 100 person‐months, and the incidence of serious ADRs was 0.01 (95% CI, 0.00–0.04) per 100 person‐months. There were no ADRs of declines in estimated glomerular filtration rates, renal failure or proximal tubulopathy. The most common ADR was hypophosphataemia in seven (1.2%) patients. Two (0.4%) patients each had decreased blood phosphorus, bone mineral density decreased, dizziness and alopecia. Overall, the proportion of virologically suppressed patients increased from 68.8% at baseline to 97.5% at Week 144. These results confirm the real‐world safety and effectiveness of TAF in Japanese patients with CHB and are consistent with the findings of other evaluations of the safety and efficacy of TAF in CHB. [ABSTRACT FROM AUTHOR]

Background: Recently, robot-assisted minimally invasive esophagectomy (RAMIE) has gained popularity worldwide. Some studies have compared the long-term results of RAMIE and minimally invasive esophagectomy (MIE). However, there are no reports on the long-term outcomes of RAMIE in Japan. This study compared the long-term outcomes of RAMIE and MIE. Methods: This retrospective study included 86 patients with thoracic esophageal cancer who underwent RAMIE or MIE at our hospital from June 2010 to December 2016. Propensity score matching (PSM) was employed, incorporating co-variables such as confounders or risk factors derived from the literature and clinical practice. These variables included age, sex, body mass index, alcohol consumption, smoking history, American Society of Anesthesiologists stage, comorbidities, tumor location, histology, clinical TNM stage, and preoperative therapy. The primary endpoint was 5-year overall survival (OS), and the secondary endpoints were 5-year disease-free survival (DFS) and recurrence rates. Results: Before PSM, the RAMIE group had a longer operation time (min) than the MIE group (P = 0.019). RAMIE also exhibited significantly lower blood loss volume (mL) (P < 0.001) and fewer three-field lymph node dissections (P = 0.028). Postoperative complications (Clavien–Dindo: CD ≥ 2) were significantly lower in the RAMIE group (P = 0.04), and postoperative hospital stay was significantly shorter than the MIE group (P < 0.001). After PSM, the RAMIE and MIE groups consisted of 26 patients each. Blood loss volume was significantly smaller (P = 0.012), postoperative complications (Clavien–Dindo ≥ 2) were significantly lower (P = 0.021), and postoperative hospital stay was significantly shorter (P < 0.001) in the RAMIE group than those in the MIE group. The median observation period was 63 months. The 5-year OS rates were 73.1% and 80.8% in the RAMIE and MIE groups, respectively (P = 0.360); the 5-year DFS rates were 76.9% and 76.9% in the RAMIE and MIE groups, respectively (P = 0.749). Six of 26 patients (23.1%) in each group experienced recurrence, with a median recurrence period of 41.5 months in the RAMIE group and 22.5 months in the MIE group. Conclusions: Compared with MIE, RAMIE led to no differences in long-term results, suggesting that RAMIE is a comparable technique. [ABSTRACT FROM AUTHOR]

Aim: Awareness of difficulty chewing may limit the diversity of food intake in older adults. However, few studies have clarified which factors are related to subjective difficulty in chewing. The aim was to identify factors related to subjective difficulty in chewing in 70‐ and 80‐year‐old Japanese older adults. Methods: A total of 1680 participants (792 men, 888 women) were surveyed. Difficulty in chewing was assessed with questionnaires regarding food intake, such as rice, apples, beef, and hard rice crackers. The participants were classified into two groups, the "with difficulty" group (participants who answered "cannot eat," "can eat with difficulty," and "can eat if small") and the "without difficulty" group (participants who answered "can eat without problems"), according to their answers to questionnaires for each food. A logistic regression analysis with subjective difficulty in chewing as the dependent variable was performed for each food. Results: Subjective difficulty in chewing was associated with age, occlusal force, and depression for rice; age, number of remaining teeth, occlusal force, and depression for apples; number of remaining teeth, occlusal force, and depression for beef; and number of remaining teeth and occlusal force for hard rice crackers. Conclusions: Age, number of remaining teeth, and occlusal force, as well as depression, might be related to subjective evaluation of difficulty chewing in community‐dwelling Japanese older adults. Geriatr Gerontol Int 2024; 24: 327–333. [ABSTRACT FROM AUTHOR]

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]

The article investigates the validity of 12 frailty-related items in Japan's annual health assessment for older adults. Confirmatory factor analysis supports these items' alignment with a five-domain frailty model, indicating their construct validity. Topics include validating these items through a cohort study, their prevalence in health checkup data, and disparities in participant characteristics between studies.

Isaza Gymnogobius isaza, a small freshwater goby endemic to Lake Biwa, Japan, is categorized as "Endangered" in the International Union for Conservation of Nature Red List of Threatened Species; nevertheless, it remains subject to fishing without any specific management strategies. The sex ratio, and gonadosomatic and hepatosomatic indices of Isaza caught by commercial bottom trawl and set net while migrating to and from an offshore pelagic area and nearshore spawning area were investigated in Lake Biwa from winter to early summer. Male spawning migrations preceded those of females. In addition, mortality during spawning was male-biased. Both findings suggested a possible impact of the commercial set net fishery on Isaza reproduction. Future conservation and fisheries management of the species need to be considered. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to investigate factors associated with impaired physical function [defined as Health Assessment Questionnaire Disability Index (HAQ-DI) >0.5] of old-old (aged 75–84 years) patients with rheumatoid arthritis. Methods: Data from 15,185 rheumatoid arthritis patients in the National Database of Rheumatic Disease in Japan were extracted from 2017 to 2018. We enrolled 3708 patients aged 55–84 years in Simplified Disease Activity Index (SDAI) ≤11 and Steinbrocker Stage I/II. Factors associated with HAQ-DI >0.5 were analysed by multivariable logistic regression. Results: About half of the old-old patients received methotrexate, which was lower than middle-aged (55–64 years) and young-old patients (65–74 years). The proportion of glucocorticoids in the old-old patients was highest among the three groups, and biological disease-modifying antirheumatic drugs were similarly used. The prevalence of HAQ-DI >0.5 was significantly higher in old-old patients with low disease activity than in those with remission. The same was true in the middle-aged and young-old patients. Multivariable analysis showed age, higher SDAI, glucocorticoid use, and methotrexate nonuse were significantly associated with HAQ-DI >0.5 in the old-old patients. Conclusions: Achieving SDAI remission was an ideal goal for old-old patients in terms of physical function. Glucocorticoids and a low proportion of methotrexate use may influence the physical function of old-old patients. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, the need to triage COVID-19 patients in ICUs emerged globally. Triage guidelines were established in many countries; however, the actual triage decision-making processes and decisions themselves made by frontline medical providers may not have exactly reflected those guidelines. Despite the need to understand decisions and processes in practice regarding patient ICU admission and mechanical ventilator usage to identify areas of improvement for medical care provision, such research is limited. This qualitative study was conducted to identify the decision-making processes regarding COVID-19 patient ICU admissions and mechanical ventilator allocation by frontline medical providers and issues associated with those processes in an ICU during the COVID-19 pandemic. Semi-structured, in-depth interviews were conducted with ICU physicians and nurses working at an urban tertiary referral hospital in Japan between February and April 2022. Patient characteristics that influenced triage decisions made by physicians and the interaction between physicians, nurses, and senior management staff upon making such decisions are discussed in this article. An implicated issue was the lack of legal support for Japanese physicians to practice withdrawal of life-sustaining treatments even during emergencies. Another issue was the impact of non-clinical forces—likely specific to health emergencies—on physicians' decisions regarding mechanical ventilator allocation, where such forces imposed a significant mental burden on the medical providers. We consider public policy and legal implications for future pandemics. [ABSTRACT FROM AUTHOR]

This study aimed to clarify the cause‐effect relationship between renal tubular damage and non‐cancer mortality in the general Japanese population. We conducted a 19‐year cohort study including 1110 men and 1,03 women who lived in three cadmium‐non‐polluted areas in 1993 or 1994. Mortality risk ratios based on urinary β2‐microglobulin (β2MG) and N‐acetyl‐β‐glucosaminidase (NAG) concentrations were estimated for specific non‐cancer diseases using the Fine and Gray competing risks regression model. In men, continuous urinary NAG (+1 μg/g cre) concentrations were significantly correlated with increased mortality caused by diseases of the respiratory system (hazard ratio (HR): 1.09, 95% confidence interval (CI): 1.03–1.15). Urinary β2MG (+100 μg/g cre) concentrations were significantly correlated with increased mortalities caused by kidney and urinary tract diseases (HR: 1.01, 95% CI: 1.00–1.03), renal diseases (HR: 1.01, 95% CI: 1.00–1.03), renal failure (HR: 1.02, 95% CI: 1.00–1.03), and external causes of mortality (HR: 1.01, 95% CI: 1.00–1.02). In women, urinary NAG (+1 μg/g cre) concentrations were significantly associated with increased mortality caused by ischemic heart diseases (HR: 1.02, 95% CI: 1.00–1.04) and kidney and urinary tract diseases (HR: 1.01, 95% CI: 1.00–1.04). Urinary β2MG (+100 μg/g cre) concentrations were significantly correlated with increased mortality caused by cardiovascular diseases (HR: 1.01, 95%CI: 1.00–1.02), ischemic heart diseases (HR: 1.01, 95%CI: 1.00–1.02), and kidney and urinary tract diseases (HR: 1.02, 95% CI: 1.01–1.03). The present study indicates that renal tubular damage was significantly related to several non‐cancer disease causes of mortality in Japan's general population living in cadmium‐non‐polluted areas. We evaluated the effect of renal tubular damage on non‐cancer mortality, by conducting a 19‐year cohort study in three cadmium‐non‐polluted areas in Japan. Mortality risk estimates based on urinary NAG and β2MG concentrations were significantly higher for respiratory, renal, and cardiovascular diseases. [ABSTRACT FROM AUTHOR]

Background: With rising worldwide population aging, the number of homebound individuals with multimorbidity is increasing. Improvement in the quality of home medical care (HMC), including medications, contributes to meeting older adults' preference for "aging in place" and securing healthcare resources. Objective: To evaluate the changes in drug prescriptions, particularly potentially inappropriate medications (PIMs), among older adults receiving HMC in recent years, during which measures addressing inappropriate polypharmacy were implemented, including the introduction of clinical practice guidelines and medical fees for deprescribing. Design: A cross-sectional study. Participants: Using data from the national claims database in Japan, this study included older adults aged ≥ 75 years who received HMC in October 2015 (N = 499,850) and October 2019 (N = 657,051). Main Measures: Number of drugs, prevalence of polypharmacy (≥ 5 regular drugs), major drug categories/classes, and PIMs according to Japanese guidelines were analyzed. Random effects logistic regression models were used to evaluate the differences in medications between 2015 and 2019, considering the correlation within individuals who contributed to the analysis in both years. Key Results: The number of drugs remained unchanged from 2015 to 2019 (median: 6; interquartile range: 4, 9). The prevalence of polypharmacy also remained unchanged at 70.0% in both years (P = 0.93). However, the prescription of some drugs (e.g., direct oral anticoagulants, new types of hypnotics, acetaminophen, proton pump inhibitors, and β-blockers) increased, whereas others (e.g., warfarin, vasodilators, H2 blockers, acetylcholinesterase inhibitors, and benzodiazepines) decreased. Among the frequently prescribed PIMs, benzodiazepines/Z-drugs (25.6% in 2015 to 21.1% in 2019; adjusted odds ratio: 0.52) and H2 blockers (11.2 to 7.3%; 0.45) decreased, whereas diuretics (23.8 to 23.6%; 0.90) and antipsychotics (9.7 to 10.5%; 1.11) remained unchanged. Conclusions: We observed some favorable changes but identified some continuous and new challenges. This study suggests that continued attention to medication optimization is required to achieve safe and effective HMC. [ABSTRACT FROM AUTHOR]

For stock enhancement of the pond smelt Hypomesus nipponensis in Japan, eyed eggs have been transplanted into numerous lakes, ponds, and reservoirs throughout the country from a number of major lake populations. For consistent effective stock enhancement, propagation skills in the recipient lakes, including conservation of spawning habitats and construction of artificial spawning sites, are necessary, independent of eyed-egg transplantation from other lakes. The physical characteristics of the spawning habitats selected by pond smelt in 6 rivers feeding Lake Yogo were surveyed, focusing on water velocity, depth, and substrate. The analysis using Jacobs' selective index shows that pond smelt selectively spawn at sites in shallow depth (5–30 cm), with moderate water velocity (10–50 cm/s), utilizing gravel, pebbles, and sand in riffles, as opposed to mud and silt near the river mouths. The biological information gained in this study is useful background for the conservation of spawning habitats and construction of artificial spawning sites in other regions of Japan. [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]

Research has demonstrated that adolescents of the digital age engage in developmental tasks by interacting with others in both online and offline environments. However, no studies have investigated how adolescents develop their identity, a crucial developmental task, by engaging in online and offline prosocial behaviors. To address this research gap, we examined the role of online and offline prosocial behavior in identity development during adolescence using variable- and person-centered approaches. The participants were 608 individuals in early adolescence (50.2% girls; age range = 12-13 years, Mage = 12.75 years, SD = 0.43) and 594 individuals in middle adolescence (50.3% girls; age range = 15-16 years, Mage = 15.79 years, SD = 0.41) in Japan. They completed questionnaires to measure identity development, online and offline prosocial behavior, and demographic characteristics. The results from the variable-centered approach (i.e., identity dimensions) revealed that both online and offline prosocial behaviors were positively related to commitments and proactive explorations in early and middle adolescence. The findings from the person-centered approach (i.e., identity statuses) demonstrated that early and middle adolescents with higher levels of online prosocial behavior were more likely to show searching moratorium than all other identity statuses, whereas those with higher levels of offline prosocial behavior were more likely to show achievement than troubled diffusion, carefree diffusion, and undifferentiated. Consistent with both variable- and personcentered approaches, these findings highlight that online prosocial behavior can be a new resource for identity development in adolescence. Moreover, the results suggest that online prosocial behaviors lead to identity status in the process of maturing identity and that offline prosocial behavior is necessary to become more mature identity status. Regarding practical implications, educating adolescents on digital media literacy, including supportive behavior in online environments, is crucial to gradually exploring their identity. In addition, for adolescents to develop more mature identity, adults should create in-person environments in which they participate in offline prosocial behavior. The limitations of our findings with respect to the online and offline prosocial behavior scale items are discussed. [ABSTRACT FROM AUTHOR]

Aim: In our previous study, we proposed that the total score of the 12 frailty‐related items in the health assessment questionnaire for the national screening program for older adults could be used as an indicator of frailty. We aim to examine the criterion validity of the 12 frailty‐related items for frailty. Methods: The data used in this study were from older Japanese individuals aged 78–81 years (n = 461) who participated in the in‐venue (2019) and mailed questionnaire (2020) surveys of the Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians study. A receiver operator characteristic (ROC) curve analysis was used to evaluate the criterion validity of the 12 frailty‐related items for frailty defined based on the Japanese version of the Cardiovascular Health Study criteria. A multivariable logistic regression model was used to examine the independent association of the 12 frailty‐related items with frailty. Results: The area under the ROC curve of the scores of the 12 frailty‐related items for frailty was 0.79 (95% confidence interval [CI] = 0.73–0.85, P < 0.001). The cut‐off value for frailty was 3 and 4 points, and the sensitivity and specificity were 55.9% and 85.8%, respectively. The multivariable logistic regression model showed that four or more scores of the 12 frailty‐related items were significantly associated with frailty (adjusted odds ratio = 7.75, 95% CI = 4.10–14.65, P < 0.001). Conclusions: The results of this study suggest that the 12 frailty‐related items in the health assessment questionnaire for older adults may be useful for assessing frailty in community‐dwelling older adults in a simplified manner. Geriatr Gerontol Int 2023; 23: 437–443. [ABSTRACT FROM AUTHOR]

Background: Frailty increases the risk of negative health‐related events, such as falls, disability, hospitalizations, and death. Although the association between oral health and physical frailty is well established, the relationship between oral health and psychological frailty has not yet been investigated. Therefore, we conducted a cross‐sectional study to examine the association between maximal occlusal force and psychological frailty in Japanese community‐dwelling older adults. Methods: Psychological frailty was defined as a World Health Organization‐5 scale (WHO‐5) score of <13, cognitive and functional status was defined as a Japanese version of the Montreal Cognitive Assessment (MoCA‐J) score of <23, and psychological robustness was defined as a WHO‐5 score of ≥13 and a MoCA‐J score of ≥23. We used a cross‐sectional study design to measure maximal occlusal force in 1810 participants, and examined the following factors relevant to psychological frailty: educational level, financial status, living situation, history of chronic diseases, handgrip strength, and instrumental activities of daily living. We used propensity score matching to match the psychological frailty and psychological robustness groups according to demographic and confounding factors. This process, resulted in 344 participants, of whom 172 were in the psychological frailty group and 172 were in the psychological robustness group. In the matched cohort, differences between groups with and without psychological frailty were compared using generalized estimating equations for maximal occlusal force after adjusting for the number of teeth. Results: After controlling for potential confounding factors of frailty, the psychological frailty group showed lower maximal occlusal force compared with the psychological robustness group (unstandardized regression coefficients = −72.7, 95% confidence interval: −126.3 to −19.1). Conclusions: Maximal occlusal force was associated with a reduced prevalence of psychological frailty among Japanese community‐dwelling older adults participating in our study. [ABSTRACT FROM AUTHOR]

Aim: The aging‐related increase in the incidence of anemia potentially affects the mortality risk. Lower cognitive function is common among older adults, and anemia is one of the causes of cognitive decline. However, to the best of our knowledge, no study has investigated whether cognitive decline is a risk factor for anemia in older people. Therefore, in this study, we used a 3‐year longitudinal evaluation to examine the association of cognitive function with anemia in community‐dwelling older adults. Methods: This longitudinal study enrolled participants without anemia (diagnosed based on the World Health Organization's criteria) at baseline. Cognitive function was assessed using the Japanese version of the Montreal Cognitive Assessment. Multiple logistic regression models were used to examine the association between cognitive function at baseline and the presence of anemia 3 years later. Results: Participants were in the 69–71 and 79–81 years age groups, and 974 older people (48.6% men) were enrolled, of whom 126 (12.9%) had anemia after 3 years. After adjusting, cognitive function at baseline was associated with anemia in women, but not in men. Conclusions: Older Japanese women with lower cognitive function have an increased risk for anemia 3 years later. The adoption of a lifestyle that utilizes or improves cognitive function might be important to prevent anemia in older women. Geriatr Gerontol Int 2023; 23: 334–340. [ABSTRACT FROM AUTHOR]

The purpose of this symposium is to provide readers with a general understanding of Japanese art and aesthetics education and its interaction with other cultures. The essays cover a variety of topics, including historical, cross-cultural, theoretical, and practical perspectives. Following an introduction by Ako Okazaki, the following papers are presented: (1) "A Historical Overview of Art Education in Japan" (Kingo Masuda); (2) "The Concept of Freedom in Art Education in Japan" (Takuya Kaneda); (3) "Restriction and Individual Expression in the 'Play Activity/Zokei Asobi'" (Yoko Hino); (4) "A Sense of Reality" (Yasuaki Okamoto); (5) "Does Art Education Dream of Disneyland?" (Kinichi Fukumoto); (6) "Encounter between Hyper-Media and Art Education: A Retrospection of Jean-Jacques Rousseau or Memories of Art and Education" (Motoki Nagamori); (7) "Evolution in Qualitative Factors Used to Evaluate Japanese Students" (Kazumi Yamada); (8) "Media Literacy Education in Art: Motion Expression and the New Vision of Art Education" (Kenta Motomura); (9) "Postmodern Approach to Art Appreciation for Integrated Study in Japan" (Kazuhiro Ishizaki); (10) "Music-Picture: One Form of Synthetic Art Education" (Masashi Okada); (11) " Arthur Wesley Dow's Address in Kyoto, Japan (1903)" (Akio Okazaki); (12) "Japanese Painting and Johannes Itten's Art Education" (Yoshimasa Kaneko); (13) "Art Education in Lower Secondary Schools in Japan and the United Kingdom" (Toshio Naoe); (14) "A Comparative Study of Artistic Play and 'Zoukei-Asobi'" (Mitsuru Fujie); and (15) "Art as Part of Daily Life--A Cross-Cultural Dialogue between Art and People" (Masako Iwano). (Contains 2 figures, 4 tables, and 200 notes.)

Representation of spatial dependence on temporal variations in climate scenarios is quite important when performing impact assessments in various sectors, including water resource management, agriculture, and energy. Although the complex terrain of Japan is closely related to the formation of regional climates, the spatial aspects of climate scenarios have not been investigated. To examine how well spatial dependency on temporal variations in precipitation is represented, we analysed the dependence of the correlation of daily precipitation time series for station pairs on the geographical distance between stations in several downscaled products for Japan. Although the bias correction (BC) method using quantile mapping was sufficient for removing the inherent biases at each station, we found minimal improvement in the spatial dependency. The performance was strongly dependent on the grid spacing of the parent model when the downscaling process was simple; it could not be improved by applying BC to the model output statistics. When analogue‐type statistical downscaling was applied, the observed spatial pattern of interstation correlations was much better reproduced; this was comparable to the results obtained using a dynamical downscaling technique with grid spacing of a few kilometres. Our results emphasize the importance of selecting appropriate data to represent the spatial variability of meteorological variables because mean bias‐based or accessibility‐based data selection may produce misleading results. The combination of an analogue method with BC of model output statistics has the potential to effectively represent the marginal and spatial aspects of climate scenarios. [ABSTRACT FROM AUTHOR]

While previous studies suggest that women have higher anxiety than men regarding COVID-19, underlying mechanisms remain unclear. This study tries to explain the mechanisms by gender difference in social interaction based on a theory of social amplification of risk framework (SARF). We surveyed older adults in Japan regarding their anxiety regarding COVID-19, as well as the frequencies of their direct and indirect social interaction in July 2020 (N = 1,587, aged 78–99 years). To explore the way in which gender and anxiety regarding COVID-19 were mediated by these two types of social interactions, MODEL4 of SPSS's Process MACRO was applied to the data. We found that older women interacted more directly and indirectly with others than did older men. And, direct social interaction was negatively and related, but indirect social interaction was positively related to older adults' anxiety regarding COVID-19. Furthermore, direct social interaction was related to older women's low anxiety regarding COVID-19, whereas indirect social interaction was related to older women's high anxiety regarding COVID-19. The findings of our study suggest that the degree of anxiety regarding COVID-19 among older women may be dependent upon the types of social interaction they have with others. [ABSTRACT FROM AUTHOR]

The possible recovery of a white-spotted charr population in a small tributary of a river to Lake Biwa, following removal of previously stocked red-spotted masu salmon, was investigated by electrofishing. We captured 30 red-spotted masu salmon and two hybrids of these two species in 2014. Prior to the stocking of red-spotted masu salmon, the estimated number of white-spotted charr ≥ 100 mm standard length (SL) in the tributary was more than 200 individuals in 2005, which had reduced to fewer than 30 individuals by 2014 when 30 red-spotted masu salmon plus two charr/masu salmon hybrids were captured. However, no red-spotted masu salmon were captured from 2015 to 2017, indicating the success of a red-spotted masu salmon removal program. The estimated number of white-spotted charr ≥ 100 mm SL ranged from 25 to 91 individuals between 2015 and 2017, implying a great reduction of red-spotted masu. The estimated population size of the former increased further to 171–221 individuals in 2021, comparable to 2005. These results suggest that the white-spotted charr population declined due to stocking of red-spotted masu salmon, and recovered following removal of the latter. [ABSTRACT FROM AUTHOR]

Aim: This cross‐sectional study aimed to investigate the associations between salivary testosterone concentrations and cognitive function in 70‐year‐old Japanese elderly people without dementia and stroke. Methods: Participants were 197 Japanese community‐dwelling people aged 69–71 years. Their salivary samples were collected, and their cognitive function was assessed using the Japanese version of the Montreal Cognitive Assessment (MoCA‐J). Participants were also administered a 10‐item recall and a 24‐item recognition test. The data for 179 (106 men and 73 women) individuals were analyzed, excluding individuals with a past history of stroke and dementia. Multivariate logistic regression analyses were performed after adjusting for lifestyle factors and analyzing data separately for men and women. Results: MoCA‐J scores showed that men with low testosterone concentrations had a significantly greater risk of low cognitive performance than those with high testosterone concentrations (adjusted odds ratio: 4.72, 95% confidence interval: 1.06–21.00), while no significant association was found in women. The 10‐item recall test scores showed that higher testosterone concentrations were significantly associated with greater recall in the second trial in women (standardized beta = 0.24, P = 0.040), whereas no significant association was found in men. Salivary testosterone concentrations were positively associated with better cognitive performance in older men and women. Conclusions: The associations between salivary testosterone concentrations and cognitive function were shown by different tasks for men and women. Geriatr Gerontol Int 2022; 22: 1040–1046. [ABSTRACT FROM AUTHOR]

This study aimed to examine the effects of substitute player allowance per match on running performance in Japanese professional football over three consecutive seasons with different numbers of maximum substitutes. Match running performance was obtained from all outfield players in the official matches of the 1st Division of the Japan Professional Football League over three seasons (2019/2020/2021; 22291 player files) by a 4th generation TRACAB® system which provided the total distance covered (TD) and the number of sprinting runs (SP; ≥24.0 km/h for≥1.0 s). The players were divided according to play time: full match (STA), replaced during match (REP), and substitutes during match (SUB). The number of SUBs increased significantly from 2019 to 2021 (p < 0.05). SUB had a significantly higher average speed than STA and REP. The analysis of covariance with the number of recovery days, ambient temperature, and relative humidity as covariates revealed that the TD and SP significantly differed based on the number of SUBs (p < 0.05). Stepwise regression analysis showed that the number of SUBs significantly contributed to the TD and SP. These results suggest that the new law, which increased the maximum SUB allowance from three to five, improved the match running performance in Japanese professional football. [ABSTRACT FROM AUTHOR]

Climate scenario data set are indispensable for assessing future climate impacts. In this study, we developed statistically downscaled climate scenarios in Japan using modified bias correction method based on five general circulation models selected from the Coupled Model Intercomparison Project (CMIP) Phase 6 to facilitate impact assessments and adaptation strategies. Modification of time window of the original correction method results in successful agreement with the observed seasonal change of variables in each grid. The original CMIP6 models have a relatively small bias compared to CMIP5 models. The advantage of CMIP6‐based bias‐corrected scenarios is its availability for multiple global circulation models, which covered wide uncertainty in CMIP6 ensembles, with various emissions scenarios for representative concentration pathway (RCP) including RCP4.5, RCP2.6, and RCP8.5. Several temperature‐related indices derived from the CMIP6‐based climate scenarios agreed well with observations. The number of extremely hot days and nights increased nonlinearly in the future with additional global warming. An increase in the global warming level from 1 to 2°C above the early 1900s would increase the probability of the number of extremely hot days per year exceeding the 2018 case by 4.1 times. The development of bias‐corrected climate scenarios facilitates the study of various climate impacts on a CMIP6 basis. Plain Language Summary: It is important to appropriately remove model biases since the impact of climate change does not always depend linearly on the climate input data. To facilitate impact assessment based on the latest data set from CMIP6, we developed bias‐corrected daily climate scenarios for eight variables using five models. The application of climate scenarios to heat mortality‐related indices showed that they reproduced historical values well and would be useful for future projections. Key Points: We developed a statistically downscaled climate scenario in Japan based on five general circulation models selected from the Coupled Model Intercomparison Project Phase 6 to facilitate impact assessmentsSimilar increasing trend was found for the temperature and precipitation between CMIP5‐ and CMIP6‐based climate scenarios, while CMIP6‐based scenario showed smaller biases for the underlying global circulation model. Addition of the moderate emission scenario for CMIP6‐based scenario enable us to consider wider range of the possible futureSeveral threshold‐based indices derived from the climate scenarios was evaluated. They agreed with the observed values for the historical period. For the future, we can discuss the possible future change of indices in comparison with the historical values. Development of the bias‐corrected climate scenarios has enabled the broader impact assessment community in Japan to study various climate impacts on a CMIP6 basis [ABSTRACT FROM AUTHOR]

Aims: To reduce Salmonella contamination of animal feeds, Salmonella contamination in a feed materials storage facility was investigated, and hazard analysis was performed to acquire the basic information necessary to establish a control method for Salmonella. The result is that managers of feed materials storage facilities will be able to introduce the Hazard Analysis and Critical Control Point (HACCP) systems to quickly and efficiently. Methods and Results: A total of 472 samples, including deposits, adhesions, environment samples and materials, were investigated. The detection rate in the storage facility was 5.1% (24/472) over the three‐year investigation period. The serovars of detected Salmonella were Agona, Anatum, Bron (or Agbeni), Chester, Infantis, Mbandaka, Minnesota, Muenster, Sinstorf, Typhimurium, O18:– and O1,3,19:–. As a result of hazard analysis after confirming the multiplication factors and detection rate, important hazards were judged to be the outdoor equipment and dust collector. Conclusions: The risk of Salmonella contamination in storage facilities was clarified. Important Salmonella hazards in storage facilities are Salmonella‐contaminated feed materials, multiplication factors such as rainwater and dew condensation, and Salmonella‐accumulated dust in dust collectors for fine‐powder recovery. These results suggest that proper control of these hazards could reduce the risk of Salmonella in storage facilities. Significance and Impact of the Study: This is the first report describing actual Salmonella contamination conditions and risk assessment using the hazard analysis at a feed materials storage facility in Japan. This study will consider implications for the feed industry because the hazard analysis clarified the sites of Salmonella contamination, the tendency of contamination and the points for implementing control measures in the feed materials storage facility. [ABSTRACT FROM AUTHOR]

The relationship between cadmium exposure, exposure‐related renal tubular dysfunction, and mortality have been reported, mainly in the residents of Cd‐contaminated areas in Japan. The aim of this study was to establish the cause–effect relationship between renal tubular dysfunction and cancer mortality in the general population in non‐contaminated areas. A 19‐year cohort study was conducted in 1110 men and 1703 women in 1993 or 1994, who lived in three cadmium‐non‐contaminated areas. Mortality risk ratios of urinary β2‐microglobulin (β2MG) and N‐acetyl‐β‐glucosaminidase (NAG) for all malignant neoplasms and specific cancers were estimated using the Fine and Gray competing risks regression model. Significant hazard ratios (HRs) for liver and pancreas cancer were observed for NAG (liver: HR corresponding to an increase of 1 IU/g cr, 1.10, 95%CI, 1.02–1.19, pancreas: HR, 1.10, 95%CI, 1.02–1.19) in men. In women, a negative HR was observed for NAG (lung cancer: HR 0.80, 95% CI, 0.67–0.96) and for β2MG (all malignant neoplasms: HR, 0.97, 95% CI, 0.93–1.00). The present study indicated that renal tubular dysfunction was significantly related to mortality in the general population of cadmium‐non‐contaminated areas in Japan. We evaluated the relationship between renal tubular damage and cancer mortality by conducting a 19‐year cohort study in three cadmium non‐polluted areas in Japan. Mortality risk of urinary β2MG and NAG for all malignant neoplasms and specific cancers was estimated. Significant hazard ratios for liver and pancreas cancer were observed for NAG in men. [ABSTRACT FROM AUTHOR]

This study aimed to elucidate the 12-month durability of neutralizing antibodies (NAbs) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in patients infected during the 2020 workplace outbreaks of coronavirus disease 2019 (COVID-19) in Japan. We followed 33 Japanese patients infected with SARS-CoV-2 in April 2020 for 12 months (12M). Patients were tested for NAbs and for antibodies against the SARS-CoV-2 nucleocapsid (anti-NC-Ab) and antibodies against the spike receptor-binding domain (anti-RBD-Ab). Tests were performed at 2M, 6M, and 12M after the primary infection (api) with commercially available test kits. In 90.9% (30/33) of patients, NAbs persisted for 12M api, though the median titers significantly declined from 78.7% (interquartile range [IQR]: 73.0–85.0%) at 2M, to 59.8% (IQR: 51.2–77.9) at 6M (P = 0.008), and to 56.2% (IQR: 39.6–74.4) at 12M (P<0.001). An exponential decay model showed that the NAb level reached undetectable concentrations at 35.5 months api (95% confidence interval: 26.5–48.0 months). Additionally, NAb titers were significantly related to anti-RBD-Ab titers (rho = 0.736, P<0.001), but not to anti-NC-Ab titers. In most patients convalescing from COVID-19, NAbs persisted for 12M api. This result suggested that patients need a booster vaccination within one year api, even though NAbs could be detected for over two years api. Anti-RBD-Ab titers could be used as a surrogate marker for predicting residual NAb levels. [ABSTRACT FROM AUTHOR]

Aim: Previous studies have shown temporal trends in the number of gastrostomies until 2016, but the recent trend is yet to be analyzed. This study aimed to evaluate temporal trends in gastrostomy (mostly percutaneous endoscopic gastrostomy) in older adults in Japan in more recent years. Methods: We extracted data on the numbers of gastrostomies and swallowing function assessment prior to gastrostomy, using the national aggregated open data (NDB Open Data) from 2014 to 2019. Results: Adults in their 80s accounted for the largest portion of gastrostomy during the study period. A decreasing trend in the total number of gastrostomy was observed in older adults from 2014 to 2016, but became almost stable thereafter (57 103 in 2014, 47 228 in 2016, and 47 944 in 2019). The age group‐stratified numbers of gastrostomy per 100 000 individuals decreased by −33.9% (≥90 years group) to −6.1% (65–69 years group) from 2014 to 2019. The implementation rate of the swallowing function assessment remained relatively low, despite a slight increase (21.4% in 2015 to 23.7% in 2019). Conclusion: We showed that the total number of gastrostomies remained almost stable after 2016 despite population aging. We considered that the avoidance of gastrostomy in frail or disabled older adults might explain the decrease, particularly for those aged over 80 years. Our findings would regain attention to appropriate decision‐making for gastrostomy. Geriatr Gerontol Int 2022; 22: 648–652. [ABSTRACT FROM AUTHOR]

A retrospective chart survey of the clinical features of indolent adult T-cell leukemia/lymphoma (ATL) was conducted in the Miyazaki Prefecture, Japan. This study enrolled 24 smoldering-type ATLs, 10 favorable chronic-type ATLs, and 20 unfavorable chronic-type ATLs diagnosed between 2010 and 2018. Among them, 4, 3, and 10 progressed to acute-type ATLs during their clinical course. The median survival time (MST) in smoldering-type ATL and favorable chronic-type ATL was not reached, and their 4-year overall survival (OS) was 73% and 79%, respectively. Compared with this, the prognosis of unfavorable chronic-type ATL was poor. Its MST was 3.32 years, and the 4-year OS was 46% (p = 0.0095). In addition to the three features that determine the unfavorable characteristics of chronic-type ATL, namely, increased lactate dehydrogenase, increased blood urea nitrogen, and decreased albumin, the high-risk category by the indolent ATL-Prognostic Index, which was defined by an increment of soluble interleukin-2 receptor (sIL2-R) of >6000 U/mL, could explain the poor prognosis in indolent ATL patients. The level of sIL-2R might be an indicator of the initiation of therapy for indolent ATL. [ABSTRACT FROM AUTHOR]

This cross-sectional study explored the prevalence of iron deficiency (ID) and associations between dietary factors and incidence of ID in female rhythmic gymnasts during preseason periods. Participants were 60 elite collegiate rhythmic gymnasts (18.1 ± 0.3 years [M ± SD]) who were recruited every August over the course of 8 years. Participants were divided into 2 groups according to the presence or absence of ID. Presence of ID was denned either by ferritin less than 12 µ/L or percentage of transferrin saturation less than 16%. Anthropometric and hematologic data, as well as dietary intake, which was estimated via a semiquantitative food frequency questionnaire, were compared. ID was noted in 48.3% of participants. No significant group-dependent differences were observed in physical characteristics, red blood cell counts, hemoglobin, hematocrit, haptoglobin, or erythropoietin concentrations. The ID group had a significantly lower total iron-binding capacity; serum-free iron; percentage of transferrin saturation; ferritin; and intake of protein, fat, zinc, vitamin B2, vitamin B6, beans, and eggs but not iron or vitamin C. The recommended dietary allowance for intake of protein, iron, zinc, and various vitamins was not met by 30%, 90%, 70%, and 22%-87% of all participants, respectively. Multiple logistic analysis showed that protein intake was significantly associated with the incidence of ID (odds ratio = 0.814, 95% confidence interval [0.669, 0.990], p = .039). Participants in the preseason's weight-loss periods showed a tendency toward insufficient nutrient intake and were at a high risk for ID, particularly because of lower protein intake. [ABSTRACT FROM AUTHOR]

The number of the children in need of social care because of child abuse in Japan is 45,000, and most of them are institutionalized to children's nursing home. The proportion of children raised in home-like environment such as foster care is remarkably lower than those of other developed countries. To promote home-like environment for the children in need of social care, we propose implementation of support for foster/adopted children and their patents by pediatricians as a social work service. In this article, we attempted to summarize the results of current surveys held in Japan and experiences of other leading countries and to disseminate knowledge for support of foster/adopted children and their parents by pediatricians for reference in Asian countries. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to investigate the utility of prostate-specific antigen (PSA) screening by conducting an all-case survey of newly diagnosed prostate cancer patients at Niigata Prefecture, Japan. Patients and Methods: Depending on whether patients were subjected to screening, information was prospectively collected on all prostate cancer patients newly diagnosed between October 1, 2019, and September 30, 2020, at all institutions in Niigata Prefecture where urologists performing prostate biopsy routinely work and differences in clinical parameters were investigated. Results: PSA was measured in 478 out of 1332 patients (35.8%) as part of a community health screening. The rate of metastatic carcinoma (M1) in all patients was 14.9%. When patients were divided into three categories of population-based screening (community health screening and workplace health screening), opportunistic screening (PSA measurements at complete medical check-ups or on patient request), and testing triggered by clinical symptoms or findings, the proportion of metastatic cancer was 4.5%, 3.7%, and 30.6%, respectively, demonstrating that the number of distant metastases was significantly lesser in all patients who underwent screening. Conclusion: The one-year all-case survey of newly diagnosed prostate cancer patients demonstrated that PSA screening significantly contributed to the early diagnosis of current prostate cancer in Japan. [ABSTRACT FROM AUTHOR]

Aim: To identify facility‐level characteristics associated with hospitalization within 30 days after admission to a geriatric intermediate care facility (GICF) (30‐day hospitalization) in Japan. Methods: This retrospective cohort study used nationwide long‐term care insurance claims data and a national survey of long‐term geriatric care facilities. The study population was residents admitted to GICFs between October 2016 and February 2018. The outcome variable was 30‐day hospitalization. The independent variables were facility‐level characteristics such as level of healthcare professionals. Results: The final sample for analysis comprised 282 991 residents of mean age ± SD, 85.8 ± 7.2 years, of whom 12 814 (4.5%) experienced 30‐day hospitalization. In a multivariable logistic generalized estimating equation model adjusted for facility‐ and resident‐level characteristics, and clustering GICFs, the odds of 30‐day hospitalization were 0.906 times lower (95% confidence interval [CI] 0.857–0.958) among residents in a GICF with dental hygienist than in those in a facility without. Furthermore, the risk of 30‐day hospitalization was lower among residents who had been admitted to a GICF with higher staffing levels of pharmacists (adjusted odds ratio [aOR] 0.941, 95% CI 0.899–0.985), registered nurses (aOR 0.931, 95% CI 0.880–0.986), care workers (aOR 0.920, 95% CI 0.879–0.964) and speech‐language pathologists (aOR 0.926, 95% CI 0.874–0.982) than in those who had been admitted to a GICF with fewer of these healthcare professionals. Conclusions: Transitional care including dental hygienist or higher staffing levels of pharmacists, registered nurses, care workers and speech‐language pathologists may be a more effective way to prevent 30‐day hospitalization. Geriatr Gerontol Int 2021; 21: 1010–1017. [ABSTRACT FROM AUTHOR]

Migration patterns of Japanese dace Pseudaspius hakonensis in and around Lake Biwa, Japan are unknown, although fluvial–lacustrine life history has been known in most tributaries, the many mature individuals migrating upstream into tributaries in early spring. Field surveys and stable isotope analyses were used to clarify the migratory history of Japanese dace in the Ishida River, inflowing to Lake Biwa. In the field surveys, the number of young of the year (YOY) individuals caught per unit effort (CPUE) by hand net and casting net in the tributary and lake-shore area was calculated. The CPUE peaked from May to July, after the spawning season, thereafter decreasing rapidly, suggesting that YOY Japanese dace migrated downstream to Lake Biwa immediately after emerging, possibly due to the abundant food resources there. From September to November, the CPUE of YOY individuals increased in the lower reaches of the stream, although their stable nitrogen isotope values were variable, in some cases being similar to those recorded in the upper reaches and the lake-shore area. This suggests that some YOY individuals migrate upstream from the lake in autumn. In the present study, the juvenile migration pattern of fluvial–lacustrine Japanese dace in Lake Biwa was described using a CPUE survey and δ15N and δ13C analyses. [ABSTRACT FROM AUTHOR]

On January 23, 2018, a small phreatic eruption (VEI = 1) occurred at the Motoshirane Pyroclastic Cone Group in the southern part of Kusatsu-Shirane Volcano in central Japan. The eruption ejected ash, lapillus, and volcanic blocks from three newly opened craters: the main crater (MC), west crater (WC), and south crater (SC). Volcanic blocks were deposited up to 0.5 km from each crater. In contrast, the ash released during this eruption fell up to 25 km ENE of the volcano. The total mass of the fall deposit generated by the eruption was estimated using two methods, yielding total masses of 3.4 × 104 t (segment integration method) and 2.4 × 104 t (Weibull fitting method). The calculations indicate that approximately 70% of the fall deposit was located within 0.5 km of the craters, which was mainly attributed to the low height of the eruption plume. [ABSTRACT FROM AUTHOR]

This follow-up study was conducted over 30 years in a cadmium-polluted area of Japan. Urinary cadmium (U-Cd) concentration decreased by nearly half from 1986 to 2008 in men and women. However, it increased from 2008 to 2014 and maintained similar levels in 2016. Because renal atrophy may induce an increase in U-Cd, kidney volumes were determined using magnetic resonance imaging (MRI) scans in 2018. Based on the MRI results, we divided the participants into two groups, namely the normal group (n = 6, three men and three women) and the lesion group (n = 6, three men and three women). The level of urinary N-acetyl-β-d-glucosaminidase/creatinine (U-NAG/Cr) in the lesion group was significantly higher than in the normal group. The level of serum alkaline phosphatase (Al-P) was positively associated with U-Cd. Age and renal cortex volumes showed significantly negative associations. However, U-Cd and renal cortex and kidney volumes showed no significant associations. These results suggest that U-NAG and serum Al-P were sensitive biomarkers to reflect renal tubular dysfunction and bone damage caused by cadmium poisoning. Individuals chronically exposed to Cd should be observed carefully, due to the increased effect of aging on renal cortex volumes. [ABSTRACT FROM AUTHOR]

Aims/Introduction: This cohort study assessed the risk for bodyweight gain and development of glucose intolerance based on the frequency of consumption of balanced meals including grain, fish or meat and vegetables. Materials and Methods: The participants (8,573 men, 3,327 women) were employees of a company in Japan. A self‐administered questionnaire was used to evaluate the frequency of balanced meal consumption. Bodyweight changes and the incidence of glucose intolerance (glycated hemoglobin >6.0%) during the 3‐year follow‐up period were determined through annual health examinations. Results: The mean bodyweight change over a period of 3 years was 0.78 kg for men and 0.84 kg for women. A lower frequency of balanced meals was associated with a higher bodyweight gain for men (P for trend = 0.004), but not for women. During the study, 464 men and 115 women developed glucose intolerance. Overall, the frequency of balanced meals was not associated with the risk of glucose intolerance in either sex. However, the interaction between the frequency of balanced meals and degree of obesity had a significant effect on the incidence of glucose intolerance in men (P = 0.005), with less frequent consumption of balanced meals being associated with a higher risk for glucose intolerance among men with a BMI ≥25.0 kg/m2 (P for trend = 0.007). Conclusions: A higher frequency of balanced meals, including grain, fish or meat and vegetable dishes – important components of healthy Japanese food – was associated with a lower risk of glucose intolerance in obese men, but not in non‐obese men and women. [ABSTRACT FROM AUTHOR]

Background: Treatment options for amyotrophic lateral sclerosis (ALS) are limited. SUNRISE Japan is an ongoing post‐marketing surveillance evaluating the long‐term efficacy and safety of edaravone, a novel neuroprotectant agent, and free radical scavenger, in patients with ALS. Aim: This study aims to describe the real‐word safety results of ALS patients enrolled in SUNRISE Japan. Methods: Patients diagnosed with ALS and prescribed edaravone for the first time during the surveillance period were included. Patients were prescribed edaravone according to the prescribing information. The incidence of adverse drug reactions (ADRs) reported up to 1 year of follow‐up was evaluated. Results: Of 805 patients enrolled up to April 2020, 800 were included in the safety analysis set. Patients had a mean age of 66.3 years, 55.1% were male, and they had a mean disease duration of 1.8 years. In total, 97 patients (12.1%) reported at least one ADR, with a total of 148 ADR events reported. Thirty patients (3.8%) reported at least one serious ADR with a total of 42 serious ADR events reported. Hepatic function abnormal was the most frequently reported ADR, with an incidence of 4.4% (35/800). A higher incidence of ADRs was observed in patients with percent forced vital capacity ≥80%, and those with previous/concomitant treatment with riluzole. Conclusion: In this surveillance study, hepatic ADRs were the most frequently reported events. These ADRs have also been reported previously in patients receiving standard therapy. No new safety concerns were raised with real‐world use of edaravone. [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 objective of this study was to assess the effect of environmental cadmium exposure according to urinary cadmium concentration (U‐Cd) on noncancer mortality in a general Japanese population. We conducted a longitudinal study for 19 years in 2804 inhabitants (1107 men and 1697 women) in some cadmium nonpolluted regions in Japan. The participants were classified into quartiles based on U‐Cd (μg/g cre) adjusted for urinary creatinine. Hazard ratio (HR) and 95% confidence interval (95% CI) for continuous U‐Cd or the quartiles of U‐Cd were calculated for noncancer mortality. By applying a Fine and Gray competing risk model, continuous U‐Cd (+1 μg/g cre) showed significant HR for cardiocerebrovascular diseases (HR 1.05, 95% CI: 1.00–1.11), cerebrovascular diseases (HR 1.08, 95% CI: 1.01–1.16), and cerebral infarction (HR 1.11, 95% CI: 1.04–1.20) in men. However, notable significant HR for continuous and quartered U‐Cd were not observed in women. In this study, U‐Cd was associated with increased cardiocerebrovascular mortality in a general Japanese population, suggesting that environmental cadmium exposure is detrimental to the life prognosis in cadmium nonpolluted regions in Japan. We conducted a longitudinal study for 19 years in 1107 men and 1697 women who lived in three cadmium nonpolluted regions in Japan, to evaluate the effect of cadmium exposure on noncancer mortality in a general Japanese population. Mortality risk ratios for urinary cadmium were estimated using a Fine and Gray competing risks model. Urinary cadmium was significantly associated with increased cardiocerebrovascular mortality in this population. [ABSTRACT FROM AUTHOR]

The relationship between urinary β2‐microglobulin (β2‐MG) and the risk of all‐cause mortality and cause‐specific mortality in a cadmium (Cd)‐polluted area was investigated in 3139 inhabitants (1404 men and 1735 women) of the Kakehashi River basin in Japan at 35‐year follow‐up. The subjects had been participants in the 1981–1982 health impact survey that assessed Cd‐induced renal dysfunction, as measured by the urinary β2‐MG concentration. Hazard ratios were calculated to assess the risk of all‐cause and cause‐specific mortality according to the urinary β2‐MG concentrations. Risk ratios (RRs) were assessed using the Fine and Gray regression model to account for competing risks of cause‐specific mortality. The mortality rate was significantly higher in participants with urinary β2‐MG concentrations >1000 μg/g creatinine (Cr) for men and >300 μg/g Cr for women. In the proportional hazard model, higher urinary β2‐MG concentrations were associated with higher risks of circulatory disease, digestive system diseases, and kidney and urinary tract diseases in men and women, and with senility for women. However, when competing risk was accounted for, the RRs were significantly higher only for kidney and urinary tract diseases in men and women (RR for each increment of 1000 μg/g Cr [95% confidence interval]: 1.02 [1.00–1.04] for men, and 1.01 [1.00–1.02] for women). The long‐term prognosis of participants with renal tubular dysfunction was poor, most likely due to kidney and renal tract diseases. We assessed long‐term mortality in the inhabitants of a cadmium polluted area in Japan. The mortality rate was higher in participants with higher urinary β2‐microglobulin concentrations. For cause‐specific mortality, higher urinary β2‐microglobulin levels were associated with a higher risk of death from renal disease. Cancer and cardiovascular disease mortality were not associated with renal damage when competing risk was accounted for. [ABSTRACT FROM AUTHOR]

In this study, we developed two high-resolution future ocean regional projection datasets for coastal applications in Japan, in which we made use of dynamical downscaling via regional ocean models with atmospheric forcing from two climate models (i.e., MIROC5 and MRI-CGCM3) participating in Coupled Model Intercomparison Project Phase 5 (CMIP5) under historical, representative concentration pathway (RCP) 2.6, and RCP8.5 scenarios. The first dataset was an eddy-resolving 10-km resolution product covering the North Pacific Ocean area and ranging continuously from 1981 to 2100, in which the Kuroshio current and mesoscale structures were reasonably resolved. The second dataset was a 2-km resolution product covering the regional domain surrounding Japan and comprising 10–15-year time slices, in which the coastal geometry and current structure were resolved even more realistically. An important feature of these datasets was the availability of reference datasets based on atmospheric and oceanic reanalysis data for cross-validation during the historical run period. Using these reference datasets, biases of regional surface thermal properties and the Kuroshio states during the historical run period were evaluated, which constitute important information for users of the datasets. In these downscaled datasets, the future surface thermal responses were generally consistent with those of their original data. Utilizing the high-resolution property of the downscaled data, possible future impact analyses regarding coastal phenomena such as strait throughflows, coastal sea level variability, and the Kuroshio intrusion phenomenon into bays ("Kyucho" phenomenon) were demonstrated and the important role of the Kuroshio state representation was indicated, which had proved difficult to analyze using the low-resolution projection data. Given these properties, the present datasets would be useful in climate change adaptation studies regarding the Japanese coastal region. [ABSTRACT FROM AUTHOR]