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Aim: The importance of comprehensive geriatric assessment (CGA) is increasing in aging societies worldwide. However, there are few comprehensive studies on CGA, resulting in a limited understanding of its implementation rate, temporal changes and factors associated with its implementation. We aimed to investigate the implementation status of CGA and its regional variance in Japan. Methods: Using the Diagnosis Procedure Combination database, we investigated CGA trends, and identified the patient, hospital and regional factors associated with its implementation. We identified patients aged ≥65 years who were admitted for the first time between 2016 and 2020 with a diagnosis of stroke, heart failure, pneumonia, bone fracture or colorectal cancer. We examined the CGA implementation rate according to patient and hospital characteristics. We also investigated temporal changes and tendencies to carry out CGA in different prefectures. Results: A total of 1 974 817 patients were analyzed, of whom 570 696 (28.9%) underwent CGA. The implementation trend increased steadily from 25.3% in fiscal year 2016 to 33.4% in fiscal year 2019. The implementation rate also increased with patient age (30.3% in patients aged ≥95 years). Regional variations in its implementation status were observed, with a higher tendency to be implemented in areas near major metropolitan regions. A trend toward carrying out CGA for colorectal cancer, but not for other diseases, has been observed in eastern Japan. Conclusion: Although CGA is increasingly carried out, considerable regional differences remain in its implementation status. Initiatives to reduce variations are necessary. Geriatr Gerontol Int 2024; 24: 904–911. [ABSTRACT FROM AUTHOR]

Aim: Patients with dementia with Lewy bodies (DLB) are at a high risk for falls and fractures. Although cholinesterase inhibitors reportedly are effective in suppressing the progression of cognitive symptoms in DLB patients, their effects on fracture risk remain unclarified. This study aimed to evaluate the association between donepezil use and hip fracture risk in older patients with DLB. Methods: Using the Japanese insurance claim database, we collected the data of patients aged ≥65 years with DLB from April 2012 to March 2019. After propensity score matching, we compared the fracture rate over 3 years between DLB patients receiving donepezil and those not receiving antidementia drugs. Results: Altogether, 24 022 239 individuals aged ≥65 years were newly registered from April 2012 to March 2016 and had verifiable information from 6 months before to 3 years after the registration. We identified 6634 pure‐DLB patients and analyzed the data of 1182 propensity score‐matched pairs. The characteristics, including age, sex, fracture history, osteoporosis, and bone mineral density test rate, of the two groups were well balanced by propensity score matching. The incidence rate of hip fracture was significantly lower in DLB patients receiving donepezil than in those not receiving antidementia drugs (0.60 vs. 1.44/100 person‐years, P < 0.001), whereas that of vertebral fractures was the same. Conclusions: Donepezil administration in Japanese people aged ≥65 years with DLB was significantly associated with a decreased risk of hip fracture. Donepezil may provide new benefits to DLB patients. Geriatr Gerontol Int 2024; 24: 782–788. [ABSTRACT FROM AUTHOR]

Aim: Although frailty could be reversible by early diagnosis and interventions, it lacks definite diagnostic criteria. The Kihon Checklist is a 25‐item questionnaire that diagnoses frailty with a cutoff score of 7/8. The Questionnaire for Medical Checkup of Old‐Old (QMCOO) was recently established and used for medical checkups among Japanese older adults, but no method or cutoff score for diagnosing frailty has been established. Thus, we aimed to diagnose frailty using the QMCOO and to determine its cutoff score by comparing it with that of the Kihon Checklist. Methods: We recruited 223 older adults in Yasugi City and Yonago City to answer all the questions in the Kihon Checklist and the QMCOO at the same time. Those scoring ≥8 for the Kihon Checklist (n = 38) were diagnosed as frail. We also determined the cutoff score for frailty for the QMCOO and examined which questionnaire items affected the frailty status. Results: The QMCOO and the Kihon Checklist score showed a significant positive correlation (r = 0.670, P < 0.001). The area under the curve was 0.851. A cutoff score of 3/4 for the QMCOO represented the best results (sensitivity, 76.3%; specificity, 88.1%; and accuracy, 86.1%). Multiple linear regression analysis revealed that subjective health status, body weight loss, slowness, and forgetfulness still affected the frailty status. Conclusions: A cutoff score of 3/4 for the QMCOO might be effective in diagnosing frailty. Geriatr Gerontol Int 2022; 22: 127–131. [ABSTRACT FROM AUTHOR]