The relationship of community activities with cognitive impairment and depressive mood independent of mobility disorder in Japanese older adults

Association between Subjective Cognitive Complaints and Sleep Disturbance among Community-Dwelling Elderly Individuals in Japan

Subjective cognitive complaints (SCCs) are a crucial modifiable risk factor for dementia. There is increasing interest in the association between SCC and sleep disturbance; however, the effects of sleep disturbance on SCC development among community-dwelling elderly individuals in Japan remain unclear. We aimed to cross-sectionally investigate the association between SCC and sleep disturbance, with adjustment for multiple factors related to cognitive decline, among 241 community-dwelling elderly persons without cognitive impairment. The measures were SCCs (Kihon Checklist-Cognitive Function, KCL-CF), sleep disturbance (Japanese version of the Athens Insomnia Scale, AIS-J), general cognitive function (Mini-Mental State Examination), and depressive symptoms (five-item version of the Geriatric Depression Scale [GDS-5]). The following data were collected: sex, age, educational history, whether the participants had visited a medical institution for diseases (hypertension, diabetes, hyperlipidemia, heart disease), and the presence/absence of established risk factors (hearing loss, history of head injury, drinking habits, smoking habits, social isolation, and physical inactivity and activity). Based on the KCL-CF, 96 and 145 participants were considered to have and lack SCCs, respectively. On logistic regression analysis, the AIS-J score and smoking history were significantly associated with SCCs. Our findings suggest that sleep disturbance is associated with SCC development among community-dwelling elderly people in Japan. Evaluating and managing sleep disturbances can be important in preventing SCCs and dementia.

Elevated Risk of Dementia Diagnosis in Older Adults with Low Frequencies and Durations of Social Conversation

Background

Social networks and social participation have protective effects on cognitive function maintenance and Alzheimer's disease and general dementia development.

Objective

We aimed to investigate the association between conversations and dementia incidence in older adults.

Methods

This longitudinal prospective cohort study used population data from the National Center for Geriatric and Gerontology-Study of Geriatric Syndromes (NCGG-SGS) from September 2015 to February 2017. The database included 4,167 individuals in Japan aged ≥60 years who were generally healthy and without major cognitive impairment. Participants were classified into two groups according to six daily conversation measures at baseline. The conversation index was calculated as a composite score for these measures. Participants were tracked monthly over 60 months for new-onset dementia.

Results

Data from 2,531 participants were analyzed (72.7±6.7 years; range: 60-96 years). Dementia incidence per 1,000 person-years was 15.7 (95% confidence interval, 13.6-18.1). The Youden index determined the cut-off point for dementia incidence, with a conversation index of 16/17 points. The low conversation group included more participants with new-onset dementia. Cox proportional hazards regression crude models showed remarkable relationships between dementia onset and specific conversation measurements, including conversation index. According to the Cox regression adjusted model, the cut-off point of the conversation index showed only a remarkable relationship with dementia onset.

Conclusions

Dementia risk was extensively associated with low daily conversation statuses. The assessment of conversational factors may be useful as a risk indicator for the development of Alzheimer's disease and general dementia.

Effectiveness of horticultural therapy in aged people with depression: A systematic review and meta-analysis

Background

Depression, an increasing global crisis, has affected many people's daily life, especially for older adults. Horticultural therapy has been widely used in non-pharmacological treatment for patients with depression, with a body of studies demonstrating its therapeutic effects. However, a lack of systematic reviews and meta-analyses makes it difficult to get a holistic picture of this research field.

Objectives

We aimed to evaluate the reliability of the previous studies and the effectiveness of horticultural therapy (including the intervention of environmental settings, activities, and duration) on older adults with depression.

Methods

This systematic review was conducted under the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA) guidelines. We searched relevant studies in multiple databases, and the original search was finished on 25 September 2022. We included studies using randomized controlled trials (RCTs) or quasi-experimental designs.

Results

We yielded a total of 7,366 studies and finally included 13 which involved 698 aged people with depression. Results from meta-analysis indicated significant effects of horticultural therapy on reducing depressive symptoms for the older adults. Besides, we found different outcomes among various horticultural interventions (such as environmental setting, activities, and duration). Depression reduction was more effective in care-providing settings than in community settings; participatory activities were more effective in reducing depression than observational activities; intervention of 4–8 weeks might represent the optimal course of treatment compared to interventions more than 8 weeks in duration.

Conclusion

We came up with a comprehensive set of recommendations based on the meta-analysis: aged people in care-providing settings with depression could get the most benefit from horticultural therapy by participating in participatory activities for 4–8 weeks.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022363134, identifier CRD42022363134.

The Association Between Patterns of Social Engagement and Conversion From Mild Cognitive Impairment to Dementia: Evidence From the Health and Retirement Study

OBJECTIVES

This study examined the association between patterns of social engagement and conversion from cognitive impairment, no dementia (CIND) to dementia. It also tested whether social engagement is associated with conversion independently from physical and cognitive engagements.

METHOD

Data from 2 waves (2010 and 2014) of the Health and Retirement Study (HRS) were used. The sample consisted of 1227 people who had CIND in 2010. To identify the heterogeneity of social engagement, latent class analysis was utilized. Multinomial logistic regression analysis was utilized to investigate the association between patterns of social engagement and probability of conversion to dementia and death or dropout.

RESULTS

The result showed that patterns of social engagement that represent higher level and more variety of social engagement were associated with lower probabilities of conversion to dementia in 4 years but not with probabilities of death or dropout. The relationship held after controlling for physical and cognitive engagements.

DISCUSSION

Findings implied that promoting social engagement may be protective against developing dementia even for the high-risk group of people with CIND. Future studies should investigate the mechanism behind the relationship between patterns of social engagement and lower probabilities of conversion to dementia.

Altruism, Volunteering and Cognitive Performance Among Older Adults: A 2-Year Longitudinal Study

This study aims to investigate whether altruism and volunteering are associated differently with cognitive functioning in community-dwelling older adults. A 2-year longitudinal study of 291 Brazilian older adults was conducted. In the baseline analysis, altruism, but not volunteering, was associated with higher scores for the composite cognitive score, the Mini-Mental State Examination, the verbal fluency and the CERAD Recall. Concerning the longitudinal analyses, volunteering at baseline, but not altruism, was associated with verbal fluency and CERAD Word List Recall after 2 years of follow up. Same results were obtained while investigating changes in score. Altruism and volunteering were associated with cognitive tests, albeit in different ways. Volunteering, but not altruism, was associated with lower cognitive decline. However, altruism, but not volunteering, was associated with higher absolute score on these tests. These findings can further understanding of this new field of health research.

Depressed mood and frailty among older people in Tokyo during the COVID-19 pandemic

BACKGROUND

The study aim was to identify depressed mood and frailty and its related factors in older people during the coronavirus disease 19 pandemic.

METHODS

Since 2010, we have conducted questionnaire surveys on all older residents, who are not certified in the long-term care insurance, living in one district of Tokyo municipality. These residents are divided into two groups by birth month, that is those born between April and September and those born between October and March, and each group completes the survey every 2 years (in April and May). Study participants were older residents who were born between April and September and who completed the survey in spring 2018 and in spring 2020, the pandemic period. Depressed mood and frailty were assessed using the Kihon Checklist, which is widely used by local governments in Japan. We had no control group in this study.

RESULTS

A total of 1736 residents responded to both surveys. From 2018 to 2020, the depressed mood rate increased from 29% to 38%, and frailty increased from 10% to 16%. The incidence of depressed mood and frailty was 25% and 11%, respectively. Incidence of depressed mood was related to subjective memory impairment and difficulty in device usage, and incidence of frailty was related to being older, subjective memory impairment, lack of emotional social support, poor subjective health, and social participation difficulties.

CONCLUSIONS

Older people with subjective memory impairment may be a high-risk group during the coronavirus pandemic. Telephone outreach for frail older people could be an effective solution. We recommend extending the scope of the 'reasonable accommodation' concept beyond disability and including older people to build an age-friendly and crisis-resistant community.

The Impact of Memory Change on Everyday Life Among Older Adults: Association with Cognition and Self-Reported Memory

OBJECTIVES

Many older adults experience memory changes that can have a meaningful impact on their everyday lives, such as restrictions to lifestyle activities and negative emotions. Older adults also report a variety of positive coping responses that help them manage these changes. The purpose of this study was to determine how objective cognitive performance and self-reported memory are related to the everyday impact of memory change.

METHODS

We examined these associations in a sample of 94 older adults (age 60-89, 52% female) along a cognitive ability continuum from normal cognition to mild cognitive impairment.

RESULTS

Correlational analyses revealed that greater restrictions to lifestyle activities (|rs| = .36-.66), more negative emotion associated with memory change (|rs| = .27-.76), and an overall greater burden of memory change on everyday living (|rs| = .28-.61) were associated with poorer objective memory performance and lower self-reported memory ability and satisfaction. Performance on objective measures of executive attention was unrelated to the impact of memory change. Self-reported strategy use was positively related to positive coping with memory change (|r| = .26), but self-reported strategy use was associated with more negative emotions regarding memory change (|r| = .23).

CONCLUSIONS

Given the prevalence of memory complaints among older adults, it is important to understand the experience of memory change and its impact on everyday functioning in order to develop services that target the specific needs of this population.

Association between physical activity participation and perceived social isolation at older ages: Do social participation, age and sex differences matter?

BACKGROUND

Physical inactivity is a major risk factor for poor health. However, it is unclear how physical activity (PA) is associated with perceived social isolation (PSI) in older age. This study aims to explore 1) association between PA and PSI among older people in Ghana and 2) if social participation (SP), age and sex modify any associations.

METHODS

The study focused on 1,201 men and women aged ≥50 years in the AgeHeaPsyWel-HeaSeeB Study. Multivariate ordinary least squares (OLS) models were specified to estimate the regression coefficients and standard errors for the associations of PA and SP with PSI adjusting for potential confounders.

RESULTS

Multivariate OLS regressions showed that engagement in SP (b = -0.442; SE = 0.140; p < 0.001) and regular PA (b = -0.338; SE = 0.152; p < 0.005) were independently associated with decreasing PSI. Also, SP modified the PA-PSI association such that resourceful SP reinforced the link between PA and PSI (b = -0.709; SE = 0.276; p < .005). Finding revealed sex (men: b= -0.712; SE = 0.266; p < 0.005; women: p = 0.083) and age differences (65+: b = -0.437; SE = 0.206; p < 0.005; 50-64: b = -0.502; SE = 0.252; p < 0.05) in the effect of PA on PSI.

CONCLUSIONS

Findings provide insight into the importance of specific and combined effects of SP and PA on PSI in older age. Public health, clinical practice, and social policy efforts should target social healing and group PA interventions to improve older adults' emotional health.

Social Participation and Healthy Aging among the Elderly Japanese: the Ohsaki Cohort 2006 Study

BACKGROUND

Our study examined the association between social participation and healthy aging using a community-based cohort study among Japanese elderly.

METHODS

This prospective study was conducted in Ohsaki City, Japan, and included 7,226 subjects aged ≥65 years at the baseline survey in 2006. We obtained information on frequency of participation in three types of community activities (i.e. neighborhood activities, hobbies, and volunteer activities) at baseline. Exposure was measured by the number of types of community activities participated in and subjects were categorized into four groups (i.e. none, one type, two types, and three types). The primary outcome was healthy aging as assessed by a questionnaire survey conducted in 2017, and was defined as meeting the following four criteria: free of disability, free of depression, high health-related quality of life, and high life satisfaction. We used multiple logistic regression models to calculate the corresponding odds ratios (ORs) and 95% confidence intervals (95%CIs).

RESULTS

During 11 years of follow-up, 574 (7.9%) subjects attained healthy aging. Compared with subjects not participating in any activity, the multivariable-adjusted ORs (95%CIs) were 1.90 (1.40, 2.59) for those participating in one type, 2.49 (1.84, 3.38) for two types, and 3.06 (2.30, 4.07) for three types (P for trend <.0001). Furthermore, for each type of community activity, a higher frequency of participation was related to higher probability of healthy aging.

CONCLUSIONS

Our study suggests that social participation is associated with the promotion of healthy aging, and that the benefits were observed across different types of community activities.

Increased frequency of participation in civic associations and reduced depressive symptoms: Prospective study of older Japanese survivors of the Great Eastern Japan Earthquake

RATIONALE

Few studies have examined whether changes in participation in civic associations can mitigate depressive symptoms among older disaster survivors.

OBJECTIVES

We examined prospectively the association between changes in participation in civic associations and changes in depressive symptoms among older survivors of the 2011 Great Eastern Japan Earthquake.

METHODS

We analyzed questionnaire-based survey data on pre- and post-disaster participation in civic associations and depressive symptoms compiled for 3567 respondents aged 65 years and above. Changes in these symptoms were assessed using a 15-item Geriatric Depression Scale (GDS) as a continuous variable for 2010 and 2013. We investigated four types of civic associations: sports, hobby, voluntary groups, and senior citizens' clubs. Changes in participation were calculated by subtracting the participation frequency measured in 2010 from that measured in 2013. Applying 95% confidence intervals, we used linear regression models with imputation to estimate the age- and sex-adjusted and multivariate-adjusted standardized coefficients.

RESULTS

The survivors' GDS scores increased by 0.13 points on average between the pre-disaster and post-disaster periods. Average changes in the participation frequencies of respondents in each group were respectively +0.36 days/year, -5.63 days/year, +0.51 days/year, and -1.45 days/year. Increased frequencies of participation in the sports and hobby groups were inversely associated with changes in GDS scores (B = -0.003, Cohen's f² = 0.10, P = 0.01 and B = -0.002, Cohen's f² = 0.08, P = 0.04, respectively). The associations did not differ depending on the experience of housing damage caused by the disaster. In addition, we did not observe a significant association between changes in participation frequencies for voluntary groups or senior citizens' clubs and changes in GDS scores after multivariable adjustment.

CONCLUSIONS

Depressive symptoms of older adults post-disaster may be mitigated through increased frequency of participation in sports and hobby groups; yet, civic participation did not mitigate the adverse impact of disaster experiences on mental health.

Frailty as a Moderator of the Relationship between Social Isolation and Health Outcomes in Community-Dwelling Older Adults

This research investigated the effects of social isolation on frailty and health outcomes and tested whether these associations varied across different levels of frailty. We performed a multivariate analysis of the first wave of Frailty: A longitudinal study of its expressions (FRéLE) among 1643 Canadian older adults aged 65 years and over. We assessed social isolation using social participation, social networks, and support from various social ties, namely, friends, children, extended family, and partner. Frailty was associated with disability, comorbidity, depression, and cognitive decline. Less social participation was associated with limitations in instrumental activities of daily living (IADLs), depression, and cognitive decline. The absence of friends was associated with depression and cognitive impairment. Less social support from children and partner was related to comorbidity, depression, and cognitive decline. Overall, social isolation is linked to mental health rather than physical health. The associations of having no siblings, receiving less support from friends, and participating less in social activities with ADL limitations, depression, and cognitive decline were higher among frail than prefrail and robust older adults. This study corroborates the pivotal role of social connectedness, particularly the quality of relationships, on the mental health of older adults. Public health policies on social relationships are paramount to ameliorate the health status of frail older adults.

The Relationship between Subjective Cognitive Decline and Health Literacy in Healthy Community-Dwelling Older Adults

Few studies have examined the effects of health literacy on people at risk of developing dementia; its effects on the pathogenesis of subjective cognitive decline (SCD) are particularly unclear. This study aimed to clarify the relationship between health literacy and SCD in a population of healthy community-dwelling older adults. SCD status was assessed using the Cognitive Function domain of the Kihon Checklist (KCL-CF). Health literacy, in turn, was evaluated using the Communicative and Critical Health Literacy (CCHL) scale. Global cognitive function and depressive symptoms were evaluated using the Mini-Mental State Examination (MMSE) and a five-item version of the Geriatric Depression Scale (GDS-5), respectively. Participants who were suspected of having SCD were significantly older than their non-SCD peers, and scored significantly worse on the CCHL, MMSE, and GDS-5. In addition, SCD status was found to be associated with CCHL and GDS-5 scores, as well as age, according to a logistic regression analysis. These findings suggest that low health literacy is linked to SCD morbidity in healthy community-dwelling older adults and should prove useful in the planning of dementia prevention and intervention programs for this population.

Voluntary work for the physical and mental health of older volunteers: A systematic review

Background

The increasing imbalance between the number of older adults not working and the number of adults in the age range of labour force participation (age range 20-64) has long been a fundamental public policy challenge in the Organization for Economic Co-operation and Development member countries. At a societal level, this growing imbalance raises serious concerns about the viability and funding of social security, pensions and health programmes. At an individual level, the concern is probably more that of aging well with the prospect of many years in retirement. Some research suggests that retiring for some carries the risk of a fast decline in health. Volunteering can play a significant role in people's lives as they transition from work to retirement, as it offers a "structured" means of making a meaningful contribution in society once the opportunity to do so through work has been cut off. Some older people consider voluntary work as a way to replicate aspects of paid work lost upon retirement, such as organisational structure and time discipline. In many countries, volunteering of the older adults is increasing and programmes designed specifically for this subpopulation are emerging. Volunteering may contribute to both individuals aging well and society aging well, as volunteering by the older adults at the same time relieves the societal burden if it helps maintain health and functionality for those who volunteer. It thus remains to be established to what extent volunteering impacts on the physical and mental health of those who volunteer.

Objectives

The main objective of this review is to answer the following research question: what are the effects of volunteering on the physical and mental health of people aged 65 years or older?

Search Strategy

Relevant studies were identified through electronic searches of bibliographic databases, governmental and grey literature repositories, hand search in specific targeted journals, citation tracking, contact to international experts and internet search engines. The database searches were carried out to December 2018 and other resources were searched in September 2019 and October 2019. We searched to identify both published and unpublished literature. The searches were international in scope. Reference lists of included studies and relevant reviews were also searched.

Selection Criteria

The intervention of interest was formal volunteering which can be described as voluntary, on-going, planned, helping behaviour that intend to increase the well-being of strangers, offers no monetary compensation and typically occurs within an organisational context. We included older people aged 65 or over who are engaged in formal voluntary work. The primary focus was on measures of physical and mental health. All study designs that used a well-defined control group were eligible for inclusion. Studies that utilised qualitative approaches were not included.

Data Collection and Analysis

The total number of potential relevant studies constituted 17,046 hits. A total of 90 studies, met the inclusion criteria and were critically appraised by the review authors. The 90 studies analysed 47 different populations. Only 26 studies (analysing 19 different populations) could be used in the data synthesis. Forty-six studies could not be used in the data synthesis as they were judged to have too high risk of bias and, in accordance with the protocol, were excluded from the meta-analysis on the basis that they would be more likely to mislead than inform. Eighteen studies did not provide enough information enabling us to calculate an effects size and standard error or did not provide results in a form enabling us to use it in the data synthesis. Finally, of the 26 studies that could be used in the data synthesis, two pairs of studies used the same two data sets and reported on the same outcome(s), thus in addition two studies were not used in the data synthesis.Meta-analysis of both physical health outcomes and mental health outcomes were conducted on each metric separately. All analyses were inverse variance weighted using random effects statistical models that incorporate both the sampling variance and between study variance components into the study level weights. Random effects weighted mean effect sizes were calculated using 95% confidence intervals (CIs).Sensitivity analysis was carried out by restricting the meta-analysis to a subset of all studies included in the original meta-analysis and was used to evaluate whether the pooled effect sizes were robust across components of risk of bias.

Results

The 24 studies (analysing 19 different populations), used for meta analysis were from Australia, Ireland, Israel, Japan, Korea and United States, three were a randomised controlled trial and 21 were NRS. The baseline time period (the year the voluntary work that was analysed was measured) spanned by the included studies is 30 years, from 1984 to 2014 and on average the baseline year was 2001. On average the number of follow up years was 5, although with great variation from 0 to 25 years. The average number of volunteers analysed (not reported in four studies) was 2,369, ranging from 15 to 27,131 and the average number of controls was 13,581, ranging from 13 to 217.297. In total the average number of participants analysed was 14,566, ranging from 28 to 244.428.Ten studies analysed the effect of voluntary work on mortality, however, eight studies reported a hazard ratio and two studies reported an odds ratio. We analysed these two types of effect sizes separately. A hazard ratio <1 indicates that the treated, the volunteers is favoured. That is, the conditional mortality rate is lower for volunteers. All reported results indicated an effect favouring the volunteers, primary study effect sizes lied in the range 0.67-0.91. The random effects weighted mean hazard ratio was 0.76 (95% CI, 0.72-0.80) and statistically significant. The two studies that reported odds ratios of mortality supported this result. There was no heterogeneity between the studies in either of the meta analyses.Three studies analysed the effect of voluntary work on incident functional disability, using a hazard ratio as effect measure. All reported results indicated an effect favouring the volunteers, primary study effect sizes lied in the range 0.70-0.99. The random effects weighted mean hazard ratio was 0.83 (95% CI, 0.72-0.97) and statistically significant. There was a small amount of heterogeneity between the studies.Two studies analysed the effect of voluntary work on decline in instrumental activities of daily living, using an odds ratio as effect measure. Both reported results indicated an effect favouring the volunteers (0.63 and 0.83). The random effects weighted mean odds ratio was 0.73 (95% CI, 0.53-1.01) and not statistically significant. There is no heterogeneity between the two studies.Three studies analysed the effect of voluntary work on maintenance of functional competence, using an odds ratio as effect measure. All reported results indicated an effect favouring the volunteers, primary study effect sizes lied in the range 0.67-0.83. The random effects weighted mean odds ratio was 0.81 (95% CI, 0.70-0.94) and statistically significant. There is no heterogeneity between the studies.In addition a number of other physical outcomes were reported in a single study only.Three studies analysed the effect of voluntary work on depression, and reported results that enabled the calculation of standardised mean difference (SMD) and variance. The effect sizes are measured such that a positive effect size favours the volunteers. All reported results indicated an effect favouring the volunteers, primary study effect sizes lied in the range 0.05-0.66. The random effects weighted SMD was 0.12 (95% CI, 0.00-0.23) and statistically significant. There is a very small amount of heterogeneity between the studies.In addition, a number of other mental health outcomes were reported in a single study only.We did not find any adverse effects.There were no appreciable changes in the results across components of risk of bias as indicated by the sensitivity analysis.

Authors' Conclusions

The review aimed to examine effects on all types of physical and mental health outcomes. With the exception of mortality, there was insufficient evidence available. The available evidence, however, does suggest that there is an effect on the mortality of volunteers, although the effect is small. We found evidence that voluntary work reduces the mortality hazard of the volunteers aged 65 and above. The effect corresponds to a 43% chance of the volunteers dying first which should be compared to a fifty-fifty chance (50%) of dying first if the intervention had no effect. The evidence seems robust in the sense that we did not find any heterogeneity between the studies. As the intervention, unlike most other interventions in the social welfare area, is not costly, it could be prescribed to more older adults. In fact as the intervention in contrary to carrying a cost is a productive activity contributing directly to community well-being and has a positive effect on the volunteers it probably should be prescribed universally. However, due to the very nature of the intervention, it is voluntary and it cannot be prescribed. But more people could be encouraged to take up voluntary work if the opportunity was immediately available and visible.

The Perceptions of People with Dementia and Key Stakeholders Regarding the Use and Impact of the Social Robot MARIO

People with dementia often experience loneliness and social isolation. This can result in increased cognitive decline which, in turn, has a negative impact on quality of life. This paper explores the use of the social robot, MARIO, with older people living with dementia as a way of addressing these issues. A descriptive qualitative study was conducted to explore the perceptions and experiences of the use and impact of MARIO. The research took place in the UK, Italy and Ireland. Semi-structured interviews were held in each location with people with dementia (n = 38), relatives/carers (n = 28), formal carers (n = 28) and managers (n = 13). The data was analyzed using qualitative content analysis. The findings revealed that despite challenges in relation to voice recognition and the practicalities of conducting research involving robots in real-life settings, most participants were positive about MARIO. Through the robot's user-led design and personalized applications, MARIO provided a point of interest, social activities, and cognitive engagement increased. However, some formal carers and managers voiced concern that robots might replace care staff.

Subjective and Objective Mental and Physical Functions Affect Subjective Cognitive Decline in Community-Dwelling Elderly Japanese People

Subjective cognitive decline (SCD) is complex and not well understood, especially among Japanese people. In the present study, we aimed to elucidate the relationships of subjective and objective mental and physical function with SCD among older community-dwelling Japanese adults. SCD was evaluated using the Kihon Checklist: Cognitive Function. Other parameters were evaluated using the Mini-Mental State Examination (MMSE) and the five-item version of the Geriatric Depression Scale (GDS-5), for an objective mental function other than SCD. A timed up-and-go test (TUG) and knee extension strength were used to test objective physical function, and the Mental Component Summary (MCS) and Physical Component Summary (PCS) in the Health-Related Quality of Life survey eight-item short form (SF-8) were used for subjective mental and physical functions. The results of the MMSE, GDS-5, TUG, knee extension strength, and MCS were significantly worse in the SCD group. In addition, logistic regression analysis showed that GDS-5 and MCS were associated with SCD onset. Depressive symptoms and decreased subjective mental function contribute to SCD among community-dwelling Japanese adults. These findings will be useful for planning dementia prevention and intervention programs for older Japanese adults.

Volunteering in the Community: Potential Benefits for Cognitive Aging

Objectives

This review aims to advance understanding of the potential benefits of volunteering in the community for older adults' cognitive functioning by taking an in-depth look at the relevant evidence to date.

Method

This review describes the main pathways through which volunteering could plausibly benefit cognitive functioning and critically examines research that has specifically investigated links between volunteering and cognition. Fifteen articles that assessed in adults aged ≥ 55 years the relationship between volunteering (predictor) and cognitive functioning (outcome) were identified via literature database searches.

Results

On balance, evidence from the small number of relevant studies to date supports the idea that volunteering can protect against cognitive aging with respect to global functioning and at least some specific cognitive domains. Studies that used robust designs and assessed domain-specific cognitive functioning produced the largest effect sizes.

Discussion

To help advance the field, this review puts forward recommendations for future research, with an emphasis on the need for robust study designs and specific investigations into the nature and extent of the cognitive benefits of volunteering. Through that work, researchers can determine how a simple and accessible activity like volunteering can best be used to help reduce the burden of age-related cognitive decline.

Self-Reported Cognitive Frailty Predicts Adverse Health Outcomes for Community-Dwelling Older Adults Based on an Analysis of Sex and Age

OBJECTIVES

The present study examined whether the combination of self-reported mobility decline (SR-MD) and cognitive decline (SR-CD) was associated with mortality and new long-term care insurance (LTCI) service certifications based on sex and age.

DESIGN

A prospective cohort study.

SETTING AND PARTICIPANTS

We analyzed cohort data from a sample of older adult residents in Kami Town, Japan. The response rate was 94.3%, and we followed 5,094 older adults for 3 years. Full analyses were conducted on 5,076 participants.

MEASURES

A total of four groups were determined through self-reported responses on the Kihon Checklist for SR-MD (a score of 3 or more on 5 items) and SR-CD (a score of 1 or more on 3 items): non-SR-cognitive frailty, non-SR-MD and SR-CD, SR-MD and non-SR-CD, and SR-cognitive frailty.

RESULTS

Main outcomes included mortality (n = 262) or new certifications for LTCI services (n = 708) during the 3-year period. Excluding overlapping, this included 845 older adults (16.6%). Among men, prevalence of non-SR-cognitive frailty, non-SR-MD and SR-CD, SR-MD and non-SR-CD, and SR-cognitive frailty (SR-MD and SR-CD) was 48.2%, 26.4%, 11.5%, and 13.8%, respectively. Respective rates for women were 45.7%, 15.5%, 23.1%, and 15.7%. Multivariate analyses revealed that for men, SR-MD and non-SR-CD significantly affected adverse health outcomes, leading to earlier negative outcomes relative to the non-SR-MD and SR-CD group. For women, non-SR-MD and SR-CD and SR-MD and non-SR-CD had similar slopes.

CONCLUSIONS

The impact of SR-MD or SR-CD on adverse health outcomes differed as a function of age and sex. Thus, we need to consider preventive approaches according to these specific target group features.

Community activities predict disability and mortality in community-dwelling older adults

AIM

With aging, it is important to maintain older community dwellers' regular engagement with familiar community activities (CA) engaged in close to home to protect them from frailty. Thus, the present study aimed to examine whether CA items or CA score were associated with mortality or the need for care under the new long-term care insurance service requirements over 3 years among community-dwelling older Japanese adults.

METHODS

We analyzed cohort data for older adults from a prospective cohort study in Kami town, Japan. The response rate to the self-reported questionnaire was 94.3% (n = 5094), and we followed these participants for 3 years. Our final sample comprised 5076 older adults. Missing data were filled in using multiple imputation. We used seven items to assess CA: (i) volunteer activity; (ii) regional activity related to the neighborhood; (iii) visiting friends; (iv) hobbies or favorite lessons; (v) earning an income; (vi) farm work and growing vegetables; and (vii) shopping daily by oneself. The Kihon Checklist and new long-term care insurance service certifications were used as the frailty screening and disability indices, respectively.

RESULTS

During the follow-up survey, 705 participants obtained new long-term care insurance service certifications and 262 died. Using the receiver operating characteristic curve, the desirable cut-off of the CA score to predict disability and mortality was at least two items for all elderly age groups in rural areas.

CONCLUSIONS

CA items and CA score could predict disability and mortality in community-dwelling older adults in Japanese rural areas. Therefore, it is recommended that older adults from all age groups participate in CA. Geriatr Gerontol Int 2018; 18: 1114-1124.