Predictive validity of the functional independence and difficulty scale in community-dwelling Japanese older adults

A systematic review of measures of ability to meet basic needs in older persons

BACKGROUND

The ability of older persons to meet their basic needs (i.e. personal, financial and housing security), as well as to perform Activities of Daily Living (ADL), is crucial. It is unclear, however, whether such measures exist. This systematic review aimed to review English-language measures of the ability of older persons to meet their basic needs, and to critically review the comprehensiveness of these measures and their psychometric properties.

METHODS

Fifteen electronic databases including PubMed, EBSCOhost and CINAHL were systematically searched for studies of measures that assessed the ability of older persons to meet their basic needs, as defined by the World Health Organization. Two review authors independently assessed the studies for inclusion in the review and evaluated their comprehensiveness and psychometrics.

RESULTS

We found seven instruments from 62 studies that assessed multi-domain function including ADL and some elements of basic needs. The instruments varied in breadth and in reporting of key psychometric criteria. Further, no single instrument provided a comprehensive assessment of the ability of older persons to meet their basic needs.

CONCLUSION

No single instrument that measures the ability to meet basic needs was identified by this review. Further research is needed to develop an instrument that assesses the ability of older persons to meet their basic needs. This measure should include an evaluation of ADL.

Are Japanese Older Adults Rejuvenating? Changes in Health-Related Measures Among Older Community Dwellers in the Last Decade

During the last three decades, Japan has become one of the world's top countries for longevity, and the increase in average life expectancy is accompanied by a sharp rise in older population 65 years of age and above to ∼28%. This study aimed to examine the changes in major health-related measures, including a physical constitution, physical function, and functional capacity of community-dwelling Japanese older people in the last decade. From the data of 13 longitudinal cohort studies on aging conducted in Japan with a total of 13,441 older subjects, this study analyzed the changes in six indices that are related to health and functioning of the older people; height, weight, body mass index, walking speed, grip strength, and instrumental activity of daily living, between 2007 (±2 years) and 2017 (±2 years). Comparison of data for the two periods between subjects matched for age group and gender evidently showed better health status and a slower decline in most of the health-related measures in 2017 compared to a decade ago. The results of this study indicate that the phenomenon of "rejuvenation" is occurring among the new generation of Japanese older adults, and the importance of this older population as a social resource in the super-aged society should be reacknowledged.

Effectiveness of community organizing interventions on social activities among older residents in Japan: A JAGES quasi-experimental study

Social activities in the community help older adults maintain functional ability. Community organizing, based on the assessment of health risks, community assets, and fostering intersectoral organizational partnerships, could increase participation opportunities. Supporting municipality staff members in building their capacity to take those actions might benefit them. Nevertheless, the effectiveness of such support remains unclear. This real-world-setting study evaluated the effectiveness of providing support for municipality health sectors in relation to older residents’ social activities.

Based on the Japan Gerontological Evaluation Study (JAGES), a nationwide study of community-dwelling older adults, from 2013 to 2016 researchers collaborated with health sector staff members in 13 participating municipalities (intervention group) in utilizing the JAGES-based community assessment data and building organizational partnerships. The remaining 12 municipalities (control) obtained the data only. We analyzed the longitudinal data of 47,106 older residents, performing a difference-in-differences (DID) analysis, weighted by the inverse of propensity to be selected for the intervention group, allowing for a multilevel (municipality/individual) data structure.

In the intervention group, the estimated group participation prevalence in men increased by 10.4 percentage points from 47.5% to 57.9%, while in the control group, participation increased by 7.9 percentage points from 47.2% to 55.0% (DID estimated = 0.025, P = 0.011). No statistically significant difference between the two groups was observed among women (P = 0.131).

Support for community organizing may improve group participation among older male residents. The community-attributable impact could be large, given that the intervention has the potential to work for all older residents in the municipality.

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Older men participated more where researchers and health sector collaborated well.

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The effects were specifically strong for participation in leisure activity groups.

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Community organizing might encourage older men to engage in social activities.

A coaching program to improve quality of life in older people in Japan: a randomised controlled trial

As the world's population ages, efforts to improve quality of life (QOL) in old age are gaining public attention. In this study, a programme was conducted for older people with the aim of clarifying their life goals related to QOL and the meaning of their existence, and the effect of the programme in improving QOL was evaluated. Participants were randomly assigned to the intervention or control group after registration. The program consisted of four 90-minute classes. The primary outcome was the Philadelphia Geriatric Center Morale Scale score (PGC), and changes in outcomes were compared between groups. The intervention group had significantly improved PGC scores (P<0.003). Further, the scores of PGC subscales 'Acceptance of one's own ageing' and 'Lonely dissatisfaction' showed significant improvements after the intervention (P<0.001). The findings suggest the effectiveness of the developed program in improving QOL in people aged ≥65 years.