Reliability and validity of the Motor Fitness Scale for older adults in the community

[Classification of community-dwelling older people based on their physical, mental, cognitive, and oral functions and comorbidities and its relationship with the fall history]

AIM

To prevent falls among older adults, healthcare professionals need to assess these individuals from multiple perspectives. This study aimed to group community-dwelling older Japanese people based on their physical, mental, cognitive, and oral functions and comorbidities, and compare the history of falling in these groups.

METHODS

Data were obtained from a cross-sectional survey conducted in 2015 among older residents of a ward of Tokyo. For the survey, a questionnaire was distributed to all residents aged ≥65 years without a certificate of long-term care (n = 132,005). Questions were posed concerning respondents' physical, mental, cognitive, and oral functions; comorbidities; and experience with falling in the past year. Cluster and logistic regression analyses were performed.

RESULTS

A total of 70,746 participants (53.4%) were included in the analysis. The mean age was 73.6 years old, and 44.9% were male. Four groups were identified in the cluster analysis: the "good general condition group" (n = 37,797, 52.4%), "poor mental function group" (n = 10,736, 14.7%), "moderate physical function group" (n = 13,461, 19.0%), and "poor general condition group" (n = 9,122, 12.9%). A logistic regression analysis with adjusting for socio-demographic characteristics, health behaviors, and fear of falling showed that the odds ratios for the experience of falling within the past year were 1.44 (95% confidence interval: 1.34-1.53), 1.54 (1.44-1.65), and 2.52 (2.34-2.71) in the poor mental function, moderate physical function, and poor general condition groups, respectively, with the good general condition group as the reference.

CONCLUSIONS

We classified community-dwelling older adults into four groups based on multiple functions and found possible variations in the risk of falling by group. These findings suggest that such classification may be useful for the prevention of falls.

Relationship between Fatigue and Self-Perception of Constipation in Community-Dwelling Older Adults during the COVID-19 Pandemic

Fatigue and constipation are common symptoms among community-dwelling older adults; however, no studies have explored the relationship between both symptoms in said group. Therefore, this study aimed to examine the relationship between fatigue and self-perception of constipation in community-dwelling older adults during the COVID-19 pandemic. A cross-sectional survey was conducted among 97 older people (response rate: 73.2%) between July and November 2021. Backward−forward stepwise linear regression was performed to identify possible predictors of fatigue among the explanatory variable (self-perception of constipation) and possible confounders, which included (a) age, (b) motor fitness scale, (c) economic satisfaction, (d) subjective memory impairment, (e) subjective health, (f) depression, (g) living alone or not, (h) sex, and (i) frequency of exercise. The intercept of the fatigue score was 42.48 points (95% CI = 32.40 to 49.99, p < 0.001). The results showed that the fatigue score in community-dwelling older adults who had self-perception of constipation was significantly lower (i.e., they had higher fatigue; B = −4.49, 95% CI = −6.58 to −2.40, p < 0.001) compared to those who did not have self-perception of constipation. Therefore, there is a need to develop self-management strategies that older people can use to improve the self-perception of constipation.

Prevalence of and factors related to homebound and semi-homebound older adults in a rural area in Japan

AIM

The homebound status is associated with unhealthy factors and physical disability. However, the prevalence of those who may be at an earlier stage of the homebound status ("semi-homebound") is unclear. This study thus examines the prevalence of semi-homebound individuals and identifies the associated physical, psychological, and social factors.

METHODS

A cross-sectional study invited 1,157 participants aged 65 years and more in rural Japan. The mean age was 74.7 ± 6.8. The survey questionnaire accounted for different parameters, such as age, sex, homebound status, morbidity, instrumental activities of daily living (IADL), and mental health. Ordinal regression analysis examined participants' homebound status; socio-demographic characteristics; and physical, psychological, and social variables.

RESULTS

The prevalence of the homebound status was 0.11 (95%CI = 0.99-0.13), and the semi-homebound status was 0.30 (95%CI = 0.28-0.33). In the multivariable analysis, the homebound status was negatively associated with IADL (p < .001), mobility (p < .001), being alone during the day (p < .001), depression and anxiety (p < .05), and self-efficacy for going out (p < .001).

DISCUSSION

The prevalence of semi-homebound individuals was approximately 30%. Homebound and semi-homebound individuals were associated with older, female, IADL, functional fitness, being alone during the day, depression and anxiety, and self-efficacy for going out. In the case of psychical, psychological, and social factors, the semi-homebound individuals revealed that these indicators fluctuated between homebound and non-homebound. Our findings further focused on semi-homebound individuals at elevated risks of disability, thereby emphasizing the need for customized intervention. Geriatr Gerontol Int 2021; 21: 1033-1039.

Long-term participation in community group exercise improves lower extremity muscle strength and delays age-related declines in walking speed and physical function in older adults

BACKGROUND

The effects of group exercise on the physical function of community-dwelling older adults remain unclear. The changes in lower extremity muscle strength, timed up and go (TUG) time, and the motor fitness scale (MFS), over time, among older adults who expressed a willingness to participate in community-based physical exercise groups, were determined using multilevel modelling.

METHODS

We analyzed data of 2407 older adults between April 2010 and December 2019 from the registry of physical tests of community-based physical exercise groups. We conducted a retrospective cohort study to assess the effect of physical exercise on lower extremity muscle strength, TUG time, and MFS scores. The durations of the exercises were evaluated by frequency of physical test's participate.

RESULTS

A deterioration in lower extremity muscle strength was found in the short-term participant group only. However, in the mid-term and long-term participation groups, lower extremity muscle strength showed a trend of improvement. The TUG time and the MFS score were negatively correlated with increasing age in both groups divided by the duration of participation. However, there was a slower rate of deterioration in the long-term participation group.

DISCUSSION

Lower extremity muscle strength, TUG time, and MFS scores decline with increasing age and there were differences in the slope of deterioration that depended on the duration of participation in community-based group exercise.

CONCLUSION

Participation in group exercise improved lower extremity muscle strength, TUG time, and MFS scores of older adults living in a community. The positive effects of group exercise were dependent on long-term participation.

Associations between exercising in a group and physical and cognitive functions in community-dwelling older adults: a cross-sectional study using data from the Kasama Study

[Purpose] To examine the associations of exercise habits, particularly exercising in a group, with physical and cognitive functions in community-dwelling older adults. [Participants and Methods] A total of 615 older adults participated in this cross-sectional study. We conducted three physical performance tests (grip strength, five times sit-to-stand, and 5-meter walk tests) and the Five-Cog test (attention, memory, visuospatial, language, and reasoning). We investigated exercise habits using questionnaires and classified the participants into three groups as follows: those who did not exercise (n=86), those who exercised alone (n=168), and those who exercised in a group (n=362). To clarify the associations of exercise habits with physical and cognitive functions, we used the analysis of covariance with adjustment for potential confounders. [Results] The participants who exercised in a group had better lower limb strength than those who exercised alone and better scores for all the variables than the non-exercisers. Furthermore, those who exercised in a group scored significantly higher on the attention, memory, visuospatial, and overall cognitive function tests than those who exercised alone. [Conclusion] Our results highlight the importance of the social aspects associated with exercising, such as the presence of exercise peers, to improve the physical and cognitive health of older adults.

Motor Function Relating to the Accuracy of Self-Overestimation Error in Community-Dwelling Older Adults

Background: Older adults often overestimate their motor performance, which represents a serious safety hazard. The cause of this self-overestimation is to date, not yet fully established. Thus, the present study aimed to reveal the factors associated with self-overestimation by focusing on motor function.

Methods: This study included 105 community-dwelling older adults [20 males, median (25, 75 percentile) age: 73.00 (69.50, 77.50)]. Participants were assessed for errors in their self-estimation using a two-step test. They estimated the two-step distance that could be reached with maximum effort. Thereafter, they performed the actual two-step action. Participants were comprehensively assessed for motor function by various tests (i.e., 10-meter Walking Test, Timed Up and Go Test, postural stability, and muscle strength). They were then divided into two groups (the self-underestimation or self-overestimation group) and their motor performances were compared. Multiple linear regression analysis was then utilized to investigate the relationship between self-estimation error and motor function.

Results: Significant differences were found between the two groups regarding age, weight, actual two-step distance, and the time required for the Timed Up and Go Test and 10-meter Walking Test (p < 0.05). The regression analysis showed that self-estimation error was significantly related to the result of the 10-meter Walking Test (beta = 0.24, p = 0.011).

Conclusions: The self-overestimation of motor performance, which is likely to lead to several dangers (i.e., falling or obstacle collision), was related to walking ability. Consequently, the results showed that the 10-meter Walking Test would assist in detecting the self-overestimation of motor performance.

Development of a scale measuring barriers to going out among community-dwelling older adults

AIM

To maintain the frequency of going out and to improve homebound status among older adults, specific barriers need to be identified. Hence, this study developed a scale to measure barriers to going out.

METHODS

A preliminary study was carried out to collect items for the scale. We conducted semi-structured interviews with five homebound older adults, and created 14 items as a draft barrier scale. The main study included 2273 older adults and their cohabitating family members in rural Japan. For older adults, the questions included demographic characteristics, responses to the draft scale and variables to examine its validity. For family members, the questions included demographic characteristics, their relationship with the older adult and their assessment of their older relative's willingness to go out. We used data from 892 pairs for our analysis.

RESULTS

We selected nine items through the criterion group strategy, and confirmed the unidimensional structure of the scale through factor analysis. The results showed significant relationships between the scale and older adults' self-efficacy about going out, their health locus of control, the frequency of going out and their reluctance to go out as assessed by family members. We carried out a receiver operating characteristic analysis to determine the scale's cut-off point. Our multivariate analysis showed that the scale had a significantly stronger association with homebound status than with other variables.

CONCLUSION

We developed a highly reliable and valid scale on barriers to going out among community-dwelling older adults and confirmed its usability. Geriatr Gerontol Int 2021; 21: 238-244.

Relationship between Fall History and Self-Perceived Motor Fitness in Community-Dwelling People: A Cross-Sectional Study

History of falling is an important fall risk factor. If a relationship between fall history and self-perceived motor fitness could be established, then treating it as a correctable risk of re-fall due to falls may be possible. We conducted a cross-sectional study of the relationship between fall history and self-perceived motor fitness in daily life among 670 community-dwelling people (mean age 62.0 ± 9.6 years, 277 men and 393 women) who had participated in health examinations. They completed a self-administered questionnaire that asked about their history of single or multiple falls and included a 14-item motor fitness scale. The responses were analyzed using multivariate logistic regression analysis. The results showed that in both younger and older (<65 years) subjects, a history of single or multiple falls was associated with a negative response to "being able to put on socks, pants or a skirt while standing without support". For subjects ≥65 years, an association was also observed with "shortness of breath when climbing stairs". Self-perceived motor fitness related to fall history can easily be noticed by an individual and may help them become aware of fall-related factors earlier in everyday life.

Reliability and Validity of the Activity Diversity Questionnaire for Older Adults in Japan

Recent research has suggested that the breadth and evenness of activity and activity diversity contribute to health outcomes among older adults. However, few established assessment tools for activity diversity have been developed. This study developed an Activity Diversity Questionnaire (ADQ) for older adults through expert consultation and a preliminary survey among 18 community-dwelling older adults. The diversity score was calculated according to Shannon’s entropy. In study 1, the intraclass correlation coefficients (ICC) of the diversity scores were determined for community-dwelling older adults (n = 30). In study 2, concurrent validity was tested with participants receiving comprehensive health checkups at the Itabashi ward in Japan in 2018 (n = 766). The correlation coefficients of the diversity scores were then calculated in reference to the Tokyo Metropolitan Institute of Gerontology Index of Competence and Japan Science and Technology Agency Index of Competence. The final version of the ADQ consisted of 20 total items with excellent test-retest reliability (ICC = 0.84) and moderate correlations with both the Tokyo Metropolitan Institute of Gerontology Index of Competence and Japan Science and Technology Agency Index of Competence (r = 0.48 and 0.60, respectively). The ADQ was developed through scientific procedures and revealed sufficient reliability and validity. As such, it is a scientifically validated tool for assessing activity diversity among older adults.

Exercise Arrangement Is Associated with Physical and Mental Health in Older Adults

PURPOSE

Although exercising with others might have health benefits, no previous study has comprehensively examined associations of exercise arrangement with physical activity (PA), physical function (PF), and mental health (MH). We examined whether PA, PF, and MH are better when exercising with others than when exercising alone or not exercising.

METHODS

We analyzed cross-sectional data from 7759 (4007 men and 3752 women) nondisabled residents age 65 to 84 yr. PA, PF, and MH were assessed with the International Physical Activity Questionnaire-Short Form (PA sufficiency defined as ≥150 min·wk of moderate-to-vigorous PA), Motor Fitness Scale (higher PF defined as total score ≥12 in men and ≥10 in women), and World Health Organization-Five Well-Being Index (better MH defined as a total score ≥13), respectively. Exercise arrangement was classified as "nonexerciser," "exercising alone," and "exercising with others." Using multilevel logistic regression analyses, we examined independent associations of exercise arrangement with PA, PF, and MH.

RESULTS

Compared with exercising alone, the multivariate-adjusted odds ratios (95% confidence interval) among nonexercisers and those exercising with others were 0.21 (0.17-0.25) and 1.32 (1.04-1.67), respectively, for PA sufficiency, 0.47 (0.40-0.57) and 1.12 (0.94-1.34) for higher PF, and 0.69 (0.58-0.82) and 1.45 (1.17-1.79) for better MH, respectively, in men. In women, the corresponding odds ratios were 0.37 (0.30-0.46) and 1.31 (1.01-1.70) for PA sufficiency, 0.66 (0.54-0.80) and 1.08 (0.88-1.32) for higher PF, and 0.70 (0.58-0.85) and 1.27 (1.03-1.56) for better MH, respectively.

CONCLUSIONS

Exercising alone and with others were better than no exercise for maintaining better PA, PF, and MH in both sexes. Although exercise arrangement had little effect on maintaining PF, exercising with others appears to enhance PA levels and MH in both sexes.

Physical, social, and psychological characteristics of community-dwelling elderly Japanese dog and cat owners

Objectives

Previous studies examined the physical characteristics of older dog owners. However, associations of health-related factors with dog/cat ownership have not been comprehensively evaluated. This cross-sectional study examined physical function, physical activity, social function, and psychological function of a population of community-dwelling older Japanese dog and cat owners after controlling for important confounders.

Methods

The analysis included data from 11,233 community-dwelling adults aged 65 years or older (51.5% women; 52.3% aged 75–84), in Ota City, Tokyo, Japan. Pet ownership experience and pet species owned were determined by self-reported questionnaire, and current, past, and never dog/cat ownership was analyzed.

Results

Analysis of variables related to physical function and physical activity showed that motor fitness scale and walking activity were significantly associated with experience of dog ownership, after adjustment for important sociodemographic and health characteristics. Analysis of social function showed that interaction with neighbors, social isolation, and trust in neighbors were significantly associated with experience of dog ownership and cat ownership.

Conclusions

As compared with respondents with no history of pet ownership, motor fitness and walking activity are greater for dog owners and social function is higher for dog and cat owners. Caring for a dog or cat might be an effective health promotion strategy to increase physical activity and facilitate social participation among older adults.

A Community-Wide Intervention Trial for Preventing and Reducing Frailty Among Older Adults Living in Metropolitan Areas: Design and Baseline Survey for a Study Integrating Participatory Action Research With a Cluster Trial

Background

Preventing and reducing frailty is an important challenge for Japan in the next decade, especially in metropolitan areas. We launched a community-wide intervention trial (the Ota Genki Senior Project) in 2016 to develop effective community-based strategies for frailty prevention in metropolitan areas. This report describes the study design and baseline survey.

Methods

This study is a community-wide intervention trial that integrates participatory action research into a cluster non-randomized controlled trial for adults aged 65 years or older living in Ota City, Tokyo. We allocated 3 of 18 districts to an intervention group and the other 15 to a control group. Using a mailed self-administered questionnaire, we conducted a baseline survey of 15,500 residents (8,000 and 7,500 in the intervention and control groups, respectively) from July through August 2016. In addition to socioeconomic status and lifestyle variables, we assessed frailty status (primary outcome) and physical, nutritional, and psychosocial variables (secondary outcomes). Based on the baseline findings, an intervention to improve outcomes will be implemented as participatory action research. Follow-up surveys will be conducted in the same manner as the baseline survey.

Results

A total of 11,925 questionnaires were returned (76.9% response rate; 6,105 [76.3%] and 5,820 [77.6%] in the intervention and control groups, respectively), and 11,701 were included in the analysis (mean age, 74.3 [standard deviation, 5.5] years; 48.5% were men).

Conclusions

This study is expected to contribute to development of a prototype of a community-wide frailty prevention strategy, especially in metropolitan areas in Japan. Trial registration: UMIN Clinical Trials Registry (UMIN000026515).

Effect of group activities on health promotion for the community-dwelling elderly

Objective: In Japan, the Integrated Community Care System aims to support residents to live as independently as possible at home. Koreisya-Kyoshitsu and Fureaiikiiki salons are two types of group activities for community-dwelling elderly. We investigated effective ways of conducting such activities.

Methods: We analyzed 96 subjects from 8 salons and 354 subjects from 10 Koreisya-Kyoshitsu. Self-completed questionnaires included the following: attributes, the Motor Fitness Scale (MFS), revised Philadelphia Geriatric Center Morale Scale (PGCMS), Measurement of Psychological Independence (MPI), instrumental activities of daily living (IADL), and self-rated health status (SRH). Follow-up assessment was conducted 6 months later. Representatives from 8 salons and staff members from 10 Koreisya-Kyoshitsu answered an additional questionnaire on management.

Results: In Koreisya-Kyoshitsu, physical performance (MFS) (p = 0.007) and subjective well-being (PGCMS) (p = 0.001) improved significantly, whereas psychological independence (MPI) deteriorated significantly (p = 0.015). The MFS scores significantly improved in the sub-group with a high number of sessions (7 or more) (p = 0.043), as well as in the non-volunteer sub-group (p = 0.004). The PGCMS scores significantly improved in the sub-group with a high number of sessions (p < 0.001). The MPI scores significantly deteriorated in the sub-group with a low frequency of sessions (6 or less) and in the non-volunteer sub-group (p = 0.013 and p = 0.010, respectively). In salons, the frequency of going out decreased significantly (p = 0.049). Functional status (IADL) significantly improved in the “twice or more a month” sub-group (p = 0.046), whereas it significantly deteriorated in the “once a month” sub-group (p = 0.004). The proportion of volunteers/organizers in Koreisya-Kyoshitsu (23.4%) was significantly lower than that in salons (39.6%).

Conclusion: The frequency (number) of sessions, but not the volunteer/non-volunteer attribute, was a key factor in obtaining the health promotion effects of group activities in both Koreisya-Kyoshitsu and salons.

Associations between the settings of exercise habits and health-related outcomes in community-dwelling older adults

[Purpose] The purpose of this study was to examine the associations between the settings of exercise habits and health-related outcomes in community-dwelling older adults. [Subjects] A total of 304 Japanese community-dwelling older adults (70.3 ± 4.1 years; 113 males and 191 females) participated in this study. [Methods] Demographic characteristics, medical conditions, exercise habits, and health-related outcomes were assessed by face-to-face interviews and self-reported questionnaires. Older adults who had exercise habits were classified into two groups: individual- and group-based exercise habits groups, and the health-related outcomes were compared between groups. [Results] The scores for the Geriatric Depression Scale, exercise self-efficacy, and dietary variety of older adults who had group-based exercise habits were better than those of older adults who had individual-based exercise habits. In addition, the exercise settings (individual- and group-based) were significantly associated with scores for the Geriatric Depression Scale (odds ratio = 0.76) and exercise self-efficacy (odds ratio = 1.26), even after adjusting for age and gender. [Conclusion] These results implied that habitual exercise in group settings may have an effective role in promoting exercise self-efficacy and mental health.

Risk factors of functional disability among community-dwelling elderly people by household in Japan: a prospective cohort study

BACKGROUND

Although the number of elderly people needing care is increasing rapidly in the home setting in Japan, family size and ability to provide such support are declining. The purpose of this study was to identify the risk factors of functional disability by household composition among community-dwelling elderly people.

METHODS

A total of 1347 elderly people aged 70 years and over participated in a baseline geriatric health examination for this prospective cohort study. In the health examination, we conducted an interview survey using a questionnaire in July 2004 and July 2005. Questionnaire items covered the following: age, sex, household, medical history, instrumental activities of daily living, intellectual activity, social role, Motor Fitness Scale, falls experienced during the past year, Dietary Variety Score, frequency of going outdoors, cognitive impairment, and depressive status. We defined the occurrence of functional disability as certification for long-term care needs of the subjects. The certification process started with a home visit for an initial assessment to evaluate nursing care needs using a questionnaire on current physical and mental status. The onset of functional disability was followed from July 2004 to March 2011. Cox proportional hazard regression analysis was used to estimate the risk factors related to the onset of functional disability, adjusted for age and sex.

RESULTS

Of the 1084 participants, 433 were male (39.9%), and the average age was 77.8 (standard deviation, 5.4). Up to March 2011, functional disabilities occurred in 226 participants (20.9%). Elderly people living only with their children demonstrated a significantly higher risk for functional disability than the three-generation household group (hazard ratio, 1.61; 95% confidence interval, 1.08-2.40). The risk factors for functional disability varied according to household group.

CONCLUSIONS

In Japan, the number of vulnerable households with elderly people in need of care has increased steadily over the years. Appropriately identifying the risks related to functional disability requires a means of assessment that takes the household composition into consideration.

Prevalence of Social Isolation in Community-Dwelling Elderly by Differences in Household Composition and Related Factors

Objective: The aim of this study was to measure the prevalence of social isolation in community-dwelling elderly and related factors based on household composition differences. Method: We used the six-item Lubben Social Network Scale to measure social isolation in 2,000 individuals. Multiple logistic regression analysis was performed to examine factors related to social isolation with household composition after adjusting for gender and age. Results: The prevalence of social isolation was 31.0% for elderly living alone and 24.1% for those living with family. For both, poor mental health and lack of social support from nonfamily members were associated with social isolation risk. For elderly living with family, low intellectual activities and poor health practice were associated with social isolation risk. Discussion: This study showed high prevalence of social isolation. For prevention, promoting mental health and encouraging them to make friends may be important. For elderly living with family, promoting intellectual activities and good health practice is recommended.

Calibrating ADL-IADL scales to improve measurement accuracy and to extend the disability construct into the preclinical range: a systematic review

BACKGROUND

Interest in measuring functional status among nondisabled older adults has increased in recent years. This is, in part, due to the notion that adults identified as 'high risk' for functional decline portray a state that is potentially easier to reverse than overt disability. Assessing relatively healthy older adults with traditional self-report measures (activities of daily living) has proven difficult because these instruments were initially developed for institutionalised older adults. Perhaps less evident, are problems associated with change scores and the potential for 'construct under-representation', which reflects the exclusion of important features of the construct (e.g., disability). Furthermore, establishing a formal hierarchy of functional status tells more than the typical simple summation of functional loss, and may have predictive value to the clinician monitoring older adults: if the sequence task difficulty is accelerated or out of order it may indicate the need for interventions.

METHODS

This review identified studies that employed item response theory (IRT) to examine or revise functional status scales. IRT can be used to transform the ordinal nature of functional status scales to interval level data, which serves to increase diagnostic precision and sensitivity to clinical change. Furthermore, IRT can be used to rank items unequivocally along a hierarchy based on difficulty. It should be noted that this review is not concerned with contrasting IRT with more traditional classical test theory methodology.

RESULTS

A systematic search of four databases (PubMed, Embase, CINAHL, and PsychInfo) resulted in the review of 2,192 manuscripts. Of these manuscripts, twelve met our inclusion/exclusion requirements and thus were targeted for further inspection.

CONCLUSIONS

Manuscripts presented in this review appear to summarise gerontology's best efforts to improve construct validity and content validity (i.e., ceiling effects) for scales measuring the early stages of activity restriction in community-dwelling older adults. Several scales in this review were exceptional at reducing ceiling effects, reducing gaps in coverage along the construct, as well as establishing a formal hierarchy of functional decline. These instrument modifications make it plausible to detect minor changes in difficulty for IADL items positioned at the edge of the disability continuum, which can be used to signal the onset of progressive type disability in older adults.

Oral intake of Lactobacillus pentosus strain b240 accelerates salivary immunoglobulin A secretion in the elderly: A randomized, placebo-controlled, double-blind trial

Background

Immunoglobulin A (IgA) secretion in saliva decreases with age and may be the cause of increased vulnerability of the elderly to respiratory infections. The effect of oral intake of lactic acid bacteria on salivary secretory IgA (SIgA) in the elderly has not been reported. The objective of this study was to demonstrate the acceleration of salivary SIgA secretion by oral intake of Lactobacillus pentosus strain b240 (b240) in the elderly.

Results

A total of 80 healthy elderly individuals were randomly allocated to either an intervention (i.e., b240) or a control (i.e., placebo) group. The elderly individuals in the b240 group were given a sterile water beverage (125 mL) containing heat-killed b240 (4 × 10⁹ cells), while those in the placebo group were given only a sterile water beverage (125 mL); both groups received their respective beverages once daily for 12 weeks. Saliva was collected before initiation of the study and every 2 weeks thereafter. Saliva flow rate and SIgA concentration were determined, and the SIgA secretion rate was calculated. The mean salivary SIgA secretion rate in the b240 group steadily increased until week 4 (exhibiting a 20% elevation relative to that at week 0), and then remained stable until week 12. Changes in SIgA secretion rate over the intervention period were significantly greater in the b240 group than in the placebo group. The treatment groups exhibited no significant differences in adverse events.

Conclusions

Oral intake of L. pentosus strain b240 for 12 weeks significantly accelerated salivary SIgA secretion, thereby indicating its potential utility in the improvement of mucosal immunity and resistance against infection in the elderly.

[Factors burdening the caregiving relatives of community-dwelling disable Japanese people]

AIM

This study examined the factors associated with burdens on the primary caregivers of community-dwelling disabled people.

METHODS

Participants were 78 disabled people (40 men, 38 women; mean age 77.8+/-11.5 years) who received home-based physical therapy and/or occupational therapy, and their 78 caregivers (20 men, 58 women; mean age 66.8+/-10.2 years). The caregiver burden was assessed using the short version of the Japanese version of the Zarit Caregiver Burden Interview (J-ZBI_8). In addition, the primary caregivers completed questionnaires about burdens arising from supporting the activities of daily living (ADL) using a visual analogue scale, available social support, subjective well-being, and the Motor Fitness Scale. The performance of the disabled subjects was assessed using the Bedside Mobility Scale and the Barthel Index. The disabled subjects and the caregivers were divided into higher burden (J-ZBI_8 score, 10 points and over) and lower burden groups (J-ZBI_8 score, 9 points and under) to compare the group differences in the measurements.

RESULTS

The disabled participants in the lower burden group (n=41) showed significantly higher Bedside Mobility Scale scores and Barthel Index scores than those in the higher burden group (n=37). The primary caregivers in the higher burden group showed significantly higher burden due to supporting the ADL, lower subjective well-being, and lower social support as compared to those in the lower-burden group.

CONCLUSION

The burden levels of the primary caregivers relating to the mobility and ADL of their recipients were assessed. The caregivers with higher burden showed less social support and low subjective well-being.