Implication of using cognitive function-related simple questions to stratify the risk of long-term care need: population-based prospective study in Kobe, Japan

Feasibility and potential value of a local governmental frail check-up program for the risk assessment of long-term care in apparently healthy older citizens: a prospective study

BACKGROUND

Earlier identification of individuals at risk of needing long-term care can increase the opportunities for preventive/therapeutic interventions, leading to a reduced social burden.

METHODS

We examined the feasibility and potential value of a frailty check-up program implemented by the local government for risk assessment of long-term care needs in 1,528 apparently healthy older (aged 64/65 years) citizens in Kobe, Japan, between August 2017 and March 2018. The program comprised a questionnaire on general frailty (Comprehensive score) and evaluation of other frailty-related measures, cognitive function-related activities of daily living (Cognitive Function Instrument), and health-related quality of life (EQ-5D-5L). In March 2020, these measures were merged with data on long-term care or support certification, where the latter represented a condition requiring care for a certain period preceding long-term care needs.

RESULTS

Overall, 15 citizens were certified as having long-term care needs and 38 as having long-term care or support needs. Using receiver operating characteristic curve analysis, certain measures, including the Comprehensive score and EQ-5D-5L, significantly predicted the incidence of long-term care or support needs.

CONCLUSIONS

The frailty checkup program conducted by the local government may be feasible and valuable for risk assessment of long-term care needs in apparently healthy older citizens.

The association of agricultural and non-agricultural work on the healthy ageing of older adults in Japan: A 6-year longitudinal study from the Japan Gerontological evaluation study

OBJECTIVES

Many studies have examined the impact of employment on health, but few large-scale longitudinal studies specifically investigate the impact of agricultural labor on the health of older adults. This study aims to identify the health effects of employment on older Japanese adults, focusing on agricultural workers.

METHODS

This study uses longitudinal data collected by the Japan Gerontological Evaluation Study (JAGES) from 2013 to 2019. We selected 48,221 older adults out of a total of 65,751 respondents, excluding missing values. The objective variables included healthy ageing, such as dementia, functional disability, loss of healthy life expectancy, and death. Explanatory variables were used to categorize participants into four groups: non-agricultural workers, agricultural workers, retired, and those who have never worked. Seven adjustment variables, including sex, age, and socioeconomic status, were considered. Logistic and modified Poisson regression analyses were employed after imputing missing values.

RESULTS

Incidence ranged from 2.6 % (dementia) to 17.3 % (any level of functional disability). Post-multiple imputation analysis showed significantly lower odds ratios and risk ratios for dementia, functional disability, loss of healthy life expectancy, and death among non-agricultural and agricultural workers compared to retirees. The odds and risk ratios for agricultural workers ranged from 0.45 (dementia) to 0.69 (loss of healthy life expectancy).

CONCLUSIONS

Compared with retirees, non-agricultural and agricultural workers experience significantly reduced risks for dementia, functional disability, loss of healthy life expectancy, and death. These findings showed potential health benefits associated with continued employment in older age.

Monitoring reaction time to digital device in the very-old to detect early cognitive decline

Early detection of cognitive decline is essential for timely intervention and effective management of age-related impairments. We monitored repetitive reaction times to a simple task on senior-friendly tablet computers among 72 functionally independent older adults, with a mean age of 82, ranging up to 100 years, within natural settings over two years. Functional principal component analyses revealed a consistent decrease in reaction time in line with their task experience among those without subjective cognitive decline. Conversely, individuals reporting subjective cognitive decline showed no consistent trend and exhibited wide variability over time. These distinctive reaction time trajectories in very old adults suggest the potential for monitoring as a non-invasive, convenient method for early detection of cognitive impairment.

Research to inform health systems' responses to rapid population ageing: a collection of studies funded by the WHO Centre for Health Development in Kobe, Japan

Population ageing is a global phenomenon that has profound implications for all aspects of health systems development. Research is needed to understand and improve the health system response to this demographic shift, especially in low- and middle-income countries where the change is happening rapidly. This Supplement was organized by the WHO Centre for Health Development in Kobe, Japan (WHO Kobe Centre) whose mission is to promote innovation and research for equitable and sustainable universal health coverage considering the impacts of population ageing. The Supplement features 10 papers all based on studies that were funded by the WHO Kobe Centre in recent years. The studies involve a diverse set of 10 countries in the Asia Pacific (Cambodia, Japan, the Lao People's Democratic Republic, Malaysia, Mongolia, Myanmar, the Philippines, Singapore, Thailand and Viet Nam); address various aspects of the health system including service delivery, workforce development and financing; and utilize a wide range of research methods, including economic modelling, household surveys and intervention evaluations. This introductory article offers a brief description of each study's methods, key findings and implications. Collectively, the studies demonstrate the potential contribution that health systems research can make toward addressing the challenges of ensuring sustainable universal health coverage even while countries undergo rapid population ageing.