[Utility of the number of steps walked daily as a health promotion parameter in community-dwelling elderly persons]

[Objective assessment of walking in housebound elderly who are able to go out alone]

AIM

The aim of this study was to objectively assess the risk parameters associated with walking in housebound elderly.

METHODS

The subjects were 622 community-dwelling elderly (210 men and 375 women: age 65-85) with independence in activities of daily living (ADL). We administered questionnaires pertaining to housebound factors and measured walking parameters, twice, in May 2008 and May 2009. Housebound status was defined as leaving the house no more than once a week, and non-housebound status as more than once every 2-3 days. We measured the following walking parameters: usual and maximum walking speed, timed up and go, obstacle-negotiating gait, stair-climbing, and number of daily steps.

RESULTS

The overall prevalence of housebound status was 10.0% in men and 8.5% in women. No statistically significant differences were seen in the prevalence of housebound status between genders or age groups. In men, maximum walking speed, timed up and go, and daily steps were slower or less in housebound than in non-housebound subjects. In women, all walking parameters, except usual walking speed, were slower or less in housebound than in non-housebound subjects. Logistic regression analysis showed that obstacle-negotiating gait was a risk factor for men (odds ratio 2.49), and for women, all walking parameters, except walking at usual speed, were risk factors, with the highest odds ratio of 4.77 for obstacle-negotiating gait. A slower obstacle-negotiating gait was a risk factor for housebound status for both men and women.

CONCLUSION

Compared with non-housebound subjects, housebound elderly with the ability to go out alone had a similar usual walking speed but a slower obstacle-negotiating gait.

[Relationship between occlusal force and preventive factors for disability among community-dwelling elderly persons]

AIM

Mastication ability is well documented as a risk factor for disability in the elderly. The aim of the present study was to assess occlusal force, one index of mastication ability, among elderly Japanese and clarify related factors through both physical measurements and questionnaires.

METHODS

Subjects were 372 community-dwelling persons (101 men, 271 women) aged 60-87 years and registered at five welfare centers for the aged in a metropolitan suburb. Occlusal force was measured with dental prescale/occluzer system. Physical measurements and questionnaires were performed to explore related factors.

RESULTS

Occlusal force was 502.4 N in men and 372.2 N in women. In the 60-69 and 70-79 age stratifications, men had significantly higher occlusal force than women. Occlusal force correlated significantly with age (r=-0.2, p<0.01), and number of residual teeth (r=0.6, p<0.01). After adjustment for age and the number of residual teeth, occlusal force had positive partial correlation with handgrip strength in men, and positive partial correlations with usual walking speed and body muscle mass, and negative partial correlation with timed up and go in women. From the questionnaire, high occlusal force was significantly associated with "can bite hard food" in both men and women; and with lifestyle factors ("walking regularly", "no smoking", and "alcohol consumption") in men; and with psychological factors ("intraoral satisfaction" and "no depression tendency") and physical factors ("can walk 1-km" and "can go out alone to distant places") in women.

CONCLUSION

Occlusal force was related to physical fitness, ability of movement, and lifestyle.

Assessment of the best gait parameter in relation to bone status in community-dwelling young-old and old-old women in Japan

Even if physical exercise contributes to bone health of the elderly, intense activities have the potential to worsen the risk of osteoporosis. This fact and the inevitable decrease of mobility with age increase the likelihood that the mobility parameter that best benefits bone health differs with age. The aim of this study was to objectively assess the gait parameter that most strongly influences bone health of young-old and old-old women. Subjects comprised 200 community-dwelling elderly women (132 young-old, 68 old-old) registered at welfare centers for the aged. Bone status was examined in the right heel by quantitative ultrasound (QUS) and indicated as stiffness index (SI). Gait parameters including usual and maximum walking speed (UWS and MWS, respectively), daily walking steps (DWS), obstacle-negotiating gait, and stair-climbing were examined objectively. Other bone-related physical factors (body components, handgrip strength, and masticatory function) were measured and adjusted while performing assessment. After adjustment for covariates, multiple linear regression analysis showed that MWS had the strongest association with SI in young-old women and DWS had the strongest association with SI in old-old women. To prevent osteoporosis, brisk walking exercise and engaging in movement in everyday life, respectively, should be advocated for young-old women and old-old women in Japan.