Search Results (48)

Background/Objectives: Frailty has been associated with various physical, psychological, and social factors; however, the influence of the residential environment—particularly walk-up buildings without elevators—remains unclear. This study aimed to examine the association between the floor of residence and frailty among functionally independent older adults. Methods: A total of 793 older adults (mean age: 76.46 ± 6.29 years; 58.83% women) living in walk-up buildings without elevators and not certified as requiring long-term care participated in a questionnaire survey. Frailty was assessed using the Kihon Checklist (KCL) and the FRAIL Scale (FS). Logistic regression analyses were conducted to examine the association between floor of residence and frailty status (non-frail vs. frail), adjusting for potential confounders. Sensitivity analyses were performed using stratified models based on age group, functional status, and living conditions. Results: Frailty prevalence was 23.28% (KCL) and 16.88% (FS). Higher floor of residence was significantly associated with lower odds of frailty (KCL: odds ratio [OR] = 0.82, 95% confidence interval [CI]: 0.69–0.97; FS: OR = 0.80, 95% CI: 0.65–0.97). Stratified analyses showed consistent associations in subgroups including those aged ≥ 75 years, with full Instrumental Activities of Daily Living scores, non-homebound status, poor subjective economic status, and living alone (all p < 0.05). Conclusions: Living on higher floors in walk-up buildings without elevators may be protective against frailty among functionally independent older adults. While barrier-free environments are essential for those with functional decline or disabilities, moderate physical challenges such as stairs may contribute to frailty prevention in populations who maintain independence. Full article

Frailty is increasingly recognized as a systemic complication in patients with obstructive pulmonary diseases (OPDs), yet its molecular basis remains unclear. Extracellular vesicles (EVs), which transport small RNAs, may offer mechanistic insight into this comorbidity. This study investigated the association between serum-derived EV small RNAs and frailty in OPD. Sixty-eight patients with OPD were enrolled, and EVs isolated from 29 patients (13 with chronic obstructive pulmonary disease [COPD], four with COPD and asthma, and 12 with asthma; median age 72 years) were analyzed. Based on the Kihon Checklist, patients were classified as frail (n = 11) or non-frail (n = 18). Small RNA sequencing and differential expression analyses were conducted, followed by age-adjusted correlation with physical factors and Ingenuity Pathway Analysis (IPA). A total of 108 small RNAs were differentially expressed between frail and non-frail groups (p < 0.05, fold change < 0.8 or >1.2). IPA linked these RNAs to lung fibrosis and transforming growth factor-beta (TGF-β) signaling pathways. Eleven small RNAs correlated with lower limb strength, and three—miR-125b-5p, miR-369-3p, and miR-615-3p—emerged as key candidates associated with frailty. These findings suggest that EV-derived small RNAs may contribute to frailty development in OPD through TGF-β–related molecular mechanisms. Full article

Background: Hospital-acquired disability (HAD), defined as a decline in activities of daily living (ADL) during hospitalization, is a significant component of post-intensive care syndrome (PICS) and may influence long-term outcomes in critically ill patients. Its impact on post-discharge functional recovery, especially among patients who appear ADL-independent at discharge, remains unclear. Methods: This analysis of the multicenter prospective J-RELIFE cohort included 357 ICU patients aged ≥ 40 years who required mechanical ventilation for ≥48 h. The primary outcome was global functional decline, defined as a Kihon Checklist (KCL) score ≥ 8 at 3 months after hospital discharge. Multivariable logistic regression and Cox proportional hazards models were used to identify independent predictors of functional decline, including HAD (Δ Barthel Index ≥ 5), age ≥ 65 years, and psychological distress at discharge (Hospital Anxiety and Depression Scale ≥ 8). Results: Global functional decline at three months was observed in 45% of patients. In logistic regression analysis, HAD (OR = 1.80, 95% CI: 1.00–3.24, p = 0.049), psychological distress (OR = 2.11, 95% CI: 1.27–3.49, p = 0.004), and older age (OR = 1.03 per year, p = 0.027) were independently associated with the outcome. Relative risk analysis confirmed similar associations: HAD (RR = 1.99, 95% CI: 1.71–2.31), psychological distress (RR = 1.35), and their combination significantly increased the risk of functional decline. Among patients who were ADL-independent at discharge (Barthel Index ≥ 85), those with all three risk factors had a markedly elevated risk (RR = 10.17, 95% CI: 6.46–16.00, p < 0.001). Conclusions: HAD, older age, and psychological distress at discharge are robust predictors of functional decline after ICU discharge, even in patients who appear functionally independent at discharge. These findings support comprehensive discharge planning that incorporates both physical and psychological assessments to identify high-risk individuals and improve long-term outcomes. Full article

Background/Objectives: Identifying adults at high risk of frailty and implementing appropriate interventions are critical for extending healthy life expectancy. This retrospective cohort study examined whether abdominal obesity predicts frailty progression over one year among 2962 community-dwelling adults aged 30–79 years in Osaka Prefecture, Japan. Methods: Data were collected from 2962 individuals (mean age, 62.7 ± 8.8 years) who completed annual surveys through a health application in both 2023 and 2024 and had available waist circumference data. Frailty was assessed using the Kihon Checklist. Logistic regression analysis was performed to identify predictors of frailty progression. Results: At baseline (2023), 23% of participants had abdominal obesity, and 18% were categorized as frail. Among 2431 participants who were non-frail at baseline, the incidence of frailty after one year was significantly higher among those with abdominal obesity than those without (10.5% vs. 7.2%, p = 0.011). However, in the multivariate logistic regression analysis, frailty awareness (“know well” vs. “do not know,” adjusted odds ratio [aOR] = 0.341, 95% confidence interval [CI] 0.212–0.548), regular exercise habits (aOR = 0.596, 95% CI 0.382–0.930), and prefrailty status (aOR = 1.767, 95% CI 1.602–1.950) were significant predictors of frailty development, whereas abdominal obesity was not independently associated with frailty progression after adjustment. Conclusions: Although abdominal obesity was associated with frailty onset in crude analyses, this association became non-significant after adjustment. Greater frailty awareness and regular exercise appear to reduce the risk of frailty development, suggesting that lifestyle education and public awareness initiatives may help mitigate the impact of abdominal obesity on frailty progression. Full article

Background: Frailty is a multidimensional syndrome characterized by reduced physiological reserve and resilience and has become a crucial predictor of outcomes in liver surgery. Unlike chronological age, frailty reflects broader vulnerabilities that significantly influence postoperative recovery. Aim: To review and synthesize current evidence on the relationship between frailty and postoperative outcomes following liver resection, with an emphasis on short-term complications, mortality, and long-term survival. Methods: A comprehensive literature review was performed, drawing on recent meta-analyses, large-scale cohort studies, and prospective observational data. Frailty was evaluated using a range of assessment tools, including the Modified Frailty Index (mFI), Clinical Frailty Scale (CFS), Kihon Checklist (KCL), and claims-based measures such as the Johns Hopkins Frailty Indicator. Results: Across studies, frailty has been consistently linked to a higher incidence of postoperative complications, such as post-hepatectomy liver failure (PHLF), infections, extended hospital stays, and increased mortality. In patients undergoing liver resection for cancer, frailty is also associated with poorer long-term survival. Importantly, frailty serves as an independent risk factor, even after adjusting for age, comorbid conditions, and tumor characteristics. Preoperative identification of frailty enhances risk stratification, informs surgical planning, potentially favoring parenchymal-sparing or minimally invasive approaches, and highlights patients who may benefit from prehabilitation. Conclusions: Frailty is a strong and independent predictor of poor outcomes after liver resection. Incorporating frailty assessment into routine preoperative evaluation can improve surgical decision-making, facilitate informed patient counseling, and optimize perioperative care strategies. Full article

Background/Objectives: Frailty is a multifactorial clinical syndrome characterized by diminished physiological reserves and increased vulnerability to stressors. It is increasingly recognized as a predictor of poor outcomes in cardiac rehabilitation (CR). However, how frailty is defined, assessed, and addressed across outpatient CR programmes remains unclear. This scoping review aimed to map the extent, range, and nature of research examining frailty in the context of outpatient CR, including how frailty is measured, its impact on CR participation and outcomes, and whether sex and gender considerations or participation barriers are reported. Methods: Following the PRISMA-ScR guidelines, we conducted a comprehensive search across six electronic databases (from inception to 15 May 2025). Eligible peer-reviewed studies included adult participants assessed for frailty using validated tools and enrolled in outpatient CR programmes. Two reviewers independently screened citations and extracted data. Results were synthesized descriptively and narratively across three domains: frailty assessment, sex and gender considerations, and barriers to CR participation. The protocol was registered with the Open Science Framework. Results: Thirty-nine studies met inclusion criteria, all conducted in the Americas, Western Pacific, or Europe. Frailty was assessed using 26 distinct tools, most commonly the Kihon Checklist, Fried’s Frailty Criteria, and Frailty Index. The median pre-CR frailty prevalence was 33.5%. Few studies (n = 15; 38.5%) re-assessed frailty post-CR. Sixteen studies reported sex or gender data, but none applied sex- or gender-based analysis (SGBA) frameworks. Only eight studies examined barriers to CR participation, identifying physical limitations, emotional distress, cognitive concerns, healthcare system-related factors, personal and social factors, and transportation as key barriers. Conclusions: The literature on frailty in CR remains fragmented, with heterogeneous assessment methods, limited global representation, and inconsistent attention to sex, gender, and participation barriers. Standardized frailty assessments and individualized CR programme adaptations are urgently needed to improve accessibility, adherence, and outcomes for frail individuals. Full article

Background/Objectives: Frailty is a multifactorial condition influenced by physical and psychosocial factors. Understanding longitudinal changes in these domains may guide prevention strategies. This study examines the relationship between frailty status, physical fitness, and psychosocial conditions in community-dwelling older adults using five-year longitudinal data. Methods: Participants were 52 out of 89 older adults who completed both baseline and five-year follow-up assessments (follow-up rate: 58.4%). Data were collected using 10 physical fitness indicators, the fitness age score (FAS), geriatric depression scale (GDS), Lubben social network scale short form (LSNS-6), and relevant items in the six Kihon Checklist (KCL) domains. Due to low prevalence of frailty, individuals with pre-frailty and frailty were combined into the frailty-risk group. Repeated measures ANOVA with sex as a covariate was conducted to compare groups. Logistic regression was used to identify baseline predictors of frailty status at five years. Statistical significance was set at p < 0.05. Results: GDS, LSNS-6, and KCL scores remained stable over five years. However, physical fitness significantly declined in several measures, including grip strength, vertical jump height, knee extension strength, functional reach, and FAS. A significant interaction for the timed up and go test showed that the robust group maintained function, while the frailty-risk group declined. Logistic regression identified KCL oral function as a significant predictor (OR = 5.331, 95% CI = 1.593–17.839, p = 0.007). Conclusions: Maintaining both oral function and physical fitness is vital for preventing frailty, even among health-conscious older adults. Proactive strategies may support healthy aging. Full article

This study investigates the relationship between social media use and frailty in older adults, focusing on the influence of social media engagement and various frailty-related factors. A survey was conducted with 103 participants aged 65 and above, who completed a questionnaire on their social media usage, psychological well-being, dietary habits, physical activity, sleep patterns, and social interactions. Frailty was assessed using the Kihon Checklist, categorizing participants into non-frailty, pre-frailty, and frailty groups. The analysis was conducted using ordinal logistic regression to examine the relationship between social media usage and other frailty-related factors (e.g., psychological factors, sociality, diet, and exercise) with frailty status. The findings revealed that social media engagement was significantly associated with frailty status, with higher levels of engagement linked to reduced frailty. Specifically, participants who reported higher levels of social media interaction also reported better psychological well-being, increased social interaction, and greater engagement in physical and leisure activities. These results suggest that social media use may have a positive impact on frailty, potentially by enhancing social connectivity and promoting healthier lifestyle choices in older adults. Further research is needed to explore the mechanisms through which social media can mitigate frailty and promote healthy aging. Full article

The percentage of older drivers is increasing worldwide. Older adults are driving for their daily lives, including drivers who should not drive, “must-watch drivers”, for health conditions, etc. The “Public Survey of Long-Term Care Prevention and Needs in Spheres of Daily Life (Needs Survey)”, including the “Kihon Checklist (KCL)”, is a triennial nationwide survey conducted by welfare administrations in Japan. The objective of this study was to demonstrate that the Needs Survey can capture situations (e.g., driving avoidance) of older drivers obtained by previous studies, many of which are one-time surveys. As for our methods, we administered a survey with a format of questions used in previous studies combined with KCL to all older adults in Tsurui Village, a rural community in Japan, obtained 393 responses, around half of them, and conducted a logistic regression analysis to estimate whether they were driving or not and a multiple regression analysis for the frequency of driving avoidance. The former analysis showed that KCL could detect must-watch drivers with relatively deteriorated health among not-so-old adults, adding to another one with relatively not-so-bad health among much older adults, and the latter analysis showed that the KCL scores could be an alternative to the self-rating of driving ability used in previous studies. In conclusion, KCL in the Needs Survey is recommended to be a valuable survey for regularly assessing the driving conditions of older drivers nationwide. Full article

Background/Objective: Frailty is a significant health concern in the aging population, particularly in Japan’s super-aging society. Community-based interventions show promise in frailty prevention; however, their effectiveness requires further investigation. This study aimed to evaluate the impact of a continuous municipal rehabilitation program on frailty status and physical function in older adults living in suburban Japan. Methods: This prospective observational study included 52 participants aged ≥ 65 years (13 males and 39 females) who underwent assessments at baseline and after six months. Participants were divided into Pre-old (65–74 years) and Older (≥75 years) groups. Frailty was assessed using the Kihon checklist (KCL), and physical function was evaluated using the New Physical Fitness Test. Changes in frailty status, physical function, and KCL subcategories were analyzed. Results: Frailty prevalence decreased significantly from baseline to 6 months (21.2% to 7.7%, p = 0.018). In the Pre-old group, significant improvements were observed in the sit-up (p = 0.035) and six-minute walking (p = 0.017) scores. The Older group showed significant improvements in KCL lifestyle (p = 0.023) and physical function (p = 0.018). Seven of ten initially frailty participants transitioned to a non-frailty status after 6 months. Conclusions: The Co-Creative Well-being System was associated with a reduction in frailty prevalence and improvements in physical function, with age-specific benefits observed. This community-based approach presents a promising strategy for addressing frailty in aging populations. Full article

Background/Objectives: In the context of an aging society, physical disability and its relationship with frailty is of growing concern. The aim of this study was to examine the associations between oral function, social participation, and loneliness among community-dwelling middle-aged and older adult physically disabled individuals. Methods: In this cross-sectional study, the participants were 140 individuals with certified physical disabilities living in the studied area. Demographic characteristics, outing activities, loneliness (Three-Item Loneliness (TIL) Scale), and frailty/ability to live independently (Kihon Checklist (KCL)) were assessed using a questionnaire survey. The participants were divided into two groups based on the presence or absence of oral dysfunction (OD), and statistical analyses were performed to compare the groups. Results: The group with OD had significantly higher TIL and KCL total scores and significantly lower mobility, confinement, cognitive function, greater levels of depression, and fewer outing activities (volunteering, movies, festivals, sports) compared to the group without OD. In a multivariate, age- and sex-adjusted binomial logistic regression analysis, outing activities (OR = 0.011, 95% CI: 0.000–0.529, p = 0.023) and loneliness (OR = 6.174, 95%CI: 1.292-29.502, p = 0.023) were identified as significant factors. Conclusions: An association was found between OD, loneliness, and social activities among middle-aged and older individuals with physical disabilities. The results suggest that future interventions should consider the relationship between oral function and factors such as depression, loneliness, social isolation, and social engagement as a means to mitigate frailty and other health and well-being concerns for physically disabled individuals. Full article

Owing to increasing super-aging societies, older adults will be encouraged to continue working. Although demand exists for older adults to continue working in Japanese society, the enabling factors have not been clarified. This study aimed to clarify (1) the life functions that affect the working status among younger-older adults who continue to work and those who do not via the Kihon Checklist (KCL) and (2) examine whether the number of areas of difficulties in daily functions of the KCL affected older adults’ employment status. This cross-sectional study involved 5386 older men and women aged 65 years or older in one city in Japan. Employment status and the seven domains of the Kihon Checklist (KCL) were analyzed. The KCL items related to employment status were the physical (odds ratio = 2.46, p < 0.01), socialization (odds ratio = 1.95, p < 0.01), and mood domains (odds ratio = 1.29, p < 0.01). Furthermore, the odds ratio increased to 2.06 when three or more domains were applicable. To remain employed, one must be physically and mentally healthy. Furthermore, since the risk of non-employment increased when one KCL domain was applicable, a broader assessment of life functions is necessary. Full article

Clinical walk tests may not predict the development of frailty in healthy older adults. With advancements in wearable technology, it may be possible to predict the development of frailty using loading asymmetry parameters during clinical walk tests. This prospective cohort study aimed to test the hypothesis that increased limb loading asymmetry predicts frailty risk in community-living older adults. Sixty-three independently ambulant community-living adults aged ≥ 65 years were recruited, and forty-seven subjects completed the ten-month follow-up after baseline. Loading asymmetry index of net and regional (forefoot, midfoot, and rearfoot) plantar forces were collected using force sensing insoles during a 10 m walk test with their maximum speed. Development of frailty was defined if the participant progressed from baseline at least one grading group of frailty at the follow-up period using the Kihon Checklist. Fourteen subjects developed frailty during the follow-up period. Increased risk of frailty was associated with each 1% increase in loading asymmetry of net impulse (Odds ratio 1.153, 95%CI 1.001 to 1.329). Net impulse asymmetry significantly correlated with asymmetry of peak force in midfoot force. These results indicate the feasibility of measuring plantar forces of gait during clinical walking tests and underscore the potential of using load asymmetry as a tool to augment frailty risk assessment in community-dwelling older adults. Full article

Background and Objectives: Frailty in older adults is associated with adverse health outcomes. This study aimed to analyze the frailty status of community-dwelling older adults in Taiwan using the Kihon Checklist (KCL) and explore associations with demographic, physiological, and functional factors. Materials and Methods: In this cross-sectional study, 278 community-dwelling older adults were classified as robust, prefrail, or frail based on their KCL scores. Participants underwent physical fitness assessments including muscle strength and endurance tests, walking speed tests, and flexibility tests. One-way ANOVA and logistic regression analyses were used to examine differences and associations between frailty status and physical fitness indicators. Results: 36% of participants were robust, 47.1% prefrail, and 16.9% frail. The robust group significantly outperformed the prefrail and frail groups in the 30 s sit-to-stand test, 2.44 m sit-to-walk test, and walking speed (p < 0.001). The 2.44 m sit-to-walk test was a significant predictor of prefrailty (OR = 1.18, 95% CI = 1.02–1.36) after adjusting for other physical fitness indicators. Conclusions: Lower limb functional capacity, particularly in the 2.44 m sit-to-walk test, was significantly associated with pre-frailty among community-dwelling older adults in Taiwan. Early screening, the classification of frailty by the Kihon Checklist, and targeted interventions focusing on lower limb strength, endurance, and mobility are crucial for preventing and delaying frailty progression in older populations. Full article

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. Full article