Aim: The present study clarified the relationship between elderly individuals providing nursing or caring for others, including their spouses, and their own health maintenance over three years.

Methods: Study participants were those who had completed the "Survey of Needs in the Spheres of Daily Life" distributed to all elderly individuals ≥65 years old in Nanto, Toyama Prefecture, Japan, in both 2014 and 2017. We evaluated data from 6,088 individuals after excluding those with insufficient data. Detailed responses were analyzed in order to understand the situation of the people to whom the respondents were providing nursing or care (e.g. spouses or others), the presence or absence of providing this nursing or care, and the relationship between these factors and the providers' health maintenance over a period of three years using multiple logistic regression analyses.

Results: Even after adjusting for critical variables, including basic attributes, overall health, and functional capacity in elderly men, among the subjects who had partners to whom they provided nursing or care, including a spouse, the number of individuals whose own health was maintained 3 years later was higher than among those who did not provide such nursing or care (odds ratio [OR], 1.67; P = 0.004). Furthermore, compared to women who did not provide nursing or care, the OR for women who did provide care for people others than their spouses was 1.44 (P = 0.045).

Conclusions: Our results suggest that providing nursing or caring for others (including a spouse for elderly men; excluding a spouse for elderly women) has a positive impact on health maintenance among the elderly.

Aim: The oral function-related items of the newly developed "Questionnaire for Latter-stage Elderly People" are based on two items of the Kihon checklist assessing the masticatory and swallowing functions. In this study, we estimated the questionnaire's application rate and investigated the oral function of the respondents.

Methods: Included were 699 older adults (274 men/425 women, average age, 73.4±6.6 years old). Those who responded positively to the related items were considered to have decreased swallowing and masticatory functions. The specific oral function was assessed based on the number of present and functional teeth; oral hygiene; oral moisture; occlusal force; oral diadochokinesis /pa/, /ta/, /ka/; tongue pressure; mixing ability; shearing ability; and Eating Assessment Tool (EAT)-10 (reference, score ≥3).

Results: The rates of decreased masticatory and swallowing functions were 21.5% and 26.6%, respectively, while 7.4% of participants had both. Those with a decreased masticatory function showed fewer present teeth; a lower occlusal force, oral diadochokinesis /pa/, mixing ability, shearing ability, and higher EAT-10 scores.

Those with a decreased swallowing function only had higher EAT-10 scores. In the early- and latter-stage elderly, the decreased masticatory function rates were 15.6% and 29.4%, respectively, the decreased swallowing function rates were 27.8% and 25.0%, respectively, and the rates of both decreased masticatory and swallowing functions were 6.0% and 9.5%, respectively.

Conclusion: The older adults who responded positively to the related questionnaire items, especially for items related to masticatory function, had a decreased oral function in multiple respects. The items related to the oral function in the Questionnaire for Latter-stage Elderly People are considered useful for identifying older adults with a decreased oral function.

Aim: This study aimed to explore the psychological and dynamic process of modification and evaluate its time-series peculiarity in family caregivers involved in associations for the families of dementia patients.

Methods: The current study included 39 family caregivers involved in two associations for the families of dementia patients. Five-year free group conversations in the family caregivers were recorded and converted into a verbatim record. The KJ method was then used to encode and group the verbatim record. After analyzing grouped terms and structuring the psychological and dynamic process of modification, time periods of the psychological status were determined based on the psychological process and the time-oriented perspective. The verbatim record extracted by the KJ method was analyzed by text-mining and a cluster analysis in order to assess validity of the psychological process and its time division. In addition, the appearance ratio of the texts extracted in each time period were analyzed to determine the longitudinal peculiarity in the psychological and dynamic process.

Results: The psychological process of family caregivers was classified broadly into four components: (1) recognizing and identifying problems, (2) seeking help and dealing with problems, (3) remedying and evaluating problems, and (4) feeling effective and empowering oneself to overcome problems. The validity of the psychological process and its time division was supported by text-mining and a cluster analysis. The appearance ratio of the texts extracted in each time period was quasi-periodic and recursive rather than transient.

Conclusions: The psychological and dynamic process elucidated in the current study consists of four major components participants experience when involved in associations for the families of dementia patients. Although this process may not have originated in associations for the families of dementia patients, a quasi-periodic and recursive tendency in the appearance ratio of extracted texts is a notable feature. In dementia care, it is vital to foresee emerging challenges on a constant basis and attempt precedent, forecasting-type care. Being involved in associations for the families of dementia patients facilitates the administration of forecasting-type care.

The purpose of this study was to clarify the trends in the activity of the initial-phase intensive support teams in Akita Prefecture and to, clarify the factors contributing to the more efficient promotion of future projects. A survey was conducted by questionnaire among 46 initial-phase intensive support team member for dementia. The results indicated that it is mostly maintained cooperation medical center for dementia and community support promoter for dementia. However, the question was insufficient cooperation with family doctor including visit the home. These findings suggest that it is important to disseminate information and improve awareness among the community as well as foster relationships of trust by families.

Aim: We developed a program to promote community activities for preventing frailty using the Community-as-Partner model. We aimed to clarify whether or not participants' extent of practice relating to frailty prevention activities increased after the classroom, as well as the effectiveness of the program for preventing frailty.

Methods: The participants were recruited from among pre-frailty and frailty individuals in a cohort study of community-dwelling older adults. Thirty-two participants completed the classroom intervention. Thereafter, every three months, through a telephone survey, the participants were asked about the extent of practice regarding their frailty prevention activities. The Kihon Checklist and Japanese version of the Cardiovascular Health Study (J-CHS) frailty index were surveyed as outcome measures during the cohort study conducted six months before the classroom (baseline [BL]) as well as approximately one year after this intervention (follow-up [FL]). The changes in the outcome measures between the BL and FL in the intervention group were compared to those in the control group matched by the propensity score.

Results: The frailty prevention activities saw a maximum increase around six to nine months after the classroom. The J-CHS frailty index showed a group × time-of-survey significant interaction (F = 6.531, p=0.012) and significantly decreased from 1.3 at BL to 0.8 at FL in the intervention group (p=0.009).

Conclusions: The practice of activities relating to frailty prevention increased after the classroom, and the participants also showed improvements in their physical frailty. The present program seems likely to be effective preventing frailty.

Primary effusion lymphoma (PEL) is a large B-cell lymphoma that only proliferates proliferating effusion in the body cavity. It is associated with human herpesvirus 8 (HHV8).

HHV8 negative effusion lymphoma, which is different from PEL in many ways, has also been reported and is referred to as HHV8-unrelated PEL-like lymphoma. This lymphoma is very rare and its clinical characteristics have not been fully clarified.

A 79-year-old male developed HHV8-negative primary effusion lymphoma during treatment for myelodysplastic syndrome.Abdominal computed tomography revealed abdominal effusion, but did not show any evidence of a tumor mass or lymph node enlargement. A cytological analysis of his pleural effusion revealed atypical lymphoid cells that were negative for CD10, and positive for CD19 and CD20. Corticosteroids were administered to treat the abdominal effusion; however, the patient died of an exacerbation of lymphoma on the 20th day after the initiation of corticosteroid therapy. We herein report the case of an HIV seronegative elderly patient with HHV8-unrelated PEL-like lymphoma.

Acinar cell carcinoma is a tumor characterized by the proliferation of cells that resemble serous acinar cells. It accounts for 1% of all salivary gland tumors, with 90% or more of these tumors frequently occurring in the parotid gland and rarely occurring in the small salivary glands. This time, we experienced a patient suffering from synchronous double cancer, found during a full body examination and triggered by acinar cell carcinoma of the upper lip. The case involved a 76-year-old woman, with a chief complaint of swelling of her right upper lip. She became aware of the swelling of her right upper lip in May 2017, and due to a gradual increase in the size thereof, she visited our department in December. Eight days after her initial consultation, a total biopsy was performed under local anesthesia, upon which the patient was diagnosed with acinar cell carcinoma. In January 2018, we asked our otolaryngologist to conduct a close examination of the parotid gland. Although computed tomography indicated no problems with the parotid gland, pancreatic head cancer was suspected. She visited the Department of Gastroenterology at our hospital in February and was diagnosed with pancreatic cancer (stage IVb) by an endoscopic biopsy in March. Chemotherapy was initiated the same month, but she died in January 2020.

An 87-year-old woman diagnosed with dementia with Lewy bodies (DLB) 2 years earlier was referred to our institution because of difficulty walking. She was diagnosed with urinary tract infection and admitted to our hospital. During hospitalisation, she became delirious, which prompted the administration of haloperidol. Afterwards, an altered level of consciousness was noted, measuring 300 on the Japan coma scale. A blood test revealed hyperammonaemia without liver damage. Urine culture detected the presence of Corynebacterium urealyticum. Therefore, we diagnosed this case as one of hyperammonaemia due to urinary tract infection caused by urease-producing bacteria. Soon after the insertion of a urethral catheter, the ammonia level decreased, and the consciousness level improved. In this case, the patient took medication to preserve her bladder function, which is frequently associated with DLB. We suspected that the drug caused urinary retention, resulting in hyperammonaemia. Hyperammonaemia due to these bacteria should be considered in DLB patients with an impaired consciousness, especially in those using regulators of the urinary bladder function.

The number of elderly patients requiring dialysis is continuously increasing. In Japan, many patients undergo hemodialysis; however, it has been associated with huge stress-mainly on the cardiovascular system-and requires frequent hospital visits. Conversely, peritoneal dialysis is much less invasive with a much lower frequency of hospital visits than that of hemodialysis; therefore, it is suitable for elderly patients. In addition, peritoneal dialysis, which originally had a high affinity for home care, has become more useful for elderly patients with renal failure thanks to the recent introduction of a cloud-based remote monitoring system at home. We performed percutaneous placement of a peritoneal dialysis catheter to reduce physical invasiveness and initiate peritoneal dialysis. The Barthel Index before hospitalization was 0 but increased to 65 at discharge. Further technology advancements in peritoneal dialysis are expected in the future. The cloud-based remote monitoring system is also expected to maintain or increase activities of daily living and the quality of life in elderly patients with renal failure with decreased activities of daily living.