Aim: This study investigated the relationships between loneliness, health status (including frailty), sense of purpose in life, and lifestyle behaviors among individuals with disabilities living in officially designated depopulated areas. Participants held either a disability certificate or a medical certificate for intractable diseases.

Methods: Self-administered questionnaires were distributed via mail or employment support facilities. Based on the median score on the UCLA Loneliness Scale ("UCLA score"), participants were divided into high- and low-loneliness groups. The Mann-Whitney U test was used for continuous variables (age, age at onset, and BMI), while chi-square or Fisher's exact tests were applied for categorical variables. A multivariate logistic regression analysis identified the factors associated with high loneliness.

Results: In total, 173 valid responses were obtained (response rate: 100%). The Hosmer-Lemeshow test showed a good model fit (p = 0.94). Two significant factors associated with higher UCLA scores were as follows: (1) a strong feeling of not living an enjoyable or purposeful life (odds ratio = 2.169, 95% confidence interval = 1.371-3.431, p = 0.001) and (2) frailty status (odds ratio = 5.528, 95% confidence interval = 2.497-12.240, p < 0.001).

Conclusion: Individuals with disabilities living in depopulated areas may face increased frailty as they transition to long-term care. Integrating social prescribing, an approach expected to reduce loneliness, into existing disability welfare programs may help prevent further health deterioration.

Aim: The combination of sarcopenia and osteoporosis is a risk factor for frailty and fractures, which are the main causes of conditions that require long-term care. The objective of this study was to clarify the association between frailty, as measured using the Kihon Checklist (KCL), sarcopenia, and low bone mass.

Methods: A total of 521 community-dwelling older adults were recruited and frailty was assessed using the KCL. A binomial logistic regression analysis was performed to determine the association between frailty and the presence or absence of sarcopenia and low bone mass, with the presence or absence of frailty as the dependent variable. In addition, the sub-items of the KCL were compared to examine the characteristics of the four groups based on the presence or absence of sarcopenia and low bone mass.

Results: Of the participants, 17.7% were frail. Only osteosarcopenia was associated with frailty (odds ratio 3.324, 95% confidence interval 1.308-8.448). Osteosarcopenia was also associated with a poor motor function, poor nutritional status, social isolation, and depressed mood.

Conclusions: The results suggest that older people with a combination of sarcopenia and low bone mass are at a high risk for frailty, as measured by the KCL, and that a comprehensive approach to their care is required that includes not only physical, but also mental, psychological, and social aspects.

Aim: The dementia support team (DST) is an initiative established based on the knowledge that, when individuals with dementia or older people at risk for delirium are hospitalized because of physical illnesses, there are often cases in which their cognitive symptoms rapidly deteriorate. However, the activities of each hospital are unknown. Therefore, a nation-wide survey of DSTs was conducted.

Methods: A questionnaire survey was conducted among 1,032 hospitals throughout Japan.

Results: A total of 422 responses were obtained, of which 292 were valid. The main results were as follows: number of beds (200 to <500 beds, n=171), number of types of medical staff (≥4 types, n=248), number of patients for intervention/month (30 patients to <100 patients, n=164), number of team meetings/week (1/week, n=240), cognitive function assessment (Hasegawa Dementia Scale Revised [HDS-R], n=141), advice regarding medication (n=279), rehabilitation (n=243), reduction of physical restraint (n=274), nutrition (n=200) and discharge adjustment (n=233). Patients were divided into 2 groups for analyses: those requested by the other divisions (n=121; 41.4%) and those managed by DST (n=171; 58.6%). There was a higher rate of requested by the other divisions than the managed by the DST related advice for medications and rehabilitation. However, the differences were not statistically significant.

Conclusions: The present study revealed that requests from other divisions involved a higher rate of advice on medication and rehabilitation than the managed by the DST. Further studies are required to confirm this hypothesis.

An 88-year-old woman was referred to our hospital due to body weight loss (9 kg) over one year. Bronchoscopy revealed Mycobacterium avium, and antimicrobial treatment was initiated. Three months later, a chest CT scan revealed a mass shadow in the left lingular segment. After a second bronchoscopic examination, a pathological diagnosis of diffuse large B-cell lymphoma was made. After one course of chemotherapy, the mass in the left middle lobar significantly decreased in size. We report a case of malignant lymphoma with NTM in an elderly patient. Impaired immunity may have played a role in the development of both diseases. In an aging society, complications associated with both diseases may increase. Careful and detailed examination is essential.