An occupation is an activity that people perform every day, and the elderly tends to reduce what they can do daily due to disease, disability, or frailty. An occupation with problems may also appear as a characteristic of the disease. Although many assessment scales for occupation, they also have different characteristics. Concretely, they can be comprehensive or specific scales, abstract or specific questions, and questions about availability or implementation. We also assess the meaning and priority of the occupation to leverage a program plan. Differences in methods of assessing activities of daily living also lead to differences in whether comprehensive or intensive support for activities of daily living is provided. On the other hand, recently, efforts have been made to clarify the goals of activities of daily living during programs, and programs that take advantage of both have been developed. Although specialized knowledge is needed to evaluate and support activities of daily living, it is desirable to develop evaluation and support methods that will be widely disseminated in society.

【Aim】 This study aimed to determine the modifiable risk factors related to mild cognitive impairment (MCI) and associations between combinations of those factors and MCI in community-dwelling older adults.【Methods】 This cross-sectional study included a total of 578 community-dwelling older adults (aged ≥ 65 years) who had undergone health checkups and were divided into MCI (n = 289) and non-MCI (n = 289) groups. Non-MCI participants were selected through propensity score matching to balance age and gender. The modifiable factors related with MCI were determined and categorized based on those combinations using a decision tree analysis.【Results】 Weakness (grip strength < 28 kg for men, < 18 kg for women), poor sleep quality, and social inactivity (non-participate in regional events) were determined as and categorized based on combinations of those factors. The lowest prevalence rate of MCI was in the non-weakness and non-poor sleep quality group (37.7%) and the highest was in the weakness and social inactivity group (82.0%).【Conclusions】 The combinational status that maintained muscle strength and better sleep quality could be associated with a lower risk of cognitive deficits. However, older adults with weakness and social inactivity would have a greater risk of MCI. Maintenance of muscle strength, sleep quality, and social activity may be helpful in preventing cognitive decline among community-dwelling older adults. When any of those factors decline, the other factors should be maintained for cognitive health.

【Aim】 This study aimed to examine the association between car accident history and fall history among community-dwelling older drivers.【Methods】 A cross-sectional analysis was conducted on 602 older drivers (mean age: 72.8 ± 5.6 years, women: 50.0%) who participated in the regional cohort study (Tarumizu Research 2018, 2019) and were driving at 65 years or older. For car accident history, we listened to their accident history for the past two years and classified it into “accident history” and “no accident history.” The fall history was classified into “with fall history” and “no fall history” based on the presence or absence of falls in the past year. In the statistical analysis, a binomial logistic regression analysis was performed with accident history as the dependent variable, fall history as the independent variable, and age and sex as the covariates.【Results】 It was found that 5.6% of the subjects had a history of car accidents, and 13.0% had a history of falls. Among those with a history of car accidents, a significantly higher percentage of people had a history of falls than among those with no history of car accidents (p = 0.003). The logistic regression analysis showed that having a history of falls was significantly associated with having a history of car accidents (odds ratio: 3.12, 95% confidence interval: 1.42–6.85, p = 0.004).【Conclusions】 The results suggested an association between a history of car accidents and a history of falls among community-dwelling older drivers.

【Objective】 This study’s objective was to clarify motivations at the time of service initiation by analyzing the goals of community-dwelling older for first-time use of day-care services in Japan.【Methods】 The target population who used the day-care facility at least once and those who certified as support levels 1-2 (mild disability) and persons eligible for the services. After administering the structured goal setting, we conducted a quantitative text analysis. Relevant terms were extracted using a text-mining method and KH coder. The extracted terms were clustered in a co-occurrence network and inductively categorized and subcategorized. Bubble charts were created for care level, age, level of independence in daily living, and gender.【Results】 Participants of this study were Ninety-six subjects (mean age 79.4 years; 59 women) using day-care services provided by long-term care insurance. The goals were categorized as follows: (1) physical function improvement, (2) walking endurance improvement, (3) independence in the minimum living space necessary to maintain one’s life, (4) going out to the train station, (5) public transportation use, (6) enjoyment of social activities, and (7) exercise-related leisure activities. The bubble charts indicated that the care level and age affected the living space size, while the level of independence in daily living and gender affected the level of social activities.【Conclusion】 The day-care service users mentioned various activities as long-term goals, including social participation, physical functions, and activities aimed at maintaining their range of daily living. This study’s results can help develop effective care prevention targets.