【Aim】 The aim of this study was to investigate the relationship between subjective sleep quality and physical function, and explore the mediating factors of psychological function and physical activity.【Methods】 A cross-sectional analysis was conducted. Data from 573 community-dwelling older individuals (mean age 74.1 ± 6.4 years, 61.8% women) who participated in a health check survey (Tarumizu Study 2019) were analyzed. Using covariance structure analysis, an optimal model was constructed with subjective sleep quality as the starting point and physical function as the ultimate outcome. The model fit was examined separately for men and women. A hypothetical model was established with latent variables for subjective sleep quality, physical function, psychological function, and physical activity. Model fit indices, including CMIN/DF, GFI, AGFI, CFI, and RMSEA, were used to assess the goodness of fit.【Results】 For men, a well-fitting model that met statistical significance was not obtained. Conversely, for women, the model (CMIN/DF = 1.592, GFI = 0.964, AGFI = 0.944, CFI = 0.954, RMSEA = 0.041) achieved a statistically significant level, indicating that subjective sleep quality was related to psychological function and indirectly related to physical function through the mediating factor of physical activity.【Conclusions】 In community-dwelling older women, poor subjective sleep quality suggests a decline in psychological function, leading to a decrease in physical activity and ultimately contributing to a decline in physical function.

Encouraging social participation among the elderly has a positive impact on reducing mortality, extending healthy life expectancy, and addressing psychological aspects. Rehabilitation professionals are expected to engage in promoting social participation, but active involvement is currently challenging. Information and Communication Technology (ICT) may offer a solution to this issue. Nevertheless, no review has been conducted to summarize the types of ICT communication that can enhance face-to-face social participation and the resulting effects. Therefore, the purpose of this study was to explore how older adults utilize ICT communication and to identify various influencing factors that promote social participation.The study employed a scoping review design. Mesh terms such as older adults, social participation, information science, communication, and interaction were used as search terms, and four databases, namely PubMed, Scopus, Web of Science, and ProQuest, were utilized.Out of 574 studies, 18 articles were included in the study. The subjects of social participation were family members and relatives, and the type of social participation involved face-to-face interaction without specifying a specific activity. The majority of the evaluations of social participation were objective, focusing on factors like frequency and time. In some studies, ICT communication was not explicitly categorized as either hardware or software. The observed effects included the prevention of cognitive decline, expansion of social networks, and reduction of loneliness.For rehabilitation professionals to effectively employ ICT in day-care centers, future studies should specifically investigate ICT communication with elderly individuals utilizing day-care centers.

Aim: This study aims to explore the association between the long-term care insurance (LTCI) level and detailed implementation of activities of daily living (ADL) among community-dwelling older adults with dementia. Methods: The participants for this exploratory study were 105 community-dwelling older adults with dementia (80.36 ± 8.41 years old, female 73%) and utilizing outpatient and day-care facilities in Japan. The assessment of ADL abilities utilized the Process Analysis of Daily Activity for Dementia (PADA-D). Participants were divided into two groups according to the severity of their LTCI level. Multivariate analysis was employed to explore the relationship between ADL and the LTCI level. The process of ADL items that showed significant association with LTCI discrimination were compared between the two groups. Results: Certain instrumental ADLs, including cooking, housework, shopping, laundry, medication management, and money management, were significantly associated with the severity of LTCI level (p < .05). In addition, specific ADL processes, such as “management of bedding,” “garbage dumping,” “enter the store,” “find a product,” “put the laundry in the washing machine,” “start the washing machine,” and “handle cash,” showed significant impairments in older adults with dementia who had more severe LTCI level (p < .05). Conclusion: Impairments in processes related to checking, manipulating, and managing instrumental ADLs may be indicative of worsening care needs among community-dwelling older adults with dementia. Caregivers are encouraged to conduct comprehensive ADL assessments, such as the PADA-D, to provide tailored support that promotes independence from both environmental and human perspectives.

【Aim】 To develop a typology of activity patterns of social participation among long-term care older adults, and to examine the differences in contextual factors and functions these patterns.【Methods】 The subjects were 190 older adults, aged 65 years or older, who were implementing social participation among home-visit rehabilitation users. The following six components were used to assess social participation: (1) organizational activities, (2) leisure activities, (3) activities with friends, (4) household roles, (5) activities with family, and (6) day care. Statistical analysis was conducted using latent class analysis to typology social participation and compare characteristics by activity patterns.【Results】Four classes with different characteristics were identified. Class 1: Leisure activity type (33.7%) consisted of men in cohabiting households with high ambulatory ability and the highest proportion of leisure activities. Class 2: Home activity type (24.7%) consisted of women in cohabiting households with moderate ambulatory ability, who were more active in household roles and with family. Class 3: High activity type (13.7%) consisted of women in single-person households with high ambulatory ability and IADLs and had the highest number of social participations. Class 4: Resource-using type (27.9%) consisted of men in cohabiting households with low overall functioning and had the highest proportion of day care services and activities with family.【Conclusions】To achieve effective support for social participation among older adults in long-term care, it is important to understand contextual factors and functions, as well as identify feasible patterns of social participation.

Objective: Technological innovations, such as smartphones, have made it possible to measure walking speed in daily life; however, the accuracy of and trends in gait speed measurement in frail older adults still need to be thoroughly investigated. This study examined the accuracy of smartphone-measured walking speed and its relationship with frailty in older adults attending preventive care facilities. Methods: Eight subjects who had been attending preventive care facilities were included in this prospective study. A walking speed measurement app, Chami, was installed on their personal smartphones, which were used to obtain the daily number of steps and daily walking speed during the one-year follow-up period. The association between the smartphone-recorded walking speed and the level of frailty assessed by the revised Japanese version of the Cardiovascular Health Study criteria was examined using Spearman's rank correlation coefficient. Results: Three of the subjects in this study were frail, and five were prefrail. A tendency was observed in those with a greater degree of frailty to have slower walking speeds measured by the app (ρ = –0.2142), fewer days in which walking speeds could be recorded (ρ = –0.7433), and a greater coefficient of variation for recorded walking speed data(ρ = 0.4662). Conclusion: The degree of frailty may be related to the smartphone-based walking speed of older adults, as well as the accuracy of the measurement.

[Aim] Loneliness is a significant factor affecting the health of older adults. This study explores the influence of social networking service (SNS) use on loneliness among community-dwelling older adults. [Methods] The study involved community-dwelling older adults who participated in a web-based survey conducted in January 2023. Loneliness was assessed using the University of California, Los Angeles (UCLA) Loneliness Scale, 3rd edition. Logistic regression analysis was conducted with loneliness as the dependent variable and SNS use, frequency of use, and type of SNS as independent variables. [Results] The analysis encompassed 1038 participants. Loneliness was significantly lower among SNS users (odds ratio [OR] 1.63, [95% confidence interval 1.23–2.30]). A significant association was noted between older adults who used SNS more than five to six times a week (OR 1.56 [1.06–2.30]) and Facebook (OR 2.24 [1.49–3.36]) and lower levels of loneliness. [Conclusions] The study demonstrated an association between SNS use and reduced loneliness among community-dwelling older adults. These findings indicate that frequent use of SNS, especially Facebook, may serve as a valuable strategy to alleviate loneliness in this demographic.

Aim: Patients with brain tumors are susceptible to cognitive dysfunction due to the site of injury, especially residual executive dysfunction. It is important to understand the living conditions of patients with executive dysfunction and to set and prioritize goals. The purpose of this study was to investigate the relationship between the presence of age-related executive dysfunction and rehabilitation goals.Methods: This was a retrospective, single-center study. Fifty participants were included in the study. Participants selected their rehabilitation goals using the Aid for Decision-making in Occupation Choice (ADOC). Participants were defined as having a mean age score of 1.0 SD or higher on either A or B of the Trail Making Test, Japanese version (TMT-J). Participants were divided into two groups: no executive dysfunction and executive dysfunction, and the proportion of selected rehabilitation goals was compared by age.Results: A significantly higher proportion of subjects aged 65 years or older with executive dysfunction (p = 0.011) reported Activities of Daily Living (ADL) as their rehabilitation goal. The group with executive dysfunction was significantly less likely to report Instrumental Activities of Daily Living (IADL) as a rehabilitation goal (p = 0.027).Conclusions: When executive dysfunction is recognized, there is a tendency to select ADLs as goals, which are essential for the formation of the foundation of life. In addition, older adults with executive dysfunction not only limit IADLs but also tend not to list IADL activities in their rehabilitation goals.

Aim: To verify the reliability and validity of the Japanese version of the Functional Vision Screening Questionnaire (J-FVSQ). This instrument was originally developed in the U.S. for identifying older people with vision impairment and their potential needs for vision impairment-relating services. Methods: This is a single-institution cross-sectional study. Participants were adults with and without vision impairment. The survey included the following items: demographic data, Functional vision score (FVS; objective evaluation for vision function, comprising of visual acuity and visual field function), and J-FVSQ. The Cronbach's alpha and intra-class correlation coefficients (ICC) were examined for reliability. The convergent validity and known-group validity were verified based on the correlations between J-FVSQ and FVS, and comparing the J-FVSQ between people with and without vision impairments, respectively. Results: This study included 38 adults with vision impairments (mean age, 56 years) and 44 adults without vision impairments (mean age, 46 years). The Cronbach's alpha and ICC were 0.91 and 0.96 (p < 0.001), respectively. The Spearman's rank correlation coefficient between J-FVSQ and FVS was -0.66 (p < 0.01). The adults with vision impairment showed significantly higher J-FVSQ scores than those without vision impairment (34 vs 15 points). Conclusion: The J-FVSQ is a reliable and valid screening tool.

Aim: This study examined the feasibility and effectiveness of a program designed and implemented by occupational therapists to improve activities of daily life performance in a salon run mainly by community-dwelling older adults.Methods: The participants were 12 older adults (mean age ± standard deviation: 80.0 ± 1.2 years) who participated in a community-based salon. The program was conducted once a month for one hour, two times in total. Using a booklet summarizing the methods of coping with daily activities that the participants felt inconvenienced in the first session, the participants themselves decided the methods they would like to implement in consultation with each other and the facilitator. Participants were asked to implement the coping methods for a period of one month. In the second session, their impressions of the program, degree of performance and satisfaction with the countermeasures, and whether the countermeasures made their daily life performance easier were surveyed.Results: The contents of the program and booklet were well-received by the participants. After one month of implementation, the degree of performance and satisfaction of half the participants increased, and more than 80% of the participants indicated that the countermeasures made their daily life performance easier.Conclusion: This program can be considered as one of the options for programs conducted by occupational therapists and other healthcare professionals in places where older adults commonly visit, and may improve the daily life performance of community-dwelling older adults.

Aim: Animal-assisted therapy (therapy) has been effective in alleviating anxiety and stress in patients. This study aimed to implement therapy using dogs for clinical elderly patients and determine its association with the patients, as well as intervention animals and healthcare workers. Methods: Participants were inpatients at hospitals and elderly residents in facilities. Further, an intervention animal (dogs) performs therapy at the facility. Saliva was collected before and after therapy, and salivary oxytocin and cortisol were extracted. In addition, the participants' comments during the activity were recorded. A conference was held between medical personnel at each facility and the handlers conducting the activities before and after the activities. Results: This study obtained 37 samples from elderly people. Salivary oxytocin levels in the elderly significantly increased after therapy (P < 0.001). Additionally, samples from a total of 80 service dogs were obtained. Salivary oxytocin and cortisol levels of the service dogs both significantly changed after the activity (P < 0.001). Information was shared between medical professionals and therapy practitioners at the conference. Conclusions: This study revealed the stress-reducing effect of therapy on elderly people and service dogs. Until now in Japan, cases in which therapy has been clinically administered to patients and physiologically analyzed in terms of its effects remained limited, and few cases in which collaboration with medical professionals was considered have been reported. The results of this study will provide an opportunity to introduce and research further on therapy to relieve stress in patients in the medical field.

Aim: The objective was to determine whether pre-stroke life-space mobility is a valuable predictor of the risk of falling at discharge in elderly patients with stroke. Methods: The participants in this study were discharged patients with stroke, aged 65 years or older. Life-space assessment (LSA) was performed as a measure of pre-stroke life-space mobility, and the risk of falling at discharge was defined using Mini-Balance Evaluation System Test scores. In the statistical analyses, multiple logistic regression analysis was used to examine the factors associated with the risk of falls at discharge, and two predictive models were developed based on the presence or absence of pre-stroke LSA. A calibration plot based on the bootstrap method was further used to compare the accuracies of the two predictive models. Results: This study included 101 patients (mean age 76.7 ± 6.4 years). Logistic regression analysis showed that age, cognitive function, paretic lower extremity function, history of orthopedic disease and pre-stroke LSA were independently associated with the risk of falls at discharge. A comparison of the two predictive models using a calibration plot showed higher accuracy for the LSA model. Conclusions: Prediction of the risk of falls at discharge may be improved by adding the pre-stroke LSA to the predictive model, indicating that the pre-stroke LSA may be a valuable predictor of the risk of falls in elderly stroke patients discharged home.