Introduction: Physical environmental assessment scales is important from the perspective of maintaining activities of daily living and alleviating behavioral and psychological symptoms in elderly people with dementia, however there is no systematic overview of the assessment scales available in Japan and their characteristics. Aim: This scoping review aimed to identify physical environmental assessment scales applicable to individuals with dementia and available for use in Japan. To ensure inclusivity, the study did not restrict the methodology and included case reports, reviews, and commentaries, while excluding conference proceedings. Methods: A literature search was conducted using Ichushi-Web and PubMed, covering publications from 2000 to 2024. Results: A total of 195 references were identified—131 from PubMed and 64 from Ichushi-Web. After primary and secondary screening, 34 studies were included. These comprised 4 reviews, 10 cross-sectional studies, 7 longitudinal studies, 5 case reports, 6 tool development studies, and 2 commentaries. In total, 42 assessment scales or guidelines were extracted, of which only 5 were available in Japanese. Of these, 25 had at least partial evidence of reliability and validity. Conclusions: Although numerous environmental assessment scales for older adults with dementia exist both in Japan and internationally, few have undergone rigorous validation. Moreover, there is a significant lack of scales available in the Japanese language.

Aim: This study aimed to elucidate the employment support experiences of individuals with early-onset dementia (EOD).Methods: Participant observation and interviews were conducted on individuals with EOD receiving continuous support for employment services – type B. Field notes and verbatim interview transcripts were analyzed using the micro-ethnography method. The Ethics Committee of the presenting institution approved the study.Results: The core category identified was "feeling unable to perform anything owing to dementia, replaced by an improved mood when attending the facility."The related categories began with "continuing to do what I can without causing trouble" and progressed to "reaching the facility without getting lost, thanks to the transportation service." Additional experiences included "informing family members and fellow users of my condition," "enjoying support and activities with other users," "engaging in favorite activities that I cannot do alone," and "facing my fears and trying things." Ultimately, these experiences culminated in "attending a safe place," "being trusted and finding meaning through cooking," and "willingly attending the facility despite worsening symptoms."Conclusion: The individual with early-onset dementia attended the facility without hesitation, engaged in meaningful activities, gained an understanding of her surroundings, and collaborated with other users. This experience gave her a sense of security and greater autonomy, expressing her desire to continue attending the facility.

Aim: We aimed to determine whether the Trail Making Test Part A (TMT-A) is a useful tool for predicting home discharge in patients with acute cerebral infarction.Methods: This was a retrospective observational study. The subjects were acute stroke patients. Logistic regression analysis was used to estimate the influence of the TMT-A on determining the home discharge. We created three models to predict home discharge. Age, NIHSS, BRS of the upper extremity, and number of people living with the patient in addition the MMSE-J was used for Model 1, the TMT-A for Model 2, and both for Model 3 as the cognitive assessment. NRI and IDI analyses were conducted to compare the predictive accuracy of each model for home discharge.Results: The analysis included 164 patients, and 119 were discharged home. Logistic regression analysis showed that the TMT-A influenced home discharge in a model that includes the TMT-A (Model 2: p = 0.009, Model 3: p = 0.024). NRI did not lead to an improvement in home discharge predictive accuracy. On the other hand, IDI showed that models containing TMT-A (Model 2 & 3)has significantly improved the prediction accuracy than a model that does not contain TMT-A (Model 1 vs Model 2: IDI = 0.034, p = 0.041; Model 1 vs Model 3: IDI = 0.033, p = 0.034).Conclusions: TMT-A helps predict discharge home in patients with acute cerebral infarction. The addition of TMT-A to the model for predicting home discharge may lead to an improvement in the accuracy of predicting home discharge.

Objective: The purpose of this study was examined the effect of shoe fit on static balance in older adults classified by risk of falls.Methods: fifty-six community-dwelling older women were classified "low fall risk group" and "high fall risk group" by open-eyed one-leg stand time. Stabilometry was used to measure static balance, and the locus length per unit time, rectangular area, and anteroposterior and mediolateral speeds were calculated. Shoe size was measured using a Brannock device, and three measurements were taken: foot length (from heel to toe), arch length (from heel to first metatarsophalangeal joint), and width (width of foot). The larger values of the indicated foot and arch lengths were determined to be the appropriate shoe lengths, and the value of the width was determined to be the appropriate shoe width. In cases wherein the shoe length and width differed between the left and right shoes, the larger value was used. Shoes were classified as either a "fit" or an "ill-fit" (when the length was 1.0 cm and the width was one size larger than compatible size). A two-way repeated-measures analysis of variance was used to analyze the effects of ill-fitting shoes on static balance.Results: A significant interaction between shoe fit and the risk of falls in the rectangular area (P = 0.012), mediolateral speeds (P = 0.032) was observed.Conclusions: The present study suggests that ill-fitting shoes affect static balance only among older adults at high risk of falls. Therefore, wearing fitted shoes may be important for fall prevention among older people at high risk of falls.

This study aimed to examine the construct-related validity of the Japanese version of The Health Enhancement Lifestyle Profile (HELP), in the hope of helping ensure a healthy lifestyle expectancy in Japan, a country with an aging population. Methods: A web-based survey was conducted using a prototype of the Japanese version of the HELP on a sample of 180 community-dwelling adults aged 55 years or older. Factor analysis (exploratory and confirmatory factor analysis) was performed to attest the construct validity of the Japanese version of the HELP. Results and Conclusions: The factor analysis results confirmed a 24-item, 6-factor structure. The confirmatory factor analysis results revealed a highly compatible factor structure with CMIN/DF = 1.435, CFI = 0.980, GFI = 0.949, and RMSEA = 0.049. The factor structure differed from the original version, which had seven factors. We will continue to examine the reliability, criterion-related validity, and responsiveness of the Japanese version of HELP in order to introduce it to the local community.

[Aim] This study aimed to clarify the current status and actual conditions of the community-based integrated care prevention services in Japan and to explore future research challenges. [Methods] A literature search was conducted using the Ichushi Web and CiNii databases, and screening was performed based on specific selection criteria. [Results] A total of 40 articles were finally selected. Of these, 9 studies included information related to diseases, 9 studies focused on activities and participation, and 6 studies involved rehabilitation professionals. [Conclusions] Since the amendment of the Long-Term Care Insurance Act in 2014, the promotion of preventive care with a focus on activity and participation, as well as the involvement of rehabilitation professionals, has been emphasized. However, the findings of this review revealed that only a limited number of studies have fully incorporated these perspectives. Further research is needed to enhance studies focusing on activities and participation and to explore the effective involvement of rehabilitation professionals.

【Aim】 The purpose of this study was to clarify the characteristics of medication management among community-dwelling older adults with subjective memory complaints (SMC) and to examine the association between SMC and medication management. 【Methods】 A total of 690 aged 65 years or older in the community cohort study in 2019 participated. Of these, 573 who met the inclusion criteria were analyzed. Participants were divided into two groups according to the presence or absence of SMC, and associations with medication management items were analyzed using Fisher's exact test for categorical variables and the unpaired t-test for continuous variables. In addition, binomial logistic regression analysis was conducted with SMC as the dependent variable and medication management items as the independent variables, adjusted for demographic variables. 【Results】 Among the community-dwelling older adults in this study, 206 were in the healthy group and 367 were in the SMC group. Covariate-adjusted binomial logistic regression analysis showed that "having residual medication" (OR: 1.62, 95% CI: 1.01 to 2.59, p = 0.04) and "depressive symptoms" (OR: 1.48, 95% CI: 1.20 to 1.69, p < 0.001) were significantly associated with SMC. 【Conclusion】 The characteristics of medication management among community-dwelling older adults with SMC were significantly associated with "residual medication". Understanding the presence or absence of residual medications from the SMC stage and taking measures to address the factors that led to residual medications may help reduce the burden of caregivers in managing medications.

Aim: Older adults with disabilities tend to engage in physical activity in a lying position rather than sitting or standing, which may affect the sleep quality and duration. This study examined the relationship between sleep quality, time, and total lying duration in older adults requiring support or care. Methods: We investigated the quality of sleep using Japanese version of the Athens Insomnia Scale (AIS-J) in 214 community-dwelling older adults who were certified as needing support or care and utilized a day rehabilitation facility. Additionally, we recorded the average daily sleep time and total lying time. The participants were divided into two groups based on the AIS-J cutoff value: less than 6 points or more than 6 points. Each index was then compared between the groups. Results: The results of two-way analysis of variance showed that total lying time was significantly higher than sleep time in both groups (p < 0.001). However, sleep time was significantly lower in the AIS-J ≥ 6 group compared to the AIS-J < 6 group. Furthermore, the AIS-J ≥ 6 group showed significantly higher total AIS-J scores for the bottom 8 items of AIS-J, and a greater difference between total lying time and sleep time compared to the AIS-J < 6 group (p < 0.01). Conclusions: Older adults with poor sleep quality have shorter sleep time and spend extended time in the lying position doing activities other than sleep. Reduced total lying time and increased time out of bed are important for improving the sleep quality and duration.

Objective: Local mobility is essential for promoting social participation and health among older adults, and it is a relevant area for occupational therapists (OTs). This study aimed to clarify the process of establishing a resident-led mobility support service using action research and to examine the evolving roles that OTs may fulfill in such initiatives. Methods: The study was conducted in Obuse, where the author supported the development of a resident-led mobility support service ("Ebesa no Kai") from October 2022 to August 2024. The process was organized chronologically, and the potential roles fulfilled by OTs were qualitatively examined based on free-text responses from a questionnaire administered to seven local government staff members. Results: Over the two-year period, the service was successfully established and implemented. The OT (i.e., the author) initially provided medical expertise but gradually shifted toward facilitating community-led decision-making and coordinating with municipal stakeholders. The OT functioned as a facilitator, fostering residents' autonomy, and eventually acted as a liaison between the community and administration, offering guidance for sustainable operation. The questionnaire responses highlighted the OT's contribution to fostering resident-led initiatives through coordination with administrative bodies. The roles were categorized into four domains: professional intervention, organizational coordination, academic support, and support for activity continuity and development. Conclusion: Resident-led mobility support requires a stepwise process and collaboration with local authorities. OTs played multifaceted roles as community enablers. These findings may inform similar initiatives in other communities and provide practice-based insights into the expanding role of occupational therapy in community development and mobility support.

Aim: Understanding the preferred way of life of people with dementia often relies on staff experience. This study aimed to identify the specific techniques that staff members use to elicit these preferences. Methods: An open-ended questionnaire was administered to 74 staff from three types of long-term care facilities in Japan who had previously participated in an intervention study. The survey asked staff to describe their techniques for conducting checklist-aided interviews about residents' preferred ways of life. Free-text data were analyzed using quantitative text mining, including co-occurrence network analysis, and qualitatively categorized. Results: Eight main categories and 15 subcategories were identified. The main categories were (1) creating situations to better understand an individual's words, (2) understanding life history, (3) inferring feelings from behavior and expressions, (4) casually asking in a person-centered manner, (5) understanding communication abilities and preferences, (6) asking concretely, (7) considering their physical condition and choosing a natural context, and (8) considering the environment. Conclusion: All identified techniques align with the process outlined in Japan's "Guidelines for Decision-Making Support for Persons with Dementia in Daily and Social Life." The systematized techniques used in this study provide a valuable framework for improving checklist-guided interviews and basis for subsequent staff reflections.

Aim: Although a decline in visual function can affect walking speed, the relationship between walking speed and visual acuity while walking remains unclear. We examined the associations of walking speed with static visual acuity and walking visual acuity under high- and low-contrast optotype conditions in older adults. Methods: Thirty community-dwelling older adults (74.6 ± 5.3 years) participated. After correcting refractive errors, static visual acuity was measured at 10 m with 100% and 25% contrast conditions. Walking visual acuity was measured while participants walked toward a stationary Landolt ring (decimal acuity 0.7, 5-m size) positioned 20 m ahead, calculated from the distance at which participants correctly identified the orientation of the target. Target contrast was the same as for static visual acuity. The walking speed was measured between the 3- and 13-m points (10 m) on the 16-m walking path. Differences in static and walking visual acuity between contrast conditions were analyzed using the Wilcoxon signed-rank test. Spearman's rank correlation coefficients were calculated between walking speed and visual acuity variables, and multiple regression analysis was performed for factors significantly correlated with walking speed. Results: Both static and walking visual acuity were significantly reduced under low-contrast conditions (p<0.001). Walking visual acuity under low-contrast conditions was associated with walking speed, but in multiple regression analysis with age as a covariate, only age remained a significant predictor (β=-0.627, p < 0.001). Conclusions: Among community-dwelling older adults, age was the primary factor associated with walking speed, whereas factors influencing walking visual acuity require further investigation.

BACKGROUND AND PURPOSE: In geriatric health services facilities (GHSFs), the rehabilitation occupations mainly shoulder the role of maintaining and improving function, but inpatients in GHSFs often have psychological problems such as depression and loneliness. Especially, loneliness is related to reduction in body function and activities of daily living, and it can become a factor which inhibits residents from returning home. In this case report, we assessed changes in loneliness as a result of engagement in group activities in a geriatric facility and evaluated the quality of the engagement in the activities provided.CASE: The patient was an 80-year-old woman of with left lower extremity paralysis caused by cardiogenic cerebral embolism. Group activity was carried out 2 times a week for 4 weeks in addition to the usual rehabilitation sessions 3 times a week. The reminiscence method was carried out in the first half of the group activity, and it was changed to work activity at the patient's request in the latter half. Loneliness was assessed before and after group activities; the Activity Engagement Scale was used during the activity, and the Three-Item Loneliness Scale (TIL) was used immediately after the activity.RESULTS: Although loneliness before and after group activities remained unchanged, TIL improved immediately after the activities. The engagement to activity improved over time, and the patient's desired work activity showed a tendency to more improve.CONCLUSION: Group activities in GHSFs may prevent worsening of or reduce loneliness immediately after implementation.

Aphasia is a major sequela of stroke, and while long-term rehabilitation can lead to functional improvement, continuing specialized support after discharge faces regional disparity challenges. This report presents a case where multidisciplinary collaboration between a part-time speech-language pathologist (SLP) and nursing/care staff at a small-scale multifunctional home nursing care facility without a full-time SLP contributed to improving practical communication abilities and reducing caregiver burden in a person with aphasia. The case involves a man in his 70s with crossed aphasia due to right putaminal hemorrhage who began using the facility after discharge. The part-time SLP provided monthly professional assessment and intervention while proposing and guiding training programs that nursing/care staff could implement. Approximately one year after onset, reassessment showed improvement in expressive language and acquisition of alternative communication methods using drawing, with the shortened Zarit Burden Interview score markedly improving from 8 to 2 points. This case suggests that even with limited regional resources, appropriate professional guidance and multidisciplinary collaboration through long-term intervention can contribute to improving the quality of life for both aphasia patients and their caregivers.