Objectives The aim of this study was to examine relations between malnutrition and social isolation among elderly residents of a city public housing facility.
Methods The present participants were 442 residents aged 65 and older of a public housing facility in Nagoya city. An anonymous self-administered questionnaire survey was conducted regarding demographics, nutritional status, and social isolation. Nutritional status was evaluated using the Mini Nutritional Assessment^®—Short Form (MNA^®). Combining “at risk for malnutrition” and “malnutrition,” the status was classified into two groups: “normal nutrition” and “at risk for malnutrition.” Social isolation was examined using the Japanese version of the abbreviated Lubben Social Network Scale (LSNS–6), which was divided into isolation (less than 12 points) and non-isolation (more than 12 points). Multivariate logistic regression analyses were conducted to assess association between malnutrition and isolation by adjusting for the following possible confounders: age, sex, living alone, self-rated economic conditions, housebound, loneliness, eligible for Long-Term Care Insurance, and the Tokyo Metropolitan Institute of Gerontology (TMIG) Index of Competence.
Results Among 343 respondents (77.6%), the number of valid responses was 288 (65.2%)—121 men and 167 women. The average age was 74.7±6.1 years old (mean±standard deviation), ranging from 65 to 98. Based on the LSNS–6, social isolation was encountered in 44.1%. According to the MNA^® classification, 171 (59.4%) were classified as “normal nutritional status,” 108 (37.5%) as “at risk for malnutrition,” and 9 (3.1%) as “malnutrition.” “At risk for malnutrition” and “malnutrition” were found in 40.6% in this study. Multivariate logistic analyses showed that risk factors for malnutrition were social isolation (OR=2.52, 95% CI; 1.44–4.41) and poor economic conditions (OR=1.98, 95% CI; 1.15–3.41). Significant interaction between age and living alone suggested that elderly individuals over 75 years of age who live alone were also at risk for malnutrition.
Conclusion This study revealed that malnutrition of elderly individuals was associated with social isolation and poor economic conditions as well as age over 75 and living alone. Malnutrition and social isolation can be prevalent in elderly residents of city public housing facilities. Measures of social isolation as well as nutritional support are necessary for health promotion and preventive care of the elderly.

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Objectives Although factors associated with falls might differ between men and women, no large-scale studies were conducted to examine the sex difference of risk factors for falls in Japanese elderly. The purpose of this study was to examine fall risk factors and sex differences among community-dwelling elderly individuals using a complete survey of the geriatric population in Kameoka city.
Methods A self-administered questionnaire survey was conducted with 18,231 community-dwelling elderly individuals aged 65 years or over in Kameoka city, Kyoto Prefecture, between July and August 2011, excluding people who were publicly certified with a long-term care need of grade 3 or higher. The questionnaire was individually distributed and collected via mail. Out of 12,159 responders (recovery rate of 72.2%), we analyzed the data of 12,054 elderly individuals who were not certified as having long-term care needs. The questionnaire was composed of basic attributes, a simple screening test for fall risk, the Kihon Check List with 25 items, and the Tokyo Metropolitan Institute of Gerontology (TMIG) index of competence with 13 items. These items were grouped into nine factors: motor function, malnutrition, oral function, houseboundness, forgetfulness, depression, Instrumental Activity of Daily Living (IADL), intellectual activities, and social role.
Results Of all the respondents, 20.8% experienced falls within the last year, and 26.6% were classified as having high fall risk. Fall risk increased with age in both sexes, and risk in all age groups was higher for women than for men. All factors were significantly associated with fall risk in both sexes. After controlling for these factors, a significant relationship was found between fall risk and motor function, malnutrition, oral function, forgetfulness, depression, and IADL in men and motor function, oral function, forgetfulness, depression, and IADL in women. The deterioration of motor function was associated with three-times-higher risk than non-deterioration of motor function. In addition, significant interaction was found in sex×malnutrition, oral function, IADL, and intellectual activities; malnutrition and low oral function were stronger factors in men than in women; and IADL and intellectual activities were stronger factors in women than in men.
Conclusion One in five community-dwelling independent elderly individuals experienced falls in the last year, and one in four had high fall risk. We found a significant relationship between fall risk and the nine factors, particularly deterioration of motor function in both sexes. Sex difference was observed for fall risk factors; therefore, a sex-specific support policy for fall prevention is necessary.

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Objectives Although the national lifestyle modification project targeting metabolic syndrome in the general population conducted by the Japanese government started in 2008, the project's long-term effects have not yet been evaluated. Associations of taking the project's lifestyle modification guidance with improvement of parameters related to metabolic syndrome after 1, 2, 3, and 4 years were assessed in participants who met the metabolic syndrome criteria for the guidance.
Methods While improvement was defined when the parameters had met the criteria for metabolic syndrome at the initial checkup but did not at the time of evaluation without medication, deterioration was defined when they had not met the criteria at the initial checkup but, at the time of evaluation, they did or the subjects received the medication. Logistic regression analyses were used to evaluate improvement by the guidance adjusted for age, sex, systolic blood pressure, HDL cholesterol level, and hemoglobin (Hb)A1c level at baseline.
Results From 2008 to 2011, 3742 participants (mean age 61±10 years, men 62%) met the criteria for the lifestyle modification guidance. Numbers of participants eligible for evaluation were 2690, 1894, 1330, and 779 at 1, 2, 3, and 4 years after the initial checkup, respectively. Based on the multivariate logistic regression analyses, receiving the guidance was significantly associated with improvement of body mass index (BMI) (odds ratio (OR)=1.66, 95% confidence interval (CI)=1.17–2.37), waist (OR=1.77, 95%CI=1.35–2.31), and HbA1c (OR=1.82, 95%CI=1.05–3.13) at the 1-year evaluation; improvement of BMI (OR=1.51, 95%CI=1.01–2.26) and waist (OR=1.61, 95%CI=1.18–2.20) at the 2-year evaluation; and improvement of waist (OR=1.67, 95%CI=1.12–2.48) at the 3-year evaluation. However, BMI, waist, and HbA1c at other evaluations including the 4-year evaluation and the remaining parameters at any evaluations were not significantly improved by the guidance. In addition, receiving the guidance was significantly associated with deterioration of HbA1c at the 4-year evaluation (OR=2.49, 95%CI=1.18–5.24).
Conclusion Although HbA1c at the 1-year evaluation and parameters related to overweight were improved at the 1-, 2-, and 3-year evaluations, no parameters of metabolic syndrome were significantly improved by the guidance at the 4-year evaluation.

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Objectives To verify if elderly individuals care can live in familiar places, the authors study cases elderly individuals needing nursing care and moving away from their areas.
Methods A depopulated area where low birthrate and aging is preceding was selected for the study. Participants were elderly individuals who received “certification of need” and moved away from their areas in the five years since April, 2008. We collected the participants’ characteristics, degrees of needing care, utilization of care service, and where they moved to. Further, we performed a hearing survey for a home care support center to determine the status of caregivers and care before moving, where they moved to, and how and why they moved, and we analyzed the reasons. Further, we discovered where they lived and their care service as of the end of August, 2013, and analyzed how they lived after moving.
Results The number of elderly individuals in need of care with “certification of need” who moved out of the town was 74. The percentage of later-stage elderly individuals was 89.2%, and 70.3% of them were women. One-person households were the most common with 47.3%, and small families with less than two family members made up over 70%. Main caregivers before moving out were family members or relatives living with them (35.1%), those not living with them (10.8%), and helpers or care staff members (33.8%). The percentage of elderly individuals who utilized ambulatory and attendant care services before moving out was 79.7%. The service use was high for ambulatory and attendant care. Those who moved to live in facilities out of town made up 73.0%. The result revealed that 58.1% of elderly individuals who moved lived in special elderly nursing homes out of town as of the end of August, 2013.
Conclusion Over 70% of the elderly individuals who moved are from small families having less than two family members. Therefore, the fact that they have care limitations serves as the background for their moving; 79.7% of the elderly individuals who moved utilized ambulatory and attendant care. Further, we found that 75.7% of them moved to nursing facilities, and those who lived in nursing facilities moved to special elderly nursing homes out of town and were away from Town A.

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