Daisuke Higuchi

Social capital is a fundamental social determinant of health for older adults in rapidly aging societies; however, existing comprehensive instruments often impose high cognitive friction through complex recall tasks, potentially leading to systematically excluding vulnerable populations. This study validated the factor structure of the Fujisawa Social Capital Scale (FSCS) - an independent, brief tool designed for inclusive community-based practice - among community-dwelling Japanese older adults participating in "Kayoi-no-ba" (neighborhood social participation hubs). Data were analyzed from 587 participants in the Gunma Aging Cohort (mean age 79.2 ± 6.0 years; 87.1% female; 29.6% living alone). Exploratory factor analysis using the Weighted Least Squares Mean- and Variance-adjusted estimator was prioritized to ensure statistical stability for this specific cohort. A robust two-factor structure emerged: Factor 1, "Sense of Security and Attachment to the Community," and Factor 2, "Mutual Aid Among Neighbors." These findings underscore the conceptual distinction between psychological belonging and functional support within community settings. The model demonstrated favorable fit indices, with a Root Mean Square Error of Approximation of 0.071 and a Tucker-Lewis Index of 0.96. High internal consistency was confirmed using McDonald's omega (ω) for the total scale (ωt = 0.85), Factor 1 (ω = 0.77), and Factor 2 (ω = 0.74). Overall, these results indicate that the FSCS is a "practice-first" instrument that minimizes respondent burden while maintaining data reliability. By distinguishing psychological attachment from functional support, it provides a "common language" for interdisciplinary teams to guide social prescribing and prioritize targeted community-based support for socially vulnerable older adults.

Lumbar spinal stenosis (LSS) affects approximately 103 million people worldwide, particularly in the aging population.1 Although surgical intervention is indicated when conservative therapy is inef...

Subjective cognitive decline (SCD) is a self-perceived deterioration in cognitive function and has been linked to both cognitive and physical decline. This study aimed to examine whether persistent SCD is associated with frailty after 3 years. A longitudinal cohort study using mailed questionnaires was conducted among community-dwelling older adults in Japan. Questionnaires were distributed at baseline, 6 months, and 3 years, assessing subjective cognitive complaints and frailty using validated screening tool. Sociodemographic and health related data were also collected. Participants who responded at all three time points and remained traceable throughout the study were included. Participants were divided into persistent SCD (consistently complaining of SCD for six months) and non-persistent SCD (had no complaint or complained intermittently) groups. Multiple regression analysis was employed to examine the association between frailty three years later and persistent SCD. In total, 268 participants were included in the analysis: 38 (14.2%) and 230 (85.8%) in the persistent and non-persistent (180 (67.2%) had no complaint and 50 (18.6%) complained intermittently) SCD groups, respectively. Multiple logistic regression analysis showed that persistent SCD was associated with frailty after 3 years, even after adjusting for age, sex, comorbidity, cohabitants, and frailty status at baseline (OR = 3.13, 95% CI: 1.25–7.79). Persistence of SCD over 6 months was significantly associated with frailty after 3 years. Our findings suggest that persistent SCD may contribute to frailty progression through psychological factors, particularly depression or anxiety, thereby highlighting the importance of early intervention and targeted support for individuals with SCD.

This study aimed to identify the characteristics of community-dwelling older people who are difficult to reach by mail survey in anticipation of a future infectious disease crisis. A baseline survey of 1808 community-dwelling older people was conducted in May 2021, and a follow-up survey of 935 respondents was conducted in May 2023. Factors predictive of responding to the follow-up survey included age at baseline, sex, comorbidities, living with family, long-term care insurance, a history of falls, the Simple Frailty Index, and a Questionnaire on Changes in Lifestyle in the Past Month (QCL). Participants were divided into the responding (n = 330) and non-responding (n = 605) groups. Binomial logistic regression analysis was used to analyze items that showed significant differences in the between-group comparison: odds ratios (ORs) of 2.36, 1.84, 1.69, 1.57, and 1.20 for living alone, having comorbidities, having long-term care insurance, fatigue, and reduced ability to communicate, respectively. If social distancing is required in the future, we believe that face-to-face support should be prioritized for people who live alone, have comorbidities, use long-term care insurance, or are aware of fatigue and limited communication, as it is highly unlikely that they will be able to continue exchanging written information.

[Purpose] The present study aimed to validate the heart rate of the consumer-level wearable device Fitbit Inspire 3. [Participants and Methods] Participants were 22 healthy university students (20.9 ± 0.6 years, 11 males and 11 females). They performed 5-minute resting lying, sitting, walking (3.2 km/h, 4.2 km/h, 6.0 km/h and 3.2 km/h with 3 kg backpack) and running (8.4 km/h running) on a treadmill, and stair climbing, with Fitbit- and electrocardiogram-based heart rate (Fitbit-HR and ECG-HR). The relationship between Fitbit-HR and ECG-HR was evaluated using a generalized linear mixed model. Additionally, Brandt–Altman analysis and absolute percentage error were used to examine the measurement error. [Results] Fitbit-HR was strongly associated with ECG-HR and oxygen uptake. In the Brandt–Altman analysis with Fitbit-HR and reference ECG-HR, most plots were within the limit of agreement. Fitbit-HR showed significant fixed errors, which were, on average, three beats smaller than those of ECG-HR. No significant proportional errors are observed. The mean absolute percentage error for most of the tasks was less than 10%. [Conclusion] The Fitbit Inspire 3 showed a strong correlation and clinically acceptable agreement with ECG-HR in healthy young adults, despite a small, consistent underestimation. Its validity was supported by its association with oxygen uptake.

This study aimed to test the hypothesis that knowledge derived from indirect assessments can be used to identify fall risk factors during a period of social distancing. A baseline survey of 1953 community-dwelling older adults was conducted in May 2020, with a follow-up survey performed in May 2023 to assess the situation 3 years later. In total, 339 individuals were followed from baseline to follow-up. Baseline age, sex, Questionnaire for Change of Life, Frailty Screening Index, and Questionnaire for Medical Checkup of Old-Old (QMCOO) scores and subscales were used to determine fall predictors. In addition, history of falls in the past year was assessed at follow-up (outcome). The participants were categorized into fall (n = 78) and non-fall (n = 261) groups. Using binary logistic regression analysis, items that showed significant differences in a between-group comparison were analyzed, and age and history of falls, which were sub-items of the QMCOO, were identified as predictors of falls. Although special assessments may be required during periods of social distancing, we believe that it is important for these assessments to continue being performed as they are performed during normal times.

Objective: To determine the association between health-related quality of life (HRQOL) and neck pain, kinesiophobia, and modalities of physical activity in individuals with postoperative degenerative cervical myelopathy and radiculopathy (DCM/R) because postoperative pain after cervical spine surgery is likely to persist, causing kinesiophobia and avoidance of physical activity.Methods: A questionnaire was distributed to 280 individuals with DCM/R. The questionnaire comprised the following four items: HRQOL (EuroQol 5-dimensions 5-level), neck pain (numerical rating scale [NRS]), kinesiophobia (11-item Tampa Scale for Kinesiophobia [TSK-11]), and physical activity (paid work, light exercise, walking, strength training, and gardening). Hierarchical multiple regression analysis was performed using the NRS, TSK-11, and physical activity as independent variables.Results: In total, 126 individuals provided analyzable responses (45.0%). After including the NRS score as an independent variable to the multiple regression equation for participants’ background, the independent rate of the regression equation significantly improved by only 4.1% (R2=0.153). The addition of the TSK-11 score significantly improved this effect by 11.1% (R2=0.264). Finally, the addition of physical activity also significantly improved the explanatory rate by 9.9% (R2=0.363).Conclusion: Neck pain, kinesiophobia, and physical activity (specifically paid work and walking) were independently associated with HRQOL in individuals with postoperative DCM/R.

The frequency of falls increases with age. In Japan, the population is aging rapidly, and fall prevention measures are an urgent issue. However, assessing fall risk during the coronavirus disease pandemic was complicated by the social distancing measures implemented to prevent the disease, while traditional assessments that involve actual measurements are complicated. This prospective cohort study predicted the risk of falls in community-dwelling older adults using an assessment method that does not require actual measurements. A survey was conducted among 434 community-dwelling older adults to obtain data regarding baseline attributes (age, sex, living with family, use of long-term care insurance, and multimorbidity), Frailty Screening Index (FSI) score, and Questionnaire for Medical Checkup of Old-Old (QMCOO) score. The participants were categorized into fall (n = 78) and non-fall (n = 356) groups. The binomial logistic regression analysis showed that it is better to focus on the QMCOO sub-item score, which focuses on multiple factors. The items significantly associated with falls were Q5 (odds ratio [OR] 1.95), Q8 (OR 2.33), and Q10 (OR 3.68). Our results were similar to common risk factors for falls in normal times. During the pandemic, being able to gauge the risk factors for falls without actually measuring them was important.

Background: Low-friction slide sheets (SS) are designed to reduce compression loads on the body during manual handling tasks, such as boosting patients. Using SS has been shown to decrease muscle activity in the lower back and upper extremities. However, it is unclear if this effect varies with different bed positions. To investigate this, we studied the effects of SS use, bed height, and their combination on muscle activity during a simulated patient boost. Methods: Thirty-three Japanese undergraduate students (age 21.0 ± 1.1 years; 14 men, 19 women) participated. Participants were asked to boost a dummy figure on the bed three times each using four conditions. During the repositioning task, electromyography of eight muscles of the lower back and upper and lower extremities, hip and knee joint flexion angles, pelvic forward tilt angle, and position of the center of mass based on the posterior superior iliac spine were evaluated. Findings: Electrophysiological activities of muscles of lower back and upper extremities were significantly lower with SS than without it in both bed positions (30% and 40% of body height); the reduction in muscle activities with SS use was 20% to 40%. Lowering the bed did not affect the SS effect magnitude on reducing muscle activities, although postural changes, including hip and knee joint flexion, were observed. Conclusions/Application to Practice: SS reduced muscle activities in the back, upper, and lower extremities when the bed was in the low position, and this effect persisted at a bed height of ≥30% of the participant’s height.