Koki Kawamura

Key summary points AbstractSection Aim To examine the clinical characteristics of Japanese older adults with heart failure (HF) diagnosed with sarcopenia using the Asian Working Group for Sarcopenia 2025 (AWGS 2025) criteria. AbstractSection Findings Sarcopenia, as defined by the AWGS 2025 criteria, was highly prevalent in Japanese older adults with HF and was significantly associated with an increased risk of all-cause and cardiovascular mortality, regardless of the skeletal muscle mass adjustment method used. AbstractSection Message Older patients with HF have a high prevalence of sarcopenia, and sarcopenia, as defined by the AWGS 2025 criteria, is associated with an increased mortality risk.

Introduction: Depressive moods can lead to a decline in physical function and the development of dementia, resulting in negative outcomes such as the need for long-term care and increased mortality. Similarly, oral frailty highlights the relationship between aging and oral health issues. Depressive moods and oral frailty contribute to the detrimental cycle of frailty and significantly affect the overall health of older adults. Early assessment of these problems and the implementation of appropriate interventions may help prevent and mitigate functional decline. However, the relationship between these two factors in older outpatients has not been sufficiently investigated. We hypothesized that a higher percentage of patients with oral frailty in a medical outpatient clinic would experience depressive moods and aimed to investigate the relationship between these two factors. Methods: This was a cross-sectional study. Patients aged ≥65 years who visited a frailty outpatient clinic were included in this study. Depressive moods were assessed using the Geriatric Depression Scale-15 (GDS-15). Oral frailty was assessed using the Oral Frailty Five-item Checklist (OF-5). The associations between depressive moods (GDS-15 ≥5), oral frailty (OF-5 ≥2), and OF-5 sub-items were analyzed using the chi-square test and logistic regression analysis. Results: A total of 337 patients (mean age: 78.4 ± 6.4 years old) were included. Of these, 126 (37%) had depressive moods, and 168 (50%) had oral frailty. A significantly higher proportion of patients with depressive moods had oral dysfunction, including chewing ability, swallowing function, and dryness, as well as oral frailty. The logistic regression analysis showed that oral frailty was associated with depressive moods with an adjusted odds ratio of 2.13 (95% confidence interval: 1.27–3.55). Conclusion: There was an association between depressive moods and oral frailty. In addition, a relationship between depressive moods and subjective oral dysfunction, such as chewing ability and dryness, was observed. A longitudinal study is required to address the causal effects of oral frailty on depressive moods.

Key summary points AbstractSection Aim This study aimed to determine whether low physical function and muscle mass are valuable for predicting falls within one year in older patients who visited an outpatient clinic for frailty. AbstractSection Findings The main finding was that either 5CS ≥ 12 s or UGS < 1.0 m/s was significantly associated with falls within one year, and those with a 5CS of 12 s or more or a UGS of less than 1.0 m/s had OR for falls within one year of the initial visit of 2.07 and 1.68 times, respectively. AbstractSection Message Early referral to specialists and fall prevention measures, such as exercise instructions, assistive devices, and adjustments to the living environment, are considered necessary in the outpatient clinic for frailty.

Purpose Falls in older adults increase the risk of mortality and hospitalization, particularly when physical function is low. This study aimed to determine whether low physical function and muscle mass, are also valuable for predicting falls within one year in older patients who visited an outpatient clinic for frailty.Methods This prospective cohort study analyzed the registry data of 624 outpatients aged > 65 years (mean age: 77.9 ± 6.0 years; female 368, male 256). The endpoint was the incidence of falls within one year. These included the five-chair standing test (5CS), usual gait speed, short physical performance battery, handgrip strength, and skeletal muscle mass index. All of these tests were performed during the first clinic appointment. The question about fall history was asked one year after the examination, and the history of falls during the period of one year from the date of the examination. We analyzed the relationship between whether these assessments were below the cutoff values and falls within one year using multiple logistic regression analysis.Results A total of 154 (25%) patients fell within one year. Those with a low result on the 5CS or usual gait speed had significantly higher rates of falls within one year, even after adjustment for covariates, with odds ratios [95% confidence interval] of 2.07 [1.37–3.13] and 1.68 [1.09–2.60], respectively.Conclusion Low physical function, particularly in the lower limbs, was associated with near-term fall risk. The 5CS is helpful in fall risk assessment.

Objective: This study aimed to investigate the relationship between falls and cognitive and balance problems in patients. Methods: This retrospective observational study analyzed the medical records of 1010 older patients admitted to a convalescent rehabilitation ward. The primary endpoint was fall occurrence during ward stays. The main outcomes were the Mini-Mental State Examination (MMSE) and Standing Test for Imbalance and Disequilibrium (SIDE), with patients divided into groups of MMSE ≥28 and <28 and SIDE ≥2b and <2b. Results: During ward stays, 220 patients (22%) fell. Estimating the fall risk of the MMSE ≥28 + SIDE ≥2b group compared to that of other groups revealed that only the MMSE <28 + SIDE <2b group had a significantly higher fall risk, with a hazard ratio [95% confidence interval] of 3.13 [1.51–6.46]. Conclusion: Combined MMSE and SIDE assessment at ward admission facilitated the easy identification of individuals at high fall risk.

In this study, we assessed the physical burden on professional caregivers when using a transfer support robot, "Hug," to transfer and move a care recipient. We compared heart rate (HR), heart rate variability (HRV), and the time-series synchronization between HRV and respiration in caregivers using the robot or a normal wheelchair as control. Under both conditions, a commercial wearable device was used to simultaneously obtain electrocardiogram and respiration signals while performing care tasks, which comprised transfer from a bed to a wheelchair or to the robot, movement to a remote location, and transfer to a chair. We found that HR was significantly higher and HRV and wavelet coherence were significantly lower in the control than with Hug during at least the first 30 seconds of rest after the task (p < 0.05). This suggests that Hug could reduce the increase in HR and thereby maintain a more constant rhythm between HRV and respiration during care tasks. A post-task questionnaire also revealed that caregivers felt the physical burden of the tasks was reduced using Hug. Our results suggest that the introduction of transfer support robots can reduce the physical burden for caregivers of daily transfer assistance tasks.

Background: Oral and social problems can exacerbate long‐term care. Understanding the relationship between social aspects and oral hypofunction can help identify high‐risk factors for long‐term care.Objective: This study aimed to investigate the social aspects of oral hypofunction among medical outpatients.Methods: This retrospective cross‐sectional study included patients who visited an outpatient clinic for frailty. The oral function was assessed using seven items: oral hygiene, occlusal force, masticatory function, tongue‐lip motor function, tongue pressure, oral dryness and swallowing function. Participants with three or more functional declines were classified as having ‘oral hypofunction’. Social aspects were assessed using 21 items in four categories: general resources, basic social needs, social resources and social behaviours/activities. We analysed the relationship between oral hypofunction and each social aspect.Results: A total of 316 participants (age 78.5 ± 6.4 years) were included, and 128 (41%) had oral hypofunction. Participants with oral hypofunction were significantly more likely to have limited education, require long‐term care, not use transportation, depend on others for shopping, not participate in events, lack association membership and not engage in charity or volunteer work. After logistic regression analysis, ‘long‐term care’ and ‘no association membership’ remained significantly associated with oral hypofunction (odds ratios 2.3, 2.3; 95% CI 1.1–5.0, 1.1–4.7, respectively).Conclusion: Participants with oral hypofunction faced challenges in ‘general resources’ and ‘social behaviour/activities’, which were linked to oral function issues. Future longitudinal studies are necessary to further investigate this relationship.