The MoCA-J could be a useful cognitive test for screening MCI, and could be recommended in a primary clinical setting and for geriatric health screening in the community.

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The JST-IC is useful for assessing competence at a higher level in community-dwelling older adults.

ABSTRACT:Previous studies have shown that low serum 25-hydroxyvitamin D [25(OH)D] level is a risk factor for falls among the elderly in European and North American populations. We used a cross-sectional community-based survey to study the association of serum 25(OH)D level and falls among Japanese community-dwelling elderly. A total of 2957 elderly persons (950 men and 2007 women) 65-92 yr of age who participated in mass health examinations for the prevention of geriatric syndrome for the elderly underwent an interview, blood analysis, and physical performance testing. Experience of falls over the previous year was assessed in an interview. Physical performance tests of handgrip strength, stork standing time with the eyes open, and normal waking speed as risk factors for falls among the elderly were conducted. Serum albumin and 25(OH)D concentrations were analyzed. Mean 25(OH)D concentration was significantly lower in women than in men (p < 0.001). Women showed a significant decline of 25(OH)D level with increased age (p < 0.001). There was also a significant difference in the prevalence of 25(OH)D insufficiency [25(OH)D level < 20 ng/ml] between the sexes (p < 0.001). The rate of falls was significantly higher in the lowest quartile of 25(OH)D level in women (p ‫ס‬ 0.02) and in women with 25(OH)D insufficiency (p ‫ס‬ 0.001). Women also showed significant declines in all three fall-related physical performance tests. Multiple logistic regression analysis showed significant and independent associations between 25(OH)D level and experience of falls in women only (p ‫ס‬ 0.01). Low 25(OH)D level was significantly associated with a high prevalence of falls in Japanese elderly women because of their inferior physical performance. Low serum 25(OH)D levels appear preventable and easily treated; there is an evident need for greater awareness to screen and thus prevent this condition.

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Improvement in the health of older people and changes in their lifestyles necessitate a scale that can better measure their competence at a higher level. This study describes the development process of the Japan Science and Technology Agency Index of Competence (JST-IC) by (a) refining conceptual definitions and developing preliminary items and (b) examining the basic properties of the items. Participants were 1,253 septuagenarians (539 men and 714 women) living in communities, who were asked to judge whether they were independent via 88 items. To examine the basic properties of the preliminary items, five different analyses were conducted. Thirty-four items were considered as inappropriate (6 overlapped between the analyses): (a) 9 due to very high or low ratios of responders who answered “yes,” (b) 4 due to gender or regional differences, (c) 5 due to their weak association with health status, (d) 9 due to low communalities in factor analysis, and (e) 13 due to redundancy of meaning with other items. Conceptual definitions and preliminary items were developed, and the basic properties of the items were examined to create the JST-IC. The next step would be to screen the remaining 54 items to create the final version of the scale.

Our study found an independent relationship between depression status and longitudinal change in functional capacity among community-dwelling older individuals, suggesting that depression status is a reliable predictor of functional decline (both of BADL decline and higher-level competence decline) in older adults.