Aim This study aimed to clarify the association between frailty and changes in lifestyle and physical or psychological conditions among community‐dwelling older adults affected by the coronavirus disease 2019 countermeasures in Japan. Methods This cross‐sectional study was carried out between 8 May and 12 June 2020 in Japan. Self‐reported questionnaires were distributed among 1353 older adults. To assess frailty, we used the frailty screening index. To assess changes in lifestyle and physical or psychological conditions, we developed the Questionnaire for Change of Life (QCL), which comprised five items related to frailty. Cronbach's α was calculated as a measure of internal consistency of QCL. We compared the score for each item in the QCL between the frailty and non‐frailty groups. Multiple logistic regression analysis was used to show the factors that affect frailty status. Results In total, 856 older adults (63.3%) were analyzed. A total of 83 participants (9.7%) had frailty, and 755 participants (90.3%) had non‐frailty. Cronbach's α for QCL was 0.552. We observed a significant decrease in daily movement, leg muscle strength and meal size among older adults with frailty compared with non‐frailty ( P < 0.001). Subjective leg muscle strength (odds ratio 3.257, 95% confidence interval 2.236–4.746) was negatively correlated with frailty. Conclusions We suggest that each individual QCL item should be used in analyses involving the QCL. This report showed that subjective lifestyle changes affected by the coronavirus disease 2019 countermeasures were associated with frailty status. In particular, as older adults were aware of a decrease in their leg muscle strength, they were significantly more frail. Geriatr Gerontol Int 2020; ••: ••–•• .

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Key summary points Aim This study aimed to clarify the actual frail status over 6 months with the COVID-19 countermeasures based on a prospective cohort study. Findings Pre-frailty and frailty prevalences among Japanese community-dwelling, older adults were 55.0 and 7.9% at the baseline, and 57.3 and 11.8% at the follow-up respectively. Frailty over the 6 months could be predicted by increasing age and multimorbidity during the COVID-19 pandemic. Message We should prevent frailty affected by the implementation of COVID-19 countermeasures.

IntroductionLocal activities that functioned to prevent frailty in the elderly have been suspended or reduced as a countermeasure against COVID-19. As a result, frailty rates are expected to increase, and frailty is expected to worsen as a secondary problem associated with COVID-19 countermeasures. Therefore, this study aims to determine the extent of frailty in the elderly associated with lifestyle changes implemented as COVID-19 countermeasures, to ascertain actual lifestyle changes and clarify the existence of Corona-Frailty. We will also conduct Corona-Frailty screening to verify the effect of support provided as feedback to supporters of the elderly.Methods and analysisThe survey target area is Takasaki City, Gunma Prefecture, Japan. Phase I aims to verify the short-term effects of COVID-19. A questionnaire will be distributed to 465 community-dwelling elderly people, and responses will be obtained by post. Frailty will be evaluated using the Frailty Screening Index. Respondents who are frail and have had many changes in their lifestyle will be screened as high-risk people, and feedback will be provided to local supporters. The aim of Phase II will be to verify the long-term effects of COVID-19 and the effect of screening. A similar survey will be distributed twice after the first survey, once after 6 months and again after 1 year and the frailty rate will be tested. Furthermore, out of the subjects identified with frailty in Phase I, the progress of those who were screened and those who were not screened will be compared between groups.Ethics and disseminationThis study has been approved by the Research Ethics Committee of the Takasaki University of Health and Welfare (approval number: 2009). The results of this study will be reported to the policymaker, presented at academic conferences and published in peer-reviewed journals.Trial registration numberUMIN000040335.

The BIOMED-2 PCR protocol for targeting the IGH gene is widely employed for detecting clonality in B-cell malignancies. Unfortunately, the detection of clonality with this method is not very sensitive when paraffin sections are used as a DNA source. To increase the sensitivity, we devised a semi-nested modification of a JH consensus primer. The clonality detection rates of three assays were compared: the standard BIOMED-2, BIOMED-2 assay followed by BIOMED-2 re-amplification, and BIOMED-2 assay followed by semi-nested BIOMED-2. We tested more than 100 cases using paraffin-embedded tissues of various B-cell lymphomas, and found that the clonality detection rates with the above three assays were 63.9%, 79.6%, and 88.0%, respectively. While BIOMED-2 re-amplification was significantly more sensitive than the standard BIOMED-2, the semi-nested BIOMED-2 was significantly more sensitive than both the standard BIOMED-2 and BIOMED-2 re-amplification. An increase in sensitivity was observed in all lymphoma subtypes examined. In conclusion, tumor clonality may be detected in nearly 90% of B-cell lymphoma cases with semi-nested BIOMED-2. This ancillary assay may be useful when the standard BIOMED-2 fails to detect clonality in histopathologically suspected B-cell lymphomas.

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Abstract.[Introduction] Local hypoxia plays a favorable role in muscle regeneration. [Subjects and Methods] The effect of hypoxia on cell growth, differentiation, and motility was examined in differentiating and growing C2C12 mouse myoblasts cells, respectively.[Results] Hypoxia induced growth suppression in the growth phase, but the suppression diminished in the differentiation phase. Hypoxia inhibited the expression of differentiation marker proteins, accompanying MyoD mRNA suppression. Expression of HIF-1α protein was induced only in the induction phase, regardless of oxygen concentration. Hypoxia did not alter motile activity in the growing phase, but augmented the motile property in the differentiation phase. Expression of autocrine motility factor mRNA was augmented under hypoxic conditions. [Conclusion] In differentiating cells, HIF-1α induced by myogenic differentiation may compensate for the cell growth suppression due to hypoxia, and support the motility augmentation. Hypoxia may shift differentiating cells into the growth phase which provides the ability to translocate to an appropriate area.

Introduction Because of the countermeasures to prevent the spread of coronavirus disease 2019 (COVID-19) in Japan, it is easy to predict that the suspension of local activities and changes in lifestyle that lead to decreased activity will result in increased frailty and prefrailty rates in older adults. Objective To clarify the actual frailty conditions and lifestyle changes among community-dwelling older adults affected by COVID-19 countermeasures in Japan. Methods This cross-sectional study was conducted between May 8 and June 12, 2020. Self-reported questionnaires were distributed to 1,078 older adults aged ≥65 years. We used the frailty screening index to assess frailty status and developed the Questionnaire for Change of Life (QCL) to assess lifestyle changes, the amount of daily movement, leg muscle strength, meal size, worry or anxiety, and opportunities to talk to people. The differences in prevalence rates of frailty, prefrailty, and robustness between this study and the reference based on the Japanese meta-analysis were verified using the chi-square goodness of fit test. We compared each of the QCL results among the frailty, prefrailty, and robust groups using Fisher’s exact test. Results Of 680 older adults (63.1%) analyzed, 60 (8.8%) had frailty and 354 (52.1%) had prefrailty. There was a significant difference between the observed and expected prevalence based on the reference (p = 0.018). The frailty status was significantly associated with lifestyle changes. In participants with frailty, the amount of daily movement, leg muscle strength, and meal size significantly decreased (p < 0.001), whereas worry or anxiety significantly increased (p = 0.040). In contrast, regardless of the frailty status, opportunities to talk to people decreased. Conclusion The prevalence of frailty and prefrailty might have increased due to the effects of COVID-19 countermeasures. Moreover, the lifestyle of community-dwelling older adults affected by COVID-19 countermeasures has changed. Lifestyle changes were more pronounced among older adults with frailty.