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Aim Frailty is a predictor of several adverse health outcomes in older adults. However, the relationship between preadmission frailty status and the incidence of dependency after discharge in hospitalized older patients remains unclear. The aim of the present study was to determine whether preadmission frailty status can predict dependency after discharge among hospitalized older patients. Methods We analyzed the cohort data for hospitalized older patients (aged ≥65 years) with internal medical problems obtained from a prospective study. The main outcome was the incidence of dependency from admission to a month after discharge. The frailty status was assessed using the Kihon Checklist. We defined scores of ≥8 as frail, 4–7 as pre‐frail and 0–3 as robust. The Cox proportional hazards regression model was used to estimate the hazard ratios and confidence intervals of the relationships between preadmission frailty status and the incidence of dependency. Results A total of 151 participants who completed follow ups were analyzed (mean age 77.2 years [SD 6.9 years]). The prevalence of frailty, pre‐frailty and robust was 22.5%, 37.8% and 39.7%, respectively. During the follow‐up period, 39 participants (25.8%) had an incidence of dependency. Participants with frailty (adjusted hazard ratio 4.29, 95% confidence interval 1.72–10.69) had a significantly elevated incidence of dependency compared with that of robust participants. Participants with pre‐frailty (adjusted hazard ratio 1.27, 95% confidence interval 0.51–10.69) had no significantly elevated incidence of dependency compared with robust participants. Conclusions The preadmission frailty status using the Kihon Checklist can predict the incidence of dependency after discharge among hospitalized older patients. Geriatr Gerontol Int 2018; 18: 1609–1613.

Our objective was to obtain clinical presentations of familial amyotrophic lateral sclerosis (FALS) with a novel Ala4Asp (A4D) SOD1 mutation in a Japanese family and to determine the epidemiological features of the SOD1 mutation on the basis of the ALS mutation database. The clinical histories and neurological findings of three affected individuals in a Japanese FALS pedigree are described. DNA analysis of SOD1 was conducted by a direct nucleotide sequence analysis. We identified a novel heterozygous A4D mutation in exon 1 in SOD1. The clinical presentations of the family were characterized by late age at onset and rapid progression. Comprehensive analysis of genotype-phenotype correlations using the ALS mutation database revealed that all the patients with SOD1 amino acid 4 mutations tended to have a rapid progressive course of the disease with a duration of 1.27 years. The age at onset varied among SOD1 amino acid 4 mutations, but all three patients with A4D mutation had a very late age at onset of over 70 years.In conclusion, FALS patients with a novel A4D mutation in SOD1 showed a late age at onset with a rapid disease course. This study supports the previous observations that SOD1 amino acid 4 mutations contribute to the acceleration of disease progression and emphasizes the usefulness of the ALS mutation database.

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Objectives: There is no established treatment for chronic fatigue and various cognitive dysfunctions (brain fog) caused by long coronavirus disease 2019 (COVID-19). We aimed to clarify the effectiveness of repetitive transcranial magnetic stimulation (rTMS) for treating these symptoms. Methods: High-frequency rTMS was applied to occipital and frontal lobes in 12 patients with chronic fatigue and cognitive dysfunction 3 months after severe acute respiratory syndrome coronavirus 2 infection. Before and after ten sessions of rTMS, Brief Fatigue Inventory (BFI), Apathy Scale (AS), and Wechsler Adult Intelligence Scale-fourth edition (WAIS4) were determined and N -isopropyl- p -[ 123 I]iodoamphetamine single photon emission computed tomography (SPECT) was performed. Results: Twelve subjects completed ten sessions of rTMS without adverse events. The mean age of the subjects was 44.3 ± 10.7 years, and the mean duration of illness was 202.4 ± 114.5 days. BFI, which was 5.7 ± 2.3 before the intervention, decreased significantly to 1.9 ± 1.8 after the intervention. The AS was significantly decreased after the intervention from 19.2 ± 8.7 to 10.3 ± 7.2. All WAIS4 sub-items were significantly improved after rTMS intervention, and the full-scale intelligence quotient increased from 94.6 ± 10.9 to 104.4 ± 13.0. Hypoperfusion in the bilateral occipital and frontal lobes observed on SPECT improved in extent and severity after ten sessions of rTMS. Conclusions: Although we are still in the early stages of exploring the effects of rTMS, the procedure has the potential for use as a new non-invasive treatment for the symptoms of long COVID.