Background The study aim was to identify depressed mood and frailty and its related factors in older people during the coronavirus disease 19 pandemic. Methods Since 2010, we have conducted questionnaire surveys on all older residents, who are not certified in the long‐term care insurance, living in one district of Tokyo municipality. These residents are divided into two groups by birth month, that is those born between April and September and those born between October and March, and each group completes the survey every 2 years (in April and May). Study participants were older residents who were born between April and September and who completed the survey in spring 2018 and in spring 2020, the pandemic period. Depressed mood and frailty were assessed using the Kihon Checklist, which is widely used by local governments in Japan. We had no control group in this study. Results A total of 1736 residents responded to both surveys. From 2018 to 2020, the depressed mood rate increased from 29% to 38%, and frailty increased from 10% to 16%. The incidence of depressed mood and frailty was 25% and 11%, respectively. Incidence of depressed mood was related to subjective memory impairment and difficulty in device usage, and incidence of frailty was related to being older, subjective memory impairment, lack of emotional social support, poor subjective health, and social participation difficulties. Conclusions Older people with subjective memory impairment may be a high‐risk group during the coronavirus pandemic. Telephone outreach for frail older people could be an effective solution. We recommend extending the scope of the ‘reasonable accommodation’ concept beyond disability and including older people to build an age‐friendly and crisis‐resistant community.
Investigating the incidence rate of early-onset dementia is challenging. We explored the incidence rate of early-onset dementia in Japan using annual performance reports from the Medical Centers for Dementia. Methods: Medical Centers for Dementia are specialized health services for dementia established as part of Japan's national health program. There are 440 such centers nationwide as of 2018. Using the annual performance reports of these centers, we calculated the number of newly diagnosed cases of early-onset dementia or late-onset dementia from April 1, 2018 to March 31, 2019, and the composition ratio by diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. The annual incidence rate of early-onset dementia was estimated using the number of cases as the numerator and the national population aged 18-64 years as the denominator. Results: In total, 1733 of cases were diagnosed with early-onset dementia, of which 52.1% were diagnosed as major neurocognitive disorder due to Alzheimer's disease, 8.9% major frontotemporal neurocognitive disorder, 8.8% major vascular neurocognitive disorder, 7.1% substance/medication-induced major neurocognitive disorder, 6.5% major neurocognitive disorder with Lewy bodies and 3.9% major neurocognitive disorder due to another medical condition. The annual incidence rate of early-onset dementia was estimated to be 2.47/100 000 person-years. Conclusions: This study provides the first nationwide estimate of the incidence rate of early-onset dementia in Japan and suggests that Medical Centers for Dementia are important resources for the epidemiological monitoring of early-onset dementia nationwide.
Background As Japanese society continues to age, the isolation of older people is increasing, and community living for people with cognitive impairment is becoming more difficult. However, the challenges faced by people with cognitive impairment living in the community have not been fully explored because of methodological difficulties. This study re-accessed people with cognitive impairment identified in a previous epidemiological survey to explore their current situation and the risk factors associated with all-cause discontinuation of community living. Methods Under a community-based participatory framework, we examined a high-risk approach for people with cognitive impairment and a community action approach in parallel, to build a dementia-friendly community. For the high-risk approach, we achieved stepwise access to 7614 older residents, which enabled us to select and visit the homes of 198 participants with a Mini-Mental State Examination score < 24 in 2016. In 2019, we re-accessed these individuals. For the community action approach, we built a community space in the study area to build partnerships with community residents and community workers and were able to re-access participants using multiple methods. Results We found that 126 (63.6%) participants had continued living in the same community, but 58 (29.3%) had discontinued community living. Of these, 18 (9.1%) had died, 18 (9.1%) were institutionalized, 9 (4.5%) were hospitalized, and 13 (6.6%) had moved out of the community. A multiple logistic regression analysis identified the following risk factors associated with discontinuation of community living: being certified under long-term care insurance, needing housing support, and needing rights protection. Conclusions Three years after the baseline survey, 29.3% of people with cognitive impairment had discontinued community living. Despite having cognitive impairment or living alone, older people were able to continue living in the community if their needs for housing support and rights protection were met. Both social interventions and medical interventions are important to build age-friendly communities. Trial registration UMIN, UMIN000038189, Registered 3 October 2019, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000043521
BackgroundThe experiences of people with cognitive impairment in the real world have not been fully explored because of methodological difficulties. This study re-accessed people with cognitive impairment identified in a previous epidemiological survey to explore their current situation and the risk factors associated with all-cause discontinuation of community living.MethodsIn 2016, a three-step survey was conducted of 7,614 older residents. In the last step of the survey, a research team visited the homes of 198 participants with a Mini-Mental State Examination score <24. In 2019, we re-accessed these people. We ran a community space in the study area for 3 years to build partnerships with community residents and community workers, and were able to re-access the participants using multiple methods.ResultsWe found that 126 (63.6%) participants had continued living in the same community, but 58 (29.3%) had discontinued community living. Of these, 18 (9.1%) had died, 18 (9.1%) were institutionalized, 9 (4.5%) were hospitalized, and 13 (6.6%) had moved out of the community. A multiple logistic regression analysis identified the following risk factors associated with discontinuation of community living: being certified under long-term insurance, needing housing support, and needing rights protection.ConclusionsThree years after the baseline survey, 29.3% people with cognitive impairment had discontinued community living. Despite having dementia or living alone, older people could continue to live in the community if their needs for housing support and rights protection were met. Both social interventions and medical interventions are important to build age-friendly communities.Trial registrationUMIN, UMIN000038189, Registered 3 October 2019, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000043521
No studies have measured the periodontal inflamed surface area in people with dementia, although periodontal disease is a major health issue in this group. This study aimed to determine the relationship between dementia severity and periodontal inflamed surface area. An interdisciplinary team, including a dentist and psychiatrist, conducted an in-home survey of older people living in the community. This cross-sectional study was designed as part of a larger cohort study. The interdisciplinary team visited 198 individuals with cognitive decline. We surveyed the clinical dementia rating, periodontal inflamed surface area, number of teeth, and other health issues. We used multiple linear regression analysis to assess the 75 people who were able to take part in all the visits. Number of teeth (Beta = 0.479, p < 0.001), clinical dementia rating (Beta = 0.258, p = 0.013), and age (Beta = 0.250, p = 0.017) were independently associated with periodontal inflamed surface area after adjusting for biological sex, depression, diabetes, collagen disease, visual disorder, and osteoporosis medication. To make communities more dementia-friendly, we must protect older people with dementia from developing poor oral health, which may require home visits for dental assessment.
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