Aim To investigate the prevalence and associated factors of cognitive frailty and cognitive frailty‐related falls in community‐dwelling older people. Methods A total of 25 out of 1192 community‐dwelling older people aged >70 years with cognitive frailty participated in the present cross‐sectional study. Cognitive function was assessed using the Mini‐Mental State Examination. Physical function measures included calf circumference, Timed Up and Go (TUG) and usual walking speed. Interviews were carried out to assess Council on Nutrition Appetite Questionnaire (CNAQ); chronic diseases including hypertension, diabetes and falls; as well as physical frailty, defined as having three of five criteria: muscle weakness, slowness, exhaustion, low activity and weight loss. Results The prevalence of cognitive frailty was 2.1%. Participants with cognitive frailty had significantly reduced Mini‐Mental State Examination and calf circumference; and higher instrumental activities of daily living disability and falls. Old age (OR 1.151, 95% CI 1.053–1.257), fall history (OR 3.577, 95% CI 1.381–9.263), having four or more chronic diseases (OR 7.419, 95% CI 2.117–26.005) and slower TUG (OR 1.234, 95% CI 1.041–1.462) were significantly associated with cognitive frailty, whereas greater calf circumference (OR 0.748, 95% CI 0.625–0.895) and CNAQ (OR 0.736, 95% CI 0.628–0.8631) had protective effects. Old age (OR 1.132, 95% CI 1.002–1.280), hospitalization (OR 10.090, 95% CI 2.554–39.854), having four or more chronic diseases (OR 5.120, 95% CI 1.113–23.557) and slower TUG (OR 1.394, 95% CI 1.167–1.665) were significantly associated with cognitive frailty‐related falls, whereas CNAQ (OR 0.704, 0.571–0.868) had protective effects. Conclusions Age, chronic disease, TUG and CNAQ were significantly associated with cognitive frailty and cognitive frailty‐related falls. The TUG and CNAQ have the greatest potential for improvement by intervention or lifestyle change. Further research is necessary to determine the efficacy of positive changes in these factors for symptomatic improvements. Geriatr Gerontol Int 2019; 19: 647–653.

The present findings suggest that walking among community-dwelling older adults can be more effective for fall prevention than balance training. However, because walking can induce more trips, walking should not be recommended for older adults who are susceptible to falling or frailty.

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Aim To examine the association between a decrease in the frequency of going out and oral function in independent older adults living in the urban area of Tokyo. Methods The participants analyzed were 785 older adults from the “Takashimadaira Study” (344 men and 441 women, age 77.0 ± 4.6 years). This study investigated the following items: decrease in frequency of going out; basic characteristics (sex, age); physical factors, such as oral function (difficulty chewing, difficulty swallowing, dry mouth); body pain; the Japan Science and Technology Agency Index of Competence; physical activities; psychological factors, such as the Geriatric Depression Scale‐15 score; and social and environmental factors, such as the presence or absence of participation in organization activities. Results To investigate the factors associated with a decrease in frequency of going out, logistic regression analysis showed an association with age (OR 1.08, 95% CI 1.03–1.13), difficulty chewing (OR 2.41, 95% CI 1.52–3.83), dry mouth (OR 1.68, 95% CI 1.07–2.64), body pain (OR 1.78, 95% CI 1.14–2.78), Japan Science and Technology Agency Index of Competence scores (OR 0.91, 95% CI 0.84–0.99), physical activities (OR 0.99, 95% CI 0.98–1.00), Geriatric Depression Scale‐15 scores (OR 1.13, 95% CI 1.05–1.21) and organization activities (OR 1.94, 95% CI 1.22–3.07). Covariance structural analyses showed that both “difficulty chewing” and “dry mouth” significantly affected “decrease in frequency of going out.” In addition, decrease in frequency of going out was significantly affected by “ Geriatric Depression Scale‐15 scores” through oral function. Conclusions The relationship between oral function and decrease in frequency of going out was clarified, after the multifaceted factors were adjusted. Geriatr Gerontol Int 2019; 19: 792–797.

Background Gait measures such as gait speed, stride length, step width, and stance duration change with advanced age and are associated with adverse health outcomes among older adults. The stride-to-stride variabilities of gait measures are also related to falls and cognitive decline in older adults; however, reference values of these gait parameters in older Japanese adults do not exist. This study aimed to determine the reference values of gait parameters as measured by a plantar pressure platform in community-dwelling older Japanese adults. Methods Community-dwelling adults (N=1,212) who were independent in basic activities of daily living and aged 70–96 years (491 men, 721 women) completed the gait performance measurement in a geriatric health assessment. We assessed 10 gait performance measures with a plantar pressure platform system (P-WALK, BTS Bioengineering) and calculated means and coefficient of variations (CVs) of the gait measures as well as quintiles for those gait parameters per age group among men and women. Results Mean (SDs) of gait speed, stride length, step width, and stance durations were 1.26 (0.24) meters per second (m/s), 121.9 (19.8) cm, 24.0 (3.2) cm, and 552.4 (60.4) milliseconds (ms), respectively, in men, and 1.27 (0.21) m/s, 115.7 (16.3) cm, 17.9 (2.8) cm, and 517.6 (59.8) ms, respectively, in women. Mean of CVs (SD) of stride length, step width, and single-stance duration were 2.76 (1.35), 12.06 (3.98), and 5.74 (2.66), respectively, in men and 2.69 (1.24), 15.65 (4.53), and 5.77 (2.40), respectively, in women. Gait parameters (except CVs of step width) declined significantly with age regardless of gender ( P < 0.01 for trends). Conclusion This study determined age group dependent gait parameter reference values, presented as means with quintile ranges, in community-dwelling older Japanese adults. These reference values may be useful metrics for gait assessment in the elderly.

These results suggest that AT before RT combined with fortified milk consumption has similar effects on skeletal muscle mass and strength compared with RT alone, but it may be a more useful strategy to improve physical performance in older adults. Although the mechanism of our intervention is uncertain, our program would be an effective prevention for sarcopenia in older adults.

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