Dynapenia and multimorbidity are common health problems affecting older adults. However, few studies have systematically reviewed the association between dynapenia and multimorbidity. Therefore, this systematic review aimed to provide a comprehensive overview of studies on the association between these conditions. We searched four electronic databases for relevant articles published in July 2023. The main inclusion criteria were the following: a description of dynapenia, which indicates loss of muscle strength, and a description of multimorbidity with two or more chronic diseases. Five studies met these inclusion criteria. In all five of these studies, the participants were community-dwelling older adults. All the studies showed an association between dynapenia and multimorbidity. The prevalence of dynapenia and multimorbidity ranged from 16% to 25.9%. The results of our systematic review demonstrated that dynapenia in older adults increases the risk of multimorbidity. We propose that interventions and reversible changes in dynapenia can prevent multimorbidity. (PROSPERO Registration No. CRD42023443282)

Purpose: This study aimed to a geographic accessibility, including patient coverage, of facilities providing specialized palliative care in Hokkaido. Methods: Vital statistics and digitized geographic information were used as data. We estimated the number of patients in need of palliative care, including both cancer and non-cancer patients, based on estimated by Murtagh et al. and the mortality statistics for Hokkaido. We analyzed the coverage rate within a 16 km radius of specialized palliative care facilities, as well as the distances and travel times to these facilities. Results: Cancer patient coverage within the 16 km radius, with hospitals providing specialized palliative care as the main purpose of coverage, was 77.2%. Patient coverage, including noncancer patients, in home-based palliative care facilities was 83.2%. The average time for cancer patients to arrive at the nearest hospital providing specialized palliative care varied from 9.7 to 197.0 minutes, with regional differences. Discussion: We assessed geographic accessibility to specialized palliative care in Hokkaido. In the future, we suggest the need for optimal allocation of medical facilities and collaboration between hospitals and home care to improve equity of specialized palliative care provision.

Background: Although the relationship between medication status, symptomatology, and outcomes has been evaluated, data on the prevalence of polypharmacy and potentially inappropriate medications (PIMs) and the association of polypharmacy and PIMs with swallowing function during follow-up are limited among hospitalized patients aged ≥65 years with dysphagia. Methods: In this 19‐center cohort study, we registered 467 inpatients aged ≥65 years and evaluated those with the Food Intake LEVEL Scale (FILS) scores ≤8 between November 2019 and March 2021. Polypharmacy was defined as prescribing ≥5 medications and PIMs were identified based on the 2023 Updated Beers Criteria. We applied a generalized linear regression model to examine the association of polypharmacy and PIMs with FILS score at discharge. Results: We analyzed 399 participants (median age, 83.0 years; males, 49.8%). The median follow‐up was 51.0 days (interquartile range, 22.0–84.0 days). Polypharmacy and PIMs were present in 67.7% of and 56.1% of patients, respectively. After adjusting for covariates, neither polypharmacy (β = 0.05; 95% confidence interval [CI], -0.04–0.13, p=0.30) nor non‐steroidal anti‐inflammatory medications (β = 0.09; 95% CI, -0.02–0.19; p=0.10) were significantly associated with FILS score at discharge. Conclusions The results of this study indicated a high proportion of polypharmacy and PIMs among inpatients aged ≥65 years with dysphagia. Although these prescribed conditions were not significantly associated with swallowing function at discharge, our findings suggest the importance of regularly reviewing medications to ensure the appropriateness of prescriptions when managing older inpatients.