Cohen syndrome is a rare genetic disorder associated with mutations in the VPS13B gene. Individuals with this disorder present with diverse clinical manifestations, including muscle hypotonia, intellectual disabilities, and typical facial characteristics, such as prominent upper central incisors and micrognathia. General anesthesia was administered to a 23-year-old man with Cohen syndrome. Although we observed prominent upper central incisors, an overjet of 10 mm, micrognathia, and thyromental distance of 4 cm, hypotonia was not observed in the patient. Intubation was rendered difficult when performing a direct laryngoscopy. However, smooth intubation was achieved using a video laryngoscope. The patient’s train of four (TOF) count remained zero close to 60 min after rocuronium administration, suggesting that the drug’s muscle-relaxant effect may have been prolonged. A TOF ratio of 0.79 was confirmed 130 min after rocuronium administration, and a TOF ratio of 1.0 was confirmed after administration of 150 mg of sugammadex. The patient’s respiration remained stable after extubation, and no recurarization of muscle relaxation was observed. As demonstrated in this case report, it is important to closely monitor recovery from muscle relaxation and prepare multiple techniques for airway management in general anesthesia management of patients with Cohen syndrome.

Objective: Physical frailty has been considered a risk factor for certification of long-term care needs (hereafter referred to as Certification) under Japan’s long-term care insurance (LTCI). Therefore, assessment of frailty in elders should be studied from multiple perspectives. The Kihon Checklist (KCL) is widely used to identify need for support/care among Japanese older adults. This study aims to examine the relationship between changes in KCL items and Certification among Japan’s young-old and old-old.Material and Methods: The KCL responses of 7,092 participants were assessed in April 2012 and March 2016, along with gender, age, and living environment. Deaths, Certifications, and relocations were tracked until March 2018. Changes in KCL items were categorized as bad, worse, improved, or good.Results: Between March 2016 and March 2018, about 7.3% of respondents obtained Certifications. KCL item changes increased the risk of new Certification for bad and worse groups, while improved cognitive function among the old-old possibly reduced the risk of new Certification.Conclusion: Therefore, rather than administering the KCL once, identifying KCL changes among people at risk could help prevent or delay their need for long-term care.

The purpose of this study is to elucidate the correlation between social capital and frailty of homebound community-dwelling elderly individuals without certification for long-term care. Subjects were 47 homebound and 47 age- and sex-matched, non-homebound elderly individuals evaluated from July to November, 2016. Variable parameters were physical, mental, and social frailty, Tilburg Frailty Indicator score, and social capital. The correlation between social capital and frailty in home-bounded elderlies was analyzed using the χ2 Test. Social capital was significantly correlated with mental frailty among homebound elderly individuals. In contrast, social capital was significantly correlated with all types of frailty among non-homebound elderly individuals. Among community-dwelling elderly individuals, social capital is related to prevention of comprehensive frailty and mental frailty. On the other hand, screening and intervention for prevention of long term-care are necessary for homebound elderly individuals.

The purpose of this cohort study is to clarify the risk factors of low well-being of elderly people who residing in a local city of a super-aging country, Japan.Subjects are people, who have selected randomly from healthy elderly people resided in Kizugawa City, Kyoto Prefecture, in 2010, followed until 2015. Question survey was conducted in both year, and questionnaire consisted of items such as basic attributes, lifestyles (health practices, consultation behaviors, social activities and so on) and well-being (WHO-5). In analysis we made multi-logistic regression analysis using lifestyle variables as an independent variable and well-being as a dependent variable.The results were as follows.1. Risk factors were not to exercise, knowledge of appropriate diet, subjective feeling of stress for at least a month, not to participate in voluntary activities, age and bad subjective feeling of health.2. Risk factors in regard to changes of lifestyles using good-good lifestyles as a reference were sustainment of having no time for hobby or relaxation, sustainment or deterioration of subject feeling of stress for at least a month, sustainment or deterioration of having no time for relaxation and deterioration of having no activities with pleasure or aim. A factor promoting well-being is to have more frequencies for going out home.This study shows that in a longevity society it is important for community-dwelling elderly Japanese to have good health practices, appropriate consultation behaviors and good social activities for the purpose of keeping good well-being, and that these results are contributed to health promotion policy for community-dwelling elderly people.

This study aimed to verify whether the incidence of frailty in elderly individuals is higher among those who are housebound than those who are not. This study found no correlation between elderly people’s houseboundedeness and physical, mental, social, and overall frailty. However, the Tilburg Frailty Indicator (TFI) frailty score and grip strength value were higher in non-housebound elderly persons than in housebound elderly ones. This suggests that being housebound may lead to frailty. On the other hand, it is thought that individual interaction with family and friends, and lack of anxiety about falls correlates with the prevention of frailty in housebound elderly persons. The results of the study also suggest that the basic checklist may be effective for ascertaining the actual situation of housebound elderly people who may be manifesting frailty.