Background: Self-perceived voice disorders (PVD) are common in later life and may affect psychological, social, and physical well-being. However, longitudinal evidence in community settings remains limited. This study sought to examine whether PVD predicted changes in well-being among community-dwelling older adults. Methods: Data were obtained from a community cohort in Kasama City, Japan. Older adults (n=273; aged 76.5 years; 57.1% female) were classified based on baseline Voice Handicap Index-10 scores (0, no; 1–4, mild; and ≥5, PVD). Outcomes were assessed annually through 2025 using the Geriatric Depression Scale (GDS), Lubben Social Network Scale (LSNS), Physical Activity Scale for the Elderly, and physical performance measures (handgrip strength, single-leg balance with eyes open, sit-and-reach, and 5-m habitual walk). Linear mixed models analyzed the fixed effects of group, time, and their interaction while adjusting for selected covariates. Results: Significant group effects were observed for the GDS, total LSNS scores, and the LSNS family scale, indicating that participants with PVD had weakened psychological and social well-being and smaller family networks. Additionally, a notable group effect was observed in sit-and-reach, with PVD participants showing less flexibility than those without it in the physical performance measures. Conclusion Among community-dwelling older adults, PVD was prospectively associated with increased depressive symptoms, diminished social networks, particularly smaller family networks, and reduced physical flexibility. These findings suggest that PVD preceding medical diagnosis may signal broader declines in psychological, social, and physical well-being, highlighting the importance of early identification and support.

Background: This study examined the validity and reliability of two smartphone-based tasks, the Symbol Search Task (SST-SP) and the Dot Memory Task (DMT-SP), in cognitively healthy older adults. Methods: Sixty participants (32 older and 28 younger adults) completed two sessions approximately one week apart. In the first session, participants performed standardized cognitive tests (Symbol Digit Substitution Test and Visual Digit Span Test) on a personal computer (PC), PCbased Symbol Search Task (SST-PC), and Dot Memory Task (DMT-PC), followed by the SST-SP and DMT-SP. The second session included only SST-SP and DMT-SP. Results: In older adults, the correlation between the SST-SP and SST-PC was very strong (r=0.83). In addition, the SST-SP showed a moderate correlation with the Symbol Digit Substitution Test (r=0.50). A very strong correlation was observed between DMT-SP and DMT-PC (r=0.86). The DMT-SP also showed a moderate correlation with the Visual Digit Span Test (r=-0.47). The SST-SP demonstrated good test–retest reliability and high split-half reliability, whereas the DMT-SP showed moderate test– retest reliability and acceptable-to-good split-half reliability. Older adults scored lower than younger adults on both the SST-SP and DMT-SP. Conclusion The SST-SP and DMT-SP are valid and reliable tools for assessing processing speed and working memory, respectively, in cognitively healthy older adults. These tools may provide new strategies for assessing the cognitive performance and/or ability in older adults in both research and clinical settings.

Background: Living alone and limited social interaction are associated with frailty, while low satisfaction with interactions is associated with negative health outcomes. However, the effects of living arrangements, interaction frequency, and interaction satisfaction on physical frailty remain unclear. This study examined the associations among living arrangements, the frequency and satisfaction of social interactions, and physical frailty among community-dwelling older adults. Methods: A cross-sectional study was conducted among 5,538 community-dwelling adults aged 60 or older living in Aichi Prefecture, Japan. The revised Japanese version of the Cardiovascular Health Study criteria evaluated physical frailty. Frequency and satisfaction of social interactions were evaluated using the National Center for Geriatrics and Gerontology–Social Network Scale (SNS). Logistic regression analysis was conducted by living arrangement, with physical frailty as the dependent variable and the SNS as the explanatory variable. In the sensitivity analysis, SNS was categorized into two groups based on the median, then combined with living arrangements into four groups to examine the association with physical frailty. Results: A total of 338 (6.3%) participants were classified as physically frail. Participants with high SNS scores showed significantly lower odds of physical frailty regardless of living arrangement (OR: 0.36, 95% confidence interval [CI]: 0.16-0.80; OR: 0.66, 95% CI: 0.45-0.96). Sensitivity analysis similarly showed the high SNS group had lower ORs for physical frailty, regardless of living arrangements. Conclusion High frequency and satisfaction with social interactions were negatively associated with physical frailty, suggesting that enhancing both aspects of social engagement may be beneficial.

Background: Vertebral compression fractures (VCFs) are associated with reduced gait ability and functional impairment in older adults. Factors related to walking aid use at discharge remain unclear. This study examined associations between walking aid use and physical function at discharge. Methods: This cross-sectional study included 143 patients with VCFs discharged from Kurume Rehabilitation Hospital. Participants were classified into independent ambulation and walking aid groups, the latter subdivided into cane and walker users. Pain, cognitive function, handgrip strength, 30-second chair stand test, Berg Balance Scale (BBS), and skeletal muscle mass index (SMI) were assessed at discharge. Logistic regression identified factors associated with walking aid use, and exploratory analysis compared cane and walker users. Receiver operating characteristic (ROC) analysis was used to determine the BBS cutoff. Results: BBS at discharge was significantly associated with walking aid use (odds ratio [OR]=0.85; 95% confidence interval [CI] 0.77–0.93; p<0.001). In exploratory analysis, pain (OR=1.43; 95% CI 1.03–1.96; p=0.029) and SMI (OR=0.40; 95% CI 0.20–0.79; p=0.010) were associated with cane versus walker use. The optimal BBS cutoff was 48.5 (area under the curve [AUC]=0.83). Conclusion BBS was associated with the distinction between independent ambulation and walking aid use, while pain and SMI were associated with differences among walking aid users. These findings may inform clinical decision-making for walking aid selection at discharge.

Background: Many smart care technologies have been developed recently, but it remains unclear which of them are necessary for use in long-term care hospitals (LTCHs). Methods: A total of 114 physicians, registered nurses (RNs), nurse assistants (NAs), and care assistants (CAs) from eight LTCHs completed a survey assessing perceived needs for 10 smart care technologies using 5-point Likert scales. One-sample t-tests, one-way ANOVA with Scheffé post-hoc tests, Friedman tests, and simple linear regression were used to examine differences by occupation and hospital characteristics. Additionally, focus group interviews with 10 participants were done. Results: Mean perceived need for smart care technologies was 3.99, with the highest ratings for smart mattresses (4.14), all-in-one patient transfer robots (4.09), and smart monitoring systems (4.06). Regarding the most preferred by occupation, physicians chose smart monitoring systems (4.19) and leg-care devices (4.19), RNs chose smart mattresses (4.11), NAs chose radar-based fall detection devices (4.22), and CAs chose all-in-one patient transport robots (4.36). Perceived need for smart care technologies was higher in LTCHs with lower monthly family fees and in those without a rehabilitation service, explaining 42.8% and 10.8% of the variability, respectively. Conclusion Smart care technologies were seen as necessary in LTCHs, but the types of technologies considered most important differed by occupational role and hospital characteristics.

Background: Handgrip strength (HGS) is a widely used indicator of muscle strength and physical performance, and its recovery in rehabilitation reflects functional improvement. Although polypharmacy is common among older patients and associated with functional decline, its impact on muscle strength recovery during convalescent rehabilitation remains unclear. We investigated the association between polypharmacy and in-hospital HGS recovery and its modification by cognitive function. Methods: This retrospective observational study included patients aged ≥65 years admitted to a convalescent rehabilitation hospital between April 2017 and March 2024. Polypharmacy was defined as using six or more regular prescription medications at discharge. HGS recovery was calculated as the logarithmic ratio of discharge to admission HGS. Multivariate linear regression analyses were performed with stratification by cognitive status, and multivariate logistic regression analysis examined the association between polypharmacy and medications associated with muscle weakness. Results: Among 1,650 patients analyzed, 1,350 had low HGS and 300 had normal HGS at admission. In the low-HGS group, polypharmacy was independently associated with poorer HGS recovery (B=-0.064), corresponding to approximately 6% lower improvement. Stratified analyses showed that the association was significant in patients with cognitive impairment but not in patients without cognitive impairment. No significant association was found in patients with normal HGS. Polypharmacy was strongly associated with use of medications known to adversely affect muscle function. Conclusion Polypharmacy was associated with poorer HGS only in patients with low baseline HGS, and stratified analyses suggested a stronger association in those with cognitive impairment.

Background: This study examined how the frequency of in-person, telephone, text-based communication, and video interactions with non-cohabiting family and friends relates to loneliness among older adults in Japan. Methods: We analyzed data from 6,786 adults aged ≥65 in the 2024 Japan COVID-19 and Society Internet Survey (JACSIS) study. Interaction frequency with non-cohabiting family and friends was categorized into none (reference), monthly, and weekly or more. Loneliness was measured using the 3-item UCLA Loneliness Scale and dichotomized at ≥4, indicating loneliness; a ≥7 cut-off was used in sensitivity analyses. Logistic regression models adjusted for sociodemographic, lifestyle, and health-related factors. Results: For family, significant associations with lower loneliness were observed only at weekly frequencies—in-person (adjusted odds ratio [aOR]=0.764, 95% confidence interval [CI] 0.664–0.879), text (aOR=0.747, 95% CI 0.659–0.846), and telephone (aOR=0.624, 95% CI 0.543–0.718), whereas for friends, significant associations were observed at monthly frequencies—in-person (aOR=0.621, 95% CI 0.549–0.701), text (aOR=0.881, 95% CI 0.778–0.997), and telephone (aOR=0.734, 95% CI 0.659–0.819). Video calls were associated with lower odds of severe loneliness (score ≥7) in sensitivity analyses—weekly calls with family (aOR=0.736, 95% CI 0.547–0.991) and monthly calls with friends (aOR=0.656, 95% CI 0.470–0.917). Conclusion Interactions with friends show associations with lower levels of loneliness at lower frequencies than family contact. While text and phone calls are broadly associated with reduced loneliness, video calls showed an association specifically with a lower prevalence of severe loneliness, underscoring the potential for tailored communication strategies.

Background: While advanced age is a known risk factor for postoperative complications following hip arthroplasty, its role as an independent predictor versus a surrogate for comorbidity remains unclear, particularly in developing countries. This study aimed to investigate the independent impact of age on postoperative outcomes and explore the mediating role of key comorbidities in a resource-limited setting. Methods: We retrospectively reviewed 769 adult patients undergoing hip arthroplasty at a Vietnamese tertiary hospital (2021–2024), categorized into three groups: younger adults (18–64 years), older adults (65–79 years), and oldest old (≥80 years). The primary outcome was a composite of major postoperative complications. Multivariable logistic regression and structural equation modeling were used to identify independent predictors and assess mediation effects. Results: Among 769 patients, 363 were younger (47.2%), 241 older adults (31.3%), and 165 oldest old (21.5%). Complication rates increased significantly with age (18.7%, 36.9%, and 60.0%, respectively; p<0.001). However, multivariable adjustment showed that age was not an independent predictor. Instead, heart failure (adjusted odds ratio [aOR]=5.49, 95% confidence interval [CI] 2.19–13.74) and preoperative anemia (aOR=1.77, 95% CI 1.21– 2.59) were identified as independent risk factors. Mediation analysis revealed that the effect of age on complications was significantly mediated through preoperative anemia. Conclusion Increased postoperative risk in older adults is driven by comorbidity burden rather than chronological age. Preoperative anemia and heart failure are critical, independent predictors, with anemia acting as a key mediator for the effects of age. Individualized correction of modifiable comorbidities may be more beneficial than using age alone to assess surgical risk.

Background: Older patients aged ≥75 years are underrepresented in major statin trials, leaving the optimal statin intensity after acute ischemic stroke (AIS) undefined. We aimed to compare functional outcomes and short-term safety between high-intensity statin therapy (HIST) and moderate-intensity statin therapy (MIST) in patients aged ≥75 years with AIS or transient ischemic attack. Methods: Using a prospective stroke registry at a single tertiary center (2019–2022), we retrospectively analyzed 337 patients aged ≥75 years with AIS or transient ischemic attack who maintained statin therapy for 3 months (HIST n=117; MIST n=220). The primary outcome was a favorable 3-month functional outcome (modified Rankin Scale score 0–2). Secondary outcomes included stroke recurrence, adverse effects, and statin discontinuation. Multivariable logistic regression with pre-specified sensitivity analyses was performed. Results: Favorable outcomes at 3 months were more frequent with HIST (70.9% vs. 55.9%; p=0.010). After multivariable adjustment, HIST was independently associated with a favorable outcome (adjusted odds ratio [aOR]=2.03, 95% confidence interval [CI] 1.17–3.53), consistent across sensitivity analyses: per-protocol (aOR=3.48, 95% CI 1.97–6.17) and atrial fibrillation-adjusted (aOR=2.21, 95% CI 1.26–3.89). No significant differences were observed in statin discontinuation, stroke recurrence, or adverse effects. Conclusion In older patients with AIS, HIST was independently associated with better functional outcomes without evidence of increased harm, broadly consistent with current guideline recommendations for HIST when tolerated. Prospective studies are needed to confirm a causal relationship.

We examined the longitudinal hypothalamic morphology in the progression of mild cognitive impairment (MCI). We used multivariable linear modelling to differentiate the structural volumetric change in the hypothalamic nuclei in nine females who developed MCI after 5 years and 61 healthy controls. We found significantly decreased left anterior-inferior (p<0.01), left anterior-superior (p<0.05), and left posterior (p<0.01) hypothalamic regions among females with MCI compared to healthy controls. There was also a significant asymmetry at the anterior-superior hypothalamus (p<0.05) in MCI females than in healthy controls. Thus, the degradation of the specific left hypothalamic subregions and leftward lateralization over time highlight the impact of early- stage MCI on the morphology of hypothalamus.