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It is predicted that the future increase in the oldest-old (85 years and older) population will have a marked influence on society. However, little is known about the features of various functions in the oldest-old. The purpose of this study was to clarify the functional status of the oldest-old. We surveyed all oldest-old residents in a small area of Itabashi ward in metropolitan Tokyo to clarify their living conditions. The oldest-old themselves and their family members were invited to participate, and 235 out of 311 residents (75.6%) agreed to do so. Forty-two percent of the participants were dependent and needed care from others. The ADL status measured by the Barthel Index showed that 30% of independent participants also had some deterioration of physical function. These results are indicative of increased frailty in the oldest-old. Comparison between independent and dependent (need care from others in daily living) showed that the functional status was lower in dependent group. However, the psychological well-being was the same in this two groups. These results indicate progressive functional deterioation and psychological adaptation to it, in the oldest-old. Further research to elucidate the process of psychological adaptation to frailty is necessary in order to promote the well-being among the oldest-old, in whom functional limitation is evident.

Aim To maintain the frequency of going out and to improve homebound status among older adults, specific barriers need to be identified. Hence, this study developed a scale to measure barriers to going out. Methods A preliminary study was carried out to collect items for the scale. We conducted semi‐structured interviews with five homebound older adults, and created 14 items as a draft barrier scale. The main study included 2273 older adults and their cohabitating family members in rural Japan. For older adults, the questions included demographic characteristics, responses to the draft scale and variables to examine its validity. For family members, the questions included demographic characteristics, their relationship with the older adult and their assessment of their older relative's willingness to go out. We used data from 892 pairs for our analysis. Results We selected nine items through the criterion group strategy, and confirmed the unidimensional structure of the scale through factor analysis. The results showed significant relationships between the scale and older adults’ self‐efficacy about going out, their health locus of control, the frequency of going out and their reluctance to go out as assessed by family members. We carried out a receiver operating characteristic analysis to determine the scale's cut‐off point. Our multivariate analysis showed that the scale had a significantly stronger association with homebound status than with other variables. Conclusion We developed a highly reliable and valid scale on barriers to going out among community‐dwelling older adults and confirmed its usability. Geriatr Gerontol Int 2021; 21: 238–244.

Background:A study was conducted to clarify the characteristics of cognitive function among physically independent very old people dwelling in an urban community in Japan. Methods:Five hundred and thirteen old-old (aged 75-84 years) and 168 oldest-old (aged 85-100 years) adults participated. We carried out the Mini-Mental State Examination (MMSE) for measuring cognitive functions in the elderly. Age-related differences in the total score and subscale scores of the MMSE were analyzed by sex using ANCOVA, controlling for education, vision and hearing problems.Results: Mean MMSE scores for old-old and oldest-old men were 27.5 and 25.9, respectively, and those for old-old and oldest-old women were 27.8 and 25.0, respectively. Age-related differences in the MMSE total score between the old-old and oldest-old were observed in both sexes, suggesting that overall cognitive functions continue to decline over time in very old age. Age-related differences between the old-old and oldest-old in items measuring, registration, calculation and delayed recall were observed in both sexes, and also in those assessing time orientation, place orientation, delayed recognition, writing sentences, and copying figures were observed in women. Conclusion:These findings suggest that the faculties are those most sensitive to normal aging among very old individuals. There were no age group differences in five items: reverse spelling, naming objects, repeating a sentence, listening and obeying, and reading and obeying.