Background Among community-dwelling older adults who require long-term care and use outpatient rehabilitation services, we aimed to examine the characteristics of patients who discontinued using outpatient rehabilitation services to prevent exposure to COVID-19 and the effects of this discontinuation on patient frailty. Methods Participants were 119 older adults (69 males, 50 females; average age 77.3 ± 8.3 years) requiring long-term care who used outpatient rehabilitation services. Our outpatient rehabilitation service involved day care for older adults undergoing rehabilitation including pick-up and drop-off services under the long-term care insurance system. They were divided into two groups: participants who discontinued using outpatient rehabilitation services and participants who continued their use. To find the factors associated with this discontinuation, binomial logistic regression analysis was performed, in which the following independent variables were used: gender, age, height, weight, long-term care level, grip strength, and normal walking speed. Frailty status was investigated in April 2020 and again in September 2020 through interviews and telephone surveys utilizing the Frailty Screening Index. Results Women and normal walking speed were independent factors associated with the discontinuation of outpatient rehabilitation due to COVID-19. According to the results of the Frailty Screening Index, similar tendencies were exhibited in both April and September. The discontinued group indicated that they were getting less exercise and having stronger feelings of fatigue than the continuing group. Conclusions The findings are in accordance with other studies indicating that women are more likely to employ prevention measures against COVID-19, as seen among the community-dwelling older adults requiring long-term care who used outpatient rehabilitation services. People with higher levels of physical function were also likely to refrain from using outpatient rehabilitation services. Results further suggested that the discontinued group had more frailty-related factors (i.e., low physical activity and strong exhaustion) than the continuing group.

Background After the outbreak of the coronavirus disease 2019 (COVID‐19), “pandemic‐associated‐frailty” or profound health deterioration, in older adults has been considered a health concern. In this study, we sought to demonstrate whether pandemic‐associated‐frailty is occurring in Japan, where the population is aging, by showing the prevalence of frailty before and during the COVID‐19 outbreak, using the same method. Methods A total of 5222 older adults in Otawara City, Tochigi Prefecture, aged 70 and 75 were surveyed annually using a complete survey, excluding those who were certified as requiring long‐term care. Frailty during 2017–2019 before the COVID‐19 outbreak and during 2020–2021 during the COVID‐19 outbreak was determined using the Kihon Checklist (KCL). Statistical analysis was performed using the χ2 test to compare annual frailty status and Kruskal–Wallis test to compare the scores. Results The frailty statuses over the five‐year period showed a significant decrease in Robust and a significant increase in Pre‐frailty and Frailty (p < 0.001). Frailty increased markedly during the second year of the pandemic. Based on the category, the scores deteriorated significantly for activities of daily living (p < 0.001), physical function (p = 0.003), oral function (p < 0.001), outdoor activity (p < 0.001), and depression (p < 0.001). Moreover, there was a significant deterioration in the total score for 25 items (p < 0.001). In addition, a significant deterioration was observed in the total score of 23 items, excluding the social withdrawal affected by self‐restraint life (p < 0.001). Conclusions The population prevalence of frailty in older adults increased steadily from the pre‐pandemic year through the first and second years of the pandemic. Based on the 25 questions of the KCL, two aspects including visiting friends and going out less stood out. This suggests that pandemic‐associated‐frailty occurred in Japan.

To identify changes in the efficacy of the Asia Working Group for Sarcopenia (AWGS) screening tools and the differences between the different screening tools following the updates from the AWGS 2014 to 2019 criteria for community-dwelling older adults. [Participants and Methods] We included 139 communitydwelling older adults aged ≥65 years. We assessed the lower calf circumference, SARC-F score, SARC-CalF score, skeletal muscle mass, grip strength, and gait speed. Moreover, we investigated the sensitivity, specificity, likelihood ratios, and area under the ROC curve of the lower calf circumference, SARC-F score, and SARC-CalF score using the AWGS 2014 and 2019 criteria for sarcopenia diagnosis. [Results] The prevalences of sarcopenia were 10.8% and 12.9%, and 5.0% using the AWGS 2014 and 2019, and 2019 severe sarcopenia diagnostic criteria, respectively. Using AWGS 2014 criteria, the sensitivity and specificity of lower calf circumference, SARC-F score, and SARC-CalF score, were 86.7% and 62.1%, 13.3% and 91.9%, and 66.7% and 80.6%, respectively. Using AWGS 2019 criteria, the sensitivity and specificity of lower calf circumference, SARC-F score, and SARC-CalF score were 83.3% and 62.8%, 11.1% and 91.7%, and 66.7% and 81.8%, respectively. Using AWGS 2019 severe sarcopenia criteria, the sensitivity and specificity of lower calf circumference, SARC-F score, and SARC-CalF score were 100% and 59.8%, 14.3% and 91.7%, and 71.4% and 78.0%, respectively. [Conclusion] All screening tools used in AWGS 2014 and 2019 were similar in terms of efficacy; however, the AWGS 2019 severe sarcopenia criteria had different characteristics.

[Purpose] The purpose was to determine the correlation between the skeletal muscle mass index and parameters of respiratory function and muscle strength in young healthy adults as predictors of sarcopenia in association with aging and respiratory diseases. [Participants and Methods] Participants were 41 males and 37 females with a mean age of 19.5 ± 1.5 years. The following were measured: body composition (skeletal muscle mass index), respiratory function (vital capacity, inspiratory reserve volume, expiratory reserve volume, inspiratory capacity, forced vital capacity, one-second forced expiratory volume, peak expiratory flow rate), and respiratory muscle strength (maximum inspiratory pressure, maximum expiratory pressure). Correlations between the skeletal muscle mass index and parameters of respiratory function and respiratory muscle strength were assessed using Pearson’s coefficient. [Results] The total skeletal muscle mass index showed a positive correlation with all items. The male skeletal muscle mass index showed a positive correlation with respiratory function excluding inspiratory reserve volume, expiratory reserve volume, maximum inspiratory pressure, and maximum expiratory pressure. The female skeletal muscle mass index showed a positive correlation with all respiratory functions including inspiratory reserve volume and expiratory reserve volume, but was not associated with respiratory muscle strength. [Conclusion] The skeletal muscle mass index showed a positive correlation with respiratory function and respiratory muscle strength. Gender-based features were correlated with respiratory muscle strength in males and lung capacity in females.