The MoCA-J could be a useful cognitive test for screening MCI, and could be recommended in a primary clinical setting and for geriatric health screening in the community.

BackgroundThis article presents an overview of the concept of social capital, reviews prospective multilevel analytic studies of the association between social capital and health, and discusses intervention strategies that enhance social capital.MethodsWe conducted a systematic search of published peer-reviewed literature on the PubMed database and categorized studies according to health outcome.ResultsWe identified 13 articles that satisfied the inclusion criteria for the review. In general, both individual social capital and area/workplace social capital had positive effects on health outcomes, regardless of study design, setting, follow-up period, or type of health outcome. Prospective studies that used a multilevel approach were mainly conducted in Western countries. Although we identified some cross-sectional multilevel studies that were conducted in Asian countries, including Japan, no prospective studies have been conducted in Asia.ConclusionsProspective evidence from multilevel analytic studies of the effect of social capital on health is very limited at present. If epidemiologic findings on the association between social capital and health are to be put to practical use, we must gather additional evidence and explore the feasibility of interventions that build social capital as a means of promoting health.

walking speed was the best physical performance measure for predicting the onset of functional dependence in a Japanese rural older population.

Background There is limited evidence on sarcopenia in Asian populations. This study aimed to clarify the prevalence, associated factors, and the magnitude of association with mortality and incident disability for sarcopenia and combinations of its components among Japanese community‐dwelling older adults. Methods We conducted a 5.8 year prospective study of 1851 Japanese residents aged 65 years or older (50.5% women; mean age 72.0 ± 5.9) who participated in health check‐ups. Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019 algorithm. Appendicular lean mass index (ALMI) was measured using direct segmental multi‐frequency bioelectrical impedance analysis. A Cox proportional hazards regression model was used to identify associations of sarcopenia and the combinations of its components with all‐cause mortality and incident disability. Results The prevalence of sarcopenia was 11.5% (105/917) in men and 16.7% (156/934) in women. Significant sarcopenia‐related factors other than ageing were hypoalbuminaemia, cognitive impairment, low activity, and recent hospitalization (all P‐values <0.05) among men and cognitive impairment (P = 0.004) and depressed mood (P < 0.001) among women. Individuals with sarcopenia had higher risks of mortality [hazard ratios (95% confidence interval): 2.0 (1.2–3.5) in men and 2.3 (1.1–4.9) in women] and incident disability [1.6 (1.0–2.7) in men and 1.7 (1.1–2.7) in women]. Compared with the individuals without any sarcopenia components, those having low grip strength and/or slow gait speed without low ALMI tended to have an increased risk of disability [1.4 (1.0–2.0), P = 0.087], but not mortality [1.3 (0.8–2.2)]. We did not find increased risks of these outcomes in participants having low ALMI in the absence of low grip strength and slow gait speed [1.2 (0.8–1.9) for mortality and 0.9 (0.6–1.3) for incident disability]. Conclusions Japanese older men and women meeting Asian criteria of sarcopenia had increased risks of all‐cause mortality and disability. There were no significant increased risks of death or incident disability for both participants with muscle weakness and/or low performance without low muscle mass and those with low muscle mass with neither muscle weakness nor low performance. Further studies are needed to examine the interaction between muscle loss, muscle weakness, and low performance for adverse health‐related outcomes.

Older people go outdoors for various purposes, such as going shopping, taking a walk, visiting friends, and working in their garden or field. These activities are important for the maintenance of health and quality of life. With advancing age, there is a decline in the frequency of going outdoors. For example, in Japan more than 50% of older people aged 65-69 years go outside the house at least once a day, but among those aged 70-79 years and over 80 years, the respective percentages are less than 40% and 30%. 1 The clinico-epidemiologic relevance of the reduction in the frequency of going outdoors in community-dwelling older adults has not been well characterized. Getting outdoors requires a certain level of physical and mental Study PopulationThis was a two-year prospective study conducted in Yoita Town, a rural area in Niigata Prefecture, Japan. In 2000, the total population of this town was 7,493, and the proportion of older adults (i.e., 65 years and older) was 22.3%. A baseline survey was conducted in November 2000, in which all residents aged 65+ years (n=1,673) were invited to participate. Out of them, 1,544 (92.3%) persons responded to the survey. Among the 129 non-responders, 80 were institutionalized, 2 were relocated, 3 had died, and 44 refused to participate.A follow-up survey was conducted in October of 2002. Out of the initial 1,544 respondents, 1,283 (83.1%) participated again. Among the 261 non-participants, 57 were institutionalized, 12 persons were relocated, 81 persons had died, 88 refused to participate, and the remaining 23 persons did not participate for miscellaneous reasons.Trained personnel conducted standardized, face-to-face interviews with study subjects either at the community hall or in their homes, both at baseline and follow-up. The purpose of the study (collecting information on how to prevent disability among older people) was explained before interview, and all subjects participated voluntarily in accordance with a protocol approved by the Ethics Committee of Tokyo Metropolitan Institute of Gerontology. VariablesThe questionnaire comprised of sociodemographic, medical and physical function, cognitive, and psychosocial items. Sociodemographic variables included age, sex, education, principal occupation, and household structure. Medical and physical function variables included the basic activities of daily living (BADL), IADL, walking ability, visual and hearing ability, pain, chronic medical conditions, urinary incontinence, use of outpatient clinics, history of hospital admission, and frequency of going outdoors. Psychosocial variables included cognitive function, subjective health, contacts with intimate friends or relatives, participation in formal or informal community groups, and depressive mood state.In regard to the assessment of the frequency of going outdoors, subjects were asked the question, "How often do you usually go outside the house?" (Examples of going outdoors include going shopping, taking a walk, going to a hospital, or going out to work in your garden or f...