Akiko Konno

Food diversity is closely associated with activities of daily living, depression, and quality of life in community-dwelling elderly people.

The authors are grateful to Ms. Ng Ada Fong Ting for her support during the study. Conflict of Interest: The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this letter. Author Contributions: Mr. Wong, Prof. Masters, Dr. Maxwell, and Prof. Abernethy were responsible for study design, data analyses, interpretation of the results, and finalization of the letter. Mr. Wong was responsible for recruitment of participants, data collection, and drafting the letter. Sponsor’s Role: None.

Comprehensive geriatric assessment of elderly highlanders in Qinghai, China IV: Comparison of food diversity and its relation to health of Han and Tibetan elderly

Aim:  To examine the association between food diversity and health status of Han and Tibetan elderly highlanders in Qinghai Plateau, China.

Comprehensive geriatric assessment of elderly highlanders in Qinghai, China I: Activities of daily living, quality of life and metabolic syndrome

Aim:  To reveal the comparison of comprehensive geriatric functions of elderly highlanders in Qinghai Plateau in China among three different ethnic groups.

Community‐dwelling elderly with chewing difficulties are more disabled, depressed and have lower quality of life scores

Since 2006, the Japanese Ministry of Health, Welfare and Labor has recommended to screen swallowing and chewing abilities with the community-based comprehensive health-check examination to prevent disability of the elderly population. However, nationwide data of the actual condition of chewing disability in the community-dwelling elderly in Japan remains to be collected and be put in order. To address this important issue in a cross-sectional study in a community in Japan, we analyzed prevalence of elderly subjects with chewing difficulty associated with comprehensive geriatric assessment. The study population consisted of 877 people aged 65 years and older (309 men, 568 women; mean age, 75.6 years; standard deviation, 6.7) living in Tosa, Kochi Prefecture, Japan (the response rate of questionnaire was 59.3% and the complete answering rate was 50.0% of the eligible population in the town). Using self-reported questionnaires, chewing difficulty was screened along with additional assessment of activities of daily living (ADL), depression and subjective quality of life (QOL) in community-dwelling elderly subjects in 2007. Each elderly subject was asked, “In the past 6 months, do you feel chewing difficulty when you eat hard foods?” to identify the deterioration in chewing ability on a yes/no basis. For the assessment of basic ADL, the scores for seven items (walking, ascending and descending stairs, feeding, dressing, using the toilet, bathing, and grooming) were summed using a rating scale from 3 to 0 (3, completely independent; 2, need some help; 1, need help much; 0, completely dependent) into a basic ADL score (0–21). For assessing higherlevel ADL, each subject rated his/her independence in the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC). This assessment consists of a 13-item index including three sublevels of competence: instrumental self-maintenance (0–5), intellectual activity (0–4) and social role (0–4). We screened for depressive symptoms using the Japanese version of the 15-item Geriatric Depression Scale (GDS-15). Quantitative QOL were assessed using a 100 mm visual analog scale (worst QOL on the left end of the scale, best on the right) in the following five items: subjective sense of health, relationship with family, relationship with friends, financial satisfaction and subjective happiness. SPSS statistical software package ver. 16.0 (SPSS, Chicago, IL, USA) was used for statistical analysis with a significance of P < 005. Table 1 shows the comparison of scores in ADL, GDS-15 and subjective QOL between elderly subjects with and without chewing difficulty. The proportion of elderly who had chewing difficulty was 35.2% in this population. The elderly subjects with chewing difficulty were significantly older than those without chewing difficulty (77.5 vs 75.5 years). Mean scores in each ADL were significantly lower in the elderly with chewing difficulty than those without chewing difficulty after the adjustment for the effect of age. Mean score in GDS15 was significantly higher and subjective QOL were lower in the elderly with chewing difficulty than those without. A significantly close association between Correspondence: ••. Email: •• 1

Positive affect as a predictor of lower risk of functional decline in community-dwelling elderly in Japan

To investigate whether positive affect independently predicts a lower risk of functional decline among community‐dwelling older Japanese.

Self-rated happiness is associated with functional ability, mood, quality of life and income, but not with medical condition in community-dwelling elderly in Japan

Subjective views of well-being, defined as emotional contentment and happiness, have been reported to decrease the risk of mortality in older adults. Factors such as economics and health have been shown to correlate with self-rated happiness (SRHa) in the general population. Kudo et al. reported that subjective health condition and some lifestyles influenced life satisfaction in older people. To our knowledge, however, little is known about the association between SRHa and healthrelated factors in older adults in Japan. We considered happiness to be a state of mind or feeling characterized by contentment, love, satisfaction, pleasure or joy. In this study, we examined SRHa-related factors in health check-ups, including comprehensive geriatric function, in community-dwelling Japanese elderly. The study population consisted of 236 communityliving people aged 75 years and older (male : female = 86:150; mean age, 81.0 1 4.6 years), who participated in annual geriatric examinations in T town, Kochi Prefecture, Japan. SRHa was assessed with the question “How would you rate your level of subjective happiness?” using a 100-mm visual analog scale (worst = 0 to best = 100). Using the median SRHa score of 64, we defined participants with a score of 64 or more as a high SRHa group and those with a score less than 64 as a low SRHa group. To assess basic activities of daily living (ADL), participants rated their independence in performing seven items (walking, ascending and descending stairs, eating, dressing, using the toilet, bathing, and grooming), based on a 3 to 0 scale (3 = completely independent, 2 = need some assistance, 1 = need much assistance, 0 = completely dependent). Sub-item scores were summed to obtain a basic ADL score (0–21), in which low scores indicated disability. Elderly participants scoring 21 were considered functionally independent in basic ADL. To assess advanced functional ability, the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) rating scale of 0–13 was used. The TMIG-IC scale includes scores for instrumental selfmaintenance (0–5), intellectual activity (0–4) and social role (0–4). Walking ability and physical balance were assessed using the Timed Up and Go Test. The MiniMental State Examination was used to assess cognitive status. Assessment of medical conditions involved selfreported medication use and physician-based diagnosis of chronic conditions, including hypertension, diabetes *Present address: Faculty of Health and Well-being Kansai University, 1-11-1 Kaorigaoka-cho, Sakai-ku, Sakai-shi, Osaka 5908515, Japan. Author contributions: M. H., data collection, data analysis and writing the manuscript; Y. I., Y. K., A. K., Y. K., E. F., C. W. L., M. N., M. F., R. S., data collection and discussion; and M. I., K. O., K. O., T. W., K. M., study concept. Sponsor’s role: None. Geriatr Gerontol Int 2011; 11: 531–533

Community-dwelling elderly Japanese people with hobbies are healthier than those lacking hobbies.

factors in adults with bacterial meningitis. N Eng J Med 2004;351:1849–1859. 3. Weisfelt M, van de Beek D, Spanjaard L et al. Community-acquired bacterial meningitis in older people. J Am Geriatr Soc 2006;54:1500–1507. 4. Gjini AB, Stuart JM, Cartwright K et al. Quality of in-hospital care for adults with acute bacterial meningitis: A national retrospective survey. Q J Med 2006;99:761–769. 5. Fuglsang-Damgaard D, Pedersen G, Schnheyder HC. Positive blood culture and diagnosis of bacterial meningitis in cases with negative culture of cerebrospinal fluid. Scandi J Infect Dis 2008;40:229–233. 6. Proulx N, Frechette D, Toye B et al. Delays in the administration of antibiotics are associated with mortality from adult acute bacterial meningitis. Q J Med 2005;98:291–298. 7. Kanegaye JT, Soliemanzadeh P, Bradley JS. Lumbar puncture in pediatric bacterial meningitis: Defining the time interval for recovery of cerebrospinal fluid pathogens after parenteral antibiotic pre-treatment. Pediatrics 2001;108: 1169–1174. 8. Ragunathan L., Ramsay M., Borrow R et al. Clinical features, laboratory findings and management of meningococcal meningitis in England and Wales: Report of a 1997 survey. J Infect 2000;40:74–79.

Comprehensive geriatric assessment of elderly highlanders in Qinghai, China, III: Oxidative stress and aging in Tibetan and Han elderly highlanders

Background:  Although there are several factors which may contribute to oxidative stress at high altitude, little is known about the association between oxidative stress and aging in the community‐dwelling elderly in the Tibetan Plateau.

AGE AND SEX SIGNIFICANTLY INFLUENCE FALL RISK IN COMMUNITY-DWELLING ELDERLY PEOPLE IN JAPAN

and would be classified as LBV from a clinico-pathological point of view. Although the main limit of this study was the lack of a pathological diagnosis, it reflects the common clinical situation. These results underscore the difficulty of a DLB diagnosis in the elderly population in which the prevalence of AD lesions is high and might alter the occurrence of clinical signs of DLB, as well as the pattern of episodic memory impairment. Further research with pathological diagnosis is needed in this age group.

Comprehensive geriatric assessment of elderly highlanders in Qinghai, China II: The association of polycythemia with lifestyle‐related diseases among the three ethnicities

Aim:  The objective of this study is to disclose the association of polycythemia with lifestyle‐related diseases (hypertension, obesity and glucose intolerance) among the three ethnicities in Qinghai, China.