Kazunori OHKAWARA (大河原 一憲)

Background/Objectives: Although information and communication technology (ICT) offers opportunities to address challenges, evidence among frail populations is limited. We aimed to evaluate the effectiveness and feasibility of an ICT-based intervention incorporating an artificial intelligence (AI)-assisted smartphone dietary application and group communication tools to improve dietary quality and social connection among community-dwelling older adults with frailty. Methods: A non-randomized, quasi-experimental study was conducted among 29 older adults (≥65 years) in Tokyo, Japan. Participants were assigned to the intervention (n = 11) or control (n = 18) group. The 3-month intervention included weekly photo uploads of meals via an AI-based dietary application providing automated image analysis and personalized feedback, supervised by registered dietitians, along with peer communication through a group chat. The primary outcome was dietary quality. The secondary outcomes included body weight, body mass index (BMI), skin carotenoid score, and loneliness. Results: The adjusted Japanese Food Guide Spinning Top Score at 3-month follow-up was 49.0 (standard error [SE] = 2.6) and 39.5 (SE = 2.0) in the intervention and control groups, respectively. The adjusted mean difference between groups was +9.5 (95% confidence interval: 2.3 to 16.7, p = 0.01). After using analysis of covariance for adjusting for respective baseline values, age, education status, and antihypertension drug use, no statistically significant between-group differences were observed at 3-month follow-up for any secondary outcomes. Conclusions: AI-based dietary intervention and peer communication effectively improved dietary quality among older adults, highlighting the potential of such an intervention to promote healthier eating habits in this population.

The association between patterns of internet use for older adults’ well-being is unclear. We examined the association between the frequency and purpose of internet use and subjective well-being in older Japanese adults. We analyzed cross-sectional data from 2343 community-dwelling older adults (aged 65–84 years). Subjective well-being was measured using the World Health Organization Well-Being Index as a continuous score, and internet use was categorized by frequency and purpose. Hierarchical linear regression analysis was controlled for sociodemographic and health-related covariates. After full adjustment, only daily (B = 1.04, 95% CI [0.53, 1.56]) and dual-purpose use (i.e., for both practical and social communication purposes; B = 0.80, 95% CI [0.28, 1.31]) were independently associated with higher well-being. The analysis of the combined patterns further suggested that daily use was the primary factor. For older adults, regularity of internet use was more strongly associated with well-being than diversity of purpose. Daily integration appears to be a key factor for realizing benefits, suggesting that sustained practice is the foundational step in building the digital capital necessary for a flourishing later life. Longitudinal studies are needed to confirm these findings and untangle the causal relationship between sustained internet use and improved well-being among older adults.

Background/Objectives: Internet use positively impacts mental health in older adults, with health literacy (HL) playing a key role. While social networks may complement individual HL, the role of neighborhood relationships in this association, particularly by gender, remains unclear. This study examined how the association between HL and Internet use among older adults was modified by neighborhood relationships. Methods: Using baseline data from the Chofu-Digital-Choju project, a cross-sectional analysis was conducted on 1955 community-dwelling adults aged 65-84 (889 men and 1066 women). HL was assessed using the Communicative and Critical Health Literacy scale and dichotomized at four points. Neighborhood relationships were categorized as high (visiting/chatting with neighbors) or low (exchanging greetings/no relationship). Gender-stratified logistic regression analyses were performed with Internet use as the dependent variable, with HL, neighborhood relationships, and their interaction as independent variables. Results: Internet user proportion was 55.6% for men and 41.8% for women. HL was positively associated with Internet use in both genders, though patterns differed. Among men, the HL-Internet use association was consistent (OR = 3.09; 95% CI: 2.25-4.24) regardless of neighborhood relationship levels. For women, this association was significantly modified (interaction OR = 0.46, 95% CI: 0.24-0.87). Women with low HL but strong neighborhood relationships showed increased odds of Internet use (OR = 2.08, 95% CI: 1.32-3.26). Conclusions: Gender-specific patterns in HL and neighborhood relationships influence Internet use among older adults. Neighborhood relationships may compensate for low HL in women, underscoring the need for gender-sensitive strategies to promote digital HL.

Background/Objective: Frailty is a growing public health challenge in Japan's rapidly aging population, where 28.8% are aged ≥ 65. While multicomponent interventions have shown potential in preventing frailty, traditional face-to-face programs face accessibility challenges. This study evaluated the feasibility and short-term changes of an online multicomponent intervention on frailty-related factors among community-dwelling older adults. Methods: In this single-arm feasibility study, 132 participants (mean age 75.7; standard deviation 4.8 years, 65.2% women) completed a six-week online intervention combining exercise, nutrition education, cognitive activities, and the Coimagination Method to foster social connections, meeting weekly for 75 min sessions in groups of up to 10 participants. Results: The intervention demonstrated feasibility with a 96.4% retention rate and a 94.0% average participation rate. While no significant changes were observed in physical activity levels, autonomic nervous system indicators, or cognitive function, carotenoid scores and hemoglobin concentration improved significantly, with more pronounced improvements among women than men. Conclusions: This study demonstrates the high feasibility of online multicomponent interventions for older adults and suggests potential benefits for nutritional status markers, particularly among women. These findings indicate a promising and accessible approach to frailty prevention, though randomized controlled trials with longer intervention periods and direct frailty assessments are required to establish effectiveness conclusively. Study Trial registration: UMIN Clinical Trials Registry (UMIN000053089).

Introduction

Studies on the relationship between parental and child dietary intakes are limited in Asian populations. Here, we examined parent-child relationships in skin carotenoid levels and vegetable intake in a Japanese community.

Methods

The study participants were 58 children aged 6–15 years and 39 of their guardians (parents) using children’s cafeterias. Skin carotenoid levels were measured using the Veggie Meter^®, and the number of vegetable dishes (equivalent to a serving of 70 g) was evaluated using a self-administered questionnaire.

Results

The mean (standard deviation; SD) skin carotenoid levels were 366.8 (74.0) in children and 315.0 (101.4) in parents. The partial correlation coefficient between parents’ and children’s skin carotenoid levels, adjusting for cafeteria, sex, parental dietary supplement use, and household financial status, was 0.38 (P = 0.02); after adjustment for smoking status and BMI, the positive correlation was attenuated (r = 0.25, P = 0.14). A positive correlation was observed between parents’ and children’s vegetable dish intake (r = 0.30, P = 0.02).

Conclusion

This cross-sectional study identified a positive correlation between parent-child intake of vegetable dishes, accounting for potential confounders. However, the positive correlation observed between parent-child skin carotenoid levels may have been attenuated by internal factors such as smoking and obesity.

As loneliness is a risk factor for mental and physical health problems in various age groups, this study aimed to explore the impact of the intergenerational Shokuiku (food and nutrition education) program (IGSP) on loneliness in a Japanese community. This single-arm intervention study conducted between 2022 and 2023 included children (n = 21), guardians (n = 16), university students (n = 3), and older adults (n = 6). The IGSP was a one-day program that included participants making and eating their own bread, butter, and sorbet. Loneliness was measured using the Five-item Loneliness Scale for Children (Five-LSC; Japanese) and the three-item UCLA Loneliness Scale (Japanese; for adults) with other direct questions. Social capital, including civic participation, social cohesion, and reciprocity, was assessed using a self-administered questionnaire. The Five-LSC score significantly decreased post-intervention (p = 0.04). There was a significant increase in adults who reported not feeling lonely (p = 0.001). However, the UCLA Loneliness Scale scores did not show any significant changes. A positive change in social cohesion, including community contribution (p = 0.001) and attachment (p = 0.002), was observed among adults. This study suggests that IGSPs have a positive impact on loneliness in children and a partly positive one in adults. These findings emphasize the potential of intergenerational programs to reduce loneliness in communities.

Promoting subjective well-being is a crucial challenge in aging societies. In 2022, we launched a community-based intervention trial (the Chofu-Digital-Choju Movement). This initiative centered on fostering in-person and online social connections to enhance the subjective well-being of older adults. This paper describes the study design and baseline survey. This quasi-experimental study involved community-dwelling older adults aged 65–84 years in Chofu City, Tokyo, Japan. A self-administered questionnaire was distributed to 3742 residents (1681 men and 2061 women), and a baseline survey was conducted in January 2022. We assessed subjective well-being (primary outcome); psychosocial, physical, and dietary factors; and the use of information and communication technology variables (secondary outcomes) among the participants. After the intervention involving online classes, community hubs, and community events, a 2-year follow-up survey will be conducted to evaluate the effects of the intervention, comparing the intervention group (participants) with the control group (non-participants). We received 2503 questionnaires (66.9% response rate); of these, the analysis included 2343 questionnaires (62.6% valid response rate; mean age, 74.4 (standard deviation, 5.4) years; 43.7% male). The mean subjective well-being score was 7.2 (standard deviation, 1.9). This study will contribute to the development of a prototype subjective well-being strategy for older adults.

Children with Down syndrome (DS) have physical characteristics such as hypotonus of the musculature. Therefore, their attainment rate of physical activity guidelines is low, and guidelines alone may not be sufficient in assessing the amount of physical activity in children with DS. Compared with normal children (NC) of the same grade, light physical activity (LPA) must be considered while assessing physical activity of children with DS, owing to muscle hypotonia. This study included 69 children with DS and 68 NC in grades 4–6 attending elementary school in Japan. The measurements for physical characteristics included age, height, weight, and body mass index. Physical activity was measured using a triaxial accelerometer, which indicated physical activity volume. Children with DS had less moderate-to-vigorous physical activity duration (DS: 53.1 min/day, NC: 65.0 min/day; p < 0.001) but significantly longer LPA duration (DS: 376.4 min/day, NC: 287.7 min/day; p < 0.001) than NC. Conversely, the amount of light to vigorous physical activity (Met’s-hours/day) was greater in children with DS (DS: 16.0 Met’s-hours/day, NC: 14.4 Met’s-hours/day; p = 0.037). In children with DS with muscular hypotonia, vigorous physical activity is challenging, but LPA is feasible. Developing and validating educational programs that promote physical activity with intensity level depending on individual’s physical characteristic are warranted.