Maki SAKAMOTO (坂本 真樹)

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.

Introduction

The number of dementia patients is increasing with population aging. Preclinical detection of dementia in patients is essential for access to adequate treatment. In previous studies, dementia patients showed texture recognition difficulties. Onomatopoeia or sound symbolic words (SSW) are intuitively associated with texture impressions and are less likely to be affected by aphasia and description of material perception can be easily obtained. In this study, we aimed to create a test of texture recognition ability expressed by SSW to detect the presence of mild cognitive disorders.

Methods

The sound symbolic words texture recognition test (SSWTRT) is constructed from 12 close-up photos of various materials and participants were to choose the best SSW out of 8 choices to describe surface texture in the images in Japanese. All 102 participants seen in Juntendo University Hospital from January to August 2023 had a diagnosis of possible iNPH (age mean 77.9, SD 6.7). The answers were scored on a comprehensive scale of 0 to 1. Neuropsychological assessments included MMSE, FAB, and the Rey Auditory Verbal Learning Test (RAVLT), Pegboard Test, and Stroop Test from the EU-iNPH Grading Scale (GS). In study 1 the correlation between SSWTRT and the neuropsychological tests were analyzed. In study 2, participants were divided into two groups: the Normal Cognition group (Group A, n = 37) with MMSE scores of 28 points or above, and the Mild Cognitive Impairment group (Group B, n = 50) with scores ranging from 22 to 27 points, and its predictability were analyzed.

Results

In study 1, the total SSWTRT score had a moderate correlation with the neuropsychological test results. In study 2, there were significant differences in the SSWTRT scores between groups A and B. ROC analysis results showed that the SSWTR test was able to predict the difference between the normal and mildly impaired cognition groups.

Conclusion

The developed SSWTRT reflects the assessment results of neuropsychological tests in cognitive deterioration and was able to detect early cognitive deficits. This test not only relates to visual perception but is likely to have an association with verbal fluency and memory ability, which are frontal lobe functions.

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.

In recent years, the accuracy of speech recognition has improved remarkably. Speech recognition software can be used to obtain text information from conversational speech data. Although text can be treated as surface level information, several studies have indicated that speech recognition can also be used to estimate emotions, which represent higher level information in a conversation. Several newly proposed models use LSTM or GRU to estimate emotion in conversations. However, when attempting to monitor or influence conversations conducted as part of a meeting or a chat, the mood of the conversation is more important than the emotion. In normal conversation, emotions such as anger and sadness are unlikely to be explicitly expressed for some purposes, including avoidance of getting into an unexpected argument and offending others. Thus, when attempting to control or monitor the state of a conversation during a meeting or casual discussion, it is often more important to estimate the mood than the emotion. Some researchers have examined the role of mood, as distinguished from emotion, and one called diffuse emotional states that persist over a long period of time "mood" and are usually distinguished based on duration and intensity of expression. However, these differences are rarely quantified, and no specific durations are fixed. Accurate identification of the mood of a conversation is especially important for Japanese people who are engaged in collaborative and democratic decision making. To construct the teacher data for the model designed to estimate the conversational mood, we first selected representative adjective pairs that could describe the conversational mood. We utilized a system developed by Iiba et al. to estimate 21 affective scales of adjective pairs from input text. The 21 adjective pairs were clustered into 4 groups based on the output scales. The 4 adjective pairs to be annotated were representative of the 4 clusters. We expected these 4 adjective pairs (gloomy-happy, easy-serious, calm-aggressive, tidy-messy) to capture the mood of a conversation.Based on the four adjective pairs, we constructed a new training data set containing 60 hours of conversations in Japanese. In this study, the data obtained only by microphones are used for estimation of conversational mood. The data set was annotated by the four adjective scales to learn the mood of the conversations. We de-veloped a LSTM deep neural network model that could read the "conversational mood" in real time. Furthermore, in our proposed neural network model, the amount of laughter which is generally measured by capturing facial expression with camera is also estimated together with the conversational mood. Because laughter is considered to play an important role in creating a cheerful environment, it can be used to evaluate the conversational mood. The evaluation results are shown to present the validity of our model. This model is expected to be applied to a system that can influence or control the mood of conversations in some ways, including presentation of ambient music and aromas, depending on the purpose of the discussion, such as during a conference, chatting, or business meeting.