井手 一茂

BACKGROUND: Age-friendly communities (AFCs) aim to create inclusive societies for older adults. The World Health Organization (WHO) highlights dementia considerations in AFC development; however, few community-level indicators include these elements. This study aimed to develop a community-level AFC indicator incorporating dementia-friendly elements based on WHO guidelines and to test its validity and reliability. METHODS: A repeated cross-sectional design used data from the 2016 and 2019 waves of the Japan Gerontological Evaluation Study (JAGES) covering 61 school districts in 16 municipalities (45,162 individuals aged 65 and older in 2016 and 39,313 in 2019). The 2016 and 2019 datasets served as the development and retest samples, respectively. The item selection process involved extracting indicators from the JAGES survey items that aligned with WHO guidelines as well as those based on prior research on dementia-friendly communities (DFCs). Following expert consultations, 23 candidate items were identified. Data were aggregated at the school district level. Exploratory factor analysis (EFA) was conducted on the 2016 data to derive the factor structure, and confirmatory factor analysis (CFA) was used to assess model fit. The reproducibility of the factor structure was evaluated using EFA on the 2019 retest sample. Internal consistency and test-retest reliability were assessed. RESULTS: The final 17-item indicator comprised three subscales: Social inclusion and dementia-friendliness (7 items, α = 0.86; e.g., Sense of belonging to the community), Social engagement and communication (5 items, α = 0.78; e.g., Participation in hobby groups), and Age-friendly physical environment (5 items, α = 0.82; e.g., Accessibility of barrier-free streets). The CFA showed an unsatisfactory model fit; however, test-retest reliability was adequate (r = 0.71-0.79; ICC = 0.67-0.78). CONCLUSIONS: A valid and reliable 17-item community-level indicator was developed, aligning with the WHO framework and incorporating dementia-friendly elements. This indicator is a valuable tool for monitoring, evaluation, and inter-community comparisons, aiding the development of AFCs and DFCs in aging societies like Japan. Additionally, this indicator can be adapted for other high-income countries with similar socioeconomic backgrounds, healthcare systems, and community structures, providing a useful tool for age- and dementia-friendly initiatives. CLINICAL TRIAL NUMBER: Not applicable.

BACKGROUND: As the aging population grows, identifying effective interventions to achieve healthy ageing is crucial. Specific environments, such as Curves, the women-only fitness club (WOFC), may provide a supportive setting for older women to engage in physical activities that promote overall healthy ageing. This study aims to compare the functional disability prediction score between WOFC members and control group in older adults. METHODS: Our study design was cross-sectional design. We applied propensity score matching to control for 9 potential confounders, including age, sociodemographic factors, health-related factors. A total of 6,058 participants were matched (3,029 WOFC memberships and 3,029 control groups from the Japan Gerontological Evaluation Study). The functional disability prediction scores we used can predict the risk of functional disability within three years for community-dwelling older adults without activity of daily living limitations. RESULTS: After propensity score matching, the covariates of the two groups were well balanced. The average age after propensity score matching was 72.4 for WOFC members and 72.7 for the control group. The average functional disability prediction score was 0.53 points lower for WOFC members than for the control group (p =.005). CONCLUSIONS: WOFC members had lower scores on the functional disability prediction score related to healthy aging. Future studies should investigate the long-term impact of such programs.

Abstract Well-being (WB) extends beyond physical health, as defined by the World Health Organization and encompasses two aspects: (1) long-term WB (LWB), such as overall life satisfaction; and (2) momentary WB (MWB), such as immediate mood. While research has demonstrated a positive association between one’s environment and LWB, limited studies have explored the association between environmental characteristics and MWB. We applied the experience sampling method (ESM) to collect data on location, perceived environmental characteristics, MWB, and LWB of adult participants living in Kashiwa-no-ha area, Kashiwa City, Japan. Structural equation modeling was used to calculate the correlation coefficients between different environments and both MWB and LWB. LWB was positively associated with MWB (standardized coefficient=0.24) and urban elements—cafés/restaurants/bars (0.11), cultural/sports/education facilities (0.04), and public spaces (0.11). Meanwhile, relaxing/clean (0.56) and natural environments (0.14) were associated with higher MWB. Conversely, vibrant environments (−0.14) and being on the move (−0.11) were linked to lower MWB. LWB was positively associated with being at cultural/sports/educational facilities (0.06), and vibrant (0.15) and communicative (0.13) urban settings. MWB was associated with various built environments, emphasizing the need for places like parks and cafés that promote a positive mood, and well-designed transportation and roads. These elements are important for developing urban areas that meet the physical requirements of residents while supporting their emotional and psychological well-being.