Background: After the outbreak of the coronavirus disease 2019 (COVID‐19), “pandemic‐associated‐frailty” or profound health deterioration, in older adults has been considered a health concern. In this study, we sought to demonstrate whether pandemic‐associated‐frailty is occurring in Japan, where the population is aging, by showing the prevalence of frailty before and during the COVID‐19 outbreak, using the same method. Methods: A total of 5222 older adults in Otawara City, Tochigi Prefecture, aged 70 and 75 were surveyed annually using a complete survey, excluding those who were certified as requiring long‐term care. Frailty during 2017–2019 before the COVID‐19 outbreak and during 2020–2021 during the COVID‐19 outbreak was determined using the Kihon Checklist (KCL). Statistical analysis was performed using the χ ² test to compare annual frailty status and Kruskal–Wallis test to compare the scores. Results: The frailty statuses over the five‐year period showed a significant decrease in Robust and a significant increase in Pre‐frailty and Frailty ( p < 0.001). Frailty increased markedly during the second year of the pandemic. Based on the category, the scores deteriorated significantly for activities of daily living ( p < 0.001), physical function ( p = 0.003), oral function ( p < 0.001), outdoor activity ( p < 0.001), and depression ( p < 0.001). Moreover, there was a significant deterioration in the total score for 25 items ( p < 0.001). In addition, a significant deterioration was observed in the total score of 23 items, excluding the social withdrawal affected by self‐restraint life ( p < 0.001). Conclusions: The population prevalence of frailty in older adults increased steadily from the pre‐pandemic year through the first and second years of the pandemic. Based on the 25 questions of the KCL, two aspects including visiting friends and going out less stood out. This suggests that pandemic‐associated‐frailty occurred in Japan.

Background: Recently, the concept of respiratory sarcopenia has been advocated, but evidence is lacking regarding which respiratory parameters are appropriate indicators. Therefore, we investigated the association between sarcopenia, respiratory function, and respiratory muscle strength to identify the most appropriate parameters for respiratory sarcopenia.Methods: We included 124 older adults (67 men, 57 women; average age 77.2 ± 8.3 years) requiring long-term care/support who underwent Day Care for rehabilitation. Handgrip strength, usual gait speed, and skeletal muscle mass were measured using bioelectrical impedance analysis. Participants were then diagnosed with sarcopenia using the algorithm of the Asian Working Group for Sarcopenia 2019. Parameters of respiratory function (forced vital capacity, forced expiratory volume in one second [FEV1.0], FEV1.0%, and peak expiratory flow rate) and respiratory muscle strength (maximal expiratory pressure [MEP] and maximal inspiratory pressure) were also measured according to American Thoracic Society guidelines. Respiratory parameters significantly related to sarcopenia were identified using binomial logistic regression and receiver operating characteristic analyses.Results: Seventy-seven participants were classified as having sarcopenia. Binomial logistic regression analysis showed that MEP was the only respiratory parameter significantly associated with sarcopenia. The cut-off MEP value for predicting sarcopenia was 47.0 cmH₂0 for men and 40.9 cmH₂0 for women.Conclusions: The most appropriate parameter for assessing respiratory sarcopenia may be MEP, which is an indicator of expiratory muscle strength, rather than FVC, MIP, or PEFR, as suggested in previous studies. Measuring MEP is simpler than measuring respiratory function parameters. Moreover, it is expected to have clinical applications such as respiratory sarcopenia screening.

[Purpose] The Asian Working Group for Sarcopenia (AWGS) criteria were recently updated. However, whether these changes would result in a difference in sarcopenia prevalence was unclear. We therefore focused on Japanese older adults who required long-term care/support and determined the differences in sarcopenia prevalence between the new and old criteria. [Participants and Methods] This cross-sectional study included 161 Japanese older adults aged ≥65 years who required long-term care/support along with ongoing daycare. Handgrip strength, usual gait speed, and skeletal muscle mass index were measured. We analyzed the difference in sarcopenia prevalence between the 2019 and 2014 AWGS criteria using the McNemar test. [Results] The overall sarcopenia prevalence rates were 60.2% and 53.4%, and the prevalence rates of sex-specific sarcopenia were 63.6% and 55.7% among males and 56.2% and 50.7% among females when the 2019 and 2014 AWGS criteria were used, respectively. Overall, males exhibited a significantly higher prevalence with the new than criteria than with the old. [Conclusion] With the 2019 AWGS criteria, more older males who required long-term care/support were diagnosed as having sarcopenia. Conversely, the sarcopenia diagnosis in females statistically remained unchanged. Thus, a mismatch might exist between the two criteria regarding sarcopenia prevalence in males.