Frailty is a multifactorial syndrome; through this study, we aimed to investigate the physiological, psychological, and social factors associated with frailty and frailty worsening in community-dwelling older adults. We conducted a cross-sectional and longitudinal study using data from the “Community Empowerment and Well-Being and Healthy Long-term Care: Evidence from a Cohort Study (CEC),” which focuses on community dwellers aged 65 and above in Japan. The sample of the cross-sectional study was drawn from a CEC study conducted in 2014 with a total of 673 participants. After excluding those who were frail during the baseline assessment (2014) and at the 3-year follow-up (2017), the study included 373 participants. Frailty assessment was extracted from the Kihon Checklist, while social relationships were assessed using the Social Interaction Index (ISI). Variable selection was performed using Least Absolute Shrinkage and Selection Operator (LASSO) regression and their predictive abilities were tested. Factors associated with frailty status and worsening were identified through the Maximum-min Hillclimb algorithm applied to Bayesian networks (BNs). At baseline, 14.1% (95 out of 673) participants were frail, and 24.1% (90 out of 373) participants experienced frailty worsening at the 3-years follow up. LASSO regression identified key variables for frailty. For frailty identification (cross-sectional), the LASSO model’s AUC was 0.943 (95%CI 0.913–0.974), indicating good discrimination, with Hosmer–Lemeshow (H–L) test p = 0.395. For frailty worsening (longitudinal), the LASSO model’s AUC was 0.722 (95%CI 0.656–0.788), indicating moderate discrimination, with H–L test p = 0.26. The BNs found that age, multimorbidity, function status, and social relationships were parent nodes directly related to frailty. It revealed an 85% probability of frailty in individuals aged 75 or older with physical dysfunction, polypharmacy, and low ISI scores; however, if their social relationships and polypharmacy status improve, the probability reduces to 50.0%. In the longitudinal-level frailty worsening model, a 75% probability of frailty worsening in individuals aged 75 or older with declined physical function and ISI scores was noted; however, if physical function and ISI improve, the probability decreases to 25.0%. Frailty and its progression are prevalent among community-dwelling older adults and are influenced by various factors, including age, physical function, and social relationships. BNs facilitate the identification of interrelationships among these variables, quantify the influence of key factors. However, further research is required to validate the proposed model.

The COVID-19 pandemic has impacted the daily life and social relationships of pre-school children globally. While many studies have examined the impact of the pandemic on children, few have compared the home environment and children’s social skills before and after the pandemic. To address this research gap, we used data from the Japan Child Care Cohort study, which included questions on home environment answered by parents (1748 in 2019 and 1349 in 2020) of children aged 0–6 years using self-reported questionnaires and data on the social skills of children aged 1–6 years (1917 in 2019 and 1989 in 2020) that were evaluated by childcare professionals in childcare centres. Using the Chi-square test, home environments and social skills were compared. We found that frequencies of family meals, no punishment, and a positive attitude toward children’s mistakes were higher in 2020. In contrast, frequencies of shopping together, visiting children’s friends and relatives, and having social support from others were lower in 2020. Additionally, children’s social skills in 2019 were better than in 2020. Childcare institutions can consider these differences and create a support plan to ensure quality child-rearing practices and healthy child development.

Objectives: This study aimed to explore the bidirectional association between frailty and social relationships in older adults while distinguishing between interpersonal and intrapersonal effects. Methods: A prospective cohort study of community-dwelling older adults was conducted in Japan in three waves spanning six years with follow-ups in every three years. Random intercept cross-lagged panel model was used to explore temporal associations between frailty and social relationships. Results: Data for 520 participants (mean age 73.02 [SD 6.38] years, 56.7% women) were analyzed. Across individuals, frailty was associated with social relationships (β = -0.514, p < 0.001). At the interpersonal level, frailty was cross-sectionally associated with social relationships separately at T1(β = -0.389, p < 0.01), T2 (β = -0.343, p < 0.001) and T3 (β = -0.273, p < 0.05). Moreover, social relationships were associated with subsequent increases in symptoms of frailty in all measurement waves (β = -0.332, p < 0.001; β = -0.169, p < 0.01) and vice versa (β = -0.149, p < 0.05; β = -0.292, p < 0.001). Conclusions: The results suggest that frailty was associated with lower levels of social relationships. Frailty improvement programs can be combined with interventions to enhance social relationships, which will be beneficial in preventing frailty. The results emphasize the importance of combining clinical treatments of frailty with interventions to improve social relationships.

Externalizing and internalizing behavioral problems occurs at a high rate among children. However, this has rarely been examined among Japanese children using a person-oriented method. Hence, this study aims to explore its subtypes and clarify their association with family-based group activities. We conducted a cross-sectional survey in a typical community-based suburban area for all families with primary school children in Japan. We investigated children’s internalizing and externalizing behaviors based on the Japanese version of the Strengths and Difficulties Questionnaire (SDQ), and different types of activities that family members frequently engaged in. Data from 206 families were collected and used for the analysis. The subtypes were explored using latent class analysis (LCA). The relationship between family activities and latent class membership was analyzed using a logistic regression model. Moreover, three latent class models and their probabilities were identified, namely, risk group (31.3%), moderate group (44.9%), and normal group (23.8%). Frequent family activities including play sports, traveling or hiking, watching TV and communicating, cooking or making a dessert, and doing housework, which were significantly related to the normal group. These results would add evidence to potential types of children’s behavioral problems and preventive childcare practices needed in the primary gate of families.

Background: Functional status crucially affects healthy aging. Identifying trajectory of functional status and related determinants is important. We aimed to identify the trajectory of functional status over 6 years among older adults with chronic diseases and its association with social relationships.Methods: A latent class growth model analysis was conducted to explore the trajectory of functional status using three time points over 6 years. After identifying the trajectories, a multi-nominal logistic regression analysis was performed to examine the association between social relationships and the trajectories.Results: We included data from 458 participants aged ≥65 years with chronic diseases in Japan. Three distinct trajectories were identified, with 73.3% of participants being functionally stable, 16.6% moderate functional decline, and 10.1% rapid functional decline. Good social relationships were associated with a lower probability of having moderate or rapid functional decline trajectories (odds ratio [OR] 0.75, 95% confidence interval [CI] 0.65–0.87 and OR 0.63, 95% CI 0.51–0.78, respectively).Conclusion: Differences were found in the functional trajectories of older adults with chronic disease over time. Older adults with more extensive social relationships appeared less likely to have a poorer functional trajectory. The findings suggest that fostering extensive social relationships could be an effective management strategy for functional decline deterioration.