Background/Objectives: Maintaining functional independence and minimizing disability among older adults living in the community is paramount for mitigating rising care demands. Our study focused on shopping as a critical instrumental activity of daily living (ADL) to explore the association between shopping assistance and functional decline among older individuals receiving support through long-term care insurance (LTCI). Methods: This retrospective, cross-sectional study included 6202 participants aged >65 years living in a Japanese regional town receiving LTCI support, suggesting that they required assistance with local community life. Logistic regression analysis identified several factors associated with shopping assistance among the participants, including physical and cognitive functions, functional ADL, and psychobehavioral symptoms. Results: In male participants, walking dysfunction, short-term memory decline, decreased frequency of going outdoors, and decreased engagement in personal grooming were significantly associated with requiring shopping assistance. Conversely, in female participants, reduced physical function and walking performance were significantly associated with requiring shopping assistance, whereas dependence on personal grooming was less pronounced than in male participants. Conclusions: These findings suggest that, in addition to direct shopping assistance, tailored interventions targeting physical, cognitive, and ADL functions—while considering gender-specific needs—may help older adults maintain independence in shopping activities as part of their daily community life.

Background: The factors necessary for successful use of chopsticks or a spoon, by patients with a paretic upper extremity (UE) following stroke are unknown. Objectives: We identified the functional capacities and interactions related to chopsticks or spoon use in patients with right hemiplegia following stroke. Methods: Participants were 139 stroke patients with right hemiplegia who required rehabilitation, divided into the following three categories: able to use chopsticks, able to use a spoon, or unable to use a spoon. We collected sociodemographic data, medical data, physical and cognitive function data, and functional grades associated with chopsticks or spoon use by the paretic dominant UE while eating. We identified a complex interaction of variables relating to functional use of chopsticks or a spoon using a classification and regression tree analytic process. Results: Patients with UE Brunnstrom recovery stage (BRS) >IV, and a Hasegawa Dementia Scale – Revised (HDS-R) score >16 had a 91.3% probability of being able to use chopsticks. Moreover, patients with a UE BRS of >IV, and the HDS-R score ≤16 had a 66.7% probability of being able to use a spoon. By contrast, patients with a UE BRS of ≤IV had a 90.5% probability of not being able to use a spoon. Conclusions: The interaction of BRS as a measure of UE function and HDS-R score as a measure of cognitive function affect the ability of patients with stroke histories to functionally use the paretic UE to operate chopsticks or a spoon.

This study aimed to determine if the vitality index predicts walking independence in inpatients with hip fractures and calculate a cutoff value. This retrospective cohort study included inpatients with hip fracture (N = 133). Logistic regression analysis was performed with walking independence at discharge and vitality index as the dependent and independent variables, respectively, and age, Berg balance scale (BBS), knee extension muscle strength, and revised Hasegawa’s dementia scale at admission as covariates. A receiver operating characteristic curve was used to calculate the cutoff value. Logistic regression analysis showed that the vitality index at admission was significantly associated with walking independence at discharge, even after adjusting for covariates (P < .01). The area under the receiver operating characteristic curve was 0.82, and the cutoff value of the vitality index at admission was 6.5 points (sensitivity, 78%; specificity, 83%). Our results suggest that the vitality index at admission can be used to predict walking independence in inpatients with hip fractures. In particular, the vitality index score ≥ 7 points at admission is a convenient index for predicting walking independence.