Association between eating alone and motor function among community-dwelling older adults during the COVID-19 pandemic: a cross-sectional study

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The relationship between motor function, depression, and nutritional status during the COVID-19 lockdown period was examined in community-dwelling older adults based on the Motor Fitness Scale (MFS) scores. Methods A questionnaire-based survey was conducted among 900 community-dwelling older people aged 65 years and above. Of 400 people who responded to the questionnaire, 66 people with missing MFS responses, 45 people with a Dementia Assessment Sheet for Community-based Integrated Care System 8-items (DASC-8) score of 11 or more, 9 people with neurological and mental problems , and 43 people certified as requiring support or care were excluded. The remaining 237 people (mean age, 73.1±6.0 years) were included for analysis. Based on MFS cutoff points of 11 or less for men and 9 or less for women, the participants were divided into the low MFS group (n=65) and normal MFS group (n=172). Nutritional status was assessed using the mini nutritional assessment, short form (MNA ® -SF). Age, gender, household situation, education, eating alone , Geriatric Depression Scale15 (GDS15), and DASC-8 data were collected. Results Compared with the normal group, the group with reduced MFS score had a significantly higher proportion of those aged 75 years or older (p=0.001, Cramer’s V=0.215) and those who ate alone (p=0.052, Cramer’s V=0 . 135). Furthermore, a higher proportion of the participants were at risk of low nutrition. Multivariate logistic regression analysis with lower MFS score as the outcome showed that dietary status: eating alone (odds ratio [OR]: 4.08, 95% confidence interval [CI] 1.39–11.99) was independently associated with lower MFS scores. The presence of MNA ® -SF risk showed an OR of 2.27 and a 95% CI of 0.96–5.38, but it was not a significant factor. Conclusions Eating alone was independently associated with lower MFS scores in community-dwelling older people. To prevent the decline of motor function in older people, attention should be paid to their nutritional status and whether they eat alone or not. This study provides a research direction for surveys to be performed in settings where performing face-to-face surveys is challenging. Community-dwelling older adults Motor function Depression Eating alone COVID-19 Figures Figure 1 Background Decreased mobility among older people living in the community increases their risk of needing care ( 1 ). Furthermore, infrequent outings and lack of participation in community associations, such as volunteering and engaging in hobbies and sports, have been reported in a three-year follow-up study as a risk factor for long-term care ( 2 ). Physical activity decline is accompanied by motor function decline. After 2020, the coronavirus disease 2019 (COVID-19) pandemic reduced outing opportunities for older people, and physical activity among older people decreased by 30% per week ( 3 ). Furthermore, the spread of COVID-19 has led to stress accumulation, which has been associated with the onset of depression and other disorders, as well as an exacerbation of existing mental illnesses ( 4 ). Older people who were restricted from leaving their homes due to the COVID-19 pandemic were at risk of reduced motor function and mental health problems. Decline in motor function is partly due to atrophy of the skeletal muscles. Skeletal muscle mass is related to nutritional status, and undernutrition leads to sarcopenia ( 5 ). In a previous study on the relationship between nutritional status and motor function in community-dwelling older people, a percentage of older people was undernourished, which was associated with reduced grip strength and knee extension muscle strength ( 6 ). Therefore, it is important to assess the nutritional status of community-dwelling older people in combination with their motor function decline. However, studies examining the motor function and nutritional status of community-dwelling older people often collected motor function data by conducting performance tests, such as muscle strength and walking speed tests ( 7 , 8 ), and assessed nutritional status using blood biochemical tests. These assessments are performed during health check-ups conducted in settings outside the home, and the motor function and nutritional status of older people who do not attend these health check-ups have rarely been examined. It is also necessary to consider different approaches for surveys in situations such as the COVID-19 pandemic, where performing face-to-face surveys is difficult. The Motor Fitness Scale (MFS), a self-administered questionnaire, is one of the scales for assessing motor function in older people. The reproducibility and criterion-related validity of the MFS in community-dwelling older people have been confirmed ( 9 ). It is a safe and simple way to assess physical function, making it a useful tool for screening people at high risk of disability ( 10 ). The MFS score is associated with the risk of needing care in older people. In a study examining the association between MFS scores and the risk of needing care and support with the participants classified according to family structure, a one-point increase in MFS scores resulted in a risk reduction of approximately 10% in the group living with three generations and approximately 22% in the group living with only a spouse ( 11 ). Clarifying the motor function and nutritional status of older people during the COVID-19 restriction period is important for extending the healthy life expectancy of older people who are less likely to go out. In this study, the MFS was used, and the relationship between motor function, depression, and nutritional dietary status during the COVID-19 lockdown period in community-dwelling older adults was examined. Methods Research design This study used a cross-sectional design. Participants The participants (n = 900) were older people aged 65 years or older living in areas where they have been recruited by the author’s university in ongoing projects. The residences of these participants were known by the established social welfare councils responsible for community welfare in prefectures and municipalities and by the community support centres that provided comprehensive support to older people in the community. Self-administered questionnaires were distributed by community coordinators in person at welfare halls or by post in 14 target wards supervised by the Council of Social Welfare from 1 March to 24 April 2021, when the emergency declaration of COVID-19 had ceased and restrictions had been lifted The completed questionnaires were collected by post to the universities. This study was approved by the Ethics Committee of Morinomiya University of Medical Care (approval number: 2020-082) and was conducted with the consent of the participants. Sample size determination G*Power 3.1.9.2 was used to calculate the sample size. Based on a previous study ( 10 ), the sample size was calculated as 25% of the people with reduced motor function, with an effect size of 0.5, an alpha error of 0.05, and a power of 0.8. The sample size for groups 1 and 2 was calculated as 166 and 42 cases, respectively, with 208 total number of cases. The questionnaire collection rate was set at 60% ( 12 ), and the target distribution number was set as 350 questionnaires. Survey items A self-administered questionnaire integrating the following items was prepared by the authors to be completed by the respondents. General information General information included age, gender, household situation (living alone or not), educational history, whether or not the person was certified as requiring support or care, height, and weight. BMI was calculated using the height and weight measurements. Assessment items The assessment items were motor function, nutritional status, dietary status, cognitive and daily functioning, degree of depression, and educational history (less than a high school diploma, high school diploma, and university diploma). The MFS was used to assess motor function. It consists of three subscales (six items for mobility, four items for muscle strength, and four items for balance), with a total score of 14 points and higher scores indicating higher subjective motor function. As the value for the MFS is not standardised in the present study, the cut-off values shown in a previous study to be associated with the risk of needing care (≤ 11 points for men and ≤ 9 points for women) ( 10 ) were used to group participants with reduced or no reduction MFS scores. Nutritional status was assessed using the MNA®-SF. Six items related to nutritional status (declined food intake over 3 months, weight loss over 3 months, gait status, presence of psychological problems, and BMI) were investigated. The participants were divided into two groups: normal group with a score of 12 or more and at risk of low nutritional status with a score of 11 or less. Eating alone group was defined as eating alone on most days, while the communal eating group was defined as eating with someone on more than one day per week. The DASC-8 was used to assess cognitive and life function. The DASC-8 is a shortened version of the DASC-21 ( 13 ); however, they correlate well, and the DASC-8 has good internal consistency ( 14 ). The Japanese version of the GDS15, a scale used for older people, was used to assess the degree of depression. A score of 6 or more was considered as depression and a score of 5 or less was considered normal ( 15 ). Statistical analysis Statistical analysis was performed using SPSS ver. 27, and the two groups of patients with reduced MFS and no reduction MFS were compared. For comparisons of nominal variables, the χ 2 or the Fisher’s exact probability tests were used. Cohen’s criteria were used to evaluate the effect sizes, which were set as small (0.10), medium (0.30), and large (0.50). The effect sizes for the nominal variables were calculated using the χ 2 value, Cramer’s V , and those for the quantitative variables were calculated using the z-value, r. Multivariate logistic regression analysis was performed to identify factors associated with reduced MFS scores, with reduced MFS scores as the outcome. To avoid multicollinearity, six independent variables were assessed as factors (gender, age, household status, MNA®-SF, eating alone, and GDS15). Age was entered as a continuous variable. Multivariate results are presented as odds ratios (ORs) and 95% confidence intervals (CIs), with p < 0.05 indicating the level of statistical significance for all statistical analyses. Results Overall, 400 people responded by post (response rate, 44.4%). Considering the validity of the responses, 66 people with deficient MFS responses, 45 people with a score of 11 or higher suspected of having moderate cognitive decline in the DASC-8, 9 people with neurological or mental problems as assessed by the MNA® -SF, and 43 people certified as requiring support or care that may affect their motor function were excluded from the survey. The final analysis included 237 MFS respondents (mean age, 73.1 ± 6.0 years; Fig. 1 ). Results of the comparison of the background factor of the two groups A comparison between 172 participants in the normal MFS group and 65 in the reduced MFS group is shown in Table 1. The group with reduced MFS scores had a significantly higher proportion of those aged 75 years and above (p = 0.001, Cramer's V = 0.215) and those who ate alone (p = 0.052, Cramer’s V = 0.135). The proportion of those showing depressive tendencies assessed using the GDS15 was significantly higher (38%) than those in the normal group (p = 0.026, Cramer’s V = 0.16). A higher proportion of those assessed as being at risk of low nutrition using the MNA®-SF was observed. (p = 0.027, Cramer’s V = 0.153). Multivariate logistic regression analysis for MFS decline Multivariate logistic regression analysis with MFS score reduction as the outcome showed that dietary status: eating alone (OR: 4.08, 95%CI 1.39–11.99) was independently associated with MFS score reduction. The presence of MNA®-SF risk showed an OR of 2.27 and a 95% CI of 0.96–5.38, but the finding was not significant (Table 2). Discussion In this study, we examined the relationship between motor function, depression, and nutritional status during the COVID-19 restriction period using the MFS scores in community-dwelling older people. In the group with reduced MFS scores, the proportion of people aged 75 years or older, eating alone, and showing depressive tendencies was significantly higher than that observed in the normal MFS group. Multivariate logistic regression analysis showed that the status of eating alone was independently associated with lower MFS scores. The risk of undernutrition was not a significant factor of lower MFS scores. Older people who eat alone are reported to have low quality of life, depression, low BMI, and poor food intake diversity ( 16 ). In addition, Nagata et al. reported an association between depression and reduced grip and chewing strength in the late elderly ( 17 ). Furthermore, a tendency toward depression has been reported as a predictor of reduced motor function after 4 years ( 18 ). Although no difference in BMI was observed between the two groups in the present study, the proportion of those with depressive tendencies was significantly higher in the reduced MFS group than in the normal MFS group. This result supports previous studies and highlights the importance of assessing depression alongside motor function. Psychological health was reported as significantly lower in solitary eaters compared with older people who ate with others ( 19 ). Furthermore, eating alone was associated with mortality among male older people ( 20 ). A decrease in food diversity and anorexia can also lead to low nutritional status ( 21 ), suggesting that eating in ‘communal eating spaces’ may be important. On the other hand, some challenges, such as the low number of male participants in communal mealtimes and the difficulty in sustaining these males in the community, exist. Regarding nutritional status, the multivariate analysis was not significant, but a significantly higher proportion of those with reduced MFS scores were at risk of low nutrition. A previous study reported that older people whose nutritional status improved within the one-year study period maintained their motor function ( 22 ). The older age group with reduced MFS scores in the present study may explain the high proportion of those at risk of low nutrition. Furthermore, the depression status and reduced activity associated with restricted access to the outside environment may have contributed to the risk of low nutrition. The nutritional status of older people is complicated by the physiological, social, and economic problems associated with aging ( 23 ), and further studies are needed. This study revealed that risk factors such as reduced opportunities for shared meals that were imposed on the older during the period of prolonged outing restrictions to prevent the spread of COVID-19 reduced their motor function. Increasing opportunities for shared meals in the community will lead to increased outing opportunities and improve the motor function of older people who tend to be confined to their homes. Aside from COVID-19, other infections may cause behavioural restrictions in the future. Assessment and efforts to maintain motor function in older people while considering infection control should be established. A report ( 24 ) have shown that in older people, eating alone is associated with their health status, but this is the first study to show that it is associated with reduced motor function. Isolated eating can be eliminated through environmental and community efforts. This study highlights the need to pay attention not only to nutritional status but also to the eating situation of older people. We also believe that this study demonstrates an approach to conducting surveys in environments where conducting face-to-face surveys is challenging. The limitations of this study are as follows. First, the questionnaire responses were provided voluntarily, and we could not assess those who did not complete the questionnaire. The response rate in this study was 44.4%, which is lower than the 63.5% response rate of other questionnaires for older people living in large cities ( 12 ); therefore, it is not representative of older people living in the region. In addition, the power of the survey was insufficient due to the large number of excluded participants. Second, the DASC-8 excluded cases of suspected cognitive decline, but the self-administered questionnaire may have included some participants with mild cognitive decline. In addition, the questionnaires were randomly distributed to older people living in the target area, which including those who were certified as requiring nursing care, indicating reduced motor function; therefore, they had to be excluded in the analysis stage. Third, as this was a cross-sectional study, the decline in MFS score may have occurred before the survey, and the causal relationship between the decline in MFS scores, eating alone, nutritional status, etc. is not clear. Fourth, since the study included older people living in a single area, the results of this study may not be applicable to older people in other areas. In the future, longitudinal follow-up studies are needed to clarify the causal relationship of eating alone, nutritional status, and other factors with motor function decline. Conclusion This study showed that eating alone is independently associated with a decline in subjective motor function in community-dwelling older people. Nutritional status and eating alone should be considered simultaneously to prevent the decline of motor function in older people. Declarations Acknowledgement We would like to thank the older people living in the Suminoe Ward area of Osaka Prefecture who agreed to this study and responded, as well as the Suminoe Ward Council of Social Welfare, the community coordinators for their cooperation and Editage (www.editage.jp) for English language editing. Ethics approval and consent to participate Approval for this study was given by the Ethics Committee of Morinomiya University of Medical Care (approval number: 2020-082) and written informed consent was obtained from the participants. All methods were performed following the Declarations of Helsinki. Consent for publication Not applicable. Availability of data and materials The datasets generated and/or analyzed during the current study are not publicly available as there was no such approval for the study protocol. The data are available from the corresponding author upon reasonable request. Competing Interest The authors declare that they have no competing interests. Funding Not applicable. Authors' contributions R.M: Study conception and design R.M, C.M and Y.S: Acquisition, analysis and interpretation of data D.M: Critical revision Corresponding author Correspondence to Ryosuke Mikiya Authors' information Authors and Affiliations Department of Physical Therapy, Faculty of Rehabilitation, Morinomiya University of Medical Sciences, 1-26-16, Nankoukita, Suminoe-ku, Osaka-shi, Osaka 559-8611, Japan Ryosuke Mikiya & Yuko Sawada Department of Food Science and Human Nutrition, Faculty of Agriculture, Setsunan University, 45-1, Nagaotoge-cho, Hirakata-City, Osaka 573-0101, Japan Chika Momoki Department of Medical nutrition, Graduate School of Life Science, Osaka Metropolitan University, 3-3-138 Sugimoto, Sumiyoshi-ku Osaka-shi, Osaka 558-8585, Japan Daiki Habu [AA1]Please note that according to the journal, the following information should be included in this section. Ethics approval and consent to participate Consent for publication Availability of data and materials Competing interests Funding Authors' contributions Acknowledgements Authors' information (optional) References Fujiwara Y, Amano H, Kumagai S, Yoshida H, Fujita K, Naito T, et al: Physical and psychological predictors for the onset of certification of long-term care insurance among older adults living independently in a community A 40-month follow-up study. Japanese Journal of Public Health. 2006; 53: 77-91 (In Japanese). Japanese). Hirai H, Kondo K, Ojima T, Murata C. Examination of risk factors for onset of certification of long-term care insurance in community-dwelling older In: AGES project 3-year follow-up study. Japanese Journal of Public Health. 2009; 56: 501-512 (In Japanese). Yamada M, Kimura Y, Ishiyama D, Otobe Y, Suzuki M, Koyama S, et al: Effect of the COVID-19 epidemic on physical activity in community-dwelling older J Nutr. Health Aging. 2020; 24(9): 948-950. 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Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4392507","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":303706194,"identity":"e30a1f53-25d8-4e68-a76d-56086b1d58cc","order_by":0,"name":"Ryosuke Mikiya","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA/UlEQVRIiWNgGAWjYDACZjaGAwwMNkAWYwOQkEBIENCSRooWBjYQcZgEd+m2syUe5qk5H80vfbjtwccci8T+Bh4Dhh81DOzmOLSYHWY7cJjn2O3cmX2J7YYzt0kkzjjAY8DYc4yB2bIBlxb2hsM8bLdzN5xhbJPmBWppuP/GgIG3gYHZ4AA+Lf/OIbTMB9nyF68WoMN42w4gtGwAamHGbwtbwsG5fcm5M3sY2ySBfjHeeICt4LDMMQncfjl/zPjDm292uf087M8kPm6rk513gHnjwzc1Nsm4QgwEmHiQOI4gs4FOkkg2wKOF8QcSxx7GsMOnZRSMglEwCkYUAAB+RltGc03lhQAAAABJRU5ErkJggg==","orcid":"","institution":"Morinomiya University of Medical Sciences","correspondingAuthor":true,"prefix":"","firstName":"Ryosuke","middleName":"","lastName":"Mikiya","suffix":""},{"id":303706195,"identity":"e3ed5e9c-93f9-4328-9557-d2f08178787b","order_by":1,"name":"Chika Momoki","email":"","orcid":"","institution":"Setsunan University","correspondingAuthor":false,"prefix":"","firstName":"Chika","middleName":"","lastName":"Momoki","suffix":""},{"id":303706196,"identity":"32befe2a-cb39-40ba-b9b0-02ab69487d48","order_by":2,"name":"Yuko Sawada","email":"","orcid":"","institution":"Morinomiya University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Yuko","middleName":"","lastName":"Sawada","suffix":""},{"id":303706197,"identity":"ab77e202-f6d0-433c-8222-b7d921d09128","order_by":3,"name":"Daiki Habu","email":"","orcid":"","institution":"Osaka Metropolitan University","correspondingAuthor":false,"prefix":"","firstName":"Daiki","middleName":"","lastName":"Habu","suffix":""}],"badges":[],"createdAt":"2024-05-09 04:38:36","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4392507/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4392507/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12877-025-06557-6","type":"published","date":"2025-11-10T15:57:08+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":57287226,"identity":"4b892fe3-b6de-4bdb-bd7b-5482af864e0a","added_by":"auto","created_at":"2024-05-28 16:43:10","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":42229,"visible":true,"origin":"","legend":"\u003cp\u003eFlowchart\u003c/p\u003e","description":"","filename":"Figure1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4392507/v1/aa1c23d7c88bcd2d50515485.jpg"},{"id":96105035,"identity":"a461ccde-3353-434a-b774-80a57733740e","added_by":"auto","created_at":"2025-11-17 16:07:37","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":647293,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4392507/v1/a6cbbc46-3309-408b-b821-a0d90a379e30.pdf"},{"id":57287227,"identity":"4d7f3e30-23b7-418a-93af-78cc0248501c","added_by":"auto","created_at":"2024-05-28 16:43:11","extension":"xlsx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":24948,"visible":true,"origin":"","legend":"","description":"","filename":"Table1.xlsx","url":"https://assets-eu.researchsquare.com/files/rs-4392507/v1/45dc2565a92e9ad1041c6219.xlsx"},{"id":57287228,"identity":"a135f243-f50e-4779-8543-013daad41494","added_by":"auto","created_at":"2024-05-28 16:43:11","extension":"xlsx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":112419,"visible":true,"origin":"","legend":"","description":"","filename":"Table2.xlsx","url":"https://assets-eu.researchsquare.com/files/rs-4392507/v1/d19a261632ed569495b91b9f.xlsx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Association between eating alone and motor function among community-dwelling older adults during the COVID-19 pandemic: a cross-sectional study","fulltext":[{"header":"Background","content":"\u003cp\u003eDecreased mobility among older people living in the community increases their risk of needing care (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Furthermore, infrequent outings and lack of participation in community associations, such as volunteering and engaging in hobbies and sports, have been reported in a three-year follow-up study as a risk factor for long-term care (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Physical activity decline is accompanied by motor function decline.\u003c/p\u003e \u003cp\u003eAfter 2020, the coronavirus disease 2019 (COVID-19) pandemic reduced outing opportunities for older people, and physical activity among older people decreased by 30% per week (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Furthermore, the spread of COVID-19 has led to stress accumulation, which has been associated with the onset of depression and other disorders, as well as an exacerbation of existing mental illnesses (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Older people who were restricted from leaving their homes due to the COVID-19 pandemic were at risk of reduced motor function and mental health problems.\u003c/p\u003e \u003cp\u003eDecline in motor function is partly due to atrophy of the skeletal muscles. Skeletal muscle mass is related to nutritional status, and undernutrition leads to sarcopenia (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). In a previous study on the relationship between nutritional status and motor function in community-dwelling older people, a percentage of older people was undernourished, which was associated with reduced grip strength and knee extension muscle strength (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eTherefore, it is important to assess the nutritional status of community-dwelling older people in combination with their motor function decline. However, studies examining the motor function and nutritional status of community-dwelling older people often collected motor function data by conducting performance tests, such as muscle strength and walking speed tests (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e), and assessed nutritional status using blood biochemical tests. These assessments are performed during health check-ups conducted in settings outside the home, and the motor function and nutritional status of older people who do not attend these health check-ups have rarely been examined. It is also necessary to consider different approaches for surveys in situations such as the COVID-19 pandemic, where performing face-to-face surveys is difficult.\u003c/p\u003e \u003cp\u003eThe Motor Fitness Scale (MFS), a self-administered questionnaire, is one of the scales for assessing motor function in older people. The reproducibility and criterion-related validity of the MFS in community-dwelling older people have been confirmed (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). It is a safe and simple way to assess physical function, making it a useful tool for screening people at high risk of disability (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). The MFS score is associated with the risk of needing care in older people. In a study examining the association between MFS scores and the risk of needing care and support with the participants classified according to family structure, a one-point increase in MFS scores resulted in a risk reduction of approximately 10% in the group living with three generations and approximately 22% in the group living with only a spouse (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eClarifying the motor function and nutritional status of older people during the COVID-19 restriction period is important for extending the healthy life expectancy of older people who are less likely to go out.\u003c/p\u003e \u003cp\u003eIn this study, the MFS was used, and the relationship between motor function, depression, and nutritional dietary status during the COVID-19 lockdown period in community-dwelling older adults was examined.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eResearch design\u003c/h2\u003e \u003cp\u003eThis study used a cross-sectional design.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eParticipants\u003c/h2\u003e \u003cp\u003eThe participants (n\u0026thinsp;=\u0026thinsp;900) were older people aged 65 years or older living in areas where they have been recruited by the author\u0026rsquo;s university in ongoing projects. The residences of these participants were known by the established social welfare councils responsible for community welfare in prefectures and municipalities and by the community support centres that provided comprehensive support to older people in the community. Self-administered questionnaires were distributed by community coordinators in person at welfare halls or by post in 14 target wards supervised by the Council of Social Welfare from 1 March to 24 April 2021, when the emergency declaration of COVID-19 had ceased and restrictions had been lifted The completed questionnaires were collected by post to the universities. This study was approved by the Ethics Committee of Morinomiya University of Medical Care (approval number: 2020-082) and was conducted with the consent of the participants.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eSample size determination\u003c/h2\u003e \u003cp\u003eG*Power 3.1.9.2 was used to calculate the sample size. Based on a previous study (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e), the sample size was calculated as 25% of the people with reduced motor function, with an effect size of 0.5, an alpha error of 0.05, and a power of 0.8. The sample size for groups 1 and 2 was calculated as 166 and 42 cases, respectively, with 208 total number of cases. The questionnaire collection rate was set at 60% (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e), and the target distribution number was set as 350 questionnaires.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eSurvey items\u003c/h2\u003e \u003cp\u003eA self-administered questionnaire integrating the following items was prepared by the authors to be completed by the respondents.\u003c/p\u003e \u003cdiv id=\"Sec7\" class=\"Section3\"\u003e \u003ch2\u003eGeneral information\u003c/h2\u003e \u003cp\u003eGeneral information included age, gender, household situation (living alone or not), educational history, whether or not the person was certified as requiring support or care, height, and weight. BMI was calculated using the height and weight measurements.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section3\"\u003e \u003ch2\u003eAssessment items\u003c/h2\u003e \u003cp\u003eThe assessment items were motor function, nutritional status, dietary status, cognitive and daily functioning, degree of depression, and educational history (less than a high school diploma, high school diploma, and university diploma).\u003c/p\u003e \u003cp\u003eThe MFS was used to assess motor function. It consists of three subscales (six items for mobility, four items for muscle strength, and four items for balance), with a total score of 14 points and higher scores indicating higher subjective motor function. As the value for the MFS is not standardised in the present study, the cut-off values shown in a previous study to be associated with the risk of needing care (\u0026le;\u0026thinsp;11 points for men and \u0026le;\u0026thinsp;9 points for women) (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e) were used to group participants with reduced or no reduction MFS scores.\u003c/p\u003e \u003cp\u003eNutritional status was assessed using the MNA\u0026reg;-SF. Six items related to nutritional status (declined food intake over 3 months, weight loss over 3 months, gait status, presence of psychological problems, and BMI) were investigated. The participants were divided into two groups: normal group with a score of 12 or more and at risk of low nutritional status with a score of 11 or less.\u003c/p\u003e \u003cp\u003eEating alone group was defined as eating alone on most days, while the communal eating group was defined as eating with someone on more than one day per week.\u003c/p\u003e \u003cp\u003eThe DASC-8 was used to assess cognitive and life function. The DASC-8 is a shortened version of the DASC-21 (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e); however, they correlate well, and the DASC-8 has good internal consistency (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe Japanese version of the GDS15, a scale used for older people, was used to assess the degree of depression. A score of 6 or more was considered as depression and a score of 5 or less was considered normal (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eStatistical analysis was performed using SPSS ver. 27, and the two groups of patients with reduced MFS and no reduction MFS were compared. For comparisons of nominal variables, the χ\u003csup\u003e2\u003c/sup\u003e or the Fisher\u0026rsquo;s exact probability tests were used. Cohen\u0026rsquo;s criteria were used to evaluate the effect sizes, which were set as small (0.10), medium (0.30), and large (0.50). The effect sizes for the nominal variables were calculated using the χ\u003csup\u003e2\u003c/sup\u003e value, Cramer\u0026rsquo;s \u003cem\u003eV\u003c/em\u003e, and those for the quantitative variables were calculated using the z-value, r.\u003c/p\u003e \u003cp\u003eMultivariate logistic regression analysis was performed to identify factors associated with reduced MFS scores, with reduced MFS scores as the outcome. To avoid multicollinearity, six independent variables were assessed as factors (gender, age, household status, MNA\u0026reg;-SF, eating alone, and GDS15). Age was entered as a continuous variable. Multivariate results are presented as odds ratios (ORs) and 95% confidence intervals (CIs), with p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 indicating the level of statistical significance for all statistical analyses.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eOverall, 400 people responded by post (response rate, 44.4%). Considering the validity of the responses, 66 people with deficient MFS responses, 45 people with a score of 11 or higher suspected of having moderate cognitive decline in the DASC-8, 9 people with neurological or mental problems as assessed by the MNA\u0026reg; -SF, and 43 people certified as requiring support or care that may affect their motor function were excluded from the survey. The final analysis included 237 MFS respondents (mean age, 73.1\u0026thinsp;\u0026plusmn;\u0026thinsp;6.0 years; Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eResults of the comparison of the background factor of the two groups\u003c/h2\u003e \u003cp\u003eA comparison between 172 participants in the normal MFS group and 65 in the reduced MFS group is shown in Table\u0026nbsp;1. The group with reduced MFS scores had a significantly higher proportion of those aged 75 years and above (p\u0026thinsp;=\u0026thinsp;0.001, Cramer's V\u0026thinsp;=\u0026thinsp;0.215) and those who ate alone (p\u0026thinsp;=\u0026thinsp;0.052, Cramer\u0026rsquo;s V\u0026thinsp;=\u0026thinsp;0.135). The proportion of those showing depressive tendencies assessed using the GDS15 was significantly higher (38%) than those in the normal group (p\u0026thinsp;=\u0026thinsp;0.026, Cramer\u0026rsquo;s V\u0026thinsp;=\u0026thinsp;0.16). A higher proportion of those assessed as being at risk of low nutrition using the MNA\u0026reg;-SF was observed. (p\u0026thinsp;=\u0026thinsp;0.027, Cramer\u0026rsquo;s V\u0026thinsp;=\u0026thinsp;0.153).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eMultivariate logistic regression analysis for MFS decline\u003c/h2\u003e \u003cp\u003eMultivariate logistic regression analysis with MFS score reduction as the outcome showed that dietary status: eating alone (OR: 4.08, 95%CI 1.39\u0026ndash;11.99) was independently associated with MFS score reduction. The presence of MNA\u0026reg;-SF risk showed an OR of 2.27 and a 95% CI of 0.96\u0026ndash;5.38, but the finding was not significant (Table\u0026nbsp;2).\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this study, we examined the relationship between motor function, depression, and nutritional status during the COVID-19 restriction period using the MFS scores in community-dwelling older people. In the group with reduced MFS scores, the proportion of people aged 75 years or older, eating alone, and showing depressive tendencies was significantly higher than that observed in the normal MFS group. Multivariate logistic regression analysis showed that the status of eating alone was independently associated with lower MFS scores. The risk of undernutrition was not a significant factor of lower MFS scores.\u003c/p\u003e \u003cp\u003eOlder people who eat alone are reported to have low quality of life, depression, low BMI, and poor food intake diversity (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). In addition, Nagata et al. reported an association between depression and reduced grip and chewing strength in the late elderly (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). Furthermore, a tendency toward depression has been reported as a predictor of reduced motor function after 4 years (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). Although no difference in BMI was observed between the two groups in the present study, the proportion of those with depressive tendencies was significantly higher in the reduced MFS group than in the normal MFS group. This result supports previous studies and highlights the importance of assessing depression alongside motor function.\u003c/p\u003e \u003cp\u003ePsychological health was reported as significantly lower in solitary eaters compared with older people who ate with others (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). Furthermore, eating alone was associated with mortality among male older people (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). A decrease in food diversity and anorexia can also lead to low nutritional status (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e), suggesting that eating in \u0026lsquo;communal eating spaces\u0026rsquo; may be important. On the other hand, some challenges, such as the low number of male participants in communal mealtimes and the difficulty in sustaining these males in the community, exist.\u003c/p\u003e \u003cp\u003eRegarding nutritional status, the multivariate analysis was not significant, but a significantly higher proportion of those with reduced MFS scores were at risk of low nutrition. A previous study reported that older people whose nutritional status improved within the one-year study period maintained their motor function (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). The older age group with reduced MFS scores in the present study may explain the high proportion of those at risk of low nutrition. Furthermore, the depression status and reduced activity associated with restricted access to the outside environment may have contributed to the risk of low nutrition. The nutritional status of older people is complicated by the physiological, social, and economic problems associated with aging (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e), and further studies are needed.\u003c/p\u003e \u003cp\u003eThis study revealed that risk factors such as reduced opportunities for shared meals that were imposed on the older during the period of prolonged outing restrictions to prevent the spread of COVID-19 reduced their motor function. Increasing opportunities for shared meals in the community will lead to increased outing opportunities and improve the motor function of older people who tend to be confined to their homes.\u003c/p\u003e \u003cp\u003eAside from COVID-19, other infections may cause behavioural restrictions in the future. Assessment and efforts to maintain motor function in older people while considering infection control should be established. A report (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e) have shown that in older people, eating alone is associated with their health status, but this is the first study to show that it is associated with reduced motor function. Isolated eating can be eliminated through environmental and community efforts. This study highlights the need to pay attention not only to nutritional status but also to the eating situation of older people. We also believe that this study demonstrates an approach to conducting surveys in environments where conducting face-to-face surveys is challenging.\u003c/p\u003e \u003cp\u003eThe limitations of this study are as follows. First, the questionnaire responses were provided voluntarily, and we could not assess those who did not complete the questionnaire. The response rate in this study was 44.4%, which is lower than the 63.5% response rate of other questionnaires for older people living in large cities (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e); therefore, it is not representative of older people living in the region. In addition, the power of the survey was insufficient due to the large number of excluded participants. Second, the DASC-8 excluded cases of suspected cognitive decline, but the self-administered questionnaire may have included some participants with mild cognitive decline. In addition, the questionnaires were randomly distributed to older people living in the target area, which including those who were certified as requiring nursing care, indicating reduced motor function; therefore, they had to be excluded in the analysis stage. Third, as this was a cross-sectional study, the decline in MFS score may have occurred before the survey, and the causal relationship between the decline in MFS scores, eating alone, nutritional status, etc. is not clear. Fourth, since the study included older people living in a single area, the results of this study may not be applicable to older people in other areas. In the future, longitudinal follow-up studies are needed to clarify the causal relationship of eating alone, nutritional status, and other factors with motor function decline.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study showed that eating alone is independently associated with a decline in subjective motor function in community-dwelling older people. Nutritional status and eating alone should be considered simultaneously to prevent the decline of motor function in older people.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to thank the older people living in the Suminoe Ward area of Osaka Prefecture who agreed to this study and responded, as well as the Suminoe Ward Council of Social Welfare, the community coordinators for their cooperation and Editage (www.editage.jp) for English language editing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eApproval for this study was given by the Ethics Committee of Morinomiya University of Medical Care (approval number: 2020-082) and written informed consent was obtained from the participants. All methods were performed following the Declarations of Helsinki.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and/or analyzed during the current study are not publicly available as there was no such approval for the study protocol. The data are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interest\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eR.M: Study conception and design\u003c/p\u003e\n\u003cp\u003eR.M, C.M and Y.S: Acquisition, analysis and interpretation of data\u003c/p\u003e\n\u003cp\u003eD.M: Critical revision\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCorresponding author\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCorrespondence to Ryosuke Mikiya\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAuthors and Affiliations\u003c/p\u003e\n\u003cp\u003eDepartment of Physical Therapy, Faculty of Rehabilitation, Morinomiya University of Medical Sciences, 1-26-16, Nankoukita, Suminoe-ku, Osaka-shi, Osaka 559-8611, Japan\u003c/p\u003e\n\u003cp\u003eRyosuke Mikiya \u0026amp; Yuko Sawada\u003c/p\u003e\n\u003cp\u003eDepartment of Food Science and Human Nutrition, Faculty of Agriculture, Setsunan University, 45-1, Nagaotoge-cho, Hirakata-City, Osaka 573-0101, Japan\u003c/p\u003e\n\u003cp\u003eChika Momoki\u003c/p\u003e\n\u003cp\u003eDepartment of Medical nutrition, Graduate School of Life Science, Osaka Metropolitan University, 3-3-138 Sugimoto, Sumiyoshi-ku Osaka-shi, Osaka 558-8585, Japan\u003c/p\u003e\n\u003cp\u003eDaiki Habu\u003c/p\u003e\n\u003cdiv id=\"_com_1\" language=\"JavaScript\"\u003e\n \u003cp\u003e[AA1]Please note that according to the journal, the following information should be included in this section.\u003c/p\u003e\n \u003cp\u003eEthics approval and consent to participate\u003c/p\u003e\n \u003cp\u003eConsent for publication\u003c/p\u003e\n \u003cp\u003eAvailability of data and materials\u003c/p\u003e\n \u003cp\u003eCompeting interests\u003c/p\u003e\n \u003cp\u003eFunding\u003c/p\u003e\n \u003cp\u003eAuthors\u0026apos; contributions\u003c/p\u003e\n \u003cp\u003eAcknowledgements\u003c/p\u003e\n \u003cp\u003eAuthors\u0026apos; information (optional)\u003c/p\u003e\n \u003cdiv id=\"_com_2\" language=\"JavaScript\"\u003e\u003cbr\u003e\u003c/div\u003e\n\u003c/div\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eFujiwara Y, Amano H, Kumagai S, Yoshida H, Fujita K, Naito T, et al: Physical and psychological predictors for the onset of certification of long-term care insurance among older adults living independently in a community A 40-month follow-up study. Japanese Journal of Public Health. 2006; 53: 77-91 (In Japanese). Japanese).\u003c/li\u003e\n\u003cli\u003eHirai H, Kondo K, Ojima T, Murata C. Examination of risk factors for onset of certification of long-term care insurance in community-dwelling older In: AGES project 3-year follow-up study. Japanese Journal of Public Health. 2009; 56: 501-512 (In Japanese).\u003c/li\u003e\n\u003cli\u003eYamada M, Kimura Y, Ishiyama D, Otobe Y, Suzuki M, Koyama S, et al: Effect of the COVID-19 epidemic on physical activity in community-dwelling older J Nutr. Health Aging. 2020; 24(9): 948-950.\u003c/li\u003e\n\u003cli\u003eC\u0026eacute;nat JM, Blais-Rochette C, Kokou-Kpolou CK, Noorishad PG, Mukunzi JN, McIntee SE, et al: Prevalence of symptoms of depression, anxiety, insomnia, and posttraumatic stress disorder, and psychological distress among populations affected by the COVID-19 pandemic: A systematic review and meta- analysis. Psychiatry Res. 2021 295: 113599.\u003c/li\u003e\n\u003cli\u003eCruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al: Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on Sarcopenia in Older People. age Age Ageing. 2010; 39(4): 412-423.\u003c/li\u003e\n\u003cli\u003eKwon J, Suzuki T, Kim H, Yoshida H, Kumagai S, Yoshida Y, et al: Health status and physical fitness of undernourished community-dwelling elderly people. Jpn. J. Phys. Fitness Sports Med. 2005; 54(1): 99-106 (In Japanese).\u003c/li\u003e\n\u003cli\u003eGuralnik JM, Ferrucci L, Pieper CF, Leveille SG, Markides KS, Ostir GV, et al: Lower extremity function and subsequent disability: consistency across studies, predictive models, and the value of gait speed alone compared with a short physical performance battery J Gerontol A Biol Sci Med Sci. 2000; 55: M 221-231.\u003c/li\u003e\n\u003cli\u003eShinkai S, Watanabe S, Kumagai S, Fujiwara Y, Amano H, Yoshida H, et al: Walking speed as a good predictor for the onset of functional dependence in a Age Aging. 2000; 29: 441-446.\u003c/li\u003e\n\u003cli\u003eKinugasa T, Nagasaki H: Reliability and validity of the Motor Fitness. Scale for older adults in the community Aging (Milano). 1998; 10: 295-302.\u003c/li\u003e\n\u003cli\u003eHoshi M, Hozawa A, Kuriyama S, Nakaya N, Ohmori-Matsuda K, Sone T, et al.: The predictive power of physical function assessed by questionnaire and Aging Clin Exp Res. 2012; 24(4): 345-353.\u003c/li\u003e\n\u003cli\u003eSaito E, Ueki S, Yasuda N, Yamazaki S, Yasumura S: Risk factors of functional disability among community-dwelling elderly people by household in Japan: a BMC Geriatr. 2014; 14: 93.\u003c/li\u003e\n\u003cli\u003eIto K, Inagaki H, Okamura T, Shimokado K, Awata S: Factors associated with the mental health well-being of urban community-dwelling elders in Japan: Nippon Ronen Igakkai Zasshi 2012; 49: 82-89 (In Japanese). Japanese).\u003c/li\u003e\n\u003cli\u003eAwata S, Sugiyama M, Ito K, Ura C, Miyamae F, Sakuma N, et al:. Development of a dementia assessment sheet for a community-based integrated care system Geriatr Gerontol Int. 2016; 16 Suppl 1: 123-131.\u003c/li\u003e\n\u003cli\u003eToyoshima K, Araki A, Tamura Y, Iritani O, Ogawa S, Kozaki K, et al:. Development of the Dementia Assessment Sheet for Community-based Integrated Care System 8-items, a short version of the Community-based Integrated Care System 21-items, for the assessment of cognitive and daily functions Geriatr Gerontol Int. 2018; 18: 1458-1462.\u003c/li\u003e\n\u003cli\u003eShimada H, Park H, Makizako H, Doi T, Lee S, Suzuki T.: Depressive symptoms and cognitive performance in older adults. J Psychiatr Res. 2014; 57: 149-156.\u003c/li\u003e\n\u003cli\u003eKimura Y, Wada T, Okumiya K, Ishimoto Y, Fukutomi E, Kasahara Y, et al: Eating alone among community-dwelling Japanese elderly: association with J Nutr Health Aging 2012; 16 (8): 728-731.\u003c/li\u003e\n\u003cli\u003eOsada H, Shibata H, Haga H, Yasumura S.: Relationship of physical condition and functional capacity to depressive status in a person aged 75 years. Koshu Eisei Zassi 1995; 42(10): 897-909 (In Japanese).\u003c/li\u003e\n\u003cli\u003ePenninx BW, Guralnik JM, Ferrucci L, Simonsick EM, Deeg DJ, Wallace RB.: Depressive symptoms and physical decline in community-dwelling older persons. jama 1998; 279(21): 1720-1726.\u003c/li\u003e\n\u003cli\u003eKimura Y, Wada T, Okumiya K, Ishimoto Y, Fukutomi E, Kasahara Y, et al: Eating alone among community-dwelling Japanese elderly: association with J Nutr Health Aging. 2012; 16(8): 728-731.\u003c/li\u003e\n\u003cli\u003eTani Y, Kondo N, Noma H, Miyaguni Y, Saito M, Kondo K.: Eating alone yet living with others is associated with mortality in older men: the JAGES Cohort Survey. j Gerontol B Psychol Sci Soc Sci. 2018; 73(7): 1330-1334.\u003c/li\u003e\n\u003cli\u003eCox NJ, Morrison L, Ibrahim K, Robinson SM, Sayer AA, Roberts HC: New horizons in appetite and the anorexia of ageing. Age Ageing. 2020; 49(4): 526-534 .\u003c/li\u003e\n\u003cli\u003eGe l, Yap CW, Heng BH.: Association of nutritional status with physical function and disability in community-dwelling older adults: a longitudinal J Nutr Gerontol Geriatr. 2020; 39(2): 131-142.\u003c/li\u003e\n\u003cli\u003eLandi F, Calvani R, Tosato M, Martone AM, Ortolani E, Savera G, et al. Anorexia of ageing: risk factors, consequences, and potential treatments. Nutrients. 2016; 8(2): 69.\u003c/li\u003e\n\u003cli\u003eKushida O, Moon JS, Matsumoto D, Yamasaki N, Takatori K: Eating alone at each meal and associated health status among community-dwelling Japanese Nutrients. 2020; 12(9):2805.\u003c/li\u003e\n\u003c/ol\u003e\n"},{"header":"Tables","content":"\u003cp\u003eTables are available in the Supplementary Files section.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-geriatrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bgtc","sideBox":"Learn more about [BMC Geriatrics](http://bmcgeriatr.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bgtc/default.aspx","title":"BMC Geriatrics","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Community-dwelling older adults, Motor function, Depression, Eating alone, COVID-19","lastPublishedDoi":"10.21203/rs.3.rs-4392507/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4392507/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe coronavirus disease 2019 (COVID-19) pandemic has affected the motor function and nutritional status of community-dwelling older adults. The relationship between motor function, depression, and nutritional status during the COVID-19 lockdown period was examined in community-dwelling older adults based on the Motor Fitness Scale (MFS) scores.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA questionnaire-based survey was conducted among 900 community-dwelling older people aged 65 years and above. Of 400 people who responded to the questionnaire, 66 people with missing MFS responses, 45 people with a Dementia Assessment Sheet for Community-based Integrated Care System 8-items (DASC-8) score of 11 or more, 9 people with neurological and mental problems\u0026nbsp;, and\u0026nbsp;43 people certified as requiring support or care were excluded. The remaining 237 people (mean age, 73.1±6.0 years) were included for analysis. Based on MFS cutoff points of 11 or less for men and 9 or less for women, the participants were divided into the low MFS group (n=65) and normal MFS group (n=172). Nutritional status was assessed using the mini nutritional assessment, short form (MNA\u003csup\u003e®\u003c/sup\u003e-SF). Age, gender, household situation, education, eating alone\u0026nbsp;, Geriatric Depression Scale15 (GDS15), and DASC-8 data were collected.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCompared with the normal group, the group with reduced MFS score had a significantly higher proportion of those aged 75 years or older (p=0.001, Cramer’s V=0.215) and those who ate alone (p=0.052, Cramer’s V=0\u003cem\u003e.\u003c/em\u003e135). Furthermore, a higher proportion of the participants were at risk of low nutrition. Multivariate \u0026nbsp;logistic regression analysis with lower MFS score as the outcome showed that dietary status: eating alone (odds ratio [OR]: 4.08, 95% confidence interval [CI] 1.39–11.99) was independently associated with lower MFS scores. The presence of MNA\u003csup\u003e®\u003c/sup\u003e-SF risk showed an OR of 2.27 and a 95% CI of 0.96–5.38, but it was not a significant factor.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEating alone was independently associated with lower MFS scores in community-dwelling older people. To prevent the decline of motor function in older people, attention should be paid to their nutritional status and whether they eat alone or not. This study provides a research direction for surveys to be performed in settings where performing face-to-face surveys is challenging.\u003c/p\u003e","manuscriptTitle":"Association between eating alone and motor function among community-dwelling older adults during the COVID-19 pandemic: a cross-sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-05-28 16:43:05","doi":"10.21203/rs.3.rs-4392507/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision 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