Longitudinal associations of social group engagement with physical activity among Japanese older adults

The association between nap time, nighttime sleep and depression in Chinese older adults: A cross-sectional study

OBJECTIVE

To explore the relationship among nap time, night sleep time, and depression among the elderly and to determine the recommended sleep time to provide a scientific and reasonable basis for the prevention and control of depression in residents.

METHODS

Based on the 2020 China Health and Elderly Care Longitudinal Survey (CHARLS) database, the demographic data and the health and lifestyle information of the study subjects were obtained. A total of 2,959 valid samples were included, and the relationship between sleep and depression was explored by logistic regression, restricted cubic spline, and isotemporal substitution model.

RESULTS

In the cross-sectional analysis, no statistical relationship was observed between napping time and depression in the elderly. The optimal sleep interval for the elderly at night is 6-7.5 hours, and the health benefits are the largest. A sleep duration of < 6 hours at night (OR = 2.25, 95% CI: 1.90 to 2.65) was associated with a high likelihood of depression. The probability of depression in the elderly continues to decrease with the increase of time after the nighttime sleep duration reaches 6 hours and is at the lowest level of about 7.5 hours. Moreover, the probability of depression will increase after the sleep duration exceeds 9.5 hours. In the range of 6-7.5 hours of recommended sleep duration, the likelihood of depression in the elderly will be reduced by 0.311 for every 30-minute increase in nighttime sleep time instead of noon sleep time.

CONCLUSION

The duration of nighttime sleep and the probability of depression have a U-shaped relationship. The likelihood of depression was lowest in the elderly who slept for 6-8 hours at night, and the likelihood of depression could be reduced by increasing the nighttime sleep time instead of napping time within the optimal nighttime sleep range.

Life-course social participation and physical activity in midlife: longitudinal associations in the 1970 British Cohort Study (BCS70)

A hypothesized benefit of social participation is that it encourages people to be more physically active. However, limited evidence exists on the association between social participation over the life-course and physical activity in midlife. We sought to apply a life-course framework to examine the association of social participation and device measured physical activity in midlife in the UK. We used the 1970 British Birth Cohort Study (BCS70), which includes all people born in Britain during a single week in 1970. Social participation was assessed at ages 16, 30, 34 and 42. Physical activity was measured by accelerometery at age 46, as mean daily step count and time spent in moderate to vigorous physical activity (MVPA). The associations of social participation and physical activity were tested using two different life-course models: the sensitive period model and the accumulation model. Individuals with medium and high participation compared to no social participation over their life-course had higher mean daily step count and MVPA in midlife, supporting the accumulation model. In the sensitive period model, only those that actively participated at age 42 had higher mean daily steps and MVPA compared to those who did not participate. Our study provides empirical evidence on the importance of sustaining social participation at all ages over the life-course rather than at a particular timepoint of someone's life. If our findings reflect causal effects, interventions to promote social participation throughout the life-course could be an avenue to promote physical activity in middle life.

Health Behaviors Before and After the Implementation of a Health Community Organization: Gangwon's Health-Plus Community Program

OBJECTIVES

Community organization is a resident-led movement aimed at creating fundamental social changes in the community by resolving its problems through the organized power of its residents. This study evaluated the effectiveness of health community organization (HCO), Gangwon's Health-Plus community program, implemented from 2013 to 2019 on residents' health behaviors.

METHODS

This study had a before-and-after design using 2011-2019 Korea Community Health Survey data. To compare the 3-year periods before and after HCO implementation, the study targeted areas where the HCO had been implemented for 4 years or longer. Therefore, a total of 4512 individuals from 11 areas with HCO start years from 2013 to 2016 were included. Complex sample multi-logistic regression analysis adjusting for demographic characteristics (sex, age, residential area, income level, education level, and HCO start year) was conducted.

RESULTS

HCO implementation was associated with decreased current smoking (adjusted odds ratio [aOR], 0.73; 95% confidence interval [CI], 0.57 to 0.95) and subjective stress recognition (aOR, 0.79; 95% CI, 0.64 to 0.97). Additionally, the HCO was associated with increased walking exercise practice (aOR, 1.39; 95% CI, 1.13 to 1.71), and attempts to control weight (aOR, 1.36; 95% CI, 1.12 to 1.64). No significant negative changes were observed in other health behavior variables.

CONCLUSIONS

The HCO seems to have contributed to improving community health indicators. In the future, a follow-up study that analyzes only the effectiveness of the HCO through structured quasi-experimental studies will be needed.

Association between diversity levels of member composition in group activities of older adults and the occurrence of need for care: the JAGES 2013-2019 longitudinal study

BACKGROUND

Participating in groups with diverse members is associated with improved health among older adults. The study examined the relationship between diversity of group members and needed support or long-term care.

METHODS

We conducted a longitudinal study for the Japan Gerontological Evaluation Study with 61,281 participants aged ≥ 65 years who were surveyed in 2013 and followed-up for six years. We assessed three dimensions of the diversity of the participating members (sex, age, and region of residence). We then graded the diversity level into four categories: level 0 (not in any group), level 1 (in a group without diversity or in a group with diversity in one of the three factors), level 2 (in a group with diversity in two of the three factors), or level 3 (in a group with diversity across all factors). We adjusted for 12 covariates using Cox hazard survival analysis models with hazard ratios (HRs) and 95% confidence intervals (CIs) estimated for the association between group members' diversity levels and needed support or long-term care. The same study was conducted when stratified by employment status at baseline.

RESULTS

Participants in social participation groups with more diverse group members had a lower incidence of needed support or long-term care as compared to their counterparts. Compared to those with no participation group, HR decreased by 14% to 24% with increasing levels of diversity. The HR for the level of care needed for participants in the social participation group with high residential diversity was 0.89 (95% CI: 0.84-0.94). For participants who were currently unemployed, HR reductions ranged from 16%-28% with increasing levels of diversity compared to the non-participating group. No association was found for employed participants.

CONCLUSIONS

The reason the HRs of Japanese elderly people certified as needing support or care are lower when the diversity of participating groups is higher could be owing to the presence of a variety of people and the diversification of social networks, which facilitates the building of bridging social relational capital. Public health policies that encourage participation in diverse organizations will be important in the future.

Association of social participation (including inconsistent participation) with the progression of frailty among older adults: Community-based cohort study in Japan

AIM

This study examined the relationship between continuity of social participation and progression of frailty among community-dwelling older adults, by baseline frailty level.

METHODS

This study was part of a 3-year community-based cohort study among adults aged ≥65 years, living independently in a rural municipality in Japan. Mail surveys were carried out in 2016, 2018 and 2019. This study involved 2799 participants who responded to the question about social participation in every survey. Frailty was evaluated by Kihon Checklist total scores. Social participation was categorized into consistent non-participation, interrupted recent non-participation, interrupted recent participation and consistent participation. We assessed the relationship between social participation and change in frailty scores using general linear regression analysis, stratifying the participants into groups by their frailty level at baseline.

RESULTS

There was a smaller frailty score increase in the robust (β -0.61, 95% CI -0.99 to -0.22) and prefrail groups (β -0.73, 95% CI -1.18 to -0.27) for consistent participation than consistent non-participation. Interrupted recent participation showed significant suppression in the prefrail group (β -0.96, 95% CI -1.60 to -0.32). Social participation had no clear effect on progression in the frail group.

CONCLUSIONS

Consistent social participation might reduce the progression of frailty in robust and prefrail people. Inconsistent participation might also help to reduce progression in prefrail older adults. It is important for prefrail older adults to return to their social activities and continue to engage as long as possible, even if their participation was intermittent in the past. Geriatr Gerontol Int 2023; 23: 25-31.

Social participation and change in walking time among older adults: a 3-year longitudinal study from the JAGES

BACKGROUND

Among all physical activities, walking is one of the easiest and most economical activities for older adults' mental and physical health. Although promoting social participation may extend the walking time of older adults, the longitudinal relationship is not well understood. Thus, this study elucidates the relationship between nine types of social participation and change in walking time during a 3-year follow-up of older adults.

METHODS

We conducted a 3-year community-based longitudinal study of independent older adults in Japan. From the 2016 and 2019 surveys, we extracted 57,042 individuals. We performed multiple regression analyses, estimating associations between change in walking time after three years and nine types of social participation in 2016: volunteer, sports, hobby, senior, neighborhood, learning, health, skills, and paid work. We conducted subgroup analysis stratified by walking time in 2016 (i.e., < 60 or ≥ 60 min/day).

RESULTS

The mean (standard deviation) change in walking time for 3 years was - 4.04 (29.4) min/day. After adjusting potential confounders, the significant predictors of increasing or maintaining walking time (min/day) were participation in paid work (+ 3.02) in the < 60 min/day subgroup; and volunteer (+ 2.15), sports (+ 2.89), hobby (+ 1.71), senior (+ 1.27), neighborhood (+ 1.70), learning (+ 1.65), health (+ 1.74), and skills (+ 1.95) in the ≥ 60 min/day subgroup compared with non-participants.

CONCLUSIONS

Paid work and community activities may be effective for maintaining or increasing walking time among older adults with less (< 60 min/day) and sufficient (≥ 60 min/day) walking time, respectively.

A Cross-Sectional Study on the Characteristics of Physical Activity in Pre-Frail Older Adults

This cross-sectional study aimed to characterize the physical activity (PA) of older adults with pre-frail status by examining sedentary behavior (SB) and PA using triaxial accelerometer data, with non-frail older adults as the control group. In this study, we divided the study participants into older adults who regularly participated in self-initiated citizen group exercise activities and those who did not. Data were collected between September and December 2017. We analyzed data from 256 older adults (women: 86.3%) aged ≥65 years. The interaction effect of participation status (participation and non-participation group) and frailty status (pre-frail and non-frail group) for moderate-to-vigorous PA (F = 9.178, p = 0.003) and daily mean number of steps (F = 9.351, p = 0.002) was significant. For the participation group, there was no difference between pre-frail older adults and non-frail older adults regarding length of SB and PA time, indicating that PA level was maintained in the participating pre-frail older adults. In contrast, moderate-to-vigorous PA and daily mean number of steps were low in pre-frail older adults who did not participate in the activities. The opportunity to participate in self-initiated group exercise activities and other PAs in the community may help pre-frail older adults maintain their PA.

An Overview of Social Participation in Older Adults: Concepts and Assessments

In older adults, social participation is an important component of rehabilitation and health promotion. Several studies have attempted to describe the definition and concepts of social participation, and there were many outcomes to measure social participation. This overview provides information about representative social participation and related concepts that have been defined in the literature. A standardized definition of social participation has not been developed; commonly, recognition for social participation was proposed as focused on involvement in social activities that provide interaction with others in a society or community. Many instruments assess the various aspects of social participation. Because of operational definition and diversity in social participation, performance in social participation was adopted as an aspect of assessment. Further discussions are needed to clarify the definition of social participation and evaluate the instruments used to assess social participation for it to be useful for rehabilitation and health promotion. In doing so, determining and developing assessment and intervention based on the purpose or perspective of social participation in older adults with and without disabilities is important.