Association between visual status and social participation in older Japanese: The JAGES cross-sectional study

Social participation classification and activities in association with health outcomes among older adults: Results from a scoping review

AIMS

The aim of this study is to summarize the characteristics of social participation classification and examine the association between activities and health outcomes among older adults.

DESIGN

Scoping review.

DATA SOURCES

Eight databases (Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library, Embase, ProQuest, Psychological Information Database, PubMed, Scopus and Web of Science) were searched. Reference lists of relevant social participation reviews were also considered.

METHODS

This study applied a five-stage methodological framework. A narrative synthesis summarized social participation classification and activities and their associations with health outcomes among older adults (≥65 years) living at home, in the community or in nursing residences.

RESULTS

Forty-two articles published between 1975 and 2022 were selected. Four classification criteria of social participation were extracted and summarized from these studies. Based on the depth and breadth of social interactions, this review proposed a four-level classification schema. A lower risk of mortality and less visual impairment were associated with participation in level-one, level-three or level-four activities, whereas less depression, less pain and better cognitive function were linked to participation in level-three or level-four activities.

CONCLUSION

Future studies should provide a clear definition, establish classification criteria for participation and properly select activity forms while considering both subjective and objective dimensions.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

The results could provide data for designing targeted social participation interventions to improve specific health outcomes among older adults.

IMPACT

This review could help researchers examine the role of social participation activities in specific health outcomes. Moreover, a proposed classification of social participation activities would benefit researchers and community nurses in discerning the similarities and differences among activities.

REPORTING METHOD

This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Extension for Scoping Reviews guideline.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Association between hearing status and social participation in Japanese older adults: A cross-sectional study from the Japan gerontological evaluation study

PURPOSE

Hearing is known to decline with age. As sensitivity to speech declines, conversation becomes more difficult and social interactions are affected, resulting in increased risk of cognitive decline. This study aimed to examine the relationship between hearing status and social participation.

MATERIALS AND METHODS

The study included 21,117 adults aged 65 years or older who responded to a survey in 2019. The survey asked participants about their hearing status and how frequently they participated in certain social activities.

RESULTS

The analysis of the relationship between degree of hearing and social activity showed lower hearing status odds ratios for those who participated more frequently in social activities compared to those who participated less frequently. The odds ratios were as follows, hobby clubs (OR 0.81, 95%CI 0.78-0.84), activities such as teaching skills or passing on experiences to others (OR 0.69, 95%CI 0.65-0.75), and meeting with friends (OR 0.77, 95%CI 0.74-0.79). Compared to those who did not participate in social activities, those who participated in three or more types of groups had significantly lower hearing impairment (OR 0.75, 95% CI 0.72-0.79).

CONCLUSION

Hearing impairment was shown to inhibit participation in activities, including those that require communication with multiple people or smooth communication, those that involve a wide range of ages, and those that involve work and movement. Hearing impairment should be identified and addressed in its early stages to prevent its negative impact on social participation.

The association of subjective vision with objectively measured intensity-specific physical activity and bout-specific sedentary behavior among community-dwelling older adults in Japan

PURPOSE

Visual impairment is a possible cause of physical frailty. Reduced physical activity (PA) may be involved in the pathway from visual impairment to physical frailty, although the association between vision and objectively measured PA among older adults remains unclear. This study examined the sex-specific association of subjective vision with intensity-specific PA and bout-specific sedentary behavior (SB) among community-dwelling, older Japanese adults.

STUDY DESIGN

Cross-sectional study METHODS: This study used data from the Neuron to Environmental Impact across Generations study analyzing older adults (527 participants, aged 65-84 years) living in rural areas of Niigata Prefecture, Japan. Subjective vision was assessed by use of a questionnaire. Intensity-specific PA (light-intensity PA and moderate-to-vigorous PA [MVPA]), bout-specific SB, and daily step count were objectively evaluated by use of an accelerometer. The association of subjective vison with PA and SB, stratified by sex, was analyzed by means of general regression analyses, with adjustment for covariates.

RESULTS

The data of 512 participants (men: 46.9%; with poor subjective vision: 22.9%) were analyzed. Poor subjective vision was significantly associated with log MVPA (partial regression coefficient = -0.261, P = .013) and log steps (partial regression coefficient = -0.164; P = .021) among women, whereas a tendency of an association was observed with prolonged SB time among men (partial regression coefficient: 39.1; P = .073).

CONCLUSION

Older Japanese women with poor subjective vision performed less MVPA and had fewer step counts than those of participants with good subjective vision, and men with poor subjective vision had longer prolonged SB, which may all accelerate the process to physical frailty.

Relationship between Eye Frailty and Physical, Social, and Psychological/Cognitive Weaknesses among Community-Dwelling Older Adults in Japan

This study investigated the relationship between eye frailty and physical, social, and psychological/cognitive weaknesses among older adults in Japan. The participants were 192 community-dwelling older adult women. We measured handgrip strength, walking speed, and skeletal muscle mass; additionally, their physical, social, and psychological/cognitive frailties were surveyed using questionnaires. Eye frailty self-checks were used to assess eye frailty. Exploratory and confirmatory factor analyses were employed to verify the validity of the eye frailty self-checks. Eye frailty prevalence and related factors were investigated by conducting a binomial logistic regression analysis, with eye frailty as the dependent variable. The factor analysis results showed that a model could be constructed with the two factors of visual acuity or contrast and visual field. The model's goodness of fit was acceptable, supporting the validity of the self-checking construct. The Kihon checklist was the only variable with a significant relationship to eye frailty. Regarding the relationship between eye frailty and subordinate items of the Kihon checklist, social withdrawal [odds ratio (OR) 2.437, 95% confidence interval 1.145-5.188], cognitive function (OR 2.047, 95%CI 1.051-3.984), and depressed mood (OR 1.820, 95%CI 1.163-2.848) were significant. Eye frailty can be considered a factor reflecting the existence of social and psychological/cognitive frailties.

Age-friendly neighbourhoods and physical activity of older Surinamese individuals in Rotterdam, the Netherlands

BACKGROUND

Age-friendly neighbourhoods seem to promote physical activity among older individuals. Physical activity is especially important for chronically ill individuals. In the Netherlands, older Surinamese individuals are more likely to have chronic diseases than are their native Dutch counterparts. This study examined relationships of neighbourhood characteristics with physical activity among older Surinamese individuals in Rotterdam, the Netherlands.

METHODS

Of 2749 potential participants, 697 (25%) community-dwelling older (age ≥ 70 years) Surinamese individuals living in Rotterdam, the Netherlands, completed a questionnaire on personal and neighbourhood characteristics between March and June 2020. Correlation and multilevel regression analyses were performed to identify associations between missing neighbourhood characteristics for ageing in place and physical activity.

RESULTS

Scores for the neighbourhood domains communication and information (r = -0.099, p ≤ 0.05), community support and health services (r = -0.139, p ≤ 0.001), and respect and social inclusion (r = -0.141, p ≤ 0.001), correlated negatively with participants' PA. In the multilevel analysis, overall missing neighbourhood characteristics to age in place scores were associated negatively with physical activity (p ≤ 0.05).

CONCLUSION

This study showed the importance of age-friendly neighbourhoods for physical activity among older Surinamese individuals in Rotterdam, the Netherlands. Our findings suggest that the neighbourhood plays an important role in supporting older individuals' leading of physically active lifestyles. Further research is needed to support the development of interventions to create age-friendly neighbourhoods.

The prevalence of uncorrected refractive error in Japan: the Locomotive Syndrome and Health Outcome in Aizu Cohort Study

PURPOSE

Uncorrected refractive error (URE) is the leading cause of vision impairment and the second leading cause of blindness. It is a major public health challenge worldwide. However, the current status of URE in Japan is unclear.

STUDY DESIGN

Cross-sectional study.

METHODS

In 2012, a population-based cross-sectional study was conducted among community dwellers aged 40 years and older who received health check-ups in Minamiaizu and Tadami, Fukushima Prefecture, Japan. URE was considered when the presenting visual acuity in the better-seeing eye was < 0.5 and when visual acuity improved more than 1 line with refractive correction in the better-seeing eye. We estimated the age-specific prevalence of URE, and calculated the p-value for trend to examine the linear pattern of the association of the prevalence of URE and age.

RESULTS

This analysis included 2952 participants. The mean age (standard deviation [SD]) of the study population was 69.10(9.67) years and 57.79% were women. The overall prevalence of URE was 10.90% (95% CI, 9.77-12.05%). Prevalence by age category was 5.00% (95% CI, 2.03-10.03%), 6.09% (95% CI, 3.59-9.58%), 7.02% (95% CI, 5.49-8.81%), 11.96% (95% CI, 10.15-13.97%), and 22.39% (95% CI, 18.41-26.78%) for 40-49 years, 50-59 years, 60-69 years, 70-79 years, and 80 years or older, respectively (p-for trend, < 0.001).

CONCLUSIONS

The prevalence of URE was 10.9% and exceeded 20%, especially in individuals older than 80 years. Given the correlation between increasing incidence of URE and increase in age, public health intervention to promote awareness of URE is important, especially for the older population.

Is social participation associated with good self-rated health among visually impaired older adults?: the JAGES cross-sectional study

Background

While it has been recognized that visual impairment is associated with poor self-rated health (SRH), in addition to various negative health outcomes of visual impairment, the number of older adults with visual impairment is increasing due to population aging. As increasing evidence has been found for the effectiveness of social participation on good SRH, we examined whether there was an association between social participation and SRH and investigated whether the effect differed by visual status.

Methods

Questionnaire data on self-reported visual status, social participation, socioeconomic status, and SRH were obtained in 2016. A total of 24,313 community-dwelling individuals aged 65 and over participated. We examined the association of social participation and SRH status among older adults with visual impairment. Stratified analysis and analysis with an interaction term between social participation and visual status were also conducted. Social participation was assessed by the number of participating groups (no participation, one, two, and three or more).

Results

Overall visual impairment prevalence was 9.3% (95% CI: 8.9–9.7). Among those with and without visual impairment, prevalence of poor SRH was 38.4 and 13.1%, respectively. However, the association between social participation with SRH was similar, especially for those who participated in one or two groups. For people with (PR = 0.54) and without visual impairment (PR = 0.50), those who participated in two groups showed lower prevalence ratios for poor SRH compared to people without social participation.

Conclusion

Social participation showed a beneficial association with SRH among older adults with visual impairment. Future interventions could focus on the potentially positive role of social participation on SRH among older adults with visual impairment.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-021-02554-7.

Impact of Pain and Psychosocial Factors on Frailty Among Older Adults With Physical Functional Limitations: A Cross-Sectional Study

AIMS

The objective of this study was to determine the prevalence of frailty and pain among older adults with physical functional limitations in China. We also assessed the impact of pain and psychosocial determinants on frailty among this vulnerable population.

DESIGN

This study was a cross-sectional study.

SETTING AND PARTICIPANTS

Totally, 2,323 Chinese elders with physical functional limitation were enrolled.

METHODS

Physical functioning was assessed by the Barthel Index, participants who reported "often troubled with pain" were further asked about the intensity of their pain using a 1-10 numeric rating scale, and frailty was assessed by the Assessment of frailty FRAIL scale. The impact of pain and psychosocial factors on frailty was assessed by multivariable binary logistic regression.

RESULTS

The prevalence of frailty and pain were 30.9% and 46.1%, respectively. Compared with subjects who reported no pain, those who reported mild (odds ratio [OR] = 1.70, 95% confidence interval [CI] = 1.21-2.31), moderate (OR = 2.10, 95% CI = 1.53-2.82), or severe pain (OR = 2.31, 95% CI = 1.56-3.40) tended to be more vulnerable to frailty. Furthermore, compared with participants with positive psychosocial determinants, those with negative psychosocial determinants seemed more likely to be frail.

CONCLUSIONS

These findings suggest that the incidence of pain, negative psychosocial status, and frailty were prevalent, and the presence of pain and negative psychosocial factors increased the risk of frailty among older adults with physical functional limitation.

Associations between vision, hearing and tooth loss and social interactions: the JAGES cross-sectional study

BACKGROUND

Difficulties in communication due to vision, hearing and tooth loss have a serious impact on health. We compared the association between and attribution of each of these factors on social interaction.

METHODS

This cross-sectional study examined data from the 2016 Japan Gerontological Evaluation Study (n=22 295) on community-dwelling people aged ≥65 years in Japan. The dependent variable was the frequency of meeting friends as a measure of social interaction, and less-than-monthly was defined as fewer social interactions. The independent variables were self-reported degrees of vision, hearing (5-point Likert scale) and tooth loss (five categories), with 'poor' or '0 teeth' defined as the worst category. Sex, age, educational attainment, comorbidity and residential area were used as covariates. Poisson regression analysis with multiple imputations was used to estimate the prevalence ratios (PRs) of fewer social interactions by each status. Subsequently, the population attributable fraction (PAF) was calculated to assess the public health impact.

RESULTS

The number of participants with fewer social interactions was 5622 (26.9%). Proportions of fewer social interactions among those with the worst vision, hearing and number of teeth categories were 48.7%, 40.1% and 32.0%, respectively. Their corresponding PRs of fewer social interactions were 1.72 (95% CI 0.97 to 3.05), 1.35 (95% CI 0.99 to 1.85) and 1.23 (95% CI 1.10 to 1.37), respectively. The total PAF for vision, hearing and number of teeth was 8.3%, 5.0% and 6.4%, respectively.

CONCLUSION

Self-reported vision, hearing and tooth loss were associated with fewer social interactions. The magnitude of these impairments was largest in vision, followed by tooth and hearing loss.