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Gao Q, Chua KC, Mayston R, Prina M. Longitudinal associations of loneliness and social isolation with care dependence among older adults in Latin America and China: A 10/66 dementia research group population-based cohort study. Int J Geriatr Psychiatry 2024; 39:e6115. [PMID: 38923024 DOI: 10.1002/gps.6115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 06/17/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVES With increasing life expectancy and rapid ageing, there is an expanding number of older people who have functional declines, greater needs for care and support and who are at increased risk of insufficient social interaction. Longitudinal investigations on the interplay between loneliness, social isolation and care dependence remain limited. This study thus aimed to investigate the longitudinal reciprocal association between social isolation/loneliness and care dependence among older adults in Latin America and China. METHODS We analysed data from the population-based cohorts from the 10/66 Dementia Research Group (DRG) project (baseline 2003-07 and follow-up 2007-2010). The 10/66 DRG study recruited and followed up older adults aged 65 years or above in 11 catchment areas in Latin America and China. A total of 15,027 older adults from Latin America and China (mean age = 73.5, standard deviation = 6.5) were included in our analyses. Cross-lagged panel models were used to investigate potential reciprocal associations. RESULTS Loneliness was positively associated with care dependence at baseline (β = 0.11, p < 0.001 in Latin America; β = 0.16, p < 0.05 in China]. Social isolation consistently had a stronger positive association with care dependence across all study sites in both waves. Longitudinally, care dependence positively predicted loneliness (β = 0.10, p < 0.001) and social isolation (β = 0.05, p < 0.001) in Latin American study sites but not in China. Yet there was no statistical evidence of lagged effects of loneliness and social isolation on care dependence in all study countries. CONCLUSIONS Older people with care dependence are at risk of developing loneliness and social isolation. It is crucial to develop complex care models using a societal approach to address social and care needs holistically, especially for the older group with declining functional capacity. Future longitudinal research is required to explore the causal mechanisms of relationships and cultural differences, in order to inform the development of culturally appropriate care models.
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Affiliation(s)
- Qian Gao
- Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- School of Public Health, Imperial College London, London, UK
| | - Kia-Chong Chua
- Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Rosie Mayston
- Global Health & Social Medicine & King's Global Health Institute, Social Science & Public Policy, King's College London, London, UK
| | - Matthew Prina
- Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
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Ueno T, Saito J, Murayama H, Saito M, Haseda M, Kondo K, Kondo N. Social participation and functional disability trajectories in the last three years of life: The Japan Gerontological Evaluation Study. Arch Gerontol Geriatr 2024; 121:105361. [PMID: 38341957 DOI: 10.1016/j.archger.2024.105361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/25/2024] [Accepted: 01/30/2024] [Indexed: 02/13/2024]
Abstract
BACKGROUND Functional disability has various patterns from onset until death. Although social participation is a known protective factor against functional disability among older individuals, it is unclear whether social participation is associated with the trajectory patterns of functional disability prior to death. This study assessed the association between social participation, specifically in horizontal and vertical groups, and the trajectories of functional disability prior to death. METHODS We used survey data from the 2010 Japan Gerontological Evaluation Study for functionally independent older adults combined with public long-term care insurance system data from 2010 to 2016 (n = 4,502). The outcome variables included five previously identified trajectory patterns using group-based trajectory modeling. As the explanatory variable, we used three definitions of social participation: any group, horizontal group (e.g., sports, hobbies), or vertical group (e.g., political, religious), at least once a month. We used a multinomial logistic regression analysis to calculate odds ratios with 95 % confidence intervals for the identified trajectory patterns. RESULTS Participation in any groups was significantly less likely to belong to "Accelerated disability" (OR=0.74 [95 % CIs 0.60-0.92]), "Persistently mild disability" (0.68 [0.55-0.84]), and "Persistently severe disability" (0.67 [0.50-0.83]) compared to "Minimum disability." Although participation in horizontal groups was similarly associated with trajectories regardless of gender, vertical groups was not associated with trajectories among males. CONCLUSIONS Social participation among older adults may be associated with an extended period of living without disabilities before death. This association may differ by gender and social participation group and requires further research.
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Affiliation(s)
- Takayuki Ueno
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, Japan.
| | - Junko Saito
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Hiroshi Murayama
- Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Masashige Saito
- Faculty of Social Welfare, Nihon Fukushi University, Aichi, Japan; Center for Well-being and Society, Nihon Fukushi University, Aichi, Japan
| | - Maho Haseda
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Naoki Kondo
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
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Fujii K, Harada K, Kurita S, Morikawa M, Nishijima C, Kakita D, Shimada H. Social participation in the neighborhood community prevents onset of disability in community-dwelling older adults whose life space with activities is limited: A 2-year prospective cohort study. Geriatr Gerontol Int 2024; 24:609-618. [PMID: 38666556 DOI: 10.1111/ggi.14884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 04/02/2024] [Accepted: 04/06/2024] [Indexed: 06/04/2024]
Abstract
AIMS For older adults with limited life space and activity, social participation in the neighborhood community is essential to ensure social interaction and activity levels. This study examined the association between social participation in the neighborhood community and the onset of disability in older adults with different life spaces and activities. METHODS The participants were 9513 older adults from a cohort study conducted at the National Center for Geriatrics and Gerontology Study of Geriatric Syndromes (NCGG-SGS). Social participation in the neighborhood community was assessed by participating in the community meetings. Life space with activities was evaluated using the Activity Mobility Index (AMI) developed in the NCGG-SGS, with higher scores indicating better mobility and movement. The participants were divided into four groups based on the quartiles of their AMI scores (Q1-Q4). Cox proportional hazard models were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for disability incidence by social participation in each quartile. RESULTS Over the 2-year follow-up period, disability occurred in 4.3% of the participants (n = 409). In the Q1 group, participants who participated in the neighborhood community had a significantly lower risk of developing a disability than those who did not (HR, 0.47; 95% CI, 0.28-0.76). There were no significant differences in onset of disability between the presence and absence of social participation for groups Q2, Q3, and Q4. CONCLUSIONS Social participation in the neighborhood community was associated with the onset of disability in the lowest life space group. Social participation within a limited life space with activities may prevent disability onset. Geriatr Gerontol Int 2024; 24: 609-618.
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Affiliation(s)
- Kazuya Fujii
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Kenji Harada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Satoshi Kurita
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Masanori Morikawa
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Chiharu Nishijima
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Daisuke Kakita
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
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Eto M, Yamatsu K. Associations of eHealth Literacy with Social Activity among Community-Dwelling Older Adults: A Cross-Sectional Study. Eur J Investig Health Psychol Educ 2024; 14:1279-1294. [PMID: 38785582 PMCID: PMC11120453 DOI: 10.3390/ejihpe14050084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 04/26/2024] [Accepted: 05/03/2024] [Indexed: 05/25/2024] Open
Abstract
Older adults who use digital technology are desired to adapt to digitalization and literacy. One required aspect is eHealth literacy, measured with the eHealth Literacy Scale (eHEALS). Many studies on eHealth literacy have used the eHEALS to examine the health behaviors of college students, relatively younger adults, and Internet users. However, the relevance of eHealth literacy to social activity has not yet been studied in older adults. The purposes of this study were to examine the relationship between eHealth literacy and health behaviors and social activities (community, cultural, and sports activities) and to investigate the factors associated with eHEALS scores among community-dwelling older adults. The mean eHEALS score was 12.4 points (SD 8.2), with the majority (73.3%) having the lowest score (the lowest score is 8 points). Males (17.6, SD 10.5) scored significantly higher than females (11.8, SD 7.7). The eHEALS score had a significant relationship with both cultural and community activity. Five factors significantly associated with having the lowest eHEALS score were cultural activity at least once a week, no cultural activity, no community activity, total IADL score, and intellectual activity. These results suggest that eHealth literacy is associated with community activity and cultural activity among older adults.
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Affiliation(s)
- Mamiko Eto
- Graduate School of Medical Science, Saga University, Saga 849-8502, Japan;
| | - Koji Yamatsu
- Graduate School of Medical Science, Saga University, Saga 849-8502, Japan;
- Graduate School of Advanced Health Sciences, Saga University, Saga 849-8502, Japan
- Faculty of Education, Saga University, Saga 840-8502, Japan
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Watanabe T, Tamiya N. Utilization of Japanese long-term care-related data including Kaigo-DB: An analysis of current trends and future directions. Glob Health Med 2024; 6:63-69. [PMID: 38450118 PMCID: PMC10912809 DOI: 10.35772/ghm.2023.01135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/09/2024] [Accepted: 01/12/2024] [Indexed: 03/08/2024]
Abstract
Despite high expectations from the government and researchers regarding data utilization, comprehensive analysis of long-term care (LTC)-related data use has been limited. This study reviewed the use of LTC-related data, including Kaigo-DB, in Japan after 2020. There was an increase in studies using LTC-related data in Japan between 2020 and 2021, followed by a stabilization period. The national government provided 13.5% of this data (6.5% from Kaigo-DB), while prefectures and municipalities contributed 85.2%, and facilities provided 1.3%. The linked data used in 90.4% of the studies primarily consisted of original questionnaire or interview surveys (34.6%) and medical claims (34.0%). None of the studies based on Kaigo-DB utilized linked data. In terms of study design, cohort studies were the most common (84.6%), followed by descriptive (5.1%), cross-sectional (3.2%), and case-control studies (1.3%). Among the 138 individual-based analytical descriptive studies, the most frequently used LTC-related data as an exposure was LTC services (26.8%), and the most common data used as an outcome was LTC certification or care need level (43.5%), followed by the independence degree of daily living for the older adults with dementia (18.1%). To enhance the use of LTC-related data, especially the valuable national Kaigo-DB, insights can be gleaned from how researchers effectively utilize municipal and prefectural data. Streamlining access to Kaigo-DB and enabling its linkage with other datasets are promising for future research in this field.
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Affiliation(s)
- Taeko Watanabe
- Department of Health Services Research, Institute of Medicine, University of Tsukuba, Ibaraki, Japan
- Health Services Research and Development Center, University of Tsukuba, Ibaraki, Japan
| | - Nanako Tamiya
- Department of Health Services Research, Institute of Medicine, University of Tsukuba, Ibaraki, Japan
- Health Services Research and Development Center, University of Tsukuba, Ibaraki, Japan
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Shan Y, Zhao W, Hao W, Kimura T, Ukawa S, Ohira H, Kawamura T, Wakai K, Ando M, Tamakoshi A, Wang C. Five-year changes of social activity and incident long-term care needs among depressed older adults: A 15-year follow up. Arch Gerontol Geriatr 2024; 116:105163. [PMID: 37633161 DOI: 10.1016/j.archger.2023.105163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/17/2023] [Accepted: 08/18/2023] [Indexed: 08/28/2023]
Abstract
OBJECTIVES To examine the effects of changes in individual/multiple social activities between 65 and 70 years of age on incident long-term care (LTC) needs between 70 and 80 in older adults with depressive symptoms. METHODS Participants were recruited from the New Integrated Suburban Seniority Investigation Project, an ongoing prospective cohort study. A total of 525 older adults with depressive symptoms were included. The validated 15-item Geriatric Depression Scale was used to assess depressive symptoms. A self-report questionnaire was used to measure social activities (social-related, learning, and personal). LTC needs was defined according to Japan's Long-term Care Insurance System. A competing risk model and a Laplace regression model were used to estimate the hazard ratios of LTC needs incidence and the 25th percentile difference in LTC-needs-free survival time and their 95% confidence intervals. RESULTS Out of 4314 person-years of mild LTC needs, 108 individuals developed it. Participants who increased their frequency of learning activities have a lower risk of developing mild LTC needs. Increasing the frequency could also prolong LTC-needs-free survival time by approximately 2.61 years. Out of 4535 person-years for severe LTC needs, 54 individuals developed it. Participants with a continuous regular frequency of learning activities had a lower risk of developing severe LTC needs. However, the association between this frequency and LTC-needs-free survival time for severe LTC needs was insignificant in the multivariable models. CONCLUSIONS Increased frequency of learning activities reduced the risk of LTC needs among older adults with depressive symptoms and prolonged their LTC-needs-free survival time.
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Affiliation(s)
- Yifan Shan
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Institute for Hospital Management of Henan Province, Zhengzhou, China; Department of Public Health, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15 Jo Nishi 7 Chome, Kita-ku, Sapporo, Hokkaido 060-8638, Japan
| | - Wenjing Zhao
- Department of Public Health, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15 Jo Nishi 7 Chome, Kita-ku, Sapporo, Hokkaido 060-8638, Japan; School of Public Health and Emergency Management, Southern University of Science and Technology, Guangdong, China
| | - Wen Hao
- Department of Public Health, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15 Jo Nishi 7 Chome, Kita-ku, Sapporo, Hokkaido 060-8638, Japan
| | - Takashi Kimura
- Department of Public Health, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15 Jo Nishi 7 Chome, Kita-ku, Sapporo, Hokkaido 060-8638, Japan
| | - Shigekazu Ukawa
- Research Unit of Advanced Interdisciplinary Care Science, Osaka Metropolitan University Graduate School of Human Life and Ecology, Osaka, Japan
| | - Hideki Ohira
- Department of Psychology, Graduate School of Informatics, Nagoya University, Nagoya, Japan
| | | | - Kenji Wakai
- Department of Preventive Medicine, Graduate School of Medicine, Nagoya University, Japan
| | - Masahiko Ando
- Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan
| | - Akiko Tamakoshi
- Department of Public Health, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15 Jo Nishi 7 Chome, Kita-ku, Sapporo, Hokkaido 060-8638, Japan.
| | - Chengzeng Wang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Institute for Hospital Management of Henan Province, Zhengzhou, China.
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Saeki N, Mizutani M, Tanimura S, Nishide R. Types and frequency of social participation and comprehensive frailty among community-dwelling older people in Japan. Prev Med Rep 2023; 36:102443. [PMID: 38021414 PMCID: PMC10656264 DOI: 10.1016/j.pmedr.2023.102443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 12/01/2023] Open
Abstract
Although research has established social participation as important for preventing frailty in older people, the association between the type and frequency of social participation and comprehensive frailty remains unclear. This study aimed to reveal the associations between types and frequency of social participation and comprehensive frailty among community-dwelling older people. This was a cross-sectional study conducted in four cities and towns (Inabe City, Nabari City, Odai Town, and Kiho Town) of Mie Prefecture, Japan, among adults who were: (i) aged ≥65 years and (ii) not certified as needing long-term care. We measured comprehensive frailty using the participants' total scores on the Kihon Checklist, developed by Ministry of Health, Labour and Welfare of Japan, which divides frailty status into three categories: robust (0-3 points), prefrail (4-7), and frail (8-25). Types and frequency of social participation were explanatory variables, and ordered logistic regression analysis adjusted for potential confounding factors identified the associations. The frailty status of the 296 participants (age 65-74 years: 44.3 %; female: 74.0 %) was as follows: frail, 21.3 %; prefrail, 40.2 %; and robust, 38.5 %. Lower level of frailty was associated with interaction using smartphones 2-3 times per month, participating in sports ≥4 times per week, participating in local improvement activities several times per year, and engaging in activities for children 2-4 times per month. Social participation among older adults at appropriate frequencies were associated with the lower level of comprehensive frailty. However, future longitudinal studies are needed using populations from more diverse countries or regions and from different cultures.
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Affiliation(s)
- Nanako Saeki
- Department of Public Health Nursing, Mie University Graduate School of Medicine, Japan
| | - Mayumi Mizutani
- Department of Public Health Nursing, Mie University Graduate School of Medicine, Japan
| | - Susumu Tanimura
- Department of Public Health Nursing, Mie University Graduate School of Medicine, Japan
| | - Ritsuko Nishide
- Department of Public Health Nursing, Mie University Graduate School of Medicine, Japan
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Kurita S, Doi T, Tsutsumimoto K, Nakakubo S, Kiuchi Y, Nishimoto K, Shimada H. Self-Monitoring of Physical, Cognitive, and Social Activities and 2-Year Disability Onset in Community-Dwelling Older Adults. J Am Med Dir Assoc 2023; 24:1497-1502. [PMID: 37245526 DOI: 10.1016/j.jamda.2023.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 04/04/2023] [Accepted: 04/08/2023] [Indexed: 05/30/2023]
Abstract
OBJECTIVES Self-monitoring of physical, cognitive, and social activities may be a means of helping older adults to adopt or maintain an active lifestyle, but its effect on disability onset is unknown. This study aimed to examine the association between self-monitoring of the activities and disability onset in older adults. DESIGN Longitudinal, observational study. SETTING AND PARTICIPANTS General community setting. Participants were 1399 older adults aged ≥75 years (mean age: 79.3 ± 3.6 years; 48.1% female). METHODS Participants conducted self-monitoring of physical, cognitive, and social activities using a specialized booklet and a pedometer. Level of engagement in self-monitoring was assessed based on the percentage of days in a year for which activities were recorded: no-engagement group (0% of days recorded; n = 438), midlevel-engagement group (0.1-89.9% of days recorded; n = 416), and high-engagement group (≥90% of days recorded; n = 545). Disability onset was determined by whether the participants were awarded a long-term care insurance certification over the 2 years after the explanation of the booklet and pedometer. RESULTS Cox proportional hazard regression models showed that the high-engagement group, when compared to the no-engagement group, had a significantly reduced hazard ratio (HR) for disability onset, after adjustment for covariates (HR 0.54, 95% CI 0.34-0.86, P = .010). After propensity score adjustment through inverse probability of treatment weighting (IPTW) and propensity score matching (PSM), the high-engagement group's HR remained significantly lower (IPTW: HR 0.54, 95% CI 0.34-0.86, P = .010; PSM: HR 0.58, 95% CI 0.35-0.96, P = .032). CONCLUSIONS AND IMPLICATIONS Self-monitoring of physical, cognitive, and social activities reduces the risk of 2-year disability onset in community-dwelling older adults. Further studies in other settings are needed to examine whether self-monitoring of activities can be a population approach for the primary prevention of disability in other settings.
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Affiliation(s)
- Satoshi Kurita
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu City, Japan.
| | - Takehiko Doi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu City, Japan
| | - Kota Tsutsumimoto
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu City, Japan
| | - Sho Nakakubo
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu City, Japan
| | - Yuto Kiuchi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu City, Japan; Graduate School of Health Sciences Kagoshima University, Kagoshima, Japan
| | - Kazuhei Nishimoto
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu City, Japan; Department of Medical Sciences, Medical Science Division, Graduate School of Medicine, Science and Technology, Shinshu University, Nagano, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu City, Japan
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Shimizu N, Ide K, Kondo K. 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. BMC Geriatr 2023; 23:579. [PMID: 37730556 PMCID: PMC10510208 DOI: 10.1186/s12877-023-04261-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 08/28/2023] [Indexed: 09/22/2023] Open
Abstract
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.
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Affiliation(s)
- Nao Shimizu
- Department of Physical Therapy, Faculty of Health Sciences, Ryotokuji University, 5-8-1 Akemi, Urayasu-Shi, Chiba, 279-8567, Japan.
- Department of Public Health, Graduate School of Medicine, Chiba University, Yayoi-Cho, Inage, Chiba, 263-8522, Japan.
| | - Kazushige Ide
- Center for Preventive Medical Sciences, Chiba University, Yayoi-Cho, Inage, Chiba, 263-8522, Japan
- Department of Community General Support, Hasegawa Hospital, Yachimata, Chiba, 289-1113, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Yayoi-Cho, Inage, Chiba, 263-8522, Japan
- Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka-Cho, Obu, Aichi, 474-8511, Japan
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10
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Ide K, Tsuji T, Kanamori S, Watanabe R, Iizuka G, Kondo K. Frequency of social participation by types and functional decline: A six-year longitudinal study. Arch Gerontol Geriatr 2023; 112:105018. [PMID: 37043839 DOI: 10.1016/j.archger.2023.105018] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 04/01/2023] [Accepted: 04/03/2023] [Indexed: 04/14/2023]
Abstract
Social participation is effective for preventing functional decline in older people. However, researchers have not fully explored how different frequencies of social participation by type. We aimed to clarify the relationship between the frequency of social participation by type and functional decline. We used data from the Japan Gerontological Evaluation Study, which consists of individuals aged 65 years and older who were not eligible to receive public long-term-care insurance benefits. From 13 municipalities, 51,968 respondents who met the criteria were included in the analysis. We used a sex-stratified Cox proportional hazards model. The outcome was the new incidence of functional decline during a six-year follow-up, and the exposure was the frequency of social participation of one of the following six types: sports, hobbies, volunteering, neighborhood, senior clubs, and industry groups. The frequency was categorized as "never," "a few times a year," "once or twice a month," and "once a week or more." We set non-participation in each activity as the reference, and we adjusted for 12 potential confounders (i.e., sociodemographic and health-related factors). After we adjusted for confounders, participation in sports and hobbies once or twice a month, once a week or more was protectively associated with functional decline. We found a similar association for participation in neighborhood a few times a year. Our findings demonstrate the importance of considering the effects of different types and frequencies of activities when promoting social participation among older people as part of public health policies.
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Affiliation(s)
- Kazushige Ide
- Center for Preventive Medical Sciences, Chiba University, Inage-ku, Chiba, Japan; Department of Community General Support, Hasegawa Hospital, Yachimata, Chiba, Japan.
| | - Taishi Tsuji
- Center for Preventive Medical Sciences, Chiba University, Inage-ku, Chiba, Japan; Faculty of Health and Sport Sciences, University of Tsukuba, Bunkyo-ku, Tokyo, Japan
| | - Satoru Kanamori
- Graduate School of Public Health, Teikyo University, Itabashi-ku, Tokyo, Japan; Department of Preventive Medicine and Public Health, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Ryota Watanabe
- Center for Preventive Medical Sciences, Chiba University, Inage-ku, Chiba, Japan; Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Gemmei Iizuka
- Center for Preventive Medical Sciences, Chiba University, Inage-ku, Chiba, Japan; Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Inage-ku, Chiba, Japan; Family Medicine Residency, Seibo International Catholic Hospital, Shinjuku-ku, Tokyo, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Inage-ku, Chiba, Japan; Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
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11
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Abe N, Ide K, Watanabe R, Hayashi T, Iizuka G, Kondo K. Social participation and incident disability and mortality among frail older adults: A JAGES longitudinal study. J Am Geriatr Soc 2023; 71:1881-1890. [PMID: 36727627 DOI: 10.1111/jgs.18269] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 01/18/2023] [Accepted: 01/19/2023] [Indexed: 02/03/2023]
Abstract
BACKGROUND Frailty is the highest risk factor for incident disability and mortality. Social participation is a modifiable factor for reducing adverse outcomes among independent older adults. However, the association between social participation and incident disability and mortality among frail older adults remains unclear. Therefore, we examined the association between various social activities and incident disability and mortality. METHODS This nationwide prospective cohort study (The Japan Gerontological Evaluation Study) recruited older adults with frailty, aged 65 years and older (N = 9090) who were followed up for 6 years (2010-2016). We examined incident disability and all-cause mortality at the end of the follow-up period. Frailty was assessed using the Kihon Checklist. The independent variable was social participation in 2010, grouped into the following seven categories: hobby groups, sports groups or clubs, volunteer groups, senior citizens' clubs, industries, neighborhood communities, and paid work. RESULTS The incidence of disability among participants was 19.5% (1770) and that of mortality was 19.2% (1753). Belonging to sports groups or clubs (Hazard Ratios [HR] = 0.74; 95% Confidence Interval [CI] = 0.57, 0.98) or hobby groups (HR = 0.77; 95% CI = 0.60, 0.98) was significantly associated with a lower risk of incident disability. Meanwhile, hobby groups (HR = 0.68; 95% CI = 0.56, 0.83), sports groups or clubs (HR = 0.71; 95% CI = 0.57, 0.88), volunteer groups (HR = 0.69; 95% CI = 0.54, 0.88), and senior citizens' club (HR = 0.75; 95% CI = 0.61, 0.90) were associated with lower risk of incident mortality. CONCLUSIONS Social participation was associated with a lower risk of incident disability and mortality, not only in healthy older adults but also in frail older adults who are at higher risk of incident disability and mortality. This suggests that frail older adults should be encouraged to participate in all the seven types of social participation examined in this study, as this may lower the risk of subsequent disability and mortality.
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Affiliation(s)
- Noriyuki Abe
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Department of Public Health, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kazushige Ide
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Department of Community General Support, Hasegawa Hospital, Chiba, Japan
| | - Ryota Watanabe
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Center for Well-being and Society, Nihon Fukushi University, Nagoya City, Aichi, Japan
- Department of Frailty Research, Research Institute, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Takahiro Hayashi
- Department of Rehabilitation and Care, Seijoh University, Aichi, Japan
| | - Genmei Iizuka
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Department of Public Health, Graduate School of Medicine, Chiba University, Chiba, Japan
- Seibo International Catholic Hospital Family Medicine Residency, Tokyo, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Department of Geriatric Evaluation, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
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12
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Ho HE, Yeh CJ, Cheng-Chung Wei J, Chu WM, Lee MC. Association between multimorbidity patterns and incident depression among older adults in Taiwan: the role of social participation. BMC Geriatr 2023; 23:177. [PMID: 36973699 PMCID: PMC10045862 DOI: 10.1186/s12877-023-03868-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 03/02/2023] [Indexed: 03/29/2023] Open
Abstract
Abstract
Background
Previous research has found different multimorbidity patterns that negatively affects health outcomes of older adults. However, there is scarce evidence, especially on the role of social participation in the association between multimorbidity patterns and depression. Our study aimed to explore the relationship between multimorbidity patterns and depression among older adults in Taiwan, including the social participation effect on the different multimorbidity patterns.
Methods
Data were retracted from the Taiwan longitudinal study on ageing (TLSA) for this population-based cohort study. 1,975 older adults (age > 50) were included and were followed up from 1996 to 2011. We used latent class analysis to determine participants’ multimorbidity patterns in 1996, whereas their incident depression was determined in 2011 by CES-D. Multivariable logistic regression was used to analyse the relationship between multimorbidity patterns and depression.
Results
The participants’ average age was 62.1 years in 1996. Four multimorbidity patterns were discovered through latent class analysis, as follows: (1) Cardiometabolic group (n = 93), (2) Arthritis-cataract group (n = 105), (3) Multimorbidity group (n = 128) and (4) Relatively healthy group (n = 1649). Greater risk of incident depression was found among participants in the Multimorbidity group (OR: 1.62; 95% CI: 1.02–2.58) than the Relatively healthy group after the multivariable analysis. Compare to participants in the relatively healthy group with social participation, participants in the arthritis-cataract group without social participation (OR: 2.22, 95% CI: 1.03–4.78) and the multimorbidity group without social participation (OR: 2.21, 95% CI: 1.14–4.30) had significantly increased risk of having depression.
Conclusion
Distinct multimorbidity patterns among older adults in Taiwan are linked with the incident depression during later life, and social participation functioned as a protective factor.
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13
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Sun J, Kong X, Li H, Chen J, Yao Q, Li H, Zhou F, Hu H. Does social participation decrease the risk of frailty? Impacts of diversity in frequency and types of social participation on frailty in middle-aged and older populations. BMC Geriatr 2022; 22:553. [PMID: 35778684 PMCID: PMC9250233 DOI: 10.1186/s12877-022-03219-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 06/15/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Social participation (SP) may be an effective measure for decreasing frailty risks. This study investigated whether frequency and type of SP is associated with decreased frailty risk among Chinese middle-aged and older populations. METHODS Data were derived from the China Health and Retirement Longitudinal Study (CHARLS). Frailty was assessed using the Rockwood's Cumulative Deficit Frailty Index. SP was measured according to frequency (none, occasional, weekly and daily) and type (interacting with friends [IWF]; playing mah-jong, chess, and cards or visiting community clubs [MCCC], going to community-organized dancing, fitness, qigong and so on [DFQ]; participating in community-related organizations [CRO]; voluntary or charitable work [VOC]; using the Internet [INT]). Smooth curves were used to describe the trend for frailty scores across survey waves. The fixed-effect model (N = 9,422) was applied to explore the association between the frequency/type of SP and frailty level. For baseline non-frail respondents (N = 6,073), the time-varying Cox regression model was used to calculate relative risk of frailty in different SP groups. RESULTS Weekly (β = - 0.006; 95%CI: [- 0.009, - 0.003]) and daily (β = - 0.009; 95% CI: [- 0.012, - 0.007]) SP is associated with lower frailty scores using the fixed-effect models. Time-varying Cox regressions present lower risks of frailty in daily SP group (HR = 0.76; 95% CI: [0.69, 0.84]). SP types that can significantly decrease frailty risk include IWF, MCCC and DFQ. Daily IWF and daily DFQ decreases frailty risk in those aged < 65 years, female and urban respondents, but not in those aged ≥ 65 years, male and rural respondents. The impact of daily MCCC is significant in all subgroups, whereas that of lower-frequent MCCC is not significant in those aged ≥ 65 years, male and rural respondents. CONCLUSION This study demonstrated that enhancing participation in social activities could decrease frailty risk among middle-aged and older populations, especially communicative activities, intellectually demanding/engaging activities and community-organized physical activities. The results suggested very accurate, operable, and valuable intervening measures for promoting healthy ageing.
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Affiliation(s)
- Ju Sun
- School of Political Science and Public Administration, Wuhan University, Wuhan, China
| | - Xuying Kong
- School of Political Science and Public Administration, Wuhan University, Wuhan, China
| | - Haomiao Li
- School of Political Science and Public Administration, Wuhan University, Wuhan, China.
| | - Jiangyun Chen
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Qiang Yao
- School of Political Science and Public Administration, Wuhan University, Wuhan, China
| | - Hanxuan Li
- School of Political Science and Public Administration, Wuhan University, Wuhan, China
| | - Feng Zhou
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Hua Hu
- College of Medicine and Health Science, Wuhan Polytechnic University, Wuhan, China
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14
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Fuji Y, Sakaniwa R, Shirai K, Saito T, Ukawa S, Iso H, Kondo K. The number of leisure-time activities and risk of functional disability among Japanese older population: the JAGES cohort. Prev Med Rep 2022; 26:101741. [PMID: 35310323 PMCID: PMC8924420 DOI: 10.1016/j.pmedr.2022.101741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 02/14/2022] [Accepted: 02/16/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Yoshihiro Fuji
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871 Japan
- Department of Rehabilitation, Osaka General Medical Center, Osaka, Japan, 3-1-56, Sumiyoshi-ku, Osaka-shi, Osaka 558-8558, Japan
| | - Ryoto Sakaniwa
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871 Japan
| | - Kokoro Shirai
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871 Japan
| | - Tami Saito
- Department of Social Science, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan, 7-430, Morioka-cho, obu-shi, Aichi 474-8511, Japan
| | - Shigekazu Ukawa
- Osaka City University Graduate School of Human Life Science, Osaka, Japan, 3-3-138, Sugimoto, Sumiyoshi-ku, Osaka-shi, Osaka 558-8585, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871 Japan
- Corresponding author. Tel.: +81-6-6879-3911.
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan, 1-8-1, Inohana, Chuo-ku, Chiba-shi, Chiba 260-0856, Japan
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan, 7-430, Morioka-cho, obu-shi, Aichi 474-8511, Japan
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15
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Miura KW, Sekiguchi T, Otake-Matsuura M, Sawada Y, Tanaka E, Watanabe T, Tomisaki E, Okumura R, Kawasaki Y, Ito S, Anme T. Patterns of social relationships among community-dwelling older adults in Japan: latent class analysis. BMC Geriatr 2022; 22:75. [PMID: 35078419 PMCID: PMC8786623 DOI: 10.1186/s12877-022-02748-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 12/23/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Social relationships may be the key to successful aging among older adults. However, little is known about the variability of social relationships among community-dwelling older people. This study aimed to describe the patterns of social relationships and examine the differences in sociodemographic characteristics and mental and physical health status among these patterns. METHODS We obtained the data from a questionnaire survey in 2017 for older adults aged 65 and above who lived in a suburban area in Japan. The Index of Social Interaction (ISI) was used to evaluate social relationships. The final sample comprised 964 people who were independently mobile and answered at least one item of the ISI. To clarify the patterns of social relationships, latent class analysis was performed with five subscales of ISI treated as indicator variables. Multinomial logistic regression was conducted to examine the factors associated with the patterns of social relationships. RESULTS The patterns of social relationships were classified into three classes: "Active" (73.6%), "Socially isolated" (14.7%), and "Less motivated" (11.7%). Persons who had depressive symptoms were more likely to be allocated to the "Socially isolated" (Odds Ratio [OR] 1.80, 95% Confidence Interval [CI] 1.13-2.86) or the "Less motivated" groups (OR 1.69, 95% CI 1.00-2.85) compared to the "Active" group. In addition, men (OR 1.72, 95% CI 1.07-2.76) and those living alone (OR 3.07, 95% CI 1.43-6.61) were more likely to be allocated to the "Socially isolated" group. Moreover, those who were dependent, according to the instrumental activities and daily living functions, were more likely to be assigned to the "Socially isolated" (OR 2.19, 95% CI 1.21-3.97) or "Less motivated" (OR 6.29, 95% CI 3.47-11.39) groups. CONCLUSION This study revealed the patterns of social relationships in older adults and suggested that there may be variations of social relationships among community dwellers. The results also indicated the necessity of assessing individual patterns of social relationships and devising strategies for each pattern in public health practice.
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Affiliation(s)
- Kumi Watanabe Miura
- Japan Society for the Promotion of Science (JSPS), Kojimachi, Chiyoda-ku, Tokyo, 102-0083, Japan
- RIKEN Center for Advanced Intelligence Project, Nihonbashi, Tokyo, 103-0027, Japan
| | - Takuya Sekiguchi
- RIKEN Center for Advanced Intelligence Project, Nihonbashi, Tokyo, 103-0027, Japan
| | | | - Yuko Sawada
- Morinomiya University of Medical Sciences, Suminoe-ku, Osaka, 559-8611, Japan
| | - Emiko Tanaka
- Musashino University, Ariake, Koto-ku, Tokyo, 135-8181, Japan
| | - Taeko Watanabe
- College of Nursing and Nutrition, Shukutoku University, Nitona-cho, Chiba, 260-8703, Japan
| | - Etsuko Tomisaki
- Faculty of Nursing and Medical Care, Keio University, Shinanomachi, Tokyo, 160-0016, Japan
| | - Rika Okumura
- Department of Public Welfare, Tobishima, Aichi, 490-1434, Japan
| | - Yuriko Kawasaki
- Department of Public Welfare, Tobishima, Aichi, 490-1434, Japan
| | - Sumio Ito
- Department of Public Welfare, Tobishima, Aichi, 490-1434, Japan
| | - Tokie Anme
- Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
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16
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Shimatani K, Komada MT, Sato J. Impact of the Changes in the Frequency of Social Participation on All-Cause Mortality in Japanese Older Adults: A Nationwide Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:270. [PMID: 35010529 PMCID: PMC8751209 DOI: 10.3390/ijerph19010270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 12/18/2021] [Accepted: 12/24/2021] [Indexed: 06/14/2023]
Abstract
Previous studies have shown that more frequent social participation was associated with a reduced risk of mortality. However, limited studies have explored the changes in the frequency of social participation in older adults. We investigated the impact of the changes in the frequency of social participation on all-cause mortality in Japanese older adults aged 60 years and older. The current study, conducted as a secondary analysis, was a retrospective cohort study using open available data. The participants were 2240 older adults (45.4% male and 54.6% female) sampled nationwide from Japan who responded to the interview survey. Changes in the frequency of social participation were categorized into four groups (none, initiated, decreased, and continued pattern) based on the responses in the baseline and last surveys. The Cox proportional-hazards model showed a decreased risk of all-cause mortality in decreased and continued patterns of social participation. Stratified analysis by sex showed a decreased risk of mortality in the continued pattern only among males. The results of the current study suggest that the initiation of social participation at an earlier phase of life transition, such as retirement, may be beneficial for individuals.
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17
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Takashima N, Nakamura Y, Miyagawa N, Kadota A, Tanaka-Mizuno S, Matsui K, Miura K, Ueshima H, Kita Y. Association between Stress-Coping Strategy and Functional Disability in the General Older Adult Population: The Takashima Study. Gerontology 2021; 68:699-706. [PMID: 34592746 DOI: 10.1159/000519194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 08/15/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Both physical and psychological factors have been associated with functional disability. However, the associations between stress-coping strategies and future functional disability remain unclear. METHODS We analyzed 2,924 participants who did not have incidence of functional disability or death within the first 3 years of the baseline survey and were aged 65 years or more at the end of follow-up. Stress-coping strategies were assessed via a self-administered questionnaire (emotional expression, emotional support seeking, positive thought, problem-solving, and disengagement) in a baseline survey from 2006 to 2014. Levels of coping strategies were classified as low, middle, and high based of frequency. Functional disability decline was followed up using the long-term-care insurance program until November 1, 2019. Functional disability decline was defined as a new long-term-care insurance program certification. Cox proportional hazards model with competing risk analysis for death was used to evaluate associations between coping strategy levels and functional disability. RESULTS During the follow-up period, we observed 341 cases of functional disability and 73 deaths without previous incidence of functional disability. A significant inverse association between "positive thought" and "problem-solving" and future functional disability was observed. Multivariable adjusted hazard ratios (95% confidence interval) for functional disability were 0.68 (0.51-0.92) for high levels of "positive thought" and 0.73 (0.55-0.95) for high levels of "problem-solving," compared with low levels of the coping strategies. The inverse association was stronger in men. CONCLUSIONS Some subcomponents of stress-coping strategies might be associated with future incidence of functional disability among older adults.
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Affiliation(s)
- Naoyuki Takashima
- Department of Public Health, Kinki University Faculty of Medicine, Osaka-Sayama, Japan.,Department of Public Health, Shiga University of Medical Science, Otsu, Japan
| | - Yasuyuki Nakamura
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan.,Yamashina Racto Clinic and Medical Examination Center, Kyoto, Japan
| | - Naoko Miyagawa
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan.,Department of Preventive Medicine and Public Health, Keio University School of Medicine, Shinjuku-ku, Japan
| | - Aya Kadota
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan.,NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan
| | - Sachiko Tanaka-Mizuno
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan.,Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kenji Matsui
- Center for Public Health Sciences, National Cancer Center Japan, Chuo-ku, Japan
| | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan.,NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan
| | - Hirotsugu Ueshima
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan.,NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan
| | - Yoshikuni Kita
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan.,Faculty of Nursing Science, Tsuruga Nursing University, Tsuruga, Japan
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18
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Hashidate H, Shimada H, Fujisawa Y, Yatsunami M. An Overview of Social Participation in Older Adults: Concepts and Assessments. Phys Ther Res 2021; 24:85-97. [PMID: 34532203 DOI: 10.1298/ptr.r0013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 05/31/2021] [Indexed: 11/23/2022]
Abstract
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.
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Affiliation(s)
- Hiroyuki Hashidate
- Department of Physical Therapy, School of Health Sciences, Kyorin University, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Japan
| | - Yuhki Fujisawa
- Department of Physical Therapy, School of Health Sciences, Kyorin University, Japan
| | - Mitsunobu Yatsunami
- Department of Physical Therapy, School of Health Sciences, Kyorin University, Japan
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19
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Hong Y, Fu J, Kong D, Liu S, Zhong Z, Tan J, Luo Y. Benefits and barriers: a qualitative study on online social participation among widowed older adults in Southwest China. BMC Geriatr 2021; 21:450. [PMID: 34344309 PMCID: PMC8329635 DOI: 10.1186/s12877-021-02381-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 07/12/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND With the development of digital media, online activities are increasingly becoming part of the daily life of older adults. Widowed older adults generally would face changes in social interactions and activities due to widowhood; thus, the importance of online participation may be more prominent in this population. However, a detailed evidence on the experiences of online social participation among widowed older adults is relatively sparse. This study aimed to explore widowed older adults' perceptions regarding online social participation in southwestern China. METHODS This study adopted a qualitative approach. Semi-structured, in-depth individual interviews were conducted with 19 widowed older adults between September-December 2020. Thematic analysis was applied to analyse the data. RESULTS Two major themes, "benefits" and "barriers" were identified from the original data analysis. Subcategories concerning the theme "benefits" were "benefit perception (convenience, flexible time, supplementation)", "health promotion", "emotional comfort", and "social connection". Subcategories of "barriers" were "worries: personal economic loss", "concerns: security of digital device", "troubles: the diversity of online social participation", and "difficulties: using digital media". CONCLUSIONS Social participation of widowed older adults in southwestern China has begun to be integrated into the digital world; however, it remains at an early stage with the simple purpose of engagement. The older adults may face many challenges for online social participation. Although there are barriers and challenges in online social participation, widowed older adults can reap its benefits, which can be used as an important measure to facilitate a fulfilling life and successful ageing. There is no doubt that online social participation will become a trend within the foreseeable future. Family, friends and health care professionals should pay more attention to the needs of online social participation in widowed older adults and provide adequate support for them to achieve a meaningful life.
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Affiliation(s)
- Yan Hong
- School of Nursing, Army Medical University / Third Military Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, 400038 People’s Republic of China
| | - Jingjing Fu
- School of Nursing, Army Medical University / Third Military Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, 400038 People’s Republic of China
| | - Dehui Kong
- School of Nursing, Army Medical University / Third Military Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, 400038 People’s Republic of China
| | - Siqi Liu
- School of Nursing, Army Medical University / Third Military Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, 400038 People’s Republic of China
| | - Zhu Zhong
- School of Nursing, Army Medical University / Third Military Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, 400038 People’s Republic of China
| | - Jing Tan
- School of Nursing, Army Medical University / Third Military Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, 400038 People’s Republic of China
| | - Yu Luo
- School of Nursing, Army Medical University / Third Military Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, 400038 People’s Republic of China
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