Social participation patterns and the incidence of functional disability: The Japan Gerontological Evaluation Study

AIM

To examine whether patterns of social participation vary in their associations with functional disability.

METHODS

Data from 44 978 participants (22 750 men and 22 228 women) who participated in the 2010 Japan Gerontological Evaluation Study were analyzed; a study of those aged ≥65 years from 23 municipalities in eight prefectures. Social participation information was obtained at baseline with an eight-item questionnaire. Incidence of functional disability from 2010 to 2013 was defined as a new certification of eligibility for municipal public long-term care insurance. Social participation patterns were analyzed using exploratory factor analysis and participants were classified into quartiles of factor scores of social participation patterns. A competing risk model was used to calculate the hazard ratios and 95% confidence intervals for the incidence of functional disability in 3 years of follow-up.

RESULTS

Two social patterns were identified: sports groups/clubs and hobby groups, and political groups/organizations and industry/trade associations. For both patterns, compared with participants in the lowest quartile, participants in the highest quartile were more likely to be male, college educated, high-income and current drinkers. Both patterns were associated with reduced incidence of functional disability (adjusted hazard ratios for top quartile of sports and hobby pattern: 0.66, 95% confidence interval: 0.59, 0.74; for political and industry/trade pattern: 0.81, 95% confidence interval: 0.72, 0.90; P for trend <0.001 for both).

CONCLUSIONS

Those whose social participation patterns were characterized by frequent participation in sports groups/clubs and hobby groups or political groups/organizations and industry/trade associations were less likely to develop a functional disability. Geriatr Gerontol Int 2020; 20: 765-772.

Social capital and physical health: An updated review of the literature for 2007-2018

PURPOSE

Social capital is frequently indicated as a determinant of population health. Despite an increase in the frequency of public health studies including such measures, our understanding of social capital's effects on health remains unclear. In 2008, a systematic review of the "first decade" of research on social capital and health was published in the textbook Social Capital and Health. Our study intends to update and expand upon this original review to account for developments in the literature over the second decade of research on social capital and health.

METHODS

We employed a systematic review of empirical studies investigating the relationship between measures of social capital and physical health outcomes published between January 1, 2007 and December 31, 2018. To identify potential studies, we conducted searches of PubMed, Embase, and PsychINFO databases in January 2019 using combinations of "social capital" and "physical health" search terms.

RESULTS

We identified 1,608 unique articles and reviewed 145 studies meeting our inclusion criteria. The most frequently examined health condition was self-reported health (57%), followed by mortality (12%), cardiovascular diseases (10%), obesity (7%), diabetes (6%), infectious diseases (5%), and cancers (3%). Of these studies, 127 (88%) reported at least partial support for a protective association between social capital and health. However, only 41 (28%) reported exclusively positive findings. The majority (59%) of results were mixed, suggesting a nuanced relationship between social capital and health. This finding could also be indicative of differences in study design, which showed substantial variation.

CONCLUSIONS

Despite limitations in the literature, our review chronicles an evolution in the field of social capital and health in terms of size and sophistication. Overall, these studies suggest that social capital may be an important protective factor for some physical health outcomes, but further research is needed to confirm and clarify these findings.

A longitudinal study of the association between social capital and mortality in community-dwelling elderly Brazilians

The aim of this study was to verify whether social capital is a predictor of all-cause mortality in community-dwelling elderly Brazilians. Participation included 935 surviving elderly from the elderly cohort of the Bambui Project in 2004, who were followed until 2011. The outcome was all-cause mortality and the exposure of interest was social capital, measured in its two components, cognitive (social cohesion and social support) and structural (social participation and neighborhood satisfaction). Sociodemographic variables, health conditions, and smoking were included in the analysis for adjustment purposes. Data analysis was based on the Cox proportional hazards model, providing hazard ratios (HR) and 95% confidence intervals (95%CI). The social participation dimension of social capital's structural component was the only dimension independently associated with mortality: elderly Brazilians that did not participate in social groups or associations showed a two-fold higher risk of death (HR = 2.28; 95%CI: 1.49-3.49) compared to their peers. The study's results reveal the need to extend interventions beyond the specific field of health in order to promote longevity, focusing on environmental and social characteristics.

Work disability functional assessment battery: feasibility and psychometric properties

OBJECTIVE

To assess the feasibility and psychometric properties of 8 scales covering 2 domains of the newly developed Work Disability Functional Assessment Battery (WD-FAB): physical function (PF) and behavioral health (BH) function.

DESIGN

Cross-sectional study.

SETTING

Community.

PARTICIPANTS

Adults (N=973) unable to work because of a physical (n=497) or a mental (n=476) disability.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Each disability group responded to a survey consisting of the relevant WD-FAB scales and existing measures of established validity. The WD-FAB scales were evaluated with regard to data quality (score distribution, percentage of "I don't know" responses), efficiency of administration (number of items required to achieve reliability criterion, time required to complete the scale) by computerized adaptive testing (CAT), and measurement accuracy as tested by person fit. Construct validity was assessed by examining both convergent and discriminant correlations between the WD-FAB scales and scores on same-domain and cross-domain established measures.

RESULTS

Data quality was good, and CAT efficiency was high across both WD-FAB domains. Measurement accuracy was very good for PF scales; BH scales demonstrated more variability. Construct validity correlations, both convergent and divergent, between all WD-FAB scales and established measures were in the expected direction and range of magnitude.

CONCLUSIONS

The data quality, CAT efficiency, person fit, and construct validity of the WD-FAB scales were well supported and suggest that the WD-FAB could be used to assess PF and BH function related to work disability. Variation in scale performance suggests the need for future work on item replenishment and refinement, particularly with regard to the Self-Efficacy scale.

Educational intervention and functional decline among older people: The modifying effects of social capital

Aim: To analyse if social capital modifies the effect of educational intervention of home visitors on mobility disability. Earlier studies have found that educational intervention of home visitors has a positive effect of older peoples′ functional decline, but how social capital might modify this effect is still unknown. Methods: We used the Danish Intervention Study on Preventive Home Visits – a prospective cohort study including 2863 75-year-olds and 1171 80-year-olds in 34 Danish municipalities – to analyse the modifying effect of different aspects of social capital on the effect of educational intervention of home visitors on functional decline. The three measures of social capital (bonding, bridging, and linking) were measured at contextual level. Data was analysed with multivariate linear regression model using generalised estimating equations to account for repeated measurements. Results: We found that 80-year-olds living in municipalities with high bonding ( B=0.089, p=0.0279) and high linking ( B=0.0929; p=0.0217) had significant better mobility disability in average at 3-year follow up if their municipality had received intervention. Conclusions: With the unique design of the Danish Intervention Study on Preventive Home Visits and with theory-based measures of social capital that distinguish between three aspects of social capital with focus on older people, this study contributes to the literature about the role of social capital for interventions on mobility disability.

Social Capital and Loneliness Among the Very Old Living at Home and in Institutional Settings

Objective: The aim of this study was to investigate the association between aspects of social capital and loneliness among the very old living at home and in institutional settings. Method: Half of those aged 85 years, and all 90- and 95-year-olds and older in urban and rural municipalities in northern Sweden and western Finland were invited to participate in a cross-sectional population-based study in 2005-2007. A sample of 483 participants who completed the study was included in the analyses. Results: Loneliness was experienced by 55% percent of those living in institutional settings often or sometimes and 45% of those living in their own homes. Loneliness was closely related to living alone, to depression, and to region (northern Sweden). Discussion: Social capital and loneliness are context dependent (i.e., geographical or living environment). Among the very old, the link between social capital resources and loneliness is also highly influenced by health status.