Association Between Social Network and Physical Function in Community-Dwelling Older Adults in Japan

Association of Social Network with Physical Function Among Community-Dwelling Older Adults in Rural Thailand: A Cross-Sectional Study

Purpose

As the number of older adults in society increases, their social roles and networks, as well as their physical function, decrease. This study aimed to clarify the association between social networks and physical function among people aged ≥ 60 years in rural Thailand.

Patients and Methods

This cross-sectional study was conducted in the Photharam District, Ratchaburi Province, Thailand. Participants were required to be at least 60 years old and be able to walk to the health center. Social networks were surveyed using the Thai version of Lubben Social Network Scores-6. Four physical function measures, namely hand grip strength, five-times-sit-to-stand test, timed up-and-go (TUG) test, and one-leg standing, were considered. Regression analysis was conducted with Lubben Social Network Scores-6 as the dependent variable and the four types of physical function as independent variables.

Results

A total of 497 older adults aged 60 years or more were enrolled; 82 were males, and 412 were females. The mean Lubben Social Network Scores-6 was 14.9 ± 5.7. Only the TUG test was associated in a single and multiple regression analysis with the Lubben Social Network Scores-6 as the dependent variable and the four physical function assessments as independent variables.

Conclusion

The TUG test assessed the smoothness of normal standing and walking, which are essential physical functions for maintaining a social network and meeting people. This suggests a relationship between physical function and social network.

A Reciprocal Relationship between Formal and Informal Social Engagement and Handgrip Strength of Older Adults in South Korea

INTRODUCTION

The relationship between social engagement and handgrip strength has been underexplored. Further, no prior research examined a plausible reciprocal association between them.

METHODS

The study employed the seven waves of data (2006-2018) from the Korean Longitudinal Study of Aging (KLoSA) survey (7,927 respondents, mean age: 59 years old at wave 1 [71 years old at wave 7], women: 58%). It used ML-SEM, a cross-lagged panel model with fixed effects fitted by structural equation modeling with maximum likelihood estimation. In particular, the ML-SEM examined whether a reciprocal relationship existed between formal social engagement (number of association memberships and frequency of organizational activities)/informal social engagement (frequency of contact with familiar persons) and handgrip strength (the average of the four dynamometer measurements).

RESULTS

The empirical analyses identified a systematic reciprocal association between formal social engagement and handgrip strength. Specifically, formal social engagement was positively associated with handgrip strength over time (the number of association memberships standardized coefficient: 0.012*, the frequency of organizational activities standardized coefficient: 0.022***). Conversely, handgrip strength was positively related to the number of memberships (the handgrip strength standardized coefficient: 0.025*) and the frequency of organizational activities (the handgrip strength standardized coefficient: 0.042**).

CONCLUSION

The study thus supports the social causation proposition that formal social engagement in and through diverse associations may be positively associated with handgrip strength. It also validates the health selection argument that handgrip strength may increase the likelihood of formal social engagement.

Feasibility, reliability, and validity of physical function tests and IADL survey questions in women living in rural, highland Ethiopia

Physical function is the physical ability to fulfill one's daily roles and responsibilities. Poor physical function is detrimental to health and income-generating activities. Unfortunately, there is a lack of validated methods to measure physical function in adult women in low- and middle-income countries, including Ethiopia, the locus of this study. This study evaluated the feasibility, reliability, and validity of physical tests, including the sit-to-stand (STS) and usual gait speed (UGS) and a context-appropriate instrumental activities of daily living (IADL) survey. The results of the STS were used to calculate a muscle quality index (MQI, STS accounting for body mass and leg length). Feasibility was ascertained qualitatively based on reports from the enumerators on their ability to administer the tests. Reliability was assessed by comparing the results of the tests and questions between each visit using either Cohen's κ or Pearson's ρ. The validity of MQI was assessed using relevant participant characteristics such as age and self-reported disability. The validity of the IADL was assessed using MQI. Study participants comprised 316 women between the ages of 18 and 45 years, living in rural Tigray, Ethiopia, who had previously participated in an impact evaluation of a safety net program. Over a one-week period, participants completed the STS and UGS tests and responded to the IADL survey questions three times. MQI was determined to be a feasible, reliable, and valid physical function test for women in rural, highland Ethiopia. UGS lacked feasibility and reliability; validity was not ascertained. The IADL questions were feasible and reliable, but validity was inconclusive. In rural Ethiopia, the MQI will be a valuable tool to develop interventions for improving physical function, which will have positive impacts on health and quality of life.

Sarcopenia and risk factors among Japanese community-dwelling older adults during the COVID-19 pandemic: A cross-sectional study

The COVID-19 pandemic exposed older adults to high risk of sarcopenia. This study aimed to investigate the prevalence of sarcopenia and its risk factors among Japanese community-dwelling older adults during the COVID-19 pandemic. We collected data through questionnaires and physical measurements among 242 older adults. Sarcopenia was assessed using the Asian Working Group for Sarcopenia 2019 criteria. The results revealed that 14.5% had sarcopenia, which was significantly associated with age, nutritional status, number of prescription medications, body mass index, and self-rated health. On multivariate analysis, the risk of malnutrition was independently significantly associated with sarcopenia. Approximately 70% of participants reported decreased social interaction and going outside, but with no significant association with sarcopenia. In addition, approximately 65% of the participants had an exercise habit and went outside at least once a week, thus maintaining a good level of activity. These findings suggest that prevention of sarcopenia during the pandemic required provision of opportunities for older adults to remain active and positive assessment of nutritional status and well-being.

Longitudinal associations between social support and sarcopenia: findings from a 5-year cohort study in Chinese aged ≥50 years

OBJECTIVES

We aimed to investigate longitudinal associations of overall social support and its sub-domains with risk of sarcopenia and its related traits in community-dwelling Chinese aged ≥ 50 years. We also explored interaction effects of potential factors on such associations.

DESIGN

A prospective cohort study.

SETTING

Community-based setting in western China.

PARTICIPANTS

We included participants aged ≥50 years with complete information necessary for analysis from the WCHAT study who did not have sarcopenia at baseline (2018) and had sufficient data for sarcopenia assessment during 2021-2023.

MEASUREMENTS

Exposures included overall social support, subjective support, objective support and support utilization, which were assessed with the Social Support Rating Scale. Outcomes included sarcopenia, low muscle mass (LMM), low muscle strength and low physical performance, which were diagnosed with the 2019 AWGS consensus. Longitudinal associations between the exposures and outcomes were estimated by logistic regression, with generalized estimating equations (GEE) as sensitivity analyses. Subgroup analyses by potential covariates were conducted to detect interaction effects.

RESULTS

A total of 1905 participants were finally included in the analytic sample, of whom 326 (17.1%) developed incident sarcopenia during 5-year follow-up. After controlling for confounders, higher degree of overall social support (OR = 0.87, 95%CI 0.76-0.99), subjective support (OR = 0.88, 95%CI 0.77-0.99) and support utilization (OR = 0.87, 95%CI 0.77-0.99) correlated with lower sarcopenia risk, among which higher support utilization degree was indicative of lower risk for LMM (OR = 0.88, 95%CI 0.79-0.98). GEE further revealed that overall support degree was negatively associated with risk for sarcopenia (OR = 0.86, 95%CI 0.76-0.98) and LMM (OR = 0.87, 95%CI 0.77-0.99). Objective support was neither significantly associated with sarcopenia nor its traits. No significant interaction effect was observed between overall support and the concerned confounders on sarcopenia (interaction P-value > 0.05).

CONCLUSION

Overall social support degree was negatively associated with sarcopenia risk, possibly primarily through affecting muscle mass rather than muscle strength or physical performance, and such an association remained robust across subgroups with distinct characteristics. This holds implications for policymakers to conduct population-based risk assessment, and supportive strategies against sarcopenia should focus on enhancing subjective support and support utilization rather than objective support alone.

Types and frequency of social participation and comprehensive frailty among community-dwelling older people in Japan

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.

Changes in Community-Dwelling Elderly's Activity and Participation Affecting Depression during COVID-19 Pandemic: A Cross-Sectional Study

We determined the changes in the activity or participation of the community-dwelling elderly in Japan during the COVID-19 pandemic and identified the activities leading to depression. This will allow us to evaluate rehabilitation interventions that can be used to minimize or eliminate the negative impact of COVID-19 on today's community-dwelling elderly. Herein, demographics, activity or participation (Activity Card Sort-Japan version: ACS-JPN), the number of social networks (Lubben Social Network Scale: LSNS), and depression (Geriatric Depression Scale: GDS) were examined in 74 community-dwelling elderly in Japan from August to October 2020. A statistical analysis was conducted to determine the effect of demographics on GDS, LSNS, and ACS-JPN, to compare the activity retention rates of the four domains using ACS-JPN, and to extract the activities that might affect depression using a generalized linear model. The results show that the retention of leisure activity with a high physical demand (H-leisure) and sociocultural activities was significantly lower than instrumental activities of daily living and leisure activity with a low physical demand (L-leisure). L-leisure and the number of social networks were possible risk factors for depression during the pandemic. This study highlighted the importance of maintaining the number of L-leisure and social networks at home to prevent depression in community-dwelling elderly when they could not perform outdoor activities and direct interpersonal interaction.

Associations of Nutrition-Related, Physical, and Social Factors and Their Combinations with Sarcopenia in Community-Dwelling Older Adults: Kashiwa Cohort Study

Background: Sarcopenia is a major cause of frailty, which relates to nutrition-related, physical, and social factors. In this study, we aimed to discuss the cross-sectional association of sarcopenia with the above three factors both individually and comprehensively. Methods: Overall, 1257 older adults (≥65 years old) participated in this study. Sarcopenia was determined via the Asian Working Group for Sarcopenia 2019 criteria. The independent variables for nutrition-related, physical, and social factors and especially their criteria for health condition were defined separately. Binomial logistic regression analysis was carried out to testify the associations of sarcopenia with three factors individually and in combination. Results: The mean age was 74.6 (±5.5), and women were 47.7%. Sarcopenia prevalence was 7.5%. Participants who did not meet the criteria of nutritional health, physical fitness, or social robustness independently had significant associations with a higher adjusted odds ratio (aOR) of sarcopenia or its indices of lower grip strength, muscle mass, or gait speed. In comparison to participants meeting three criteria, those who met two, one, or none showed (marginally) significant association with increased aOR for sarcopenia (aOR (95% confidence interval)): two: 1.97 (0.84–4.64); one: 2.35 (1.00–5.23); none: 5.52 (2.30–13.23). Conclusions: Comprehensive countermeasures with the above three factors are indispensable for sarcopenia prevention.

Social isolation is associated with future decline of physical performance in community-dwelling older adults: a 1-year longitudinal study

BACKGROUND

Social isolation and decline of physical function, such as muscle strength and physical performance, are known to be associated with deterioration of functional capacity. However, the relationship between social isolation and physical function has not been sufficiently clarified by a longitudinal observational study.

AIMS

The aim of this study was to examine whether social isolation is associated with a future decline in physical function in older people.

METHODS

The participants were 166 community-dwelling older people (aged ≥ 65 years). Social isolation and physical function were assessed using the 6-item Lubben Social Network Scale and handgrip strength, knee extensor strength, usual walking time, and the Timed Up and Go (TUG) test in both the baseline and follow-up surveys. To define the presence or absence of physical function decline over time, we used the minimal detectable change. The associations between social isolation and physical function were analyzed using logistic regression analysis adjusted for confounding factors. Further, to examine the possibility of drop-out bias, inverse probability weighting (IPW) was performed.

RESULTS

The results of the logistic regression analysis adjusted for confounding factors showed social isolation at baseline was significantly associated with future TUG decline (OR 2.88, 95% CI 1.15-7.22). Social isolation was not associated with a decline in other physical functions. Similar results were found in an analysis using IPW.

CONCLUSIONS

Social isolation was an independent risk factor for future TUG decline in community-dwelling older people. Our results indicated that assessment of social isolation may be necessary to assess the risk of physical performance decline.

Impact of Social Isolation on Physical Functioning Among Older Adults: A 9-Year Longitudinal Study of a U.S.-Representative Sample

INTRODUCTION

Social isolation among older adults is associated with poor health and premature mortality, but its impact on physical functioning is not fully understood. Previous studies have typically relied on community samples, cross-sectional data, and suboptimal prospective designs. This study generates more robust evidence by investigating the longitudinal associations between social isolation and physical functioning in a large panel of older adults.

METHODS

Analyses were based on 9 waves of data (2011-2019) from a sample of adults aged ≥65 years from the U.S. National Health and Aging Trends Study (N=12,427 individuals; 54,860 person-year observations) and within-individual fixed-effect panel regression models. Analyses were conducted in 2020. Social isolation was measured using the Social Isolation Index, and physical functioning was measured through the Short Physical Performance Battery.

RESULTS

In fully adjusted fixed-effect regression models, each 1-unit increase in the Social Isolation Index resulted in an average decrease of 0.27 units in the Short Physical Performance Battery (95% CI= -0.31, -0.24). This relationship was moderated by age, with the Social Isolation Index bearing a significantly and substantially stronger influence on the Short Physical Performance Battery at older ages than at younger ages.

CONCLUSIONS

This study confirms that social isolation is associated with deficits in physical functioning among older adults in the U.S. using more robust data and methods than earlier studies. These findings highlight the importance of incorporating strategies to reduce social isolation in policies aimed at promoting successful aging.