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Shimoda T, Tomida K, Nakajima C, Kawakami A, Shimada H. Development of a weighted scoring model for social activities to predict disability incidents among older Japanese adults. Arch Gerontol Geriatr 2024; 122:105387. [PMID: 38422605 DOI: 10.1016/j.archger.2024.105387] [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: 11/22/2023] [Revised: 02/16/2024] [Accepted: 02/25/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Social activities contribute to health improvements in older adults, but methods for evaluating these activities are not yet established. We developed a scoring model for social activity, weighted by specific activities, to assess the association between disability incidence in older adults and social activities. METHODS Data were obtained from Japan's National Center for Geriatrics and Gerontology Study of Geriatric Syndromes (NCGG-SGS). Social activity was evaluated across 16 domains. Disability was determined using data extracted from Japan's long-term care insurance system. RESULTS Data from 4998 older adults were analyzed; among them, 422 (8.4 %) developed a disability within 35 months (Interquartile range: 32-39). The Cox proportional hazards model was used to assess 16 domains of social activity. The results yielded risk factors for disability incidence in six social activity domains: work, travel, hobbies, babysitting, family caregiving, and events. The coefficients for these activities were assigned weights of 3, 3, 2, 1, 1, and 1, respectively. The weighted social activity scoring model significantly improved the ability to predict disability incidence when the number of social activities in which individuals participated was considered (social activity score: area under the curve [AUC] 0.691, 95 % confidence interval [CI] 0.664-0.717; number of social activities: AUC 0.681, 95 % CI 0.654-0.707, P = 0.042). CONCLUSIONS The composite score derived from the weighted social activity scoring model serves as a valuable tool due to its enhanced predictability, which complements established background factors associated with the incidence of disability in older adults.
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Affiliation(s)
- Takahiro Shimoda
- Department of Preventive Gerontology Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan.
| | - Kouki Tomida
- Department of Preventive Gerontology Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Chika Nakajima
- Department of Preventive Gerontology Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Ayuka Kawakami
- Department of Preventive Gerontology Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
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Saito M, Watanabe R, Tamada Y, Takeuchi K, Tani Y, Kondo K, Ojima T. Social disconnection and suicide mortality among Japanese older adults: A seven-year follow-up study. Soc Sci Med 2024; 347:116778. [PMID: 38513565 DOI: 10.1016/j.socscimed.2024.116778] [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: 10/12/2023] [Revised: 03/06/2024] [Accepted: 03/09/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Few prospective studies have examined the association between social disconnection and late-life suicide. Therefore, we conducted a large-scale prospective study of older adults in Japan to examine differences in suicide mortality according to specific aspects of social disconnectedness. METHODS We conducted a nationwide baseline survey of functionally independent older adults (age ≥65 years) from 12 municipalities in Japan from 2010 to 2011. We followed the participants (n = 46,144) for cause of death through December 2017 using vital statistics. Social disconnection was assessed based on the indicators of eating alone, a lack of instrumental/emotional support, no participation in community activities, and no contact with friends. We adopted Cox regression models with multiple imputation for missing values and calculated the population-attributable fraction (PAF). RESULTS A total of 55 suicide deaths were recorded during an average follow-up of 7 years. Older adults with social disconnection had a marginally increased risk of suicide. The hazard ratio for eating alone vs. eating together was 2.81 (95% confidence interval [CI]: 1.47-5.37). The direction of these associations and point estimations did not largely change after controlling for depressive symptoms, an evident risk factor for suicidal behavior. The PAF indicated that eating alone was attributable to around 1800 (29%) of the suicide deaths among older adults annually in Japan. CONCLUSION Avoidance of not only depressive symptoms, but also social disconnection including eating alone, is useful in suicide prevention among older adults.
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Affiliation(s)
- Masashige Saito
- Faculty of Social Welfare, Nihon Fukushi University, Aichi, Japan; Center for Well-being and Society, Nihon Fukushi University, Aichi, Japan.
| | - Ryota Watanabe
- Center for Well-being and Society, Nihon Fukushi University, Aichi, Japan; Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan; Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Yudai Tamada
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Aichi, Japan; Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Miyagi, Japan
| | - Kenji Takeuchi
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Aichi, Japan; Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Miyagi, Japan; Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Miyagi, Japan
| | - Yukako Tani
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Katsunori Kondo
- Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan; Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
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Chen YR, Hanazato M, Saito M, Koga C, Matsuoka Y, Yoshida H, Kondo K. Does the neighborhood built and social environment reduce long-term care costs for Japanese older people? The JAGES2010-2019 cohort study. Health Place 2024; 86:103223. [PMID: 38479102 DOI: 10.1016/j.healthplace.2024.103223] [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: 07/11/2023] [Revised: 02/27/2024] [Accepted: 03/04/2024] [Indexed: 03/23/2024]
Abstract
Japan's population has been aging steadily, evidenced by it spending JPY 11 trillion (USD 110 billion) on annual long-term care (LTC) costs in 2021. In this context, understanding the factors influencing LTC costs has become increasingly vital. Although studies have reported positive relationships between neighborhood environment and health outcomes, the connection between LTC costs and neighborhood environment remains unclear. To address this gap in the literature, this cohort study, conducted from 2010 to 2019 across seven Japanese municipalities and involving 34,982 older people, examined the relationship between eight neighborhood environment elements and the mean monthly cumulate costs (MMCC) of LTC. The results showed that older people who reported the presence of fresh food stores nearby and dangerous places for walking alone at night in the neighborhood had lower MMCC, by JPY 1,367.6 and 1,383.3 per month, respectively, than respondents who did not report the presence of these neighborhood elements. Meanwhile, older people whose neighborhoods had easily accessible facilities had higher MMCC of JPY 739.4. This study's key findings reveal significant relationships between neighborhood environment elements and LTC costs and can be used to support developments in urban design to support healthy aging and reduced LTC costs.
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Affiliation(s)
- Yu-Ru Chen
- Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, Japan.
| | - Masamichi Hanazato
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Design Research Institute, Chiba University, Tokyo, Japan
| | - Masashige Saito
- Faculty of Social Welfare, Nihon Fukushi University, Aichi, Japan
| | - Chie Koga
- Research Center for Advanced Science and Technology, Tokyo University, Tokyo, Japan
| | - Yoko Matsuoka
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Hiroaki Yoshida
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morikoka-cho, Obu-shi, Aichi, 474-8511, Japan
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Nakamura M, Urabe Y, Kanauchi N. Competency acquisition among rehabilitation professionals supporting older residents' community-based activities in Japan: a qualitative study. J Phys Ther Sci 2024; 36:26-32. [PMID: 38186963 PMCID: PMC10766407 DOI: 10.1589/jpts.36.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 10/17/2023] [Indexed: 01/09/2024] Open
Abstract
[Purpose] In Japan, community-gathering initiatives for older residents often involve support from rehabilitation professionals. However, the quality of this support varies. This study aimed to clarify the rehabilitation professionals' competency-acquisition process for establishing better support methods and processes, thereby reducing regional and individual differences. [Participants and Methods] The study included 10 rehabilitation professionals (nine physical therapists and one occupational therapist; eight males and two females, aged 34-57 years) with 2-7 years of experience facilitating community gatherings. Semi-structured interviews and the modified grounded theory approach were used. [Results] The results of this study identified 38 concepts, 15 subcategories, and finally the following 6 categories pertaining to the effective support process of care prevention: "not confident", "prepare for support", "form a rapport", "know the field", "implement effective support", and "utilize support experiences". [Conclusion] To prevent long-term frailty among older residents, rehabilitation professionals should 1) establish a system for ensuring their participation in the project, 2) understand the core principles of community rehabilitation, 3) facilitate residents' initiatives, and 4) mediate group activities. Apart from conventional physical-therapy skills, rehabilitation professionals must acquire specific competencies to support community gatherings as a part of their education, such as providing indirect group support rather than direct individual support.
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Affiliation(s)
- Mutsumi Nakamura
- Department of Physical Therapy, Tohto University Faculty of
Human Care at Makuhari: 1-1 Hibino Mihama-ku, Chiba 261-0021, Japan
| | - Yoshifumi Urabe
- Department of Rehabilitation Medicine, Ohashi Hospital,
Japan
| | - Noriko Kanauchi
- Department of Physical Therapy, Tohto University Faculty of
Human Care at Makuhari: 1-1 Hibino Mihama-ku, Chiba 261-0021, Japan
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Oe N, Tadaka E. Development of the Self-efficacy for Social Participation scale (SOSA) for community-dwelling older adults. BMC Public Health 2023; 23:2294. [PMID: 37985978 PMCID: PMC10662651 DOI: 10.1186/s12889-023-16774-6] [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: 02/01/2023] [Accepted: 09/16/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Social participation is important for the health of older adults and super-aging societies. However, relatively few independent older adults in advanced countries actually participate in society, even though many of them have the capacity to do so. One possible reason for this could be a lack of self-efficacy for social participation. However, few scales have been developed to measure self-efficacy for social participation among community-dwelling independent older adults. Therefore, we developed the "Self-efficacy for Social Participation" scale (SOSA) to assess the self-efficacy of community-dwelling independent older adults, and examined the scale's reliability and validity. METHODS We distributed a self-administered mail survey to approximately 5,000 randomly selected independent older adults throughout Japan. The construct validity of the SOSA was determined using exploratory and confirmatory factor analyses. Criterion-related validity was assessed using the General Self-Efficacy Scale (GSES) and according to subjective health status. RESULTS In total, 1,336 older adults responded to the survey. Exploratory and confirmatory factor analyses identified 12 items distributed among four factors: instrumental self-efficacy, managerial self-efficacy, interpersonal self-efficacy and cultural self-efficacy. The final model had a Cronbach's alpha of 0.90, goodness-of-fit index of 0.948, adjusted goodness-of-fit index of 0.915, comparative fit index of 0.952, and root mean square error of approximation of 0.078. Significant correlations existed between the SOSA score and GSES (r = 0.550, p < 0.01) and subjective health status (r = 0.384, p < 0.01) scores. CONCLUSIONS The SOSA showed sufficient reliability and validity to assess self-efficacy for social participation among older adults. This scale could aid efforts to improve the physical and mental health, and longevity, of older adults through increased behavioralizing social participation.
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Affiliation(s)
- Nanami Oe
- Department of Community and Public Health Nursing, Graduate School of Health Sciences, Hokkaido University, N12-W5, Kita-Ku, Sapporo, Hokkaido, 060-0812, Japan
| | - Etsuko Tadaka
- Department of Community and Public Health Nursing, Faculty of Health Sciences, Hokkaido University, N12-W5, Kita-Ku, Sapporo, Hokkaido, 060-0812, Japan.
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Kojima K, Saito M, Miyaguni Y, Okada E, Ojima T. Oral function and cumulative long-term care costs among older Japanese adults: a prospective 6-year follow-up study of long care receipt data. BMJ Open 2023; 13:e066349. [PMID: 36787975 PMCID: PMC9930558 DOI: 10.1136/bmjopen-2022-066349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
OBJECTIVES This study evaluated the relationship between status of oral function and related long-term care service costs. DESIGN This was a prospective 6-year follow-up study of previous survey data. SETTING The data were obtained from the Japan Gerontological Evaluation Study conducted between 2010 and 2011. PARTICIPANTS The participants were functionally independent older adults in 12 municipalities across Japan. INTERVENTIONS Care service benefit costs were tracked over 6 years using publicly available claims records (n=46 616) to monitor respondents' cumulative care costs. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome variable was the cumulative cost of long-term care insurance services during the follow-up period. We adjusted for the presence or absence of oral function problems, age, sex, physical function and socioeconomic and lifestyle background at the time of the baseline survey. RESULTS Tobit analysis revealed that, compared with those with no oral function problems, cumulative long-term care service benefit costs for those with one, two or three oral function problems were approximately US$4020, US$4775 and US$82 92, respectively, over 6 years. Compared with those with maintained oral function, there was a maximum difference of approximately US$8292 in long-term care service costs for those with oral function problems. With increase in number of oral function problems, there was a concomitant elevation in the cost of long-term care. CONCLUSIONS Oral function in older people was associated with cumulative long-term care insurance costs. The oral function of older people should be maintained to reduce future accumulated long-term care insurance costs. Compared with those with maintained oral function, there was a maximum difference of approximately US$8292 in long-term care service costs for those with oral function problems. The cost of long-term care was amplified as oral problems increased.
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Affiliation(s)
- Kaori Kojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Masashige Saito
- Faculty of Social Welfare, Nihon Fukushi University, Chita-gun, Japan
- Center for Well-Being and Society, Nihon Fukushi University, Nagoya, Japan
| | - Yasuhiro Miyaguni
- Faculty of Social Welfare, Nihon Fukushi University, Chita-gun, Japan
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Eisaku Okada
- Center for Well-Being and Society, Nihon Fukushi University, Nagoya, Japan
- Faculty of Social Policy & Administration, Hosei University, Machida, Japan
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
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