Sachiko Inoue1, Takashi Yorifuji, Soshi Takao, Hiroyuki Doi, Ichiro Kawachi. 1. Sachiko Inoue, Soshi Takao, and Hiroyuki Doi are with the Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan. Sachiko Inoue is also with and Ichiro Kawachi is with the Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA. Takashi Yorifuji is with the Department of Human Ecology, Okayama University Graduate School of Environmental and Life Science, Okayama, Japan.
Abstract
OBJECTIVES: We examined the association between social cohesion and mortality in a sample of older adults in Japan. METHODS: Data were derived from a cohort study of elderly individuals (65-84 years) in Shizuoka Prefecture; 14 001 participants were enrolled at baseline (1999) and followed up in 2002, 2006, and 2009. Among the 11 092 participants for whom we had complete data, 1427 had died during follow-up. We examined the association between social cohesion (assessed at both the community and individual levels) and subsequent mortality after control for baseline and time-varying covariates. We used clustered proportional hazard regression models to estimate hazard ratios (HRs) and confidence intervals (CIs). RESULTS: After control for individual characteristics, individual perceptions of community cohesion were associated with a reduced risk of all-cause mortality (HR = 0.78; 95% CI = 0.73, 0.84) as well as mortality from cardiovascular disease (HR = 0.75; 95% CI = 0.67, 0.84), pulmonary disease (HR = 0.66; 95% CI = 0.58, 0.75), and all other causes (HR = 0.76; 95% CI = 0.66, 0.89). However, no statistically significant relationship was found between community cohesion and mortality risk. CONCLUSIONS: Among the elderly in Japan, more positive individual perceptions of community cohesion are associated with reduced risks of all-cause and cause-specific mortality.
OBJECTIVES: We examined the association between social cohesion and mortality in a sample of older adults in Japan. METHODS: Data were derived from a cohort study of elderly individuals (65-84 years) in Shizuoka Prefecture; 14 001 participants were enrolled at baseline (1999) and followed up in 2002, 2006, and 2009. Among the 11 092 participants for whom we had complete data, 1427 had died during follow-up. We examined the association between social cohesion (assessed at both the community and individual levels) and subsequent mortality after control for baseline and time-varying covariates. We used clustered proportional hazard regression models to estimate hazard ratios (HRs) and confidence intervals (CIs). RESULTS: After control for individual characteristics, individual perceptions of community cohesion were associated with a reduced risk of all-cause mortality (HR = 0.78; 95% CI = 0.73, 0.84) as well as mortality from cardiovascular disease (HR = 0.75; 95% CI = 0.67, 0.84), pulmonary disease (HR = 0.66; 95% CI = 0.58, 0.75), and all other causes (HR = 0.76; 95% CI = 0.66, 0.89). However, no statistically significant relationship was found between community cohesion and mortality risk. CONCLUSIONS: Among the elderly in Japan, more positive individual perceptions of community cohesion are associated with reduced risks of all-cause and cause-specific mortality.
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