Tatsui Otsuka1, Yasutake Tomata2, Shu Zhang3, Kemmyo Sugiyama3, Fumiya Tanji3, Yumi Sugawara3, Ichiro Tsuji3. 1. Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan; Child and Adolescent Psychiatry, Miyagi Psychiatric Center, Natori, Japan. 2. Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan. Electronic address: y-tomata@med.tohoku.ac.jp. 3. Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan.
Abstract
BACKGROUND: Although several longitudinal studies have examined the relationship between social participation and incident functional disability, the related mechanisms have remained unclear. The aim of this study was to examine the mechanisms linking social participation to incident functional disability. METHODS: We analyzed follow-up data for 11,992 older adults (≥65 years) participating in a community-based, prospective cohort study covering a 9-year period. At the baseline, the subjects were asked about three types of participation in community activities (volunteering, hobbies, and neighborhood associations) and the frequency of their participation. Data on incident functional disability were retrieved from the public Long-term Care Insurance database. The Cox model was used to estimate the multivariate-adjusted hazard ratios of incident functional disability. We then conducted mediation analysis to assess the magnitude of the mediating effect. RESULTS: Among 84,760 person-years of follow-up, there were 3,984 cases of incident functional disability. The hazard ratio was 0.79 (95% CI: 0.73-0.86) for participating in one type of activity, 0.82 (95% CI: 0.74-0.90) for two types of activity and 0.70 (95% CI: 0.64-0.77) for three types of activity in comparison with no participation in any activity. Among the estimated mediating effects, cognitive activity accounted for 9.3%, time spent walking for 8.3%, psychological state for 4.6%, and social support for 2.8% of the reduced risk of incident functional disability. CONCLUSION: The results of this population-based cohort study indicate that cognitive activity and time spent walking are important mechanisms linking social participation to incident functional disability.
BACKGROUND: Although several longitudinal studies have examined the relationship between social participation and incident functional disability, the related mechanisms have remained unclear. The aim of this study was to examine the mechanisms linking social participation to incident functional disability. METHODS: We analyzed follow-up data for 11,992 older adults (≥65 years) participating in a community-based, prospective cohort study covering a 9-year period. At the baseline, the subjects were asked about three types of participation in community activities (volunteering, hobbies, and neighborhood associations) and the frequency of their participation. Data on incident functional disability were retrieved from the public Long-term Care Insurance database. The Cox model was used to estimate the multivariate-adjusted hazard ratios of incident functional disability. We then conducted mediation analysis to assess the magnitude of the mediating effect. RESULTS: Among 84,760 person-years of follow-up, there were 3,984 cases of incident functional disability. The hazard ratio was 0.79 (95% CI: 0.73-0.86) for participating in one type of activity, 0.82 (95% CI: 0.74-0.90) for two types of activity and 0.70 (95% CI: 0.64-0.77) for three types of activity in comparison with no participation in any activity. Among the estimated mediating effects, cognitive activity accounted for 9.3%, time spent walking for 8.3%, psychological state for 4.6%, and social support for 2.8% of the reduced risk of incident functional disability. CONCLUSION: The results of this population-based cohort study indicate that cognitive activity and time spent walking are important mechanisms linking social participation to incident functional disability.
Authors: Kazushige Ide; Taishi Tsuji; Satoru Kanamori; Seungwon Jeong; Yuiko Nagamine; Katsunori Kondo Journal: Int J Environ Res Public Health Date: 2020-01-18 Impact factor: 3.390