Association of social disengagement with health status and all-cause mortality among community-dwelling older adults: evidence from the Otassha study

Abstract

This study examined the impact of disengagement on health status and mortality among community-dwelling older adults in Japan. Disengagement from society was operationally defined as dropping out of a longitudinal survey. A follow-up mail survey was conducted, in 2014, among respondents (n = 3696) of the baseline mail survey. Step-by-step follow-up surveys (FLs), including simplified mail, postcard, and home-visit surveys, were sent to participants who did not respond. Disengagement levels were defined according to the response to the FLs as zero (mail survey), low (simplified mail survey), middle (postcard survey), high (home-visit survey), and highest (non-responders to the home-visit survey). After adjusting for health status at baseline, the proportion of respondents self-rated as "not healthy" during FLs was significantly higher in the high-level than in the zero-level group. The proportion of respondents reporting a "once a week or less" frequency of going outdoors during FLs was significantly higher in the low-, middle-, and high-level groups than in the zero-level group. Mortality rates were significantly higher in the high and highest levels than in the zero-level group. Higher disengagement levels increased the risk of lower health status and mortality, suggesting an urgent need to prevent societal disengagement among older adults.