Community-level social participation and functional disability among older adults: A JAGES multilevel longitudinal study

Abstract

Purpose: This study investigates the contextual association between types of community-level social participation and functional disability.

Methods: We used 6-year prospective cohort data from the Japan Gerontological Evaluation Study 2010-2016, a nationwide survey of 35,519 functionally independent older adults (mean age: 73.30 ± 5.91 years, 49.6% females). The incidence of functional disability was obtained from municipal long-term care insurance databases. Social participation was assessed at individual and community levels and was categorized as: volunteer, sports, hobby and neighborhood groups, and senior citizen clubs. We calculated the 95% confidence interval (CI) and the hazard ratio (HR) by applying a three-level multilevel survival analysis.

Results: During the 6-year observation period, the onset of functional disability occurred among 3473 adults. A higher prevalence of sports (HR 0.88, 95% CI 0.80 to 0.96) and hobby group participation (HR 0.91, 95% CI 0.87 to 0.96) showed significant contextual relationships with functional disability after adjusting for potential confounders. Among females, community-level neighborhood group participation significantly lowered the incidence of functional disability (HR 0.87, 95% CI 0.76 to 0.998).

Conclusions: We found a beneficial effect of a contextual relationship between community-level sports and hobby group participation and functional disability among older adults. Moreover, females benefited a lot from community-level social participation. We propose that promoting sports and hobby groups in a community may help to prevent functional disability among older adults.

Keywords: Functional disability; Multilevel analysis; Social medicine; Social participation.