Association Between Social Participation and 3‐Year Change in Instrumental Activities of Daily Living in Community‐Dwelling Elderly Adults

Abstract

OBJECTIVES:To investigate whether social participation (SP) in older adults is associated with ability to perform instrumental activities of daily living (IADLs). DESIGN: Prospective cohort study. SETTING: Two local municipalities of Nara, Japan. PARTICIPANTS: Individuals aged 65 to 96 (n = 2,774 male, n = 3,586 female) free of IADL disability at baseline. MEASUREMENTS: SP and IADLs were assessed using self-administered questionnaires. SP was categorized into five types and assessed using the number and type of social activities. IADLs were evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Logistic regression analysis stratified according to sex was used to examine change in IADLs according to SP, with nonparticipation as a reference. RESULTS: During the 3-year follow-up, 13.6% of men and 9.0% of women reported IADL decline. After adjusting for age, family structure, body mass index, pension, occupation, medical treatment, self-rated health, drinking, smoking, depression, cognitive function, and activities of daily living, participation in various social activities was inversely associated with change in IADLs in women but not men. Participation in the following types of social activities had significant inverse associations with IADL disability: hobby clubs (odds ratio (OR) = 0.68, 95% confidence interval (CI) = 0.49-0.94) for men and local events (OR = 0.68, 95% CI = 0.48-0.95), hobby clubs (OR = 0.53, 95% CI = 0.36-0.79), senior citizen clubs (OR = 0.74, 95% CI = 0.56-0.97), and volunteer groups (OR = 0.56, 95% CI = 0.32-0.99) for women. CONCLUSION: Participation in a variety of different types of social activities was associated with change in IADLs over the 3 years of this study in women, and participation in hobby clubs was associated with change in IADLs in men and women. Recommending that community-dwelling elderly adults participate in social activities appropriate for their sex may promote successful aging. J Am Geriatr Soc 65:107-113, 2017.

Age and gender differences in the association between social participation and instrumental activities of daily living among community-dwelling elderly

“…Based on prior studies [4–9, 14, 15, 23–25], the following variables were used as covariates that may mediate the association between SP and IADL: age, residential area, marital status, subjective economic situations, pensions, chronic diseases, body mass index (BMI), alcohol, smoking, dietary habit, depression, cognitive function, self-rated health, and having a purpose in life. Data on age and residential areas were provided by city governments, and data for other covariates were procured from the questionnaire.…”

“…Because it’s noted that there are gender differences in IADL difficulties among older adults [13], it is necessary to examine male and female IADL separately when viewing it as a health outcome. Since there are limited numbers of studies regarding the association between SP and IADL, we examined the types of social activities which community dwelling elderly people participate in as well as the impact of SP on IADL with specific attention given to gender difference [14, 15]. Their results were as follows; a prospective cohort study [14] revealed that among females, participation in volunteer groups, hobby groups, senior citizen clubs, and local events was associated with decreased risk of IADL decline, whereas among males, only participation in hobby groups was protective for IADL decline.…”

“…Since there are limited numbers of studies regarding the association between SP and IADL, we examined the types of social activities which community dwelling elderly people participate in as well as the impact of SP on IADL with specific attention given to gender difference [14, 15]. Their results were as follows; a prospective cohort study [14] revealed that among females, participation in volunteer groups, hobby groups, senior citizen clubs, and local events was associated with decreased risk of IADL decline, whereas among males, only participation in hobby groups was protective for IADL decline. A cross-sectional study [15] revealed that among females, a significant inverse association between frequent participation and poor IADL was observed for all types of social groups, whereas among males, the association was limited to sports groups and senior citizens’ clubs.…”

“…Although there are several studies regarding SP of community dwelling elderly people with focus given to gender differences [2, 6, 8, 9], there are very few studies giving attention to the impact of age at the time of SP [5]. In our previous studies, too, age was only used as a covariate [14, 15]. As the rate of those who participate in social activities and those who maintain IADL decrease along with aging [17, 18], we consider the examination of age difference in association between SP and IADL to be essential.…”

“…As the rate of those who participate in social activities and those who maintain IADL decrease along with aging [17, 18], we consider the examination of age difference in association between SP and IADL to be essential. Furthermore, our previous studies [14, 15] didn’t consider “paid work” as one of the most important SPs for elderly people [1, 19]. In countries like Japan, where an aging population combined with a diminishing number of children is progressing, employment of the elderly is an important issue in securing manpower [20].…”