Combined Impacts of Physical Activity, Dietary Variety, and Social Interaction on Incident Functional Disability in Older Japanese Adults

Abstract

Background: This 3.6-year prospective study examined combined impacts of physical activity, dietary variety, and social interaction on incident disability and estimated population-attributable fraction for disability reduction in older adults. Methods: Participants were 7,822 initially non-disabled residents (3,966 men and 3,856 women) aged 65-84 years of Ota City, Tokyo, Japan. Sufficiency of moderate-to-vigorous-intensity physical activity (MVPA) ≥150 min/week, dietary variety score (DVS) ≥3 (median), and social interaction (face-to-face and/or non-face-to-face) ≥1 time/week was assessed using selfadministered questionnaires. Disability incidence was prospectively identified using the long-term care insurance system's nationally unified database. Results: During a follow-up of 3.6 years, 1,046 (13.4%) individuals had disabilities. Independent multivariate-hazard ratios (HRs) and 95% confidence intervals (CIs) of MVPA, DVS, and social interaction sufficiency for incident disability were 0.68 (95% CI, 0.59-0.78), 0.87 (95% CI, 0.77-0.99), and 0.90 (95% CI, 0.79-1.03), respectively. Incident disability HRs gradually reduced with increased frequency of satisfying these behaviors (any one: HR 0.82; 95% CI, 0.65-1.03; any two: HR 0.65; 95% CI, 0.52-0.82; and all three behaviors: HR 0.54; 95% CI, 0.43-0.69), in an inverse dose-response manner (P < 0.001 for trend). Population-attributable fraction for disability reduction in satisfying any one, any two, and all three behaviors were 4.0% (95% CI, −0.2 to 7.9%), 9.6% (95% CI, 4.8-14.1%), and 16.0% (95% CI, 8.7-22.8%), respectively. Conclusion: Combining physical activity, dietary variety, and social interaction substantially enhances the impacts on preventing disability among older adults, with evidence of an inverse dose-response manner. Improving insufficient behavior elements through individual habits and preexisting social group activities may be effective in preventing disability in the community.

Bidirectional association between functional disability and multimorbidity among middle-aged and older adults in Thailand

“…In line with previous studies ( 32 ), the prevalence of MM was higher in women than in men, while functional disability did not differ by sex, as found previously ( 29 , 38 , 39 ). The prevalence of MM and functional disability was higher among those who were physically inactive, which is consistent with previous research ( 32 , 34 , 40 , 43 , 44 ). Consistent with previous studies ( 32 , 35 ), MM was higher among those with a higher BMI (obesity) and consistent with a study in India ( 59 ), underweight was higher among those with functional disabilities.…”

“…The first model is unadjusted; in the second model, adjustments are made for age, income, sex, education, and marital status, and in the third model, adjustments are made for model 2 variables plus smoking, physical activity, BMI, alcohol use, and social engagement. The selection of covariates is based on a previous review of the literature ( 6 – 8 , 14 , 15 , 25 , 29 , 32 – 44 ). A value of p ≤ 0.05 was considered statistically significant.…”

“…Previous studies have shown that demographic factors, such as older age and female sex ( 32 ), lower socioeconomic status ( 6 , 9 ), and lifestyle factors, such as smoking ( 33 ), alcohol use ( 32 , 33 ), physical inactivity ( 32 , 34 ), body weight status and obesity ( 32 , 35 ), and lack of social engagement ( 36 , 37 ) were associated with MM. Furthermore, demographic factors, such as older age ( 15 , 29 ) and female sex ( 29 , 38 , 39 ), lower socioeconomic status ( 38 , 40 ), lifestyle factors, such as smoking ( 41 ), alcohol use ( 42 ), physical inactivity ( 40 , 43 , 44 ), body weight status and obesity ( 40 , 41 ), low social capital ( 15 ) and low social interaction ( 44 ) were associated with functional disability.…”

Physical, social, and dietary behavioral changes during the COVID-19 crisis and their effects on functional capacity in older adults

“…Hence, changes in lifestyle behaviors could be highlighted only during the restricted period, although some older adults could continue to engage in unhealthy lifestyle behaviors after the restrictions eased. These previous studies examined one aspect of daily lifestyle; however, focusing on multiple behaviors would be more effective in preventing adverse health outcomes ( Seino et al, 2022 ; Haider et al, 2020 ). Therefore, considering multiple behaviors during the prolonged COVID-19 pandemic to identify older adults with unhealthy daily lifestyles is crucial.…”

Relationship between Dietary Patterns and Subjectively Measured Physical Activity in Japanese Individuals 85 Years and Older: A Cross-Sectional Study

“…Diet and physical activity are closely related to energy intake and consumption behaviors and are summarized as energy balance-related behaviors (EBRBs) [ 1 ]. Consuming a high-quality diet and engaging in high physical activity (PA) are considered healthy behaviors (HBs) and have been reported to be associated with health-related outcomes (such as quality of life, cognitive function, development of disease, and functional disability) in a variety of populations [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 ].…”