Social Participation and Functional Decline: A Comparative Study of Rural and Urban Older People, Using Japan Gerontological Evaluation Study Longitudinal Data

Abstract

This study compared the relationship between social participation, including work, and incidence of functional decline in rural and urban older people in Japan, by focusing on the number and types of organizations older people participated in. The longitudinal data of the Japan Gerontological Evaluation Study (JAGES) that followed 55,243 individuals aged 65 years or older for six years were used. The Cox proportional hazards model was employed to calculate the hazard ratio (HR) of the incidence of functional decline over six years and the stratification of rural and urban settings. In this model, we adjusted 13 variables as behavioral, psychosocial, and functional confounders. The more rural and urban older people participated in various organizations, the more they were protected from functional decline. Participation in sports (HR: rural = 0.79; urban = 0.83), hobby groups (HR: rural = 0.76; urban = 0.90), and work (HR: rural = 0.83; urban = 0.80) significantly protected against the incidence of decline in both rural and urban areas. For both rural and urban older people, promoting social participation, such as sports and hobby groups and employment support, seemed to be an important aspect of public health policies that would prevent functional decline.

Allaying Post-COVID 19 Negative Health Impacts Among Older People: The “Need To Do Something With Others”—Lessons From the Japan Gerontological Evaluation Study

“…11 For example, Kanamori et al, 10 found that older people who participated in one group demonstrated a 0.83 times lower incidence of disability, while those who participated in two groups demonstrated a 0.72 times, and those who participated in three or more different types of groups demonstrated a 0.57 times lower risk of disability than those who did not participate in any group. Similarly, Ide et al 8 reported that the number of groups an older adult participated in was associated with lowered risk of functional decline in both rural and urban areas (0.76-0.92 times lower risks than those who did not participate in any group). Furthermore, compared with the active participant group (ie, exercising once a month or more, and participation in a sports organization), the sedentary group (ie, exercising less than once a month and no participation in a sports organization) exhibited a 1.65 times increase in risk, while the exercise-alone group (ie, exercising once a month or more and no participation in a sports organization) demonstrated a 1.29 times increased risk for incidence of functional disability.…”

“…Third, while social gatherings increase the risk of spreading the coronavirus, the benefits of social participation should also be taken into account. Using data from JAGES, various studies have presented the relationships between increased social participation and health, such as a decreased risk of dementia, 4 , 5 and cognitive impairment, 6 increased instrumental activities of daily living scores, 7 decreased incidence of functional disability, 8 - 11 and death. 11 For example, Kanamori et al, 10 found that older people who participated in 1 group demonstrated a 0.83 times lower incidence of disability, while those who participated in 2 groups demonstrated a 0.72 times, and those who participated in 3 or more different types of groups demonstrated a 0.57 times lower risk of disability than those who did not participate in any group.…”

Social participation and physical prefrailty in older Japanese adults: The Shimane CoHRE study

“…Participants reported their frequency of participation in each type of organization by choosing one of the following response options: four times or more per week, two to three times per week, once a week, one to three times per month, several times per year, and never. The response was categorized as “yes” if the participants answered “several times per year or more” and “no” if they answered “never” [ 24 ]. Involvement in various types of social activities was counted and classified from 5 (participation in all) to 0 (no participation).…”

What Types of Greenspaces Are Associated with Depression in Urban and Rural Older Adults? A Multilevel Cross-Sectional Study from JAGES

“…A study on urban and rural differences in China found that older adults in rural areas had higher levels of depression than those in urban areas [ 14 ]. According to a study comparing urban and rural Japan, older adults in rural areas display lower social participation and higher dementia risk than those in urban areas [ 15 , 16 ]. Moreover, depression is one of the factors of dementia in older adults [ 1 ].…”