Social participation and incident disability and mortality among frail older adults: A JAGES longitudinal study

Abstract

Background Frailty is the highest risk factor for incident disability and mortality. Social participation is a modifiable factor for reducing adverse outcomes among independent older adults. However, the association between social participation and incident disability and mortality among frail older adults remains unclear. Therefore, we examined the association between various social activities and incident disability and mortality. Methods This nationwide prospective cohort study (The Japan Gerontological Evaluation Study) recruited older adults with frailty, aged 65 years and older (N = 9090) who were followed up for 6 years (2010–2016). We examined incident disability and all‐cause mortality at the end of the follow‐up period. Frailty was assessed using the Kihon Checklist. The independent variable was social participation in 2010, grouped into the following seven categories: hobby groups, sports groups or clubs, volunteer groups, senior citizens' clubs, industries, neighborhood communities, and paid work. Results The incidence of disability among participants was 19.5% (1770) and that of mortality was 19.2% (1753). Belonging to sports groups or clubs (Hazard Ratios [HR] = 0.74; 95% Confidence Interval [CI] = 0.57, 0.98) or hobby groups (HR = 0.77; 95% CI = 0.60, 0.98) was significantly associated with a lower risk of incident disability. Meanwhile, hobby groups (HR = 0.68; 95% CI = 0.56, 0.83), sports groups or clubs (HR = 0.71; 95% CI = 0.57, 0.88), volunteer groups (HR = 0.69; 95% CI = 0.54, 0.88), and senior citizens' club (HR = 0.75; 95% CI = 0.61, 0.90) were associated with lower risk of incident mortality. Conclusions Social participation was associated with a lower risk of incident disability and mortality, not only in healthy older adults but also in frail older adults who are at higher risk of incident disability and mortality. This suggests that frail older adults should be encouraged to participate in all the seven types of social participation examined in this study, as this may lower the risk of subsequent disability and mortality.

Prevalence and factors associated with changes in frailty among community‐dwelling older adults in Japan during the COVID‐19 pandemic: A prospective cohort study from 2020 to 2022

“…[24][25][26][27] Furthermore, it has been reported that high levels of social participation and engagement in hobbies can also contribute to the prevention of disability among older adults. 11,12,28 We have reaffirmed the importance of social participation in frailty prevention, as demonstrated by numerous previous studies and our own research during the COVID-19 pandemic. Previous studies conducted during the COVID-19pandemic have shown that individuals who have less interaction with their neighbors are at a higher risk of developing frailty.…”

“…It is clear that hobbies and community activities reduce the risk of disability and death in older people with frailty, that participation in neighborhood associations as a community activity has a positive impact, and that duplicating cultural and community activities are associated with the prevention of frailty. [11][12][13] However, many of these activities were limited as a result of the COVID-19 pandemic. This led us to hypothesize that the continuation of hobbies and community activities might be key factors in preventing frailty even during the COVID-19 pandemic.…”

The relationship between working status in old age and cause‐specific disability in Japanese community‐dwelling older adults with or without frailty: A 3.6‐year prospective study

“…Covariates used in the questionnaire survey covered a wide range of variables that would predict functional decline, that is, demographic, lifestyle‐related, and health‐related variables based on systematic reviews 22,23 and articles related to working and incidence of disability 4–7,24 …”

“…Covariates used in the questionnaire survey covered a wide range of variables that would predict functional decline, that is, demographic, lifestyle-related, and health-related variables based on systematic reviews 22,23 and articles related to working and incidence of disability. [4][5][6][7]24 The covariates particularly included age, sex, living situation (living with others or alone), and educational level (junior high school, high school, or junior college/vocational college/college/ graduate school graduate). Equivalent income was calculated by dividing household income by the square root of the number of household members (<1.2, ≥1.2 million yen).…”

“…5 Even if older adults are frail, they might be able to engage in part-time work and remain healthy. However, knowledge about the number and proportion of frail older adults who are employed is limited, 6,7 and characteristics of frail workers and whether engaging in employment is beneficial for them remain unclear.…”