Community social capital and the improvement of functional ability among older people in Japan

Abstract

Background The aim of this study was to investigate the contextual effects of community social capital on the improvement of functional ability among older people in Japan. Methods We performed a multilevel survival analysis on 1936 men and 2207 women nested within 320 communities included in Japan Gerontological Evaluation Study in 2010. We used the objective data of the functional ability trajectories based on national long-term care insurance systems. We used multilevel Weibull survival models including a community-level random intercept. We stratified the analyses by gender. We used a validated measure of community social capital that captured three components: the levels of civic participation, social cohesion, and reciprocity. Results In a community with high social cohesion, older men with the low perception of community social cohesion were less likely to improve their functional ability than older men with the high perception of community social cohesion (P for interaction = 0.007). Among women, community social cohesion was inversely associated with the improvement of functional ability regardless of the individual perception of community social cohesion. In a community with high civic participation, women who did not participate in any group in the community were less likely to improve their functional ability than women who participate in some groups (P for interaction = 0.008), whereas such cross-level interaction was not found among older men. Community reciprocity was not associated with the improvement in functional ability in men and women. Conclusion The effect of community social capital on the improvement of functional ability might differ between individuals depending on their psychosocial components in the same community. There might be older people who do not benefit from and excluded from community social capital.