Engagement in paid work as a protective predictor of basic activities of daily living disability in Japanese urban and rural community-dwelling elderly residents: An 8-year prospective study.

Abstract

To examine whether engaging in paid work is a predictor of maintaining good functional health among Japanese older adults in both urban and rural communities. We used the 8-year longitudinal Tokyo Metropolitan Institute of Gerontology Longitudinal Interdisciplinary Study on Aging with 306 and 675 persons aged 65-84 years from Koganei City (urban) and Nangai Village (rural), respectively, who are independent in basic activities of daily living (BADL). In order to examine the declining patterns in BADL and evaluate the predictive value of working status for future BADL disability, we applied the log-rank test of cumulative proportion curves and the Cox proportional hazard model by sex, controlling for age, research fields, years of education, marital state, chronic medical conditions, pain, instrumental activities of daily living (IADL), smoking status, exercise habits, life satisfaction, usual walking speed and serum albumin for evaluating the predictive value of working status at baseline for future BADL disability. In both areas, participants who were not working were more likely to decline in BADL than those working (P < 0.05), except for women in urban Koganei. Male participants who did not engage in paid work had a higher adjusted hazard ratio of onset of BADL disability, compared with those working, but this was not seen for female participants. Working might be protective from a decline in BADL only for men, but not for women. Regarding the difference of sex roles in conventional Japanese society, working would be an effective solution especially for men to participate in social activities.