Abstract
BackgroundThis study’s aim was to clarify the relationship of having hobbies and a purpose in life (PIL; in Japanese, ikigai) with mortality and a decline in the activities of daily living (ADL) and instrumental ADL (IADL) among the community-dwelling elderly.MethodsProspective observational data from residents aged ≥65 years who were at increased risk for death (n = 1853) and developing a decline in ADL (n = 1254) and IADL (n = 1162) were analyzed. Cox proportional hazard models were used for mortality analysis of data from February 2011 to November 2014. ADL and IADL were evaluated using the Barthel Index and the Tokyo Metropolitan Institute of Gerontology Index of Competence, respectively. ADL and IADL were assessed at baseline and follow-up and were evaluated using logistic regression models. Fully adjusted models included terms for age, gender, BMI, income, alcohol intake, smoking history, number of chronic diseases, cognitive function, and depression.ResultsDuring the follow-up of eligible participants, 248 had died, 119 saw a decline in ADL, and 178 saw a decline in IADL. In fully adjusted models, having neither hobbies nor PIL was significantly associated with an increased risk of mortality (hazard ratio 2.08; 95% confidence interval [CI], 1.47–2.94), decline in ADL (odds ratio 2.74; 95% CI, 1.44–5.21), and decline in IADL (odds ratio 1.89; 95% CI, 1.01–3.55) compared to having both hobbies and PIL.ConclusionsAlthough effect modifications by cognitive functioning and depression cannot be ruled out, our findings suggest that having hobbies and PIL may extend not only longevity, but also healthy life expectancy among community-dwelling older adults.
Highlights
Behavioral factors and psychological factors have serious effects on mortality risk in the elderly
In Model 4, where the data was adjusted for all covariates, the hazard ratios (HRs) of mortality were 1.66 (95% confidence interval [CI], 1.17–2.35) for those who had purpose in life (PIL) only and 2.08 for those who had neither hobbies nor PIL compared with those who had both hobbies and PIL
Significant associations of having PIL only were observed only for subjects with low income and for those without depression. In this prospective cohort study, we assessed the relationships of having hobbies and PIL with mortality and decline in activities of daily living (ADL) and instrumental ADL (IADL) among community-dwelling elderly adults
Summary
Behavioral factors and psychological factors have serious effects on mortality risk in the elderly. Prior studies have reported that behavioral factors, such as smoking,[1] excessive alcohol consumption,[2] and physical inactivity,[2,3] and psychological factors, such as a low subjective sense of well-being,[4] hopelessness,[5] loneliness,[6] and dissatisfaction,[7] were associated with an increased risk of mortality. This study’s aim was to clarify the relationship of having hobbies and a purpose in life (PIL; in Japanese, ikigai) with mortality and a decline in the activities of daily living (ADL) and instrumental ADL (IADL) among the community-dwelling elderly. In fully adjusted models, having neither hobbies nor PIL was significantly associated with an increased risk of mortality (hazard ratio 2.08; 95% confidence interval [CI], 1.47–2.94), decline in ADL (odds ratio 2.74; 95% CI, 1.44–5.21), and decline in IADL (odds ratio 1.89; 95% CI, 1.01–3.55) compared to having both hobbies and PIL. Conclusions: effect modifications by cognitive functioning and depression cannot be ruled out, our findings suggest that having hobbies and PIL may extend longevity, and healthy life expectancy among community-dwelling older adults
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