Abstract
We investigated the contextual effects of community social capital on functional ability among older people with functional disability in Japan, and the cross-level interaction effects between community social capital and individual psychosocial characteristics. We used data from the Japan Gerontological Evaluation Study for 1936 men and 2207 women nested within 320 communities and followed for 46 months. We used objective data for functional ability trajectories derived from the national long-term care-insurance system, and a validated measure of health-related community social capital comprising three components: civic participation, social cohesion, and reciprocity. A multilevel survival analysis with a community-level random intercept showed that in communities with high civic participation, women who actively participated in any community group showed greater functional ability improvement than did women who did not participate (pinteraction = 0.05). In communities with high social cohesion, older men who perceived that their communities’ social cohesion was high showed greater functional ability improvement than men who perceived it to be low (pinteraction = 0.02). Community social capital can thus affect functional ability improvements variously, depending on individual psychosocial characteristics and gender. Community interventions aiming to foster social capital should focus on people who are excluded from existing opportunities to participate.
Highlights
Populations are ageing rapidly worldwide, and over a third of older people in high-income countries have a functional disability [1]
This study examined, by measuring three components, the effect of community social capital on improvements in the functional ability of older people with disabilities, using longitudinal large-scale cohort data linked to a national long-term care system database in Japan
Ability.communities with high social cohesion, men who perceive their communities to be cohesive are more likely to improve their social cohesion, men who perceive their communities to be cohesive are more likely to improve their functional ability, whereas, for men who perceive their communities not to be cohesive, the cohesive functional ability, whereas, for men who perceive their communities not to be cohesive, the cohesive community characteristics may reduce the possibility of improvement in their functional ability
Summary
We used data from the Japan Gerontological Evaluation Study (JAGES) program and. The JAGES program was designed to investigate the social determinants of the health of older adults. The study participants were Japanese people aged 65 or older without functional impairment (which was defined as not being certified by the public LTCI system as using care services) at baseline [24]. We used data from the JAGES 2010 survey (94,358 people in 24 municipalities). We linked the JAGES 2010 survey data to the LTCI database with regard to information on levels of disability, the dates at which these levels changed, and the dates at which individuals died or moved to a different municipality.
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