Social participation and the prevention of functional disability in older Japanese: the JAGES cohort study.

Kayo Suzuki,Jun Aida,Yoshiki Ishikawa,Yuko Kai,The Jages Group ,Hiroshi Hirai,Ichiro Kawachi,Satoru Kanamori,Katsunori Kondo,Kokoro Shirai

doi:10.1371/journal.pone.0099638

Abstract

BackgroundWe examined the relationship between incident functional disability and social participation from the perspective of number of types of organizations participated in and type of social participation in a prospective cohort study.MethodThe study was based on the Aichi Gerontological Evaluation Study (AGES) Cohort Study data. We followed 13,310 individuals aged 65 years or older for 4 years. Analysis was carried out on 12,951 subjects, excluding 359 people whose information on age or sex was missing. Social participation was categorized into 8 types.ResultsCompared to those that did not participate in any organizations, the hazard ratio (HR) was 0.83 (95% CI: 0.73–0.95) for participation in one, 0.72 (0.61–0.85) for participation in two, and 0.57 (0.46–0.70) for participation in three or more different types of organizations. In multivariable adjusted models, participation in the following types of organization was protective for incident disability: local community organizations (HR = 0.85, 95% CI: 0.76–0.96), hobby organizations (HR = 0.75, 95% CI: 0.64–0.87), and sports organizations (HR = 0.64, 95% CI: 0.54–0.81).ConclusionSocial participation may decrease the risk of incident functional disability in older people in Japan. This effect may be strengthened by participation in a variety of different types of organizations. Participating in a local community, hobby, or sports group or organization may be especially effective for decreasing the risk of disability.

Highlights

We examined the relationship between incident functional disability and social participation from the perspective of number of types of organizations participated in and type of social participation in a prospective cohort study
Compared to those that did not participate in any organizations, the hazard ratio (HR) was 0.83 for participation in one, 0.72 (0.61–0.85) for participation in two, and 0.57 (0.46–0.70) for participation in three or more different types of organizations
Participation in the following types of organization was protective for incident disability: local community organizations (HR = 0.85, 95% CI: 0.76–0.96), hobby organizations (HR = 0.75, 95% CI: 0.64–0.87), and sports organizations (HR = 0.64, 95% CI: 0.54–0.81)

Summary

Results

In Model 1, where the data was adjusted for age, sex, annual equivalized income, educational attainment, marital status, occupational status, self-reported medical conditions, and participation in all 8 organizations (only for ‘‘type of social participation’’), the hazard ratios became statistically significant for one or more different types of organizations HRs, and local community, hobby, and sports organizations HRs. Trend analysis of the data set omitting the missing categories for number of types of organizations yielded a p for liner trend of ,0.01. No depression Depressive tendency Depression Missing Emotional support Available Not available Missing Instrumental support Available Not available Missing Frequency of meeting friends Almost daily 2–3 times/week About once/week 1–2 times/month A few times a year or less Missing IADL High Middle Low Missing Number of types of organizations 0 1 2 $3 missing Type of social participation Local community. Politics Citizen doi:10.1371/journal.pone.0099638.t001 participation non-participation missing participation non-participation missing

Conclusion

Background

Methods

Discussion