Abstract
BackgroundMaintenance of instrumental activities of daily living (IADL) and social role (SR) is crucial to keep independent life because the decline in SR and IADL was a significant predictor of dependence in basic ADL in later. The independent effect of physical and cultural leisure activities and their effect modification on the IADL remains unknown.MethodsWe prospectively observed 3241 elderly with intact IADL at baseline for 5 years. Higher level functional capacity such as IADL and SR was assessed using the Tokyo Metropolitan Institute of Gerontology Index of competence (TMIG index).ResultsThe mean age of the participants was 72.3 years (standard deviation 5.1), and 46.9% were male, and 90.9% of them received a follow-up assessment. Of the participants, 10.4% developed an IADL decline. Engagement in leisure physical activity was associated with a significantly lower risk of IADL decline (adjusted risk ratio, 0.73; 95% confidence interval [CI], 0.60 to 0.89), and cultural leisure activity was also associated with lower risk of IADL decline (adjusted risk ratio, 0.77; 95% CI, 0.63 to 0.95) independent of potential confounders. We also found significant and positive interaction between physical and cultural leisure activities at risk for IADL decline (P = 0.024) and SR decline (P = 0.004).ConclusionsWe found an independent association of physical and cultural leisure activities with a lower risk for functional decline in IADL and SR with positive interaction. Combined engagement in physical and cultural activities may effectively prevent from IADL decline and SR decline.
Highlights
To sustain an independent life with a satisfying quality of life, maintenance of function of the activities of daily living (ADL) is essential
Monma et al found that engagement in leisure physical activity and cultural leisure activity are independently associated with a lower risk of basic ADL decline [25], but information about the independent effect of each kind of leisure activity on instrumental activities of daily living (IADL) is lacking
Engagement in leisure physical activity was associated with lower risk of IADL decline, Intellectual activity (IA) decline (0.78, 0.62 to 0.98), and social role (SR) decline (0.78, 0.64 to 0.96) compared with those without it (Table 2)
Summary
To sustain an independent life with a satisfying quality of life, maintenance of function of the activities of daily living (ADL) is essential. Higher physical activity is associated with a lower risk of decline in basic ADL and IADL [22,23,24]. Monma et al found that engagement in leisure physical activity and cultural leisure activity are independently associated with a lower risk of basic ADL decline [25], but information about the independent effect of each kind of leisure activity on IADL is lacking. If the combined engagement in physical and cultural leisure activities strengthens the effect on the prevention from functional decline, we can recommend participation in both kinds of leisure activity. The independent effect of physical and cultural leisure activities and their effect modification on the IADL remains unknown
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