Community-level social participation and functional disability among older adults: A JAGES multilevel longitudinal study
Community-level social participation and functional disability among older adults: A JAGES multilevel longitudinal study
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DOI：
10.1016/j.archger.2022.104632
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发表时间：
2022-02-01
影响因子：
4
通讯作者：
Kondo, Katsunori
中科院分区：
文献类型：
--
作者：
Fujihara, Satoko;Miyaguni, Yasuhiro;Kondo, Katsunori
目的：探讨社区社会参与类型与功能障碍之间的关系。方法：我们使用了2010-2016年日本老年学评估研究的6年前瞻性队列数据，这是一项对35519名功能独立的老年人（平均年龄：73.30岁，PLUSMN； 5.91岁，女性49.6%）进行的全国性调查。功能性残疾发生率来源于市级长期护理保险数据库。社会参与在个人和社区层面进行评估，并分为：志愿者、体育、爱好和邻里团体、老年公民俱乐部。我们采用三水平多水平生存分析计算95%置信区间（CI）和风险比（HR）。结果：在6年的观察期内，3473名成人发生功能障碍。在调整潜在混杂因素后，较高的运动患病率（HR 0.88, 95% CI 0.80至0.96）和爱好组参与（HR 0.91, 95% CI 0.87至0.96）显示与功能残疾有显著的背景关系。在女性中，社区水平的邻里团体参与显著降低了功能障碍的发生率（HR 0.87, 95% CI 0.76 ~ 0.998）。结论：我们发现社区水平的体育和兴趣小组参与与老年人的功能残疾之间存在有益的关系。此外，妇女从社区层面的社会参与中获益良多。我们建议在社区中促进运动和兴趣小组可能有助于预防老年人的功能残疾。
Purpose: This study investigates the contextual association between types of community-level social participation and functional disability. Methods: We used 6-year prospective cohort data from the Japan Gerontological Evaluation Study 2010-2016, a nationwide survey of 35,519 functionally independent older adults (mean age: 73.30 & PLUSMN; 5.91 years, 49.6% females). The incidence of functional disability was obtained from municipal long-term care insurance databases. Social participation was assessed at individual and community levels and was categorized as: volunteer, sports, hobby and neighborhood groups, and senior citizen clubs. We calculated the 95% confidence interval (CI) and the hazard ratio (HR) by applying a three-level multilevel survival analysis. Results: During the 6-year observation period, the onset of functional disability occurred among 3473 adults. A higher prevalence of sports (HR 0.88, 95% CI 0.80 to 0.96) and hobby group participation (HR 0.91, 95% CI 0.87 to 0.96) showed significant contextual relationships with functional disability after adjusting for potential confounders. Among females, community-level neighborhood group participation significantly lowered the incidence of functional disability (HR 0.87, 95% CI 0.76 to 0.998). Conclusions: We found a beneficial effect of a contextual relationship between community-level sports and hobby group participation and functional disability among older adults. Moreover, females benefited a lot from community-level social participation. We propose that promoting sports and hobby groups in a community may help to prevent functional disability among older adults.