Community social capital and the onset of functional disability among older adults in Japan: a multilevel longitudinal study using Japan Gerontological Evaluation Study (JAGES) data
Community social capital and the onset of functional disability among older adults in Japan: a multilevel longitudinal study using Japan Gerontological Evaluation Study (JAGES) data
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DOI：
10.1136/bmjopen-2019-029279
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发表时间：
2019-10-01
期刊：
影响因子：
2.9
通讯作者：
Suzuki, Sadao
中科院分区：
文献类型：
--
作者：
Noguchi, Taiji;Kondo, Katsunori;Suzuki, Sadao
目的运用社会资本指标和前瞻性多水平设计，探讨社区社会资本与日本老年人功能障碍发病的关系。前瞻性队列研究设置我们使用来自日本老年学评价研究的数据，该研究于2010年8月至2012年1月在323个地区建立。参与者目标人群限于65岁或以上的非机构人士，他们在日常生活中独立活动。参与者包括73 021人（34 051名男性和38 970名女性），随访时间超过3年。主要结局指标主要结局指标是功能性残疾的发生，定义为在公共长期护理保险系统记录中新登记的护理需求水平为2级或以上的患者，并通过社区社会资本（公民参与、社会凝聚力和互惠性）使用多水平Cox比例风险回归模型进行分析。结果男性平均年龄为73.3岁（SD=6.0），女性平均年龄为73.8岁（SD=6.2）。在研究期间，1465名男性（4.3%）和1519名女性（3.9%）发生了功能障碍。在三个社区社会资本变量中，在调整了个人社会和行为变量后，社会凝聚力显著降低了男性发生功能性残疾的风险（HR 0.910; 95% CI 0.830至0.998）。在女性中没有明显的影响。结论：生活在社会凝聚力强的社区中，日本老年男性的功能残疾发生率较低。
Objective The present study examined the association between community social capital and the onset of functional disability among older Japanese people by using validated indicators of social capital and a prospective multilevel design.Design Prospective cohort studySetting We used data from the Japan Gerontological Evaluation Study, established from August 2010 to January 2012 in 323 districts.Participants The target population was restricted to non-institutionalised people aged 65 years or older who were independent in activities of daily living. Participants included 73 021 people (34 051 men and 38 970 women) who were followed up over a 3-year period.Primary outcome measure The primary outcome measure was the onset of functional disability, defined as a new registration in public long-term care insurance system records with a care-needs level of two or above, analysed with multilevel Cox proportional hazards regression models by community social capital (civic participation, social cohesion and reciprocity).Results The mean age of participants was 73.3 years (SD=6.0) for men and 73.8 years (SD=6.2) for women. During the study period, the onset of functional disability occurred in 1465 (4.3%) men and 1519 (3.9%) women. Of three community social capital variables, social cohesion significantly reduced the risk of onset of functional disability (HR 0.910; 95% CI 0.830 to 0.998) among men, after adjusting for individual social and behavioural variables. There was no significant effect among women.Conclusions Living in a community with rich social cohesion is associated with a lower incidence of onset of functional disability among older Japanese men.