Preventive role of social support and networks for the elderly with pre-dementia status and declined ADL/depression -Cohort Study of the elderly in a large city, an ex-coal-mining town and a rural area

最近的科学研究已经建立了强有力的经验证据，证明社会关系对老年人健康的因果影响。从1991年起，我们在北海道县的三个队列中研究了老年人的健康与社会关系之间的关系。本研究的目的是确定日常活动和社会支持网络是否与维持老年人积极生活有关。本研究的人群包括653名老年人，他们在1992年居住在北海道的高须，并参加了我们的纵向研究。经过六年的跟踪调查，653人中有437人被界定为在社区中“长期活跃”。被定义为“主动死亡”的人包括109人死亡，12人被送入机构，15人住院超过三个月，70人在社区生活，日常活动依赖。多因素Logistic回归分析显示，在男性中，调整所有潜在的混杂因素，“不自己走远”、“不放雪”、“较低的社会参与”、“年龄”和“住院史”与“主动寿命损失”显著相关。在女性中，“不自己打扫房间”、“不自己去很远的地方”、“没有结婚”、“自评健康水平较低”和“视力障碍”是“主动寿命损失”的显著危险因素。这些结果表明，为了维持老年人的积极生活，社区护理系统不仅要注意预测疾病，还要注意维持日常活动和确认老年人的社会网络。

Recent scientific research has established strong empirical evidence for a causal impact of social relationships on the health of the elderly. From 1991, we have studied the relationship between health and the social relationships of the elderly, in three cohorts in Hokkaido prefecture. The purpose of this study is to ascertain if daily activities, and social support networks were related to sustaining active lives among the elderly. The population for this study comprised of 653 elderly persons who, in 1992, had lived in Takasu, in Hokkaido, and who had participated in our longitudinal study. After six years follow-up, 437 of 653 persons were defined as "extended active" in the community. Persons who were defined as "active life loss" included, 109 dead, 12 institutionalized, 15 admitted in hospitals for over three months, and 70 persons dependent in daily activities living in the community. Multiple logistic analysis showed that among men, adjusting all potential confounders, "not going far away by himself", "not putting snow away", "lower social participation", "age", and "history of hospital admission" were significantly related to "active life loss". Among women, "not cleaning up rooms by themselves", "not going far away by themselves", "not being married", "lower self-rated health" and "visual disfunction" were significant risk factors for "active life loss". These results suggest that in order to sustain active lives among the elderly, community care systems should pay attention not only to predicting diseases, but also to maintaining daily activities and to confirming a social network for the elderly.