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

概要

Objective: The present study aimed to examine the association between community-level social capital and the onset of functional disability among older Japanese people by using validated indicators of social capital and prospective multilevel analysis.

Methods: This prospective cohort study utilized data from the Japan Gerontological Evaluation Study (JAGES), established from August 2010 to January 2012 in 323 districts. The target population was restricted to non-institutionalized 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 three-year period. 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. Data were analyzed with multilevel Cox proportional hazards regression models by community-level social capital (civic participation, social cohesion, and reciprocity).

Results: The mean age (standard deviation) of participants was 73.3 years (6.0) for men and 73.8 years (6.2) for women. During the study period, the onset of functional disability occurred in 1,465 (4.3%) men and 1,519 (3.9%) women. Of the three community-level social capital variables, social cohesion significantly reduced the risk of the onset of functional disability among men, after adjusting for individual social and behavioral variables (hazard ratio = 0.910; 95% CI = 0.830 0.998). There was no significant effect among women.

Conclusions: Living in a community with rich social cohesion was associated with a　lower incidence of onset of functional disability onset among older Japanese men.

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