Tomioka Kimiko, Kurumatani Norio, Hosoi Hiroshi
Nara Prefectural Health Research Center, Nara Medical University.
J Epidemiol. 2016 Oct 5;26(10):553-561. doi: 10.2188/jea.JE20150253. Epub 2016 May 14.
Population-based data examining the relationship between social participation (SP) and instrumental activities of daily living (IADL) are scarce. This study examined the cross-sectional relationship between SP and IADL in community-dwelling elderly persons.
Self-administered questionnaires were mailed to 23 710 residents aged ≥65 years in Nara, Japan (response rate: 74.2%). Data from 14 956 respondents (6935 males and 8021 females) without dependency in basic activities of daily living (ADL) were analyzed. The number, type, and frequency of participation in social groups (SGs) were used to measure SP. SGs included volunteer groups, sports groups, hobby groups, senior citizens' clubs, neighborhood community associations, and cultural groups. IADL was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Logistic regression models stratified by gender were used.
After adjustment for putative confounding factors, including demographics, health status, life-style habits, ADL, depression, cognitive function, social networks, social support, and social roles, participation in various SGs among both genders was inversely associated with poor IADL, showing a significant dose-response relationship between an increasing number of SGs and a lower proportion of those with poor IADL (P for trend <0.001). A significant inverse association between frequent participation and poor IADL was observed for all types of SGs among females, whereas the association was limited to sports groups and senior citizens' clubs among males.
Our results show that participation in a variety of SGs is associated with independent IADL among the community-dwelling elderly, regardless of gender. However, the beneficial effects of frequent participation on IADL may be stronger for females than for males.
基于人群研究社会参与(SP)与日常生活活动能力(IADL)之间关系的数据较为匮乏。本研究调查了社区居住老年人中SP与IADL之间的横断面关系。
向日本奈良市23710名年龄≥65岁的居民邮寄了自填式问卷(回复率:74.2%)。对14956名在日常生活基本活动(ADL)方面无依赖的受访者(6935名男性和8021名女性)的数据进行了分析。参与社会群体(SG)的数量、类型和频率用于衡量SP。SG包括志愿者团体、体育团体、兴趣小组、老年俱乐部、邻里社区协会和文化团体。使用东京都老人综合研究所能力指数评估IADL。采用按性别分层的逻辑回归模型。
在对包括人口统计学、健康状况、生活方式习惯ADL、抑郁、认知功能、社会网络、社会支持和社会角色等假定混杂因素进行调整后,男女参与各种SG均与IADL较差呈负相关,显示出参与SG数量增加与IADL较差比例降低之间存在显著的剂量反应关系(趋势P<0.001)。在女性中,观察到所有类型的SG频繁参与与IADL较差之间存在显著负相关,而在男性中,这种关联仅限于体育团体和老年俱乐部。
我们的结果表明,无论性别如何,参与各种SG与社区居住老年人的独立IADL相关。然而,频繁参与对IADL的有益影响在女性中可能比在男性中更强。