日本老年人的社会参与、未来长期护理需求与死亡率的关系：来自爱知县老年学评估研究（AGES）的前瞻性队列研究
Social participation and the combination of future needs for long-term care and mortality among older Japanese people: a prospective cohort study from the Aichi Gerontological Evaluation Study (AGES).
作者信息
Takahashi Sei, Ojima Toshiyuki, Kondo Katsunori, Shimizu Sayaka, Fukuhara Shunichi, Yamamoto Yosuke
机构信息
Center for Innovative Research for Communities and Clinical Excellence, Fukushima Medical University, Fukushima, Japan.
Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan.
出版信息
BMJ Open. 2019 Nov 11;9(11):e030500. doi: 10.1136/bmjopen-2019-030500.
OBJECTIVES
Our study aimed to examine the longitudinal association between social participation and both mortality and the need for long-term care (LTC) simultaneously.
DESIGN
A prospective cohort study with 9.4 years of follow-up.
SETTING
Six Japanese municipalities.
PARTICIPANTS
The participants were 15 313 people who did not qualify to receive LTC insurance at a baseline based on the data from the Aichi Gerontological Evaluation Study (AGES, 2003-2013). They received a questionnaire to measure social participation and other potential confounders. Social participation was defined as participating in at least one organisation from eight categories.
PRIMARY AND SECONDARY OUTCOME MEASURES
The primary outcomes were classified into three categories at the end of the 9.4 years observational period: living without the need for LTC, living with the need for LTC and death. We estimated the adjusted OR (AOR) using multinomial logistic regression analyses with adjustment for possible confounders.
RESULTS
The primary analysis included 9741 participants. Multinomial logistic regression analysis revealed that social participation was associated with a significantly lower risk of the need for LTC (AOR 0.82, 95% CI 0.69 to 0.97) or death (AOR 0.78, 95% CI 0.70 to 0.88).
CONCLUSIONS
Social participation may be associated with a decreased risk of the need for LTC and mortality among elderly patients.
目的
我们的研究旨在同时考察社会参与与死亡率以及长期护理（LTC）需求之间的纵向关联。
设计
一项进行了9.4年随访的前瞻性队列研究。
地点
日本六个城市。
参与者
参与者为15313人，根据爱知县老年医学评估研究（AGES，2003 - 2013年）的数据，他们在基线时不符合接受LTC保险的条件。他们接受了一份问卷，以测量社会参与和其他潜在混杂因素。社会参与被定义为参与八个类别中的至少一个组织。
主要和次要结局指标
主要结局在9.4年观察期结束时分为三类：无需LTC生活、需要LTC生活和死亡。我们使用多项逻辑回归分析估计调整后的OR（AOR），并对可能的混杂因素进行调整。
结果
主要分析纳入了9741名参与者。多项逻辑回归分析显示，社会参与与LTC需求风险显著降低（AOR 0.82，95%CI 0.69至0.97）或死亡风险显著降低（AOR 0.78，95%CI 0.70至0.88）相关。
结论
社会参与可能与老年患者LTC需求风险和死亡率降低相关。
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