Division of Epidemiology, Department of Health Informatics and Public Health, School of Public Health, Tohoku University Graduate School of Medicine.
Department of Medical Statistics, Faculty of Medicine, Toho University.
J Epidemiol. 2022 Oct 5;32(10):456-463. doi: 10.2188/jea.JE20200574. Epub 2021 Aug 11.
Although social participation has been reported to be associated with significantly lower risks of mortality and disability, to our knowledge, no study has estimated its impact on disability-free life expectancy (DFLE). Therefore, this study aimed to investigate the association between social participation and DFLE in community-dwelling older people.
We analyzed 11-year follow-up data from a cohort study of 11,982 Japanese older adults (age ≥65 years) in 2006. We collected information on the number of social participations using a questionnaire. Using this information, we categorized the participants into four groups. DFLE was defined as the average number of years a person could expect to live without disability. The multistate life table method using a Markov model was employed for calculating DFLE.
The results revealed that DFLE according to the number of social participations was 17.8 years (95% confidence interval [CI], 17.3-18.2) for no activities, 20.9 (95% CI, 20.4-21.5) for one activity, 21.5 (95% CI, 20.9-22.0) for two activities, and 22.7 (95% CI, 22.1-23.2) for three activities in men, and 21.8 (95% CI, 21.5-22.2), 25.1 (95% CI, 24.6-25.6), 25.3 (95% CI, 24.7-25.9), and 26.7 years (95% CI, 26.1-27.4), respectively, in women. This difference in DFLE did not change after the participants were stratified for smoking, body mass index, physical activity, and depression.
Social participation is associated with longer DFLE among Japanese older people; therefore, encouraging social participation at the population level could increase life-years lived in good health.
尽管社会参与与死亡率和残疾率显著降低相关,但据我们所知,尚无研究估计其对无残疾预期寿命(DFLE)的影响。因此,本研究旨在调查社区居住的老年人社会参与与 DFLE 之间的关系。
我们分析了 2006 年一项针对 11982 名日本老年人(年龄≥65 岁)的队列研究的 11 年随访数据。我们使用问卷收集社会参与次数的信息。根据这些信息,我们将参与者分为四组。DFLE 定义为一个人无残疾预期可存活的平均年数。使用多状态生命表法和马尔可夫模型计算 DFLE。
结果显示,根据社会参与次数,男性的 DFLE 分别为无活动 17.8 年(95%置信区间 [CI],17.3-18.2)、1 项活动 20.9 年(95% CI,20.4-21.5)、2 项活动 21.5 年(95% CI,20.9-22.0)和 3 项活动 22.7 年(95% CI,22.1-23.2),女性分别为无活动 21.8 年(95% CI,21.5-22.2)、1 项活动 25.1 年(95% CI,24.6-25.6)、2 项活动 25.3 年(95% CI,24.7-25.9)和 3 项活动 26.7 年(95% CI,26.1-27.4)。在对参与者进行吸烟、体重指数、身体活动和抑郁状况分层后,DFLE 的差异并未改变。
社会参与与日本老年人更长的 DFLE 相关;因此,在人群层面鼓励社会参与可以增加健康生活的年限。