Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.
Japan Society for the Promotion of Science, Chiyoda-ku, Tokyo, Japan.
Gerontology. 2023;69(5):641-649. doi: 10.1159/000528134. Epub 2022 Dec 30.
Delaying the onset of disability is important for maintaining independence and quality of life in community-dwelling older adults. Given that social isolation is a significant risk factor for disability, effective means associated with social isolation are needed to alleviate disability. Although information and communication technology (ICT) may be a reasonable measure considering the recent social contexts due to the coronavirus disease 2019 pandemic, further insights are required. This study aimed to investigate whether ICT use can alleviate the onset of disability in community-dwelling older adults with and without social isolation.
This longitudinal cohort study on 4,346 community-dwelling independent Japanese older adults (mean age, 73.5 ± 5.3 years) was conducted between 2017 and 2018. Participants were classified into four groups based on social isolation (the condition where two or more of the following measures were met: domestic isolation, less social contact, and social disengagement) and ICT users (those who had recently used a computer or a smartphone) and followed up to assess disability incidence for 24 months after baseline assessments. Cox proportional-hazards regression models were used to identify the effect of social isolation and ICT use on the risk of disability onset by adjusting for age, sex, education history, number of medications, eye disease, level of annual income, Mini-Mental State Examination, Geriatric Depression Scale 15, and gait speed.
The group comprised nonsocial isolation and ICT users (44.7%), social isolation and ICT users (5.4%), nonsocial isolation and ICT nonusers (41.7%), and social isolation and ICT nonusers (8.2%). At the follow-up, 2.2%, 2.4%, 5.5%, and 12.4% of the participants in the above order developed disability (p < 0.01). Cox regression models revealed a significantly higher risk of disability onset in the social isolation and ICT nonusers group than in the social isolation and ICT users group (HR = 2.939; 95% confidence interval (CI) 1.029-8.397; p = 0.044). In the subgroup analysis stratified by social isolation, ICT use significantly reduced the risk of disability onset in the socially isolated group (HR = 0.320; 95% CI 0.109-0.943; p = 0.039), although the same association was not observed in the nonsocially isolated group (HR = 0.845; 95% CI 0.565-1.264; p = 0.411).
ICT use can alleviate the onset of disability in socially isolated older adults in a community setting. Considering ICT-applied methods for alleviating disability is beneficial for older adults in social isolation.
延缓残疾的发生对于维持社区居住的老年人的独立性和生活质量很重要。由于社会隔离是残疾的一个重要危险因素，因此需要采取有效的社会隔离相关措施来减轻残疾。虽然考虑到 2019 年冠状病毒病大流行带来的近期社会背景，信息和通信技术（ICT）可能是一种合理的措施，但还需要进一步的深入了解。本研究旨在调查 ICT 的使用是否可以减轻有和没有社会隔离的社区居住的老年人群体残疾的发生。
这是一项针对 4346 名社区居住的独立日本老年人（平均年龄 73.5±5.3 岁）的纵向队列研究，于 2017 年至 2018 年进行。根据社会隔离情况（以下两项或多项指标符合条件：家庭隔离、社交接触较少和社会脱离）和 ICT 用户（最近使用过计算机或智能手机的人）将参与者分为四组，并在基线评估后随访 24 个月，以评估残疾的发生率。使用 Cox 比例风险回归模型，通过调整年龄、性别、教育史、用药数量、眼病、年收入水平、简易精神状态检查、老年抑郁量表 15 和步态速度，确定社会隔离和 ICT 使用对残疾发病风险的影响。
该组包括非社会隔离和 ICT 用户（44.7%）、社会隔离和 ICT 用户（5.4%）、非社会隔离和 ICT 非用户（41.7%）和社会隔离和 ICT 非用户（8.2%）。在随访期间，按上述顺序，参与者中分别有 2.2%、2.4%、5.5%和 12.4%发生残疾（p<0.01）。Cox 回归模型显示，社会隔离和 ICT 非用户组残疾发病的风险明显高于社会隔离和 ICT 用户组（HR=2.939；95%置信区间（CI）1.029-8.397；p=0.044）。在按社会隔离分层的亚组分析中，ICT 使用显著降低了社会隔离组残疾发病的风险（HR=0.320；95%CI 0.109-0.943；p=0.039），而在非社会隔离组则没有观察到这种关联（HR=0.845；95%CI 0.565-1.264；p=0.411）。
ICT 的使用可以减轻社区环境中社会隔离的老年人残疾的发生。考虑采用 ICT 方法来减轻残疾对社会隔离的老年人有益。
