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日本的社区社会资本与全因死亡率:足立队列研究的结果

Community Social Capital and All-cause Mortality in Japan: Findings From the Adachi Cohort Study.

作者信息

Murayama Hiroshi, Sugiyama Mika, Inagaki Hiroki, Edahiro Ayako, Miyamae Fumiko, Ura Chiaki, Motokawa Keiko, Okamura Tsuyoshi, Awata Shuichi

机构信息

Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology.

Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology.

出版信息

J Epidemiol. 2025 Jun 5;35(6):270-277. doi: 10.2188/jea.JE20240277. Epub 2025 Apr 30.

Abstract

BACKGROUND

Community social capital is associated with various health outcomes; however, its impact on mortality is not fully understood, particularly in non-Western settings. This study examined the association between community-level social capital and all-cause mortality among community-dwelling older Japanese adults.

METHODS

The baseline data were obtained from a 2015 questionnaire survey for all 132,005 residents aged ≥65 years without long-term care insurance certification in Adachi Ward (consisting of 262 small districts) of the Tokyo metropolitan area. We measured two aspects of social capital: neighborhood cohesion as cognitive social capital and neighborhood network as structural social capital. For district-level social capital, we aggregated the individual responses of neighborhood cohesion and neighborhood network in each district.

RESULTS

A total of 75,338 were analyzed. A multilevel survival analysis with an average follow-up of 1,656 days showed that higher district-level neighborhood cohesion was associated with a lower risk of all-cause mortality in men (hazard ratio 0.92; 95% confidence interval [CI], 0.84-0.99 for the highest quintile and 0.91; 95% CI, 0.82-0.99 for the second, compared to the lowest), but not in women. This association was more pronounced in men aged 65-74 years.

CONCLUSION

This study provides valuable insights from the Asian population. Men, who typically have fewer social networks and support systems than women, could receive more benefits from residing in a cohesive community, which may contribute to their longevity. These findings support public health strategies that bolster community social capital as a means of archiving longevity among older men, underscoring the importance of social integration in aging societies.

摘要

背景

社区社会资本与多种健康结果相关;然而,其对死亡率的影响尚未完全明确,尤其是在非西方背景下。本研究调查了社区层面的社会资本与居住在社区中的日本老年成年人全因死亡率之间的关联。

方法

基线数据来自2015年对东京都足立区(由262个小区组成)所有132,005名年龄≥65岁且无长期护理保险认证的居民进行的问卷调查。我们测量了社会资本的两个方面:作为认知社会资本的邻里凝聚力和作为结构社会资本的邻里网络。对于地区层面的社会资本,我们汇总了每个地区邻里凝聚力和邻里网络的个体回答。

结果

共分析了75,338人。平均随访1,656天的多层次生存分析表明,较高的地区层面邻里凝聚力与男性全因死亡率风险较低相关(最高五分位数的风险比为0.92;95%置信区间[CI],0.84 - 0.99,第二五分位数为0.91;95%CI,0.82 - 0.99,与最低五分位数相比),但在女性中并非如此。这种关联在65 - 74岁的男性中更为明显。

结论

本研究为亚洲人群提供了有价值的见解。男性通常比女性拥有更少的社交网络和支持系统,居住在凝聚力强的社区可能会使他们受益更多,这可能有助于他们长寿。这些发现支持将加强社区社会资本作为提高老年男性寿命的一种公共卫生策略,强调了社会融合在老龄化社会中的重要性。

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