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Published on: July 24, 2013
Effect of social participation on the association between frailty and disability
Toshimasa Sone1, Naoki Nakaya2, Yumi Sugawara3
1Department of Occupational Therapy, School of Health Sciences, Fukushima Medical University, 10-6 Sakae-machi, Fukushima 960-8516, Japan; Division of Epidemiology, Department of Health Informatics and Public Health, Graduate School of Medicine, Tohoku University School of Public Health, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan.
Objectives:
To examine whether social participation affects the association between frailty and disability.
Methods:
A baseline survey conducted from December 1 to 15, 2006, included 11,992 participants who were classified based on the Kihon Checklist into three categories and based on the number of activities in which they socially participated into four categories. The study outcome, incident functional disability, was defined as in Long-Term Care Insurance certification. A Cox proportional hazards model was used to calculate hazard ratios (HRs) for incident functional disability according to frailty and social participation categories. Combination analysis was performed between the nine groups using the above-mentioned Cox proportional hazards model.
Results:
During the 13-year follow-up (107,170 person-years), 5,732 incident cases of functional disability were certified. Compared with the robust group, the other groups had significantly higher incident functional disability. However, the HRs for those participating in social activities were lower than that for those not participating in any activity [1.52 (pre-frail + none group); 1.31 (pre-frail + one activity group); 1.42 (pre-frail + two activities group); 1.37 (pre-frail + three activities group); 2.35 (frail + none group); 1.87 (frail + one activity group); 1.85 (frail + two activities group); and 1.71 (frail + three activities group)].
Conclusions:
The risk of functional disability for those participating in social activities was lower than that for those not participating in any activity, irrespective of being pre-frail or frail. Comprehensive social systems for disability prevention need to focus on social participation in frail older adults.
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