Social Participation and Functional Decline: A Comparative Study of Rural and Urban Older People, Using Japan Gerontological Evaluation Study Longitudinal Data
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data
2.2. Dependent Variable
2.3. Independent Variable
2.4. Covariates
2.5. Classification of Rural and Urban Settings
2.6. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Variables | Rural (n = 15,083) | Urban (n = 32,223) | p-Value (Cramer’s V) | |||
---|---|---|---|---|---|---|
n | % | n | % | |||
Sex | Male | 6758 | 44.8 | 15,163 | 47.0 | <0.001 (0.02) |
Female | 8325 | 55.2 | 17,063 | 53.0 | ||
Age (years) | 65–69 | 4287 | 28.4 | 9676 | 30.0 | <0.001 (0.04) |
70–74 | 4536 | 30.1 | 10,343 | 32.1 | ||
75–79 | 3470 | 23.0 | 7257 | 22.5 | ||
80–84 | 1973 | 13.1 | 3611 | 11.2 | ||
85+ | 817 | 5.4 | 1336 | 4.2 | ||
Equivalent income (million yen) | Low (<2.0) | 7127 | 47.3 | 11,815 | 36.7 | <0.001 (0.13) |
Middle (2.0–3.9) | 3988 | 26.4 | 11,321 | 35.1 | ||
High (≥4.0) | 939 | 6.2 | 3616 | 11.2 | ||
Missing | 3029 | 20.1 | 5471 | 17.0 | ||
Educational attainment (years) | <10 | 8404 | 55.7 | 14,103 | 43.8 | <0.001 (0.12) |
10–12 | 4432 | 29.4 | 11,182 | 34.7 | ||
≥13 | 1853 | 12.3 | 6255 | 19.4 | ||
Missing | 394 | 2.6 | 683 | 2.1 | ||
Marital status | Married | 10,611 | 70.3 | 23,315 | 72.4 | <0.001 0.04 |
Single | 4111 | 27.3 | 8480 | 26.3 | ||
Missing | 361 | 2.4 | 428 | 1.3 | ||
Self-reported medical conditions | Illness | 10,267 | 68.1 | 21,859 | 67.8 | 0.243 (0.01) |
No illness | 3508 | 23.2 | 7677 | 23.8 | ||
Missing | 1308 | 8.7 | 2687 | 8.4 | ||
Smoking | Never smoked | 8440 | 56.0 | 17,174 | 53.3 | <0.001 (0.04) |
Past smoker | 3566 | 23.6 | 8649 | 26.9 | ||
Current smoker | 1437 | 9.5 | 3330 | 10.3 | ||
Missing | 1640 | 10.9 | 3070 | 9.5 | ||
Alcohol consumption | Never drank | 9122 | 60.5 | 18,420 | 57.2 | <0.001 (0.03) |
Past drinker | 440 | 2.9 | 1021 | 3.2 | ||
Current drinker | 4684 | 31.1 | 10,836 | 33.6 | ||
Missing | 837 | 5.5 | 1946 | 6.0 | ||
Walking time (per day) | >90 min | 2515 | 16.7 | 5004 | 15.5 | <0.001 (0.05) |
60–90 min | 2130 | 14.1 | 5029 | 15.6 | ||
30–60 min | 4558 | 30.2 | 10,960 | 34.0 | ||
<30 min | 4905 | 32.5 | 9341 | 29.0 | ||
Missing | 975 | 6.5 | 1889 | 5.9 | ||
Frequency of going outdoors | Almost everyday | 6607 | 43.8 | 18,496 | 57.4 | <0.001 (0.15) |
2–3 times/week | 4601 | 30.5 | 8288 | 25.7 | ||
About once/week | 1755 | 11.6 | 2253 | 7.0 | ||
Rarely | 1351 | 9.0 | 1384 | 4.3 | ||
Missing | 769 | 5.1 | 1802 | 5.6 | ||
Depression | No depression | 9313 | 61.8 | 19,977 | 62.0 | 0.002 (0.02) |
Depressive tendency | 2613 | 17.3 | 5343 | 16.6 | ||
Depression | 822 | 5.4 | 1595 | 4.9 | ||
Missing | 2335 | 15.5 | 5308 | 16.5 | ||
Emotional support | Available | 13,052 | 86.5 | 28,584 | 88.7 | <0.001 (0.03) |
Not available | 1209 | 8.0 | 2310 | 7.2 | ||
Missing | 822 | 5.5 | 1329 | 4.1 | ||
Instrumental support | Available | 12,369 | 82.0 | 26,971 | 83.7 | <0.001 (0.03) |
Not available | 1906 | 12.6 | 3906 | 12.1 | ||
Missing | 808 | 5.4 | 1346 | 4.2 | ||
Frequency of meeting friends | Almost everyday | 2247 | 14.90 | 4347 | 13.5 | <0.001 (0.04) |
2–3 times/week | 3513 | 23.30 | 7206 | 22.4 | ||
About once/week | 2461 | 16.30 | 5293 | 16.4 | ||
1–2 times/month | 2914 | 19.30 | 6049 | 18.8 | ||
A few times a year or less | 2841 | 18.80 | 7251 | 22.5 | ||
Missing | 1107 | 7.40 | 2077 | 6.4 | ||
Instrumental activity of daily living (IADL) | Not decline | 6073 | 40.3 | 12,578 | 39.0 | 0.025 (0.01) |
Decline | 7230 | 47.9 | 15,856 | 49.2 | ||
Missing | 1780 | 11.8 | 3789 | 11.8 | ||
Number of types of organizations | 0 | 3187 | 21.1 | 7700 | 23.9 | <0.001 (0.06) |
1 | 3420 | 22.7 | 7964 | 24.7 | ||
2 | 2691 | 17.8 | 6173 | 19.1 | ||
≥3 | 5227 | 34.7 | 9588 | 29.8 | ||
Missing | 558 | 3.7 | 798 | 2.5 | ||
Type of social participation | ||||||
Local community | Nonparticipation | 5909 | 39.2 | 14,781 | 45.9 | <0.001 (0.07) |
Participation | 5886 | 39.0 | 10,802 | 33.5 | ||
Missing | 3288 | 21.8 | 6640 | 20.6 | ||
Hobby | Nonparticipation | 6656 | 44.1 | 13,411 | 41.6 | <0.001 (0.05) |
Participation | 5430 | 36.0 | 13,212 | 41.0 | ||
Missing | 2997 | 19.9 | 5600 | 17.4 | ||
Sports | Nonparticipation | 8540 | 56.6 | 18,242 | 56.6 | 0.001 (0.02) |
Participation | 3272 | 21.7 | 7375 | 22.9 | ||
Missing | 3271 | 21.7 | 6606 | 20.5 | ||
Industry | Nonparticipation | 8791 | 58.3 | 19,293 | 59.9 | <0.001 (0.04) |
Participation | 2020 | 13.4 | 4829 | 15.0 | ||
Missing | 4272 | 28.3 | 8101 | 25.1 | ||
Volunteer | Nonparticipation | 8787 | 58.3 | 19,803 | 61.5 | <0.001 (0.03) |
Participation | 2292 | 15.2 | 4526 | 14.0 | ||
Missing | 4004 | 26.5 | 7894 | 24.5 | ||
Citizen | Nonparticipation | 7842 | 52.0 | 19,244 | 59.7 | <0.001 (0.10) |
Participation | 4247 | 28.2 | 6165 | 19.1 | ||
Missing | 2994 | 19.8 | 6814 | 21.2 | ||
Work | Nonparticipation | 9002 | 59.7 | 21,572 | 67.0 | <0.001 (0.10) |
Participation | 3397 | 22.5 | 7166 | 22.2 | ||
Missing | 2684 | 17.8 | 3485 | 10.8 |
Rural | Crude Model | Model 1 | Model 2 |
HR (95% CI) | HR (95% CI) | HR (95% CI) | |
0 | 1.00 Ref | 1.00 Ref | 1.00 Ref |
1 | 0.71 * (0.64–0.79) | 0.87 * (0.78–0.97) | 0.94 (0.84–1.05) |
2 | 0.57 * (0.50–0.64) | 0.75 * (0.66–0.85) | 0.85 * (0.75–0.97) |
≥3 | 0.43 * (0.39–0.49) | 0.62 * (0.56–0.70) | 0.76 * (0.67–0.86) |
Trend p | p < 0.05 | p < 0.05 | p < 0.05 |
Urban | Crude model | Model 1 | Model 2 |
HR (95% CI) | HR (95% CI) | HR (95% CI) | |
0 | 1.00 Ref | 1.00 Ref | 1.00 Ref |
1 | 0.69 * (0.64–0.75) | 0.85 * (0.79–0.91) | 0.92 * (0.85–0.99) |
2 | 0.59 * (0.55–0.65) | 0.77 * (0.71–0.84) | 0.87 * (0.80–0.96) |
≥3 | 0.48 * (0.44–0.52) | 0.67 * (0.62–0.72) | 0.82 * (0.75–0.89) |
Trend p | p < 0.05 | p < 0.05 | p < 0.05 |
Rural | Crude Model | Model 1 | Model 2 |
HR (95% CI) | HR (95% CI) | HR (95% CI) | |
Local Community | 0.59 * (0.54–0.65) | 0.77 * (0.70–0.86) | 0.86 * (0.77–0.95) |
Hobby | 0.57 * (0.52–0.64) | 0.61 * (0.60–0.75) | 0.76 * (0.68–0.85) |
Sports | 0.62 * (0.55–0.70) | 0.70 * (0.62–0.78) | 0.79 * (0.69–0.89) |
Industry | 0.67 * (0.58–0.78) | 0.92 (0.84–1.01) | 1.01 (0.87–1.18) |
Volunteer | 0.62 * (0.54–0.72) | 0.77 * (0.67–0.89) | 0.89 (0.77–1.03) |
Citizen | 1.40 * (1.27–1.54) | 0.94 (0.85–1.03) | 1.02 (0.93–1.13) |
Work | 0.48 * (0.42–0.54) | 0.74 * (0.65–0.84) | 0.83 * (0.76–0.91) |
Urban | Crude Model | Model 1 | Model 2 |
HR (95% CI) | HR (95% CI) | HR (95% CI) | |
Local Community | 0.70 * (0.65–0.75) | 0.84 * (0.79–0.90) | 0.95 (0.88–1.01) |
Hobby | 0.70 * (0.66–0.75) | 0.78 * (0.73–0.84) | 0.90 * (0.84–0.97) |
Sports | 0.60 * (0.55–0.65) | 0.73 * (0.67–0.79) | 0.83 *(0.77–0.91) |
Industry | 0.81 * (0.74–0.89) | 0.90 (0.78–1.05) | 1.04 (0.95–1.15) |
Volunteer | 0.66 * (0.60–0.73) | 0.80 * (0.73–0.89) | 0.94 (0.85–1.04) |
Citizen | 1.37 * (1.28–1.47) | 0.89 * (0.83–0.96) | 0.99 (0.92–1.07) |
Work | 0.50 * (0.46–0.55) | 0.80 *(0.73–0.87) | 0.80 * (0.70–0.91) |
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Ide, K.; Tsuji, T.; Kanamori, S.; Jeong, S.; Nagamine, Y.; Kondo, K. Social Participation and Functional Decline: A Comparative Study of Rural and Urban Older People, Using Japan Gerontological Evaluation Study Longitudinal Data. Int. J. Environ. Res. Public Health 2020, 17, 617. https://doi.org/10.3390/ijerph17020617
Ide K, Tsuji T, Kanamori S, Jeong S, Nagamine Y, Kondo K. Social Participation and Functional Decline: A Comparative Study of Rural and Urban Older People, Using Japan Gerontological Evaluation Study Longitudinal Data. International Journal of Environmental Research and Public Health. 2020; 17(2):617. https://doi.org/10.3390/ijerph17020617
Chicago/Turabian StyleIde, Kazushige, Taishi Tsuji, Satoru Kanamori, Seungwon Jeong, Yuiko Nagamine, and Katsunori Kondo. 2020. "Social Participation and Functional Decline: A Comparative Study of Rural and Urban Older People, Using Japan Gerontological Evaluation Study Longitudinal Data" International Journal of Environmental Research and Public Health 17, no. 2: 617. https://doi.org/10.3390/ijerph17020617