Association between diversity levels of member composition in group activities of older adults and the occurrence of need for care: The JAGES 2013-2019 longitudinal study

Abstract

Abstract Background Diverse group participation among older adults is thought to be associated with improved health. We conducted a longitudinal study to examine the association between diversity of group membership and caregiving needs. Method We conducted a longitudinal study for the Japan Gerontological Evaluation Study with 61,281 participants aged ≥ 65 years who were surveyed in 2013 and followed-up for six years. The diversity levels of the participating members were assessed by (1) continuous variables (range 0–3) with dummy variables corresponding to each diversity factor (sex, age, and region of residence). We adjusted for 12 covariates using Cox hazard survival analysis models with hazard ratios (HRs) and 95% confidence intervals (CIs) estimated for the association between group members’ diversity levels and certification of need for support or care. The same study was conducted when stratified by employment status at baseline. Results Participants in more diverse social participation groups were found to have a lower incidence of requiring Long term care. Conclusion Compared to those with no participation group, HRs decreased by 14–24% with increasing levels of diversity. The HR for care needed for those in diverse neighborhoods was 0.89 (95% CI, 0.84–0.94). For participants who were currently unemployed, HR reductions ranged from 16–28% with increasing levels of diversity compared to the non-participating group. No association was found for employed participants. Conclusions The higher the diversity of participating groups, the lower the HR for certification of support and care requirement among older adults in Japan. Diversity of residential area is a factor associated with certification of need for long-term care. Public health policies that encourage participation in diverse organizations will be important in the future.