Age differences in the association of physical leisure activities with incident disability among community-dwelling older adults

Abstract

Background The relationship between leisure activities (LA) in old age and prevention of disability has not been fully investigated, and age and gender differences of these relationships are unknown. This study aimed to investigate whether physical and cognitive LA predicted incident disability among community-dwelling older adults by age and gender. Methods We prospectively observed 8,275 residents aged 65 or above without disability at baseline for 3 years. Incident disability was defined as a new certification of the public long-term care insurance system. LA were classified into two types: physical LA and cognitive LA. The frequency of LA was categorized into frequent (i.e., once a week or more), moderate (i.e., monthly or yearly), and non-engagement. Covariates included age, gender, family number, education, perceived economic situation, body mass index, chronic medical conditions, alcohol consumption, smoking status, regular dental visits, depression, cognitive functioning, and social participation. Multivariable Poisson regression models were used to estimate adjusted cumulative incidence ratio (CIR) and 95% confidence interval (CI) for incident disability. We performed stratified analyses by age groups (i.e., the young-old aged 65–74 and the old-old aged 75–97) and gender (i.e., men and women). Results The 3-year cumulative incidence of disability was 7.5%. After adjustment for covariates and mutual adjustment for both types of LA, a significant dose-response relationship between more frequent LA and lower risk of incident disability was found in young-old physical LA ( P -trend < 0.001), in old-old cognitive LA ( P -trend = 0.012), in male cognitive LA ( P -trend = 0.006), and in female physical LA ( P -trend = 0.030). Compared with people without LA, adjusted CIR (95% CI) of frequent LA was 0.47 (0.30–0.74) in young-old physical, 0.75 (0.58–0.96) in old-old cognitive, 0.65 (0.46–0.89) in male cognitive, and 0.70 (0.52–0.95) in female physical. Regarding the effect modification according to age and gender, only interaction between age and physical LA significantly prevented incident disability ( P for interaction = 0.019). Conclusion We found age differences in the association of physical LA with incident disability among community-dwelling older adults. An effective measure to prevent long-term care in the community would be to recommend frequent physical LA for the young-old. Supplementary information The online version contains supplementary material available at https://doi.org/10.1265/ehpm.21-00018 .

Longitudinal association between frequency of Internet use and incident disability among community-dwelling older people during the COVID-19 pandemic

“…It has been reported that among Japanese people aged 60 and older, the proportion of Internet users is higher in men than in women, and decreases with age [ 27 ]. Previous studies of community-dwelling older people in Japan reported that the risk of developing incident disability was higher in women than in men, and increased with age [ 3 , 28 ]. Because the association between the frequency of Internet use and incident disability may differ by age and gender, we conducted stratified analyses by age or gender.…”

“…In countries, including Japan, where the aging of the population is progressing rapidly, preventing older people from requiring long-term care is an urgent issue to address, in order to ensure the sustainability of the social security system. Numerous studies have reported that social participation in old age is associated with a lower risk of developing disability [ 1 – 3 ]. This is because through social participation, older people can connect with other people, increase their physical activity, receive intellectual stimulation, and have a sense of purpose in life, which helps prevent deterioration of mental and physical functions.…”