Reduced long-term care cost by social participation among older Japanese adults: a prospective follow-up study in JAGES

Abstract

ObjectivesReducing costs related to functional disabilities and long-term care (LTC) is necessary in ageing societies. We evaluated the differences in the cumulative cost of public LTC insurance (LTCI) services by social participation.DesignProspective observational study.SettingOur baseline survey was conducted in March 2006 among people aged 65 or older who were not eligible for public LTCI benefits and were selected using a complete enumeration in Tokoname City, Japan. We followed up with their LTC services costs over a period of 11 years. Social participation was assessed by the frequency of participation in clubs for hobbies, sports or volunteering. We adopted a classical linear regression analysis and an inverse probability weighting (IPW), with multiple imputation of missing values.ParticipantsFunctionally independent 5377 older adults.Primary outcome measuresThe cumulative cost of public LTCI services for 11 years.ResultsEven when adjusting for the confounding variables, social participation at the baseline was negatively associated with the cumulative cost of LTCI services. The IPW model showed that in respondents who participated in hobby activities once a week or more, the cumulative cost of LTCI services for 11 years was lower, approximately US$3500 per person, in comparison to non-participants. Similarly, that in respondents who participated in sports group or clubs was lower, approximately US$6000 than non-participants.ConclusionsOlder adults’ participation in community organisations may help reduce future LTC costs. Promoting participation opportunities in the community could ensure the financial stability of LTCI services.

Social participation and the combination of future needs for long-term care and mortality among older Japanese people: a prospective cohort study from the Aichi Gerontological Evaluation Study (AGES)

“…The results of the present study support previous studies, but these studies evaluated only one outcome (the need for LTC or death)8–16 and did not take both outcomes into account in a single model 14. The present study is the first to focus on the combination of two relevant outcomes in the same model.…”

“…It was defined by WHO as a component of the social determinant of health and it contains various kinds of forms as follows: informing people with balanced, objective information; consulting, whereby the affected community provides feedback; involving or working directly with communities; collaborating by partnering with affected communities in each aspect of the decision-making process, including the development of alternatives and the identification of solutions and empowering people by ensuring that communities retain ultimate control over the key decisions that affect their well-being 7. Previous studies have shown that social participation among older people is associated with a reduced risk of the need for long-term care (LTC)8–11 or death 12–16. However, previous studies have several limitations.…”

“…However, previous studies have several limitations. For example, in studies that examined the relationship between social participation and the need for LTC, patients who died were treated as censored cases or were not described in the results 8–11. Other studies that investigated the association between social participation and mortality did not simultaneously analyse functional disability and death.…”

Long-Term Care System in Japan

“…These group activities lead to reduced disability incidence and further long-term care costs in older adults. 13,14) Therefore, both the Japanese central and local governments have been promoting community group activities in each community. As a result, the number of groups increased from 43,154 in 2013 to 91,059 in 2017 ( Fig.…”

Age differences in associations of different indicators of socioeconomic status with social isolation: A cross-sectional study

“…A meta-analytic review suggests that the influence of social isolation on mortality is comparable with well-established risk factors like cigarette smoking and alcohol consumption [14]. Being socially isolated also results in higher spending in health and social care services [15,16]. Social isolation is not only prevalent and significant for older adults, but it also affects younger individuals at different stages of life [17][18][19].…”