Efficacy of HP-3070, A Once-Daily Asenapine Transdermal System, in the Treatment of Adults with Schizophrenia: A PANSS Five-Factor Analysis.

Introduction: HP-3070, a once-daily asenapine transdermal system, is the first antipsychotic "patch" formulation FDA approved for adults with schizophrenia. Positive and Negative Syndrome Scale (PANSS) score items can be grouped into a five-factor structure to describe specific schizophrenia symptom domains. This post hoc analysis of data from a pivotal study evaluated HP-3070's efficacy by examining these factors. Methods: In a phase 3 study, adults with an acute exacerbation of schizophrenia were randomized to six weeks of treatment with HP-3070 3.8mg/24h, 7.6mg/24h, or placebo. An analysis was performed using the five PANSS factor domains (negative symptoms, positive symptoms, disorganized thought, uncontrolled hostility/excitement, anxiety/depression). Mixed-model repeated-measures (MMRM) analysis included change from baseline (CFB) in PANSS factor score as the repeated dependent variable, with country, treatment, visit, treatment by visit interaction, and baseline PANSS score as covariates. Results: The analysis included 607 patients. Treatment with HP-3070 3.8mg/24h resulted in a statistically significant LS mean CFB (improvement) vs placebo at Weeks 4-6 for all domains except for anxiety/depression, where a numerical difference was observed in favor of active treatments. Among the domains, the positive symptom factor demonstrated the numerically greatest LS mean (SE) difference from placebo in CFB, which for HP-3070 7.6mg/24h was -2.0 [0.57] and for HP-3070 3.8mg/24h was -2.3 [0.57]; P<0.001 for both. Treatment effect size for the positive symptom factor using Cohen's d (95% confidence intervals) was 0.39 (0.17, 0.61) for HP-3070 7.6mg/24h and 0.45 (0.20, 0.64) for HP-3070 3.8mg/24h. Discussion: Post hoc analysis using a PANSS five-factor model suggests that HP-3070 may address a broad range of symptoms in people with schizophrenia.

Effects of adverse life events on mental health in single older adults in Japan.

BACKGROUND: This study tested a hypothesised model of the effects of adverse life events on the mental health of middle-aged and older adults living alone, as mediated by thought suppression and help-seeking behaviours, considering gender differences. METHODS: A questionnaire survey was conducted on a sample of 1202 (622 men; 580 women) individuals from 247445 residents aged 50-79 in District A of Tokyo. The questionnaire items covered parameters on adverse life events, help-seeking behaviour, thought suppression, and mental health status. RESULTS: Multiple group structural equation-modelling analysis revealed that the seriousness of adverse life events, help-seeking behaviours, and mental health scores were higher in women than in men. No significant gender differences were observed in thought suppression. The findings support all three proposed hypotheses: severe adverse life events will: (a) give rise to help-seeking behaviours, which will have a positive effect on mental health; (b) intensify thought suppression, which will harm mental health; and (c) inhibit help-seeking behaviour, especially in single middle-aged and older adult men. CONCLUSION: There is a need to develop interventional programs based on the theory of replacement thinking to encourage help-seeking behaviours in middle-aged and older adults.

Examining health risk behaviors of self-employed and employed workers in Japan: a cross-sectional study.

OBJECTIVES: Self-employed workers have a higher risk for adverse health outcomes than employed workers. However, the differences in health risk behaviors by employment status are largely unknown. This study examined differences in health risk behaviors between self-employed and employed (permanent/non-permanent) workers by sex and age (20-59 years, 60-79 years). STUDY DESIGN: This was a cross-sectional study involving community-dwelling adults living in urban cities in Japan. METHODS: In 2019, we conducted a mail survey in Wako city, Saitama, and Fuchu city, Tokyo. In total, 30,315 adults aged ≥18 years were randomly selected, and 14,185 completed the survey (response rate: 46.8%). The participants for analysis were 8538 workers. Health risk behaviors included physical inactivity (<150 min/wk of moderate-to-vigorous physical activity), prolonged sitting (>480 min/d), high-frequency drinking (≥3 d/wk), tobacco use (current smoker), and overweight (body mass index ≥ 25 kg/m2). We also calculated the total number of health risk behaviors. RESULTS: Self-employed workers had more health risk behaviors than permanent and non-permanent employees, with this difference more significant among younger males. In younger males, compared with self-employment, permanent employment was associated with less tobacco use, and non-permanent employment was associated with less physical inactivity, prolonged sitting, high-frequency drinking, and overweight. In younger females, non-permanent employment was associated with less prolonged sitting and overweight than self-employment. In older males and females, the prevalence of physical inactivity was lower in non-permanent employed than in self-employed workers. CONCLUSIONS: Promoting health behaviors among self-employed may be beneficial for reducing health inequalities between self-employed and employed workers.

Psychological Factors That Suppress Help-Seeking among Middle-Aged and Older Adults Living Alone.

Help-seeking among destitute adults has not been adequately investigated. Therefore, this study clarifies the mechanisms that suppress help-seeking in middle-aged and older adults living alone. Data were collected from 1274 individuals (aged 50-79 years) who were living alone, using a survey that measured future time perspective, barriers to help-seeking, help-seeking intentions, and current and childhood economic statuses. Men living alone experienced lower help-seeking intention than women, were more likely to try to solve problems by themselves, and experienced greater distrust in others. No sex differences were observed in "future anxiety" and "resignation to the future." Poor economic status was associated with high "resignation to the future," "future anxiety," and "distrust of others" for both sexes. "Resignation to the future" was particularly higher among men with a poorer current economic status, which suppressed help-seeking. Abandoning hope for the future, which is characteristic of middle-aged and older men living alone, may inhibit help-seeking behavior.

Efficacy of HP-3070, an Asenapine Transdermal System, on Symptoms of Hostility in Adults With Schizophrenia: A Post Hoc Analysis of a 6-Week Phase 3 Study.

Objective: Patients with schizophrenia may exhibit symptoms of hostility. HP-3070 is the first antipsychotic patch approved by the US Food and Drug Administration (FDA) for adults with schizophrenia. Its efficacy was demonstrated in a phase 3 study. This post hoc analysis assessed the efficacy of HP-3070 in treating hostility in schizophrenia.Methods: In the pivotal phase 3 study, conducted between August 2016 and November 2017, adults with schizophrenia (per DSM-5 criteria) were randomized to HP-3070 3.8 mg/24 h, HP-3070 7.6 mg/24 h, or placebo. Least-squares mean (LSM) changes in Positive and Negative Syndrome Scale (PANSS) hostility item and PANSS-Excited Component (PANSS-EC) scores from baseline to week 6 were assessed post hoc using a mixed-effects model for repeated measures adjusted for selected PANSS-Positive symptoms and presence of somnolence or akathisia.Results: Among 442 patients with baseline PANSS hostility item score > 1 (n = 151, HP-3070 7.6 mg/24 h; n = 147, 3.8 mg/24 h; n = 144, placebo), week 6 LSM (95% CI) change from baseline (CFB) in hostility score was superior with HP-3070 versus placebo for 7.6 mg/24 h (-0.4 [-0.6 to -0.2]; P < .001) and 3.8 mg/24 h (-0.3 [-0.6 to -0.1]; P < .01), with similar results for 7.6 mg/24 h after adjusting for covariates (P < .05). For all patients regardless of baseline PANSS hostility item score, PANSS-EC week 6 LSM CFB was greater for HP-3070 7.6 mg/24 h (-1.1 [-1.9 to -0.4]; n = 203; P < .01) and 3.8 mg/24 h (-1.3 [-2.0 to -0.6]; n = 201; P < .001) than for placebo (n = 203), with similar results observed in patients with baseline hostility item score > 1.Conclusions: In this post hoc analysis, HP-3070 was superior to placebo in reducing schizophrenia-associated hostility, even after adjusting for covariates, suggesting these effects are at least partially independent of general antipsychotic effects or effects on sedation or akathisia. These findings suggest HP-3070 has a specific antihostility effect in patients with schizophrenia.Clinical Trials Registration: ClinicalTrials.gov identifier: NCT02876900; EudraCT number: 2015-005134-21.

[Relationship between local seniors' longest-held occupation, current work situation, and reasons for working].

Objective　The purpose of this study was to clarify how the type and industry of longest-held occupations correlate with current work situations and reasons for working.Methods　In August 2015, we mailed anonymous, self-administered questionnaires to all 8,075 residents aged 65 and over of a district in Ota Ward, Tokyo, excluding those admitted to institutions. The questionnaire inquired about their basic attributes, current employment status, as well as the type of work and industry of their longest-held occupation. Furthermore, those who were currently employed were asked about their reasons for working. We conducted a multinomial logistic regression analysis with the current employment situation as the dependent variable, and a binary logistic regression analysis with the applicability of individual reasons as the dependent variable.Results　A total of 5,184 questionnaires were returned (response rate: 64.2%), and 5,050 were analyzed. For the longest-held form of work, the most common response was full-time and part-time employment (42.7%), and the most common industry was sales and service (24.2%). Roughly 30% of respondents were currently working, with the most common reason being "For a living," followed by "For my health," "To have a purpose in life (ikigai)," and "To contribute to society and build connections." The industry of the longest-held occupation for those currently working was most often self-employment; executive roles in independent businesses, companies, or organizations for those in full-time positions; and professional jobs for those working part-time. For those not currently working, most had been full-time employees or unemployed. With regard to the longest-held occupations, those currently working and who gave the reason "For a living" were most often owners of independent businesses or self-employed, while those stating "For my health," "To have a purpose in life," and "To contribute to society and build connections" had often been full-time employees, executives at a company or organization, or in administrative or technical positions.Conclusion　For seniors' employment or social participation to go smoothly, we believe a support that emphasizes individuality would be effective, including an emphasis on their longest-held occupation, which is deeply connected to their health conditions and quality of life in old age.

The effects of reciprocal support on mental health among intergenerational non-relatives-A comparison by age group.

PURPOSE: This study aimed to verify the direction of providing and receiving intergenerational support and examine its effects on mental health among intergenerational non-relatives. MATERIALS AND METHODS: In the initial survey (Time1), approximately 65,000 residents of Wako City in Saitama Prefecture, Japan, were considered, from which, a sample of 7,000 people was obtained. A total of 2,982 valid responses was received, and a follow-up survey was conducted two years later (Time2). RESULTS: Structural equation modeling with a cross-lagged effect model and a synchronous effect model showed that the direction of giving and receiving intergenerational support had changed with age; while the young and middle-aged groups shifted their direction from receiving support to giving support, the older adults shifted their direction from giving support to receiving support. Furthermore, in the young-adults group, receiving support from older adults positively influenced their mental health two years later. For the middle-aged group, giving support positively influenced their mental health at Time2. For the old-old group, receiving support from young and middle-aged people positively influenced the mental health at Time2. CONCLUSIONS: To facilitate intergenerational mutual help in the local community, it is necessary to create opportunities for older adults to provide support to young and middle-aged people and, in return, create a mechanism to prompt support from young and middle-aged people for older adults.

The impact of mutual aid on mental health and perceived isolation among the single elderly: An examination of economic status.

AIM: This study aimed to identify patterns in mutual aid relationships between older people living alone and their relatives and neighbors, and to examine the impact of mutual aid relationship patterns on mental health and perceived isolation through the mediating effect of subjective economic status. METHODS: We conducted a survey with 5000 randomly selected adults aged 65 years or older, from the five official senior care service areas of city A in Saitama Prefecture, Japan. Valid responses were received from 3941 participants (78.8%), of whom 436 participants from single-person households constituted the study sample. RESULTS: Latent class analysis revealed four types of mutual aid: family; family and intra-generational neighbors; no mutual aid; and family and multi-generational neighbors. Regression analysis showed that the interaction effect between family and neighbors' mutual aid and subjective economic status was a significant predictor of depressive symptoms. Simple slope analysis clarified that subjective economic status had a negative effect on depressive symptoms for the non-family/neighbors group, but not for the family/neighbors group. Furthermore, the interaction term between no mutual aid and subjective economic status was negatively associated with the fear of future isolation. Finally, the significantly negative effect observed was greater for the no mutual aid group than for the non-no mutual aid group. CONCLUSIONS: Mutual aid relationships are effective in improving the mental health and decreasing the fear of future isolation of older adults living alone who experience low economic status. Geriatr Gerontol Int 2021; 21: 555-560.

Social Contact with Family and Non-Family Members Differentially Affects Physical Activity: A Parallel Latent Growth Curve Modeling Approach.

BACKGROUND: Social contact leads to an increased likelihood of engaging in physical activity (PA). However, the influence of social contact on PA would be different depending on the social contact source. This study aimed to identify the association of changes in social contact with family and non-family members with the change in PA using a parallel latent growth curve modeling. METHODS: Participants were randomly selected from among residents in the study area age ≥ 20 years (n = 7000). We conducted mail surveys in 2014, 2016, and 2019. The 1365 participants completed all surveys. PA was assessed with validated single-item physical activity measure. Social contact was assessed by summing frequencies of face-to-face and non-face-to-face contacts with family/relatives not living with the participant and friends/neighbors. Parallel latent growth curve modeling was used to assess the cross-sectional, prospective, and parallel associations of social contact with PA change. RESULTS: There was a positive cross-sectional association between contact with friends/neighbors and PA, whereas prospective and parallel associations between contact with family/relatives and PA. CONCLUSION: Contacting friends/neighbors did not predict the change in PA, and a high frequency of contact with family/relatives at baseline and increasing contact with family/relatives was associated with increased PA over 5-year.

Influence of co-existing social isolation and homebound status on medical care utilization and expenditure among older adults in Japan.

OBJECTIVE: To examine whether co-existing social isolation and homebound status influence medical care utilization and expenditure in older adults. METHODS: Postal surveys on social isolation and homebound status were performed on older adults aged ≥65 years residing in a Japanese suburban city. Information on medical care utilization and expenditure was obtained from insurance claims data. These outcomes were examined over a three-year period (December 2008 to November 2011) for all participants (Analysis I, n = 1386) and during the last year of life for mortality cases (Analysis II, n = 107). A two-part model was used to analyze the influence of social isolation and homebound status on medical care utilization (first model: logistic regression model) and its related expenditure (second model: generalized linear model). RESULTS: Almost 12 % of participants were both socially isolated and homebound. Analysis I showed that these participants were significantly less likely to use outpatient and home medical care than participants with neither characteristic (odds ratio: 0.536, 95 % confidence interval: 0.303-0.948). However, Analysis II showed that participants with both characteristics had significantly higher daily outpatient and home medical expenditure in the year before death than participants with neither characteristic (risk ratio: 2.155, 95 % confidence interval: 1.338-3.470). DISCUSSION: Older adults who are both socially isolated and homebound are less likely to regularly utilize medical care, which may eventually lead to serious health problems that require more intensive treatment. Measures are needed to encourage the appropriate use of medical care in these individuals to effectively manage any existing conditions.

Workplace and community social capital and burnout among professionals of health and welfare services for the seniors: A multilevel analysis in Japan.

OBJECTIVE: Despite the potential of the social capital approach in preventing burnout, there is sparse evidence of its contextual effect. This study aimed to reveal the contextual association of workplace and community social capital on burnout among professionals of health and welfare services for seniors in Japan. METHODS: We collected data from a cross-sectional questionnaire survey for all health and welfare professionals working in Community Comprehensive Support Centers (CCSCs) in the central Tokyo area in 2015. We assessed burnout using the Japanese version of the Maslach Burnout Inventory, which consists of three subscales: emotional exhaustion, depersonalization, and reduced personal accomplishment. We prepared social capital items regarding workplace (the CCSC the participants belonged to) and community (the current catchment area of the CCSC). We aggregated individual responses of workplace and community social capital within each CCSC to create group-level workplace and community social capital indicators. RESULTS: Among the 1771 questionnaires distributed, we analyzed 1110 from 211 CCSCs. Multilevel analysis showed that higher group-level workplace social capital was significantly associated with lower scores of all three subscales after adjusting for covariates. Moreover, we found a significant association between greater group-level community social capital and lower scores of depersonalization and reduced personal accomplishment. CONCLUSION: Working in workplaces and communities with higher social capital is related to lower burnout. The findings suggest that strategies to enhance the social capital of their workplace and community would be beneficial in the prevention of burnout among professionals in the field of health and social welfare.

Working for only financial reasons attenuates the health effects of working beyond retirement age: A 2-year longitudinal study.

AIM: The health benefits of paid employment in late life are understood, but they might vary according to work motives. We examined the health effects of employment among older adults, focusing on motivation. METHODS: We carried out a 2-year longitudinal survey from 2013 (baseline) to 2015 (follow up). Among 7608 older adults, the analysis included 1069 who completed both surveys and were employed at baseline. Work motives were assessed using a questionnaire. Participants were assigned to groups based on their responses: (i) financial reasons; (ii) motivation other than financial reasons; and (iii) both financial and non-financial reasons. Self-rated health, mental health and higher-level functional capacity were evaluated as health outcomes. RESULTS: There were group differences in baseline demographic variables and health status; those with financial reasons had lower socioeconomic status and worse mental health. Multivariable logistic regression analysis showed that compared with older workers with non-financial reasons, those with financial reasons were more likely to decline in self-rated health (OR 1.42; 95% CI 1.00-2.03) and higher-level functional capacity (OR 1.55; 95% CI 1.16-2.07), which was independent of potential covariates, including socioeconomic status. However, no differences were evident between those with only non-financial reasons and those having both financial and non-financial reasons. CONCLUSIONS: We found that the participants who worked only for financial rewards had reduced health benefits through working in old age. A prolonged working life among older workers can contribute to maintaining health and can be enhanced by non-financial reasons, such as finding meaning in life and social contact. Geriatr Gerontol Int 2020; 20: 745-751.

Chronic stressors, stress coping and depressive tendencies among older adults.

AIMS: This study aimed to clarify the association between chronic stressors, stress coping and depressive tendencies among older adults. METHODS: We carried out a survey with 500 participants aged in their 70s, who were randomly selected from the basic resident register. Of these, 304 residents responded to the survey (60.8%). RESULTS: Findings from a factor analysis and cluster analysis revealed five groups of chronic stressors: physical, economic and interpersonal stressor; physical and economic stressor; interpersonal stressor; physical stressor; and low stressor. The factor analysis revealed four factors of coping: cognitive coping, support-seeking, positive problem solving and escape-avoidance. Furthermore, a multiple logistic regression analysis showed that both physical, economic and interpersonal stressor, and physical and economic stressor had negative associations with depressive tendencies. With respect to stress coping, positive problem solving had a positive association with depressive tendencies, whereas escape-avoidance had a negative association with depressive tendencies. CONCLUSIONS: For older individuals, the more complex the overlapping chronic stressors that are experienced, the higher the depressive tendencies. Furthermore, although older individuals selectively use various coping strategies, they do not alleviate the stress responses induced by chronic stressors. Geriatr Gerontol Int 2020; 20: 297-303.

Factors relating to social isolation in urban Japanese older people: A 2-year prospective cohort study.

PURPOSE: We analyzed the data from a 2-year prospective-cohort survey to identify factors relating to new incidences of social isolation and recovery from social isolation in community-dwelling older people. MATERIALS AND METHODS: We conducted a longitudinal study (2013-2015) involving 2657 older residents of Iriarai, Japan. A chi-square test, an independent t-test, and logistic regression analysis with imputed data were conducted to examine categorical data, continuous variables, and factors relating to social isolation, respectively. PRINCIPAL RESULTS: The results suggested that the factors that predicted future social isolation included being a man, being older, living with others, having a decline in mental health, having a lower frequency of going out, and not participating in community groups. On the other hand, being younger, having a higher level of mental health, having a higher frequency of going out, and participating in community groups were identified as factors that predicted participants' recovery from social isolation. MAJOR CONCLUSIONS: Some demographic, mental, and social factors could relate to new incidences of social isolation and recovery from social isolation in community-dwelling older people. As aging is an irreversible phenomenon, and there is a limit to preventing all disorders, either building a safety net or introducing exchange programs to prevent social isolation are important interventions for older people.

[The influence of types of living alone on 2-year health changes according to elderly adults' marital status: Based on the Comprehensive Regional Studies for Preventing Isolation of the Elderly Who Live in Metropolitan Area (CAPITAL Study)].

Objectives　The aim of this research is to classify elderly adults who live alone by their marital status type and to clarify how those types affect their higher-level functional capacity and mental health with a 2-year follow-up survey.Methods　This research is based on the results from a survey in 2013. The base-line scores were from 757 participants who completed a survey by mail, carried out in B area of A ward, Tokyo, within the jurisdiction of community general support centers, with people who were not at nursing care levels 4 or 5 and who were not residents of welfare facilities. This study analyzed data for 517 of 527 participants, who answered all questions in the 2015 survey and indicated their marital status. This research categorized the respondents into 4 types of marital status: separation, divorce, bereavement, and unmarried groups. This study adopted the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) as the index of higher-level functional capacity, and the WHO-Five Well-Being Index (WHO-5-J) as the mental health index. In the analysis of the causes of 2-year variations in TMIG-IC total scores and WHO-5-J scores, the dependent variable was each variation. This study used an analysis of covariance in which the fixed factors were types of living alone, sex, annual income, and having children who lived separately in the 2013 survey, and the covariance comprised the base-line scores for the dependent variables, age, and chronic diseases in the 2013 survey.Results　With regards to the variation in TMIG-IC total scores, main effects of the types of living alone were observed. The adjusted variation of covariance decreased most in the separation group (-0.95). For the variation in WHO-5-J scores, main effects of the types of living alone were indicated. In the divorce group, the adjusted variation of covariance was significantly higher than for the unmarried group (2.33 vs. -0.55).Conclusion　The results revealed that the types of marital status: separated, divorced, bereaved, and unmarried, affect changes in the higher-level functional capacity and mental health status of elderly adults living alone, 2 years later. Thus, although previously regarded as a single category, types of marital status should be considered in the analysis of elderly adults who live alone.

The impact of intergenerational programs on social capital in Japan: a randomized population-based cross-sectional study.

BACKGROUND: Over the last several decades, social isolation and loneliness among older adults have posed an increasingly urgent challenge due to the rapidly aging population in Japan. To remedy the situation, many communities have introduced intergenerational programs. However, few studies have investigated the benefits of social capital across generations as a result of intergenerational interaction between children and older generations. Therefore, we aim to ascertain the degree to which intergenerational programs that take root in a community will affect the social capital of all generations in the community. METHODS: We focus our research on one specific program, REPRINTS, an intergenerational health promotion program for older adults that has been active for over 10 years in Tama Ward, Kawasaki City, Kanagawa Prefecture. We conducted a population-based cross-sectional study of residents between the ages of 20 and 84 years who were randomly selected from the basic resident register. Approximately 2500 residents were selected, of which 978 responded; data from 891 respondents were analyzed. RESULTS: Hierarchical linear modeling suggests that the duration of programs was a significant community-level indicator of neighborhood trust. At the individual level, people between 30 and 59 years of age and people over 60 years of age have more positive effects on neighborhood trust than do people between 20 and 39 years of age. CONCLUSIONS: The ongoing intergenerational programs between older citizens and children can enforce neighborhood trust, thus strengthening a community's intergenerational ties. The REPRINTS program has been developed through cooperation with local citizens, senior volunteers, and teachers from the community. Its collaborative nature ensures longevity and continuous growth in a community. It is challenging to create long-term intergenerational programs that take root in communities, making persistence and collaboration a crucial factor in fruitful intergenerational relationships. Overall, ongoing intergenerational program implementation associates with building social capital, thereby strengthening potential intergenerational ties and promote mutual support among local residents which will reduce or prevent social isolation among older.

Co-existence of social isolation and homebound status increase the risk of all-cause mortality.

ABSTRACTBackground:Social isolation and homebound statuses are possible risk factors for increased mortality among older adults. However, no study has addressed the impact of accumulation of these two factors on mortality. The aim of this study was to examine whether such accumulation increased the risk of all-cause mortality. METHODS: The analyzed sample was drawn from a mail survey of 1,023 older adults without instrumental activities of daily living disability. Participants were classified into four groups according to the frequency of both face-to-face and non-face-to-face interactions with others (social isolation and non-social isolation) and the frequency of going outdoors (homebound and non-homebound). Social isolation and homebound statuses were defined as having a social interaction less than once a week and going outdoors either every few days or less, respectively. All-cause mortality information during a six-year follow-up was obtained. RESULTS: In total, 78 (7.6%) participants were both socially isolated and homebound. During the follow-up period, 65 participants died, with an overall mortality rate of 10.6 per 1000 person-years. Cox proportional hazards regression analyses demonstrated that older adults who were socially isolated and homebound showed a significantly higher risk of subsequent all-cause mortality compared with healthy adults who were neither socially isolated nor homebound, independent of potential covariates (aHR, 2.19; 95% CI: 1.04-4.63). CONCLUSION: Our results suggest that the co-existence of social isolation and homebound statuses may synergistically increase risk of mortality. Both active and socially integrated lifestyle in later life might play a major role in maintaining a healthy status.

Factors that promote new or continuous participation in social group activity among Japanese community-dwelling older adults: A 2-year longitudinal study.

AIM: Identifying factors that influence participation in social group activities in older adults might be helpful in promoting social participation in this population. We examined factors related to new or continuous participation in social group activities according to group type. METHODS: We carried out a community-based, longitudinal study with a 2-year follow-up period. Of 7608 older adults aged ≥65 years, 3380 completed the follow-up survey and were included in the analysis. We examined private group (hobbies, sports and volunteering; PrG) and public group (neighborhood associations and senior citizen clubs; PuG) activity. RESULTS: For PrG, 39.6% of the participants were engaged at baseline, 25.5% initiated participation and 9.5% withdrew during the study period. For PuG, 20.8% of the participants were engaged at baseline, 10.8% initiated participation and 31.5% withdrew during the study period. Logistic regression analysis showed mental health, self-rated health, employment, relationships with neighbors, subjective economic status, educational attainment and participation in PuG were related to new participation in PrG. Mental health, employment and relationships with neighbors were significantly related to continuous participation. For PuG, mental health, sex and relationships with neighbors were significantly related to new participation, whereas sex, relationships with neighbors and educational attainment were related to continuous participation. CONCLUSIONS: The rate of new and continuous participation in PrG was higher than that in PuG, and different related factors were identified as existing between social group types. Geriatr Gerontol Int 2018; 18: 1259-1266.

For how many days and what types of group activities should older Japanese adults be involved in to maintain health? A 4-year longitudinal study.

OBJECTIVE: Studies have suggested that frequent participation in social groups contributes to the well-being of older people. The primary aim of this study was to identify the number of days older adults should participate in the activities of social groups to maintain their health for 4 years. This study also aimed to examine whether the effective frequency differs by the type of social group activity. METHOD: We examined a prospective cohort of 1,320 community-dwelling older adults over 65 years of age, who responded to both a baseline and a follow-up mail survey, in a suburban city of Tokyo, Japan. The dependent variable was the change in functional competence during 4 years. Logistic regression analyses were conducted to examine the effects of participation in the activities of the 5 most common social groups among older Japanese on maintaining functional competence. RESULTS: Nine hundred and ninety-four participants (76.5%) maintained their functional competence for 4 years. The results of the logistic regression analyses showed that participating in alumni groups less than once a month and being an inactive member were associated with higher odds of maintaining functional competence, after controlling for socioeconomic, demographic and baseline health status. Additionally, the odds of maintaining functional competence for 4 years increased upon participating in volunteer groups once a month or more. These results were also confirmed using logistic regression analysis, even after adjustment for the effects of participation in other social groups. DISCUSSION: The results indicated the effectiveness of volunteer activities that fulfill a social role in maintaining health. Therefore, older adults should be encouraged to participate in activities of volunteer groups at least once a month. Additionally, older adults can obtain positive health outcomes through less frequent participation in alumni groups, compared with the activities of volunteer groups.

Synergistic or independent impacts of low frequency of going outside the home and social isolation on functional decline: A 4-year prospective study of urban Japanese older adults.

AIM: Decreased frequency of going outside the home and being socially isolated are regarded as predictors of poor health. The object of the present study was to clarify whether these factors have synergistic or independent impacts on future functional decline. METHODS: We examined a prospective cohort of 2427 community-dwelling persons, aged ≥65 years, who responded to the baseline mail survey in Wako City, in 2008. Participants were asked about the frequency of going outside the home, social isolation status (having contact less than once a week with anyone outside household), functional capacity (Tokyo Metropolitan Institute of Gerontology-Index of Competence), age, sex, annual income, self-rated health, depressive mood and mobility. RESULTS: Of 1575 persons (72.1%) who completely responded to the follow-up survey (T2) in 2012, we defined the groups as follows: group 1, not isolated and going outside the home every day (n = 897); group 2, not isolated and going outside the home less than every day (n = 311); group 3, isolated and going outside the home every day (n = 224); and group 4, isolated and going outside the home less than every day (n = 143). Multiple logistic regression analyses showed that the variables identifying group 3 for men and group 2 for women with reference to group 1 were predictors of subsequent functional decline even after adjustment for confounders (odds ratios 2.01, 1.63; 95% CI 1.20-3.38, 1.03-2.56, respectively). CONCLUSION: Social isolation regardless of going outside the home every day for men and going outside the home less than every day regardless of being not socially isolated for women might predict functional decline. Geriatr Gerontol Int 2017; 17: 500-508.