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Does Community-Level Social Capital Predict Decline in Instrumental Activities of Daily Living? A JAGES Prospective Cohort Study

Department of Public Health, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba 260-8670, Japan
Center for Preventive Medical Sciences, Chiba University, Chuo-ku, Chiba 260-8670, Japan
Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan
Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Aoba-ku, Sendai, Miyagi 980-8575, Japan
Department of Social Welfare, Nihon Fukushi University, Mihama-cho, Chita-gun, Aichi 470-3295, Japan
Department of Cancer Epidemiology, Cancer Control Center, Osaka International Cancer Institute, Chuo-ku, Osaka 541-8567, Japan
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(5), 828;
Received: 31 December 2018 / Revised: 1 March 2019 / Accepted: 2 March 2019 / Published: 7 March 2019
(This article belongs to the Special Issue Statistical Advances in Epidemiology and Public Health)
PDF [722 KB, uploaded 7 March 2019]


Instrumental activities of daily living (IADL) represent the most relevant action capacity in older people with regard to independent living. Previous studies have reported that there are geographical disparities in IADL decline. This study examined the associations between each element of community-level social capital (SC) and IADL disability. This prospective cohort study conducted between 2010 and 2013 by the Japan Gerontological Evaluation Study (JAGES) surveyed 30,587 people aged 65 years or older without long-term care requirements in 380 communities throughout Japan. Multilevel logistic-regression analyses were used to determine whether association exists between community-level SC (i.e., civic participation, social cohesion, and reciprocity) and IADL disability, with adjustment for individual-level SC and covariates such as demographic variables, socioeconomic status, health status, and behavior. At three-year follow-up, 2886 respondents (9.4%) had suffered IADL disability. Residents in a community with higher civic participation showed significantly lower IADL disability (odds ratio: 0.90 per 1 standard deviation increase in civic participation score, 95% confidence interval: 0.84–0.96) after adjustment for covariates. Two other community-level SC elements showed no significant associations with IADL disability. Our findings suggest that community-based interventions to promote community-level civic participation could help prevent or reduce IADL disability in older people. View Full-Text
Keywords: physical function; civic participation; multilevel analysis physical function; civic participation; multilevel analysis

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Fujihara, S.; Tsuji, T.; Miyaguni, Y.; Aida, J.; Saito, M.; Koyama, S.; Kondo, K. Does Community-Level Social Capital Predict Decline in Instrumental Activities of Daily Living? A JAGES Prospective Cohort Study. Int. J. Environ. Res. Public Health 2019, 16, 828.

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