Participation in community gathering places and loss of independence among older adults with and without mild disability in Habikino City, Japan: A four-year longitudinal study.

Abstract

Loss of independence (LOI) significantly affects quality of life and increases societal costs. Community gathering places supported by local governments aim to prevent LOI. However, evidence of their effectiveness among older adults with mild disability is limited. We investigated whether participation in community gathering places reduces the risk of LOI among older adults, including those with mild disability. This retrospective cohort study used data from the Public Survey of Long-Term Care Prevention in Habikino City, Japan. The study was conducted from January 2020 to January 2024 and included 1961 adults aged ≥65 years without care needs. Participation in community gathering places was assessed at baseline, and LOI (new certification of need for long-term care, or death) was followed for four years. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs), with adjustment for demographics and health conditions. We also performed a subgroup analysis to assess the potential effect modification of mild disability (support levels 1-2 under Japan's Long-Term Care Insurance system). Participants in community gathering places had a significantly lower risk of LOI than non-participants (adjusted HR 0.57, 95 % CI 0.36 0.90). Subgroup analyses showed that older adults with mild disability benefited similarly, with no effect modification (P for interaction = 0.22). Participation in community gathering places appeared to reduce the risk of LOI across different functional levels. These findings support initiatives to promote such environments and emphasize the role of social engagement in aging policies.