Social and Activity Participation and Subjective Well-Being Among Older Adults in Japan: A Comparative Analysis of Healthy and Care-Needing Groups.

Objectives: This study explores the relationship between social and activity participation (SAP) and subjective well-being (SWB) among older adults in Japan, with a particular focus on differences by care-needing status. Methods: Data were drawn from the 2019 Sakai City Older Adults Survey, including 5469 healthy and 406 care-needing individuals aged 65 and over (65.59% female). An ordered probit model was used to estimate the association between SAP and SWB, which was measured on an 11-point scale and categorized into three levels. To address potential endogeneity, instrumental variable (IV) analysis was conducted using information source diversity and health consciousness as instruments. Results: Higher frequency of SAP was positively associated with SWB among both healthy and care-needing older adults. While the association was stronger and more consistent among the healthy group, IV analysis revealed a statistically significant and robust relationship among care-needing individuals as well. The findings suggest that even older adults facing physical or cognitive limitations may experience psychological benefits from SAP. Conclusions: SAP is associated with better SWB among older adults, including those with care-needing status. These results support the promotion of inclusive community-based programs to enhance psychosocial health in aging populations.