持续的社会参与和痴呆：来自日本纵向队列研究的证据与时变暴露分析。

IF 5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine Pub Date : 2025-09-22 DOI:10.1016/j.socscimed.2025.118608

Yusuke Matsuyama , Kokoro Shirai , Jun Aida

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引用次数: 0

摘要

社会参与与降低认知障碍和痴呆症的风险有关。然而，很少有研究考虑到社会参与与认知能力下降之间的双向关系。我们的目的是估计持续的社会参与对日本老年人痴呆症风险降低的影响，考虑到双向关系引起的偏差。利用日本老年学评估研究的数据进行了一项纵向研究。2013年进行了一项基线调查，从市政登记处获得了截至2022年的痴呆发病信息（n = 47,698；中位随访时间9.2年）。2016年和2019年的额外问卷调查收集了有关社会参与和时变混杂因素的数据。持续社会参与对痴呆发病的平均治疗效果（ATE）使用双稳健的目标最小损失估计估计。在参与者中，17.2%的人患有痴呆症。与没有社会参与的参与者（17.8%）相比，有基线社会参与的参与者的痴呆发病率（14.7%）较低。从2013年到2019年，与从未参加过社会活动的人群相比，每周至少参加一次社会活动的人群无痴呆生存几率（95%置信区间：1.9,4.5）增加了3.2个百分点。在特定的组类型中，参加运动组（ATE = 4.2; 95% CI: 2.0, 6.4）和爱好组（ATE = 5.3; 95% CI: 2.5, 8.0）与增加无痴呆生存几率显著相关。在日本老年人中，持续的社会参与与痴呆症风险降低有关。

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Sustained social participation and dementia: evidence from a Japanese longitudinal cohort study with a time-varying exposure analysis

Social participation is linked to a reduced risk of cognitive impairment and dementia. However, few studies have considered the bidirectional relationship between social participation and cognitive decline over time. We aimed to estimate the effect of sustained social participation on dementia risk reduction among older Japanese adults, accounting for the bias induced by the bidirectional relationship.

A longitudinal study was conducted using data from the Japan Gerontological Evaluation Study. A baseline survey was administered in 2013, with dementia onset information up to 2022 obtained from the municipality registry (n = 47,698; median follow-up 9.2 years). Additional questionnaire surveys in 2016 and 2019 collected data on social participation and time-varying confounders. The average treatment effect (ATE) of sustained social participation on dementia onset was estimated using doubly robust targeted minimum loss-based estimation.

Of the participants, 17.2 % got dementia. Participants with baseline social participation had a lower incidence of dementia (14.7 %) compared to those without social participation (17.8 %). Sustained social participation in any group at least once per week from 2013 to 2019 was associated with a 3.2 percentage point increase in dementia-free survival probability (95 % confidence interval, CI: 1.9, 4.5) compared to never participated. Among specific group types, participation in sports groups (ATE = 4.2; 95 % CI: 2.0, 6.4) and hobby groups (ATE = 5.3; 95 % CI: 2.5, 8.0) was significantly associated with increased dementia-free survival probability.

Sustained social participation was associated with reduced dementia risk among older Japanese adults.

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来源期刊

Social Science & Medicine PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

9.10

自引率

5.60%

发文量

762

审稿时长

38 days

期刊介绍： Social Science & Medicine provides an international and interdisciplinary forum for the dissemination of social science research on health. We publish original research articles (both empirical and theoretical), reviews, position papers and commentaries on health issues, to inform current research, policy and practice in all areas of common interest to social scientists, health practitioners, and policy makers. The journal publishes material relevant to any aspect of health from a wide range of social science disciplines (anthropology, economics, epidemiology, geography, policy, psychology, and sociology), and material relevant to the social sciences from any of the professions concerned with physical and mental health, health care, clinical practice, and health policy and organization. We encourage material which is of general interest to an international readership.