title: Engagement in paid work as a protective predictor of basic activities of daily living disability in Japanese urban and rural community-dwelling elderly residents: An 8-year prospective study.
abstract: OBJECTIVE
  To examine whether engaging in paid work is a predictor of maintaining good functional health among Japanese older adults in both urban and rural communities.
  
  
  METHODS
  We used the 8-year longitudinal Tokyo Metropolitan Institute of Gerontology Longitudinal Interdisciplinary Study on Aging with 306 and 675 persons aged 65-84 years from Koganei City (urban) and Nangai Village (rural), respectively, who are independent in basic activities of daily living (BADL). In order to examine the declining patterns in BADL and evaluate the predictive value of working status for future BADL disability, we applied the log-rank test of cumulative proportion curves and the Cox proportional hazard model by sex, controlling for age, research fields, years of education, marital state, chronic medical conditions, pain, instrumental activities of daily living (IADL), smoking status, exercise habits, life satisfaction, usual walking speed and serum albumin for evaluating the predictive value of working status at baseline for future BADL disability.
  
  
  RESULTS
  In both areas, participants who were not working were more likely to decline in BADL than those working (P < 0.05), except for women in urban Koganei. Male participants who did not engage in paid work had a higher adjusted hazard ratio of onset of BADL disability, compared with those working, but this was not seen for female participants.
  
  
  CONCLUSIONS
  Working might be protective from a decline in BADL only for men, but not for women. Regarding the difference of sex roles in conventional Japanese society, working would be an effective solution especially for men to participate in social activities.
authors.affiliation: Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Fujiwara
authors.affiliation: Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
authors.forename: Shoji
authors.initials: S
authors.lastname: Shinkai
authors.affiliation: Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
authors.forename: Erika
authors.initials: E
authors.lastname: Kobayashi
authors.affiliation: Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
authors.forename: Ushio
authors.initials: U
authors.lastname: Minami
authors.affiliation: Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Suzuki
authors.affiliation: Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
authors.forename: Hideyo
authors.initials: H
authors.lastname: Yoshida
authors.affiliation: Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Ishizaki
authors.affiliation: Graduate School of University of Human Arts and Sciences, Saitama, Japan.
authors.forename: Shu
authors.initials: S
authors.lastname: Kumagai
authors.affiliation: Graduate School of Gerontology, J.F. Oberlin University, Tokyo, Japan.
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Watanabe
authors.affiliation: School of Health Sciences, Sapporo Medical University, Sapporo, Japan.
authors.forename: Taketo
authors.initials: T
authors.lastname: Furuna
authors.affiliation: National Center for Geriatrics and Gerontology, Obu, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Suzuki
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D004651:Employment; D005260:Female; D006304:Health Status; D006801:Humans; D007564:Japan; D008137:Longitudinal Studies; D008297:Male; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012111:Residence Characteristics; D012424:Rural Population; D013997:Time Factors; D014505:Urban Population
keywords: basic activities of daily livings; community-dwelling elderly residents; paid work; predictor; social activities