title: Social Participation and the Prevention of Decline in Effectance among Community-Dwelling Elderly: A Population-Based Cohort Study.
abstract: BACKGROUND
  We examined the association between a decline in effectance and social participation (SP) from the perspective of the number and the type of SP in a prospective cohort study.
  
  
  METHODS
  Included in this analysis were community-dwelling elderly aged ≥ 65 without dependency on the basic activities of daily living and reporting a perfect baseline effectance score (n = 4,588; mean age 72.8 ± 5.7). SP was categorized into 5 types: neighborhood associations, hobby groups, local event groups, senior citizen clubs, and volunteer groups. Effectance was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Using logistic regression analysis, odds ratio (OR) and a 95% confidence interval (CI) for a decline in effectance were calculated. Age, family, BMI, pensions, medical history, medications, alcohol, smoking, cognitive function, depression, social support, ADL, and IADL were used as covariates.
  
  
  RESULTS
  During the 3-year follow-up, 17.8% of eligible participants reported a decline in effectance. After adjustment for covariates, participation in various groups was associated with the preservation of effectance for both genders. Regarding the type of SP, among females, participation in neighborhood associations (OR: 0.62, 95%CI: 0.48-0.81), hobby groups (0.58, 0.43-0.77), local event groups (0.63, 0.47-0.86), and volunteer groups (0.53, 0.35-0.82) was inversely associated with a decline in effectance. Among males, the beneficial effect was more likely limited to hobby groups (0.59, 0.43-0.81) and volunteer groups (0.57, 0.39-0.83).
  
  
  CONCLUSIONS
  Our results suggest that participation in a variety of social groups is effective for maintenance of older people's effectance, while the beneficial effect of each type of SP on effectance is stronger for females than for males. Recommending community-dwelling elderly to participate in social groups appropriate for their gender may be effective for successful aging.
authors.affiliation: Nara Prefectural Health Research Center, Nara Medical University, Kashihara, Nara, Japan.
authors.forename: Kimiko
authors.initials: K
authors.lastname: Tomioka
authors.affiliation: Nara Prefectural Health Research Center, Nara Medical University, Kashihara, Nara, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Kurumatani
authors.affiliation: Nara Prefectural Health Research Center, Nara Medical University, Kashihara, Nara, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hosoi
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D005260:Female; D006801:Humans; D057187:Independent Living / Q000523:psychology* / Q000706:statistics & numerical data; D008297:Male; D009042:Motivation; D058992:Social Participation