Background: Frailty is the highest risk factor for incident disability and mortality. Social participation is a modifiable factor for reducing adverse outcomes among independent older adults. However, the association between social participation and incident disability and mortality among frail older adults remains unclear. Therefore, we examined the association between various social activities and incident disability and mortality. Methods: This nationwide prospective cohort study (The Japan Gerontological Evaluation Study) recruited older adults with frailty, aged 65 years and older ( N = 9090) who were followed up for 6 years (2010–2016). We examined incident disability and all‐cause mortality at the end of the follow‐up period. Frailty was assessed using the Kihon Checklist. The independent variable was social participation in 2010, grouped into the following seven categories: hobby groups, sports groups or clubs, volunteer groups, senior citizens' clubs, industries, neighborhood communities, and paid work. Results: The incidence of disability among participants was 19.5% (1770) and that of mortality was 19.2% (1753). Belonging to sports groups or clubs (Hazard Ratios [HR] = 0.74; 95% Confidence Interval [CI] = 0.57, 0.98) or hobby groups (HR = 0.77; 95% CI = 0.60, 0.98) was significantly associated with a lower risk of incident disability. Meanwhile, hobby groups (HR = 0.68; 95% CI = 0.56, 0.83), sports groups or clubs (HR = 0.71; 95% CI = 0.57, 0.88), volunteer groups (HR = 0.69; 95% CI = 0.54, 0.88), and senior citizens' club (HR = 0.75; 95% CI = 0.61, 0.90) were associated with lower risk of incident mortality. Conclusions: Social participation was associated with a lower risk of incident disability and mortality, not only in healthy older adults but also in frail older adults who are at higher risk of incident disability and mortality. This suggests that frail older adults should be encouraged to participate in all the seven types of social participation examined in this study, as this may lower the risk of subsequent disability and mortality.

Novel coronavirus disease (COVID-19) pandemic could increase the mental health burden of family caregivers of older adults, but related reports are limited. We examined the association between family caregiving and changes in the depressive symptom status during the pandemic. This cross-sectional study included 957 (mean age [standard deviation] = 80.8 [4.8] years; 53.5% females) community-dwelling older adults aged ≥ 65 years from a semi-urban area of Japan, who completed a mailed questionnaire. Based on the depressive symptom status assessed with the Two-Question Screen between March and October 2020, participants were classified into four groups: "non-depressive symptoms," "incidence of depressive symptoms," "remission from depressive symptoms," or "persistence of depressive symptoms." Participants were assessed in October 2020 for the family caregiving status, caregiving role, the severity of care recipients' needs, and increased caregiver burden during the pandemic, each with the simple question. Multinomial logistic regression analysis was applied to obtain the odds ratios (ORs) and 95% confidence intervals (CIs) for changes in depressive symptom status. Compared to non-caregivers, family caregivers were associated with the incidence (OR [95% CI] = 3.17 [1.55-6.51], p < 0.01) and persistence of depressive symptoms (OR [95% CI] = 2.39 [1.30-4.38], p < 0.01). Primary caregivers, caregivers for individuals with severe care needs, and caregivers with increased burden during the pandemic had a high risk of depressive symptoms. Family caregivers had a high risk of depressive symptoms during the pandemic. Our findings highlight the need for a support system for family caregivers.

This study examined the difference in falls between older adults who participated in group exercise and those who exercised alone. We used cross-sectional data from the Japan Gerontological Evaluation Study. Data were obtained from functionally independent residents aged 65 years or older across 30 municipalities in Japan (n = 19,257). Logistic regression analysis was performed with experience of multiple falls over the past year as the dependent variable and type of exercise as the independent variable. Respondents were divided into three groups according to how they performed exercise: (1) non-exercisers (NE, no exercise), (2) those who only exercised alone (IE, individual exercise), and (3) those whose exercise included participation in group exercise (GE, group exercise). In total, 887 (4.6%) respondents reported multiple falls. After adjustment for 10 possible confounders, the GE group had an odds ratio (OR) for falls of 0.75 (95% confidence intervals 0.60–0.95) compared with the IE group. After adjustment for physiological factors and a psychological factor, the OR for the GE group increased slightly; however, an association between falls and exercise type was indicated. Older adults who participate in group exercise may receive additional benefits related to falls prevention compared with those who exercise alone.