Positive and negative influences of social participation on physical and mental health among community-dwelling elderly aged 65-70 years: a cross-sectional study in Japan.
BACKGROUND
Although numerous investigations have indicated that social participation (SP) has positive effects on the health of older adults, there have been few studies on its negative health consequences. We examined the cross-sectional associations of the type, frequency, and autonomy for SP with physical and mental health.


METHODS
The analytical subjects were 5126 males and 7006 females who were functionally independent, born between 1945 and 1949, and covered by A City's medical insurance system. Physical and mental health were measured using the SF-8 Health Survey. SP was measured through six types of social groups. These social groups included volunteer groups, sports groups, hobby clubs, senior citizens' clubs, neighborhood community associations, and cultural groups. Analysis of covariance was conducted to compare adjusted physical health component summary scores (PCS) and mental health component summary scores (MCS) by the frequency and autonomy of SP. Age, family size, body mass index, chronic conditions, smoking, alcohol intake, depression and cognitive functioning were included as covariates. To examine whether the associations between SP and PCS/MCS are different between genders, we performed analyses stratified by gender.


RESULTS
Overall, positive associations of the frequency and autonomy of SP with PCS and MCS were stronger in females than males. As to frequency, frequent participation in sports groups and hobby clubs had significantly better PCS among both genders and better MCS among females than non-participation. None of the groups differed significantly in the MCS among males. As to autonomy, among both genders, voluntary participation in sports groups and hobby clubs had significantly better PCS than non-participation, and better MCS than not only non-participation, but also obligatory participation. Among females, obligatory participation in all groups had significantly poorer MCS than voluntary participation, and obligatory participation in sports groups had significantly poorer MCS than non-participation.


CONCLUSIONS
Obligatory SP had significantly poorer MCS than voluntary participation, occasionally than non-participation; there is a possibility that obligatory SP has harmful influences on mental health of community-dwelling elderly. Measures to promote SP with consideration for individuals' autonomy may be effective in the public health approach to maintaining mental health.
['Tomioka|Kimiko|K|0000-0002-9471-6987', 'Kurumatani|Norio|N|', 'Hosoi|Hiroshi|H|']
D000368:Aged D002908:Chronic Disease D003430:Cross-Sectional Studies D005260:Female D006304:Health Status D006306:Health Surveys D006801:Humans D057187:Independent Living D007564:Japan D008297:Male D008603:Mental Health D008875:Middle Aged D026684:Personal Autonomy D012737:Sex Factors D012933:Social Identification D058992:Social Participation D014836:Volition
Social participation Mental health Elderly Autonomy Physical health Gender differences