田中 笑子

OBJECTIVE: This study aimed to explore the direct and indirect effects of social frailty on functional state trajectories mediated by subjective cognitive function in older adults. DESIGN: Longitudinal study. SETTING AND PARTICIPANTS: Overall, 514 adults aged ≥65 years living in a suburban area of central Japan were included in this study. METHODS: Five-item social frailty index (going out, visiting, feeling helpful, living alone, and talking to others), subjective cognitive function from the Kihon Checklist, and instrumental activities of daily living disability. Latent growth curve models were applied to examine the longitudinal relations among the variables. RESULTS: During the 6-year follow-up in latent growth curve models, the initial level of social frailty in older adults was negatively associated with that of functional status (β = -0.53, P < .001), and the rate of change in social frailty was negatively associated with that in functional status (β = -0.78, P < .001). In the mediation model, the indirect effect from the social frailty level to functional status level through subjective cognitive function level was significant (β = -0.14, 95% CI -0.29, -0.09); the rates of change in subjective cognitive function mediated the relationship between those in social frailty and functional status (β = -0.35, 95% CI -0.46, -0.25). CONCLUSIONS AND IMPLICATIONS: This study found that there is an association between social frailty and functional status in Japanese older adults. Subjective cognitive function mediated this relationship. Hence, additional research is required to investigate additional potential factors linking social frailty and functional status in order to gain a better understanding of the underlying mechanisms.

OBJECTIVES: This study aimed to explore the bidirectional association between frailty and social relationships in older adults while distinguishing between interpersonal and intrapersonal effects. METHODS: A prospective cohort study of community-dwelling older adults was conducted in Japan in three waves spanning six years with follow-ups in every three years. Random intercept cross-lagged panel model was used to explore temporal associations between frailty and social relationships. RESULTS: Data for 520 participants (mean age 73.02 [SD 6.38] years, 56.7% women) were analyzed. Across individuals, frailty was associated with social relationships (β = -0.514, p < 0.001). At the interpersonal level, frailty was cross-sectionally associated with social relationships separately at T1(β = -0.389, p < 0.01), T2 (β = -0.343, p < 0.001) and T3 (β = -0.273, p < 0.05). Moreover, social relationships were associated with subsequent increases in symptoms of frailty in all measurement waves (β = -0.332, p < 0.001; β = -0.169, p < 0.01) and vice versa (β = -0.149, p < 0.05; β = -0.292, p < 0.001). CONCLUSIONS: The results suggest that frailty was associated with lower levels of social relationships. Frailty improvement programs can be combined with interventions to enhance social relationships, which will be beneficial in preventing frailty. The results emphasize the importance of combining clinical treatments of frailty with interventions to improve social relationships.

This study aimed to explore all the relevant subtypes of cognitive frailty among Japanese community-dwelling older adults with multimorbidity. Moreover, it examined the associations between these potential subtypes of cognitive frailty and social relationships. This study targeted relevant cross-sectional data regarding community-based older adults with multimorbidity. It employed a person-centered method to perform a latent class analysis and explore the subtypes of cognitive frailty among older adults. Moreover, a multinominal logistic regression analysis was employed to examine the association between potential subtypes of cognitive frailty and social relationships. Data for 396 participants (mean age, 75.8 [SD, 7.3] years; 51.3% females) were analyzed. Three cognitive frailty subtypes were subsequently revealed: the robust group (42.0%), the group with partial cognitive frailty (38.6%), and the group with cognitive frailty (19.4%). People with high levels of social relationships were more likely to be in the robust and the partial cognitive frailty groups. This study identified different subtypes of cognitive frailty among multimorbid older adults and highlighted the significance of social relationships. These findings could serve as a reference for conceptualizing cognitive frailty through the person-centered method. Promoting a high level of social relationships could be useful to prevent the cognitive frailty among older adults with multimorbidity.

Objective: This study aimed to examine the longitudinal association between social relationships and physical functioning among community-dwelling older adults with chronic conditions. Methods: Self-reported questionnaires were distributed and collected between 2014 and 2017 from participants aged 65 years and older. The Index of Social Interaction was used to evaluate social relationships, and the instrumental activities of daily living (IADL) subscale of the Tokyo Metropolitan Institute of Gerontology Index of Competence was used to examine functional status. Data from 422 participants (190 men and 232 women) were included in the final analysis. Results: High social relationships demonstrated significant adverse effects (OR = 0.77, 95% CI = 0.64 – 0.93) on the decline of IADL in the overall sample, particularly for women (OR = 0.71, 95% CI = 0.55 – 0.93) but not for men ( p = 0.131). Conclusion: The finding suggests that functional limitation was influenced by social relationships among the disabled older adults, and the influence of social relationships on functional limitation differed based on gender. Keywords: Interpersonal Relations; Functional Status; Gender; Aged; Chronic Disease; Longitudinal Studies; Health Behaviour.

Objectives: The study aimed to examine the long-term effects of parenting practice during preschool years on children’s movement performance in primary school. Methods: This study involved a three-year longitudinal study including 225 children aged 3–6 years old. Parents reported baseline parenting practice and evaluated children’s movement performance three years later. Latent class analysis was used to explore latent classes of movement performance. A post hoc test was used to identify the characteristics of different patterns. Finally, adjusted multinomial logistic regression models were used to test the influence of parenting practice on identified patterns of movement performance. Results: Children in this study were grouped into three movement performance pattens, labelled as ‘least difficulties’ (58.2%, n = 131), ‘low back pain’ (30.2%, n = 68), and ‘most difficulties’ (11.6%, n = 26). After controlling for age, gender, having siblings or not, family structure, BMI SDS, sleep condition and dietary habits, we found that if parents played games with children frequently, the children would have a 0.287 times lower probability of being in the ‘low back pain’ class, 95%CI [0.105, 0.783], and if parents take children to meet peers of a similar age frequently, the children would have a 0.339 times lower probability of being in ‘most difficulties’ class, 95%CI [0.139, 0.825]. Conclusions: Primary healthcare providers should pay careful attention to children with movement difficulties. The study provides longitudinal evidence to support the applicability of positive parenting practice in early childhood to prevent children’s movement difficulties. Keywords: Movement performance; Parenting practice; Latent class analysis; Child; Longitudinal study; Japan.

Strong relationship exists between loneliness and depression in older adults. However, the effect of multifaceted social relationships on the relationship between loneliness and depression has not been explored. The purpose of the current study was to find out how multifaceted social relationships affect the aforementioned processes. We investigated and evaluated the loneliness status, depression symptoms, social relationships, and demographic information of 1116 older adults aged ≥65 years living in rural Japan. The final 555 participants were included in the analysis. Statistical evidence showed a direct effect between loneliness and depression symptoms. Additionally, the mediation model found that social curiosity and participation acted as mediators between loneliness and depression symptoms. Further, independence and participation, independence, and feeling safe played a conditional moderating role in the model of loneliness–social curiosity–depression symptoms and loneliness–participation–depression symptoms, respectively. Interaction can be an individual moderator in the link between loneliness and depression symptoms without any mediator. The moderated mediation model suggests that social curiosity and participation could mediate the association between loneliness and depression symptoms. In this process, independence, participation, and feeling safe may act as moderators.

ABSTRACT Background Social relationships are associated with physical function. However, little scholarly attention has been focused on the effect of changing social factors on physical function. Purpose This study was designed to examine the effects on physical function of changes in social relationships in adults aged 65 years and older. Methods This study is part of a longitudinal, prospective cohort study that was conducted on community-dwelling older adults in a suburban area of central Japan. Baseline self-report data were collected in 2011, and a follow-up survey was conducted in 2017. Social relationships were assessed using the Index of Social Interaction, and physical function was evaluated using a subscale of the Kihon Checklist. Chi-square tests, Mann–Whitney U tests, and multiple logistic regression analysis were used to analyze data from 442 older adults who were functionally independent at baseline. Results After controlling for covariates in 2011, negative changes in social relationships (odds ratio [OR] = 3.20, 95% CI [1.18, 8.69]) were found to be associated with physical function decline. Moreover, 1-point increases in the different social-relationship values between baseline and follow-up were associated with protective effects against functional decline (OR = 0.71, 95% CI [0.63, 0.80]). Furthermore, median trends between baseline and follow-up revealed associations between decreasing (OR = 4.18, 95% CI [1.53, 11.39]) and continuously low (OR = 2.98, 95% CI [1.42, 6.28]) social relationships and physical function decline. Conclusions/Implications for Practice The findings support a strong association between negative changes in social relationships and physical function decline and highlight the importance of promoting social relationships to delay physical function decline in older adults.

The diversity of child social skills development is not well detected among Asian countries. Culturally validated assessments are needed for practitioners to evaluate child social skills. This study tested the measurement invariance of the Social Skill Scale (SSS) across Japanese and Chinese samples and explored country differences in child social skills development. The SSS utilizes a widely used factor structure (assertion, self-control, and cooperation subdomains) and has established Japanese and Chinese versions. We conducted investigations with an identical process and materials with different language versions, collecting data from 931 Japanese kindergarten children (Mage = 4.35, SDage = 1.07; 53.6% boys) and from 1130 Chinese kindergarten children (Mage = 4.47, SDage = 1.00; 52.3% boys). We used multiple confirmatory factor analysis to test measurement invariance of the SSS and established the validity, reliability, and scalar measurement invariance for the first-order factor structure of the SSS across the two country samples. We also examined country differences on the associations between demographics, parenting practice, and child social skills development. We found that, compared to the Chinese sample, cooperation skills significantly increased more with age among the Japanese sample. However, spanking was negatively related to self-control skills development in both countries. Our findings contribute to the demonstration of the diversity of child social skills development and have important implications for assessing and developing child social skills using culture-specific strategies.

<title>Abstract</title><sec> <title>Background</title> Social relationships may be the key to successful aging among older adults. However, little is known about the variability of social relationships among community-dwelling older people. This study aimed to describe the patterns of social relationships and examine the differences in sociodemographic characteristics and mental and physical health status among these patterns. </sec><sec> <title>Methods</title> We obtained the data from a questionnaire survey in 2017 for older adults aged 65 and above who lived in a suburban area in Japan. The Index of Social Interaction (ISI) was used to evaluate social relationships. The final sample comprised 964 people who were independently mobile and answered at least one item of the ISI. To clarify the patterns of social relationships, latent class analysis was performed with five subscales of ISI treated as indicator variables. Multinomial logistic regression was conducted to examine the factors associated with the patterns of social relationships. </sec><sec> <title>Results</title> The patterns of social relationships were classified into three classes: “Active” (73.6%), “Socially isolated” (14.7%), and “Less motivated” (11.7%). Persons who had depressive symptoms were more likely to be allocated to the “Socially isolated” (Odds Ratio [OR] 1.80, 95% Confidence Interval [CI] 1.13–2.86) or the “Less motivated” groups (OR 1.69, 95% CI 1.00–2.85) compared to the “Active” group. In addition, men (OR 1.72, 95% CI 1.07–2.76) and those living alone (OR 3.07, 95% CI 1.43–6.61) were more likely to be allocated to the “Socially isolated” group. Moreover, those who were dependent, according to the instrumental activities and daily living functions, were more likely to be assigned to the “Socially isolated” (OR 2.19, 95% CI 1.21–3.97) or “Less motivated” (OR 6.29, 95% CI 3.47–11.39) groups. </sec><sec> <title>Conclusion</title> This study revealed the patterns of social relationships in older adults and suggested that there may be variations of social relationships among community dwellers. The results also indicated the necessity of assessing individual patterns of social relationships and devising strategies for each pattern in public health practice. </sec>

Social skills acquired during early childhood are often the foundation for success later in life. Using a nationwide survey dataset in Japan, this study aims to explore the multiple growth trajectories of social skills among children in kindergarten by using a latent class growth modeling approach. It also examines whether, and to what extent, the home-rearing environment at early age predict trajectories of social skills development. Children in this study were assessed on social skills at three waves, four home-rearing environment dimensions (human stimulation, social stimulation, avoidance of punishment, and social support for parenting) and demographic background were measured at wave 1. The results indicated that three distinct growth trajectories of social skills existed during kindergarten: high increase levels, moderate increase levels, and decreased levels. The avoidance of punishment and children's gender significantly predicted the growth trajectories of social skills. Thus, the results suggest that more attention should be paid to the home-rearing environment and boys.

<p>目的：養育者の生活リズムの乱れが子どもの睡眠を不規則にし、子どもの成長発達に影響するとした報告が多数ある。一方、子どもの睡眠不規則と、養育者のストレスの関連が指摘されている。そこで本研究では、就学前児の睡眠リズムと就労する養育者のストレスとの関連を明らかにすることを目的とした。</p><p>方法：全国の認可保育所21箇所を利用する養育者に、2014年4月～2015年3月に質問紙調査を実施した。5〜6歳児をもつ養育者593人のうち404人から回答を得た。就労する養育者のストレスを目的変数、子どもの睡眠リズム、仕事負担感、育児の自信喪失感、子どもの性別、家族構成を説明変数としてカイ二乗検定を行った。家族構成は2つのモデルで検討した。さらに多重ロジスティック回帰分析により、各項目のオッズ比を算出した。</p><p>結果：調査項目に欠損のない就労する母親350人を分析対象とした。多重ロジスティック回帰分析の結果、モデル1では、就労する養育者のストレス高群は低群と比較して、育児の自信喪失感3.10倍、仕事負担感2.34倍、子どもの睡眠リズム1.97倍と、有意に高かった。モデル2では、育児の自信喪失感3.12倍、家族構成2.39倍、仕事負担感2.33倍子どもの睡眠リズム1.93倍と、有意に高かった。</p><p>結論：子どもの睡眠リズムと就労する養育者のストレスの関連を明らかにした。子どもの睡眠習慣の確立は、子どもの健やかな成長発達のみならず、養育者のストレスマネジメントの観点からも重要である可能性が示唆された。</p>

<p>目的 孤立化，無縁化と高齢者の社会との関わりの問題が社会問題とされる現在，実際の社会との関わりの変化を比較した研究や社会との関わりへの影響要因に関する研究は乏しい。本研究は地域在住高齢者の20年間の社会関連性の変化および，コミュニティリソースに焦点を当てて，その影響要因を明らかにすることを目的とする。</p><p>方法 対象は大都市近郊に存する農村である飛鳥村に居住する65歳以上高齢者である。分析は，1994年から2014年に行われた計8回の悉皆調査の質問紙調査においてそれぞれの調査年度ごとに社会関連性指標の領域点および総合得点を算出し，1994年時と2014年時の得点をWilcoxonの順位和検定を用いて比較した。また，社会関連性の変化の要因を明らかにするため，2014年の社会関連性を目的変数とした多重ロジスティック回帰分析を行い，2011年時のコミュニティリソースの利用経験（地域包括支援センターや保健センター，健康増進施設，図書館）の利用との3年後の関連を検討した。多重ロジスティック回帰モデルには調整因子として年齢・性別・疾患・移動能力を投入した。</p><p>結果 1994年と2014年の社会関連性指標得点を比較するとすべての年代で総合得点が有意に上昇し，男女別にみると女性の総合得点が漸増していた。領域別では，生活の主体性領域で，女性の65歳以上および75-84歳の得点が有意に上昇していた。社会への関心領域は男女ともに得点が有意に漸増しており，20年間で高齢者の社会への関心が高まっていた。社会関連性の要因分析では，健康増進施設の利用および地域包括センター，保健センターの利用が3年後の社会関連性総合得点と関連していた。</p><p>結論 本研究では，社会関連性指標に着目し，同一コミュニティの高齢者の20年間の社会との関わりの推移を総合的，領域的に明らかにした。地縁の希薄化など高齢者の社会との関わりの低下が注目されている昨今だが，本研究の結果より，高齢者の社会への関心や生活の主体化などの社会との関わりが20年で高くなっていることが示唆された。これらは地域包括支援センターや保健センターでの予防的介入や健康増進施設での介入など介護予防事業の効果が一因として考えられる。</p>