Does Lack of Social Supports Predict Functional Decline among the Old in Japan?: A 4 year Follow-up Study from the AGES Project

Background: Social support plays important roles in elderly health. However, if such effect of social support also holds for future functional status is less clear. Methods: To investigate if baseline social support predicts functional status among the old, we used a data from the AGES (Aichi Gerontological Evaluation Study). Subjects were functionally independent elderly at baseline (N=13,295) living in 6 communities. They were followed from 2003 to 2007 for the onset of functional impairment which requires nursing care (=functional decline). Social support at baseline was assessed by asking if they had someone who listened to their concerns (receiving support) and if they listened to someone's concerns (giving support). Also, we asked if they had someone who showed respect for them, since such kind of appraisal was important predictor of the health of the old. After adjustment for age and health status, lacking social support at baseline significantly predicted functional decline with odds ratios of 1.21and 1.30 for not receiving support and 1.36 and 1.22 for not giving support, for men and women, respectively. In addition, those lacked someone who showed respects for them were 1.57 times more likely to experience functional decline irrespective of their age, sex, and health status. Conclusions: Lack of social support predicted onset of functional dependence among the old in Japan. However, lacking someone who showed respects for them were even stronger predictor. To prevent functional decline among the old, psychological aspects of social supports also need to be considered.