ASSOCIATION BETWEEN CAR USE AND SOCIAL FRAILTY AMONG RURAL COMMUNITY-DWELLING OLDER PEOPLE WITH PHYSICAL DISABILITY

K. Uchida¹, R. Ono¹, E. Perrein¹, S. Murata², T. Endo³, K. Otani⁴

Background: Social frailty increases the risk of mortality and disability. To prevent social frailty, older people need to have a high level of social participation. However, some previous studies suggested that physical disability has a negative impact on social participation, because older people are limited in transferring to places of social activity. It is important that there are ways of locomotion to go to the place of social activity, and car is the main means of transportation in rural area. Therefore, having a means of transportation such as a car, may facilitate social participation and prevent social frail among rural community-dwelling older people with physical disability.

Purpose: The aim of study was to investigate the association between car use and social frailty among rural community-dwelling older people with physical disability.

Methods: In this cross-sectional study, data from health check-ups performed in 2019 were used. 643 older people were eligible for this study. Inclusion criteria were older people (age ≥ 65 years) with physical disability. Exclusion criteria was missing data on measurement variables (n = 104). Physical disability was assessed by 25-question Geriatric Locomotive Function Scale (The GLFS-25). The GLFS-25 was developed to identify Japanese individuals with high-risk conditions who may soon require care services because of locomotive organ problems. In this study, physical disability was defined as the GLFS-25 score ≥ 7. Car use was determined by using a question: “Do you drive at least once a week?”. Social frailty was assessed by using five questions (i.e., going out less frequently compared with the previous year, visiting friends sometimes, feeling helpful to friends or family, living alone, and talking with someone daily). The logistic regression model was used to assess the association between car use and social frailty with age, sex, score of the GLFS-25, and number of comorbidities were used as confounding factors.

Results: This study analyzed 543 community-dwelling older people (mean age: 75.8, women: 59.3%). Car use group was including 378 older people, and 153 older people were classified with social frailty. The proportion of older people with social frailty tended to be lower in the car use group (user group: 24.1%; nonuser group: 37.6%, p = 0.002). The results suggested that car use induced significantly lower odds of social frailty even after adjustment for confounding factors (OR = 0.53, p < 0.001).

Conclusion(s): Our study suggested that car use might have an important role to prevent social frailty among rural community-dwelling older people with physical disability.

Implications: This study was performed in rural area, where car is the main means of transportation. To prevent social frailty among community-dwelling older people living in rural area with physical disability, it is needed to enable older people to continue to drive safely.

Funding, acknowledgements: The study was supported by the Japanese Orthopedic Association.

Keywords: Older people, Social frailty, Car use

Topic: Health promotion & wellbeing/healthy ageing/physical activity

Did this work require ethics approval? Yes

Institution: Fukushima Medical University School of Medicine

Committee: Research Ethics Committee of Fukushima Medical University School of Medicine

Ethics number: 2907