The Relationship Between Frailty and Ikigai Among Community-Dwelling Older Adults in Mongolia

This study aims to clarify the relationship between frailty status and Ikigai among community-dwelling older adults in Mongolia and to provide insights for future preventive care strategies in the country.

A cross-sectional survey was conducted using a questionnaire among individuals aged 65 and older living in Ulaanbaatar, the capital of Mongolia, and Mandalgobi, a provincial city. Frailty status was assessed using the Kihon Checklist, a comprehensive evaluation of daily functioning. Based on their scores, participants were categorized into three groups: frail (8 points or higher), pre-frail (4–7 points), and robust (0–3 points). The Ikigai-9 scale was used to evaluate the sense of Ikigai. To examine the relationship between frailty status and Ikigai, comparisons were made between the three groups for total Ikigai-9 scores and subscale scores (I-III). Statistical analysis was conducted using the Kruskal-Wallis test for group comparisons, followed by Bonferroni correction for multiple comparisons. A significance level of 5% was set for all statistical analyses.

The study included 69 participants, with an average age of 72.2 ± 5.8 years, of whom 52 were female (75.4%). The frailty status distribution was as follows: frail group (n=32, 46.4%), pre-frail group (n=27, 39.1%), and robust group (n=10, 14.5%). Group comparisons showed significant differences in the total Ikigai-9 score (p=0.006), subscale II (p=0.016), and subscale III (p=0.009), though subscale I did not reach significance (p=0.109). Post-hoc analysis with Bonferroni correction revealed that the frail group had significantly lower scores than the robust group for the total Ikigai score and subscales II and III.

The results indicate that older adults in the frail group had significantly lower total Ikigai scores and lower scores in "II. Proactive and positive attitude toward the future" and "III. Positive recognition of the meaning of one's existence within social relationships" compared to the robust group. No significant differences were found between the groups for subscale I, "Optimistic and positive attitude toward one's current life and existence." As this is a cross-sectional study, the causal relationship between frailty and ikigai is unclear. However, frailty may worsen by forming a vicious cycle, one cause of which is decreased activity (Fried L.P. et al., 2001). Living a life that maintains ikigai may help prevent the frailty cycle.

Currently, there are no established public care services for older adults in Mongolia. This study suggests the need for a preventive care approach that recognizes the importance of older adults having a role and ikigai within social relationships, while also encouraging proactive activities.