The Impact of Generativity on Maintaining Higher-Level Functional Capacity of Older Adults: A Longitudinal Study in Japan.

Generativity is defined as an individual's concern for and actions dedicated toward the well-being of others, especially youth and subsequent generations. It is a key stage of psychological development from midlife to older age and can be a guiding concept for promoting engagement of older adults in productive and contributive activities, which benefit their well-being. This study examined the longitudinal association between generativity and higher-level functional capacity (HLFC) decline in older Japanese adults. The two-year longitudinal data of 879 older adults aged 65-84 years were analyzed. Participants' HLFC and generativity were assessed using the Tokyo Metropolitan Institute of Gerontology Index of Competence and the Revised Japanese version of the Generativity Scale, respectively. The binary logistic regression analysis results showed that a higher generativity score was negatively associated with HLFC decline, indicating that generativity effectively prevents HLFC decline over 2 years. On adding the interaction term between generativity and sex to examine whether the protective effect of generativity differed by sex, we found that generativity was especially effective in protecting the HLFC decline in men with higher generativity. The study results highlight the importance of promoting engagement of older adults in generative activities to maintain their HLFC.

Effects of intergenerational contact on social capital in community-dwelling adults aged 25-84 years: a non-randomized community-based intervention.

BACKGROUND: Accumulating social capital in urban areas is essential to improve community health. Previous studies suggested that intergenerational contact may be effective for enhancing social capital. However, no study has examined the effect of intergenerational contact on social capital through a population-based evaluation. This study aimed to investigate the effects of a community-based intervention to increase the frequency of intergenerational contact on social capital among adults aged 25-84 years. METHODS: This study used a non-randomized controlled trial design to conduct a community-based intervention (from March 2016 to March 2019). The study area was Tama ward, Kawasaki city, Kanagawa, Japan. The area comprises five districts; one district was assigned as the intervention group and the other four districts as the control group. We provided the intervention to residents in the intervention group. The intervention comprised three phases: Phase 1 was the preparation term (organizing the project committee); Phase 2 was the implementation term (trained volunteer staff members, conducted the intergenerational greeting campaign, and held intergenerational contact events); and Phase 3 was the transition term (surrendering the lead role of the project to the city hall field workers). In the control group, field workers provided public health services as usual. We conducted mail surveys in September 2016 and November 2018 to assess the effects of the intervention on social capital during Phase 2. Eligible participants were randomly selected from community-dwelling adults aged 25-84 years according to age (10,620 control group individuals and 4479 intervention group individuals). We evaluated social trust, norm of reciprocity, and social support as outcome variables. RESULTS: In total, 2518 participants completed both surveys and were analyzed (control group: 1727; intervention group: 791). We found that social trust (coefficient = 0.065; 95% confidence interval [CI]: 0.006, 0.125) and norm of reciprocity (coefficient = 0.084; 95% CI: 0.020, 0.149) positively changed in the intervention group compared with the control group. CONCLUSIONS: This community-based intervention may contribute to sustaining and improving social capital among community-dwelling adults. TRIAL REGISTRATION: UMIN000046769 (UMIN-CTR); first registered on January 28, 2022 (retrospectively registered).

[Actual work situation of second-layer Seikatsu-shien coordinators before and after the first emergency declaration during the COVID-19 pandemic].

Objective　This study aims to understand the status of the resident support activities of second-layer Seikatsu-shien coordinators, who assist in local residents' community development activities, based on long-term care. It observes the effects of these activities, and the presence or absence of relevant instructions from the government or affiliated institutions during and after a state of emergency, such as a lockdown situation. This was examined during the first state of emergency following the COVID-19 crisis, from April to May 2020.Method　In October 2020, a self-administered questionnaire was distributed by mail to 279 second-layer Seikatsu-shien coordinators working in Tokyo's special wards, and 181 responses were collected. The survey focused on the coordinators' activities and activity frequency before the spread of COVID-19, during the state of emergency, and after the activities resumed. Furthermore, the survey questioned whether relevant instructions from the government or affiliated institutions were given during the state of emergency and after the activities resumed. Their details were confirmed in the free comments section.Activity　In creating and revising regional diagnosis tables for the area covered, creating and distributing information magazines and leaflets, etc. included in "understanding social resources and providing information to relevant parties," activity frequency was significantly higher after activities resumed, than before the spread of infection. During the state of emergency, activity frequency was high in the affiliated institution, and only 3.4% of the coordinators visited and spoke to local residents; 91.1% of respondents received instructions from government and affiliated institutions during the state of emergency, and activity frequency was significantly higher when there were instructions; 76.5% received instructions after resuming activities, and activity frequency, such as understanding residents' needs through individual interviews and visits, matching them with services, and supporting the resumption of activity groups was significantly higher when instructions were provided.Conclusion　 After resuming activities, understanding the value of social resources and providing information to the relevant parties was prioritized. During the state of emergency, almost no visits or calls were made to local residents. The frequency of activities to reach out to residents was higher in the presence of instructions, especially after activities resumed. It was suggested that with the rapid spread of a new infectious disease, confusion will likely occur in the field, and having specific instructions will affect the Seikatsu-shien coordinators' activities.

Influence of "Face-to-Face Contact" and "Non-Face-to-Face Contact" on the Subsequent Decline in Self-Rated Health and Mental Health Status of Young, Middle-Aged, and Older Japanese Adults: A Two-Year Prospective Study.

This study aims to identify the independent influence of face-to-face contact (FFC) and non-face-to-face contact (NFFC) on the subsequent decline in self-rated health and mental health status by age. A total of 12,000 participants were randomly selected among residents in the study area, and 1751 of them responded to both the 2016 and 2018 mail surveys. The participants were subsequently classified into three age groups (25-49: Young adults; 50-64: Mid-aged adults; and 65-84: Older adults). Social contact was assessed by computing the frequencies of FFC and NFFC. Multiple logistic regression analysis showed the risk of social contact on the decline in self-rated health and World Health Organization-Five Well-Being Index. Both FFC and NFFC were significantly associated with maintaining mental health; however, the impacts of FFC on mental health were more significant than that of NFFC among older adults and young adults. Compared with the no contact group, FFC was significantly associated with maintaining self-rated health in mid-aged adults. The influence of FFC and NFFC on health differed by age group.

Association between the frequency of daily intellectual activities and cognitive domains: A cross-sectional study in older adults with complaints of forgetfulness.

OBJECTIVES: Frequent engagement in intellectual activities has been shown to reduce the risk of developing dementia. The present study sought to examine the association between the frequency of daily intellectual activities and cognitive domains in older adults with complaints of forgetfulness. METHODS: A cross-sectional study was conducted as a part of regional health examination in Tokyo from 2014 to 2016. A total of 436 participants were asked the frequency of intellectual activities in four categories: 1) reading, 2) writing, 3) using technology, and 4) watching TV and listening to the radio. The Japanese version of the Montreal Cognitive Assessment (MoCA-J) scale was used for the cognitive assessments. The relationships between MoCA-J scores and each intellectual activity were explored. RESULTS: Binominal logistic regression analysis revealed that the frequencies of reading, writing, and using technology were significantly related to the language and attention, language, and memory domains, respectively, even after adjusting for demographic characteristics. CONCLUSIONS: The results suggested that the frequency of daily intellectual activities differed depending on the activity type, and each activity was related to a specific cognitive domain.

[School students' greeting behavior and its association with their community attachment and helping behavior].

Objectives　Many local governments and elementary and junior high schools in Japan have conducted a "greeting campaign". This has been done in order to activate communication among local residents, and to instill public spirit and sociability in students' minds. However, few studies have explored the significance of greeting campaigns. The present study investigates greeting in neighborhoods and its relationship with students' spontaneous greeting behavior. The study also seeks to understand the quantity of greeting in daily life and its association with a student's community attachment and helping behavior.Methods　A self-completion questionnaire survey was conducted with 1,346 students studying in the fourth and higher grades at elementary schools, and 1,357 students in the first and second grade at junior high schools. There were 2,692 valid respondents. We performed the following analyses using the data of elementary school students and junior high school students separately. A partial correlation analysis was conducted wherein gender and grade were introduced as control variables. This analysis tested the correlation between the frequency of being greeted by surrounding people and the frequency of greeting by students, of their own accord. A path analysis that tested the relationship between students' greeting behavior, their attachment to residential areas, and helping behavior was also conducted.Results　The results of the partial correlation analysis revealed that there was a positive correlation between the frequency of being greeted by surrounding people and the frequency of greeting by students, of their own accord, regardless of gender and grade. Moreover, the results of the path analysis revealed that the frequency of being greeted was positively associated with community attachment and that the frequency of students' spontaneous greeting behavior was positively associated not only with community attachment but also with helping behavior. The goodness of model fit was high for both the data of elementary school students as well as the data of junior high school students.Conclusion　We found that exchanging greetings with surrounding people in daily life enhanced students' attachment to the community. In particular, we showed that students' spontaneous greeting behavior led to their helping behavior, which supports the significance of recommending greeting at home, school, or in the local community. Since there was a correlation between the frequency of being greeted and the frequency of greeting willingly, we consider that actions of surrounding adults become important to help students acquire spontaneous greeting behavior.

[The relationship between intra- and inter-generational exchange and mental health among young and older adults].

Objective　The purpose of this study was to examine the relationship between intra- and inter-generational exchange and mental health among young adults aged 25-49 years and older adults aged 65-84 years.Methods　In 2016, a community-based, cross-sectional survey was conducted. A total of 3,334 young adults (valid response rate: 24.6%), and 3,116 older adults (valid response rate: 46.0%) completed the survey and were included in the analysis. Their mental health was evaluated using the World Health Organization-Five Well-Being Index (WHO-5), and those who scored under 13 or scored less than one on any item were considered to have poor mental health. To evaluate the intra- or inter-generational exchange, participants were asked about their frequency of interaction with people aged 20-49 years or aged ≥70, excluding family and co-workers. Young adults who interacted with people aged 20-49 years or older adults who interacted with people ≥70 were classified as "having intra-generational exchange," while young adults who interacted with people ≥70 years or older adults who interacted with people aged 20-49 years were classified as "having intergenerational exchange." Therefore, individuals who interacted with both generations were classified as "having multi-generational exchange," and those who did not interact with any generation were categorized as "no exchange." We conducted a logistic regression analysis that included mental health as a dependent variable, intra- and inter-generational exchange as independent variables, and gender, age, educational attainment, marital status, living situation, subjective economic status, social participation, employment, self-rated health, and Instrumental Activity of Daily Living as covariates.Results　Of the 3,334 young adults, 61.5% were mentally healthy, 51.3% had intra-generational exchange, 21.9% had inter-generational exchange, 16.5% had multi-generational exchange, and 42.7% did not have any exchange. Of the 3,116 older adults, 65.8% were mentally healthy, 67.9% had intra-generational exchange, 34.3% had inter-generational exchange, 29.9% had multi-generational exchange, and 21.1% did not have any exchange. A logistic regression analysis revealed that "having intra-generational exchange" and "having intergenerational exchange" were significantly related to better mental health in both young adults (intra-generational; Odds ratios (OR) 1.19, 95% confidence intervals (CI) 1.10-1.30: inter-generational; OR 1.13, 95% CI 1.03-1.25) and older adults (intra-generational; OR 1.15, 95% CI 1.02-1.29: inter-generational; OR 1.46, 95% CI 1.30-1.65). Therefore, "having multi-generational exchange" was more strongly related to better mental health compared with "only having intra-generational exchange."Conclusion　Among young and older adults, intra- and inter-generational exchange were related to better mental health, and multi-generational exchange showed the strongest relationship with better mental health.

[Community Child-Rearing Support Scale: Applicability across generations and differences in the supportive behaviors among generations].

Objectives　Using the Community Child-Rearing Support Scale (CCRSS), which was developed for older adults, we examined 1) the reliability and validity of the scale for multiple generations, as well as the generational differences in the 2) degree and content of supportive behaviors for child rearing and 3) correlates of the behavior, in conjunction with gender differences.Methods　A mail survey was conducted with residents aged 25-84 years who were randomly selected from two cities in Tokyo and the surrounding areas, and responses were obtained from 8918 residents (response rate: 33%). The respondents were grouped as follows: old-aged (65-84 years), middle-aged (50-64 years), and young-aged (25-49 years). We performed the following analyses by age group and gender: 1) Cronbach's reliability coefficient and a confirmatory factor analysis of the CCRSS, 2) analysis of variance of the total CCRSS scores and scores of the three subscales ("children's security and sound growth," "instrumental support to parents," and "emotional support to parents"), and 3) a multiple regression analysis of the total scores in which various individual characteristics were introduced as explanatory variables.Results　The reliability coefficient was over 0.85 for each age group, and the factor analysis showed good model fitness. Compared to the middle- and young-aged groups, the old-aged group was more likely to provide support for "children's security and sound growth," and equally (for women) or more likely (for men) to provide "emotional support to parents," thereby resulting in the highest total score among the three generations. The mean score of "instrumental support to parents," such as taking care of a child, was the highest for young women, although the score was low overall. Having a child or grandchild under 13 years old and stronger generativity were positively associated with child-rearing support for all age groups; however, the degree of associations varied across the groups. While having a child was strongly associated with support among the young-aged group, the association between support and generativity was stronger for older groups. Moreover, participation in neighborhood associations or volunteer groups and high school or lower education were associated with more support among all age groups, whereas living in rental apartments was associated with less support among the young-aged group.Conclusion　Our findings suggest that the CCRSS can be used for multiple generations and that old people play an important role in child rearing in the community. We found both differences and similarities between generations with respect to the correlates of child-rearing support.

[Characteristics of elderly people registering with emergency contacts systems Case study of "elderly monitoring key ring"].

OBJECTIVES: Here we investigated the characteristics of users of an emergency system that tracks elderly people, known as the "elderly monitoring key ring." The relevance of a spreading policy or strategy and the user characteristics were investigated to develop programs conducted by local governments to manage unidentified elderly people with dementia. METHODS: A questionnaire was conducted in July 2013 in a district of the Ota Ward in Tokyo. The questionnaire was administered to residents >65 years of age (N=7,608), of which 5,166 (67.9%) responded. Fully completed responses (N=4,475) were analyzed with binomial logistic regression analysis using "monitoring key rings" as the dependent variable and simultaneously inputted sex, age, living arrangement, social isolation, Instrumental Activities of Daily Living (IADL), and complaints of memory loss as independent variables. Interviews were also conducted in August 2014 of the staff members (N=12) of six community comprehensive support centers in the Ota Ward. RESULTS: The logistic regression analysis results indicated that women used the monitoring key rings 1.64 times more often than men, late elderly used it 4.39 times more often than early elderly, elderly living alone used it 2.14 times more often than elderly not living alone, non-isolated people used it 1.36 times more often than isolated people, IADL non-independent people used it 1.50 times more often than independent people, and people with complaints of memory loss used it 1.37 times more often than those without such complaints. On the other hand, the results of interviews indicated that elderly people living alone, those with worries, and relatively young and healthy elderly people were targets. The main targets of community comprehensive support centers were elderly individuals living alone and early elderly individuals. The utilization rate of elderly people living alone was high; however, that of early elderly people was low. They recognized that people registered with the system tended to have high anxiety, be relatively young and highly independent, and register after learning about the system from their peers or through neighborhood associations. CONCLUSION: Individuals who were female, late elderly, elderly living alone, non-isolated, IADL non-independent, or had complaints of memory loss were most likely to be registered with the key ring. The circumstance of registration which community comprehensive support centers recognize related to the low utilization rate of elderly people who are isolated. In the future, the system should be introduced to socially isolated as well as relatively young elderly people.