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Open Access 01-12-2019 | Dementia | Research article

Does community social capital buffer the relationship between educational disadvantage and cognitive impairment? A multilevel analysis in Japan

Authors: Hiroshi Murayama, Fumiko Miyamae, Chiaki Ura, Naoko Sakuma, Mika Sugiyama, Hiroki Inagaki, Tsuyoshi Okamura, Shuichi Awata

Published in: BMC Public Health | Issue 1/2019

Abstract

Background

This study explored the relationship between community social capital and cognitive impairment, with a focus on the buffering role of community social capital in the association between educational disadvantage and cognitive impairment in community-dwelling older adults in Japan.

Methods

We used data from two population-based, cross-sectional surveys targeting people aged ≥65 years in a suburban city of the Tokyo metropolitan area (n = 897; 49.8% men; average age = 74.4 years). Social capital included social support (emotional and instrumental support) and the strength of social networks (neighborly ties). To create district-level social capital indicators, we aggregated individual responses on social capital within each district. The Mini-Mental State Examination, Japanese version was used for the assessment of cognitive function.

Results

Using multilevel logistic regression analysis, we found that lower amounts of district-level emotional and instrumental support were associated with a greater likelihood of cognitive impairment among men. For women, district-level emotional support was associated with a greater likelihood of cognitive impairment. Additionally, a strong district-level social network buffered the relationship between low education and cognitive impairment in both sexes.

Conclusions

Community social capital appears to have a protective role in determining cognitive function in old age. Our findings may facilitate the development of new community-based strategies to combat dementia.

Plassman BL, Williams JW Jr, Burke JR, Holsinger T, Benjamin S. Systematic review: factors associated with risk for and possible prevention of cognitive decline in later life. Ann Intern Med. 2010;153:182–93. https://doi.org/10.7326/0003-4819-153-3-201008030-00258.CrossRefPubMed

Xu W, Tan L, Wang HF, Jiang T, Tan MS, Tan L, et al. Meta-analysis of modifiable risk factors for Alzheimer's disease. J Neurol Neurosurg Psychiatry. 2015;86:1299–306. https://doi.org/10.1136/jnnp-2015-310548.CrossRefPubMed

Besser LM, McDonald NC, Song Y, Kukull WA, Rodriguez DA. Neighborhood environment and cognition in older adults: a systematic review. Am J Prev Med. 2017;53:241–51. https://doi.org/10.1016/j.amepre.2017.02.013.CrossRefPubMedPubMedCentral

Besser LM, Rodriguez DA, McDonald N, Kukull WA, Fitzpatrick AL, Rapp SR, et al. 2018. Neighborhood built environment and cognition in non-demented older adults: the multi-ethnic study of atherosclerosis. Soc Sci Med. 2018;200:27–35. https://doi.org/10.1016/j.socscimed.2018.01.007.CrossRefPubMedPubMedCentral

Clarke PJ. Weuve J, Barnes L, Evans DA, Mendes de Leon CF. cognitive decline and the neighborhood environment. Ann Epidemiol. 2015;25:849–54. https://doi.org/10.1016/j.annepidem.2015.07.001.CrossRefPubMedPubMedCentral

Kawachi I, Berkman LF. Social cohesion, social capital, and health. In: Berkman LF, Kawachi I, Glymour MM, editors. Social Epidemiology. 2nd ed. New York: Oxford University Press; 2014. p. 174–90.

Kuiper JS, Zuidersma M, Zuidema SU, Burgerhof JG, Stolk RP, Oude Voshaar RC, et al. Social relationships and cognitive decline: a systematic review and meta-analysis of longitudinal cohort studies. Int J Epidemiol. 2016;45:1169–206. https://doi.org/10.1093/ije/dyw089.CrossRefPubMed

Kuiper JS, Zuidersma M, Oude Voshaar RC, Zuidema SU, van den Heuvel ER, Stolk RP, et al. Social relationships and risk of dementia: a systematic review and meta-analysis of longitudinal cohort studies. Ageing Res Rev. 2015;22:39–57. https://doi.org/10.1016/j.arr.2015.04.006.CrossRefPubMed

Hikichi H, Aida J, Matsuyama Y, Tsuboya T, Kondo K, Kawachi I. Community-level social capital and cognitive decline after a natural disaster: A natural experiment from the 2011 great East Japan earthquake and tsunami. Soc Sci Med in press. https://doi.org/10.1016/j.socscimed.2018.09.057.

10.

Murayama H, Sugiyama M, Inagaki H, Okamura T, Miyamae F, Ura C, et al. Is community social capital associated with subjective symptoms of dementia among older people? A cross-sectional study in Japan. Geriatr Gerontol Int. 2018;18:1537–42. https://doi.org/10.1111/ggi.13519.CrossRefPubMed

11.

Hanibuchi T, Kondo K, Nakaya T, Shirai K, Hirai H, Kawachi I. Does walkable mean sociable? Neighborhood determinants of social capital among older adults in Japan. Health Place. 2012;18:229–39. https://doi.org/10.1016/j.healthplace.2011.09.015.CrossRefPubMed

12.

Tamiya N, Noguchi H, Nishi A, Reich MR, Ikegami N, Hashimoto H, et al. Population ageing and wellbeing: lessons from Japan's long-term care insurance policy. Lancet. 2011;378:1183–92. https://doi.org/10.1016/S0140-6736(11)61176-8.CrossRefPubMed

13.

Miyamae F, Ura C, Sakuma N, Niikawa H, Inagaki H, Ijuin M, et al. The development of a self-administered dementia checklist: the examination of concurrent validity and discriminant validity. Jpn J Geriatr. 2016;53:354–62. https://doi.org/10.3143/geriatrics.53.354.CrossRef

14.

Ura C, Miyamae F, Sakuma N, Niikawa H, Inagaki H, Ijuin M, et al. Development of a self-administered dementia checklist: examination of factorial validity and internal reliability. Jpn J Geriatr. 2015;52:243–53. https://doi.org/10.3143/geriatrics.52.243.CrossRef

15.

Diez Roux AV, Mair C. Neighborhoods and health. Ann N Y Acad Sci. 2010;1186:125–45. https://doi.org/10.1111/j.1749-6632.2009.05333.x.CrossRefPubMed

16.

Fone D, Dunstan F, Lloyd K, Williams G, Watkins J, Palmer S. Does social cohesion modify the association between area income deprivation and mental health? A multilevel analysis. Int J Epidemiol. 2007;36:338–45. https://doi.org/10.1093/ije/dym004.CrossRefPubMed

17.

Takagi D, Kondo K, Kondo N, Cable N, Ikeda K, Kawachi I. Social disorganization/social fragmentation and risk of depression among older people in Japan: multilevel investigation of indices of social distance. Soc Sci Med. 2013;83:81–9. https://doi.org/10.1016/j.socscimed.2013.01.001.CrossRefPubMed

18.

Wilson RS, Hebert LE, Scherr PA, Barnes LL, Mendes de Leon CF, Evans DA. Educational attainment and cognitive decline in old age. Neurology. 2009;72:460–5. https://doi.org/10.1212/01.wnl.0000341782.71418.6c.CrossRefPubMedPubMedCentral

19.

Xu W, Tan L, Wang HF, Tan MS, Tan L, Li JQ, et al. Education and risk of dementia: dose-response meta-analysis of prospective cohort studies. Mol Neurobiol. 2016;53:3113–23. https://doi.org/10.1007/s12035-015-9211-5.CrossRefPubMed

20.

Livingston G, Sommerlad A, Orgeta V, Costafreda SG, Huntley J, Ames D, et al. Dementia prevention, intervention, and care. Lancet. 2017;390:2673–734. https://doi.org/10.1016/S0140-6736(17)31363-6.CrossRef

21.

Machida City. Machida City. https://www.city.machida.tokyo.jp/. Accessed 1 Jul 2019.

22.

Sugishita M, Hemmi I, Takeuchi T. Reexamination of the validity and reliability of the Japanese version of the mini-mental state examination (MMSE-J). JapanJ Cogn Neurosci. 2016;18:168–83. https://doi.org/10.11253/ninchishinkeikagaku.18.168.CrossRef

23.

Sakuma N, Ura C, Miyamae F, Inagaki H, Ito K, Niikawa H, et al. Distribution of mini-mental state examination scores among urban community-dwelling older adults in Japan. Int J Geriatr Psychiatry. 2017;32:718–25. https://doi.org/10.1002/gps.4513.CrossRefPubMed

24.

Murayama H, Fujiwara Y, Kawachi I. Social capital and health: a review of prospective multilevel studies. J Epidemiol. 2012;22:179–87. https://doi.org/10.2188/jea.JE20110128.CrossRefPubMedPubMedCentral

25.

Oakes JM. The (mis)estimation of neighborhood effects: causal inference for a practicable social epidemiology. Soc Sci Med. 2004;58:1929–52. https://doi.org/10.1016/j.socscimed.2003.08.004.CrossRefPubMed

26.

Murayama H, Nofuji Y, Matsuo E, Nishi M, Taniguchi Y, Fujiwara Y, et al. Are neighborhood bonding and bridging social capital protective against depressive mood in old age? A multilevel analysis in Japan. Soc Sci Med. 2015;124:171–9. https://doi.org/10.1016/j.socscimed.2014.11.042.CrossRefPubMed

27.

John A, Patel U, Rusted J, Richards M, Gaysina D. Affective problems and decline in cognitive state in older adults: a systematic review and meta-analysis. Psychol Med. 2019;49:353–65. https://doi.org/10.1017/S0033291718001137.CrossRefPubMed

28.

Altschuler A, Somkin CP, Adler NE. Local services and amenities, neighborhood social capital, and health. Soc Sci Med. 2004;59:1219–29. https://doi.org/10.1016/j.socscimed.2004.01.008.CrossRefPubMed

29.

Bourassa KJ, Memel M, Woolverton C, Sbarra DA. Social participation predicts cognitive functioning in aging adults over time: comparisons with physical health, depression, and physical activity. Aging Ment Health. 2017;21:133–46. https://doi.org/10.1080/13607863.2015.1081152.CrossRefPubMed

30.

Pynoos J, Hade-Kaplan B, Fleisher D. Intergenerational neighborhood networks: a basis for aiding the frail elderly. Gerontologist. 1984;24:233–7.CrossRef

31.

Ministry of Health, Labour and Welfare. Annual Health, Labour and Welfare Report 2016. Tokyo: Gyosei; 2016.

32.

Hiscock R, Bauld L, Amos A, Fidler JA, Munafò M. Socioeconomic status and smoking: a review. Ann N Y Acad Sci. 2012;1248:107–23. https://doi.org/10.1111/j.1749-6632.2011.06202.x.CrossRefPubMed

33.

Devaux M. Social disparities in alcohol drinking. In: Sassi F, editor. Tackling harmful alcohol use: economics and public health policy. Paris: OECD Publishing; 2015. p. 61–80.

34.

O'Donoghue G, Kennedy A, Puggina A, Aleksovska K, Buck C, Burns C, et al. Socio-economic determinants of physical activity across the life course: A "DEterminants of DIet and Physical ACtivity" (DEDIPAC) umbrella literature review. PLoS One. 2018;13:e0190737. https://doi.org/10.1371/journal.pone.0190737.CrossRefPubMedPubMedCentral

35.

Lee Y, Back JH, Kim J, Kim SH, Na DL, Cheong HK, et al. Systematic review of health behavioral risks and cognitive health in older adults. Int Psychogeriatr. 2010;22:174–87. https://doi.org/10.1017/S1041610209991189.CrossRefPubMed

36.

Rogers EM. Diffusion of Innovations. 3rd ed. New York: The Free Press; 1983.

37.

Bandura A. Social leaning theory. New York: General Learning Press; 1971.

Title: Does community social capital buffer the relationship between educational disadvantage and cognitive impairment? A multilevel analysis in Japan
Authors: Hiroshi Murayama
Fumiko Miyamae
Chiaki Ura
Naoko Sakuma
Mika Sugiyama
Hiroki Inagaki
Tsuyoshi Okamura
Shuichi Awata
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Dementia
Dementia
Published in: BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-019-7803-0

At a glance: The STEP trials

Springer Medicine

Does community social capital buffer the relationship between educational disadvantage and cognitive impairment? A multilevel analysis in Japan

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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