Association of social participation with progression and reversion of intrinsic capacity in older adults: based on multistate model

OBJECTIVES: This study aimed to investigate the link of social participation with progression and reversion of intrinsic capacity (IC). DESIGN: A prospective cohort study. SETTING AND PARTICIPANTS: 2955 adults aged 60 years and older in China Health and Retirement Longitudinal Study were included in this study. MEASUREMENTS: IC was measured by locomotion, vitality, cognition, psychological capacity, and sensory (vision and hearing), and was further divided into intact IC and impaired IC. Social participation was measured by the frequencies of six types of social activities and classified as low, moderate, and high levels by tertiles. Multistate Markov model was employed to investigate the associations of social participation with transitions of intact IC, impaired IC, and death. RESULTS: Those with moderate or high social participation had higher likelihoods of residing in intact IC and reversion from impaired IC to intact IC, while had lower probabilities of progression from intact IC to impaired IC and from impaired IC to death than those with low social participation over three-year period. Moderate social participation (HR: 0.62, 95% CI: 0.39, 0.98) and high social participation (HR: 0.61, 95% CI: 0.39, 0.96) were related to reduced probabilities for progression from impaired IC to death. High social participation was also related to a 22% reduction of probability for progression from intact IC to impaired IC (HR: 0.78, 95% CI: 0.62, 0.98). Those with moderate or high social participation had longer total life expectancy and life expectancy of intact IC than those with low social participation. CONCLUSION: Social participation could slow down the IC declines, mitigate mortality, and prolong life expectancy. The findings provide evidence to call for all sectors to embed social participation into healthcare and pension systems to promote healthy, active, and successful ageing, and ultimately support the achievement of universal health coverage.