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

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Title: Association of social participation with progression and reversion of intrinsic capacity in older adults: based on multistate model.
Authors: Xie G; Institute of Population Research, Peking University, Beijing 100871, P.R. China., Focacci CN; Oxford Institute of Population Ageing, University of Oxford, Oxford OX2 6PR, United Kingdom., Li J; Institute of Population Research, Peking University, Beijing 100871, P.R. China., Wang R; Vanke School of Public Health, Tsinghua University, Beijing 100084, P.R. China., Chen G; Institute of Population Research, Peking University, Beijing 100871, P.R. China. Electronic address: chengong@pku.edu.cn.
Source: The journal of nutrition, health & aging [J Nutr Health Aging] 2025 Dec; Vol. 29 (12), pp. 100719. Date of Electronic Publication: 2025 Nov 09.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: Elsevier Masson SAS on behalf of SERDI Publisher Country of Publication: France NLM ID: 100893366 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1760-4788 (Electronic) Linking ISSN: 12797707 NLM ISO Abbreviation: J Nutr Health Aging Subsets: MEDLINE
Imprint Name(s): Publication: 2024- : [Paris, France] : Elsevier Masson SAS on behalf of SERDI Publisher
Original Publication: Paris, France : New York, NY : Serdi Publisher ; Springer Pub. Co.,
MeSH Terms: Social Participation* , Aging*/psychology, Humans ; Aged ; Male ; Female ; Longitudinal Studies ; Middle Aged ; Prospective Studies ; China ; Markov Chains ; Geriatric Assessment ; Aged, 80 and over ; Disease Progression ; Cognition
Abstract: Competing Interests: Declaration of competing interest The authors declare that they have no competing interests.
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.
(Copyright © 2025 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)
Contributed Indexing: Keywords: Intrinsic capacity; Life expectancy; Multistate model; Social participation
Entry Date(s): Date Created: 20251108 Date Completed: 20251129 Latest Revision: 20251129
Update Code: 20251130
PubMed Central ID: PMC12639603
DOI: 10.1016/j.jnha.2025.100719
PMID: 41205419
Database: MEDLINE
Description
Abstract:Competing Interests: Declaration of competing interest The authors declare that they have no competing interests.<br />Objectives: This study aimed to investigate the link of social participation with progression and reversion of intrinsic capacity (IC).<br />Design: A prospective cohort study.<br />Setting and Participants: 2955 adults aged 60 years and older in China Health and Retirement Longitudinal Study were included in this study.<br />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.<br />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.<br />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.<br /> (Copyright © 2025 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)
ISSN:1760-4788
DOI:10.1016/j.jnha.2025.100719