Can Social Participation Reduce and Postpone the Need for Long-Term Care? Evidence from a 17-Wave Nationwide Survey in Japan

Social participation (SP) is often argued to have a favorable impact on health outcomes. This study examines whether and to what extent social participation can reduce and postpone the need for long-term care (LTC) among middle-aged and older adults in Japan. We used longitudinal data of 17,454 individuals born from 1946 to 1955, obtained from a 17-wave nationwide panel survey conducted from 2005 to 2021 in Japan. We examined (1) whether SP at baseline (2005) was associated with a lower risk of having LTC needs in the last wave (2021) using logistic regression models and (2) whether SP at baseline postponed the onset of these needs using Cox proportional hazards models, both controlling for baseline covariates. The results of different SP activities were compared. Participating in one or more SP activities in 2005 was associated with lower needs for LTC in 2021, with an odds ratio of 0.69 (95% confidence interval [CI], 0.49–0.96), and postponed their onset, with a hazard ratio of 0.71 (95% CI, 0.65–0.78). However, these favorable features of SP were observed only for leisure activities, and no satisfaction with SP activities had a limited association with LTC needs. The results suggest that SP can be associated with a lower risk of LTC needs and postpone their onset; however, these favorable features are limited to leisure activities, and satisfaction with SP activities is needed to enhance them.