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Public health
Research
Social participation and risk of influenza infection in older adults: a cross-sectional study
  1. Yugo Shobugawa1,
  2. Takeo Fujiwara2,
  3. Atsushi Tashiro3,
  4. Reiko Saito1,
  5. Katsunori Kondo4,5
  1. 1 Division of International Health, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
  2. 2 Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
  3. 3 Niigata City Public Health Center, Niigata, Japan
  4. 4 Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
  5. 5 Department of Gerontology and Evaluation Study, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
  1. Correspondence to Dr Yugo Shobugawa; yugo{at}med.niigata-u.ac.jp

Abstract

Objectives Influenza infection can cause severe pneumonia, which is sometimes fatal, particularly in older adults. Influenza results in 3–5 million cases of severe illness and about 250 000 to 500 000 deaths annually worldwide. Social participation in the context of influenza infection is controversial because, although social participation is beneficial in maintaining physical function and mental health, it also increases the risk of contact with infected people. This study examined the association between social participation and influenza infection in Japanese adults aged 65 years or older.

Design Cross-sectional study.

Setting Japanese functionally independent adults aged 65 years or older.

Participants Among the respondents to the Japan Gerontological Evaluation Study (JAGES) 2013 survey, which took place during the period from October to December 2013, 12 231 men and 14 091 women responded to questions on influenza vaccination and influenza infection.

Outcome measures Using JAGES data for 12 231 men and 14 091 women aged ≥65 years, we examined the association between social participation and influenza infection. The association between influenza infection and number of groups in which respondents participated was investigated among adults aged≥65 years, stratified by vaccination status and sex.

Results Unvaccinated women who participated in two or more social activities were 2.20 times (95% CI 1.47 to 3.29) as likely to report an influenza infection as those who reported no social participation. In contrast, vaccinated women who participated in two or more social groups had no additional risk of influenza infection as compared with female elders with no social participation. Among men, participation in social activities was not significantly associated with influenza infection, regardless of vaccination status.

Conclusions Social participation was associated with a higher risk of influenza infection among unvaccinated older women, which suggests a need for further efforts to promote influenza vaccination, particularly among socially active elderly women.

  • influenza
  • social participation
  • vaccination
  • older people
  • social capital

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2017-016876

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    Footnotes

    • Contributors All authors met the International Committee of Medical Journal Editors criteria for authorship. YS and TF contributed to the study design. YS performed statistical analysis and drafted the manuscript. TF advised on data analysis and interpretation. RS, KK and TF revised the manuscript. KK is the principal investigator of the JAGES project. AT helped to develop the idea of the study. All authors read and approved the final manuscript.

    • Funding This work was supported by JSPS KAKENHI Grant Number 26460828. This study was also supported by a Health Labour Sciences Research Grant for conduct of a nationwide survey. Additional support included grants for Comprehensive Research on Aging and Health (H26-Choju-Ippan-006, H25-Choju-Ippan-003, H25-Kenki-Wakate-015, H25-Irryo-Shitei-003 [Fukkou], H24-Junkanki [Syosyu]-Ippan-007) from the Japanese Ministry of Health, Labour and Welfare, grants from the Department of Health and Human Services, the National Institutes of Health, Grants-in-Aid for Scientific Research (20319338, 22390400, 23243070, 23590786, 23790710, 24140701, 24390469, 24530698, 24653150, 24683018, 25253052, 25870881) from the Japan Society for the Promotion of Science, and a grant from the National Center for Geriatrics and Gerontology (number: 24-17, Chiyoe Murata; number: 24-23, Tami Saito; number: J09KF00804, Yuri Sasaki).

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval Nihon Fukushi University.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.

    • Collaborators The members of the JAGES group are as follows: Kondo K (the lead investigator), Hanazato M, Hikichi H, Miyaguni Y, Sasaki Y, Nagamine Y, Chiba University, Chiba; Ashida T, Kondo N, Takagi D, Tani Y, The University of Tokyo, Tokyo; Aida J, Osaka K, Tsuboya T, Tohoku University, Miyagi; Jeong S, Murata C, Saito T, National Center for Geriatrics and Gerontology, Aichi; Ojima T, Okada E, Hamamatsu University School of Medicine, Shizuoka; Shirai K, Todoriki H, University of the Ryukyus, Okinawa; Saito M, Nihon Fukushi University, Aichi; Hirai H, Iwate University, Iwate; Misawa J, Rikkyo University, Tokyo; Suzuki K, Aichi Gakuin University, Aichi; Ichida Y, Doctoral Institute for Evidence Based Policy, Tokyo; Takeda T, Seijoh University, Aichi; Yamamoto T, Kanagawa Dental University, Kanagawa; Nakade M, Tokaigakuen University, Aichi; Cable N, University College London, London; Tamakoshi A, Hokkaido University Graduate School of Medicine, Hokkaido; Fujino Y, University of Occupational and Environmental Health, Fukuoka; Hayashi T, Tokai College of Medical Science, Aichi.