The people of Japan have the highest life expectancy in the world. Yet older adults who struggle economically may refrain from seeking medical help or using long-term care insurance. These choices may increase the occurrence of frailty and its progression in people’s lives. A team of scientists undertook a study of older adults to examine the connection between a sense of economic insecurity and a person’s participation in social activities.

The results showed that a person’s sense of economic insecurity was not associated with physical conditions, subjective symptoms of dementia, or social conditions. However, it grew with increased loneliness and decreased with a greater sense of well-being.

The team published their research in the journal PLOS ONE on March 28.

Statistics show that older adults account for 37.7 percent of Japan's suicide mortality rate. In 2022, the most common causes of suicide were “health problems,” followed by “family problems” and “economic and lifestyle problems.” The risk factors associated with frailty – a state of increased vulnerability to health changes due to an age-related decline in bodily functions – include low income. The Ministry of Health, Labour and Welfare encourages older adults to participate in social activities to prevent them from becoming frail.

“For low-cost social activities to function as a place for preventing frailty and suicide, it is necessary to investigate the actual state of the participants’ economic insecurity and discuss how to provide support for effective social activities,” said co-authors Yuriko Inoue and Hisae Nakatani, both from Hiroshima University’s (HU) Graduate School of Biomedical and Health Sciences, in a joint response. Inoue is a Ph.D. student at the graduate school’s Division of Integrated Health Sciences while Nakatani is a professor emeritus at the university.

The team conducted a cross-sectional survey to identify factors related to a sense of economic insecurity among older adults who participate in social activities. The people who participated in the survey were 65 years or older in age. They were people who voluntarily participated in low-cost community-based social activities, such as exercise and hobby activities. The self-administered survey form was distributed to 1,351 adults in Hiroshima City, Japan, during July to December 2022. The surveys were distributed to these adults by the staff of community general support centers.

To determine a person’s sense of economic insecurity, the survey asked “Do you have economic anxieties?” Participants responded on a four-point scale where answers ranged from “not worried” to “worried.”

There were also questions related to a person’s physical condition and whether or not they had subjective symptoms of dementia. The survey also asked questions related to a person’s social conditions. These questions focused on the frequency of outings, social activities, working status, and whether or not the person was socially isolated. The last category of survey questions focused on psychological conditions. These questions were designed to assess a person’s loneliness and subjective well-being.

The team’s survey results showed that 43.6 percent of older adults who participate in social activities had economic insecurity. 

Their sense of economic insecurity was not associated with physical conditions, subjective symptoms of dementia, or social conditions, such as frequency of outings or social isolation. However, the team did note that the sense of economic insecurity was lower among older adults aged 85 and older, and higher among those who felt psychologically lonely and had a lower subjective sense of well-being.

“Given that nearly half of the older adults participating in social activities felt economic insecurity, receiving support to alleviate this issue through social activities could contribute to improving their mental health,” said Inoue.

This study measured the subjective economic insecurity of older adults. However, the association between actual income and expenses could not be surveyed.

“Given the cross-sectional nature of the study design, further investigation through longitudinal and intervention studies involving factors based on objective indicators is needed to validate this association,” said Inoue. 

Looking ahead, the team suggests that background factors related to loneliness and subjective well-being should be analyzed, including the number of interactions and the level of intimacy involved in social support.

The team’s results may lead health care providers who promote community-based social participation to consider support tailored to older adults’ age and psychological and economic insecurities. Because nearly half of the older adults taking part in social activities felt economic insecurity, receiving support to ease this issue through social activities could contribute to improving their quality of life, including their mental health.

The research team includes Inoue, Nakatani, and Xuxin Peng from HU’s Graduate School of Biomedical and Health Sciences and Ichie Ono from the Yasuda Women’s University’s Department of Nursing.

The research is funded by France Bed Medical Home Care Research Subsidy Public Incorporated Foundation and Hiroshima University Research Fellowship.