Community-Level Sports Group Participation and Older Individuals’ Depressive Symptoms

ABSTRACTPurposeCommunity-level group participation is a structural aspect of social capital that may have a contextual influence on an individual's health. Herein, we sought to investigate a contextual relationship between community-level prevalence of sports group participation and depressive symptoms in older individuals.MethodsWe used data from the 2010 Japan Gerontological Evaluation Study (JAGES), a population-based, cross-sectional study of individuals aged ≥65 years without long-term care needs in Japan. Overall, 74,681 participants in 516 communities were analyzed. Depressive symptoms were diagnosed as the 15-item Geriatric Depression Scale score ≥5. Participation in a sports group 1 day/month or more often was defined as "participation." For this study, we applied two-level multilevel Poisson regression analysis stratified by sex, calculated prevalence ratios (PRs), and 95% confidence intervals (CIs).ResultsOverall, 17,420 individuals (23.3%) had depressive symptoms, and 16,915 (22.6%) participated in a sports group. Higher prevalence of community-level sports group participation had a statistically significant relationship with a lower likelihood of depressive symptoms (male, PR: 0.89, 95% CI: 0.85–0.92; female, PR: 0.96, 95% CI: 0.92–0.99, estimated by 10% of participation proportion) after adjusting for individual-level sports group participation, age, diseases, family form, alcohol, smoking, education, equivalent income, and population density. We found statistically significant cross-level interaction terms in males only (PR: 0.86, 95% CI: 0.77–0.95).ConclusionWe found a contextual preventive relationship between community-level sports group participation and depressive symptoms in older individuals. Therefore, promoting sports groups in a community may be effective as a population-based strategy for the prevention of depression in older individuals. Furthermore, the benefit may favor male sports group participants.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Purpose Community-level group participation is a structural aspect of social capital that may have a contextual influence on an individual's health. Herein, we sought to investigate a contextual relationship between community-level prevalence of sports group participation and depressive symptoms in older individuals. Methods We used data from the 2010 Japan Gerontological Evaluation Study (JAGES), a population-based, cross-sectional study of individuals aged ≥65 years without long-term care needs in Japan. Overall, 74,681 participants in 516 communities were analyzed. Depressive symptoms were diagnosed as the 15-item Geriatric Depression Scale score ≥5. Participation in a sports group 1 day/month or more often was defined as "participation." For this study, we applied two-level multilevel Poisson regression analysis stratified by sex, calculated prevalence ratios (PRs), and 95% confidence intervals (CIs). Results Overall, 17,420 individuals (23.3%) had depressive symptoms, and 16,915 (22.6%) participated in a sports group. Higher prevalence of community-level sports group participation had a statistically significant relationship with a lower likelihood of depressive symptoms (male, PR: 0.89, 95% CI: 0.85–0.92; female, PR: 0.96, 95% CI: 0.92–0.99, estimated by 10% of participation proportion) after adjusting for individual-level sports group participation, age, diseases, family form, alcohol, smoking, education, equivalent income, and population density. We found statistically significant cross-level interaction terms in males only (PR: 0.86, 95% CI: 0.77–0.95). Conclusion We found a contextual preventive relationship between community-level sports group participation and depressive symptoms in older individuals. Therefore, promoting sports groups in a community may be effective as a population-based strategy for the prevention of depression in older individuals. Furthermore, the benefit may favor male sports group participants. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Corresponding author: Taishi Tsuji, Center for Preventive Medical Sciences, Chiba University, 1-8-1 Inohana, Chuo Ward, Chiba City, Chiba 260-8670 Japan, E-mail: tsuji.t@chiba-u.jp, Tel. +81.43.226.2803, Fax +81.43.226.2018 This study was supported by a grant of the Strategic Research Foundation Grant-aided Project for Private Universities from the Ministry of Education, Culture, Sport, Science, and Technology, Japan (MEXT), 2009–2013, for the Center for Well-being and Society, Nihon Fukushi University; a Health Labour Sciences Research Grant, Comprehensive Research on Aging and Health (H22-Choju-Shitei-008, H24-Junkankitou-Ippan-007, H24-Chikyukibo-Ippan-009, H24-Choju-Wakate-009, H25-Kenki-Wakate-015, H25-Irryo-Shitei-003 (Fukkou), H26-Choju-Ippan-006, H28-Chouju-Ippan-02) from the Japanese Ministry of Health, Labour and Welfare; JSPS KAKENHI (22330172, 22390400, 23243070, 23590786, 23790710, 24390469, 24530698, 24653150, 24683018, 25253052, 25870573, 25870881, 22390400, 15K18174, 15KT0007, 15H01972, 16K16595, 17K15822) from the Japan Society for the Promotion of Science; a grant from the National Center for Geriatrics and Gerontology (24-17, 24-23); the Research and Development Grants for Longevity Science from AMED; a grant from the Japan Foundation for Aging and Health; and also World Health Organization Centre for Health Development (WHO Kobe Centre) (WHO APW 2017/713981). The funding sources had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. We declare that the results of the present study are presented clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation, and do not constitute endorsement by ACSM. None of the authors have a conflict of interest in relation to this manuscript. Accepted for Publication: 22 December 2017 © 2018 American College of Sports Medicine

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