Abstract
BACKGROUND: This study investigated social participation trajectories following the Coronavirus Disease 19 (COVID-19) pandemic and its relationship with frailty among community-dwelling older adults. METHODS: We selected 5000 older residents (65-84 years) from Kitaibaraki City, Japan, excluding those certified for long-term care. After the first survey in April 2022, the second survey was conducted with 1931 respondents from the first survey in May 2023. Respondents of the second survey who had participated in social participation activities in January 2020 were eligible for this study. The questionnaire included social participation status in January 2020, April 2022, and May 2023, along with the Kihon Checklist in April 2022 and May 2023. Participants were categorized into four groups according to the participation status: Continued, Resumed, Discontinued in 2023, and Discontinued in 2022. Binary logistic regression analysis assessed the relationship between these groups and frailty risk assessed by Kihon Checklist, adjusting for age, gender, living status, economic conditions, working status, self-rated health, and 2022 frailty status. RESULTS: Of 1289 respondents (66.8%), 648 were analyzed. Social participation groups were: Continued (284, 43.8%), Resumed (119, 18.4%), Discontinued in 2023 (92, 14.2%), and Discontinued in 2022 (153, 23.6%). The Discontinued in 2022 group had a significantly higher risk of frailty (OR = 2.26, 95% CI: 1.16-4.42, p = 0.017) compared to the Continued group. CONCLUSIONS: Social participation trajectories are associated with frailty risk in older adults. Sustained discontinuation of social activities, particularly since 2022, is related to increased frailty risk, highlighting the importance of maintaining social engagement.