Factors associated with follow-up difficulty in longitudinal studies involving community-dwelling older adults [post]

2019 unpublished
To clarify the factors associated with the gradual drop-out from society in older adults, we defined the stages of follow-up difficulty based on four follow-up surveys on non-respondents of longitudinal mail surveys in community-dwelling older adults. This study aimed to examine the main factors associated with the stages of follow-up difficulty. Methods We conducted a follow-up mail survey (FL1) aimed at the baseline respondents and conducted followup surveys on non-respondents of each survey
more » ... nts of each survey as follows; simplified mail (FL2), post card (FL3), and home visit surveys (FL4). The respondents of each follow-up survey were defined as a stage of followup difficulty and their characteristics concerning social participation and interaction at the baseline in each stage were analyzed. Results The respondent numbers of the FL1, FL2, FL3, and FL4 and NR (non-respondents) stages were 2,361; 462; 234; 84; and 101 respectively. Participation in hobby groups for FL2 and FL3, in sports groups in FL4, and for the neighborhood association and social isolation in NR were significantly associated with the stage of follow-up difficulty. Conclusions Based on these results, we conclude that the factors associated with each stage of follow-up difficulty are: 1) their activities start to be restricted by a decline in IADL in the FL2 and FL3 stages, 2) they dislike taking part in physical activity such as sports in the FL4 stage, and 3) they are more socially isolated, not belong to even a neighborhood association owing to be low social interaction in the NR group. Background Many studies have been conducted on the characteristics of those who drop out of a longitudinal study to assess the representativeness of the participants in follow-up surveys (1-7). These studies reported that individuals who dropped out of a longitudinal study often have characteristics such as little hard, very hard. Statistical Analysis Participants with complete data for social participation, social interaction, and all the covariates at BL were included in the statistical analyses. Differences concerning social participation, social interaction, and the covariates between FL1, FL2, FL3, FL4 and NR at BL were examined by a chisquare test for categorical variables, a one-way analysis of variance, and a post-hoc Bonferroni test for continuous variables. Linear trends among the stages of follow-up difficulty were assessed by the Jonckheere-Terpstra trend test or chi-square test for trends. To examine the factors associated with the stage of follow-up difficulty from participants' characteristics at BL, multinomial logistic regression analyses were conducted using the stage of follow-up difficulty as the dependent variable and the social participation and social interaction at BL as the explanatory variables. Two logistic regression models were calculated; one with the sex and age covariates adjusted (Model 1) and one with all the covariates adjusted (Model 2). Statistical analyses were performed using SPSS version 25 (IBM Japan, Ltd., Tokyo, Japan). Statistical significance was set at P < 0.05. Results The participants' characteristics are shown in Table 1 . The FL4 respondents were significantly older than the FL1 and FL2 respondents. The IADL scores for the FL2, FL3, and FL4 respondents were significantly lower than that of the FL1 respondents. There were no significant differences of proportion between men and women among the follow-up difficulty stages. The percentage of participants that belonged to hobby groups were significantly higher in the FL1 group than that in the FL3 group. The percentage of participants that took part in sports groups were significantly higher in the FL1 and FL2 groups than in the FL4 group. The percentage of respondents that were categorized as isolated was significantly higher in the NR group than in the FL1 group. The percentage of respondents that rated themselves as "not very healthy" in the self-rated health question was significantly higher in the FL3 group than in the FL1 group. Additionally, the percentage of respondents that rated themselves as "not healthy" was significantly higher in the FL4 group than identified the moving away or death factors only by information from the participants or their family members. Therefore, non-responders for the FL3 group and later groups may include more moves and deaths. However, the surveys after the FL3 survey were conducted within one year and the impact on the results obtained in this study would be small. Since this study was a longitudinal mail survey, it was not possible to assess details concerning educational status, work, and cognitive function, which have been indicated by prior studies to be associated with increased rates of attrition. In future studies, it is necessary to determine whether these factors are associated with follow-up difficulty. Conclusions This study identified the stages of follow-up difficulty based on four follow-up surveys on nonrespondents of longitudinal mail surveys in community-dwelling older adults, thereby examining the factors associated with the drop-out from society in older adults. These findings would be useful to address the gradual drop-out from society in older adults. Declarations Ethics approval and consent to participate:
doi:10.21203/rs.2.10136/v1 fatcat:uqqp4mlz6vg47kzmlgenrfk3zi