Effect of car use on social frailty among community-dwelling older adults in rural areas

Introduction: Cars are essential for the mobility of older adults in rural areas, and driving a car is likely to contribute to the maintenance of a socially active lifestyle. The purpose of this study was to investigate the effect of car use on the onset of social frailty among older adults in rural areas and verify whether the effect differed with the level of locomotive function.Methods: This longitudinal study included 1160 older adults in rural areas. The onset of social frailty was defined as giving two or more negative responses to the five questions asked during the follow-up assessment and no social frailty at baseline. Car use was assessed by determining whether participants drove a car at least once a week. Locomotive function was measured using the Geriatric Locomotive Function Scale-25; a total score of >= 7 was defined as a low locomotive function. Logistic regression analysis was used to investigate the effect of car use on the onset of social frailty. Furthermore, subgroup analysis by locomotive function was also performed.Results: In the follow-up assessment, 11.1% of older adults developed social frailty after 1 year. Participants who drove a car had lower odds of onset of social frailty (adjusted odds ratio [aOR] = 0.50, 95% confidence interval [CI] = 0.30-0.83). Subgroup analysis showed the same rela-tionship only among those with a low locomotive function (aOR = 0.49, 95% CI, 0.31-0.91).Conclusion: The findings of this study may helpful for policy-makers to discuss transportation among older adults in a rural area from the point of preventing social frailty.