Association between social capital and mortality among community-dwelling older adults in Myanmar 2018–2022: a prospective cohort study

Abstract Background Healthy aging is crucial in Asia given its rapidly aging society. Social capital, which refers to the resources derived from social networks, norms, and trust that facilitate cooperation and collective action within a community or society, has demonstrated health benefits for old...

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Main Authors: Yuka Ohaku, Yuki Shirakura, Yuiko Nagamine, Yuri Sasaki, Daisuke Takagi, Ikuma Nozaki, Than Win Nyunt, Reiko Saito, Yugo Shobugawa
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Global and Public Health
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Online Access:https://doi.org/10.1186/s44263-025-00137-x
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author Yuka Ohaku
Yuki Shirakura
Yuiko Nagamine
Yuri Sasaki
Daisuke Takagi
Ikuma Nozaki
Than Win Nyunt
Reiko Saito
Yugo Shobugawa
author_facet Yuka Ohaku
Yuki Shirakura
Yuiko Nagamine
Yuri Sasaki
Daisuke Takagi
Ikuma Nozaki
Than Win Nyunt
Reiko Saito
Yugo Shobugawa
author_sort Yuka Ohaku
collection DOAJ
description Abstract Background Healthy aging is crucial in Asia given its rapidly aging society. Social capital, which refers to the resources derived from social networks, norms, and trust that facilitate cooperation and collective action within a community or society, has demonstrated health benefits for older adults. However, its impact varies by country. Most research focuses on high-income countries, with little attention on low- and middle-income countries. Methods This prospective cohort study examined the effects of social capital on all-cause mortality among older adults in Myanmar from 2018 to 2022, using structured questionnaires based on the Japan Gerontological Evaluation Study. Multistage random sampling and face-to-face interviews were conducted with community-dwelling older adults aged 60 and above in Yangon and Bago in 2018. Subsequently, three waves of follow-up telephone surveys were conducted in 2020, 2021, and 2022. The questionnaires evaluated three components of social capital: civic participation, social cohesion, and social support, alongside baseline demographic information. Their impact on all-cause mortality was assessed using the Cox proportional hazards model with multiple imputations, adjusting for potential confounders including age, gender, body mass index, self-rated health, socioeconomic status, lifestyle, illness, and residential area. Results A total of 1200 individuals were followed for an average of 2.6 years (3123 person-years), with 143 all-cause deaths observed among 1031 participants. Bivariate analyses showed that participants who died were more likely to be older, underweight, have shorter daily walking times, live in Bago, and have less social support. Higher social support was significantly associated with lower mortality after adjusting for all covariates (HR = 0.80, 95% CI 0.69–0.94). Specifically, instrumental support, defined as the exchange of practical assistance, such as receiving or providing care during illness, was found to be protectively associated with mortality. When stratified by residential area, significant associations were found only in Bago, a rural area. Among older adults in Myanmar, instrumental support was a more prominent protector against all-cause mortality than emotional support, especially in rural areas. Conclusions Our findings indicate that social support networks play an important role in the survival of older adults in Myanmar, even under unstable social conditions.
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spelling doaj-art-d7499f28548e4477852fe21a5be22ea82025-08-20T03:42:03ZengBMCBMC Global and Public Health2731-913X2025-03-013111510.1186/s44263-025-00137-xAssociation between social capital and mortality among community-dwelling older adults in Myanmar 2018–2022: a prospective cohort studyYuka Ohaku0Yuki Shirakura1Yuiko Nagamine2Yuri Sasaki3Daisuke Takagi4Ikuma Nozaki5Than Win Nyunt6Reiko Saito7Yugo Shobugawa8Division of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata UniversityDepartment of Active Ageing, Graduate School of Medical and Dental Sciences, Niigata UniversityDepartment of Public Health, Institute of Science TokyoDepartment of Public Health Policy, National Institute of Public HealthDepartment of Health and Social Behavior, School of Public Health, The University of TokyoBureau of International Health Cooperation, National Center for Global Health and MedicineDepartment of Geriatric Medicine, University of Medicine 1Division of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata UniversityDepartment of Active Ageing, Graduate School of Medical and Dental Sciences, Niigata UniversityAbstract Background Healthy aging is crucial in Asia given its rapidly aging society. Social capital, which refers to the resources derived from social networks, norms, and trust that facilitate cooperation and collective action within a community or society, has demonstrated health benefits for older adults. However, its impact varies by country. Most research focuses on high-income countries, with little attention on low- and middle-income countries. Methods This prospective cohort study examined the effects of social capital on all-cause mortality among older adults in Myanmar from 2018 to 2022, using structured questionnaires based on the Japan Gerontological Evaluation Study. Multistage random sampling and face-to-face interviews were conducted with community-dwelling older adults aged 60 and above in Yangon and Bago in 2018. Subsequently, three waves of follow-up telephone surveys were conducted in 2020, 2021, and 2022. The questionnaires evaluated three components of social capital: civic participation, social cohesion, and social support, alongside baseline demographic information. Their impact on all-cause mortality was assessed using the Cox proportional hazards model with multiple imputations, adjusting for potential confounders including age, gender, body mass index, self-rated health, socioeconomic status, lifestyle, illness, and residential area. Results A total of 1200 individuals were followed for an average of 2.6 years (3123 person-years), with 143 all-cause deaths observed among 1031 participants. Bivariate analyses showed that participants who died were more likely to be older, underweight, have shorter daily walking times, live in Bago, and have less social support. Higher social support was significantly associated with lower mortality after adjusting for all covariates (HR = 0.80, 95% CI 0.69–0.94). Specifically, instrumental support, defined as the exchange of practical assistance, such as receiving or providing care during illness, was found to be protectively associated with mortality. When stratified by residential area, significant associations were found only in Bago, a rural area. Among older adults in Myanmar, instrumental support was a more prominent protector against all-cause mortality than emotional support, especially in rural areas. Conclusions Our findings indicate that social support networks play an important role in the survival of older adults in Myanmar, even under unstable social conditions.https://doi.org/10.1186/s44263-025-00137-xHealthy agingSocial capitalSocial supportMortalityMyanmar
spellingShingle Yuka Ohaku
Yuki Shirakura
Yuiko Nagamine
Yuri Sasaki
Daisuke Takagi
Ikuma Nozaki
Than Win Nyunt
Reiko Saito
Yugo Shobugawa
Association between social capital and mortality among community-dwelling older adults in Myanmar 2018–2022: a prospective cohort study
BMC Global and Public Health
Healthy aging
Social capital
Social support
Mortality
Myanmar
title Association between social capital and mortality among community-dwelling older adults in Myanmar 2018–2022: a prospective cohort study
title_full Association between social capital and mortality among community-dwelling older adults in Myanmar 2018–2022: a prospective cohort study
title_fullStr Association between social capital and mortality among community-dwelling older adults in Myanmar 2018–2022: a prospective cohort study
title_full_unstemmed Association between social capital and mortality among community-dwelling older adults in Myanmar 2018–2022: a prospective cohort study
title_short Association between social capital and mortality among community-dwelling older adults in Myanmar 2018–2022: a prospective cohort study
title_sort association between social capital and mortality among community dwelling older adults in myanmar 2018 2022 a prospective cohort study
topic Healthy aging
Social capital
Social support
Mortality
Myanmar
url https://doi.org/10.1186/s44263-025-00137-x
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