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Peer-reviewedCC BY 4.0PLOS One

Association between sense of coherence and loss of independence or death in older adults: Locomotive Syndrome and Health Outcomes in Aizu Cohort Study

  • Sho Matsushita1
  • Hajime Yamazaki2
  • Yoshie Yamada3
  • Yusuke Ogawa4
  • Yosuke Yamamoto
4 affiliations
  1. 1Department of Healthcare Epidemiology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
  2. 2Department of General Internal Medicine, Hashimoto Municipal Hospital, Wakayama, Japan
  3. 3Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
  4. 4Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University, Fukushima, Japan
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Abstract

Background: Although sense of coherence (SOC) is a core concept to promote healthy aging, evidence of whether SOC improves loss of independence (LOI) or death is lacking. We aimed to investigate the association between SOC and LOI or death in older adults. Methods: We enrolled independent older adults aged 65 years or over from a population-based cohort. SOC was assessed using a three-item SOC scale at baseline. The primary outcome was a composite of LOI (defined by Japanese long-term care insurance certification) or death. We investigated the association of SOC with LOI or death using the Cox proportional hazards model. Results: During a median follow-up of 5.8 years, 128 out of 1,661 (7.7%) participants had LOI or death. Lower SOC (per 1 standard deviation [SD] decrease) was associated with a higher risk of LOI or death (adjusted hazard ratio 1.25, 95% confidence interval [CI] 1.07 to 1.46, p = 0.005). Lower SOC (per 1 SD decrease) was associated with a higher risk of death (adjusted hazard ratio 1.24, 95% CI 1.03 to 1.50, p = 0.022) as well. Conclusions: Older adults with a lower SOC were more likely to experience LOI or death. Enhancing SOC could promote healthy aging in older adults.

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Cite

BibTeXRIS
BibTeX
@article{matsushita2026association,
  title = {{Association between sense of coherence and loss of independence or death in older adults: Locomotive Syndrome and Health Outcomes in Aizu Cohort Study}},
  author = {Sho Matsushita and Hajime Yamazaki and Yoshie Yamada and Yusuke Ogawa and Yosuke Yamamoto},
  journal = {PLOS One},
  year = {2026},
  month = aug,
  doi = {10.1371/journal.pone.0355726},
  url = {https://doi.org/10.1371/journal.pone.0355726},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Association between sense of coherence and loss of independence or death in older adults: Locomotive Syndrome and Health Outcomes in Aizu Cohort Study
AU  - Sho Matsushita
AU  - Hajime Yamazaki
AU  - Yoshie Yamada
AU  - Yusuke Ogawa
AU  - Yosuke Yamamoto
PY  - 2026
DA  - 2026/08/31
JO  - PLOS One
DO  - 10.1371/journal.pone.0355726
UR  - https://doi.org/10.1371/journal.pone.0355726
AB  - Background: Although sense of coherence (SOC) is a core concept to promote healthy aging, evidence of whether SOC improves loss of independence (LOI) or death is lacking. We aimed to investigate the association between SOC and LOI or death in older adults. Methods: We enrolled independent older adults aged 65 years or over from a population-based cohort. SOC was assessed using a three-item SOC scale at baseline. The primary outcome was a composite of LOI (defined by Japanese long-term care insurance certification) or death. We investigated the association of SOC with LOI or death using the Cox proportional hazards model. Results: During a median follow-up of 5.8 years, 128 out of 1,661 (7.7%) participants had LOI or death. Lower SOC (per 1 standard deviation [SD] decrease) was associated with a higher risk of LOI or death (adjusted hazard ratio 1.25, 95% confidence interval [CI] 1.07 to 1.46, p = 0.005). Lower SOC (per 1 SD decrease) was associated with a higher risk of death (adjusted hazard ratio 1.24, 95% CI 1.03 to 1.50, p = 0.022) as well. Conclusions: Older adults with a lower SOC were more likely to experience LOI or death. Enhancing SOC could promote healthy aging in older adults.
SN  - 1932-6203
ER  -