Participation in Community Gathering Places and Subsequent Care Costs in Older Adults: A 2-Year Follow-Up Study

OBJECTIVES: With the aging population, community-based activities promoting social connections are increasingly encouraged internationally to delay functional decline. In Japan, "community gathering places" are municipally supported for disability prevention. However, whether participation in such programs reduces long-term care (LTC) costs, especially among older adults certified as requiring LTC insurance (LTCI) services, remains unclear. This study examined these associations using a municipal administrative database. DESIGN: We conducted a historical cohort study using data from the National Health Insurance Database in Toyonaka City, Japan, integrating health checkups, community gathering place assessments, and LTCI claims. SETTING AND PARTICIPANTS: Participants included residents aged ≥75 years with available 15-item Questionnaire for Medical Checkup of Old-Old data between April 2021 and September 2022, excluding those certified at LTCI care levels 2 to 5. METHODS: Participation in community gatherings was defined using the Questionnaire for Medical Checkup of Old-Old data source, with those assessed through health checkups serving as the comparison group (nonparticipants). We used a 2-part model to estimate monthly LTC cost differences, stratified by LTCI certification status. RESULTS: This study included 9489 residents (428 participants and 9061 nonparticipants). Participation in community gathering places was associated with lower LTC costs only among those with LTCI certification (cost ratio, 0.71; 95% confidence interval, 0.55-0.91), corresponding to approximately US$98.1 monthly reduction. No association was observed among those without certification. CONCLUSIONS AND IMPLICATIONS: Participation in community gatherings is associated with reduced LTC costs among older adults with mild disabilities under the LTCI system. These programs may promote more efficient use of care resources and support municipal strategies to contain LTC costs.