Association between community attachment and social activity participation among older adults in depopulated areas: a focus on gender-based differences

Abstract

Objective: This study investigated the relationship between social activity participation and community attachment among older adults living in depopulated areas stratified by gender.

Materials and Methods: Data from a 2023 survey of 2,642 community-dwelling older adults residing in a depopulated area were used. Logistic regression analyses were conducted separately for men and women, with community attachment as the dependent variable, nine social activities as explanatory variables, and adjustments for age, years of residence, depression, and social support.

Results: The mean residence length was 49.1 years. Among men, participation in paid work was consistently and significantly associated with community attachment across all models (odds ratio, 1.52; 95% confidence interval, 1.05–2.20). Among women, participation in sports clubs was significantly associated with community attachment in all models except the final model after adjusting for all other social activities. No significant gender-based differences were found in community attachment, with >70% of men and women reporting high levels. Our findings suggest that for men, community attachment is underpinned by a sense of role fulfillment and contribution to the community through employment. In contrast, for women, long-term residential history, community ties, and mental health—as life foundations developed over years of living in the area—supported community attachment more than participation in any specific activity.

Conclusion: Gender-specific, multifaceted support is necessary for care prevention in depopulated areas. For men, establishing a framework for lifelong active employment and for women, creating gatherings that sustain informal social connections, and building outreach-based consultation systems are important.

Introduction

Japan’s aging population continues to increase, with the older adult population reaching 29.4% of the total population as of September 2025¹⁾. Depopulated areas experience a significant outmigration of younger residents, resulting in population structures that are markedly different from the national average. The overall aging rate in depopulated areas has reached 39.7%²⁾. Furthermore, 40.2% of settlements have populations in which residents aged ≥65 years account for at least half of the population; thus, maintenance of community life in depopulated regions is considered a critical juncture³⁾. Reducing the need for long-term care and extending healthy life expectancy are key challenges in depopulated areas, many of which face a decline in personnel capable of providing care prevention services. There is a growing need for older residents in these areas to engage in preventive care activities that do not rely solely on public services. One approach is to foster social capital (SC), including trust in and bonds among residents⁴⁾. The relationship between SC and care prevention has been reported previously. Among the SC factors, older men living in areas with high community attachment have a significantly reduced risk of requiring long-term care⁵⁾. Furthermore, community attachment was identified as a factor related to SC in both mountainous and rural areas⁶⁾. These studies suggest that fostering community attachment is a key factor in care prevention.

Previous studies targeting older adult residents in depopulated areas have reported that, for both older women and men, the degree of social interaction within the community, social support, and age are associated with attachment to the community. Additionally, gender-specific factors were identified: “religious activities” for men and “salon activities” for women⁷⁾. However, these findings are likely specific to the regions in which the studies were conducted. Further studies are required to investigate external validity in regions with different characteristics. Particularly, in depopulated areas, the impact of activities directly linked to sustaining daily life, such as employment and neighborhood association activities, versus leisure activities, such as sports and hobbies, on forming an attachment to the community is expected to differ between men and women. Reexamining the specific social activities associated with community attachment, considering gender-based differences, is critically important for formulating realistic and achievable policies. This study aimed to examine the relationship between social activities and community attachment among older residents in depopulated areas, separately for men and women, to inform the development of effective community development and preventive care measures that consider gender roles and living conditions specific to depopulated areas.

Materials and Methods

1. Research design

A cross-sectional study was conducted using secondary data from a self-administered questionnaire survey of residents aged ≥65 years conducted by municipal governments.

2. Data used

Secondary data from the “Long-Term Care Prevention and Local Area Needs Survey” was used. This survey targeted 3,900 individuals aged ≥65 years, living at home in Town B, Prefecture A, designated as a depopulated area, who were not certified for long-term care insurance.

This survey was conducted by long-term care insurance providers to identify regional challenges (community diagnosis) for older adult residents within each daily living area⁸⁾. The survey was conducted by mail in December 2023 and yielded 2,642 valid responses (67.7% response rate) from 3,900 distributed questionnaires.

From these, data with missing age, gender, years of residence, and attachment to local community variables were excluded, leaving 2,409 cases for analysis.

3. Analysis variables

1) Dependent variable

The dependent variable was the degree of attachment to the local community in which the respondents lived. This was measured using a 5-point scale (1=Strongly attached, 2=Somewhat attached, 3=Neither attached nor detached, 4=Not very attached, 5=Not at all attached) in response to the question “How attached are you to the area where you currently live?”

This item is a component of the community-level health-related SC index⁹⁾ developed by Saito et al. Following the classification used in a previous study⁵⁾, employing this scale, responses of “Strongly attached” and “Somewhat attached” were coded as “Attached=1”, whereas “Neither attached nor detached”, “Not very attached”, and “Not at all attached” were coded as “no attachment=0”.

2) Explanatory variables

The explanatory variables included participation in study/cultural circles, preventive care activities, paid work, hobby groups, sports clubs, neighborhood association activities, skill-sharing activities, volunteering, and senior citizen clubs. For each variable, participation frequency was measured using a 6-point scale (1=4+ times/week, 2=2 or 3 times/week, 3=1 time/week, 4=1–3 times/month, 5=several times/year, and 6=no participation). Longitudinal studies have shown that participating in social activities at least once a month is associated with the prevention of physical decline¹⁰⁾. Therefore, participation at least once per month was coded as “Participation=1”, and all other cases as “No participation=0”.

3) Adjustment variables

Adjustment variables related to community attachment included age, years of residence, social support, and depression (Geriatric Depression Scale [GDS]), based on previous research^{7, 11, 12)}. Social support was defined as individuals who listen to or share concerns or complaints or provide care during illness or injury, selected from the following: spouse, cohabiting children, non-cohabiting children, siblings, relatives, parents, grandchildren, neighbors, friends, others, or “no such person” (multiple responses allowed).

4. Analysis methods

1) Descriptive statistics were calculated for all variables. Fisher’s exact test and t-tests were performed to compare gender-based differences.

2) Logistic regression analyses were conducted separately for men and women, with attachment to the community as the dependent variable and participation in each social activity as the independent variable. This study aimed to clarify the relationship between participation in social activities and attachment to the community among older adults living in depopulated areas by gender, with participation in social activities serving as the primary independent variable. To keep the overall model structure simple and provide intuitive decision-making criteria that professionals involved in community development and preventive care can easily apply in the field, age and length of residence were treated as continuous variables and used as raw numerical data to maximize the use of this information. All other items were dichotomized. Given that the two-way nature of both providing and receiving social support has been shown to contribute to the well-being of older adults^13,14,15), it was coded as follows: those who answered “No such person exists” for any item were coded as “None=0”, and those who selected spouse, cohabiting children, non-cohabiting children, siblings/relatives/parents/grandchildren, neighbors, friends, or other for any item were coded as “Exists=1”. Since previous studies have demonstrated the screening accuracy of the GDS when using a cutoff score of 5¹⁶⁾, GDS scores were coded as “depressive tendency=0” for scores ≥5, and “no depressive tendency=1” for scores ≤4. Furthermore, because responses regarding participation in social activities allowed for multiple selections, all social activities other than the target activity were included as adjustment variables. Model 1: Only the specific social activity was included. Model 2: Adjusted for age, years of residence, GDS, and social support. Model 3: Model 2 plus simultaneous adjustment for all other social activities (remaining eight items).

All statistical analyses were performed using EZR (Jichi Medical University, Tochigi, Japan), a graphical user interface for R (R Foundation for Statistical Computing, Vienna, Austria), which is a modified version of R Commander designed to include statistical functions frequently used in biostatistics¹⁷⁾.

Results

1. Participant characteristics

The characteristics of the participants are shown in Table 1. The study included 1,099 men (45.6%) and 1,310 women (54.4%). The mean age was 73.9 years (standard deviation [SD], 6.4) for men and 74.0 years (SD, 6.5) for women, with no significant gender-based differences. The overall mean length of residence was 49.1 years (SD, 18.9), with men (52.5 years) having a significantly longer residence time than women (46.3 years) (P<0.001). Regarding participation in social activities, the rate of participation in “paid work” was significantly higher for men (45.5%) than for women (31.5%). Participation in “sports clubs” was 16.9% for men and 19.4% for women.

Table 1. Participant characteristics and community attachment.

		Total (n=2,409)	Men (n=1,099)	Women (n=1,310)	P-value
		n (%)	n (%)	n (%)
Community attachment	Absent	498 (20.7)	223 (20.3)	275 (21)	0.686
	Present	1,911 (79.3)	876 (79.7)	1,035 (79)
Study/cultural circles	No	2,160 (89.7)	1,023 (93.1)	1,137 (86.8)	<0.001
	Yes	154 (6.4)	41 (3.7)	113 (8.6)
Preventive care activities	No	2,160 (89.7)	1,019 (92.7)	1,141 (87.1)	<0.001
	Yes	166 (6.9)	43 (3.9)	123 (9.4)
Paid work	No	1,304 (54.1)	526 (47.9)	778 (59.4)	<0.001
	Yes	913 (37.9)	500 (45.5)	413 (31.5)
Hobby groups	No	1,820 (75.6)	863 (78.5)	957 (73.1)	0.005
	Yes	500 (20.8)	202 (18.4)	298 (22.8)
Sports clubs	No	1,886 (78.3)	881 (80.2)	1,005 (76.7)	0.100
	Yes	440 (18.3)	186 (16.9)	254 (19.4)
Neighborhood association activities	No	1,985 (82.4)	832 (75.7)	1,153 (88)	<0.001
	Yes	337 (14)	234 (21.3)	103 (7.9)
Skill-sharing activities	No	2,195 (91.1)	1,015 (92.4)	1,180 (90.1)	0.686
	Yes	102 (4.2)	45 (4.1)	57 (4.4)
Volunteering	No	2,050 (85.1)	933 (84.9)	1,117 (85.3)	0.190
	Yes	263 (10.9)	131 (11.9)	132 (10.1)
Senior citizen clubs	No	2,202 (91.4)	1,008 (91.7)	1,194 (91.2)	0.236
	Yes	108 (4.5)	56 (5.1)	52 (4)
Depression (GDS)	Absent	1,640 (68.1)	758 (69)	882 (67.3)	0.815
	Present	634 (26.3)	289 (26.3)	345 (26.3)
Social support	Absent	179 (7.4)	120 (10.9)	59 (4.5)	<0.001
	Present	2,160 (89.7)	946 (86.1)	1,214 (92.7)
Age, years	Mean (SD)	74.0 (6.5)	73.9 (6.4)	74.0 (6.5)	0.938†
Years of residence	Mean (SD)	49.1 (18.9)	52.5 (20.8)	46.3 (16.5)	<0.001†

P-values calculated using Fisher’s exact test, except where noted. ^†P-values calculated using independent samples t-test. Due to missing data, the number of respondents varies by item. GDS: geriatric depression scale.

Overall, comparisons between men and women revealed significant gender-based differences in the length of residence, social support, and participation in four of the nine social activities (“learning/cultural circles”, “prevention of care needs activities”, “paid work”, and “neighborhood association/residents’ association activities”).

Regarding community attachment, the study’s dependent variable, the proportion responding “Attachment Present”, was 79.7% for men and 79.0% for women, with no significant difference between the genders.

2. Association between community attachment and social activities

The results of the logistic regression analysis are presented in Table 2. For men, “Paid Work” showed a significant association with community attachment. In Model 1, participation in “paid work” showed a significant positive association with community attachment (odds ratio [OR], 1.44; 95% confidence interval [CI], 1.06–1.96). This association remained consistently significant in Model 2 (OR, 1.52; 95% CI, 1.05–2.18), which adjusted for age, years of residence, depression, and social support, as well as in Model 3 (OR, 1.52; 95% CI, 1.05–2.20), which further adjusted for the effects of other social activities. Volunteer activities, sports clubs, senior citizens’ clubs, and neighborhood association activities, which showed an association in Model 1, no longer showed an association in Model 2 or subsequent models.

Table 2. Association between community attachment and social activity participation (logistic regression analysis).

	Men			Women
	Model 1	Model 2	Model 3	Model 1	Model 2	Model 3
Volunteering	1.91*	1.61	1.25	1.95*	1.8	1.8
	(1.11–3.30)	(0.89–2.92)	(0.66–2.40)	(1.15–3.31)	(0.99–3.26)	(0.90–3.63)
	P=0.020	P=0.115	P=0.496	P=0.013	P=0.054	P=0.099
Sports clubs	1.58*	1.26	1.14	1.57*	1.52*	1.42
	(1.02–2.44)	(0.77–2.06)	(0.61–2.13)	(1.09–2.27)	(1.01–2.28)	(0.87–2.32)
	P=0.042	P=0.351	P=0.681	P=0.016	P=0.043	P=0.162
Hobby groups	1.46	1.21	1.06	1.71**	1.45	1.1
	(0.97–2.22)	(0.76–1.91)	(0.60–1.86)	(1.20–2.43)	(0.99–2.13)	(0.69–1.77)
	P=0.073	P=0.425	P=0.844	P=0.003	P=0.058	P=0.679
Senior citizen clubs	3.38*	2.46	1.54	1.79	1.98	1.68
	(1.21–9.45)	(0.74–8.21)	(0.43–5.52)	(0.80–4.02)	(0.75–5.22)	(0.55–5.09)
	P=0.020	P=0.142	P=0.506	P=0.158	P=0.169	P=0.363
Neighborhood association activities	1.67*	1.54	1.37	1.31	0.98	0.88
	(1.12–2.50)	(0.98–2.41)	(0.85–2.20)	(0.78–2.23)	(0.55–1.73)	(0.45–1.73)
	P=0.013	P=0.062	P=0.193	P=0.310	P=0.933	P=0.713
Study/cultural circles	1.84	1.21	1.3	2.41**	1.8	1.32
	(0.71–4.74)	(0.45–3.24)	(0.42–4.01)	(1.30–4.45)	(0.94–3.41)	(0.64–2.76)
	P=0.208	P=0.702	P=0.651	P=0.005	P=0.074	P=0.455
Preventive care activities	0.82	0.73	0.69	1.54	1.48	0.91
	(0.40–1.69)	(0.32–1.70)	(0.25–1.92)	(0.92–2.55)	(0.80–2.71)	(0.44–1.91)
	P=0.593	P=0.467	P=0.483	P=0.098	P=0.209	P=0.810
Skill-sharing activities	2.04	1.51	1.41	1.73	1.47	1.14
	(0.79–5.23)	(0.57–4.04)	(0.46–4.28)	(0.81–3.70)	(0.67–3.25)	(0.44–3.01)
	P=0.139	P=0.408	P=0.550	P=0.157	P=0.337	P=0.784
Paid work	1.44*	1.52*	1.52*	1	1.13	1.18
	(1.06–1.96)	(1.05–2.18)	(1.05–2.20)	(0.75–1.34)	(0.81–1.59)	(0.83–1.67)
	P=0.021	P=0.025	P=0.028	P=0.981	P=0.462	P=0.356

OR: odds ratio; CI: confidence interval. *P<0.05; **P<0.01; ***P<0.001. Bold values indicate statistically significant associations (P<0.05). Model 1: Unadjusted. Model 2: Adjusted for age, years of residence, depression (Geriatric Depression Scale), and social support. Model 3: Model 2 plus simultaneous adjustment for all other social activities (remaining eight items).

Among older women, participation in “sports clubs” showed a significant positive association with community attachment in Model 1 (OR, 1.57; 95% CI, 1.09–2.27). This association remained significant in Model 2 (OR, 1.52; 95% CI, 1.01–2.28) after adjusting for age, years of residence, depression, and social support; however, it disappeared in Model 3 after adjusting for the effects of other social activities. Furthermore, volunteer activities, hobby clubs, and study/cultural circles, which showed associations in Model 1, no longer showed associations in Model 2 and subsequent models.

Discussion

Several factors should be considered while interpreting the results of this study. First, as attachment to the local community was measured using a single item, it is possible that the study did not fully capture the multifaceted nature of an individual’s internal attachment. Second, although the variables in this study were dichotomized, this dichotomization was not, in principle, straightforward. Although classifications consistent with previous research were used, this process may have resulted in the loss of information inherent to each variable, and the findings must be interpreted with caution in the following discussion.

1. Overview of participants and community attachment

The mean length of residence of the participants in this study was 49.1 years (SD, 18.9), indicating that most participants spent most of their lives in the same region. Although not directly comparable, this result was longer than the 21.4 years (SD, 12.8) reported in a previous study on aging in suburban areas near the Tokyo metropolitan area¹¹⁾. This suggests that, in depopulated areas, although the outmigration of younger residents is high, older residents continue to maintain local ties despite depopulation. Regarding participation in social activities, the trends observed in the present study were similar to those observed in a previous study⁷⁾ and survey¹⁸⁾. This finding suggests that there are no trends specific to depopulated areas concerning participation in social activities. On the other hand, regardless of participation in social activities, >70% of the respondents indicated that they had an attachment to their community, suggesting that attachment occurred regardless of participation.

The absence of gender-based differences in attachment to the community aligns with the findings of a previous study on elderly residents in depopulated areas⁷⁾. Although a previous study reported inconsistent results, such as men showing higher attachment domestically¹¹⁾ and women internationally¹⁹⁾, the findings of the present study suggest that in depopulated areas with long residency times, attachment to the community is firmly rooted, regardless of gender.

2. Relationship between social activity participation and community attachment among older men

Among older men, participation in paid work consistently showed a significant association with community attachment. This finding differs from that of a previous study⁷⁾ that examined the relationship between social activities and community attachment among seniors in depopulated areas and reported “religious activities” as the most relevant factor for men. In the study area, the proportion of men engaged in work (45.5%) was significantly higher than that of women (31.5%), indicating that work was a primary form of social participation for older men. Previous research suggests that older men tend to have higher community attachment as their subjective health improves, with good health serving as a source of social interaction that fosters community attachment⁷⁾. Although this study did not include subjective health as a control variable, a previous study has reported a positive association between employment in old age and good subjective health²⁰⁾. For older men in depopulated areas, employment likely functions not only as an economic activity but also as a daily reaffirmation of vitality, reflecting the perception that continued work is possible because of good health. Furthermore, in depopulated areas with declining labor forces, employment of older adults likely contributes directly to sustaining the community as a form of contribution to the region. Thus, recognizing one’s role through work and believing that it supports life in the community may contribute to community attachment. However, as this study was cross-sectional, we were unable to determine causality, as individuals with a stronger attachment to the region may also be more likely to continue working. However, further studies are required to confirm this hypothesis.

3. Relationship between social activity participation and community attachment among older women

For older women, participation in sports clubs showed a significant positive association with community attachment in Model 2, which was adjusted for basic attributes and health/social factors. However, this significance disappeared in Model 3, which included the effects of all other social activities. In Model 3, the OR decreased from 1.57 to 1.42, but the CI widened to 0.87–2.32, and the association was no longer significant. Since the participation rate in sports clubs among women was only 19.4%, and given the limited number of participants, the simultaneous inclusion of eight social activities in Model 3 may have dispersed the information used for estimation, potentially reducing statistical precision. Furthermore, women may participate in multiple activities, and the overlap between activities likely contributes to the instability of the estimates.

Several possibilities should be considered when interpreting these results. First, if the primary purpose of participating in social activities is not the activity itself but rather the interaction with familiar people, a similar effect would occur regardless of the specific type of activity, making it difficult to statistically isolate the effect of sports clubs alone. Previous studies have also reported a relationship between participation in hobby groups and community attachment¹¹⁾, suggesting the importance of interactions that transcend the type of activity. Second, a reverse causal relationship, in which those with a higher attachment to the community are more likely to participate in sports clubs and similar groups, has also been reported²¹⁾, and the cross-sectional design of this study does not allow for the identification of the direction of causality. Third, this study did not account for aspects such as individuals’ subjective interpretations of activity participation or the quality of social interaction. Therefore, it cannot be ruled out that such qualitative factors may have influenced the results.

In light of the above, the loss of significance in Model 3 does not indicate that participation in sports clubs is unrelated to attachment to the community. Rather, it can be interpreted as suggesting that for older women in depopulated areas, it is the very foundation of their lives—such as long-term residency, informal relationships built over time, and good mental health—that supports their attachment to the community, rather than whether they participate in specific social activities.

When individuals have a long history of living in a depopulated area and have cultivated close personal relationships within that context, their attachment to the community may already be saturated regardless of the type of activity in which they participate. The absence of an association with social activities in the final model likely reflects the significant contribution of these “foundational factors to the preceding activities”. Future research should examine not only the type of activity but also aspects such as the presence or absence of roles within activities and the quality of interactions.

4. Prospects for measures to enhance community attachment

This study examined the factors related to community attachment among older adult residents in depopulated areas based on gender-based differences. For older men, participation in paid work was significantly associated with attachment to their community. To maintain and enhance men’s attachment in depopulated areas, it is crucial to go beyond merely promoting hobby-based activities and instead strengthen employment counseling and job support systems tailored for seniors. Creating a “lifelong active participation” framework that allows individuals to continue holding roles within the community based on their own wishes and health status may help prevent the need for care and foster community attachment.

For older women, although no significant association with specific social activities was found, the importance of long-term residency, informal mutual support networks, and maintaining good mental health was suggested. Policies supporting women’s attachment to the community should include the continuous provision of casual gathering places without specific programs and the establishment of easily accessible counseling services for mental health concerns. Furthermore, establishing an outreach-based support system in which residents informally watch over one another, enabling neighbors to connect with individuals who cannot directly seek help from professionals, is believed to serve as the foundation necessary for continuing to live in familiar communities and maintaining attachment to the community.

5. New findings and limitations

This study yields two key findings. First, among older men in depopulated areas, participation in “paid work” was the factor most strongly associated with attachment to the community. Although previous studies reported that “religious activities” and “subjective health perceptions” were related to men’s attachment to their community⁷⁾, our findings demonstrate that within the context of depopulated areas with limited social resources, the creation of roles through work and the sense of contributing to the community are important factors that strengthen men’s bonds to their community.

Second, for older women, we found that life foundations such as years of residence, social support, and mental health, rather than participation in specific social activities, underpin attachment to the community. Previous studies have reported that participation in salon activities⁷⁾ and hobby clubs¹¹⁾ is associated with community attachment. Furthermore, although the univariate analysis suggested associations with sports clubs, this influence disappeared in the final model adjusted for background factors. This suggests that for women in depopulated areas, attachment to the community does not depend on specific activities, but is cultivated in a multilayered manner over a long life history.

This study has several limitations. First, because this study focused on a specific municipality designated as a depopulated area, there are limitations to generalizing the results to all depopulated areas across Japan. The study area is characterized by relatively strong social ties, with an average length of residence of 49.1 years, approximately 80% of residents reported a sense of attachment to the community, and approximately 90% reported that they had social support. Furthermore, the fact that participation rates in social activities remain at approximately 20% for each activity may reflect the limited availability of social resources in depopulated areas. Given that these regional characteristics may have influenced the results of this study, future research should include comparative analyses of other depopulated areas that differ in geographical conditions and industrial structures. Second, among the variables identified in previous research as factors related to community attachment, the selection of adjustment variables in the multivariate analysis was not exhaustively examined in this study. Therefore, the influence of uncontrolled confounding factors may have persisted. Additionally, although the variables in this study were dichotomized in accordance with previous research, this process may have resulted in the loss of information inherent to each variable, and the findings should be interpreted with caution. Third, because this was a cross-sectional study, we could not identify a causal relationship between participation in social activities and community attachment. However, in the study area, the average length of residence was 49.1 years, and while approximately 80% of residents reported attachment to the community, participation rates in various social activities remained at approximately 20% at most. This suggests that the association observed in this study may reflect which activities people with a pre-existing high level of attachment to the community participate in, rather than participation in activities that increase their attachment. In other words, in depopulated areas, attachment has already been formed through long-term residency, and participation in social activities may not create new attachment but rather serve to maintain and strengthen existing attachment. Longitudinal studies examining changes over time are required to clarify the direction of causality. Fourth, survey items were limited to the presence or absence of participation in social activities. Qualitative aspects, such as roles/the participant’s position, quality of interactions with others, and subjective satisfaction with participation, were not captured. Future research requires multifaceted verification that includes the qualitative content of social activities. Fifth, this study utilized secondary data from existing need surveys conducted by municipal governments. Attachment to the community was derived from one item of a community-level health-related SC indicator⁹⁾. Although this scale has been validated for reliability and validity, it is fundamentally designed to measure community-level social capital. Careful interpretation is required to determine whether it accurately measures the degree of internalized attachment experienced by individuals. Future research should conduct a detailed analysis and verification based on concepts that capture individual psychological aspects, such as attachment to community.

Conclusion

This study examined the factors related to community attachment among older adults living in depopulated areas, focusing on gender-based differences. The results showed that, for older men, participation in paid work was significantly associated with attachment to the community. This suggests that fostering a lifelong active system that enables older adults to maintain their roles in the community through employment support tailored to their needs, rather than merely promoting hobby-based activities, contributes to cultivating attachment to the community. For older women, although no significant association with specific social activities was found, the importance of long-term residency, informal mutual support, and good mental health was suggested. To support women’s attachment to their community, establishing casual gathering places independent of specific programs, providing mental health counseling services, and building an outreach-based support system where residents collaborate with professionals are considered necessary.

Conflict of interest

No disclosures related to the content of this paper.

Funding information

This study received no external funding.

Ethics approval and consent to participate

The study was conducted in accordance with the principles of the Declaration of Helsinki. Ethical approval was obtained from the Ethics Review Committee of the Department of Nursing, Faculty of Health Sciences, Asahi University (Approval No. 2024002). Because this study used secondary data from an existing municipal survey, the requirement for individual informed consent was waived by the Ethics Review Committee. The data were confirmed to have been anonymized by the provider and managed in an unlinked manner using research IDs.

Consent for publication

All authors have read and approved the final manuscript and consented for publication in the Journal of Rural Medicine.

Author contributions

Kato: Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Writing – original draft, Writing – review & editing. Nakamura: Investigation, Conceptualization, Methodology, Writing – review & editing. Additionally, generative AI was partially used to verify the structure of the text during the preparation of this paper; however, the authors and co-authors confirmed the consistency of the generated content.

Data availability statement

The data supporting the findings of this study are not publicly available because of restrictions imposed by the data provider.