Eating Alone as Social Disengagement is Strongly Associated With Depressive Symptoms in Japanese Community-Dwelling Older Adults

Aki Kuroda; Tomoki Tanaka; Hirohiko Hirano; Yuki Ohara; Takeshi Kikutani; Hiroyasu Furuya; Shuichi P Obuchi; Hisashi Kawai; Shinya Ishii; Masahiro Akishita; Tetsuo Tsuji; Katsuya Iijima

doi:10.1016/j.jamda.2015.01.078

Eating Alone as Social Disengagement is Strongly Associated With Depressive Symptoms in Japanese Community-Dwelling Older Adults

J Am Med Dir Assoc. 2015 Jul 1;16(7):578-85. doi: 10.1016/j.jamda.2015.01.078. Epub 2015 Feb 14.

Authors

Affiliations

¹ Institute of Gerontology, The University of Tokyo, Tokyo, Japan.
² Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
³ Department of Oral Health Care Education, Graduate School of Medical and Dental Sciences, The Tokyo Medical and Dental University, Tokyo, Japan.
⁴ Division of Clinical Oral Rehabilitation, The Nippon Dental University Graduate School of Life Dentistry at Tokyo, Tokyo, Japan.
⁵ Department of Geriatric Medicine, The University of Tokyo, Tokyo, Japan.
⁶ Institute of Gerontology, The University of Tokyo, Tokyo, Japan. Electronic address: iijima@iog.u-tokyo.ac.jp.

PMID: 25687929
DOI: 10.1016/j.jamda.2015.01.078

Abstract

Objectives: Depression in later life poses a grave challenge for the aging countries. The reported key risk factors include social disengagement, but the lack of social companionship during mealtimes, namely eating alone, has not been examined extensively, especially in relation to living arrangement. Past studies on changes along geriatric trajectories in the association between social engagement and depression also remain inadequate. This study aims to examine the association between social engagement and depressive symptoms with a particular focus on eating alone and how the association changes along the aging and mental frailty trajectories.

Design: A cross-sectional study.

Setting: Kashiwa-city, Chiba-prefecture in Japan.

Participants: A total of 1856 community-dwelling older adults.

Measurements: The 15-item Geriatric Depression Scale was used to measure depressive symptoms. The indicators used to assess social engagement included eating alone, living arrangement, reciprocity of social support, social participation, social stressors and social ties.

Results: Social engagement was significantly associated with depressive symptoms. Those who live with their families yet eat alone were found to be at particular risk (odds ratio = 5.02, 95% confidence interval 2.5-9.9 for young-old; odds ratio = 2.41, 95% confidence interval 1.2-4.8 for old-old). Younger and less mentally frail populations showed stronger associations.

Conclusions: Eating alone was a key risk factor for depressive symptoms in community-dwelling older adults. The living arrangement in which they eat alone is important in identifying those with the greatest risk. Mental health management for older adults requires comprehensive assessment of their social relations that takes into account their companionship during mealtimes. Social preventive measures need to involve early interventions in order to augment their effectiveness against mental frailty.

Keywords: Eating alone; depressive symptoms; social engagement.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aged, 80 and over
Cross-Sectional Studies
Depression*
Feeding Behavior*
Female
Geriatric Assessment*
Homes for the Aged*
Humans
Japan
Male
Social Behavior*
Surveys and Questionnaires