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BMC Geriatrics
Published in: BMC Geriatrics 1/2017

Open Access 01-12-2017 | Research Article

Cohort study on living arrangements of older men and women and risk for basic activities of daily living disability: findings from the AGES project

Authors: Tami Saito, Chiyoe Murata, Jun Aida, Katsunori Kondo

Published in: BMC Geriatrics | Issue 1/2017

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Abstract

Background

Living arrangements of older adults have changed worldwide with increasing solitary and non-spouse households, which could affect social care systems. However, the relationship between these households and disability onset has remained unclear. We examined the relationship between living arrangements and the onset of basic activities of daily living disability in older adults, with a focus on gender differences and cohabitation status of those without a spouse.

Methods

Data from 6600 men and 6868 women aged 65 years or older without disability were obtained from the Aichi Gerontological Evaluation Study Project in Japan. Onset of disability was followed for 9.4 years. Disability was assessed based on Long-term Care Insurance System registration. A hierarchical Cox proportional hazards model was conducted to examine the risk of living alone and living only with non-spousal cohabitants compared to those living with spouses.

Results

Men living only with non-spousal cohabitants and those living alone were significantly more likely to develop disability after controlling for health and other covariates (hazard ratio = 1.38 and 1.45, respectively), while a significant difference was found only for women living alone (hazard ratio = 1.19). The risk of living with non-spousal cohabitants was marginally stronger in men, indicated by the interaction effect model (p = .08). A series of hierarchical analyses showed that social support exchange explained 24.4% and 15.8% of the excess risk of disability onset in men living alone and those living only with non-spousal cohabitants, respectively. A subsequent analysis also showed that support provision by older adults more greatly explained such excess risk than receiving support from others.

Conclusions

Older men without spouses were more likely to develop disability onset regardless of cohabitants. Health professionals should consider programs that enhance social support exchange, particularly support provision by older adults who are at risk of disability.

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Metadata
Title
Cohort study on living arrangements of older men and women and risk for basic activities of daily living disability: findings from the AGES project
Authors
Tami Saito
Chiyoe Murata
Jun Aida
Katsunori Kondo
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2017
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-017-0580-7

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