Living Alone, Cognitive Function, and Well-Being of Japanese Older Men and Women: A Cross-Sectional Study
Living Alone, Cognitive Function, and Well-Being of Japanese Older Men and Women: A Cross-Sectional Study
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日本老年男性和女性的独居、认知功能和幸福感：一项横断面研究
DOI：
10.1155/2023/7183821
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发表时间：
2023
影响因子：
2.4
通讯作者：
Awata Shuichi
中科院分区：
文献类型：
--
作者：
Tsuda Shuji;Inagaki Hiroki;Sugiyama Mika;Okamura Tsuyoshi;Miyamae Fumiko;Ura Chiaki;Edahiro Ayako;Awata Shuichi
这项研究考察了独居与老年男性和女性幸福感相关的认知能力下降之间的相互作用。我们分析了来自横断面、自我管理的问卷调查的数据，调查对象是东京社区居住的65岁以上老年人，他们没有接受长期护理。问卷包括10项自我管理的痴呆检查表（SDC）、世界卫生组织(WHO) - 5幸福感量表、一个关于他们生活安排的问题、参与者的基线特征、社会支持和社会联系。分析按性别分层，并采用相互作用的线性回归模型进行拟合。共有34255名男性和41056名女性参与了调查。男性和女性的样本平均年龄分别为73.5岁（SD 6.1）和73.6岁（SD 6.0），分别为18.5%和26.0%。SDC评分分布显示95.9%和97.0%的患者认知状态从完整到可能轻度痴呆不等。认知能力下降与男性（β - 0.53; 95% CI - 0.58, - 0.48;p< 0.001）和女性（β - 0.38; 95% CI - 0.42, - 0.34;p< 0.001）的幸福感降低呈线性相关。与与他人同住的男性和女性相比，独居者随着认知功能的下降而经历较低的幸福感，并且相互作用（生活安排* SDC）具有统计学意义。在控制了被试的特征、社会支持和社会接触后，这种相互作用在男性中显著（p< 0.001），而在女性中不显著（p= 0.46）。我们的研究结果表明，与与他人同住的老年人相比，独居的老年男性和女性在认知能力下降和幸福感下降方面略显陡峭。控制男女之间的混淆因素所产生的明确影响表明，福利服务部门需要采取按性别区分的对策。
This study examined the interaction of living alone and cognitive decline in relation to the well‐being of older men and women. We analyzed the data from a cross‐sectional, self‐administered questionnaire survey of community‐dwelling older adults in Tokyo, who were aged 65+ and not on long‐term care. The questionnaire included the 10‐item self‐administered dementia checklist (SDC), the WHO‐5 Well‐Being Scale, a question on their living arrangement, and participants’ baseline characteristics and social support and social contact. The analyses were stratified by sex and fitted with linear regression models with interaction. A total of 34,255 men and 41,056 women participated. Sample mean age was 73.5 (SD 6.1) for men and 73.6 (SD 6.0) for women, and 18.5% and 26.0% lived alone. The distribution of SDC scores indicated 95.9% and 97.0% had a cognitive status varying from intact to possible mild dementia. Cognitive decline showed a linear association with lower well‐being in men (beta −0.53; 95% CI −0.58, −0.48;p< 0.001) and women (beta −0.38; 95% CI −0.42, −0.34;p< 0.001). Compared to men and women living with others, those living alone experienced lower well‐being as their cognitive function declined, and the interactions (living arrangements∗SDC) were statistically significant. After controlling participants’ characteristics and social support and social contact, the interaction was significant in men (p< 0.001) but not in women (p= 0.46). Our findings support that older men and women living alone experience a slightly steeper downward trajectory of cognitive decline and poor well‐being than their counterparts living with others. The unequivocal effects of controlling confounding factors between men and women indicate the need for gendered countermeasures by welfare services.