ABSTRACT
ObjectivesãThe aim of this research is to classify elderly adults who live alone by their marital status type and to clarify how those types affect their higher-level functional capacity and mental health with a 2-year follow-up survey.MethodsãThis research is based on the results from a survey in 2013. The base-line scores were from 757 participants who completed a survey by mail, carried out in B area of A ward, Tokyo, within the jurisdiction of community general support centers, with people who were not at nursing care levels 4 or 5 and who were not residents of welfare facilities. This study analyzed data for 517 of 527 participants, who answered all questions in the 2015 survey and indicated their marital status. This research categorized the respondents into 4 types of marital status: separation, divorce, bereavement, and unmarried groups. This study adopted the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) as the index of higher-level functional capacity, and the WHO-Five Well-Being Index (WHO-5-J) as the mental health index. In the analysis of the causes of 2-year variations in TMIG-IC total scores and WHO-5-J scores, the dependent variable was each variation. This study used an analysis of covariance in which the fixed factors were types of living alone, sex, annual income, and having children who lived separately in the 2013 survey, and the covariance comprised the base-line scores for the dependent variables, age, and chronic diseases in the 2013 survey.ResultsãWith regards to the variation in TMIG-IC total scores, main effects of the types of living alone were observed. The adjusted variation of covariance decreased most in the separation group (-0.95). For the variation in WHO-5-J scores, main effects of the types of living alone were indicated. In the divorce group, the adjusted variation of covariance was significantly higher than for the unmarried group (2.33 vs. -0.55).ConclusionãThe results revealed that the types of marital status: separated, divorced, bereaved, and unmarried, affect changes in the higher-level functional capacity and mental health status of elderly adults living alone, 2 years later. Thus, although previously regarded as a single category, types of marital status should be considered in the analysis of elderly adults who live alone.
Subject(s)
Health Status , Marital Status , Mental Healing , Residence Characteristics , Social Isolation , Spouses , Age Factors , Aged , Aged, 80 and over , Female , Humans , Male , Time Factors , TokyoABSTRACT
OBJECTIVES: Area Comprehensive Support Centers play critical roles in identifying those elderly not currently using medical or long-term health care services, offering preventative measures against further health crises and possible isolated death. The purpose of this study was to develop an "At-Risk Elderly Checklist." This checklist can help in identifying those at-risk elderly, allowing people in communities to provide the Area Comprehensive Support Center with information about at-risk elderly. METHODS: As a preliminary step, interviews were conducted with 29 professionals who work for 17 different Area Comprehensive Support Centers located in 4 municipalities around the Tokyo Metropolitan Area. We constructed 23 items based on the findings of this preliminary research and existing tools used in different areas. These items represented distinctive characteristics of elderly who need support from Area Comprehensive Support Centers in order to receive necessary medical and long-term care services. A self-report survey was conducted on 109 professionals of 20 Area Comprehensive Support Centers of Ota-ku, Tokyo in order to examine the content validity of the items. RESULTS: Using factor analysis, we identified 5 factors consisting of 19 items. The first factor consisted of 5 items helping people to identify a serious health crisis from the appearance and condition of the elderly individual's home. The health crisis indicated by these items might require immediate hospitalization. The second factor consisted of 5 items that can help people notice symptoms of dementia through their communication with elderly. The third factor consisted of 4 items useful for assessing health deterioration of the elderly by observing various behaviors. The fourth factor consisted of 3 items that people can use to measure the progress of dementia, including issues with how the elderly dressed themselves. The fifth factor consisted of 2 items that can be used to understand signs of declining health or the progress of dementia by paying attention to the elderly individuals' body odor and personal appearance. From the original 19 items, 14 that were considered the most useful in detecting at-risk elderly were selected based on a frequency distribution. The content validity of 14 items was confirmed by 20 professionals from Area Comprehensive Support Centers in Outa-ku. CONCLUSION: This checklist may be effective in the early detection of elderly at risk of serious health crises and isolated death due to not using necessary medical and long-term care services.
