title: [Factors associated with mental health well-being of urban community-dwelling elders in Japan: comparison between subjects with and without long-term care insurance certification].
abstract: OBJECTIVE
  The present study aimed to (1) examine the mental health well-being of urban community-dwelling elderly individuals; and (2) examine factors related to mental health well-being of those with long-term care insurance certification (LTCI+) and those without LTCI certification (LTCI-).
  
  
  METHODS
  We conducted a community-based, cross-sectional study that included 3,905 subjects aged 65 years or older living in Tokyo, Japan. A self-administered questionnaire was mailed to each participant. Mental health well-being was assessed using the Japanese version of the World Health Organization Mental Health Wellbeing Index--five items (WHO-5).
  
  
  RESULTS
  Of the 2,431 respondents (response rate, 63.5%), 1,954 who completed WHO-5 were analyzed (241 LTCI+; 1,713 LTCI-). The total score of WHO-5 was 15.61±6.08 among all subjects; when a cut-off criterion of 12/13 was used, the frequency of low mental health well-being was 29.5% among all subjects. In a stratified analysis according to LTCI certification using multivariate logistic regression analysis, small social support network, heart disease, and daytime sleepiness were independently associated with low mental health well-being for the LTCI+ group; low education level, small social support network, low subjective health, daytime sleepiness, and worries about forgetfulness were independently associated with low mental health well-being for the LTCI- group.
  
  
  CONCLUSIONS
  To improve mental health well-being of community-dwelling elderly individuals with LTCI certification, attention should be focused on those with small social network or daytime sleepiness. To improve mental health well-being of community-dwelling elderly individuals without LTCI certification, attention should be focused on those with small social network, low subjective health, or worries about forgetfulness.
authors.affiliation: Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute of Gerontology.
authors.forename: Kae
authors.initials: K
authors.lastname: Ito
authors.forename: Hiroki
authors.initials: H
authors.lastname: Inagaki
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Okamura
authors.forename: Kentaro
authors.initials: K
authors.lastname: Shimokado
authors.forename: Shuichi
authors.initials: S
authors.lastname: Awata
mesh_terms: D000368:Aged; D019058:Community Networks; D003625:Data Collection; D005260:Female; D006801:Humans; D007353:Insurance, Long-Term Care / Q000191:economics*; D008297:Male; D008603:Mental Health; D012944:Social Support; D014041:Tokyo; D014505:Urban Population