title: A comparison of family care infrastructure for demented elderly in inner cities and regional areas in Japan.
abstract: BACKGROUND
  Family members' observations of daily life are important for the diagnosis and treatment of dementia. However, elderly people are increasingly living alone, and family structures tend to differ between inner-city areas and regional areas. We aimed to compare the family caregiving infrastructure of demented elderly visiting a memory clinic.
  
  
  METHODS
  Subjects were consecutive outpatients with dementia at the memory clinic at a university hospital in two different areas. We compared subjects' demographic data, residency status, housemates and companion status at the time of their initial visit.
  
  
  RESULTS
  Patients in the inner-city area (n= 99) had more education and higher Mini-Mental State Examination scores than those in the regional area (n= 172). In both areas, the highest proportion of patients lived with their spouse. In the inner city, patients' housemates were either their spouse (34%) or their child (13%); 22% lived alone. In regional areas, patients lived with their spouse only (39%) or in their child's household (23%); 14% lived alone. At their initial consultation, inner-city patients were accompanied by a family member other than their spouse (49%), a spouse (27%), or they were alone (7%). In the regional area, patients' companions were their spouse (35%) or their spouse and other family members (18%); patients rarely arrived alone. Regression analysis showed that education, diagnosis, housemate state (child only), and companion state (alone) significantly influenced the living area.
  
  
  CONCLUSIONS
  Our results suggest family caregiving infrastructure of demented elderly differ between the two areas. This may reflect changes in social structure and increased awareness regarding dementia in inner-city areas.
authors.affiliation: Department of Psychiatry, Jikei University School of Medicine, Tokyo, Japan. shinagawa@jikei.ac.jp
authors.forename: Shunichiro
authors.initials: S
authors.lastname: Shinagawa
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Yatabe
authors.forename: Mamoru
authors.initials: M
authors.lastname: Hashimoto
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakayama
authors.forename: Manabu
authors.initials: M
authors.lastname: Ikeda
mesh_terms: D000368:Aged; D017028:Caregivers / Q000706:statistics & numerical data*; D003704:Dementia / Q000453:epidemiology* / Q000628:therapy*; D005190:Family; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D013383:Suburban Population / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data*