Eating alone among community-dwelling Japanese elderly: association with depression and food diversity.
Eating alone is an emerging social concern these days along with the background of serious aging population growth and increasing number of single-dwellers in Japan. However, little study is focused eating alone and its relation to the health status of community-dwelling elderly.


OBJECTIVE
To clarify the relations between eating alone and geriatric functions such as depression, quantitative subjective quality of life (QOL), activities of daily living (ADL) and dietary status of community-dwelling Japanese elderly.


METHODS
A cross-sectional study.


METHODS
Tosa town, one of the "super-aged" towns in Japan.


METHODS
The study population consisted of 856 community-dwelling elderly aged ≥65 living in Tosa town.


METHODS
Eating alone and living arrangement was defined by the questionnaire. Geriatric functions were assessed by measuring activities of daily living (ADL), depressive symptom using 15-item geriatric depression scale (GDS-15), and quality of life (QOL). Food diversity was investigated as a measure of dietary quality using 11-item Food Diversity Score Kyoto (FDSK-11). Body mass index (BMI) was calculated using height and body weight during a medical assessment.


RESULTS
The proportion of the elderly who usually eat alone was 33.2% in this study population. Even among 697 elderly subjects who live with others, 136 persons (19.5%) ate alone. The participants who ate alone were significantly depressed according to the assessment using GDS-15 score (5.7±4.3 vs. 4.4±3.8, P<0.001). Those who ate alone have lower scores of QOL items than those who ate with others (Subjective sense of health: 52.5±21.9 vs. 55.7±20.2 P=0.035, Relationship with family: 74.1±23.5 vs. 78.9±18.6 P<0.001, Subjective happiness: 58.5±22.7 vs. 62.2±21.1 P=0.019). A significant close association was found between eating alone and lower food diversity (FDSK-11 score 9.9±1.3 vs. 10.2±1.3, P=0.002). BMI was lower in the elderly subjects who ate alone than those with others. By the multivariate analysis, depression was independently associated with eating alone in the logistic regression model adjusted for age, sex, BMI and food diversity as confounding factors (OR: 1.42, CI: 1.00-2.11, P=0.043). Food diversity was also significantly associated even after the adjustment of these confounding factors.


CONCLUSIONS
Eating alone is an important issue related to depression and QOL as well as dietary status of community-dwellingl elderly in Japan. This study shows the simple and inexpensive way "eating together" may contribute to improve depressive mood of elderly persons, with a strong message that supports of family, friends and neighbors are very important.
Department of Field Medicine, School of Public Health, Kyoto University, 46 Shimoadachi-cho, Yoshida, Sakyo-ku, 606-8501 Kyoto, Japan. yumi621@gmail.com
Y
Y
Kimura
T
T
Wada
K
K
Okumiya
Y
Y
Ishimoto
E
E
Fukutomi
Y
Y
Kasahara
W
W
Chen
R
R
Sakamoto
M
M
Fujisawa
K
K
Otsuka
K
K
Matsubayashi
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology / Q000517:prevention & control; D004032:Diet / Q000208:ethnology / Q000523:psychology*; D005260:Female; D015577:Geriatric Assessment; D006306:Health Surveys; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D011788:Quality of Life; D012423:Rural Health / Q000208:ethnology; D012847:Single Person / Q000523:psychology; D012934:Social Isolation / Q000523:psychology*; D012944:Social Support