title: Gender differences in association between psychological distress and detailed living arrangements among Japanese older adults, aged 65-74 years.
abstract: OBJECTIVE
  Past studies have shown that living alone is detrimental to older adults' mental health. However, there has been little focus on how older adults' psychological distress differed by more detailed living arrangement, as well as by gender. The present study investigates various living arrangements in association with psychological distress among older men and women.
  
  
  METHODS
  Data from community-dwelling Japanese older adults were collected through a mail survey (n = 1,807, aged 65-74 years, 51.5 % men). Psychological distress level was measured using Kessler's six-item psychological distress scale. Living arrangements were categorized into four groups; "living with spouse only", "living with spouse and other family", "living with other family without spouse" or "living alone". Multiple logistic regression analyses were used to examine the associations of living arrangements with psychological distress level.
  
  
  RESULTS
  Older adults living alone were observed to have higher psychological distress. In addition, gender-stratified analyses showed that higher distress levels were observed among older men living with family, but without a spouse (OR: 2.85, 95 % CI: 1.51-5.39). In contrast, higher distress was observed among older women living with spouse and other family (OR: 1.53, 95 % CI: 1.03-2.28).
  
  
  CONCLUSIONS
  Psychological distress in older Japanese adults was associated with living arrangements, but such associations differed by gender. The association of living with a spouse on older men's mental health was striking, while living with any family was found to be rather important for older women, aged 65-74 years.
authors.affiliation: Department of Preventive Medicine and Public Health, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo, 160-8402, Japan, kikuchih@tokyo-med.ac.jp.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kikuchi
authors.forename: Tomoko
authors.initials: T
authors.lastname: Takamiya
authors.forename: Yuko
authors.initials: Y
authors.lastname: Odagiri
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Ohya
authors.forename: Tomoki
authors.initials: T
authors.lastname: Nakaya
authors.forename: Teruichi
authors.initials: T
authors.lastname: Shimomitsu
authors.forename: Shigeru
authors.initials: S
authors.lastname: Inoue
mesh_terms: D000368:Aged; D005191:Family Characteristics; D005260:Female; D006798:Housing; D006801:Humans; D057187:Independent Living; D007564:Japan; D016015:Logistic Models; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D012111:Residence Characteristics; D012737:Sex Factors; D012959:Socioeconomic Factors; D018454:Spouses; D013315:Stress, Psychological / Q000208:ethnology*