title: Eating Alone as Social Disengagement is Strongly Associated With Depressive Symptoms in Japanese Community-Dwelling Older Adults.
abstract: OBJECTIVE
  Depression in later life poses a grave challenge for the aging countries. The reported key risk factors include social disengagement, but the lack of social companionship during mealtimes, namely eating alone, has not been examined extensively, especially in relation to living arrangement. Past studies on changes along geriatric trajectories in the association between social engagement and depression also remain inadequate. This study aims to examine the association between social engagement and depressive symptoms with a particular focus on eating alone and how the association changes along the aging and mental frailty trajectories.
  
  
  METHODS
  A cross-sectional study.
  
  
  METHODS
  Kashiwa-city, Chiba-prefecture in Japan.
  
  
  METHODS
  A total of 1856 community-dwelling older adults.
  
  
  METHODS
  The 15-item Geriatric Depression Scale was used to measure depressive symptoms. The indicators used to assess social engagement included eating alone, living arrangement, reciprocity of social support, social participation, social stressors and social ties.
  
  
  RESULTS
  Social engagement was significantly associated with depressive symptoms. Those who live with their families yet eat alone were found to be at particular risk (odds ratio = 5.02, 95% confidence interval 2.5-9.9 for young-old; odds ratio = 2.41, 95% confidence interval 1.2-4.8 for old-old). Younger and less mentally frail populations showed stronger associations.
  
  
  CONCLUSIONS
  Eating alone was a key risk factor for depressive symptoms in community-dwelling older adults. The living arrangement in which they eat alone is important in identifying those with the greatest risk. Mental health management for older adults requires comprehensive assessment of their social relations that takes into account their companionship during mealtimes. Social preventive measures need to involve early interventions in order to augment their effectiveness against mental frailty.
authors: Institute of Gerontology, The University of Tokyo, Tokyo, Japan.
authors: Aki
authors: A
authors: Kuroda
authors: Institute of Gerontology, The University of Tokyo, Tokyo, Japan.
authors: Tomoki
authors: T
authors: Tanaka
authors: Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
authors: Hirohiko
authors: H
authors: Hirano
authors: Department of Oral Health Care Education, Graduate School of Medical and Dental Sciences, The Tokyo Medical and Dental University, Tokyo, Japan.
authors: Yuki
authors: Y
authors: Ohara
authors: Division of Clinical Oral Rehabilitation, The Nippon Dental University Graduate School of Life Dentistry at Tokyo, Tokyo, Japan.
authors: Takeshi
authors: T
authors: Kikutani
authors: Division of Clinical Oral Rehabilitation, The Nippon Dental University Graduate School of Life Dentistry at Tokyo, Tokyo, Japan.
authors: Hiroyasu
authors: H
authors: Furuya
authors: Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
authors: Shuichi P
authors: SP
authors: Obuchi
authors: Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
authors: Hisashi
authors: H
authors: Kawai
authors: Department of Geriatric Medicine, The University of Tokyo, Tokyo, Japan.
authors: Shinya
authors: S
authors: Ishii
authors: Department of Geriatric Medicine, The University of Tokyo, Tokyo, Japan.
authors: Masahiro
authors: M
authors: Akishita
authors: Institute of Gerontology, The University of Tokyo, Tokyo, Japan.
authors: Tetsuo
authors: T
authors: Tsuji
authors: Institute of Gerontology, The University of Tokyo, Tokyo, Japan. Electronic address: iijima@iog.u-tokyo.ac.jp.
authors: Katsuya
authors: K
authors: Iijima
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003863:Depression; D005247:Feeding Behavior; D005260:Female; D015577:Geriatric Assessment; D006707:Homes for the Aged; D006801:Humans; D007564:Japan; D008297:Male; D012919:Social Behavior; D011795:Surveys and Questionnaires
keywords: Eating alone; depressive symptoms; social engagement