title: The association between living alone and frailty in a rural Japanese population: the Nagasaki Islands study.
abstract: BACKGROUND
  Demographic changes in Japan have resulted in an increased number of elderly living alone.
  
  
  OBJECTIVE
  The aim of this study was to identify if there is an association between frailty and living alone.
  
  
  METHODS
  We conducted a cross-sectional study of 1602 Japanese men and women living in isolated islands. Information obtained included height, body weight, handgrip strength, and family structure; antihypertensive, hypoglycaemic, and lipid-lowering medication use; history of stroke or ischaemic heart disease, smoking history, alcohol intake, joint pain or swelling. Relevant laboratory test results were obtained from recent health check-ups. The Frailty Index for Japanese elderly, a 15-item self-report questionnaire was completed by participants and the Kessler Psychological Distress Scale (K6) was administered.
  
  
  RESULTS
  After individuals aged below 60 years old or those with missing data were excluded, data from 1224 participants were analysed. Living alone (single household family structure) was significantly associated with frailty in men (odds ratio [OR] 3.85; 95% confidence interval [CI] 1.94-7.65), but not in women (OR 1.08; 95% CI 0.72-1.63). This association in men remained statistically significant after adjustment for known risk factors for frailty.
  
  
  CONCLUSIONS
  In the elderly population in rural Nagasaki, men living alone have a high risk of frailty. Screening and intervention to prevent frailty in this population is urgently needed.
authors.affiliation: Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Sakamoto, Nagasaki, and Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Science, Goto, Nagasaki, Japan.
authors.forename: Hirotomo
authors.initials: H
authors.lastname: Yamanashi
authors.affiliation: Department of Community Medicine, Nagasaki University Graduate School of Biomedical Science, Sakamoto, Nagasaki, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Shimizu
authors.affiliation: Department of General Practice, University of Tasmania, Hobart, Tasmania, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Nelson
authors.affiliation: Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Science, Goto, Nagasaki, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Koyamatsu
authors.affiliation: Department of Community Medicine, Nagasaki University Graduate School of Biomedical Science, Sakamoto, Nagasaki, Japan.
authors.forename: Mako
authors.initials: M
authors.lastname: Nagayoshi
authors.affiliation: Department of Community Medicine, Nagasaki University Graduate School of Biomedical Science, Sakamoto, Nagasaki, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Kadota
authors.affiliation: Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Science, Sakamoto, Nagasaki, Japan.
authors.forename: Mami
authors.initials: M
authors.lastname: Tamai
authors.affiliation: Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Sakamoto, Nagasaki, Japan.
authors.forename: Koya
authors.initials: K
authors.lastname: Ariyoshi
authors.affiliation: Department of Community Medicine, Nagasaki University Graduate School of Biomedical Science, Sakamoto, Nagasaki, and Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Science, Goto, Nagasaki, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Maeda
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology; D018771:Arthralgia / Q000453:epidemiology; D001837:Body Weights and Measures; D002317:Cardiovascular Agents / Q000008:administration & dosage; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D018737:Hand Strength; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D062312:Islands; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D012934:Social Isolation
chemical_list: D002317:Cardiovascular Agents; D007004:Hypoglycemic Agents