title: Sex differences in attachment to spouses among older Japanese couples.
abstract: OBJECTIVE
  Attachment among older adults can partially explain sex differences in bereavement outcomes, but there is currently little evidence regarding this. The aim was to quantify sex differences in the proportion of spouses as attachment figures among older couples.
  
  
  METHODS
  We carried out a secondary analysis of cross-sectional questionnaire survey data. The dataset included information about 5137 respondents aged 65 years or older in Kanonji and Mitoyo, two rural cities in Kagawa prefecture, Japan; those who were never married or were widowed or divorced were excluded. The questionnaire asked participants whom they most want to be close by when they die (this person was defined as an "attachment figure"), and compared the proportion of older people of each sex who named their spouse. We used multiple logistic regression analyses to examine the independent association of sex with the proportion of spouses as attachment figures.
  
  
  RESULTS
  Of the 2513 male respondents, 1494 (59.5%) answered "spouse." Of the 2624 female respondents, 904 (34.5%) answered "spouse." Multiple logistic regression analyses adjusted for age, live-in children, annual income, participation in community activities, presence of a long-term primary care doctor, anxiety about death and preferences for place of death showed that men had a higher probability of attachment to spouses than women (odds ratio 2.83, 95% confidence interval 2.43-3.31).
  
  
  CONCLUSIONS
  Spouses are more likely to be attachment figures for men than for women. The present study supports the theory that sex differences in attachment might partially explain the differences in the bereavement effect between sexes among older people. Geriatr Gerontol Int 2017; 17: 834-838.
authors.affiliation: Department of Anesthesiology, Graduate School of Medicine, Kagawa University, Kagawa, Japan.
authors.forename: Katsunori
authors.initials: K
authors.lastname: Yokoyama
authors.affiliation: Department of Surgery, Mitoyo General Hospital, Kagawa, Japan.
authors.forename: Kazutoyo
authors.initials: K
authors.lastname: Shirakawa
authors.affiliation: Department of Public Health, Faculty of Medicine, Kagawa University, Kagawa, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Hirao
authors.affiliation: Department of Community Health, Mitoyo General Hospital, Kagawa, Japan.
authors.forename: Morihito
authors.initials: M
authors.lastname: Nakatsu
authors.affiliation: Department of Public Health, Faculty of Medicine, Kagawa University, Kagawa, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yoda
authors.affiliation: Department of Public Health, Faculty of Medicine, Kagawa University, Kagawa, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Suzuki
authors.affiliation: Department of Anesthesiology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
authors.forename: Yugo
authors.initials: Y
authors.lastname: Okabe
authors.affiliation: Department of Anesthesiology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
authors.forename: Gotaro
authors.initials: G
authors.lastname: Shirakami
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001601:Bereavement; D002908:Chronic Disease / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D011159:Population Surveillance / Q000379:methods*; D015995:Prevalence; D012424:Rural Population; D012737:Sex Factors; D012959:Socioeconomic Factors; D018454:Spouses / Q000706:statistics & numerical data*
keywords: attachment figure; bereavement effect; older couple; sex difference; spouse