Social relationaship factors and risk of care requirement in Japanese elderly

OBJECTIVE: To identify associations between social relationship factors and risk of requirement for care in elderly people living at home. METHOD: In February 2000, a questionnaire was distributed to all residents aged 65 and over in a city in Aichi prefecture, Japan. The number of responses was 3596, a return rate of 72.0%. The records of 2725 subjects who were not under care as of April 2000 were selected as a sample and treated with Cox's proportional hazards model in order to analyze associations between social relationship variables and the risk of care requirement. RESULTS: (1) For males, the higher the acceptance of support, the higher the risk of care requirement (hazard ratio (HR) 1.12, 95% confidence interval (CI) 1.04-1.21). For females, the lower the contact frequency with separately-living family members, the higher the incidence (HR2.14, 95% CI 1.27-3.62). Also, the analysis of female subjects showed a strong association between not providing social support to others and the risk of care requirement (HR2.75, 95% CI 1.61-4.71). (2) Analysis of the effects of social support indicated that the male subjects who did not provide support to others but received such support themselves were at significantly high risk of care requirement (HR2.90, 95% CI 1.17-7.18). (3) In the case of female subjects who lived alone, unlike those with other living arrangements, there appeared to be no significant associations between involvement in social networks and their support provision to others, and the risk of care requirement. CONCLUSIONS: The study confirmed that gender and living arrangements both influence associations between the risk of care requirement in the elderly and social networks and support. The study also indicated that provision of support by the elderly is one important factor that can lower the risk of needing care.