Abstract
Objective
Design
Setting and Participants
Methods
Results
Conclusion and Implications
Keywords
White Paper on Aging Society 2021.
Archived: WHO Timeline - COVID-19.
Basic data on new social security issues in view of the spread of the novel coronavirus infection.
- Fujiwara Y.
- Nonaka K.
- Kuraoka M.
- et al.
Methods
Study Participants
Depressive Symptoms
Living Arrangement
Non–Face-to-Face Social Interactions
Statistical Analysis
Results
Overall | Living Arrangement | ||
---|---|---|---|
Living Together | Living Alone | ||
n = 1001 | n = 863 | n = 138 | |
Age, y, mean (SD) | 79.9 (4.9) | 79.7 (4.9) | 81.5 (5.0) |
Gender, n (%) | |||
Male | 467 (46.7) | 433 (50.2) | 34 (24.6) |
Female | 534 (53.3) | 430 (49.8) | 104 (75.4) |
Educational attainment, y, n (%) | |||
Low | 663 (66.2) | 578 (67.0) | 85 (61.6) |
High | 322 (32.2) | 273 (31.6) | 49 (35.5) |
Missing | 16 (1.6) | 12 (1.4) | 4 (2.9) |
Subjective economic status, n (%) | |||
Severe | 751 (75.0) | 651 (75.4) | 100 (72.5) |
Normal or rich | 230 (23.0) | 194 (22.5) | 36 (26.1) |
Missing | 20 (2.0) | 18 (2.1) | 2 (1.4) |
Comorbidities, n (%) | |||
None | 77 (7.7) | 68 (7.9) | 9 (6.5) |
One | 512 (51.1) | 435 (50.4) | 77 (55.8) |
Two or more | 410 (41.0) | 358 (41.5) | 52 (37.7) |
Missing | 2 (0.2) | 2 (0.2) | 0 (0.0) |
Basic activities of daily living performance, n (%) | |||
No difficulty | 866 (86.5) | 751 (87.0) | 115 (83.3) |
Difficulty | 95 (9.5) | 78 (9.0) | 17 (12.3) |
Missing | 40 (4.0) | 34 (3.9) | 6 (4.3) |
Instrumental activities of daily living performance, n (%) | |||
No difficulty | 851 (85.0) | 727 (84.2) | 124 (89.9) |
Difficulty | 108 (10.8) | 100 (11.6) | 8 (5.8) |
Missing | 42 (4.2) | 36 (4.2) | 6 (4.3) |
Subjective health status, n (%) | |||
Good | 765 (76.4) | 656 (76.0) | 109 (79.0) |
Poor | 188 (18.8) | 163 (18.9) | 25 (18.1) |
Missing | 48 (4.8) | 44 (5.1) | 4 (2.9) |
Subjective memory complaints, n (%) | |||
No | 447 (44.7) | 387 (44.8) | 60 (43.5) |
Yes | 525 (52.4) | 454 (52.6) | 71 (51.4) |
Missing | 29 (2.9) | 22 (2.5) | 7 (5.1) |
Motor function, n (%) | |||
Not impaired | 825 (82.4) | 713 (82.6) | 112 (81.2) |
Impaired | 124 (12.4) | 102 (11.8) | 22 (15.9) |
Missing | 52 (5.2) | 48 (5.6) | 4 (2.9) |
Depressive symptoms, n (%) | |||
Without depressive symptoms | 551 (55.0) | 479 (55.5) | 72 (52.2) |
With depressive symptoms | 392 (39.2) | 334 (38.7) | 58 (42.0) |
Missing | 58 (5.8) | 50 (5.8) | 8 (5.8) |
Frequency of going out, n (%) | |||
≥5 d/wk | 361 (36.1) | 322 (37.3) | 39 (28.3) |
Two to 4 d/wk | 434 (43.4) | 372 (43.1) | 62 (44.9) |
≤1 d/wk | 191 (19.1) | 157 (18.2) | 34 (24.6) |
Missing | 15 (1.5) | 12 (1.4) | 3 (2.2) |
Frequency of meeting with friends, n (%) | |||
≥ once/week | 362 (36.2) | 306 (35.5) | 56 (40.6) |
Once/mo to once/wk | 306 (30.6) | 263 (30.5) | 43 (31.2) |
< once/month | 259 (25.9) | 229 (26.5) | 30 (21.7) |
Missing | 74 (7.4) | 65 (7.5) | 9 (6.5) |
Non–face-to-face social interactions during the pandemic, n (%) | |||
Less than weekly | 452 (45.2) | 406 (47.0) | 46 (33.3) |
Weekly | 423 (42.3) | 343 (39.7) | 80 (58.0) |
Missing | 126 (12.6) | 114 (13.2) | 12 (8.7) |
Changes in Depressive Symptom Status, n (%) | |||||
---|---|---|---|---|---|
Non-case | Onset | Remission | Persistence | ||
Overall | n = 1001 | 406 (40.6) | 117 (11.7) | 110 (11.0) | 271 (27.1) |
Living arrangement | |||||
Living together | n = 863 | 362 (89.2) | 94 (80.3) | 97 (88.2) | 228 (84.1) |
Living alone | n = 138 | 44 (10.8) | 23 (19.7) | 13 (11.8) | 43 (15.9) |
Non–face-to-face social interactions during the pandemic | |||||
Less than weekly | n = 452 | 194 (52.6) | 63 (60.0) | 49 (48.5) | 123 (50.6) |
Weekly | n = 423 | 175 (47.4) | 42 (40.0) | 52 (51.5) | 120 (49.4) |
Model 1 | Model 2 | Model 3 | Model 4 | |
---|---|---|---|---|
OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | |
Onset (ref: non-case) | ||||
Living alone (ref: living together) | 2.01 (1.16–3.50) | 1.89 (1.02–3.49) | 1.92 (1.03–3.56) | 4.32 (1.71–10.90) |
Weekly non–face-to-face social interactions during the pandemic (ref: less than weekly) | 0.84 (0.52–1.36) | 1.04 (0.62–1.76) | ||
Living alone × weekly non–face-to-face social interactions during the pandemic | 0.23 (0.06–0.84) | |||
Remission (ref: non-case) | ||||
Living alone (ref: living together) | 1.10 (0.57–2.13) | 1.01 (0.49–2.06) | 0.96 (0.47–1.99) | 2.31 (0.76–6.98) |
Weekly non–face-to-face social interactions during the pandemic (ref: less than weekly) | 1.44 (0.88–2.36) | 1.68 (1.00–2.83) | ||
Living alone × weekly non–face-to-face social interactions during the pandemic | 0.24 (0.06–1.06) | |||
Persistence (ref: non-case) | ||||
Living alone (ref: living together) | 1.55 (0.99–2.44) | 1.43 (0.84–2.44) | 1.39 (0.81–2.37) | 2.34 (0.93–5.88) |
Weekly non–face-to-face social interactions during the pandemic (ref: less than weekly) | 1.39 (0.94–2.08) | 1.51 (0.99–2.31) | ||
Living alone × weekly non–face-to-face social interactions during the pandemic | 0.46 (0.15–1.44) |
Discussion
Conclusions and Implications
Acknowledgments
Supplementary Data
Variables | Definition |
---|---|
Age, y | Continuous quantity |
Gender | Male or female |
Educational attainment, y | Educational attainment was dichotomized as “low” (<10 y) and “high” (≥10). |
Subjective economic status | Subjective economic status was dichotomized from 5 possible responses as “severe” (“very severe” or “slightly severe”) and “normal or rich” (“normal,” “slightly rich,” or “very rich”). |
Comorbidities | Participants selected those illnesses for which they received treatment from a list of 16 illnesses. The number of selected illnesses was then summed, and participants were classified as having “none,” “1,” and “2 or more.” |
BADL performance | BADL performance was assessed using the question, “Do you need someone’s care or assistance in your daily life?” and dichotomized as “not difficulty” (“no need for care or assistance”) and “difficulty” (“need some care or assistance but do not currently receive any” or “currently receive some care”). |
IADL performance | IADL performance was assessed using a 5-item subscale based on a previous study and categorized participants who had difficulty with at least 1 item as “difficulty” and the others as “not difficulty.” |
Subjective health status | Subjective health status was assessed by the question, “How is your current health status,” and dichotomized as “poor” and “good.” |
Subjective memory complaints | Subjective memory complaints were assessed by the following question, “Do you feel you are forgetful?” and participants were classified according to their responses of “yes” and “no.” |
Motor function | Motor function was assessed using a 5-point subscale based on a previous study and classified as “not impaired” (<3 points) and “impaired” (≥3). |
Frequency of going out | The frequency of going out was categorized as “≥5 d/wk,” “2 to 4 d/wk,” and “≤1 d/wk.” |
Frequency of meeting with friends | The frequency of meeting with friends was categorized as “≥ once/wk,” “once/mo to once/wk,” and “< once/mo.” |
Model 1 | Model 2 | Model 3 | Model 4 | |||||
---|---|---|---|---|---|---|---|---|
OR (95% CI) | P Value | OR (95% CI) | P Value | OR (95% CI) | P Value | OR (95% CI) | P Value | |
Onset (ref: non-case) | ||||||||
Living arrangement (ref: living together) | ||||||||
Living alone | 2.01 (1.16–3.50) | .013 | 1.89 (1.02–3.49) | .044 | 1.92 (1.03–3.56) | .039 | 4.32 (1.71–10.90) | .002 |
Non–face-to-face social interactions during the pandemic (ref: less than weekly) | ||||||||
Weekly | 0.84 (0.52–1.36) | 0.474 | 1.04 (0.62–1.76) | .878 | ||||
Age, y | 0.99 (0.95–1.04) | .762 | 0.99 (0.95–1.04) | .766 | 1.00 (0.95–1.05) | .858 | ||
Gender (ref: male) | ||||||||
Female | 1.13 (0.70–1.81) | .619 | 1.16 (0.72–1.87) | .550 | 1.15 (0.71–1.86) | .574 | ||
Educational attainment, y (ref: high) | ||||||||
Low | 1.13 (0.71–1.82) | .603 | 1.12 (0.70–1.80) | .630 | 1.11 (0.69–1.79) | .663 | ||
Subjective economic status (ref: normal or rich) | ||||||||
Severe | 1.56 (0.92–2.64) | .100 | 1.56 (0.92–2.64) | .101 | 1.55 (0.91–2.63) | .106 | ||
Comorbidities (ref: none) | ||||||||
1 | 0.56 (0.26–1.25) | .158 | 0.56 (0.25–1.23) | .148 | 0.53 (0.24–1.18) | .119 | ||
≥2 | 0.58 (0.25–1.31) | .188 | 0.57 (0.25–1.29) | .174 | 0.55 (0.24–1.26) | .160 | ||
BADL performance (ref: not difficulty) | ||||||||
Difficulty | 1.87 (0.77–4.57) | .168 | 1.87 (0.77–4.56) | .170 | 1.88 (0.77–4.61) | .166 | ||
IADL performance (ref: not difficulty) | ||||||||
Difficulty | 1.56 (0.72–3.39) | .262 | 1.55 (0.71–3.37) | .270 | 1.54 (0.71–3.37) | .277 | ||
Subjective health status (ref: good) | ||||||||
Poor | 3.58 (1.83–6.98) | < .001 | 3.53 (1.80–6.89) | < .001 | 3.55 (1.81–6.95) | < .001 | ||
Subjective memory complaints (ref: no) | ||||||||
Yes | 1.68 (1.06–2.68) | .028 | 1.67 (1.05–2.65) | .032 | 1.66 (1.04–2.64) | .034 | ||
Motor function (ref: not impaired) | ||||||||
Impaired | 0.56 (0.23–1.38) | .208 | 0.56 (0.23–1.39) | .212 | 0.56 (0.23–1.38) | .209 | ||
Frequency of going out (ref: ≥5 d/wk) | ||||||||
2 to 4 d/wk | 0.83 (0.49–1.41) | .498 | 0.83 (0.49–1.41) | .497 | 0.85 (0.50–1.44) | .536 | ||
≤1 d/wk | 1.05 (0.60–1.84) | .862 | 1.02 (0.58–1.80) | .945 | 1.01 (0.57–1.80) | .960 | ||
Frequency of meeting with friends (ref: ≥ once/wk) | ||||||||
Once/mo to once /wk | 0.77 (0.47–1.27) | .302 | 0.76 (0.46–1.25) | .279 | 0.75 (0.46–1.25) | .271 | ||
< once/mo | 1.45 (0.76–2.78) | .257 | 1.44 (0.75–2.75) | .271 | 1.48 (0.77–2.84) | .239 | ||
Living arrangement × non–face-to-face social interactions during the pandemic | 0.23 (0.06–0.84) | .026 | ||||||
Remission (ref: non-case) | ||||||||
Living arrangement (ref: living together) | ||||||||
Living alone | 1.10 (0.57–2.13) | .771 | 1.01 (0.49–2.06) | .988 | 0.96 (0.47–1.99) | .919 | 2.31 (0.76–6.98) | .140 |
Non–face-to-face social interactions during the pandemic (ref: less than weekly) | ||||||||
Weekly | 1.44 (0.88–2.36) | .144 | 1.68 (1.00–2.83) | .052 | ||||
Age, y | 1.02 (0.97–1.07) | .481 | 1.02 (0.97–1.07) | .446 | 1.02 (0.97–1.07) | .399 | ||
Gender (ref: male) | ||||||||
Female | 1.31 (0.80–2.13) | .280 | 1.24 (0.76–2.02) | .399 | 1.23 (0.75–2.02) | .403 | ||
Educational attainment, y (ref: high) | ||||||||
Low | 1.02 (0.63–1.66) | .938 | 1.04 (0.64–1.69) | .882 | 1.03 (0.63–1.68) | .916 | ||
Subjective economic status (ref: normal or rich) | ||||||||
Severe | 1.07 (0.59–1.91) | .828 | 1.09 (0.61–1.95) | .778 | 1.08 (0.60–1.94) | .798 | ||
Comorbidities (ref: none) | ||||||||
1 | 1.14 (0.40–3.21) | .805 | 1.16 (0.41–3.26) | .784 | 1.12 (0.39–3.16) | .837 | ||
≥2 | 1.48 (0.52–4.20) | .466 | 1.50 (0.52–4.27) | .452 | 1.46 (0.51–4.19) | .477 | ||
BADL performance (ref: not difficulty) | ||||||||
Difficulty | 1.32 (0.53–3.30) | .548 | 1.33 (0.53–3.33) | .537 | 1.35 (0.54–3.38) | .519 | ||
IADL performance (ref: not difficulty) | ||||||||
Difficulty | 1.20 (0.53–2.75) | .658 | 1.20 (0.53–2.74) | .663 | 1.20 (0.52–2.75) | .672 | ||
Subjective health status (ref: good) | ||||||||
Poor | 3.88 (2.01–7.48) | < .001 | 4.12 (2.12–8.00) | < .001 | 4.16 (2.14–8.10) | < .001 | ||
Subjective memory complaints (ref: no) | ||||||||
Yes | 2.76 (1.72–4.44) | < .001 | 2.81 (1.75–4.52) | < .001 | 2.80 (1.74–4.51) | < .001 | ||
Motor function (ref: not impaired) | ||||||||
Impaired | 1.10 (0.49–2.47) | .823 | 1.10 (0.49–2.48) | .822 | 1.08 (0.48–2.44) | .848 | ||
Frequency of going out (ref: ≥5 d/wk) | ||||||||
2 to 4 d/wk | 1.08 (0.63–1.85) | .789 | 1.10 (0.64–1.90) | .724 | 1.12 (0.65–1.93) | .689 | ||
≤1 d/wk | 1.18 (0.65–2.12) | .584 | 1.26 (0.70–2.30) | .442 | 1.27 (0.70–2.30) | .440 | ||
Frequency of meeting with friends (ref: ≥ once/wk) | ||||||||
Once/mo to once /wk | 0.68 (0.41–1.14) | .148 | 0.68 (0.41–1.14) | .145 | 0.68 (0.40–1.13) | .137 | ||
< once/mo | 1.07 (0.55–2.11) | .836 | 1.07 (0.54–2.10) | .852 | 1.09 (0.55–2.14) | .811 | ||
Living arrangement × non–face-to-face social interactions during the pandemic | 0.24 (0.06–1.06) | .059 | ||||||
Persistence (ref: non-case) | ||||||||
Living arrangement (ref: living together) | ||||||||
Living alone | 1.55 (0.99–2.44) | .057 | 1.43 (0.84–2.44) | .187 | 1.39 (0.81–2.37) | .229 | 2.34 (0.93–5.88) | .072 |
Non–face-to-face social interactions during the pandemic (ref: less than weekly) | ||||||||
Weekly | 1.39 (0.94–2.08) | .102 | 1.51 (0.99–2.31) | .057 | ||||
Age, y | 0.96 (0.92–1.00) | .034 | 0.96 (0.92–1.00) | .036 | 0.96 (0.92–1.00) | .041 | ||
Gender (ref: male) | ||||||||
Female | 2.13 (1.43–3.15) | < .001 | 2.02 (1.35–3.01) | < .001 | 2.01 (1.35–3.01) | .001 | ||
Educational attainment, y (ref: high) | ||||||||
Low | 0.84 (0.56–1.24) | .377 | 0.85 (0.57–1.26) | .424 | 0.84 (0.57–1.26) | .405 | ||
Subjective economic status (ref: normal or rich) | ||||||||
Severe | 2.15 (1.40–3.28) | < .001 | 2.18 (1.43–3.35) | .000 | 2.17 (1.41–3.33) | < .001 | ||
Comorbidities (ref: none) | ||||||||
1 | 0.69 (0.33–1.42) | .310 | 0.69 (0.34–1.44) | .328 | 0.68 (0.33–1.41) | .296 | ||
≥2 | 1.05 (0.51–2.19) | .889 | 1.06 (0.51–2.22) | .872 | 1.05 (0.50–2.19) | .896 | ||
BADL performance (ref: not difficulty) | ||||||||
Difficulty | 1.93 (0.93–4.00) | .077 | 1.94 (0.93–4.02) | .076 | 1.95 (0.94–4.05) | .073 | ||
IADL performance (ref: not difficulty) | ||||||||
Difficulty | 1.91 (1.01–3.61) | .048 | 1.92 (1.01–3.64) | .045 | 1.94 (1.02–3.68) | .044 | ||
Subjective health status (ref: good) | ||||||||
Poor | 4.66 (2.71–8.02) | < .001 | 4.91 (2.84–8.49) | < .001 | 4.94 (2.86–8.56) | < .001 | ||
Subjective memory complaints (ref: no) | ||||||||
Yes | 2.98 (2.05–4.35) | < .001 | 3.03 (2.08–4.43) | < .001 | 3.02 (2.07–4.41) | < .001 | ||
Motor function (ref: not impaired) | ||||||||
Impaired | 1.42 (0.74–2.72) | .288 | 1.42 (0.74–2.73) | .289 | 1.40 (0.73–2.69) | .308 | ||
Frequency of going out (ref: ≥5 d/wk) | ||||||||
2 to 4 d/wk | 0.95 (0.62–1.45) | .795 | 0.95 (0.62–1.46) | .831 | 0.96 (0.62–1.47) | .837 | ||
≤1 d/wk | 1.09 (0.68–1.74) | .724 | 1.15 (0.72–1.85) | .561 | 1.15 (0.71–1.84) | .575 | ||
Frequency of meeting with friends (ref: ≥ once/wk) | ||||||||
Once/mo to once /wk | 1.06 (0.70–1.60) | .779 | 1.07 (0.71–1.62) | .732 | 1.07 (0.71–1.62) | .738 | ||
< once/mo | 1.62 (0.94–2.81) | .085 | 1.64 (0.94–2.84) | .080 | 1.66 (0.96–2.89) | .071 | ||
Living arrangement × non–face-to-face social interactions during the pandemic | 0.46 (0.15–1.44) | .181 |
Non–face-to-face social interactions during the COVID-19 pandemic | ||
---|---|---|
Less than weekly | Weekly | |
Living alone (ref: living together) | Living alone (ref: living together) | |
OR (95% CI) | OR (95% CI) | |
Changes in depressive symptom status (ref: non-case) | ||
Onset | 4.70 (1.82–12.14) | 1.00 (0.38–2.66) |
Remission | 2.36 (0.77–7.25) | 0.56 (0.20–1.53) |
Persistence | 2.55 (1.00–6.47) | 0.92 (0.45–1.88) |
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Article info
Publication history
Footnotes
This work was supported by the Japan Society for the Promotion of Science (JSPS) KAKENHI Grant (19K24277, 19K02200, 21K17322, 22J01409); a research grant from the Health Sciences Centre Foundation; the Japan Full-hap Survey Research Grant from the Japan Small Business Welfare Foundation; a research grant from Foundation for Total Health Promotion; Yumi Memorial Foundation; and Research Funding for Longevity Sciences from the National Center for Geriatrics and Gerontology (20-40, 21-17).
The authors declare no conflicts of interest.
This study was reviewed and approved by the ethics committees of the National Center for Geriatrics and Gerontology (No. 20TB4) and Seijoh University (No. 2020C0013). The mailed questionnaire was accompanied by an explanation of the study purpose, and participants were informed that there were no consequences to withdrawing from the study at any point. Informed consent was obtained when participants agreed to complete the questionnaire and returned the completed survey. All procedures conformed to the principles of the Declaration of Helsinki.
All datasets have ethical or legal restrictions for public deposition because of the inclusion of sensitive information about the human participants.