Abstract
Aim: This study investigated the relationships between loneliness, health status (including frailty), sense of purpose in life, and lifestyle behaviors among individuals with disabilities living in officially designated depopulated areas. Participants held either a disability certificate or a medical certificate for intractable diseases.
Methods: Self-administered questionnaires were distributed via mail or employment support facilities. Based on the median score on the UCLA Loneliness Scale ("UCLA score"), participants were divided into high- and low-loneliness groups. The Mann-Whitney U test was used for continuous variables (age, age at onset, and BMI), while chi-square or Fisher's exact tests were applied for categorical variables. A multivariate logistic regression analysis identified the factors associated with high loneliness.
Results: In total, 173 valid responses were obtained (response rate: 100%). The Hosmer-Lemeshow test showed a good model fit (p = 0.94). Two significant factors associated with higher UCLA scores were as follows: (1) a strong feeling of not living an enjoyable or purposeful life (odds ratio = 2.169, 95% confidence interval = 1.371-3.431, p = 0.001) and (2) frailty status (odds ratio = 5.528, 95% confidence interval = 2.497-12.240, p < 0.001).
Conclusion: Individuals with disabilities living in depopulated areas may face increased frailty as they transition to long-term care. Integrating social prescribing, an approach expected to reduce loneliness, into existing disability welfare programs may help prevent further health deterioration.
