Abstract
Recently, the proportion of elderly people has been increasing in Japan; with 25.0％ of the population aged 65-years-old or more. Furthermore, the number of solitary households is increasing. According to the data from the Japanese population survey in 2010, solitary households account for 32.4％ and represent the most popular category among the household types. The Japanese government defines solitary death as a “miserable death with no care that remains undiscovered for a long period”. Due to the ambiguity of this description, many surveys have focused on persons who live alone. We consider that living alone is not sufficient when considering solitary death, but rather, less communication with others is the most important factor. In order to quantitate the number of solitary deaths in Japan and determine effective intervention（s） to reduce these deaths, we investigated the postmortem interval to discovery of the death as an indicator of solitary deaths. We administered a survey to 448 elderly people aged 65 years or more in the Osaka Medical Examiner’s Office over three years, from April 2010 through March 2012, and we excluded suicidal deaths. Data were collected regarding gender, age, postmortem interval （PMI）, family structure, situation of discovery of the body, cause of death, and the interval from the last hospital visit to discovery. The elderly who lived alone were generally discovered more shortly after death than the younger deceased. Subjects who were male, unemployed and living alone were at higher risk of longer PMI. We found that regular referral to the hospital reduced the PMI. As the number of solitary households increases, it is essential to reduce the PMI for those persons maintaining a solitary household. We suggest that comprehensive measures are necessary, including waking the elderly people for work, as well as a system of regular hospital care and for frequent calls by caregivers, in order to reduce the PMI.
