Background: There is little longitudinal evidence on the impact of specific living arrangements (ie, who individuals
live
with) on mental health among older adults,
and
no studies have examined the modifying effect of residential social cohesion level on this association. We aimed to examine the association between living arrangements
and
depressive symptoms
and
whether this association varies with residential neighborhood social cohesion level among 19,656 men
and
22,513 women aged 65 years
and
older in Japan.
Methods: We analyzed the association between baseline living arrangements in 2010
and
depressive symptoms in 2013. We calculated gender-specific odds ratios (ORs) of living arrangements for depressive symptoms using a logistic regression
and
conducted subgroup analyses by neighborhood social cohesion level.
Results: Among men (but not women), living alone (OR 1.43; 95% confidence intervals [CI], 1.18–1.73)
and
living with spouse
and
parent (OR 1.47, 95% CI, 1.09–1.98) were associated with increased odds of depressive symptoms compared with living with a spouse only. Living with spouse
and
child was a risk for men in the young age group but a protective factor for women. We also identified that the negative impact of living arrangements on depressive symptoms was attenuated in neighborhoods with higher levels of social cohesion.
Conclusions: Living arrangements are associated with risk of depressive symptoms among men
and
women; these associations differ by gender
and
neighborhood social cohesion level. Our results suggest the need to pay more attention to whether individuals
live
alone, as well as who individuals
live
with, to prevent depressive symptoms among older adults.
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