Types of Elder Abuse and Dementia Onset among Older Adults in Japan: A 6-year Longitudinal Study from the Japan Gerontological Evaluation Study

Living in public rental housing is healthier than private rental housing a 9-year cohort study from Japan Gerontological Evaluation Study

Housing tenure is an important aspect to determine health. However, even though renters tend to have more socioeconomic disadvantages than homeowners, mortality risk between private and public renters compared with homeowners remains unclear. Japanese public rented housing, such as the Urban Renaissance Agency, has been developed for supplying an adequate living environment since 1950s. This study aimed to examine the mortality risk among older Japanese residents living in private and public rented houses compared with those living in owner-occupied houses using 9-year follow-up data. This study drew upon a 9-year follow-up of participants in the Japan Gerontological Evaluation Study, a population-based cohort study of Japanese independent adults aged ≥ 65 years. Mortality from 2010 to 2019 was analyzed for 44,007 respondents. Housing tenure was defined by a questionnaire. Cox regression models were used for calculating the hazard ratio for mortality. Bonferroni correction was used to account for multiple testing between rental houses. Overall, 10,638 deaths occurred during the follow-up period. Compared with housing owners, all rental housing groups had a significantly higher risk of mortality. Among renters, participants who lived in public rental housing had the lowest risk of mortality even after adjusting for sociodemographic characteristics, health status, social status, and environmental status. Multiple testing among renters with Bonferroni correction showed that public renters had 0.80 times (95% CI 0.72-0.89) lower mortality risk than private renters. Although Japanese older adults living in public rental housing had a higher mortality risk than homeowners, this risk was lower than that among private renters. A positive neighborhood environment based on well-planned urban development may have contributed to this result. The results suggest that planned urban development lowers the risk of mortality in older renters in Japan.

The association between elder abuse and refrainment from daily activities during the COVID-19 pandemic among older adults in Japan: A cross-sectional study from the Japan Gerontological Evaluation Study

Objectives

Elder abuse is a public health issue that is thought to have increased during the COVID-19 pandemic due to lockdowns and behavioral restrictions. This study examines the association between elder abuse and refrainment from daily activities during the pandemic.

Methods

We used data from a self-administered mail survey conducted by the Japan Gerontological Evaluation Study (JAGES) from November 2020 to February 2021 in 11 municipalities. Our participants included 18,263 older adults (age ≥65 years) who were independent in their daily lives. Logistic regression analysis was conducted to evaluate the association between elder abuse and refrainment from 10 daily activities, and the total number of refrained behaviors.

Results

Experiences of abuse were reported by 288 participants (1.6%). The risk of elder abuse was 1.37 times (95% confidence interval, 1.04–1.81) higher among those who refrained from shopping for food and daily necessities and 1.60 times (1.20–2.13) higher among those who refrained from interaction with neighbors, than those who did not. Also, a dose-response relationship was observed where the risk of abuse increased with the number of restrictions.

Conclusion

The risk of elder abuse increased as the number of refrained behaviors increased which suggests that refrainment from multiple behaviors may significantly increase the risk of elder abuse, compared with refrainment from a single behavior. To avoid increasing the risk of abuse in likely future pandemics, it is necessary to maintain social connections without face-to-face contact, or with adequate infection control measures.

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The risk of elder abuse was higher among those who refrained from shopping for food and daily necessities and from interaction with neighbors.

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The risk of abuse increased as the number of refrained behaviors increased.

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Our results illustrate that refraining from multiple behaviors may be significantly associated with an increased risk of abuse over that of refraining from a single behavior.