[Relationship between local seniors' longest-held occupation, current work situation, and reasons for working].

Objective　The purpose of this study was to clarify how the type and industry of longest-held occupations correlate with current work situations and reasons for working.Methods　In August 2015, we mailed anonymous, self-administered questionnaires to all 8,075 residents aged 65 and over of a district in Ota Ward, Tokyo, excluding those admitted to institutions. The questionnaire inquired about their basic attributes, current employment status, as well as the type of work and industry of their longest-held occupation. Furthermore, those who were currently employed were asked about their reasons for working. We conducted a multinomial logistic regression analysis with the current employment situation as the dependent variable, and a binary logistic regression analysis with the applicability of individual reasons as the dependent variable.Results　A total of 5,184 questionnaires were returned (response rate: 64.2%), and 5,050 were analyzed. For the longest-held form of work, the most common response was full-time and part-time employment (42.7%), and the most common industry was sales and service (24.2%). Roughly 30% of respondents were currently working, with the most common reason being "For a living," followed by "For my health," "To have a purpose in life (ikigai)," and "To contribute to society and build connections." The industry of the longest-held occupation for those currently working was most often self-employment; executive roles in independent businesses, companies, or organizations for those in full-time positions; and professional jobs for those working part-time. For those not currently working, most had been full-time employees or unemployed. With regard to the longest-held occupations, those currently working and who gave the reason "For a living" were most often owners of independent businesses or self-employed, while those stating "For my health," "To have a purpose in life," and "To contribute to society and build connections" had often been full-time employees, executives at a company or organization, or in administrative or technical positions.Conclusion　For seniors' employment or social participation to go smoothly, we believe a support that emphasizes individuality would be effective, including an emphasis on their longest-held occupation, which is deeply connected to their health conditions and quality of life in old age.

The impact of mutual aid on mental health and perceived isolation among the single elderly: An examination of economic status.

AIM: This study aimed to identify patterns in mutual aid relationships between older people living alone and their relatives and neighbors, and to examine the impact of mutual aid relationship patterns on mental health and perceived isolation through the mediating effect of subjective economic status. METHODS: We conducted a survey with 5000 randomly selected adults aged 65 years or older, from the five official senior care service areas of city A in Saitama Prefecture, Japan. Valid responses were received from 3941 participants (78.8%), of whom 436 participants from single-person households constituted the study sample. RESULTS: Latent class analysis revealed four types of mutual aid: family; family and intra-generational neighbors; no mutual aid; and family and multi-generational neighbors. Regression analysis showed that the interaction effect between family and neighbors' mutual aid and subjective economic status was a significant predictor of depressive symptoms. Simple slope analysis clarified that subjective economic status had a negative effect on depressive symptoms for the non-family/neighbors group, but not for the family/neighbors group. Furthermore, the interaction term between no mutual aid and subjective economic status was negatively associated with the fear of future isolation. Finally, the significantly negative effect observed was greater for the no mutual aid group than for the non-no mutual aid group. CONCLUSIONS: Mutual aid relationships are effective in improving the mental health and decreasing the fear of future isolation of older adults living alone who experience low economic status. Geriatr Gerontol Int 2021; 21: 555-560.

Influence of co-existing social isolation and homebound status on medical care utilization and expenditure among older adults in Japan.

OBJECTIVE: To examine whether co-existing social isolation and homebound status influence medical care utilization and expenditure in older adults. METHODS: Postal surveys on social isolation and homebound status were performed on older adults aged ≥65 years residing in a Japanese suburban city. Information on medical care utilization and expenditure was obtained from insurance claims data. These outcomes were examined over a three-year period (December 2008 to November 2011) for all participants (Analysis I, n = 1386) and during the last year of life for mortality cases (Analysis II, n = 107). A two-part model was used to analyze the influence of social isolation and homebound status on medical care utilization (first model: logistic regression model) and its related expenditure (second model: generalized linear model). RESULTS: Almost 12 % of participants were both socially isolated and homebound. Analysis I showed that these participants were significantly less likely to use outpatient and home medical care than participants with neither characteristic (odds ratio: 0.536, 95 % confidence interval: 0.303-0.948). However, Analysis II showed that participants with both characteristics had significantly higher daily outpatient and home medical expenditure in the year before death than participants with neither characteristic (risk ratio: 2.155, 95 % confidence interval: 1.338-3.470). DISCUSSION: Older adults who are both socially isolated and homebound are less likely to regularly utilize medical care, which may eventually lead to serious health problems that require more intensive treatment. Measures are needed to encourage the appropriate use of medical care in these individuals to effectively manage any existing conditions.

Workplace and community social capital and burnout among professionals of health and welfare services for the seniors: A multilevel analysis in Japan.

OBJECTIVE: Despite the potential of the social capital approach in preventing burnout, there is sparse evidence of its contextual effect. This study aimed to reveal the contextual association of workplace and community social capital on burnout among professionals of health and welfare services for seniors in Japan. METHODS: We collected data from a cross-sectional questionnaire survey for all health and welfare professionals working in Community Comprehensive Support Centers (CCSCs) in the central Tokyo area in 2015. We assessed burnout using the Japanese version of the Maslach Burnout Inventory, which consists of three subscales: emotional exhaustion, depersonalization, and reduced personal accomplishment. We prepared social capital items regarding workplace (the CCSC the participants belonged to) and community (the current catchment area of the CCSC). We aggregated individual responses of workplace and community social capital within each CCSC to create group-level workplace and community social capital indicators. RESULTS: Among the 1771 questionnaires distributed, we analyzed 1110 from 211 CCSCs. Multilevel analysis showed that higher group-level workplace social capital was significantly associated with lower scores of all three subscales after adjusting for covariates. Moreover, we found a significant association between greater group-level community social capital and lower scores of depersonalization and reduced personal accomplishment. CONCLUSION: Working in workplaces and communities with higher social capital is related to lower burnout. The findings suggest that strategies to enhance the social capital of their workplace and community would be beneficial in the prevention of burnout among professionals in the field of health and social welfare.

Working for only financial reasons attenuates the health effects of working beyond retirement age: A 2-year longitudinal study.

AIM: The health benefits of paid employment in late life are understood, but they might vary according to work motives. We examined the health effects of employment among older adults, focusing on motivation. METHODS: We carried out a 2-year longitudinal survey from 2013 (baseline) to 2015 (follow up). Among 7608 older adults, the analysis included 1069 who completed both surveys and were employed at baseline. Work motives were assessed using a questionnaire. Participants were assigned to groups based on their responses: (i) financial reasons; (ii) motivation other than financial reasons; and (iii) both financial and non-financial reasons. Self-rated health, mental health and higher-level functional capacity were evaluated as health outcomes. RESULTS: There were group differences in baseline demographic variables and health status; those with financial reasons had lower socioeconomic status and worse mental health. Multivariable logistic regression analysis showed that compared with older workers with non-financial reasons, those with financial reasons were more likely to decline in self-rated health (OR 1.42; 95% CI 1.00-2.03) and higher-level functional capacity (OR 1.55; 95% CI 1.16-2.07), which was independent of potential covariates, including socioeconomic status. However, no differences were evident between those with only non-financial reasons and those having both financial and non-financial reasons. CONCLUSIONS: We found that the participants who worked only for financial rewards had reduced health benefits through working in old age. A prolonged working life among older workers can contribute to maintaining health and can be enhanced by non-financial reasons, such as finding meaning in life and social contact. Geriatr Gerontol Int 2020; 20: 745-751.

Factors relating to social isolation in urban Japanese older people: A 2-year prospective cohort study.

PURPOSE: We analyzed the data from a 2-year prospective-cohort survey to identify factors relating to new incidences of social isolation and recovery from social isolation in community-dwelling older people. MATERIALS AND METHODS: We conducted a longitudinal study (2013-2015) involving 2657 older residents of Iriarai, Japan. A chi-square test, an independent t-test, and logistic regression analysis with imputed data were conducted to examine categorical data, continuous variables, and factors relating to social isolation, respectively. PRINCIPAL RESULTS: The results suggested that the factors that predicted future social isolation included being a man, being older, living with others, having a decline in mental health, having a lower frequency of going out, and not participating in community groups. On the other hand, being younger, having a higher level of mental health, having a higher frequency of going out, and participating in community groups were identified as factors that predicted participants' recovery from social isolation. MAJOR CONCLUSIONS: Some demographic, mental, and social factors could relate to new incidences of social isolation and recovery from social isolation in community-dwelling older people. As aging is an irreversible phenomenon, and there is a limit to preventing all disorders, either building a safety net or introducing exchange programs to prevent social isolation are important interventions for older people.

For how many days and what types of group activities should older Japanese adults be involved in to maintain health? A 4-year longitudinal study.

OBJECTIVE: Studies have suggested that frequent participation in social groups contributes to the well-being of older people. The primary aim of this study was to identify the number of days older adults should participate in the activities of social groups to maintain their health for 4 years. This study also aimed to examine whether the effective frequency differs by the type of social group activity. METHOD: We examined a prospective cohort of 1,320 community-dwelling older adults over 65 years of age, who responded to both a baseline and a follow-up mail survey, in a suburban city of Tokyo, Japan. The dependent variable was the change in functional competence during 4 years. Logistic regression analyses were conducted to examine the effects of participation in the activities of the 5 most common social groups among older Japanese on maintaining functional competence. RESULTS: Nine hundred and ninety-four participants (76.5%) maintained their functional competence for 4 years. The results of the logistic regression analyses showed that participating in alumni groups less than once a month and being an inactive member were associated with higher odds of maintaining functional competence, after controlling for socioeconomic, demographic and baseline health status. Additionally, the odds of maintaining functional competence for 4 years increased upon participating in volunteer groups once a month or more. These results were also confirmed using logistic regression analysis, even after adjustment for the effects of participation in other social groups. DISCUSSION: The results indicated the effectiveness of volunteer activities that fulfill a social role in maintaining health. Therefore, older adults should be encouraged to participate in activities of volunteer groups at least once a month. Additionally, older adults can obtain positive health outcomes through less frequent participation in alumni groups, compared with the activities of volunteer groups.