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Co-existence of social isolation and homebound status increase the risk of all-cause mortality

Published online by Cambridge University Press:  19 July 2018

Ryota Sakurai Open the ORCID record for Ryota Sakurai [Opens in a new window] ,
Masashi Yasunaga ,
Mariko Nishi ,
Taro Fukaya ,
Masami Hasebe ,
Yoh Murayama ,
Takashi Koike ,
Hiroko Matsunaga ,
Kumiko Nonaka  and
Hiroyuki Suzuki
...Show all authors
Ryota Sakurai
Affiliation:
Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
Masashi Yasunaga
Affiliation:
Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
Mariko Nishi
Affiliation:
Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
Taro Fukaya
Affiliation:
Department of Translational Research Promotion, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
Masami Hasebe
Affiliation:
Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan Faculty of Psychology and Social Welfare, Seigakuin University, Saitama, Japan
Yoh Murayama
Affiliation:
Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
Takashi Koike
Affiliation:
Department of Regional Development, Kyushu Sangyo University, Fukuoka, Japan
Hiroko Matsunaga
Affiliation:
Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
Kumiko Nonaka
Affiliation:
Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
Hiroyuki Suzuki
Affiliation:
Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
Masashige Saito
Affiliation:
Faculty of Social Welfare, Nihon Fukushi University, Mihama-cho, Japan
Erika Kobayashi
Affiliation:
Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
Yoshinori Fujiwara*
Affiliation:
Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
*
Correspondence should be addressed to: Yoshinori Fujiwara, Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan. Email: fujiwayo@tmig.or.jp (YF).
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Abstract

Background:

Social isolation and homebound statuses are possible risk factors for increased mortality among older adults. However, no study has addressed the impact of accumulation of these two factors on mortality. The aim of this study was to examine whether such accumulation increased the risk of all-cause mortality.

Methods:

The analyzed sample was drawn from a mail survey of 1,023 older adults without instrumental activities of daily living disability. Participants were classified into four groups according to the frequency of both face-to-face and non-face-to-face interactions with others (social isolation and non-social isolation) and the frequency of going outdoors (homebound and non-homebound). Social isolation and homebound statuses were defined as having a social interaction less than once a week and going outdoors either every few days or less, respectively. All-cause mortality information during a six-year follow-up was obtained.

Results:

In total, 78 (7.6%) participants were both socially isolated and homebound. During the follow-up period, 65 participants died, with an overall mortality rate of 10.6 per 1000 person-years. Cox proportional hazards regression analyses demonstrated that older adults who were socially isolated and homebound showed a significantly higher risk of subsequent all-cause mortality compared with healthy adults who were neither socially isolated nor homebound, independent of potential covariates (aHR, 2.19; 95% CI: 1.04–4.63).

Conclusion:

Our results suggest that the co-existence of social isolation and homebound statuses may synergistically increase risk of mortality. Both active and socially integrated lifestyle in later life might play a major role in maintaining a healthy status.

Keywords

social isolationhomeboundmortalitysocial frailtyolder adults
Type
Original Research Article
Information
International Psychogeriatrics , Volume 31 , Issue 5: Issue Theme: Well-Being in Dementia , May 2019 , pp. 703 - 711
Copyright
© International Psychogeriatric Association 2018 

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Footnotes

*

These authors contributed equally to this work.

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