Homebound status and life space among Japanese community-dwelling elderly in an urban area

  • MURAYAMA Hiroshi
    Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology
  • SHIBUI Yu
    Measures for Health Division, Nishitama Public Health Center, Tokyo Metropolitan Government
  • KAWASHIMA Takako
    Preventive Long-Term Care and Community Support Division, Community Welfare Department, Setagaya Ward
  • KANO Noriko
    Preventive Long-Term Care and Community Support Division, Community Welfare Department, Setagaya Ward
  • TORATANI Akiko
    Preventive Long-Term Care and Community Support Division, Community Welfare Department, Setagaya Ward
  • TACHIBANA Reiko
    Infectious Diseases Control Division, Setagaya Public Health Center, Setagaya Ward
  • SHIBUTA Keiko
    Public Health and Welfare Division, Kinuta District Administration Office, Setagaya Ward
  • FUKUDA Yoshiharu
    Department of Community Health and Medicine, Yamaguchi University School of Medicine
  • MURASHIMA Sachiyo
    Department of Community Health Nursing, Graduate School of Medicine, The University of Tokyo

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Other Title
  • 都市部高齢者の閉じこもりと生活空間要因との関連
  • トシブ コウレイシャ ノ トジコモリ ト セイカツ クウカン ヨウイン ト ノ カンレン

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Abstract

Objectives To examine the relationship between homebound status and physical, mental, social and life space factors among community-dwelling elderly in an urban area.<br/>Methods A cross-sectional survey was conducted using a mail-in self-administered questionnaire between July and September 2009. The target population comprised 149,991 community residents, aged 65 years and over, living in Setagaya Ward, Tokyo, as of April 2009. “Homebound” was defined as going out (leaving the home) only once a week or less. The respondents were further identified as “type 1” or “type 2” homebound; type 1 included those with a low frequency of outings and low mobility level, and type 2 included those with a low frequency of outings despite having a high mobility level. Questionnaire items encompassed frequency of outings and demographic data, as well as physical, mental, social and life space factors.<br/>Results A total of 103,684 questionnaires were included in the analysis (valid response rate: 69.1%). Among the participants, 3.7% were found to be type 1 homebound and 4.5% were type 2. The older the age group, the higher was the proportion of both types of homebound. Physical and social factors were associated with type 1 homebound, and physical, mental and social factors with type 2. Moreover, regarding the life space factor, poor physical accessibility of the home was associated with type 2 homebound, and less space utilization in daily life was associated with both types.<br/>Conclusion It is important for homebound reduction among the elderly to address the physical, mental and social factors that affect homebound status. In addition, assessing the current home environment and expanding the daily living space could also be strategies to reduce homebound prevalence among the elderly. Collaboration with the housing and public transportation sectors is needed to plan a comprehensive homebound reduction strategy.

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