RELATIONSHIP BETWEEN THIRD PLACES AND NEEDING LONG-TERM CARE OF THE LATE ELDERLY IN THE SUBURB

<p> In Japan, late elderly (≥75 years old) individuals tend to difficulty forming social groups due to declining physical function and health. Previous studies have shown that people who have a third place (a communal location outside the home that people can freely visit and spend time in) are significantly more outgoing and have more interpersonal conversation. The aim of this study was to clarify the relationship between the third place and the risk for long-term care/support in the late elderly. We conducted a questionnaire survey for 3 weeks from September to October 2016. Targets were late elderly in Takasu, Kitakyushu City. Survey contents included their utilization of third places, their neighborhood environment, and health status. A total of 629 questionnaires were distributed by mail, and 349 were correctly completed (valid response rate = 55.5%).</p><p> A total of 58.6% of respondents were able to identify a third place, 75.6% of whom visit their third place more than once a week. Additionally, 35.7% of the participants gave responses to the Kaigo-Yobo Check List indicating a high risk of needing long-term care. Samples for analysis (n=153) excluded people with certification of long-term care/support need, those unable to leave the house, and those with missing data. Ordered Mann–Whitney U test showed that having a third place had a statistically significant positive association with frequency of going out (p<0.01), frequency of having conversations (p<0.01), Kaigo-Yobo Check List score, and Geriatric Depression Scale-5 score (p<0.01). We therefore conducted logistic regression analysis to clarify the effect of having a third place on the risk of shut-in behavior (defined as leaving the house less than once a week), social isolation (defined as having conversation less than once a week), long-term care/support need, and depressive symptoms. The analysis model considered age, body mass index, marital status, physical pain, household structure, educational attainment, and length of residence in the area. The model for long-term care/support need and depressive symptoms was adjusted for shut-in behavior and social isolation. Odds ratio (OR) for risk of shut-in behavior was 8.46 (p<0.01), OR for risk of social isolation was 4.40 (p<0.01), and OR for risk of needing long-term care/support was 3.70 (p<0.01); however, presence of a third place was not related to depressive symptoms.</p><p> We also analyzed the relationship between neighborhood environment and presence of a third place. Ordered multilevel logistic regression analysis revealed that for late elderly, living in a neighbourhood with a higher perceived flower bed was positively associated with having third place.</p><p> In summary, this study had two major findings. First, not having a third place was strongly associated with high risk of needing long-term care/support. Secondly, it is highly likely that improvement of the neighborhood environment affects the creation of third places, which our study found reduces the risk of needing long-term care/support.</p>