Objective Social isolation is a risk factor for depression in older age. However, little is known regarding whether its impact varies depending on country-specific cultural contexts regarding social relationships. The present study examined the association of social isolation with depression onset among older adults in England, which has taken advanced measures against social isolation, and Japan, a super-aged society with a rapidly increasing number of socially isolated people. Design Prospective longitudinal study. Setting We used data from two ongoing studies: the English Longitudinal Study of Ageing (ELSA) and the Japan Gerontological Evaluation Study (JAGES). Participants Older adults aged ≥65 years without depression at baseline were followed up regarding depression onset for 2 years (2010/2011–2012/2013) for the ELSA and 2.5 years (2010/2011–2013) for the JAGES. Primary outcome measure Depression was assessed with eight items from the Centre for Epidemiologic Studies Depression Scale for the ELSA and Geriatric Depression Scale for the JAGES. Multivariable logistic regression analysis was performed to evaluate social isolation using multiple parameters (marital status; interaction with children, relatives and friends; and social participation). Results The data of 3331 respondents from the ELSA and 33 127 from the JAGES were analysed. Multivariable logistic regression analysis demonstrated that social isolation was significantly associated with depression onset in both countries. In the ELSA, poor interaction with children was marginally associated with depression onset, while in the JAGES, poor interaction with children and no social participation significantly affected depression onset. Conclusions Despite variations in cultural background, social isolation was associated with depression onset in both England and Japan. Addressing social isolation to safeguard older adults’ mental health must be globally prioritised.

This study compared the relationship between social participation, including work, and incidence of functional decline in rural and urban older people in Japan, by focusing on the number and types of organizations older people participated in. The longitudinal data of the Japan Gerontological Evaluation Study (JAGES) that followed 55,243 individuals aged 65 years or older for six years were used. The Cox proportional hazards model was employed to calculate the hazard ratio (HR) of the incidence of functional decline over six years and the stratification of rural and urban settings. In this model, we adjusted 13 variables as behavioral, psychosocial, and functional confounders. The more rural and urban older people participated in various organizations, the more they were protected from functional decline. Participation in sports (HR: rural = 0.79; urban = 0.83), hobby groups (HR: rural = 0.76; urban = 0.90), and work (HR: rural = 0.83; urban = 0.80) significantly protected against the incidence of decline in both rural and urban areas. For both rural and urban older people, promoting social participation, such as sports and hobby groups and employment support, seemed to be an important aspect of public health policies that would prevent functional decline.

In Western countries, the most important part of the face in communication is the mouth, whereas it is the eyes in Asian countries; thus oral health could be more important in social interactions in Western countries. Our aim was to examine differences in the association between oral health status and social isolation among older people by comparing Japan and England. We used cross-sectional information obtained from adults aged 65+ in two ongoing prospective cohort studies: The Japan Gerontological Evaluation Study (JAGES, N = 120,195) and the English Longitudinal Study of Ageing (ELSA, N = 3,958). The dependent variable, social isolation score (SIS) was calculated from five factors (marital status, social support from children, social support from family, social support from friends, and social participation). The independent variables were self-reported number of remaining teeth (0, 1-9, 10-19, ≥20) and denture use (≥20 teeth, 10-19 teeth with denture, 10-19 teeth without denture, 0-9 teeth with denture, 0-9 teeth without denture), while the covariates in the model were: sex, age, educational attainment, self-rated health, number of comorbidities, household annual equivalized income, mental health status, daily living activities, and smoking status. We examined associations between oral health status and SIS by applying an ordered logit model by country. Compared to England, more Japanese participants were socially isolated (1.4% vs. 5.8%), but fewer were edentulous (13.1% vs. 7.7%). In both countries, poorer oral health further increased the odds of being socially isolated. Pooled analysis of the ordered logit model with an interaction term showed that the association of number of remaining teeth with SIS was stronger in edentulous participants and in England (odds ratio = 1.50, 95% Confidence interval:1.26-1.80). In both countries, oral health was associated with social isolation; this association could be stronger in England than in Japan.

Aim: Existing evidence links social isolation with poor health. To examine differences in the mortality risk by social isolation, and in socio‐economic correlates of social isolation, we analyzed large‐scale cohort studies in Japan and England.Methods: Participants were drawn from the Japan Gerontological Evaluation Study (JAGES) and the English Longitudinal Study of Ageing (ELSA). We analyzed the 10‐year mortality among 15 313 JAGES participants and 5124 ELSA respondents. Social isolation was measured by two scales, i.e., scoring the frequency of contact with close ties, and a composite measurement of social isolation risk. We calculated the population attributable fraction, and Cox regression models with multiple imputations were used to estimate hazard ratios (HRs) for mortality due to social isolation.Results: The proportion of those with contact frequency of less than once a month was 8.5% in JAGES and 1.3% in ELSA. Males, older people, those with poor self‐rated health, and unmarried people were significantly associated with social isolation in both countries. Both scales showed that social isolation among older adults had a remarkably higher risk for premature death (less frequent contact with others in JAGES: hazard ratio [HR] = 1.18, 95% confidence interval [CI]: 1.05–1.33, in ELSA: HR = 1.27, 95% CI: 0.85–1.89; and high isolation risk score in JAGES: HR = 1.30, 95% CI: 1.12–1.50, in ELSA: HR = 2.05, 95% CI: 1.52–2.73). The population attributable fraction showed less frequent contact with close ties was attributed to about 18 000 premature deaths annually in Japan, in contrast with about 1800 in England.Conclusions: Negative health impacts of social isolation were higher among older Japanese compared with those in England. Geriatr Gerontol Int 2021; 21: 209–214.

We examined whether pre-disaster social support functions as a disaster preparedness resource to mitigate post-disaster depressive symptoms among older survivors of the 2011 Great East Japan earthquake and tsunami. The participants were 3,567 individuals aged ≥65 years living in Iwanuma city who completed a baseline survey as part of the nationwide Japan Gerontological Evaluation Study seven months before the disaster. A follow-up survey was administered approximately 2.5 years after the disaster. The analysis included a total of 2,293 participants, and social support (giving and receiving emotional & instrumental help) before the disaster was measured using four items. Depressive symptoms were assessed using the GDS with a cut-off score of 4/5 (not depressed/depressed). We discovered that participants who gave and received emotional and instrumental support before the disaster were significantly less likely to develop depressive symptoms after the disaster compared to those without support (ARR = 0.70; 95% CI: 0.56–0.88). The risk of the onset of depressive symptoms was 1.34 (95% CI: 1.03–1.74) among those who experienced disaster damages but had also given and received social support, and 1.70 (95% CI: 1.03–2.76) among those who experienced damages but lacked support. Strengthening social aid may help cultivate psychological resilience to disasters.