{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T16:04:43Z","timestamp":1777392283155,"version":"3.51.4"},"reference-count":21,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,2,2]],"date-time":"2018-02-02T00:00:00Z","timestamp":1517529600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Sapporo Medical University"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Geriatrics Gerontology Int"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>In order to clarify the risks of institutionalization or mortality among older adults living alone compared with those not living alone, we carried out a prospective study on older adults in Hamanaka Town in the far eastern part of Hokkaido, Japan.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All 978 community\u2010dwelling residents aged 70\u201385 years in the town were chosen as study candidates between February and May of 2014. Written informed consent was obtained from 562 residents (57.5%), and a self\u2010administered questionnaire, including a question about living arrangements, was mailed to them. They returned the completed questionnaire to us in 2014. A follow\u2010up survey was carried out with a questionnaire mailed to each participant about institutionalization and mortality, three times, in February of 2015 and 2016, and in April of 2017. Hazard ratios and 95% confidence intervals were calculated with the Cox proportional hazards model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Living alone was significantly associated with an increased risk of institutionalization in the male participants, after adjusting for age, sex and having daily support from family around a participant (hazard ratio 5.71, 95% confidence interval 1.17\u201327.83), although it was not significant in the total participants or the female participants. Additional adjustments for a history of having common diseases did not change the results meaningfully. Living alone was not associated with the risk of mortality in the total participants, the male participants or the female participants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Poor social support in social networks for older men living alone may be etiologically associated with increased risk of institutionalization in rural area. Further study with a larger sample size is necessary to confirm this finding. <jats:bold>Geriatr Gerontol Int 2018; 18: 867\u2013872<\/jats:bold><\/jats:p><\/jats:sec>","DOI":"10.1111\/ggi.13267","type":"journal-article","created":{"date-parts":[[2018,2,2]],"date-time":"2018-02-02T06:48:50Z","timestamp":1517554130000},"page":"867-872","source":"Crossref","is-referenced-by-count":11,"title":["Living alone is associated with an increased risk of institutionalization in older men: A follow\u2010up study in Hamanaka Town of Hokkaido, Japan"],"prefix":"10.1111","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9754-8632","authenticated-orcid":false,"given":"Miki","family":"Takeuchi","sequence":"first","affiliation":[{"name":"Department of Public Health Sapporo Medical University School of Medicine  Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoko","family":"Showa","sequence":"additional","affiliation":[{"name":"NonProfit Organization for Community Health in Hokkaido  Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazutoshi","family":"Kitazawa","sequence":"additional","affiliation":[{"name":"Hokkaido University of Education, Kushiro Campus  Kushiro Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsuru","family":"Mori","sequence":"additional","affiliation":[{"name":"Hokkaido Chitose Rehabilitation University  Chitose Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,2,2]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"24","article-title":"Living arrangements among older people: an overview of trends in Europe and the USA","volume":"115","author":"Tomassini C","year":"2004","journal-title":"Popul Trends"},{"key":"e_1_2_7_3_1","first-page":"51","article-title":"Trend of National Health Statistics (Kokumin Eisei No Doko)","volume":"63","author":"Health, Labour and Welfare Statistics Association","year":"2016","journal-title":"J Health Welfare Statistics"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-10-186"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajag.12071"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/ckv052"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dym212"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2012.2782"},{"key":"e_1_2_7_9_1","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1016\/S0277-9536(01)00219-2","article-title":"Cohabitation and marital status as predictors of mortality\u2010 an eight year follow\u2010up study","volume":"55","author":"Lund K","year":"2002","journal-title":"Soc Sci Med"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech.2010.128397"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-7-335"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.2188\/jea.15.78"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a115301"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a114711"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/1403494807086421"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/geronb\/63.2.S99"},{"key":"e_1_2_7_17_1","first-page":"271","article-title":"Health risk appraisal in older people 1: are older people living alone an \u201cat\u2010risk\u201d group?","volume":"57","author":"Kharicha K","year":"2007","journal-title":"Br J Gen Pract"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/PSY.0b013e3181ae5770"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.4091\/iken1991.13.1_67"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1219686110"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291711001772"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1265\/jjh.56.535"}],"container-title":["Geriatrics &amp; 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