Factors associated with risk for assisted living among community-dwelling older Japanese

• We investigated factors associated with risk for assisted living in one entire city.
• Risk for assisted living was associated with sex, age, illness, and social factors.
• There was a sex difference in factors associated with risk for assisted living.
• Present illness showed the strongest association with risk for assisted living.

ObjectivesTo clarify the factors associated with risk for assisted living among community-dwelling older people, we conducted a large-scale survey in an urban city in Japan.DesignPopulation-based cross-sectional study.SettingA mid-sized urban city in western Japan with a population of approximately 410,000.ParticipantsNondisabled and nondemented community-dwelling older people (≥65 years).MeasurementsA self-administered postal questionnaire, including a health checklist for the screening of older people at high risk for assisted living, as well as demographic/sociodemographic questions on sex, age, present illness, living alone, duration of residence within the current city, community participation, and employment status, was distributed.ResultsThere were 41,796 returned questionnaires (response rate: 73.8%, average age: 72.0). Participants who were at high risk for assisted living accounted for 25.2%. The independent factors associated with risk for men and women were higher age, present illness, lack of community participation, unemployment, and <20 years of residence. Living alone was a significant factor for men, whereas it was insignificant among women. The types of illnesses among people at risk were different between men and women.ConclusionHigher age, present illness, and several social factors were independently associated with high-risk status for assisted living in the large-scale whole community survey, and there was a sex difference. Our results may provide basic information for the further application of effective preventive intervention in the community.