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Article

The Impact of Living Arrangements on Depressive Symptoms by Gender Among Community-Dwelling Older Adults in Japan

by
Shinpei Ikeda
1,2,*,
Hirotomo Shibahashi
3,
Kanta Ohno
3 and
Yousuke Seike
4
1
Division of Occupational Therapy, Department of Rehabilitation, Faculty of Medical Sciences, Shonan University of Medical Sciences, Kanagawa 244-0806, Japan
2
Institute for Gerontology, J. F. Oberlin University, Tokyo 194-0294, Japan
3
Major of Occupational Therapy, Department of Rehabilitation, School of Health Sciences, Tokyo University of Technology, Tokyo 144-8535, Japan
4
Faculty of Social Welfare, University of Kochi, Kochi 781-8515, Japan
*
Author to whom correspondence should be addressed.
J. Ageing Longev. 2025, 5(2), 17; https://doi.org/10.3390/jal5020017
Submission received: 7 February 2025 / Revised: 1 April 2025 / Accepted: 28 April 2025 / Published: 14 May 2025
Versions Notes

Abstract

:
This study examines the relationship between living arrangements and depressive symptoms among community-dwelling older adults in Japan, with a particular focus on gender differences. A cross-sectional survey was conducted in Ayase City, Kanagawa Prefecture, using mailed questionnaires, and the analysis was conducted on data from 1409 participants aged 65 and older. Logistic regression analysis was performed to assess the associations between living arrangements, social networks, social participation, and depressive symptoms, adjusting for sociodemographic and health-related factors. The findings indicate that older adults living alone and those co-residing with their children are particularly vulnerable. Those living alone were more likely to be women aged 75 and older, with economic difficulties, and exhibited higher rates of depressive symptoms and care needs. Similarly, older adults living with their children had a higher prevalence of depressive symptoms and care requirements despite experiencing fewer economic hardships. This group was also characterized by lower educational attainment. Additionally, gender-specific factors were identified in the relationship between social relationships, including living arrangements, and depressive symptoms. These results underscore the necessity of interventions that consider both living arrangements and gender-specific social factors to mitigate mental health risks among older adults.

1. Introduction

The global population is aging rapidly. In 2020, the number of people aged 60 years or older reached one billion worldwide, and this figure is projected to rise to 1.4 billion by 2030, accounting for one in six individuals globally [1]. Japan, as one of the most rapidly aging societies, recorded that 29.3% of its population was aged 65 and older in 2023, the highest aging rate among over 200 countries and regions [2]. Depression is among the most prevalent mental health conditions affecting older adults, posing significant challenges to their quality of life and overall well-being. In Japan, this issue constitutes a pressing public health concern, highlighting the need for effective interventions and support systems for the elderly population. According to Richardson RA et al., the prevalence of probable depression among adults aged 55 years and older in Japan was estimated at 34.8%, as assessed by the 8-item Center for Epidemiologic Studies Depression (CES-D) scale [3]. Depression in older adults has been extensively studied, and several systematic reviews have reported consistent findings regarding its risk factors. These include living alone, low socioeconomic status, female gender, advancing age, chronic illness, and sleep disturbances. These factors suggest that older adults in socially vulnerable or disadvantaged positions are at a higher risk of developing depression [4,5]. Social activities have been identified as an effective psychosocial intervention for the prevention of depression in older adults and should be integrated into community-based care plans, as it is emphasized that cost-effective approaches can be achieved by identifying high-risk groups and implementing preventive interventions [6]. As healthcare providers, the authors are particularly focused on determining which population groups should be prioritized for depression prevention among community-dwelling older adults.
The convoy model offers a concise framework for understanding the complex nature of social relationships, describing individuals as being surrounded by dynamic networks of supportive ties that accompany them throughout life [7]. By categorizing relationships into three levels of closeness—close, closer, and closest—the model highlights the central importance of intimate support networks. Within this framework, living alone is particularly disadvantageous for older adults, as it often reflects the absence of the closest and most supportive relationships. In Japan, according to the 2020 national census, approximately 6.72 million older adults (aged 65 and above) live alone, accounting for 20% of the elderly population [8]. This trend, influenced by the rise of nuclear families and the decline of three-generation households, highlights the increasing vulnerability of older adults who lack familial support. Evidence supporting the link between living alone and frailty is strong. Evidence from a meta-analysis integrating multiple previous studies has demonstrated a significant association between living alone and physical frailty [9]. Therefore, living alone can serve as an important indicator for assessing vulnerability in later life, particularly in relation to mental health issues such as depression, as well as physical weakness. However, when comparing different living arrangements among older adults, living alone does not necessarily pose the greatest risk for mental health issues. In South Korea, for women, the highest risks of depression were observed among those living without a spouse in a nuclear family. In contrast, men living alone faced the highest risks [10]. Additionally, living with family members other than a spouse was associated with greater risks of stress, depression, and suicidal ideation compared to other living arrangements [11]. In Japanese older adults, among the living arrangements of men, living alone and living with family members without a spouse were significantly associated with high nonspecific psychological distress (NPD) as measured by the K6 scale [12]. For women, both living with a spouse and other family members and living alone were linked to higher levels of NPD [12]. A study from Japan reported that living with a spouse and children had a protective effect against depressive symptoms for women, while no such effect was observed for men. Notably, women living alone faced a heightened risk of depressive symptoms compared to those living with a spouse and children [13]. Despite these findings, the Japanese government has recently focused on older adults living alone and, more specifically, elderly couples, due to the increasing prevalence of nuclear families. However, this focus overlooks the potential impact of living with children, neglecting the broader implications of various living arrangements on mental health. According to the convoy model, cohabitants are positioned as the closest sources of support. However, the mental health challenges faced by older adults are not solely attributable to living alone but are shaped by the overall household composition. It is also necessary to consider the gender of older adults, the relationship and dynamics with their cohabitants, and the need for care or support. Furthermore, in light of the convoy model, it is necessary to examine not only household composition but also the support relationships with friends [14,15] and the networks within the community [16,17], which have been shown to be related to depression. The hypotheses of our study are that the impact of different living arrangements, such as living alone, living with a spouse, or living with children, on depressive symptoms will vary by gender among older adults. Additionally, depressive symptoms are influenced not only by relationships with family members but also by social networks, including friendships and community connections.
This study aims to explore the characteristics of vulnerabilities in various living arrangements among community-dwelling older adults in Japan and examine how these arrangements influence depression by gender.

2. Materials and Methods

2.1. Study Design and Participants

This study involved a cross-sectional survey of older adults living in Ayase City, located in Kanagawa Prefecture, which borders Tokyo. Kanagawa, the second most populous prefecture in Japan after Tokyo, has a population of around 9 million people. The prefectural capital is Yokohama City. Ayase City, situated in the northern-central region of the prefecture, has a population of about 84,000, with 23,000 of them being older adults. The survey targeted two districts designated by Ayase City’s Senior Citizen Welfare Division for health promotion initiatives. District A comprises 1511 older adults, while District B has 2200. To ensure an equivalent sample size, four subareas were selected in District B, encompassing 1547 individuals. Thus, the combined sample included 3058 participants from both districts. Data were gathered through mailed questionnaires between 28 June and 9 July 2017. Responses were received from 1899 participants, yielding a response rate of approximately 62.1%.
The study received approval from the Ethics Committee of J. F. Oberlin University (Approval Number: 17007).

2.2. Measures

2.2.1. Living Arrangements

Living arrangements were assessed by asking participants, “Who do you currently live with?” The options for response were living alone, spouse (husband or wife), children, children’s spouse, grandchildren, own parents, spouse’s parents, or other. Participants were categorized into groups based on their responses: living alone, living with spouse only, living with children, living with spouse and children, and other.

2.2.2. Social Network and Social Participation

Based on the convoy model, we examined social networks and social participation among older adults. The convoy model conceptualizes social relationships as dynamic networks of supportive ties that accompany individuals throughout life [6]. In this study, relationships categorized as “closest” and “closer” were analyzed as components of social networks, encompassing ties with close family, extended family, and close friends. In contrast, relationships categorized as “close” were examined in the context of social participation, emphasizing community engagement.
Social network was measured using the two subscales of the 6-item Lubben Social Network Scale (LSNS-6) [18], Japanese version. The LSNS-6 consists of a family subscale, which evaluates social connectedness with relatives, and a friends subscale, which evaluates social connectedness with friends. This scale consists of six items that assess the size, closeness, and frequency of interaction within the respondent’s social network of family and friends, with each evaluated using a 6-point Likert scale. The scores for each subscale range from 0 to 15, with lower scores indicating a narrower social network.
Social participation was assessed by asking participants about the frequency of their involvement in six types of community activities over the past year. The activities included local community events, neighborhood associations, senior activity clubs, interest-based groups, skill-exchange groups, and volunteer groups. Participants were asked to specify how often they participated in each activity, with the following categories: 3 (once a week or more), 2 (1–3 times per month), 1 (a few times per year), and 0 (not at all). Scores ranging from 0 to 3 were assigned for each type of social participation.

2.2.3. Depressive Symptoms

The Geriatric Depression Scale (GDS), developed by Yesavage et al., is commonly used to assess depression in older adults [19]. In this study, we utilized the Japanese version of the short form, GDS-5, to evaluate depressive symptoms. Participants were classified as normal (<2 points) or as having depressive symptoms (≥2 points) [20].

2.2.4. Covariates

Basic attributes and health status were considered as covariates in this study. Age was divided into two groups: young–old (65–74 years old) and old–old (75 years and older). Educational attainment was categorized based on the total years of schooling from elementary school onward: 13 years or more and less than 13 years. Previous studies have shown that older Japanese men with 13 or more years of education are more likely to participate in sports, hobbies, and volunteer groups [21]. Therefore, this classification criterion was used as a reference for categorization in this study. Economic status was assessed by asking participants, “How do you feel about your current living situation?”. The responses ranged from “Very comfortable” to “Very difficult” and were categorized as either good or poor based on the four choices.
Health status was assessed using two components: the number of diseases and Activities of Daily Living (ADL) disability. The number of diseases was evaluated based on self-reported diagnoses from a list of 23 conditions commonly found in older adults, including hypertension, stroke, osteoporosis, rheumatoid arthritis, diabetes, cancer, dementia, and others. The total number of diseases was then calculated. ADL disability was assessed based on whether participants required care or support, as determined by the Japanese Long-Term Care Insurance system’s certification. The system is a public program providing universal coverage for all residents aged 40 and above. Municipalities act as insurers, offering care and support services based on assessed needs, ensuring comprehensive assistance for older adults and individuals with disabilities [22]. Participants were categorized into two groups: care uncertified and care certified. Uncertified individuals are those who do not meet the criteria for care or support, while care-certified individuals are those officially recognized as requiring care, with their level of need assessed through a comprehensive certification process that includes a medical examination, evaluation of physical and cognitive abilities, and a review of ADL.

2.3. Statistical Analysis

This study focused on the differences in living arrangements: living alone, living with spouse only, living with children, and living with spouse and children, and their impact on depressive symptoms. First, statistical analyses were conducted to examine the differences in variables among the four groups of living arrangements. A one-way analysis of variance (ANOVA) was used for continuous variables. When significant differences were found using ANOVA, post hoc pairwise multiple comparisons were performed using the Tukey test. For discrete variables, the chi-square test was used. When significant differences were found using the chi-square test, pairwise comparisons were conducted with Bonferroni correction applied to adjust for multiple comparisons.
Next, to determine whether living arrangements, social network, and social participation were associated with depressive symptoms, we used logistic regression analyses to predict each of these variables. For living arrangements, we used “living alone” as the reference category and examined the impact of “living with spouse only”, “living with children”, and “living with spouse and children” on depressive symptoms, which we referred to as Model 1. Then, in Model 2, we included covariates such as age, educational attainment, economic status, number of diseases, and ADL disability. These analyses were conducted separately for men and women. Statistical analyses were performed using IBM SPSS Statistics, version 25. The level of significance was set at p < 0.05.

3. Results

3.1. Descriptive Analysis of Living Arrangements

Out of 1899 respondents, 436 participants who had missing responses for any of the survey items were first excluded. The highest rates of missing data or non-responses were observed for the GDS-5, the friends subscale of the LSNS-6, and ADL disability. Subsequently, 54 participants whose household types were outside the scope of this study were also excluded, resulting in a final sample of 1409 participants. Table 1 shows the distribution of participants based on their living arrangements. The participants had an average age of 74.8 ± 6.1 years. Regarding gender, 47.9% were men and 52.1% were women. Of the participants, 13.6% lived alone, 51.0% lived with a spouse only, 12.6% lived with children, and 22.9% lived with both a spouse and children. Regarding GDS-5, 23.8% of the participants had depressive symptoms. The proportion of individuals with depressive symptoms was highest in the living alone group (39.8%), followed by the living with children group (32.2%), the living with spouse and children group (19.8%), and the living with spouse only group (19.2%). In the chi-square test and ANOVA, significant differences were observed between living arrangement groups in all variables, except for social participation in local community events, neighborhood associations, interest-based groups, and skill-exchange groups.

3.2. Pairwise Comparisons of Living Arrangements by Post-Hoc Analyses

As shown in Table 2, in a comparison of social networks between the living alone group and the living with spouse only group, a significant difference was found in the family subscale, with the living alone group reporting fewer family subscale. Additionally, the living with spouse only group had significantly fewer diseases compared to the living with children group. They also scored higher on both the family and friends subscales, as well as on volunteer groups, than the living with children group. Furthermore, the living with spouse only group had a higher score on the family subscale compared to the living with spouse and children group. No significant differences were observed between the living arrangements with regard to participation in senior activity clubs. As indicated in Table 3, when examining the living alone group versus the living with spouse only group, significant differences were observed in the categories of old–old, women, less than 13 years of educational attainment, poor economic status, care certified, and having depressive symptoms, with the living alone group showing higher proportions in all of these categories. Compared to the living with spouse and children group, the living alone group had higher proportions of women, care-certified people, and those with depressive symptoms. However, the living alone group had significantly fewer old–old and women compared to the living with children group. In contrast to the living with children group, the living with spouse only group showed significant differences in the categories of old–old, women, less than 13 years of educational attainment, care certified, and having depressive symptoms, with the living with spouse only group showing lower proportions in all of these categories. Compared to the living with spouse and children group, the living with spouse only group had lower proportions of poor economic status. Lastly, in the comparison between the living with children group and the living with spouse and children group, significant differences were observed in the categories of old–old, women, less than 13 years of educational attainment, care certified, and having depressive symptoms. The living with children group showed higher proportions in all of these categories.

3.3. Relationship Between Living Arrangements, Social Network, Social Participation, and Depressive Symptoms

Table 4 shows the findings regarding how living arrangements, social network, and social participation are associated with depressive symptoms by gender, based on logistic regression analysis. In Model 1 for men, living arrangements, social network, and social participation variables were significantly associated with depressive symptoms. Specifically, “living with spouse only” (OR = 0.31, p < 0.001) and “living with spouse and children” (OR = 0.29, p < 0.001) were negatively correlated with depressive symptoms. The family subscale of LSNS-6 was also associated with a lower likelihood of depressive symptoms (OR = 0.90, p < 0.01), as was participation in local community events (OR = 0.61, p < 0.05). In Model 2, after adjusting for age, educational attainment, economic status, number of diseases, and ADL disability, these associations remained unchanged. Specifically, “living with spouse only” (OR = 0.33, p < 0.001), “living with spouse and children” (OR = 0.26, p < 0.001), the family subscale of LSNS-6 (OR = 0.90, p < 0.01), and participation in local community events (OR = 0.55, p < 0.05) all continued to show significant negative correlations with depressive symptoms.
In Model 1 for women, living arrangements, social network, and social participation variables were also significantly associated with depressive symptoms. Specifically, “living with spouse only” (OR = 0.54, p < 0.05) and “living with spouse and children” (OR = 0.43, p < 0.01) were negatively correlated with depressive symptoms. The family subscale of LSNS-6 (OR = 0.92, p < 0.01) and the friends subscale of LSNS-6 (OR = 0.92, p < 0.01) were similarly associated with a lower likelihood of depressive symptoms. Additionally, participation in neighborhood associations (OR = 0.56, p < 0.01), interest-based groups (OR = 0.81, p < 0.05), and skill-exchange groups (OR = 0.62, p < 0.05) were all significantly negatively related to depressive symptoms. In Model 2, the significant associations between “living with spouse only” and “living with spouse and children” were no longer present. However, the family subscale of LSNS-6 (OR = 0.93, p < 0.05) and the friends subscale of LSNS-6 (OR = 0.92, p < 0.05) remained significantly negatively associated with depressive symptoms. Participation in neighborhood associations (OR = 0.54, p < 0.01) and skill-exchange groups (OR = 0.55, p < 0.05) continued to show significant negative relationships with depressive symptoms.

4. Discussion

4.1. Characteristics of Health and Lifestyle Challenges Across Different Living Arrangements

In this study, one of the objectives is to explore the characteristics of vulnerabilities in various living arrangements among community-dwelling older adults in Japan. Previous studies focusing on the mental health of older adults, like this study, have examined the distribution of basic attributes and health status according to living arrangements [10,11,12,13]. However, a distinctive feature of our study is the detailed examination of differences among these groups through statistical verification and post-hoc analyses. Based on the findings, the potential health risks and lifestyle characteristics associated with each living arrangement are described below.
Older adults in the living alone group generally receive lower levels of support from their closest family members. This group is characterized by a higher proportion of individuals aged 75 and older, women, those with fewer than 13 years of education, and individuals experiencing economic hardship. Similarly, previous studies have observed a higher proportion of women and economically disadvantaged individuals among older adults living alone [23]. These findings highlight the vulnerability of this group, as they often face social isolation and economic difficulties. Furthermore, our study indicates that a significant proportion of this group has been certified as requiring care or support and exhibits a higher prevalence of depressive symptoms. Prior research has reported that this group has the highest proportion of depressive tendencies, as measured by the GDS-5 [24]. Additionally, studies have identified a strong association between living alone and suicidal ideation [25], suggesting that individuals in this group may require targeted mental health care.
Another group that warrants attention is the older adults living with their children. The findings of this study indicate that this group is characterized by a higher proportion of individuals aged 75 and older, a greater percentage of women, fewer years of education, and a higher prevalence of those certified as requiring care or support, as well as those experiencing depressive symptoms. Our results suggest that economic difficulties are less pronounced in this group compared to the living alone group, implying that these older adults might be financially dependent on their children. The lower level of education observed in this group has also been noted in previous studies [24,25,26,27,28,29]. Furthermore, a particularly high prevalence of cognitive decline in this group has been reported [23]. The high proportion of individuals requiring care suggests that they might be receiving caregiving support from their co-residing children, and cognitive decline could be a key factor contributing to their increased reliance on care. Our study also reveals that family support in this household type is weaker compared to households where older adults live with their spouses. In other words, there appears to be a difference in the type of support provided by spouses versus children. Previous studies have reported that older adults living with their children receive more support than those in other household types; however, this support has also been identified as a risk factor for future mortality [26]. Additionally, research indicates that older adults living with their children have a shorter active life expectancy and worse health outcomes compared to those living alone, highlighting the potential health risks associated with this living arrangement [30]. On the other hand, it has been suggested that this group tends to have more children and experience less loneliness than those in the living alone group, indicating that co-residence with children may provide psychological stability [26]. These findings suggest that the significance of co-residence between older adults and their children varies depending on future health and mental health outcomes. In summary, the overall lower health status and increased vulnerability observed in these two groups, those living alone or in households without a spouse, may affect their need for professional support. If these individuals are not certified for care under the Japanese Long Term Care Insurance system, the urgency for such support becomes even more critical.
The analysis identified key characteristics of older adults in the living with a spouse only group. This group has a lower proportion of individuals aged 75 or older and includes fewer women. They tend to have higher educational attainment and are relatively economically stable. Regarding social relationships, they have stronger support networks with family and friends and are more actively engaged in volunteer activities. Additionally, they exhibit the lowest prevalence of depressive symptoms among all groups. These findings align with previous reports highlighting the strong support provided by family [27] and the active social participation of this group [25]. A distinctive characteristic of this group is their strong interpersonal relationships, both within and outside the household, which may play a crucial role in mitigating depressive symptoms. Compared to other living arrangements, they are more likely to maintain close ties with their spouses, actively participate in social activities, and receive substantial emotional and practical support. While the prevalence of chronic diseases appears relatively low in this group, one possible explanation is that couples are more likely to engage in health-promoting behaviors together as preventive care [31]. However, previous studies have noted that this group also has the highest prevalence of drinking and smoking [11,23]. The shared lifestyle habits of couples can have both positive and negative effects on their health, while mutual encouragement could promote healthier behaviors, shared unhealthy habits can increase the risk of lifestyle-related diseases. This highlights the need for proactive interventions to reinforce health-promoting behaviors and mitigate potential risks. Furthermore, individuals living solely with their spouses or partners tend to have a longer lifespan, experience more years without disability, and spend fewer years with disability compared to those in other living arrangements [30]. Additionally, their quality of life (QOL) is reportedly higher than that of older adults living with children [27]. Taken together, these findings suggest that older adults living only with a spouse may be at lower risk for both physical and mental health issues.
Older adults who live with both a spouse and children tend to be younger and include a lower proportion of women compared to those living only with their children. They also have higher educational attainment, lower rates of long-term care certification, and fewer depressive symptoms. The characteristics of this group identified in our study align with previous research: a higher proportion of women reported in previous studies [23], greater educational attainment noted in studies [11,25,27], better economic conditions described in studies [11,27], and a lower prevalence of depression observed in studies [11,24]. Similar to those living only with a spouse, this group appears to be at a lower risk for health-related issues. However, a key difference is their greater financial difficulty and lower levels of family support compared to those living solely with a spouse. This suggests that co-residence with both a spouse and children does not necessarily guarantee financial security or sufficient family support. Our results indicate that this group experiences fewer physical and mental health issues and does not require assistance in daily life. Their co-residence with children, despite not needing care themselves, suggests that their children might rely on them for support, possibly due to the parents’ higher education compensating for their children’s life management skills. On the other hand, older adults living with both a spouse and children tend to have better health-related quality of life (HRQOL), as reported in previous studies [11], and higher well-being, as noted in studies [32], compared to other groups. These findings suggest that this group may maintain better mental health.

4.2. Living Arrangements and Their Influence on Depressive Symptoms in Older Adults: The Role of Social Networks

This section discusses the results of the logistic regression analysis, focusing on the findings of Model 2, which accounts for confounding factors, and examines the impact of social networks on depressive symptoms. Additionally, differences in social networks between men and women and their implications are explored.
For men, the results indicate that social relationships remain associated with depressive symptoms even after adjusting for confounding factors. Notably, the living arrangements of “living with spouse only” and “living with spouse and children” continued to show significant negative associations with depressive symptoms. The importance of family networks is evident, as the LSNS-6 family subscale maintained a significant negative correlation with depressive symptoms. Social participation, particularly engagement in local community events, also retained its significance, suggesting that men might prefer participation in low-frequency community-based activities that do not necessitate strong interpersonal ties. Previous studies have reported that living alone and living without a spouse in a nuclear family are particularly associated with depressive symptoms among older adults [10], which is consistent with our findings. Additionally, research has shown that among men aged 65–74 years, living with a spouse only has a protective effect against depressive symptoms compared to those aged 75 years and older [13]. This suggests that, particularly for men, the presence of a spouse may be more important than that of children. Regarding cohabitation with children, studies have demonstrated that living with children contributes to subjective well-being [23]. Conversely, other research has highlighted a strong association between living with children and future mortality risk [33]. Furthermore, findings indicate that even when living with children, participation in social activities helps prevent frailty [29]. Similarly, living as a couple without engaging in social participation may also increase the risk of frailty [29]. These findings underscore the varying significance of household composition and social networks depending on the outcome measure emphasized in each study.
Our study incorporates relationships with both family and friends, as well as social participation, underscoring the critical importance of social networks beyond household composition. Notably, our study revealed intriguing findings for women. After adjusting for confounding factors, living arrangements were no longer significantly associated with depressive symptoms. Instead, relationships with family and friends played a crucial role. These findings align with previous research that also found no significant association between household composition and depressive symptoms in women [13]. Both the family and friends subscales of LSNS-6 remained significant, emphasizing the importance of emotional and instrumental support from close social ties. Additionally, participation in neighborhood associations and skill-exchange groups continued to show significant negative correlations with depressive symptoms, suggesting that women place greater value on interpersonal relationships and roles in structured social activities such as community organizations and skill-based engagements. Further studies have indicated that women living with a spouse and children, or with children alone, have a higher risk of developing coronary heart disease in the future [33], possibly due to gender roles that require them to provide support to their spouse and children, which could negatively impact their physical and mental health in later life. Additionally, even among women living with a spouse and children, higher levels of social cohesion in neighborhoods have been shown to have a protective effect against depressive symptoms [13]. This suggests that social relationships beyond the family are crucial for women’s mental health.
This study was conducted under the hypothesis that the impact of different living arrangements—such as living alone, living with a spouse, or living with children—on depressive symptoms would differ by gender among older adults. Additionally, it was hypothesized that depressive symptoms are influenced not only by relationships with family members but also by social networks, including friendships and community connections. The results of our study indicate that, for men, living with a spouse and engaging in community activities play significant roles in mitigating depressive symptoms. In contrast, for women, relationships with family and friends, rather than household composition, have a stronger influence on depressive symptoms. Furthermore, women place greater value on interpersonal relationships and roles in structured social activities, such as those within community organizations or skill-based engagements. Overall, the findings largely support both hypotheses, providing evidence of gender differences in the impact of living arrangements on depressive symptoms and highlighting the critical role of social networks in mental health. These results suggest that gender-specific social support strategies are essential for preventing depressive symptoms.

4.3. Study Limitations

While the survey targeted older adults in specific districts of Ayase City, it is important to note that the respondents were self-selected by researchers, which may introduce a selection bias. Participants who were more interested in or proactive about their health might have been more likely to respond to the mailed questionnaires, while those in poorer health, with mobility issues, or less engaged in their health may have been less likely to participate. This self-selection bias could influence the generalizability of the findings, as the sample may not fully represent the entire population of older adults in Ayase City, let alone Japan as a whole. Therefore, the results might skew toward individuals who are healthier or more proactive about their health. To reduce the impact of such bias in future studies, it would be beneficial to include a broader range of methods, such as in-person interviews or telephone surveys, and to employ stratified random sampling techniques.
Furthermore, our study did not assess potential mediators and confounding factors, such as marital status, reasons for living alone (e.g., divorce, bereavement), the quality of marital relationships among older adults, or how these factors might influence parent–child relationships and multigenerational living arrangements. Research in Korea has found no association between marital status (married or single) and suicidal ideation in women; however, studies suggest that single men living alone and married men without children are at higher risk for suicidal ideation [25]. Previous studies have also highlighted that spousal loss is a significant risk factor for depression in older adults [34], with widowhood showing a particularly negative impact on depressive symptoms among men who end up living alone after the death of their spouse in Japan [35]. Focusing on adult children, those who have experienced parental divorce tend to have less frequent contact with their parents and lower-quality relationships compared to those whose parents remain married [36]. Furthermore, research indicates that the quality of a child’s (or son’s) marital relationship significantly influences parent–child dynamics [37]. Previous studies have also shown that parent–child relationships, such as emotional closeness, monetary support, and housework exchange, are associated with depressive symptoms. Closer relationships are linked to lower symptom levels, while more distant relationships are linked to higher levels [38]. Research in the U.S. life course literature suggests that returning to a coresidential arrangement after a period of independent living may particularly cause stress for parents. Newly coresidential children are typically aged 35 and older, unemployed, and unpartnered, and coresidential living arrangements may be especially distressing in societies where such arrangements are less normative [39]. These findings suggest that parent–child relationships are highly sensitive to life changes in either generation. These variables may also influence the relationship between living arrangements and depression. Addressing these factors could help clarify the causal mechanisms underlying the effects observed in our study.
In Singapore, older adults living in multigenerational households with adult children and grandchildren have been found to be at a higher risk for cognitive impairment compared to those living solely with a spouse or partner [28]. Conversely, older adults in multigenerational households that include grandchildren in India had the lowest odds of experiencing illness. However, multigenerational households without grandchildren showed a slightly higher risk, although both types of multigenerational households were still associated with lower odds of illness compared to those living alone or only with a spouse [40]. These findings suggest that the presence of grandchildren may have a differential impact on the mental health of older adults, warranting further investigation.
Japan, like other East Asian countries, shares a socio-cultural context where the traditional cultural norm of filial piety significantly influences intergenerational family relationships and living arrangements. The cultural practice of filial piety is reflected in the fact that a significant portion of Japan’s elderly population lives with their adult children [26]. In contrast, the Confucian tradition of filial piety has weakened in South Korea, leading to a decline in extended families. Currently, the primary household structure for older adults in South Korea is the spouse-only household [10]. Given these findings, future longitudinal studies should investigate the impact of changes in household composition and evolving family dynamics. Understanding the sociocultural context of the target region would offer deeper insights into how these relationships are shaped.

5. Conclusions

Older adults living alone and those co-residing with their children represent particularly vulnerable groups in terms of both physical and mental well-being. Those living alone often receive limited support from their closest family members and are more likely to be women, aged 75 and older, with lower educational attainment and economic difficulties. This group faces a higher prevalence of depressive symptoms and an increased likelihood of requiring care or support, making them particularly susceptible to social isolation and mental health concerns. Similarly, older adults living with their children exhibit notable vulnerabilities. While economic hardship may be less pronounced in this group compared to those living alone, they still experience significant challenges, including a high prevalence of cognitive decline [23] and a greater need for care. Previous studies indicate that living with children may be associated with poorer long-term health outcomes and reduced active life expectancy [30].
In later life, social connections outside the immediate family become increasingly significant. For men, both the presence of a spouse and community involvement act as protective factors against depressive symptoms. In contrast, for women, emotional and instrumental support from close social ties plays a more critical role than household composition. These findings highlight the necessity of tailored social policies and interventions that address the distinct needs of men and women.

Author Contributions

Conceptualization, S.I. and H.S.; methodology, S.I., H.S., K.O. and Y.S.; validation, S.I. and H.S.; formal analysis, S.I.; investigation, S.I.; resources, S.I.; data curation, S.I., H.S., K.O. and Y.S.; writing—original draft preparation, S.I.; writing—review and editing, S.I., H.S., K.O. and Y.S.; supervision, S.I.; project administration, S.I. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of J. F. Oberlin University (Approval Number: 17007, 30 May 2017).

Informed Consent Statement

Informed consent was obtained from all the participants involved in the study.

Data Availability Statement

The datasets produced and analyzed in this study are not publicly available.

Acknowledgments

The authors appreciate the data shared by the Senior Citizen Welfare Division, Ayase City, Kanagawa Prefecture.

Conflicts of Interest

The authors declare no conflicts of interest.

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Table 1. Characteristics of older adults by living arrangements.
Table 1. Characteristics of older adults by living arrangements.
CharacteristicsTotal
(n = 1409)		Living
Alone
(n = 191)		Living with
Spouse Only
(n = 718)		Living with
Children
(n = 177)		Living with
Spouse and
Children
(n = 323)		Test
Statistic
Age a
 Young–old (65–74 years old)704 (50.0%)82 (42.9%)400 (55.7%)46 (26.0%)176 (54.5%)56.60 ***
 Old–old (75 years and older)705 (50.0%)109 (57.1%)318 (44.3%)131 (74.0%)147 (45.5%)
Gender a
 Men675 (47.9%)73 (38.2%)387 (53.9%)38 (21.5%)177 (54.8%)73.24 ***
 Women734 (52.1%)118 (61.8%)331 (46.1%)139 (78.5%)146 (45.2%)
Educational attainment a
 13 years or more472 (33.5%)46 (24.1%)287 (40.0%)29 (16.4%)110 (34.1%)44.24 ***
 Less than 13 years937 (66.5%)145 (75.9%)431 (60.0%)148 (83.6%)213 (65.9%)
Economic status a
 Good1004 (71.3%)120 (62.8%)544 (75.8%)125 (70.6%)215 (66.6%)17.26 **
 Poor405 (28.7%)71 (37.2%)174 (24.2%)52 (29.4%)108 (33.4%)
Number of diseases b1.56 ± 1.361.64 ± 1.471.47 ± 1.331.84 ± 1.441.55 ± 1.313.62 *
ADL disability a
 Care uncertified1280 (90.8%)156 (81.7%)677 (94.3%)144 (81.4%)303 (93.8%)52.12 ***
 Care certified129 (9.2%)35 (18.3%)41 (5.7%)33 (18.6%)20 (6.2%)
Depressive symptoms
(GDS-5) a
 Normal (<2 points)1074 (76.2%)115 (60.2%)580 (80.8%)120 (67.8%)259 (80.2%)44.99 ***
 Having depressive symptoms (≥2 points)335 (23.8%)76 (39.8%)138 (19.2%)57 (32.2%)64 (19.8%)
Social network (LSNS-6) b
 Family subscale7.31 ± 3.256.66 ± 3.457.81 ± 3.016.57 ± 3.556.99 ± 3.2912.59 ***
 Friends subscale6.29 ± 4.066.21 ± 3.836.60 ± 4.075.43 ± 3.756.11 ± 4.274.33 **
Social participation b
 Local community events0.46 ± 0.610.38 ± 0.610.47 ± 0.590.41 ± 0.600.49 ± 0.631.84
 Neighborhood associations0.59 ± 0.730.55 ± 0.690.60 ± 0.710.51 ± 0.720.62 ± 0.791.13
 Senior activity clubs0.17 ± 0.530.25 ± 0.650.14 ± 0.480.23 ± 0.560.16 ± 0.562.78 *
 Interest-based groups0.90 ± 1.170.85 ± 1.180.99 ± 1.180.77 ± 1.110.83 ± 1.162.53
 Skill-exchange groups0.23 ± 0.670.24 ± 0.730.25 ± 0.690.15 ± 0.550.21 ± 0.641.07
 Volunteer groups0.36 ± 0.790.29 ± 0.720.43 ± 0.860.23 ± 0.640.33 ± 0.744.14 **
a. Chi-square test (χ2), b. ANOVA (F), *: p < 0.05, **: p < 0.01, ***: p < 0.001.
Table 2. Comparison of mean difference between pairs of living arrangements using the Tukey test.
Table 2. Comparison of mean difference between pairs of living arrangements using the Tukey test.
Compared GroupComparing GroupsNumber
of Diseases		Social Network (LSNS-6)Social Participation
Family
Subscale		Friends
Subscale		Senior Activity
Clubs		Volunteer
Groups
Living aloneLiving with spouse only0.17−1.14 *−0.390.11−0.14
Living with children−0.190.090.780.030.07
Living with spouse and children0.09−0.330.100.09−0.04
Living with
spouse only		Living with children−0.36 *1.24 *1.17 *−0.080.20 *
Living with spouse and children−0.080.82 *0.49−0.010.10
Living with
children		Living with spouse and children0.29−0.420.680.07−0.11
*: p < 0.05.
Table 3. Comparison of proportion differences between pairs of living arrangements using the chi-square test with Bonferroni correction.
Table 3. Comparison of proportion differences between pairs of living arrangements using the chi-square test with Bonferroni correction.
Compared GroupComparing GroupsAge
(Old–Old)		Gender
(Women)		Educational
Attainment
(Less than
13 Years)		Economic
Status
(Poor)		ADL Disability
(Care Certified)		Depressive Symptoms
(Having Depressive Symptoms)
Living aloneLiving with spouse only12.8% *15.7% *15.9% *13.0% *12.6% *20.6% *
Living with children−16.9% *−16.7% *−7.7% 7.8% −0.3% 7.6%
Living with spouse and children11.6%16.6% *10.0% 3.8% 12.1% *20.0% *
Living with
spouse only		Living with children−29.7% *−32.4% *−23.6% * −5.2% −12.9% *−13.0% *
Living with spouse and children−1.2%0.9%−5.9%−9.2% * −0.5% −0.6%
Living with
children		Living with spouse and children28.5% *33.3% *17.7% * −4.0% 12.4% *12.4% *
*: p < 0.0083 (Bonferroni-adjusted for multiple comparisons).
Table 4. Relationship between living arrangements, social network, social participation, and depressive symptoms by gender using a logistic regression analysis.
Table 4. Relationship between living arrangements, social network, social participation, and depressive symptoms by gender using a logistic regression analysis.
VariablesMenWomen
Model 1
OR (95% CI)		Model 2
OR (95% CI)		Model 1
OR (95% CI)		Model 2
OR (95% CI)
Living Arrangements
 Living alone1111
 Living with spouse only0.31 (0.17–0.55) ***0.33 (0.18–0.61) ***0.54 (0.32–0.89) *0.69 (0.40–1.21)
 Living with children0.53 (0.21–1.30)0.46 (0.18–1.20)0.63 (0.36–1.12)0.60 (0.32–1.12)
 Living with spouse and children0.29 (0.15–0.54) ***0.26 (0.13–0.51) ***0.43 (0.23–0.78) **0.53 (0.27–1.02)
Social Network (LSNS-6) a
 Family subscale0.90 (0.84–0.96) **0.90 (0.84–0.96) **0.92 (0.86–0.98) **0.93 (0.86–0.99) *
 Friends subscale0.95 (0.90–1.00)0.97 (0.92–1.03)0.92 (0.87–0.98) **0.92 (0.86–0.98) *
Social participation b
 Local community events0.61 (0.38–0.97) *0.55 (0.33–0.90) *0.92 (0.61–1.39)1.09 (0.71–1.67)
 Neighborhood associations0.73 (0.50–1.05)0.84 (0.57–1.24)0.56 (0.38–0.81) **0.54 (0.37–0.80) **
 Senior activity clubs0.76 (0.45–1.29)0.65 (0.36–1.17)1.50 (1.00–2.24)1.41 (0.92–2.16)
 Interest-based groups0.88 (0.71–1.10)0.92 (0.73–1.16)0.81 (0.67–0.98) *0.84 (0.68–1.03)
 Skill-exchange groups1.02 (0.68–1.54)0.99 (0.64–1.54)0.62 (0.40–0.97) *0.55 (0.34–0.89) *
 Volunteer groups0.81 (0.57–1.14)0.83 (0.58–1.19)0.89 (0.62–1.26)1.00 (0.70–1.44)
Model 2: adjusted for covariates such as age, educational attainment, economic status, number of diseases, and ADL disability. a. the responses are scored as: 0 to 15. b. the responses are scored as: 3 = once a week or more, 2 = 1–3 times per month, 1 = a few times per year, and 0 = not at all. *: p < 0.05, **: p < 0.01, ***: p < 0.001.
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Ikeda, S.; Shibahashi, H.; Ohno, K.; Seike, Y. The Impact of Living Arrangements on Depressive Symptoms by Gender Among Community-Dwelling Older Adults in Japan. J. Ageing Longev. 2025, 5, 17. https://doi.org/10.3390/jal5020017

AMA Style

Ikeda S, Shibahashi H, Ohno K, Seike Y. The Impact of Living Arrangements on Depressive Symptoms by Gender Among Community-Dwelling Older Adults in Japan. Journal of Ageing and Longevity. 2025; 5(2):17. https://doi.org/10.3390/jal5020017

Chicago/Turabian Style

Ikeda, Shinpei, Hirotomo Shibahashi, Kanta Ohno, and Yousuke Seike. 2025. "The Impact of Living Arrangements on Depressive Symptoms by Gender Among Community-Dwelling Older Adults in Japan" Journal of Ageing and Longevity 5, no. 2: 17. https://doi.org/10.3390/jal5020017

APA Style

Ikeda, S., Shibahashi, H., Ohno, K., & Seike, Y. (2025). The Impact of Living Arrangements on Depressive Symptoms by Gender Among Community-Dwelling Older Adults in Japan. Journal of Ageing and Longevity, 5(2), 17. https://doi.org/10.3390/jal5020017

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