SUBJECTIVE WELL-BEING IS ASSOCIATED WITH FOOD BEHAVIOR AND DEMOGRAPHIC FACTORS IN CHRONICALLY ILL OLDER JAPANESE PEOPLE LIVING ALONE.

Objectives: This study aimed to examine the relationships among subjective well-being, food and health behaviors, socioeconomic factors, and geography in chronically ill older Japanese adults living alone. Design: The design was a cross-sectional, multilevel survey. A questionnaire was distributed by post and self-completed by participants. Setting: The sample was drawn from seven towns and cities across Japan. Participants: A geographic information system was used to select a representative sample of older people living alone based on their proximity to a supermarket. Study recruitment was conducted with municipal assistance. Measurements: To assess subjective well-being and food and health behaviors of respondents with disease, a logistic regression analysis was performed using stepwise variable analyses, adjusted for respondent age, socioeconomic status, and proximity to a supermarket. The dependent variable was good or poor subjective well-being. Results: In total, 2,165 older people (744 men, 1,421 women) completed the questionnaire (63.5% response rate). Data from 737 men and 1,414 women were used in this study. Among people with a chronic disease, individuals with good subjective well-being had significantly higher rates than those with poor subjective well-being for satisfaction with meal quality and chewing ability, food diversity, food intake frequency, perception of shopping ease, having someone to help with food shopping, eating home-produced vegetables, preparing breakfast themselves, eating with other people, and high alcohol consumption. A stepwise logistic analysis showed that the factors strongly related to poor subjective well-being were shopping difficulty (men: odds ratio [OR] = 3.19, 95% confidence interval [CI], 1.94-5.23; P < 0.0001; women: OR = 2.20, 95% CI, 1.54-3.14; P < 0.0001), not having someone to help with food shopping (women: OR = 1.41, 95% CI, 1.01-1.97; P = 0.043), not preparing breakfast (women: OR = 2.36, 95% CI, 1.40-3.98; P = 0.001), and eating together less often (women: OR = 1.99, 95% CI, 1.32-3.00; P = 0.002). Conclusion: Subjective well-being of people with chronic diseases is associated with food intake and food behavior. The factors that affect poor subjective wellbeing in chronically ill older Japanese people living alone include food accessibility and social communication. [ABSTRACT FROM AUTHOR]
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