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During the coronavirus disease 2019 (COVID-19) pandemic, informal caregivers' mental health deteriorated more than that of non-caregivers. We examined the association between increased caregiver burden during the pandemic and severe psychological distress (SPD).We used cross-sectional data from a nationwide internet survey conducted between August and September 2020 in Japan. Of 25,482 participants aged 15-79 years, 1,920 informal caregivers were included. SPD was defined as Kessler 6 Scale (K6) score ≥ 13. Self-rated change in caregiver burden was measured retrospectively with a single question item. Binary logistic regression analysis was used to examine the association between SPD and increased caregiver burden during the pandemic, adjusted for demographic, socioeconomic, health, and caregiving variables. To examine the differential association between increased caregiver burden and SPD, interaction terms were added and binary logistic regression was separately conducted for all variables.Participants' mean age was 52.3 years (standard deviation 15.9), 48.8% of participants were male, 56.7% reported increased caregiver burden, and 19.3% exhibited SPD. Increased caregiver burden was significantly associated with SPD (adjusted odds ratio: 1.90; 95% confidence interval: 1.37-2.66). The association between increased caregiver burden and SPD was stronger among caregivers who were married, those undergoing disease treatment, and those with a care-receiver with a care need level of 1-2.The results revealed that more than half of caregivers reported increased caregiver burden, and increased caregiver burden was associated with SPD during the pandemic. Measures supporting mental health for caregivers with increased caregiver burden should be implemented immediately.

Social isolation among the elderly is a concern in developed countries. Using a randomized trial, this study examined the effect of a social isolation prevention program on loneliness, depression, and subjective well-being of the elderly in Japan. Among the elderly people who relocated to suburban Tokyo, 63 who responded to a pre-test were randomized and assessed 1 and 6 months after the program. Four sessions of a group-based program were designed to prevent social isolation by improving community knowledge and networking with other participants and community "gatekeepers." The Life Satisfaction Index A (LSI-A), Geriatric Depression Scale (GDS), Ando-Osada-Kodama (AOK) loneliness scale, social support, and other variables were used as outcomes of this study. A linear mixed model was used to compare 20 of the 21 people in the intervention group to 40 of the 42 in the control group, and showed that the intervention program had a significant positive effect on LSI-A, social support, and familiarity with services scores and a significant negative effect on AOK over the study period. The program had no significant effect on depression. The findings of this study suggest that programs aimed at preventing social isolation are effective when they utilize existing community resources, are tailor-made based on the specific needs of the individual, and target people who can share similar experiences.

In Asian families, where patriarchal family systems are common, living arrangements of older adults are characterized by residing with a married son. This study examines the synergic effects of intergenerational solidarity (emotional and instrumental support exchange and anticipated support) on depression of older adults from a developing country, Nepal. Gender differences are also explored in the study. This was a cross-sectional face-to-face interview study of 489 community dwelling older adults living in an urban area of Nepal. The data were analyzed using multiple regression models with each dimension of intergenerational solidarity and conflict variables entered one-by-one with the confounding variables. The results illustrate that older women receiving lower emotional and instrumental support were significantly more likely to be depressed compared to older men receiving less support from their son. Also, women reporting lower anticipated support and higher conflict with their son were more likely to be depressed than men. Regarding synergic effects, emotional support exchange buffered against the deleterious effects of conflict with depression in older adults. The results highlight a need for further research on late life intergenerational relationships (IR) and mental health of older adults in developing countries so that it can be useful for health care practitioners.

The purpose of this study is to examine participation in volunteer work among older adults in Japan; in particular, to identify the determinants of volunteer participation and reasons for non-participation. Subjects were 593 older peoples aged 60-74 residing in a suburb of Tokyo, Japan. Multivariate logistic regression analyses were conducted to examine the relationship between relevant characteristics and volunteer participation. Among females, those who had lived in the community longer, residing in a single household, actively participating in hobbies or continuing education, not working and reporting better self-rated health were more likely to participate in volunteer activities. By contrast, there were no specific correlations among males. 51.0% of the non-participants reported that they would like to participate in volunteer work in the future. The most frequently given reason for non-participation was "Don't have time to participate". Additional concerns were related to accessibility such as "Don't know where I should go to participate". For promoting volunteer activities among older Japanese, diverse volunteer activities should be offered with consideration to differences in lifestyle by gender and also by available flexible time. A plan for improving the accessibility to volunteer work is also needed.

In Japan, few studies have investigated the effects of moving residence among the elderly, despite the fact that Japanese elderly will be increasingly required to switch residence in the future. Here, we used representative sampling to examine the characteristics of elderly persons who had moved residence to a Tokyo suburb and compared results with those of non-moving residents of the suburb. Movers aged 65 years old or older who had relocated within the previous 2 years (movers) and residents aged 65 years old or older and had lived in the area longer than 5 years (non-movers) were surveyed by mail in 2004, with a focus on health and psychosocial measures. Compared with non-movers (N=117), movers (N=97) were more depressed, socially isolated, and fulfilled less active social roles among family members. The majority of movers had moved to find affordable housing or to live with or near family. Two factors preceded co-residence with family, namely retirement and imminent loss of functional independence. Our findings suggest that movers require community support to prevent social isolation, dependency and health declines.

Social support, subjective well-being (SWB), and loneliness are issues of central importance in research concerned with the quality of life (QOL) of elderly people in the 21st century. However, very little is known about the situation in low-income countries such as in Nepal. The purpose of this paper is to identify the relationships significant in social support (received (SSR) and provided (SSP)) and analyze their connections with loneliness and SWB. The subjects, not suffering from dementia, were 60 years and above living in Kathmandu city. The data was analyzed using logistic regression with some confounding variables controlled. The results indicate that loneliness is high and SWB is low amongst Nepalese older adults. SSR from children living together and SSP to spouse, children living together and friends and neighbors reduce loneliness. SSP to children living apart increases SWB-life satisfaction. SSR from children living together and SSP to children (living together and apart) increases SWB-life stability. However, SSP to relatives reduces SWB-life satisfaction and SSR from relatives reduces SWB-life stability in Nepalese older adult men.