Effect of eating alone and depression symptoms on incident disability among community-dwelling older adults

Objectives: The intent of the present study was to elucidate the association of eating alone and depressive symptoms with the development of disability among community-dwelling older adults, using a longitudinal study.

Method: Participants included 4648 Japanese older adults (mean age 73.8 ± 5.4 years; 44.3% men) aged ≥ 65 years at the time of the examination. Eating status was divided into two categories: "Eating with others at least once a day" and "Other." The 15-item Geriatric Depression Scale was used to measure depressive symptoms. Incident disability was certified by long-term care insurance (median duration: 36 months).

Results: During a median follow-up at 36 months, 8.0% of the participants developed an incident disability. Adjusted for covariates, the participants who ate alone were associated with a higher hazard ratio of incident disability compared to those who ate with others (hazard ratio: 1.36, 95% confidence interval: 1.05-1.75). However, adjusted for the covariate depressive symptoms, eating alone was not significantly associated with incident disability. Structural equation models revealed that the indirect model confirmed eating alone habits were associated with disability via depressive symptoms.

Conclusions: This study confirmed that eating alone was associated with an incident disability after adjusting for the covariates. Furthermore, the present study suggests an indirect relationship between eating alone and incident disability via depressive symptoms, the result of the structural equation model.