Japanese older adults’ loneliness, family relationships and mortality: Does one's living arrangement make a difference?

Aim This study examines how the association between older adults' family relationships and all-cause mortality differs among different household contexts: living alone, living with only a spouse and living with adult children. Methods We carried out a discrete-time event history analysis on all-cause mortality with measures of family relationships for each group of older adults. The study analyzed person-wave data from the Nihon University Japanese Longitudinal Study of Aging, including 11 225 longitudinal episodes between consecutive waves and 555 deaths reported in total. Results The family relationship measures were significantly associated with mortality only for older adults who resided with children. While providing support to children was negatively related to mortality, receiving support from children was positively associated with mortality. Feelings of loneliness were associated with higher mortality for older adults in intergenerational coresidence arrangements, but not for those in other living arrangements. Conclusion The extent of support exchange between older adults and adult children tends to be associated with older adults' mortality only within the household context where parents and children live together. In other types of living arrangements (i.e. living alone and living with only a spouse), the association between family relationship measures and mortality is limited. Geriatr Gerontol Int 2019; ••: ••-••. Geriatr Gerontol Int 2020; 20: 156-160.