Contribution of the sense of place to survival: 5-year follow-up study among senior citizens

In response to growing healthcare resource and cost demands, the community has re-emerged as a key site for the provision and consumption of care for the elderly. The present study evaluates contribution of the subjective meaning and importance the elderly give to where they reside (i.e., the sense of place) to their five-year survival. Systematically selected 2,601 healthy non-institutionalized Tokyo residents, born in 1903, 1908, 1913, or 1918, filled a questionnaire about their neighborhood perception and involvement and agreed with a five-year follow-up survey using their registration record. The analyses revealed that the sense of place was positively associated with a range of perceived social and physical features of the neighborhood (i.e., social coheison, green, space, quietness, sunlight, all p<0.05) and neighborhood involvement (house ownership, length of stay, participation to neighborhood activity, all p<0.05). With respect to survival, the sense of place significantly predicted a five-year survival independent of characteristics associated with demographics, lifestyle and disease history among women (OR=1.61, 95%CI=1.06-2.46, p<0.05) but not among men. These results highlight the importance of strengthening the community power to sustain the well-being and quality of life of the growing number of the elderly women. Communities should provide opportunities for their senior citizens to feel connected as well as to be involved in their neighborhood.