Data for this study were accessed via the Japan Gerontological Evaluation Study (JAGES). Set up in Aichi in 2003, this was a prospective cohort study of the Center for Well-being and Society of the Nihon Fukushi University.19 The research was carried out in seven—three larger (Handa, Tokoname and Chita Hokubu) and four smaller (Agui, Mihama, Minamichita and Taketoyo)—municipalities that encompass the entire southern region of the Chita peninsula and the Aichi Prefecture. In October 2003, an estimated 276 208 people resided in these locations where 18.0% were aged 65 years or above.17 On average, the data of 6300 residents in the 44 school districts were analysed in this study. From the three larger municipalities, 5000 survey candidates were randomly selected from the list of persons insured by long-term care insurance who were not certified as requiring long-term care. In the four smaller municipalities, candidates were randomly selected from those not receiving public long-term care insurance benefits due to a physical or cognitive disability. Of the 33 152 people selected, 15 313 individuals answered the baseline survey (response rate=52.1%).15 The exclusion criteria were: (1) people who had difficulty in performing activities of daily living as a result of disabilities; (2) people who did not provide baseline information (n=579); (3) people who did not provide social support information (n=1359); and (4) people who did not provide a school district code (n=2343). Ultimately, 11 032 subjects (5627 women and 5405 men) were included in this analysis.

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