Effect of Social Support Reciprocity on Mental Health Status Among Community‐Dwelling Older Adults: A Cross‐Sectional Study of the Kashiwa Cohort Study

ABSTRACT Background and Aims Reciprocity of informal social support is associated with improved mental health in older adults. While several studies have examined support provision or receipt separately, this study clarifies reciprocity's effect on mental health among older adults in Japanese urban areas. Methods A 2014 survey targeted community‐dwelling adults aged ≥ 65 years in Kashiwa City, Chiba, Japan. Quality of life was assessed using the WHO‐Five Well‐Being Index (0–25 points) with a cutoff of < 13 points indicating suspected depression. Independent variables included four mutually exclusive categories of receiving and providing emotional and instrumental social support. Sex‐stratified multivariate logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CI) for suspected depression. Ethical approval was obtained from The University of Tokyo (No. 21‐192). Results Data from 1302 participants were analyzed. The mean age was 74.7 (standard deviation, 5.5) years, and 623 (47.8%) were women. Suspected depression was identified in 93 men (7.1%) and 80 women (6.1%). Compared to those with no support exchange, the ORs for reciprocal emotional support were 0.16 (CI: 0.06–0.42; p < 0.001) for men and 0.44 (CI: 0.75–2.58; p = 0.365) for women. For instrumental support, ORs were 0.90 (CI: 0.28–2.86; p = 0.871) for men and 0.30 (CI: 0.11–0.80; p = 0.016) for women. Conclusion Social support reciprocity positively influences mental health among older adults living in urban Japan. Facilitating environments for mutual social support helps maintain mental health in urban‐dwelling older adults in Japan.