Challenges of Dementia Care among Older Adults Living Alone in Japan: Insights from a Memory Clinic Study

Introduction: Japanese society is rapidly aging, and increasing numbers of older adults are living alone, which may hinder the early detection and management of dementia. This study aimed to investigate the characteristics of older adults living alone who attended a memory clinic, focusing on cognitive, physical, and caregiving burdens. Methods: A total of 278 older adults (aged 66-94 years) were categorized as living alone (n = 57) or living with others (n = 221). Evaluations included cognitive, physical, and behavioral assessments, caregiver burden (Zarit Burden Interview-8), and long-term care insurance (LTCI) status. Results: The group living alone was older and included a higher proportion of women. They had lower cognitive scores on the Montreal Cognitive Assessment-Japanese version and the Raven's Colored Progressive Matrices but showed higher grip strength, Rivermead Mobility Index, and Vitality Index scores. Walking speed, Timed Up and Go Test, and depressive symptoms were similar between groups. Caregivers of those living with others reported greater role strain, while LTCI use was generally low, particularly among participants living alone. Conclusions: Older adults living alone face a greater risk of cognitive decline despite preserved physical function. Low LTCI utilization highlights the need for enhanced support. Effective strategies should aim to maintain both cognitive and physical function while addressing caregiver needs across different living arrangements.