Gender Differences in the Association between Psychological Distress and Sociability among Older Adult Survivors: Cross-Sectional Survey Four Years after the 2016 Kumamoto Earthquake in Japan.

Mental health deterioration after a disaster is a concern. Individuals' sociability is expected to relate to the risk of this deterioration; however, research focusing on older adults is lacking. We aimed to investigate the relationship between psychological distress and sociability in older adults who survived the 2016 Kumamoto earthquake. We conducted a self-reported questionnaire survey in 2020. Data on 3,588 people aged 65 years and over (2,024 women and 1,564 men, mean age 74.6 ± 7.2, mean ± standard deviation) were analyzed. The overall prevalence of psychological distress (the Kessler psychological distress scale: K6 ≧ 10) was 10.5%; by gender, it was 11.2% in women and 9.5% in men. Logistic regression analysis revealed that, in the total sample, age, gender, public housing, reduction in income resulting from the coronavirus disease 2019 pandemic, self-rated unhealthy conditions, subjective social isolation, and a lack of awareness of community events were positively associated with psychological distress. For women, a lack of community participation was positively related to psychological distress. For men, not knowing the change in school district after relocation was negatively associated with psychological distress, probably due to men's scarce community participation and reliance on friendships, compared to women's stronger dependence on community. Moreover, having a family member or friend to consult with was associated with a lower risk of psychological distress, regardless of gender. Gender differences were related to different conditions of social participation and types of social relationships. Enhancing community participation and family relationships among women and social contact with friends among men is essential.