Older adults’ staying at home in greater Tokyo: Association with population density and roles of car ownership and public transport

Going out of the home is important for older people's health. This study examined how staying at home was associated with population density and whether car ownership and public transport mediated the association. Data from 86,077 older adults who participated in the Sixth Greater Tokyo Metropolitan Area Household Travel Survey were used. We conducted multilevel logistic regression analyses to estimate the odds of staying at home (not reporting any travel on a survey day) by population density. Further analyses for the samples stratified by car ownership and public transport stop (PTS) density were conducted. Staying at home was more common in low population density areas. Each additional 100 persons/ha was associated with a 15% lower odds ratio of staying at home. This association was moderated by PTS density score but not by car ownership. Population density was not significantly associated with staying at home in areas with high PTS density score (odds ratio [OR] = 0.97, 95% confidence interval [CI]: 0.93, 1.02), but low density was associated with a higher odds ratio in areas with lower PTS density score (OR = 0.80, 95% CI: 0.76, 0.85) and regardless of car ownership. Better access to public transport may protect older adults living in lower density areas from staying at home. Transport initiatives may be needed to support older adults’ out-of-home mobility in low density areas. •Higher population density was associated with lower odds of staying at home.•This association did not differ by car ownership.•This association was moderated by public transport stop (PTS) density.•Higher PTS density protects older adults from staying at home in low density areas.