Neighborhood food store and subsequent health and well-being of older adults in Japan: an outcome-wide study.

Fewer neighborhood food stores were associated with worse physical and cognitive health outcomes in older adults.

• Outcomes assessed included self-rated health and instrumental activities of daily living (IADL).
• Compared to those reporting many available neighborhood food stores, those reporting fewer stores had lower self-rated health and lower IADL scores.
• Associations remained statistically significant after Bonferroni correction (p < 0.0013).
• Analysis used logistic and linear regression adjusted for pre-exposure covariates including prior outcomes measured in 2013.

Fewer neighborhood food stores were associated with lower frequency of going out as a health behavior outcome.

• Going out frequency was one of 40 health and well-being outcomes assessed across seven domains.
• This finding survived Bonferroni correction (p < 0.0013).
• The health behaviors domain showed significant association in the outcome-wide analysis.
• The study included 34,181 respondents for this behavioral outcome.

Fewer neighborhood food stores were associated with worse mental health, specifically more depressive symptoms and hopelessness.

• Both depressive symptoms and hopelessness were significantly associated with fewer neighborhood food stores.
• These associations remained statistically significant after Bonferroni correction (p < 0.0013).
• The mental health domain was one of 5 out of 7 domains showing significant associations.
• Analysis was conducted using three-wave longitudinal data from 2013, 2016, and 2019.

Fewer neighborhood food stores were associated with lower psychological well-being, including lower happiness and life satisfaction.

• Both happiness and life satisfaction outcomes were significantly associated with fewer available neighborhood food stores.
• These associations survived Bonferroni correction (p < 0.0013).
• Psychological well-being was one of 5 of 7 domains showing statistically significant associations.
• Exposure was the perceived availability of neighborhood food stores measured in 2016, with outcomes assessed in 2019.

Fewer neighborhood food stores were associated with lower community attachment as a measure of cognitive social capital.

• Community attachment was significantly lower among older adults reporting fewer neighborhood food stores.
• This association remained significant after Bonferroni correction (p < 0.0013).
• Cognitive social capital was one of 5 of 7 domains showing significant associations.
• The cognitive social capital domain was among those assessed in the outcome-wide approach covering 40 total outcomes.

The study used an outcome-wide design examining 40 health and well-being outcomes across seven domains in a large nationwide cohort of older Japanese adults.

• Three-wave data were used from 2013, 2016, and 2019 from a nationwide cohort study of physically and cognitively independent older adults aged ≥65 years in Japan.
• The study included 47,318 respondents for 4 outcomes (death, dementia, any level of functional disability, and level 2 or greater functional disability) and 34,181 respondents for 36 other outcomes.
• Exposure was the perceived availability of neighborhood food stores measured in 2016.
• Seven domains were assessed: physical/cognitive health, health behaviors, mental health, psychological well-being, social well-being, character and virtue, and cognitive social capital.
• Bonferroni correction was applied to correct for multiple tests, with the threshold set at p < 0.0013.

Significant associations between fewer neighborhood food stores and health outcomes were found in 5 of 7 domains, with no significant associations found in social well-being or character and virtue domains.

• Domains showing significant associations were: physical/cognitive health, health behaviors, mental health, psychological well-being, and cognitive social capital.
• Social well-being and character and virtue domains did not show statistically significant associations after Bonferroni correction.
• A total of 8 specific outcomes were identified as significantly associated with fewer neighborhood food stores across the 5 domains.
• All significant associations were in the direction of less favorable outcomes for those reporting fewer stores.