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Dang M, Chen Y, Ji JS, Zhang Y, Chen C, Zhang Z. The association between household and family composition and mental health of the elderly: mediating role of lifestyle. BMC Public Health 2024; 24:2055. [PMID: 39080574 PMCID: PMC11290097 DOI: 10.1186/s12889-024-19516-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 07/17/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Mental health in the elderly has multiple determinants, and studies indicate household and family composition, economic status, and family support are key factors. However, these are difficult to modify, and better lifestyle for the elderly can be a possible intervention. The current study examined the mediating role of lifestyle in the association between these three types of the household and family composition (living alone, living with a spouse, and living with children) and mental health in older adults. METHODS We studied 5,407 participants (58.7% female, age 45 + years) from the Beijing Aging Brain Rejuvenation Initiative Project. All participants underwent a battery of examinations to measure degree loneliness, depression, and global cognitive function. We also surveyed personal lifestyles. We used a mediation analysis to determine the relative contribution of each lifestyle factor on mental health outcomes. RESULTS Older adults living alone rarely participated in mental and social activities and often had irregular diets; those adults living with children spent most of their time caring for grandchildren and had irregular eating and sleeping schedules; those living with a spouse often engaged in a variety of leisure activities and had the best life habits. Mediation analyses showed that dietary and sleeping irregularity partially mediated the negative effects of living alone on mental health, and were moderated by age and gender. CONCLUSIONS Living with a spouse was associated with benefits for the mental health of middle-aged and older adults (especially older and female individuals), through modifying better lifestyles than those of individuals with the other two types of the household and family composition.
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Affiliation(s)
- Mingxi Dang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, P. R. China
- BABRI Centre, Beijing Normal University, Beijing, 100875, P. R. China
| | - Yaojing Chen
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, P. R. China.
- BABRI Centre, Beijing Normal University, Beijing, 100875, P. R. China.
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, Beijing, 100083, P. R. China
| | - Yutong Zhang
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Chuansheng Chen
- Department of Psychological Science, University of California, Irvine, CA, 92697, USA
| | - Zhanjun Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, P. R. China.
- BABRI Centre, Beijing Normal University, Beijing, 100875, P. R. China.
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Wasserman JS, Holtzer R. Depressive Symptoms are Associated with Decline Over Time in Verbal Fluency Performance in Female but Not Male Community-Dwelling Older Adults. Exp Aging Res 2024; 50:360-375. [PMID: 36989442 PMCID: PMC10539484 DOI: 10.1080/0361073x.2023.2195295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 03/16/2023] [Indexed: 03/31/2023]
Abstract
OBJECTIVE The current study was designed to examine associations between depressive symptoms and longitudinal declines in category and letter fluency performance in a gender-stratified sample of older adults. METHOD Participants were community-residing older adults (females: n = 289; males: n = 233) followed annually (2011-2018) as part of a cohort study conducted at Albert Einstein College of Medicine in New York. Depressive symptoms were assessed using the Geriatric Depression Scale (GDS). Standard forms assessed category and letter fluency performance. Participants were dementia-free during study enrollment. RESULTS The presence of baseline depressive symptoms suggestive of subclinical depression was associated with a worse longitudinal decline in category fluency performance in female but not male participants. These associations remained significant when excluding participants with prevalent and incident mild cognitive impairment and incident dementia. Irrespective of gender, letter fluency performance did not decline over time and was not influenced by the presence of depressive symptoms. DISCUSSION The present study's results can aid in identification of older adults who may be at greater risk for cognitive decline, and add to the limited literature examining the influence of gender on longitudinal associations between depressive symptoms and verbal fluency performance.
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Affiliation(s)
| | - Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
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Lee MA, Ryu H, Kim G. Is living alone beneficial to older adults during the COVID-19 pandemic? Examining associations between living arrangements and life satisfaction by gender in Korea. Aging Ment Health 2024; 28:121-129. [PMID: 37697800 DOI: 10.1080/13607863.2023.2253182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 06/29/2023] [Indexed: 09/13/2023]
Abstract
OBJECTIVES This study examines associations between living arrangements and life satisfaction and the associated effects of gender among Korean older adults during the pandemic. METHOD Data were drawn from the 2020 National Survey of Older Koreans-a nationally representative survey. Living arrangements were categorized into four groups: living alone; living with spouse only; living with family and spouse; and living with family without spouse. Logistic regression analyses were used to examine associations between living arrangements and life satisfaction measured as a binary outcome. RESULTS Older adults living alone were more likely to be satisfied with life compared with those who lived with a spouse only. However, living alone became nonsignificant after controlling for social contact with friends or neighbors and social participation. Interestingly, there was a significant interaction between living arrangements and gender, showing that living alone was beneficial to older women but not to men. Subsample analysis by gender confirmed that older women living alone had a greater likelihood of being satisfied with life than those living with a spouse only, whereas men living alone had lower life satisfaction. CONCLUSION Findings suggest that living alone is not always deleterious to older adults, particularly women. During the pandemic, older Korean women living with their spouse and/or family might be less satisfied with life due to the dual burden of family care and housework, associated with traditional gendered norms and social context.
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Affiliation(s)
- Min-Ah Lee
- Department of Sociology, Chung-Ang University, Seoul, South Korea
| | - Hanso Ryu
- Department of Sociology, Chung-Ang University, Seoul, South Korea
| | - Giyeon Kim
- Department of Psychology, Chung-Ang University, Seoul, South Korea
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Decreasing patterns of depression in living alone across middle-aged and older men and women using a longitudinal mixed-effects model. Soc Sci Med 2023; 317:115513. [PMID: 36450172 DOI: 10.1016/j.socscimed.2022.115513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/23/2022] [Accepted: 11/03/2022] [Indexed: 11/22/2022]
Abstract
There is little evidence regarding the association between living arrangement and depression, and no studies have examined the age- and gender-specific differences in this association. The present study sought to examine the longitudinal changes in depression patterns between isolative living versus living in company among middle-aged and older men and women by obtaining data from waves 1-7 of the Korean Longitudinal Study of Aging (KloSA), which comprises a sample of persons at least 45 years of age in the Republic of Korea (2273 middle-aged and 1387 older men, 2805 middle aged and 1862 older women). Depression scores were based on the self-reported Center for Epidemiologic Studies Depression Scale (CES-D-10) short forms. Using mixed-effect linear regression models, we estimated depression patterns by living arrangement across age- and gender groups. Our findings from the mixed-effects model revealed that over a 14-year follow-up period, there were significant decreasing patterns of depression were among middle-aged men and women, and older men living alone compared to living with a spouse and living with others. However, living alone still had the highest depression compared to other living arrangement types. On the other hand, the depression of older women living alone changed to a level similar to those living with others during the follow-up period. In conclusion, these findings indicate that living alone significantly increases the risk of depression, but the risk decreases over time. Additionally, depression patterns by living arrangement proved to differ across age and gender groups.
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Azizabadi Z, Aminisani N, Emamian MH. Socioeconomic inequality in depression and anxiety and its determinants in Iranian older adults. BMC Psychiatry 2022; 22:761. [PMID: 36471352 PMCID: PMC9721087 DOI: 10.1186/s12888-022-04433-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 11/28/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Older adults with lower socioeconomic status are more vulnerable to stressful life events and at increased risk of common mental health disorders like anxiety and depression. This study investigates the socioeconomic inequality in depressive symptoms and anxiety. METHODS The data were from 7462 participants of the Neyshabur longitudinal study of ageing registered during 2016-2018. The outcome variables were anxiety and depressive symptoms. Anxiety was defined by the "Hospital Anxiety and Depression scale Questionnaire", and depressive symptoms was defined and measured by the "short-term form of the Epidemiological Center Questionnaire." The socioeconomic status was defined using principal component analysis of home assets. The Concentration Index (C) was used to measure socioeconomic inequality in anxiety and depressive symptoms. Concentration index was decomposed to its determinants to determine the role of the independent variables on inequality. RESULTS The prevalence of depressive symptoms and anxiety was 12.2% (95% CI: 11.4, 12.9) and 7.0% (95% CI: 6.4, 7.5), respectively. Moreover, the C for anxiety was -0.195 (95% CI: -0.254, -0.136) and for depressive symptoms was -0.206 (95% CI: -0.252, -0.159), which indicate a considerable inequality in favor of high socioeconomic group for anxiety and depressive symptoms. Decomposition of the concentration Index showed that education, unemployment and male sex were the most important positive contributors to the observed inequality in anxiety and depressive symptoms, while age and number of grandchildren were main negative contributors of this inequality. CONCLUSION Low socioeconomic groups were more affected by anxiety and depressive symptoms. Any intervention for alleviation of inequality in anxiety and depression should be focus on education and employment of people, especially in younger elderly.
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Affiliation(s)
- Zahra Azizabadi
- grid.444858.10000 0004 0384 8816Student Research Committee, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Nayyereh Aminisani
- grid.502998.f0000 0004 0550 3395Healthy Ageing Research Centre, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Mohammad Hassan Emamian
- Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran.
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Zhao X, Zhang Q, Ji Y, Liu H, Lou VWQ. Influence of spousal caregiving and living arrangement on depression among husband caregivers in rural China. Aging Ment Health 2022:1-8. [PMID: 35758023 DOI: 10.1080/13607863.2022.2089630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVES With sociodemographic changes, men are increasingly taking responsibility for spousal caregiving. Previous studies have described gender differences in the psychological outcomes of caregiving; however, few have focused exclusively on husband caregivers. This study investigates the influence of starting spousal caregiving on the psychological well-being of older husbands in rural areas and examines whether living arrangements can moderate this relationship. METHODS A total of 1,167 baseline non-caregiver husbands aged 60 and above in rural areas were taken from the 2011-2015 China Health and Retirement Longitudinal Study (CHARLS). The generalized estimating equation (GEE) was employed to examine the effects of spousal caregiving transitions and living arrangement changes on depressive symptoms over four years. RESULTS Compared with rural husbands who remained non-caregivers, those transitioning into activities of daily living (ADL) caregiving reported higher depressive symptoms at follow-up (B = 1.67, p < 0.05). Moreover, the increase in depressive symptoms when transitioning into ADL caregiving was significantly lower among participants who changed from living with spouse alone to living with spouse and other family members together (B = - 5.37, p < 0.05). CONCLUSION There was an association between transitioning into ADL caregiving and an elevated level of depression over four years among older husbands, which could be alleviated by living with family members. Co-residence with family members could serve as a natural support resource, buffering adverse mental health outcomes when older husbands start a demanding caregiving role.
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Affiliation(s)
- Xinyi Zhao
- School of Health Humanities, Peking University, Beijing, China
| | - Quan Zhang
- National School of Development, Peking University, Beijing, China
| | - Ying Ji
- School of Public Health, Peking University, Beijing, China
| | - Huiying Liu
- Department of Sociology, Central South University, Changsha, China
| | - Vivian W Q Lou
- Department of Social Work and Social Administration, Sau Po Centre on Ageing, The University of Hong Kong, Pokfulam, Hong Kong
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Muhammad T, Skariah AE, Kumar M, Srivastava S. Socioeconomic and health-related inequalities in major depressive symptoms among older adults: a Wagstaff's decomposition analysis of data from the LASI baseline survey, 2017-2018. BMJ Open 2022; 12:e054730. [PMID: 35649601 PMCID: PMC9161106 DOI: 10.1136/bmjopen-2021-054730] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES To find out the association between socioeconomic and health status and depression among older adults and explore the contributing factors in the socioeconomic and health-related inequalities in late-life depression. DESIGN A cross-sectional study was conducted using large representative survey data. SETTING AND PARTICIPANTS Data for this study were derived from the baseline wave of the Longitudinal Ageing Study in India conducted during 2017-2018. The effective sample size was 30 888 older adults aged 60 years and above. PRIMARY AND SECONDARY OUTCOME MEASURES The outcome variable in this study was depression among older adults. Descriptive statistics along with bivariate analysis was conducted to report the preliminary results. Multivariable binary logistic regression analysis and Wagstaff's decomposition were used to fulfil the objectives of the study. RESULTS There was a significant difference for the prevalence of depression (4.3%; p<0.05) among older adults from poor (11.2%) and non-poor categories (6.8%). The value of the Concentration Index was -0.179 which also confirms that the major depression was more concentrated among poor older adults. About 38.4% of the socioeconomic and health-related inequality was explained by the wealth quintile for major depression among older adults. Moreover, about 26.6% of the inequality in major depression was explained by psychological distress. Self-rated health (SRH), difficulty in activities of daily living (ADL) and instrumental ADL (IADL) contributed 8.7%, 3.3% and 4.8% to the inequality, respectively. Additionally, region explained about 23.1% of inequality followed by life satisfaction (11.2) and working status (9.8%) for major depression among older adults. CONCLUSIONS Findings revealed large socioeconomic and health-related inequalities in depression in older adults which were especially pronounced by poor household economy, widowhood, poor SRH, ADL and IADL difficulty, and psychological distress. In designing prevention programmes, detection and management of older adults with depression should be a high priority, especially for those who are more vulnerable.
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Affiliation(s)
- T Muhammad
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | | | - Manish Kumar
- Department of Survey Research & Data Analytics, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Shobhit Srivastava
- Department of Survey Research & Data Analytics, International Institute for Population Sciences, Mumbai, Maharashtra, India
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Muhammad T, Maurya P. Social support moderates the association of functional difficulty with major depression among community-dwelling older adults: evidence from LASI, 2017-18. BMC Psychiatry 2022; 22:317. [PMID: 35509005 PMCID: PMC9066756 DOI: 10.1186/s12888-022-03959-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 04/22/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND This study aimed to examine the potential independent association of functional disability with major depression and moderating effects of social support variables including marital status, living arrangement and social participation in such associations. METHODS Data for the study were drawn from the Longitudinal Ageing Study in India (LASI) wave 1 that was collected during 2017-18 including a sample of 31,464 individuals aged 60 years and above. Descriptive statistics and results from bivariate analysis have been reported. Further, moderated multivariable logistic regression models were used to fulfil the study objective. Major depressive disorder was assessed using the scale of the Short Form Composite International Diagnostic Interview (CIDI-SF). RESULTS It was found that 8.67% of older participants were depressed in this study. Older adults who had difficulty in basic activities of daily living (BADL) (15.34%), difficulty in instrumental activities of daily living (IADL) (12.06%), unmarried (10.13%), separate living (9.67%) and socially inactive (10.09) were having higher prevalence of major depression compared to their respective counterparts. The adjusted model-1 revealed that older adults who had difficulty in BADL and IADL were 2.53 times [AOR: 2.53, CI: 2.17-2.95] and 2.27 times [AOR: 2.27, CI: 1.97-2.64] more likely to have major depression than those with no difficulty in BADL and IADL respectively. Further, interaction analyses found that currently unmarried status, separate living and being socially inactive have moderation effects in the observed associations and exacerbate the likelihood of major depression among older adults who are functionally impaired. CONCLUSIONS The findings highlight the importance of integrating social participation in the daily life of older adults and developing initiatives that promote a healthy surrounding such as social connectedness, co-residential living and special care for those who are physically disabled to protect against late-life depression.
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Affiliation(s)
- T. Muhammad
- Department of Family and Generations, International Institute for Population Sciences, Deonar, Mumbai, Maharashtra India 400088
| | - Priya Maurya
- Department of Population and Development, International Institute for Population Sciences, Mumbai, Maharashtra India 400088
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The Relationship between Living Arrangements and Sleep Quality in Older Adults: Gender Differences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073893. [PMID: 35409576 PMCID: PMC8997604 DOI: 10.3390/ijerph19073893] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 02/04/2023]
Abstract
(1) Background: This study examined the effects of living arrangements on the quality of sleep among older adults and analyzed related gender differences; (2) Methods: A total of 4756 older adults in Seoul were included. After adjusting for socio-demographic factors, older adults living alone showed a poorer sleep quality compared with those living with others; (3) Results: When we analyzed the effects of living arrangements on sleep quality by gender, there was no difference in the risk of poor sleep quality between male older adults living alone and those living with others (OR = 1.089, 95% CI = 0.729–1.628), whereas the risk of poor sleep quality was higher for female older adults living alone than those living with others (OR = 1.359, 95% CI = 1.088–1.696); (4) Conclusions: In this study, we have confirmed that older women living alone had poor sleep quality compared to older men. Hence, gender-based approaches will be helpful when providing social support resources to older adults living alone.
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McLaren S. The Relationship Between Living Alone and Depressive Symptoms Among Older Gay Men: The Moderating Role of Age. JOURNAL OF HOMOSEXUALITY 2022; 69:120-131. [PMID: 32880528 DOI: 10.1080/00918369.2020.1813511] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Living alone is a risk factor for depressive symptoms among older gay men. It is likely this relationship strengthens as gay men age, due to social isolation and fewer family supports. This study investigated whether the relationship between living alone and depressive symptoms was moderated by age among older gay men. A community sample of 270 Australian gay men aged 60 to 91 years (M = 68.81, SD = 8.69) completed the Center for Epidemiologic Studies-Depression Scale. Results supported the moderation model. The Johnson-Neyman analysis indicated that living alone was associated with depressive symptoms among gay men aged older than 66.28 years. Results imply that gay men older aged in their mid-sixties and older who live alone are at increased risk of depressive symptoms, and are a group of men that need targeted interventions to reduce depressive symptoms.
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Affiliation(s)
- Suzanne McLaren
- School of Psychology, Charles Sturt University, Bathurst, Australia
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Muhammad T, Sulaiman MK, Srivastava S. Migration of adult male children and associated depression among community-dwelling older parents: A cross-sectional gender analysis from Longitudinal Ageing Study in India, 2017-2018. Int J Geriatr Psychiatry 2022; 37. [PMID: 35015321 DOI: 10.1002/gps.5675] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 12/21/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVES This study empirically examines the association of migration of an adult male child (ren) on the mental health of the older parents left behind. It also examines the interaction effects of sex of older parents and male child migration on major depression to explore whether there is a gender differential in the possible association. METHODS The data for this study were obtained from the first wave of the Longitudinal Ageing Study in India (LASI, 2017-2018). The total sample size for the present study was 27,248 older adults aged 60 years and above (male-12,624; female-14,624). Descriptive statistics along with cross-tabulation were presented. Proportion test was used to evaluate the significance level of differences in depression by sex. Additionally, binary logistic regression analysis was used to find out the associations. Major depression with symptoms of dysphoria, was calculated using the Short-Form Composite International Diagnostic Interview (CIDI-SF). RESULTS About 10.5% and 9.0% of older males and females had migrant sons. It was found that there was significant gender differential in depression in older age (male: 7.5% and female: 9.7%; p < 0.001). It was further found that the prevalence of depression was found among older men (9.3% vs. 7.3%) and women (12.5% vs. 9.4%) with migrant son. Older adults with migrant son had 26% significantly higher likelihood to be depressed in reference to older adults with non-migrant son (AOR: 1.26; CI: 1.02-1.56). Further, older women with a migrant son had 76% significantly higher likelihood to be depressed in reference to older men with migrant son (AOR: 1.76; CI: 1.32-2.39). CONCLUSIONS This study invites policymakers' attention towards migration of adult children and its potential effects on mental health of left-behind older parents in community-settings and in women in particular. Policies should focus on spreading awareness to migrant children of older adults on maintaining frequent contacts and visits to their ageing parents.
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Affiliation(s)
- Thalil Muhammad
- Department of Family and Generations, International Institute for Population Sciences, Mumbai, India
| | - Madathil K Sulaiman
- Department of Family and Generations, International Institute for Population Sciences, Mumbai, India
| | - Shobhit Srivastava
- Department of Family and Generations, International Institute for Population Sciences, Mumbai, India
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12
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Pei Z, Hu F, Qin W, Zhao Y, Zhang X, Cong X, Liu C, Xu L. The relationship between living arrangements and depression among older adults in Shandong, China: The mediating role of social support. Front Psychiatry 2022; 13:896938. [PMID: 36451767 PMCID: PMC9701745 DOI: 10.3389/fpsyt.2022.896938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 10/25/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Living arrangements and social support have an impact on depression among older adults. However, the underlying mechanism between those variables remains unknown. This study aims to investigate the mediating role of social support in the relationship between living arrangements and depression among older adults. MATERIALS AND METHODS Multi-stage stratified sampling method was used to select 3,859 older adults from Taian City, Shandong Province, China, for cross-sectional investigation. Living arrangements were measured by a question. Social support and depression were measured using the Multidimensional Scale of Perceived Social Support and Patient Health Questionnaire-9. Multiple linear regression models were used to assess the relationship between living arrangements and depression and the possible influence of social support on the relationship between living arrangements and depression. RESULTS Statistics showed that 15.08% of older adults lived alone. After controlling for covariates, living arrangements (ß = 0.45, t = 2.87, P < 0.01) and social support (ß =-0.08, t =-16.93, P < 0.001) were significantly associated with depression. The linear regression model showed that social support mediated the relationship between living arrangements and depression, and the mediating effect accounted for 18.20% of the total effect. CONCLUSION This study revealed that living arrangements played an essential role in indirectly predicting depression in older adults through social support. This provided evidence for how to reduce depression in older adults.
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Affiliation(s)
- Zhongfei Pei
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,National Health Commission Key Laboratory of Health Economics and Policy Research, Cheeloo College of Medicine, Shandong University, Jinan, China.,Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, China
| | - Fangfang Hu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,National Health Commission Key Laboratory of Health Economics and Policy Research, Cheeloo College of Medicine, Shandong University, Jinan, China.,Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, China
| | - Wenzhe Qin
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,National Health Commission Key Laboratory of Health Economics and Policy Research, Cheeloo College of Medicine, Shandong University, Jinan, China.,Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, China
| | - Yan Zhao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,National Health Commission Key Laboratory of Health Economics and Policy Research, Cheeloo College of Medicine, Shandong University, Jinan, China.,Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, China
| | - Xiaohong Zhang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,National Health Commission Key Laboratory of Health Economics and Policy Research, Cheeloo College of Medicine, Shandong University, Jinan, China.,Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, China
| | - Xinxia Cong
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,National Health Commission Key Laboratory of Health Economics and Policy Research, Cheeloo College of Medicine, Shandong University, Jinan, China.,Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, China
| | - Chuanli Liu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,National Health Commission Key Laboratory of Health Economics and Policy Research, Cheeloo College of Medicine, Shandong University, Jinan, China.,Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, China
| | - Lingzhong Xu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,National Health Commission Key Laboratory of Health Economics and Policy Research, Cheeloo College of Medicine, Shandong University, Jinan, China.,Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, China
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Lee C, Yi JS. Socioeconomic Classes among Oldest-Old Women in South Korea: A Latent Class Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413183. [PMID: 34948797 PMCID: PMC8701893 DOI: 10.3390/ijerph182413183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 12/11/2021] [Accepted: 12/13/2021] [Indexed: 11/26/2022]
Abstract
Oldest-old women are known to live at the intersection of multiple socioeconomic disadvantages in South Korean society. This study classified oldest-old Korean women into several socioeconomically homogeneous classes based on various socioeconomic status (SES) risks and compared health characteristics among the identified classes. This cross-sectional study utilized the 2019 Korean Community Health Survey, including data from 11,053 women (≥80 years). Latent class analysis determined the number of underlying socioeconomic classes based on nine selected SES variables. Four distinct socioeconomic classes were identified: “Urban, living alone, recipient of NBLSS, moderate education, leisure activity” (Class 1), “Rural, traditional house, living with others, not financially deprived, low education, employed” (Class 2), “Urban, living with family, financially affluent, not employed, no barriers to healthcare” (Class 3), “Rural, traditional house, living alone, financially deprived, uneducated, employed, barriers to healthcare” (Class 4). Depressive symptoms, subjective stress, and the prevalence of sleep disorder and diabetes were higher in Class 1 compared to other classes. Health-related quality of life, perceived health, and self-rated oral health were the poorest in Class 4. Class 3 reported the best health status. Understanding the intersecting SES risk factors in this group can aid in developing targeted interventions.
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Affiliation(s)
- Chiyoung Lee
- School of Nursing & Health Studies, University of Washington Bothell, Bothell, WA 98011, USA;
| | - Jee-Seon Yi
- Institute of Health Sciences, College of Nursing, Gyeongsang National University, Jinju 52727, Korea
- Correspondence: ; Tel.: 82-55-772-8252
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Kim C, Chang EJ, Kim CY. Regional Differences in the Effects of Social Relations on Depression Among Korean Elderly and the Moderating Effect of Living Alone. J Prev Med Public Health 2021; 54:441-450. [PMID: 34875827 PMCID: PMC8655370 DOI: 10.3961/jpmph.21.337] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 10/08/2021] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES Socioeconomic disadvantages interact with numerous factors which affect geriatric mental health. One of the main factors is the social relations of the elderly. The elderly have different experiences and meanings in their social lives depending on their socio-cultural environment. In this study, we compared the effects of social relations on depression among the elderly according to their living arrangement (living alone or living with others) and residential area. METHODS We defined social relations as "meetings with neighbors" (MN). We then analyzed the impact of MN on depression using data from the Korean Longitudinal Study of Aging Panel with the generalized estimating equation model. We also examined the moderating effect of living alone and performed subgroup analysis by dividing the sample according to which area they lived in. RESULTS MN was associated with a reduced risk of depressive symptoms among elderlies. The size of the effect was larger in rural areas than in large cities. However, elderly those who lived alone in rural areas had a smaller protective impact of MN on depression, comparing to those who lived with others. The moderating effect of living alone was significant only in rural areas. CONCLUSIONS The social relations among elderlies had a positive effect on their mental health: The more frequent MN were held, the less risk of depressive symptoms occurred. However, the effect may vary depending on their living arrangement and environment. Thus, policies or programs targeting to enhance geriatric mental health should consider different socio-cultural backgrounds among elderlies.
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Affiliation(s)
- Chanki Kim
- Department of Preventive Medicine, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Eun Jee Chang
- Department of Preventive Medicine, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Chang-yup Kim
- Department of Preventive Medicine, Graduate School of Public Health, Seoul National University, Seoul, Korea
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Development of an Anomaly Alert System Triggered by Unusual Behaviors at Home. SENSORS 2021; 21:s21165454. [PMID: 34450896 PMCID: PMC8400924 DOI: 10.3390/s21165454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/23/2021] [Accepted: 08/11/2021] [Indexed: 12/26/2022]
Abstract
In many countries, the number of elderly people has grown due to the increase in the life expectancy of the population, many of whom currently live alone and are prone to having accidents that they cannot report, especially if they are immobilized. For this reason, we have developed a non-intrusive IoT device, which, through multiple integrated sensors, collects information on habitual user behavior patterns and uses it to generate unusual behavior rules. These rules are used by our SecurHome system to send alert messages to the dependent person’s family members or caregivers if their behavior changes abruptly over the course of their daily life. This document describes in detail the design and development of the SecurHome system.
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Ansari S, Muhammad T, Dhar M. How Does Multi-Morbidity Relate to Feeling of Loneliness among Older Adults? Evidence from a Population-Based Survey in India. JOURNAL OF POPULATION AGEING 2021. [DOI: 10.1007/s12062-021-09343-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Muhammad T, Srivastava S, Sekher TV. Association of self-perceived income status with psychological distress and subjective well-being: a cross-sectional study among older adults in India. BMC Psychol 2021; 9:82. [PMID: 34006311 PMCID: PMC8130272 DOI: 10.1186/s40359-021-00588-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 05/10/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND As the older population aged 65 and over worldwide, is estimated to increase from 9% in 2019 to 16% in 2050, rapid aging will transform the aspects such as economic security, employment status, and family structure. The effects of lower levels of perceived income and poor socioeconomic status on the mental health of older adults appear to be large and enduring. Therefore, the present study contributes to the literature on understanding the association of socioeconomic conditions and self-perceived income status in particular, with self-assessed mental health outcomes (psychological distress and subjective well-being) among older adults in India. METHODS Data for the present study was derived from the Building Knowledge Base on Population Ageing (BKPAI) in India. Bivariate and binary logistic regression analyses were conducted to understand the relationship between socioeconomic status and outcome variables. RESULTS About 43% of older adults had no income whereas 7% had income but perceived as not sufficient to fulfil their basic needs. Nearly, 9% of older adults were retired from regular employment. Almost 70% older adults had received no pension and nearly 18% of older adults had no asset ownership. It is revealed that older adults with income that is partially sufficient to fulfil their basic needs were 2.23 times [OR: 2.23, CI: 1.75-2.84] and 1.96 times [OR: 1.96, CI: 1.55-2.47] significantly more likely to suffer from psychological distress and low subjective well-being than those who had income which was sufficient to fulfil their basic needs. CONCLUSIONS By focusing on four target areas such as the income support, education, family oriented initiatives and local or regional policies, the current framework for assessing the mental health among older adults in India can be modified. A move towards a guaranteed pension for eligible older individuals by which they do not have to remain as a financial burden on their children, may reduce their self-perceived economic distress and result in higher levels of wellbeing in older ages. Also, strategies to address socioeconomic disadvantages and gender differentials related to mental health status among older population are urgently needed.
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Affiliation(s)
- T. Muhammad
- Department of Population Policies and Programs, International Institute for Population Sciences, Mumbai, Maharashtra India 400088
| | - Shobhit Srivastava
- Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Mumbai, Maharashtra India 400088
| | - T. V. Sekher
- Department of Population Policies and Programs, International Institute for Population Sciences, Mumbai, Maharashtra India 400088
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Chen Y, Cui PY, Pan YY, Li YX, Waili N, Li Y. Association between housing environment and depressive symptoms among older people: a multidimensional assessment. BMC Geriatr 2021; 21:259. [PMID: 33865321 PMCID: PMC8052816 DOI: 10.1186/s12877-021-02207-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 04/08/2021] [Indexed: 12/02/2022] Open
Abstract
Background Depression is a common mental disorder among older people. This study aimed to assess the association between housing environment factors and depressive symptoms among older people using a multidimensional assessment method. Methods The study uses a population-based cross-sectional design. A total of 950 participants aged ≥ 60 years were selected using a complex multistage sampling design from 22 locations in China. All data were collected using questionnaires by face-to-face interviews. A total of 938 participants were included in the analysis, and 17.1% of males and 23.1% of females were identified as having depressive symptoms. The depressive symptoms were assessed using the 15-item Geriatric Depression Scale. The housing environment was assessed on the basis of four dimensions: physical, social, psychological, and cognition and physical function. Cumulative logistic regression analysis was used to evaluate the association between housing environment and depressive symptoms. Results The Cochran–Armitage trend test showed that the depressive symptom scores were linearly negatively associated with self-assessed housing environment, living arrangement, life satisfaction, and other physical environment factors and linearly positively associated with cognitive and physical function scores. The results of cumulative logistic regression analysis showed that the housing environment was significantly associated with depressive symptoms. The participants’ self-assessed housing environment was strongly associated with the levels of depressive symptom scores, and the odds ratio was 3.47 (95% CI, 1.14–10.82, P = 0.003). Conclusion The housing environment was significantly associated with depressive symptoms. Our results suggest that multi-dimensional assessment in the housing environment may be an effective way to develop intervention strategies of depressive symptoms among older people.
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Affiliation(s)
- Yuan Chen
- Department of Social Medicine, School of Public Health, Zhejiang University, 866 Yu-hang-tang Road, Zhejiang, 310058, Hangzhou, China
| | - Ping Yu Cui
- Department of Social Medicine, School of Public Health, Zhejiang University, 866 Yu-hang-tang Road, Zhejiang, 310058, Hangzhou, China
| | - Yi Yang Pan
- Department of Social Medicine, School of Public Health, Zhejiang University, 866 Yu-hang-tang Road, Zhejiang, 310058, Hangzhou, China
| | - Ya Xing Li
- Department of Social Medicine, School of Public Health, Zhejiang University, 866 Yu-hang-tang Road, Zhejiang, 310058, Hangzhou, China
| | - Nuremaguli Waili
- Department of Social Medicine, School of Public Health, Zhejiang University, 866 Yu-hang-tang Road, Zhejiang, 310058, Hangzhou, China
| | - Ying Li
- Department of Social Medicine, School of Public Health, Zhejiang University, 866 Yu-hang-tang Road, Zhejiang, 310058, Hangzhou, China.
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Park NS, Jang Y, Chiriboga DA, Chung S. The Relations of Social Network Types With Mental Distress Among Older Korean Americans: The Interactive Role of Living Arrangement. Res Aging 2021; 44:111-122. [PMID: 33678067 DOI: 10.1177/0164027521999780] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this study is to identify social network types in older Korean Americans and to examine their direct associations, as well as interactions with living arrangement, on mental distress. Drawn from the Study of Older Korean Americans (SOKA), participants were aged 60 or over and lived in five states. Analyses included 2,140 cases surveyed during 2017-2018. To identify social network types, latent profile analyses were conducted using 10 network-related criterion variables. A model with five social network types was identified as best fit. The groups were labeled as diverse, moderately diverse, family deficit, friend deficit, and restricted. As hypothesized, greater mental distress was associated with belonging to more deprived networks such as family deficit and restricted groups. Interaction effects also suggest that members of the restricted group were more distressed when they lived alone than when they lived with others. Implications based on the results are discussed.
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Affiliation(s)
- Nan Sook Park
- School of Social Work, University of South Florida, Tampa, FL, USA
| | - Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - David A Chiriboga
- Department of Child and Family Studies, University of South Florida, Tampa, FL, USA
| | - Soondool Chung
- Department of Social Welfare, Ewha Womans University, Seoul, South Korea
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Widhowati SS, Chen CM, Chang LH, Lee CK, Fetzer S. Living alone, loneliness, and depressive symptoms among Indonesian older women. Health Care Women Int 2020; 41:984-996. [PMID: 33079645 DOI: 10.1080/07399332.2020.1797039] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In this study, the researchers aimed to investigate the factors associated with loneliness and depressive symptoms among Indonesian older women. A secondary data analysis of the Indonesian Family Life Survey-5 was conducted. Data from 1233 women aged 60 years or above were analyzed using logistic regression. Results indicated fewer than one in five older women lived alone, half reported loneliness, and 16% reported depressive symptoms. Living alone was significantly associated with loneliness and depressive symptoms. Different factors were associated with loneliness and depressive symptoms. Loneliness and depression were found to be independent constructs of older women living alone in Indonesia.
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Affiliation(s)
- Siwi Sri Widhowati
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ching-Min Chen
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ling-Hui Chang
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chia-Kuei Lee
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Susan Fetzer
- Department of Nursing, University of New Hampshire, Durham, New Hampshire, USA
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Kim O, Yeom EY, Jeon HO. Relationships between depression, family function, physical symptoms, and illness uncertainty in female patients with chronic kidney disease. Nurs Health Sci 2020; 22:548-556. [PMID: 32150660 DOI: 10.1111/nhs.12691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 01/02/2020] [Accepted: 02/06/2020] [Indexed: 12/11/2022]
Abstract
This study investigated the relationship between depression, family function, physical symptoms, and illness uncertainty in women with chronic kidney disease. Data were collected through structured questionnaire that was completed by 120 women undergoing hemodialysis. Assessment instruments consisted of the Family Adaptability, Partnership, Growth, Affection, Resolve Scale, Symptom Experience Scale, Mishel's Uncertainty in Illness Scale for Adults, and the Center for Epidemiological Studies-Depression Scale. The higher the uncertainty about illness and physical symptoms, the higher is the level of depression, and the better the family function, the lower is the level of depression. Greater uncertainty was associated with poorer family function and worsening physical symptoms. A regression model explained 41% of the variance in depression. Significant predictors of depression were physical symptoms, living alone, illness uncertainty, and "poor" subjective health status. To improve depression of women with chronic kidney disease, nurses need to reduce physical symptoms and illness uncertainty in these patients and improve their subjective health status. In addition, the establishment of a therapeutic support system considering living arrangement will help to reduce depression in women with chronic kidney disease.
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Affiliation(s)
- Oksoo Kim
- College of Nursing, Ewha Womans University, Seoul, Republic of Korea
| | - Eun Yi Yeom
- Department of Nursing, Chungwoon University, Chungwoon, Republic of Korea
| | - Hae Ok Jeon
- Department of Nursing, Cheongju University, Cheongju, Republic of Korea
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Kim N, Kim H, Kwon S. Factors associated with different numbers of health behaviors by living arrangements. BMC Public Health 2020; 20:1141. [PMID: 32689961 PMCID: PMC7372790 DOI: 10.1186/s12889-020-09242-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 07/12/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND As the number of individuals living alone increases, it becomes clear that health disparities vary according to a person's living arrangement. However, very few studies have investigated the characteristics of individuals who improve or maintain multiple healthy behaviors based on their living arrangements. This study aimed to explore the differing individual characteristics and multiple health behaviors in Korean adults living alone compared to those living with others and to identify the factors significantly associated with these behaviors. METHODS This study utilized a secondary analysis, using 2013-2015 Korea National Health and Nutrition Examination Survey data, with a cross-sectional and descriptive correlational design (N = 15,934). Multiple health behaviors, based on the comparison of past and present behaviors, included smoking, alcohol consumption, and weight control. The total number of health behaviors was calculated as the sum of each single health behavior. The different numbers of health behaviors were categorized into four levels: from 0, none of the three health behaviors to 3, all three health behaviors. Descriptive statistics and generalized ordinal logistic regression analysis were used. RESULTS People living alone engaged in fewer healthy behaviors (p < 0.05) and reported lower rates of maintenance of abstinence from smoking and weight control compared to those living with others, but they maintained a status of abstaining from alcohol consumption more than those living with others (p ≤ 0.001). In particular, higher self-rated health statuses (Adjusted Odds Ratio [aOR] = 2.03, 95% Confidence Interval [CI] = 1.04-3.97), being overweight (aOR = 1.46, 95% CI = 1.11-1.92), and having shorter sleep durations per day (aOR = 0.74, 95% CI = 0.55-0.99) were significantly associated with 0, 1 versus 2, 3 levels of healthy behaviors in those living alone. CONCLUSIONS Korean adults who lived alone had different factors associated with different combinations of multiple healthy behaviors compared to those living with others. Therefore, we need to manage healthy behaviors by considering associated factors for those living alone. Specifically, clinicians should consider the vulnerability of health behaviors in people living alone and provide customized approaches and multidimensional interventions based on their living arrangements.
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Affiliation(s)
- Namhee Kim
- College of Nursing, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea 03722
| | - Heejung Kim
- College of Nursing, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea 03722
- Mo-Im Kim Nursing Research Institute, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea 03722
| | - Sooyoung Kwon
- College of Nursing, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea 03722
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Choi YR, Park HR, Song KH, Lee Y, Lim YS. Disparities in dietary quantity and quality between the two different types of Korean family of older adults living with spouses and living alone: using data from the 6th Korea National Health and Nutrition Examination Survey. Nutr Res Pract 2020; 14:242-251. [PMID: 32528631 PMCID: PMC7263895 DOI: 10.4162/nrp.2020.14.3.242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 12/20/2019] [Accepted: 12/26/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/OBJECTIVES This study was conducted to examine disparities in food and nutrient intakes based on family types identified among 1,856 participants who were the Korean elderly people in the 6th Korea National Health and Nutrition Examination Survey (KNHNES) excluding those who were currently practicing the diet therapy. SUBJECTS/METHODS We separated the subjects into two groups: living alone (LA, n = 638) and living with a spouse (LS, n = 1,218). We also examined the disparities of dietary quantity and quality of those two groups using complex sampling design general linear regression analyses (CS GLM). RESULTS In the LA group, there was a higher percentage of females and average age in LA group was higher than the participants in the LS group. Household income and education level were significantly lower in LA compared to those of LS. The frequencies of skipping meals were higher in LA. LA's food and nutrient intakes showed lower consumption of vegetables, fruits, seaweeds, and of most nutrients. Even after adjusting for the confounding factors, the consumption of vegetables, seaweeds, carbohydrates, potassium, riboflavin, and vitamin C showed lower in LA than LS. Moreover, LA's nutrient intake ratios compared to the KDRIs were lower which turned out to be similar to their nutrient intakes. CONCLUSIONS These results show that dietary behavior and food intake of the elderly are associated with family types. Frequently skipping meals and less dietary variety are more common with elderly persons who were living alone. Therefore, it is necessary to integrate the supplementary food programs and nutrition education programs for the elderly living alone.
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Affiliation(s)
- Yu Rim Choi
- Department of Food and Nutrition, Myongji University, Yongin 17058, Korea
| | - Hae Ryun Park
- Department of Food and Nutrition, Myongji University, Yongin 17058, Korea
| | - Kyung Hee Song
- Department of Food and Nutrition, Myongji University, Yongin 17058, Korea
| | - Youngmi Lee
- Department of Food and Nutrition, Myongji University, Yongin 17058, Korea
| | - Young Suk Lim
- Department of Food and Nutrition, Myongji University, Yongin 17058, Korea
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Shang Q. Social support, rural/urban residence, and depressive symptoms among Chinese adults. JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 48:849-861. [PMID: 31816099 DOI: 10.1002/jcop.22302] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 10/30/2019] [Accepted: 11/28/2019] [Indexed: 06/10/2023]
Abstract
This study aims to examine the extent to which people are socially integrated and the association between social support and depressive symptoms among Chinese adults, with regard to the moderating effect of the rural or urban residence. The author used data from the China health and longitudinal study (CHARLS), a nationally representative longitudinal survey of the population of adults aged over 45 in China. A total of 16,372 participants were included in this study, and the mean age of the sample was 59.7. Three variables were used to measure participants' social support: family size, proximity of support, and social involvement. The Chinese version of 10-item center for epidemiologic studies depression scale was used as a measurement tool for depressive symptoms. The findings demonstrate that small family size, living with a spouse, frequency of contact with children, and a number of social activities have significant effects on depressive symptoms. For all aspects of social support, the influence on depressive symptoms is not significantly different between urban and rural areas. Family support, especially the support of a spouse is crucial to prevent depression. This study also identifies the vital effect of social activity and encourages the government to improve public services, especially in rural areas.
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Affiliation(s)
- Qiaoqiong Shang
- School of Sociology and Population Studies, Renmin University of China, Beijing, China
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25
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McLaren S. The Relationship between living alone, sense of belonging, and depressive symptoms among older men: the moderating role of sexual orientation. Aging Ment Health 2020; 24:103-109. [PMID: 30588832 DOI: 10.1080/13607863.2018.1531373] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: Living alone is a risk factor for depressive symptoms among older men, and is likely to occur due to belongingness needs being unmet. It is proposed the living alone-sense of belonging and living alone-depressive symptoms relations are stronger for gay men than heterosexual men, due to different family circumstances. This research tested a moderated mediation model, specifically whether the relationship between living alone and depressive symptoms is mediated by sense of belonging, and whether the living alone-sense of belonging and living alone-depressive symptoms relationships are moderated by sexual orientation.Method: A community sample of 169 Australian gay men aged 65 to 93 years and 187 Australian heterosexual men aged 65 to 94 years completed the Psychological subscale of the Sense of Belonging Instrument and the Center for Epidemiologic Studies Depression Scale.Results: Results supported the simple mediation model, with living alone being associated directly and indirectly with depressive symptoms via sense of belonging. The conditional indirect effect of living alone on depressive symptoms via sense of belonging was not significant, and therefore the moderated mediation model was not supported.Conclusion: Results imply that older men who live alone are at increased risk of depressive symptoms directly and indirectly via lower levels of sense of belonging.
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Affiliation(s)
- Suzanne McLaren
- School of Health and Life Sciences, Federation University Australia, Australia
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Chang M. Cross-cultural comparative study of psychological distress between older Korean immigrants in the United States and older Koreans in South Korea. Aging Ment Health 2019; 23:1234-1245. [PMID: 30482041 DOI: 10.1080/13607863.2018.1484887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: This study aims to answer questions about the similarities and differences in the prevalence and distribution of psychological distress across these populations. Methods: Survey data from older Koreans between the ages 60 and 79 from the two countries (n = 480) was analyzed descriptively and in hierarchical multiple regressions. The stress coping framework was used as a conceptual model Results: This study found significantly different prevalence of psychological distress in both countries. About 13% of older Korean immigrants(US) experienced 'severe' psychological distress versus 21% of their counterparts ( Korea). Health status and overall financial status were significantly associated with the experience of psychological distress in both countries, while income was not significantly associated with psychological distress. Hierarchical multiple regression revealed significant associations between family relationships and help-seeking behavior among older Korean immigrants in the United States while there were significant associations between social support, social networks and psychological distress among older Koreans in South Korea. Conclusion: This is the first time that a comparative study has been used to understand psychological distress among older Koreans in both countries. The findings build on prior research on social support and social networks as stress coping buffers, adding a much-needed understanding of how stressors and different types of resources influence psychological distress outcomes.
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Affiliation(s)
- Miya Chang
- a Center for Multicultural Studies , Daegu Catholic University , Gyeohgsan-si , Republic of Korea
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27
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Zhang Y, Liu Z, Zhang L, Zhu P, Wang X, Huang Y. Association of living arrangements with depressive symptoms among older adults in China: a cross-sectional study. BMC Public Health 2019; 19:1017. [PMID: 31357982 PMCID: PMC6664592 DOI: 10.1186/s12889-019-7350-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 07/22/2019] [Indexed: 02/04/2023] Open
Abstract
Background Depression is regarded as a major public health concern in our society. While living arrangements as a structural factor of social support may contribute to older adults’ depression. Our study aims to investigate the association between living arrangements and depressive symptoms among older adults in the whole China, and to explore whether such influences differ by genders. Methods Data were obtained from the 2015 China Health and Retirement Longitudinal Study. The sample was comprised of 6001 individuals aged ≥60 years. Depressive symptoms were measured by the 10-item Short-Form Center for Epidemiological Studies Depression. Independent variables were divided into 4 groups, considering living with/without a spouse and living with/without a child. The multivariate logistic regression was used to estimate the relationship between living arrangements and depressive symptoms in four models. Results Compared with living only with a spouse, people living with a spouse and child, or living alone were more likely to have depressive symptoms (odds ratio = 1.23 95% CI 1.06–1.42 and 1.40 95% CI 1.03–1.92, respectively). Women were more associated with depressive symptoms (odds ratio = 2.13), but there were no significant associations between living arrangements and depressive symptoms among women. Men living with a spouse and a child had stronger positively depressive symptoms (odds ratio = 1.37). Conclusions Older adults living alone, or living with both a child and spouse were more likely to have depressive symptoms. It is important to provide more social services for those older adult, particularly for men living with a spouse and child. Electronic supplementary material The online version of this article (10.1186/s12889-019-7350-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yong Zhang
- Department of Health Policy & Management, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou, Guangdong, 510080, People's Republic of China
| | - Zifeng Liu
- Department of Pathology, the 3rd Affiliated Hospital, Sun Yat University, 600 Tianhe Road, Guangzhou, Guangdong, China
| | - Lingling Zhang
- Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts, Boston, MA, USA
| | - Paiyi Zhu
- Department of Health Policy & Management, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou, Guangdong, 510080, People's Republic of China
| | - Xin Wang
- Department of Health Policy & Management, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou, Guangdong, 510080, People's Republic of China.,Health Development Research Center, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou, Guangdong, China
| | - Yixiang Huang
- Department of Health Policy & Management, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou, Guangdong, 510080, People's Republic of China. .,Health Development Research Center, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou, Guangdong, China.
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Jacob L, Haro JM, Koyanagi A. Relationship between living alone and common mental disorders in the 1993, 2000 and 2007 National Psychiatric Morbidity Surveys. PLoS One 2019; 14:e0215182. [PMID: 31042720 PMCID: PMC6493731 DOI: 10.1371/journal.pone.0215182] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Accepted: 03/27/2019] [Indexed: 12/27/2022] Open
Abstract
Given the high prevalence of common mental disorders (CMDs) and individuals living alone in the United Kingdom, the goal of this study using English nationally representative data was to examine the association between living alone and CMDs, and to identify potential mediating factors of this association. The data were drawn from the 1993, 2000 and 2007 National Psychiatric Morbidity Surveys. CMDs were assessed using the Clinical Interview Schedule-Revised (CIS-R), a questionnaire focusing on past week neurotic symptoms. The presence of CMDs was defined as a CIS-R total score of 12 and above. Multivariable logistic regression and mediation analyses were conducted to analyze the association between living alone and CMDs, and to identify mediators in this association. The prevalence of CMDs was higher in individuals living alone than in those not living alone in all survey years. Multivariable analysis showed a positive association between living alone and CMDs in all survey years (1993: odds ratio [OR] = 1.69; 2000: OR = 1.63; and 2007: OR = 1.88). Overall, loneliness explained 84% of the living alone-CMD association. Living alone was positively associated with CMDs. Interventions addressing loneliness among individuals living alone may be particularly important for the mental wellbeing of this vulnerable population.
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Affiliation(s)
- Louis Jacob
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
- * E-mail:
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
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Kim W, Chun SY, Lee JE, Lee TH, Park EC. Factors Related to the Institutionalization of Older Aged Individuals Using Home- and Community-Based Care Services: Data From the South Korea Long-Term Care Insurance Program, 2008-2013. J Aging Soc Policy 2019; 31:321-337. [PMID: 30895918 DOI: 10.1080/08959420.2019.1589890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
South Korea introduced a public long-term care insurance (LTCI) program in response to its rapidly aging population. This study analyzed the association between living arrangement and caregiver type with institutionalization in LTCI grade 1 (very severe limitations), 2 (severe limitations), and 3 (moderate limitations) beneficiaries using data from the LTCI cohort, 2008 to 2013. The dependent variable was alteration status from home to institutional care within 1 year of receiving home service. Independent variables were living arrangement and primary caregiver type. The analysis was conducted using the generalized estimating equation model. Higher likelihoods of institutionalization were found in individuals living with a non-family member compared to individuals living with their spouses. Individuals without a caregiver or with a paid caregiver were also more likely to experience institutionalization than individuals with a spouse primary caregiver. Our findings underscore the importance of monitoring identified vulnerable groups of individuals to attain LTCI sustainability and enhance elderly quality of life.
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Affiliation(s)
- Woorim Kim
- a Department of Public Health, Graduate School , Yonsei University , Seoul , Republic of Korea
| | - Sung Youn Chun
- a Department of Public Health, Graduate School , Yonsei University , Seoul , Republic of Korea
| | - Joo Eun Lee
- a Department of Public Health, Graduate School , Yonsei University , Seoul , Republic of Korea
| | - Tae-Hoon Lee
- b HIRA Research Institute , Health Insurance Review and Assessment Service , Gangwon-do , Republic of Korea
| | - Eun-Cheol Park
- c Department of Preventive Medicine & Institute of Health Services Research , Yonsei University College of Medicine , Seoul , Republic of Korea
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30
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Yang J, Park EC, Lee SA, Lee JE, Choi DW, Chae W, Jang SI. The Association between Social Contacts and Depressive Symptoms among Elderly Koreans. Psychiatry Investig 2018; 15:861-868. [PMID: 30184614 PMCID: PMC6166029 DOI: 10.30773/pi.2018.06.28.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 06/28/2018] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE South Korea has an increasing aging population; thus, the management of depressive symptoms in elderly individuals is important. In this population, fewer social contacts might be a risk factor for depressive symptoms. We examined associations between the frequency of social contacts and depressive symptoms among elderly Koreans and factors associated with these symptoms. METHODS Data from 62,845 individuals over 65 years of age enrolled in the 2015 Community Health Survey were used in this study. Logistic regression was performed to test the association between depressive symptoms and social contacts. RESULTS Individuals who had contact with neighbors less than once a week were more likely to experience depressive symptoms [odds ratio (OR): 1.22, 95% confidence interval (CI): 1.10-1.35] compared to those who had contact more than once a week. Individuals who had frequent contact with neighbors and friends, neighbors and relatives, or all three groups were significantly less likely to experience depressive symptoms. CONCLUSION The frequency of social contact with neighbors was the most powerful factor associated with elderly adults' depressive symptoms among other social relationships. Additional senior welfare centers may facilitate the ability of elderly individuals in meeting neighbors, thereby reducing the risk of depressive symptoms.
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Affiliation(s)
- Jieun Yang
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea.,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sang Ah Lee
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Joo Eun Lee
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Dong-Woo Choi
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Wonjeong Chae
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Sung-In Jang
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea.,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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Kim H, Kwon S, Hong S, Lee S. Health behaviors influencing depressive symptoms in older Koreans living alone: secondary data analysis of the 2014 Korean longitudinal study of aging. BMC Geriatr 2018; 18:186. [PMID: 30126354 PMCID: PMC6102924 DOI: 10.1186/s12877-018-0882-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 08/15/2018] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Geriatric depression is a societal problem, specifically in those living alone in Korea. This study aims are to investigate (1) how sociodemographic factors, health status, and health behaviors are differently associated with depressive symptoms in older Koreans living alone compared to those living with others and (2) how living arrangements attenuated or strengthened the associations between four types of health behaviors and depressive symptoms. METHODS This secondary data analysis was conducted using data from the 2014 Korean Longitudinal Study of Aging. A structured survey assessing sociodemographic factors, health status, and health behaviors was conducted with people aged 65 or older who lived alone (n = 1359) and living with others (n = 2864). A multiple linear regression with interaction terms was conducted between mean-centered health behaviors and the status of living alone. All statistical analyses were performed using SPSS Statistics 23.0, and the two-tailed level of significance was set at 0.05. RESULTS Those living alone reported higher levels of depressive symptoms than those living with others (Mdiff = 2.129, SE = 0.005, p < 0.001). The variance of depressive symptoms explained by 13 variables was 18.1% for those living alone compared to 23.7% for those living with others. Compared to health behaviors, sociodemographic factors and health status more explained depressive symptoms, specifically with psychiatric disorders, pain, and impaired functionality as risk factors. Smoking, alcohol abstinence, physical inactivity, and social inactivity were associated with more depressive symptoms. Living arrangements moderated the association between depressive symptoms and each health behavior, except for physical inactivity (all p values < 0.001). CONCLUSIONS Older Koreans living alone were exposed to different risk factors for depressive symptoms compared to those living with others. Non-modifiable sociodemographic and health status factors were highly associated with depressive symptoms relative to health behaviors; thus, it is important to conduct early assessment and classification of vulnerable subgroups regarding geriatric depression. Specific assessment instruments should be prepared in practice according to living arrangements among older Koreans. Targeted interventions are essential to addressing living arrangements and modifying health behaviors to reduce smoking, alcohol consumption, and social inactivity, specifically in those living alone.
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Affiliation(s)
- Heejung Kim
- College of Nursing, Yonsei University, Seoul, South Korea
- Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
| | - Sooyoung Kwon
- College of Nursing, Yonsei University, Seoul, South Korea
| | - Soyun Hong
- College of Nursing, Yonsei University, Seoul, South Korea
| | - Sangeun Lee
- College of Nursing, Yonsei University, Seoul, South Korea
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32
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Park NS, Jang Y, Lee BS, Chiriboga DA, Chang S, Kim SY. Associations of a social network typology with physical and mental health risks among older adults in South Korea. Aging Ment Health 2018; 22:631-638. [PMID: 28290722 DOI: 10.1080/13607863.2017.1286456] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The objectives of this study were to (1) develop an empirical typology of social networks in older Koreans; and (2) examine its effect on physical and mental health. METHOD A sample of 6900 community-dwelling older adults in South Korea was drawn from the 2014 Korean National Elderly Survey. Latent profile analysis (LPA) was conducted to derive social network types using eight common social network characteristics (marital status, living arrangement, the number and frequency of contact with close family/relatives, the number and frequency of contact with close friends, frequency of participation in social activities, and frequency of having visitors at home). The identified typologies were then regressed on self-rated health and depressive symptoms to explore the health risks posed by the group membership. RESULTS The LPA identified a model with five types of social network as being most optimal (BIC = 153,848.34, entropy = .90). The groups were named diverse/family (enriched networks with more engagement with family), diverse/friend (enriched networks with more engagement with friends), friend-focused (high engagement with friends), distant (structurally disengaged), and restricted (structurally engaged but disengaged in family/friends networks). A series of regression analyses showed that membership in the restricted type was associated with more health and mental health risks than all types of social networks except the distant type. CONCLUSION Findings demonstrate the importance of family and friends as a source of social network and call attention to not only structural but also non-structural aspects of social isolation. Findings and implications are discussed in cultural contexts.
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Affiliation(s)
- N S Park
- a School of Social Work, University of South Florida , Tampa , FL , USA
| | - Y Jang
- b School of Social Work, The University of Texas at Austin , Austin , TX , USA
| | - B S Lee
- c Department of Mental Health Law and Policy , University of South Florida , Tampa , FL , USA
| | - D A Chiriboga
- d Department of Child and Family Studies , University of South Florida , Tampa , FL , USA
| | - S Chang
- e Department of Social Welfare , Kyungsung University , Busan , South Korea
| | - S Y Kim
- e Department of Social Welfare , Kyungsung University , Busan , South Korea
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Zhang CJP, Barnett A, Sit CHP, Lai PC, Johnston JM, Lee RSY, Cerin E. Cross-sectional associations of objectively assessed neighbourhood attributes with depressive symptoms in older adults of an ultra-dense urban environment: the Hong Kong ALECS study. BMJ Open 2018; 8:e020480. [PMID: 29581207 PMCID: PMC5875633 DOI: 10.1136/bmjopen-2017-020480] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES This study aimed to examine the associations between objectively assessed neighbourhood environmental attributes and depressive symptoms in Hong Kong Chinese older adults and the moderating effects of neighbourhood environmental attributes on the associations between living arrangements and depressive symptoms. DESIGN Cross-sectional observational study. SETTING Hong Kong. PARTICIPANTS 909 Hong Kong Chinese community dwellers aged 65+ years residing in preselected areas stratified by walkability and socioeconomic status. EXPOSURE AND OUTCOME MEASURES Attributes of participants' neighbourhood environment were objectively assessed using geographic information systems and environmental audits. Depressive symptoms were measured using the Geriatric Depression Scale. RESULTS Overall, pedestrian infrastructure (OR=1.025; P=0.008), connectivity (OR=1.039; P=0.002) and prevalence of public transport stops (OR=1.056; P=0.012) were positively associated with the odds of reporting depressive symptoms. Older adults living alone were at higher risk of reporting any depressive symptoms than those living with others (OR=1.497; P=0.039). This association was moderated by neighbourhood crowdedness, perceptible pollution, access to destinations and presence of people. Residing in neighbourhoods with lower levels of these attributes was associated with increased deleterious effects of living alone. Living in neighbourhoods with lower public transport density also increased the deleterious effects of living alone on the number of depressive symptoms. Those living alone and residing in neighbourhoods with higher levels of connectivity tended to report more depressive symptoms than their counterparts. CONCLUSIONS The level of access to destinations and social networks across Hong Kong may be sufficiently high to reduce the risk of depressive symptoms in older adults. Yet, exposure to extreme levels of public transport density and associated traffic volumes may increase the risk of depressive symptoms. The provision of good access to a variety of destinations, public transport and public open spaces for socialising in the neighbourhood may help reduce the risk of depressive symptoms in older adults who live alone.
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Affiliation(s)
- Casper J P Zhang
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Anthony Barnett
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Cindy H P Sit
- Department of Sports Science and Physical Education, Faculty of Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Poh-chin Lai
- Department of Geography, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, China
| | - Janice M Johnston
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Ruby S Y Lee
- Elderly Health Service, Department of Health, The Government of Hong Kong Special Administration Region, Hong Kong, China
| | - Ester Cerin
- School of Public Health, The University of Hong Kong, Hong Kong, China
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
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34
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Honjo K, Tani Y, Saito M, Sasaki Y, Kondo K, Kawachi I, Kondo N. Living Alone or With Others and Depressive Symptoms, and Effect Modification by Residential Social Cohesion Among Older Adults in Japan: The JAGES Longitudinal Study. J Epidemiol 2018; 28:315-322. [PMID: 29398683 PMCID: PMC6004365 DOI: 10.2188/jea.je20170065] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background There is little longitudinal evidence on the impact of specific living arrangements (ie, who individuals live with) on mental health among older adults, and no studies have examined the modifying effect of residential social cohesion level on this association. We aimed to examine the association between living arrangements and depressive symptoms and whether this association varies with residential neighborhood social cohesion level among 19,656 men and 22,513 women aged 65 years and older in Japan. Methods We analyzed the association between baseline living arrangements in 2010 and depressive symptoms in 2013. We calculated gender-specific odds ratios (ORs) of living arrangements for depressive symptoms using a logistic regression and conducted subgroup analyses by neighborhood social cohesion level. Results Among men (but not women), living alone (OR 1.43; 95% confidence intervals [CI], 1.18–1.73) and living with spouse and parent (OR 1.47, 95% CI, 1.09–1.98) were associated with increased odds of depressive symptoms compared with living with a spouse only. Living with spouse and child was a risk for men in the young age group but a protective factor for women. We also identified that the negative impact of living arrangements on depressive symptoms was attenuated in neighborhoods with higher levels of social cohesion. Conclusions Living arrangements are associated with risk of depressive symptoms among men and women; these associations differ by gender and neighborhood social cohesion level. Our results suggest the need to pay more attention to whether individuals live alone, as well as who individuals live with, to prevent depressive symptoms among older adults.
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Affiliation(s)
- Kaori Honjo
- Osaka Medical College, Faculty of Medicine.,Osaka University, Graduate School of Medicine, Department of Public Health
| | - Yukako Tani
- Department of Global Health Promotion, Tokyo Medical and Dental University.,Research Fellow of Japan Society for the Promotion of Science
| | | | - Yuri Sasaki
- Chiba University, Center for Preventive Medical Sciences
| | - Katsunori Kondo
- Chiba University, Center for Preventive Medical Sciences.,Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology
| | - Ichiro Kawachi
- Harvard School of Public Health, Department of Social and Behavioral Sciences
| | - Naoki Kondo
- The University of Tokyo, School of Public Health
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35
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Girgus JS, Yang K, Ferri CV. The Gender Difference in Depression: Are Elderly Women at Greater Risk for Depression Than Elderly Men? Geriatrics (Basel) 2017; 2:geriatrics2040035. [PMID: 31011045 PMCID: PMC6371140 DOI: 10.3390/geriatrics2040035] [Citation(s) in RCA: 129] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 10/31/2017] [Accepted: 11/02/2017] [Indexed: 12/20/2022] Open
Abstract
Numerous epidemiological reports have found that adolescent, young adult, and middle-aged adult girls and women are more likely to be diagnosed with unipolar depression and report greater symptoms of depression when compared to boys and men of similar ages. What is less well-known is whether this gender difference persists into late life. This literature review examines whether the well-known gender difference in unipolar depression continues into old age, and, if it does, whether the variables that are known to contribute to the gender difference in unipolar depression from adolescence through adulthood continue to contribute to the gender difference in the elderly, and/or whether there are new variables that arise in old age and contribute to the gender difference in the elderly. In this review of 85 empirical studies from every continent except for Antarctica, we find substantial support for the gender difference in depression in individuals who are 60 and older. More research is necessary to determine which factors are the strongest predictors of the gender difference in depression in late life, and particularly whether the factors that seem to be responsible for the gender difference in depression in earlier life stages continue to predict the gender difference in the elderly, and/or whether new factors come into play in late life. Longitudinal research, meta-analyses, and model-based investigations of predictors of the gender difference in depression are needed to provide insights into how and why the gender difference in depression persists in older age.
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Affiliation(s)
- Joan S Girgus
- Department of Psychology, Princeton University, Princeton, NJ 08540, USA.
| | - Kaite Yang
- School of Social and Behavioral Sciences, Stockton University, 101 Vera King Farris Drive, Galloway, NJ 08205, USA.
| | - Christine V Ferri
- School of Social and Behavioral Sciences, Stockton University, 101 Vera King Farris Drive, Galloway, NJ 08205, USA.
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Seo J, Choi B, Kim S, Lee H, Oh D. The relationship between multiple chronic diseases and depressive symptoms among middle-aged and elderly populations: results of a 2009 korean community health survey of 156,747 participants. BMC Public Health 2017; 17:844. [PMID: 29070021 PMCID: PMC5657127 DOI: 10.1186/s12889-017-4798-2] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 09/22/2017] [Indexed: 12/30/2022] Open
Abstract
Background The purpose of this study was to investigate the relationship between multiple chronic diseases and depressive symptoms in middle-aged and elderly populations. Methods This study was performed using the 2009 Korean Community Health Survey, which targeted adults over the age of 40 (N = 156,747 participants, 88,749 aged 40–59 years and 67,998 aged ≥60 years). The Korean version of the Center for Epidemiologic Studies Depression Scale (CES-D-K) was used as the measurement tool for depressive symptoms (CES-D-K score over 16). Multiple chronic diseases were defined as the concurrent presence of two or more chronic diseases. Results The prevalence and risk ratios (RRs) of experiencing depressive symptoms increased in the presence of multiple chronic diseases and with the number of comorbidities. The RRs of experiencing depressive symptoms according to the presence of multiple chronic diseases were higher in the middle-aged population (adjusted RR, 1.939, 95% confidence limits (CL), 1.82-2.06) than in the elderly population (adjusted RR, 1.620, 95% CL, 1.55-1.69). In particular, middle-aged women who suffer from 4 or more chronic diseases have the highest RR (adjusted RR, 4.985, 95% CL, 4.13-6.03) for depressive symptoms. Conclusions Multiple chronic diseases are closely associated with depressive symptoms in middle-aged and elderly populations. Given the mutual relationship between multiple chronic diseases and depressive symptoms, attention to and the assessment of depressive symptoms are needed in people with multiple chronic diseases. Electronic supplementary material The online version of this article (10.1186/s12889-017-4798-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- JooYeon Seo
- Institute for Health and Society, College of Medicine, Hanyang University, 222 Wangsimni-ro, Sungdong-Gu, Seoul, 04763, South Korea.,Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, South Korea
| | - BoYoul Choi
- Institute for Health and Society, College of Medicine, Hanyang University, 222 Wangsimni-ro, Sungdong-Gu, Seoul, 04763, South Korea.,Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, South Korea
| | - Shinah Kim
- Center for Farmers' Safety & Health, Dankook University Hospital, Cheonan, South Korea
| | - HyeYoung Lee
- Institute for Health and Society, College of Medicine, Hanyang University, 222 Wangsimni-ro, Sungdong-Gu, Seoul, 04763, South Korea.,Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, South Korea
| | - DongHoon Oh
- Institute for Health and Society, College of Medicine, Hanyang University, 222 Wangsimni-ro, Sungdong-Gu, Seoul, 04763, South Korea. .,Seulha Mental Health Clinic, Jeju, South Korea.
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37
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Park NS, Jang Y, Lee BS, Chiriboga DA. The relation between living alone and depressive symptoms in older Korean Americans: do feelings of loneliness mediate? Aging Ment Health 2017; 21:304-312. [PMID: 26465083 DOI: 10.1080/13607863.2015.1099035] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES As the opposite end of the continuum from social integration, social isolation may put individuals at a greater risk of poor mental health. Conceptualizing living alone as an objective and structural indicator of social isolation and loneliness as subjective perceptions of social isolation, the present study hypothesized that the relation between living alone and depressive symptoms would be mediated by the feelings of loneliness. Using older Korean Americans as the target population, the mediation model was examined in consideration of the contextual factors such as demographics (age, gender, education, perceived income, and length of stay in the USA), health (chronic conditions and functional disability), and general social integration (size of social network and community social cohesion). METHOD Date were drawn from surveys with 209 older Korean Americans in Central Texas (Mage = 69.6, SD = 7.5). Multivariate regression models of depressive symptoms were entered in the following order: (1) demographics, (2) health, (3) living alone, (4) social network/community social cohesion, and (5) loneliness. The mediation effect of loneliness in the relationship between living alone and depressive symptoms was separately examined using the bootstrapping method. RESULTS Loneliness was found to mediate the relation between living alone and depressive symptoms (indirect effect = 1.03, 95% CI = .05-2.08). CONCLUSION The results suggest that subjective perceptions of loneliness may explain the mechanism through which objective social isolation presents risks for depressive symptoms in older Korean Americans.
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Affiliation(s)
- Nan Sook Park
- a School of Social Work , University of South Florida , Tampa , FL , USA
| | - Yuri Jang
- b School of Social Work , University of Texas at Austin , Austin , TX , USA
| | - Beom S Lee
- c Department of Mental Health Law and Policy , University of South Florida , Tampa , FL , USA
| | - David A Chiriboga
- d Department of Child and Family Studies , University of South Florida , Tampa , FL , USA
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The relationship between living alone and depressive symptoms among older gay men: the moderating role of sense of belonging with gay friends. Int Psychogeriatr 2016; 28:1895-1901. [PMID: 27503166 DOI: 10.1017/s1041610216001241] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Living alone is a risk factor for depressive symptoms among older adults, although it is unclear if it is a risk factor for older gay men. A sense of belonging to the gay community is protective and might compensate for living alone. This research investigated whether a sense of belonging with gay friends weakened the relationship between living alone and depressive symptoms among older gay men. METHODS A community sample of 160 Australian gay men aged 65-92 years completed the Center for Epidemiologic Studies Depression Scale and two visual analogue scales assessing a sense of belonging with gay friends. RESULTS Results supported the moderation model, with increasing levels of belonging with gay friends weakening the relationship between living alone and depressive symptoms. CONCLUSION Results imply that enhancing a sense of belonging with gay friends among older gay men who live alone is likely to be a protective factor in relation to depressive symptoms.
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39
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Lee S, Hong GRS. Predictors of Depression Among Community-Dwelling Older Women Living Alone in Korea. Arch Psychiatr Nurs 2016; 30:513-20. [PMID: 27654230 DOI: 10.1016/j.apnu.2016.05.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 05/09/2016] [Accepted: 05/10/2016] [Indexed: 01/01/2023]
Abstract
This study examined the prevalence and predicting factors of depression among community-dwelling older women living alone in Korea. Of the 2054 older women living alone in this study, 42.9% (881) were experiencing depression. Factors associated with a higher prevalence of depression were overall difficulty with living alone, taking more than six medications, limitations of instrumental activities of daily living, limitations of muscle strength, limitations of exercise performance in upper extremities, trouble with hearing, and perceptions of poor health status. These results provide a basis for designing preventive interventional programs to decrease depression among older women living alone in Korea.
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Affiliation(s)
- SiEun Lee
- College of Nursing, Hanyang University, Seoul, South Korea.
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Wang X, Shen W, Wang C, Zhang X, Xiao Y, He F, Zhai Y, Li F, Shang X, Lin J. Association between eating alone and depressive symptom in elders: a cross-sectional study. BMC Geriatr 2016; 16:19. [PMID: 26774626 PMCID: PMC4715343 DOI: 10.1186/s12877-016-0197-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 01/12/2016] [Indexed: 12/20/2022] Open
Abstract
Background Depression is one of the main health concerns in elders which could lead to many negative outcomes. Eating alone is an emerging issue in elders in China and would become more serious along with the fast course of industrialization and urbanization, as well as population aging. However, their relationship was seldom researched. Methods Using a two-stage cluster sampling strategy, an investigation was conducted in 2014 among 9,361 permanent residents aged 60 years and above in Zhejiang Province, China. Totally, 7,968 cognitively normal elders were included in our analysis. Multilevel logistic regression was used to explore the association between eating arrangement (number of companions in mealtime) and depressive symptom as well as the association between eating alone and depressive symptom in relation to living alone. Results In our sample, 17.1 % of the elders ate alone and 8.7 % had depressive symptom. We observed a distinct inverse association between eating arrangement (number of companions in mealtime) and geriatric depressive symptom (female: OR = 1.12, P = 0.027; aged 60–74 years: OR = 1.16, P = 0.002), after adjustment for demography, socioeconomic status, social relation, health behaviors, underlying conditions and living alone. We then introduced a combined variable of eating alone and living alone and examined its relationship with depressive symptom. We found that compared with elders who ate and lived with others, those who ate alone but lived with others had a significant increased odds of depressive symptom (female: OR = 1.62, P = 0.027; aged 60–74 years: OR = 1.59, P = 0.025). Conclusions Our results suggested that a lack of companionship in mealtime might be independently associated with geriatric depressive symptom for females and those aged 60–74 years. What’s more, eating alone might be a stronger factor associated with depressive symptom than living alone. We recommend interventions to be performed in encouraging elders especially females and those aged 60–74 years to eat with others. Longitudinal studies in different populations which focus on this topic are required to better understand this issue.
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Affiliation(s)
- Xinyi Wang
- Zhejiang Provincial Centre for Disease Control and Prevention, 3399 Binsheng Road, Binjiang District, Hangzhou, Zhejiang Province, China.
| | - Wei Shen
- Zhejiang Provincial Centre for Disease Control and Prevention, 3399 Binsheng Road, Binjiang District, Hangzhou, Zhejiang Province, China.
| | - Chunmei Wang
- Tongxiang Centre for Disease Control and Prevention, 64 East Maodun Road, Wutong Subdistrict, Tongxiang, Zhejiang Province, China.
| | - Xiaoyi Zhang
- Tongxiang Centre for Disease Control and Prevention, 64 East Maodun Road, Wutong Subdistrict, Tongxiang, Zhejiang Province, China.
| | - Yuanyuan Xiao
- School of Public Health, Kunming Medical University, 1168 Yuhua Road, Chenggong District, Kunming, Yunnan, China.
| | - Fan He
- Zhejiang Provincial Centre for Disease Control and Prevention, 3399 Binsheng Road, Binjiang District, Hangzhou, Zhejiang Province, China.
| | - Yujia Zhai
- Zhejiang Provincial Centre for Disease Control and Prevention, 3399 Binsheng Road, Binjiang District, Hangzhou, Zhejiang Province, China.
| | - Fudong Li
- Zhejiang Provincial Centre for Disease Control and Prevention, 3399 Binsheng Road, Binjiang District, Hangzhou, Zhejiang Province, China.
| | - Xiaopeng Shang
- Zhejiang Provincial Centre for Disease Control and Prevention, 3399 Binsheng Road, Binjiang District, Hangzhou, Zhejiang Province, China.
| | - Junfen Lin
- Zhejiang Provincial Centre for Disease Control and Prevention, 3399 Binsheng Road, Binjiang District, Hangzhou, Zhejiang Province, China.
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