Introduction: Aging in Asia--perennial concerns on support and caring for the old

The burden of mental disorders in Asian countries, 1990-2019: an analysis for the global burden of disease study 2019

Mental disorders are the leading contributors to the globally nonfatal burden of disease. This study was aimed to estimate the burden of mental disorders in Asian countries. Based on GBD 2019, the prevalence and disability-adjusted life of years (DALYs) rates with 95% uncertainty intervals (UI) were estimated in Asian countries. Predictions for the future burden of 8 selected countries, ranks of the burden of mental disorders and correlations with Sociodemographic Index (SDI) were also estimated. During the past 3 decades, while the number of DALYs of mental disorders increased from 43.9 million (95% UI: 32.5-57.2) to 69.0 million (95% UI: 51.0-89.7), the age-standardized rates of DALYs of mental disorders remained largely consistent from 1452.2 (95% UI: 1080.16-1888.53) per 100,000 population in 1990 to 1434.82 (95% UI: 1065.02-1867.27) per 100,000 population in 2019, ranked as the eighth most significant disease burden in Asia in 2019. Depressive disorders (37.2%) were the leading contributors to the age-standardized DALY rates of mental disorders in Asia, followed by anxiety disorders (21.5%). The age-standardized DALY rates in females were higher than their male counterparts, both peaked at 30-34 years. The age-standardized DALY rates were predicted to remain stable, with the number of DALYs presented an upward trend in the future. There was no significant correlation between the burden of mental disorders and SDI. All mental disorders ranked higher in 2019, compared in 1990. To reduce this burden, urgent measures for prevention, treatment, and rehabilitation for mental disorders need to be taken by Asian governments.

Exploring Coping and Religiosity in an Indian Ashram for Older Adults

BACKGROUND AND OBJECTIVES

With the aging of Indians and the cultural context of family care, faith-based ashrams are a possible middle way for older adult care for strained families. Religiosity is multidimensional, but it is unclear how its different dimensions relate to coping. This exploratory study investigates the profile of residents living in a faith-based ashram of Haridwar, a pilgrimage town in Northern India. Additionally, it examines religiosity and coping in this population, and the correlates of positive coping response (PCR).

METHODOLOGY

Preliminary field survey helped zero in on a single consenting ashram. We included 95 older adult participants (≥ 60 years) residing for more than six months. Relevant dimensions were captured with a survey interview form to record sociodemographics, BriefCOPE, and Duke University Religion Index. The sample was representative of the institutionalized older-adult population considering the overlap of sociodemographics (age, gender, and marital status). We conducted linear regression to examine possible predictors of PCR.

RESULTS

Most older adults were Hindus, higher educated, married, and lived with their spouses. The participants were highly religious. Coping through religion was most common, followed by active coping. On linear regression, a significant model emerged [F (13, 63) = 3.411, p < .001), where age, education, and organizational religious activity were significant predictors of PCR. However, other sociodemographic (sex, marital status, economics, family contact) and dimensions of religiosity (non-organizational religious activity and intrinsic religiosity) variables failed to predict PCR.

CONCLUSION

Lesser age, higher education, and involvement in the public practice of religiosity are essential contributors to PCR in older adults. How different aspects of religiosity influence coping and lend meaning to dealing with stress, needs further exploration.

The global burden of thyroid cancer in high-income Asia-Pacific: a systematic analysis of the Global Burden of Disease study

BACKGROUND

Thyroid cancer has become increasingly prevalent and threatens human health. Few studies have explored the incidence of thyroid cancer in Asia and its relationship with social-progress factors.

METHODS

We analyzed Global Burden of Disease (GBD) Study 2019 data specific to thyroid cancer. Incidence, prevalence, mortality, and disability-adjusted life year (DALY) rates were used to evaluate the burden of thyroid cancer.

RESULTS

The age-standardized incidence, prevalence, and DALY rates per 100,000 population were 1.34% (95% UI, 2.44-3.07), 2.79% (95% UI, 18.82-23.77) and 16.49% (95% UI, 14.6-18), respectively, for all of Asia in 2019. In 2019, the DALY rate of thyroid cancer in the High-income Asia-Pacific region was the highest and mortality due to thyroid cancer in the High-income Asia-Pacific region was also the highest. The growth trend of DALYs in the High-income Asia-Pacific region was much steeper than those in other Asian regions. In all Asian regions and in the High-income Asia-Pacific region, the incidence, prevalence, mortality and DALY rates of thyroid cancer in female patients were drastically higher than those in male patients. Among Asian patients with thyroid cancer, the DALY rate was higher in men aged 80-89 years than in women. The DALY rate gradually increased with age. In the High-income Asia-Pacific region, the mortality rate of patients with thyroid cancer decreased with age. The prevalence was highest in those aged 40-79 years.

CONCLUSION

The disease burden of thyroid cancer in the High-income Asia-Pacific region was significantly higher than those in other regions, which may be due to overdiagnosis. The increasing incidence of thyroid cancer seems to indicate that thyroid cancer is still a public health problem in Asia. Therefore, some health policy adjustments will be meaningful.

Aging in community and local NGOs: Empowering marginalized older women in South Korea

This article is based on an embedded case study of selected older people's self-help groups in urban South Korea, which aim to assist community-dwelling older adults, particularly poor and marginalized women, to age in their community and remain active and contributing members. The study highlights the importance of the role and capacity of nongovernmental organizations (NGOs) as partner organizations. Implications are important for other aging societies, particularly in Asia, where older women have been often confined by patriarchal oppression.

Caregiving expectations and challenges among elders and their adult children in Southern Sri Lanka

The elderly population in Sri Lanka is growing rapidly. Elders are traditionally cared for in the homes of their adult children, but the shifting socio-economic environment in Sri Lanka challenges this arrangement. This paper describes the dynamics of elder-caregiver relationships in Southern Sri Lanka. Data included 4 focus group discussions and 5 in-depth interviews with elderly, and 10 in-depth interviews with adult children of the elderly. Discussion guide topics included caregiving arrangements, and roles/responsibilities of elders and caregivers. Using a grounded theory approach, a comprehensive analytic memo was developed and discussed to explore emerging themes on the caregiver dynamic. Both elders and caregivers felt that elders should be taken care of in the home by their children. They pointed to a sense of duty and role modeling of parental caregiving that is passed down through generations. Even as elders desired support from their children, they feared losing their independence, and saw financial autonomy as important for maintaining relationship balance. Caregiving challenges included: households where both the adult child and his/her spouse worked outside the home; households where elders had a disproportionate amount of household work; economically stressed households; and lack of direct communication between elders and caregivers regarding conflicts. Results point to strong values around caring for elderly in the home, but identify challenges to this arrangement in the future.

Care-givers’ perspectives of occupational engagement of persons with dementia

Meaningful engagement in activity is associated with the maintenance of health and wellbeing, but reduced activity participation is common among persons with dementia. Family care-givers play an important role in engaging their relatives with dementia in activities but little is known about their perception of occupational engagement. This study aimed to examine care-givers’ perception of occupational performance of their relatives from three aspects: person, occupation and environment. Adopting a qualitative methodology, semi-structured and in-depth interviews were conducted with 14 family care-givers. Care-givers were also asked to document the activity patterns of their relative, using the Activity Card Sort Hong Kong version (ACS-HK). The ACS-HK findings suggested that high-demand leisure activities were mostly retained (61%) while instrumental activities of daily living were the least retained (37%). Qualitative analysis revealed that care-givers’ perception of activity participation was intertwined with their motives and behaviours to get their relatives engaged in activities. Care-givers acknowledged occupational engagement as a means of maintaining wellness and used various strategies to encourage their relative's activity participation. Apathy and passivity, however, are difficult to deal with. Also, activity decisions appear to depend on the availability of support resources and a balance between safety concern and risk-taking. Clinical practitioners could assist care-givers by suggesting activity strategies and providing support resources for continued engagement of their relative in activities.

Leisure and religious activity participation and mental health: gender analysis of older adults in Nepal

Background

Involvement in activities has been found to be beneficial for improving quality of life and successful aging for older adults. Little is known, however, about the involvement in activities and depression of older adults in Asian developing countries. This study explores whether participation in leisure social and religious activities are related to depression and satisfaction with life in older adults of Nepal. Gender differences are also explored.

Methods

The study sample was derived from a survey which aimed to determine the intergenerational relationships between older adults and their married sons. A cross-sectional quantitative study of older adults sixty years and over in Nepal was conducted with face-to-face interviews using structured instruments. A convenience sample of 489 community dwelling older adults, 247 men and 242 women, were included in the study. The dependent variables, depression and satisfaction with life, were measured by the Geriatric Depression Scale (GDS) and Satisfaction With Life Scale (SWLS) respectively. Age, gender, marital status, education, perceived health, financial satisfaction, social support received and provided by older adults, and social activity were independent variables in the study.

Results

Saying prayers (B = -2.75; p < 0.005), watching television and listening to the radio (B = -1.88; p < 0.05), and participating in physical activity (B = -1.05; p < 0.05) correlated to lower depression for older men, but only watching television and listening to the radio (B = -2.68; p < 0.005) related to lower rates of depression for women. Socializing with others (B = 1.22; p < 0.05) was related to higher satisfaction with life for men, but for women visiting friends (B = 1.29; p < 0.05), socializing with others (B = 1.45; p < 0.005), and watching television and listening to the radio (B = 0.92; p < 0.05) related to improved satisfaction with life. Activity engagement significantly improved mental health in older adults.

Conclusion

Specific activity participation was a significant correlate of lower levels of depression and higher levels of satisfaction with life among older adults in Nepal. The findings explore the need for further research on activity participation in developing countries so that it can be useful for health care practioners and those involved with the activities of aged populations in developing countries.