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Jin Z, Liu X, Guo H, Chen S, Zhu X, Pan S, Wu Y. Sex-specific modulating role of social support in the associations between oxidative stress, inflammation, and telomere length in older adults. J Behav Med 2024:10.1007/s10865-024-00515-0. [PMID: 39179728 DOI: 10.1007/s10865-024-00515-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 08/08/2024] [Indexed: 08/26/2024]
Abstract
Telomere length, a biomarker of human aging, is related to adverse health outcomes. Growing evidence indicates that oxidative stress and inflammation contributes to telomere shortening, whereas social support may protect from telomere shortening. Despite sex differences in telomere length and social support, little is known about whether there are sex differences in the relationship between oxidative stress/inflammation and telomere length, and sex-specific moderating roles of social support in older adults. Using data from the National Health and Nutrition Examination Survey (NHANES) 1999-2002, this study assessed whether the associations between oxidative stress/inflammation and telomere length vary with sex and explored social support as a moderator in these associations among 2289 older adults. Oxidative stress was measured based on serum Gamma-glutamyl transferase (GGT), and inflammation was measured based on C-reactive protein (CRP). After adjusting for the covariates, GGT was significantly associated with telomere length in females only (β = - 0.037, 95% CI = - 0.070, - 0.005), while CRP was associated with telomere length in males only (β = - 0.019, 95% CI = - 0.035, - 0.002). Moreover, high social support mitigated the negative association between GGT and telomere length, which was more evident in females. Furthermore, social support moderated the association between CRP and telomere length in males aged 70 and above. Our findings indicated that biological mechanisms related to telomere length may vary with sex, while social support plays a sex-specific moderating role.
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Affiliation(s)
- Zhou Jin
- Zhejiang Provincial Clinical Research Center for Mental Disorders, Wenzhou Key Laboratory of Basic and Translational Research for Mental Disorders, School of Mental Health and The Affiliated Wenzhou Kangning Hospital, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Institute of Aging, Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China
| | - Xuejian Liu
- Zhejiang Provincial Clinical Research Center for Mental Disorders, Wenzhou Key Laboratory of Basic and Translational Research for Mental Disorders, School of Mental Health and The Affiliated Wenzhou Kangning Hospital, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Institute of Aging, Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China
| | - Haonan Guo
- Department of Sociology, Faculty of Social Science, University of Macau, Avenida da Universidade, Taipa, Macau, China
| | - Sixuan Chen
- Zhejiang Provincial Clinical Research Center for Mental Disorders, Wenzhou Key Laboratory of Basic and Translational Research for Mental Disorders, School of Mental Health and The Affiliated Wenzhou Kangning Hospital, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Institute of Aging, Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China
| | - Xianghe Zhu
- Zhejiang Provincial Clinical Research Center for Mental Disorders, Wenzhou Key Laboratory of Basic and Translational Research for Mental Disorders, School of Mental Health and The Affiliated Wenzhou Kangning Hospital, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Institute of Aging, Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China
| | - Sipei Pan
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yili Wu
- Zhejiang Provincial Clinical Research Center for Mental Disorders, Wenzhou Key Laboratory of Basic and Translational Research for Mental Disorders, School of Mental Health and The Affiliated Wenzhou Kangning Hospital, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Institute of Aging, Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China.
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Blotenberg I, Boekholt M, Michalowsky B, Platen M, Rodriguez FS, Teipel S, Hoffmann W, Thyrian JR. What influences life expectancy in people with dementia? Social support as an emerging protective factor. Age Ageing 2024; 53:afae044. [PMID: 38497234 PMCID: PMC10945357 DOI: 10.1093/ageing/afae044] [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: 10/14/2023] [Revised: 01/08/2024] [Indexed: 03/19/2024] Open
Abstract
BACKGROUND The aim of this study was to investigate the role of support from the social environment for the life expectancy in people with dementia beyond well-established individual demographic and clinical predictors over a period of up to 8 years. METHODS The analyses are based on data from 500 community-dwelling individuals in Germany who tested positive for dementia and were followed up for up to 8 years. Life expectancy was examined in relation to perceived social support as well as well-established socio-demographic (age, sex) and clinical predictors (cognitive status, functional status, comorbidities), using Cox regressions. RESULTS Greater support from the social environment reduced the risk of mortality (hazard ratio [HR]: 0.78; 95% confidence interval [CI]: 0.63-0.98), with the role of emotional support being particularly important. Furthermore, higher age was associated with an increased mortality risk (HR: 1.08; 95% CI: 1.05-1.11), while female sex (HR: 0.64; 95% CI: 0.48-0.85) and higher cognitive (HR: 0.96; 95% CI: 0.93-0.98) and functional status (HR: 0.91; 95% CI: 0.86-0.97) were associated with higher life expectancy. CONCLUSION Our study provides novel evidence that less support from the social environment, especially emotional support, is a risk factor for shorter life expectancy in people with dementia-beyond known clinical factors. Not only the clinical and caregiving needs but also their psychosocial needs of individuals with dementia should be emphasised.
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Affiliation(s)
- Iris Blotenberg
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), site Greifswald, Ellernholzstraße 1-2, 17489 Greifswald, Germany
| | - Melanie Boekholt
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), site Greifswald, Ellernholzstraße 1-2, 17489 Greifswald, Germany
| | - Bernhard Michalowsky
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), site Greifswald, Ellernholzstraße 1-2, 17489 Greifswald, Germany
| | - Moritz Platen
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), site Greifswald, Ellernholzstraße 1-2, 17489 Greifswald, Germany
| | - Francisca S Rodriguez
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), site Greifswald, Ellernholzstraße 1-2, 17489 Greifswald, Germany
| | - Stefan Teipel
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), site Rostock, Gehlsheimer Str. 20, 18147 Rostock, Germany
- Department of Psychosomatic Medicine, University Hospital Rostock, Gehlsheimer Str. 20, 18147 Rostock, Germany
| | - Wolfgang Hoffmann
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), site Greifswald, Ellernholzstraße 1-2, 17489 Greifswald, Germany
- Institute for Community Medicine, University Medicine Greifswald, Ellernholzstr. 1-2, 17489 Greifswald, Germany
| | - Jochen René Thyrian
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), site Greifswald, Ellernholzstraße 1-2, 17489 Greifswald, Germany
- Institute for Community Medicine, University Medicine Greifswald, Ellernholzstr. 1-2, 17489 Greifswald, Germany
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Jiang Y, Zhou C, Zhu L, Miao W, Fang Y, Ma L, Ying Y, Fu L, Geng G, Yin Z. Cross-cultural adaptation and validation of the positive and negative social exchange scale in older adults with disabilities in China. Disabil Rehabil 2024; 46:581-590. [PMID: 36597917 DOI: 10.1080/09638288.2022.2164365] [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: 05/28/2022] [Accepted: 12/24/2022] [Indexed: 01/05/2023]
Abstract
PURPOSE This study translated the Positive and Negative Social Exchange (PANSE) scale into Chinese, examined its psychometric characteristics, and explored its feasibility for use among older adults with disabilities from China. MATERIALS AND METHODS A two-stage study procedure was employed. In the first stage, the English version of the PANSE scale was translated and cross-culturally adapted. In the second stage, the reliability and validity of the scale were assessed based on item-total correlation, internal consistency, test-retest reliability, content validity, structural validity, concurrent criterion validity, and known group validity. RESULTS A total of 357 older adults with disabilities participated in the survey. The Chinese version of the PANSE scale consisted of two parts, the Positive Social Exchange Scale and the Negative Social Exchange Scale. Exploratory factor analysis extracted six communal factors. The cumulative contribution of the two parts of the scale was 69.90% and 77.88%, respectively. The item-total correlation was 0.353 to 0.802, the internal consistency of the PANSE was 0.653 to 0.886. The PANSE demonstrated good content validity and it was correlated with the SSRS scale. CONCLUSION The Chinese version of the PANSE is a valid and reliable instrument for assessing social exchange in Chinese older adults with disabilities.Implication for rehabilitationDespite the growing number of older adults with disabilities being a concern in China, the lack of tools to measure the type of social support limits research related to the health status of these people.This study cross-culturally adapted, translated into Chinese and validated the Positive and Negative Social Exchange (PANSE) scale as the measurement tool to be used in the cultural context of China.The two subscales of PANSE were validated in the Chinese population of older adults with disabilities.The PANSE scale measures social exchange among older adults with disabilities in China, which can guide the development of interventions to address issues in the social exchange of these people.
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Affiliation(s)
- Yuqi Jiang
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Chuncong Zhou
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Lijuan Zhu
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Weiwei Miao
- Medical School, Nantong University, Nantong, China
| | - Yi Fang
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Linlin Ma
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Yisha Ying
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Liyan Fu
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Guiling Geng
- Medical School, Nantong University, Nantong, China
| | - Zhiqin Yin
- School of Nursing, Wenzhou Medical University, Wenzhou, China
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Geigl C, Loss J, Leitzmann M, Janssen C. Social factors of health-related quality of life in older adults: a multivariable analysis. Qual Life Res 2023; 32:3257-3268. [PMID: 37458960 PMCID: PMC10522508 DOI: 10.1007/s11136-023-03472-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2023] [Indexed: 09/28/2023]
Abstract
PURPOSE The objective of the analysis was to examine the relationships between sociodemographic, socioeconomic, psychosocial, and behavioural factors and both physical and mental health-related quality of life (HRQOL) in older adults. METHODS The analysis was based on recent cross-sectional data of 1687 community residents from a whole population postal survey of German adults aged 65 years and older (33% response rate, 52% female, mean age 76 years). HRQOL was assessed using the 36-Item Short Form Survey (SF-36v2). For a differentiated analysis, hierarchical multiple linear regressions were performed. RESULTS An internal health locus of control, physical activity, social support, and income were positively associated with physical HRQOL (Adj. R2 = 0.34; p < 0.001) and mental HRQOL (Adj. R2 = 0.18; p < 0.001), whereas an external health locus of control and age were negatively associated with both. Alcohol use and educational level were positively associated only with physical HRQOL, whilst female gender was negatively associated only with mental HRQOL. CONCLUSION Sociodemographic, socioeconomic, psychosocial, and behavioural factors were associated with physical and mental HRQOL. These results highlight the importance of social factors in HRQOL and provide approaches for policy and practice to develop and implement tailored health interventions for older adults. Our findings may be transferable to municipalities in metropolitan areas of high-income European countries. CLINICAL TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Christoph Geigl
- Department of Applied Social Sciences, Munich University of Applied Sciences, 81243, Munich, Germany.
- Department of Epidemiology and Preventive Medicine, University of Regensburg, 93053, Regensburg, Germany.
| | - Julika Loss
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, 13353, Berlin, Germany
| | - Michael Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, 93053, Regensburg, Germany
| | - Christian Janssen
- Department of Applied Social Sciences, Munich University of Applied Sciences, 81243, Munich, Germany
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Greenfield N, Becker J, Jariwala S, Wisnivesky J, Federman A, Feldman JM. The relationship between social support, self-efficacy, and asthma outcomes in older adults. J Asthma 2023; 60:1853-1861. [PMID: 36972524 PMCID: PMC10523994 DOI: 10.1080/02770903.2023.2196560] [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: 01/23/2023] [Revised: 03/06/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023]
Abstract
OBJECTIVE There has been a call for research examining factors that influence asthma outcomes in older adults because of the notable disparities observed in this age group. Social support and self-efficacy are resources that factor into asthma outcomes. The current study aimed to examine the relationship between these resources (independently and jointly) and asthma control and quality of life. METHODS Older adults with moderate-severe asthma were recruited from NYC. Data were obtained during in-person interviews via validated measures of social support, asthma self-efficacy, asthma control, and asthma quality of life. Linear regression evaluated self-efficacy in the relationship between social support and asthma outcomes. RESULTS In a sample of 359 older adults (M = 68.04, 47.9% Hispanic, 26.5% Black, and 25.6% other), social support had an inverse association with asthma control. As social support increased, asthma control decreased (β = 0.95, t(356) = -3.13, p = .002). Self-efficacy significantly moderated this relationship (β = 0.01, t(356) = 2.37, p = .018). For individuals with low or moderate asthma self-efficacy, more received social support was associated with worse asthma control (β = -0.33, t(356) = -4.66, p < .0001; β = -0.20, t(356) = -3.21, p = .0014, respectively). For individuals with high self-efficacy, no relationship was found between received social support and asthma control (β = -0.10, t(356)= -1.20, p =.23). For asthma quality of life, higher levels of received social support were associated with worse quality of life (β = -0.88, t(356) = -2.64, p = .009), but this association was not significantly moderated by self-efficacy (β = 0.01, t(356) = 1.90, p = .0582). CONCLUSIONS For older adults with asthma, receiving more social support is associated with worse asthma outcomes, especially for older adults with lower asthma self-efficacy.
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Affiliation(s)
- Naomi Greenfield
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY
| | - Jacqueline Becker
- Icahn School of Medicine at Mount Sinai, Division of General Internal Medicine, New York, NY
| | - Sunit Jariwala
- Albert Einstein College of Medicine/Montefiore Medical Center, Department of Medicine, Division of Allergy/Immunology, Bronx, NY
| | - Juan Wisnivesky
- Icahn School of Medicine at Mount Sinai, Division of General Internal Medicine, New York, NY
| | - Alex Federman
- Icahn School of Medicine at Mount Sinai, Division of General Internal Medicine, New York, NY
| | - Jonathan M. Feldman
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY
- Albert Einstein College of Medicine, Children’s Hospital at Montefiore, Department of Pediatrics, Division of Academic General Pediatrics, Bronx, NY
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Hajek A, Kretzler B, Walther C, Aarabi G, Zwar L, König HH. Neighbourhood cohesion, loneliness and perceived social isolation prior and during the COVID-19 pandemic. Longitudinal evidence from the German Ageing Survey. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1411-1420. [PMID: 36914882 PMCID: PMC10010637 DOI: 10.1007/s00127-023-02447-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 02/27/2023] [Indexed: 03/15/2023]
Abstract
PURPOSE To investigate the longitudinal association between neighbourhood cohesion and loneliness as well as perceived social isolation prior and during the COVID-19 pandemic (stratified by sex). METHODS Longitudinal data were taken from a nationally representative sample (German Ageing Survey) of inhabitants aged 40 years and over in Germany prior (wave 6: year 2017) and during the COVID-19 pandemic (wave 8: November 2020 until February 2021; n = 6688 observations, mean age was 67.4 years). The De Jong Gierveld tool was used to measure loneliness and the Bude and Lantermann tool was used to measure perceived social isolation. Neighbourhood cohesion was assessed based on different items. RESULTS FE regressions showed that decreases in closeness of contact with neighbours were associated with increases in loneliness and perceived social isolation levels among men, but not women. In contrast, decreases in different indicators of involvement in neighbourhood activities were associated with increases in loneliness and perceived social isolation levels among women, but not men. CONCLUSION Changes in neighbourhood factors are differently associated with loneliness and perceived social isolation among middle-aged and older women and men. Gender-specific efforts to avoid loneliness and social isolation are, therefore, needed.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Martinistr. 52, 20246, Hamburg, Germany.
| | - Benedikt Kretzler
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Martinistr. 52, 20246, Hamburg, Germany
| | - Carolin Walther
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ghazal Aarabi
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Larissa Zwar
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Martinistr. 52, 20246, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Martinistr. 52, 20246, Hamburg, Germany
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Beygi Z, Solhi M, Irandoost SF, Hoseini AF. The relationship between social support and happiness in older adults referred to health centers in Zarrin Shahr, Iran. Heliyon 2023; 9:e19529. [PMID: 37810085 PMCID: PMC10558722 DOI: 10.1016/j.heliyon.2023.e19529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 08/18/2023] [Accepted: 08/25/2023] [Indexed: 10/10/2023] Open
Abstract
BACKGROUND Creasing the older adult population has become a major public health challenge. Social support plays an important role in people's health. Social support helps improve the living conditions of the elderly and brings happiness into the lives of the elderly. This study aimed to investigate the relationship between social support and happiness status in 60-75-year-olds referred to health centers of Zarrin Shahr, Iran in 2019. METHODS In this cross-sectional study, 584 samples (female: 62.2%, men: 37.8%) participated in this study. To collect data for this study, Oxford Happiness, and Social Support questionnaires were used. The older adults of the target group were selected through simple multistage random sampling from the health centers of Zarrin Shahr. The collected data were entered into SPSS software version 22. They were described and analyzed by inferential statistics and regressions at a 95% confidence level. RESULTS Sex, marital status, and level of education influenced total social support (P < 0.05). Moreover, age, marital status, and level of education affected happiness (P < 0.05). There was a significant positive correlation between total social support and components of social support with happiness (P < 0.05). Also, the multi-stage regression test showed emotional social support and education level were highly correlated with happiness (R2 = 0.265). CONCLUSION The results highlight the need to increase social support for older adults because it can increase the level of happiness in this age group. In interventions to improve the social support and happiness of older adults, low-educated, unmarried, divorced, or deceased spouses should be prioritized.
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Affiliation(s)
- Zohreh Beygi
- Health Education and Health Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Solhi
- Health Promotion Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Fahim Irandoost
- Department of Community Medicine, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Agha Fatemeh Hoseini
- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
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Espinoza MA, Severino R, Balmaceda C, Abbott T, Cabieses B. The socioeconomic distribution of life expectancy and healthy life expectancy in Chile. Int J Equity Health 2023; 22:160. [PMID: 37608366 PMCID: PMC10463281 DOI: 10.1186/s12939-023-01972-w] [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: 05/02/2022] [Accepted: 07/21/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Life expectancy (LE) has usually been used as a metric to monitor population health. In the last few years, metrics such as Quality-Adjusted-Life-Expectancy (QALE) and Health-Adjusted-Life- Expectancy (HALE) have gained popularity in health research, given their capacity to capture health related quality of life, providing a more comprehensive approach to the health concept. We aimed to estimate the distribution of the LE, QALEs and HALEs across Socioeconomic Status in the Chilean population. METHODS Based on life tables constructed using Chiang II´s method, we estimated the LE of the population in Chile by age strata. Probabilities of dying were estimated from mortality data obtained from national registries. Then, life tables were stratified into five socioeconomic quintiles, based on age-adjusted years of education (pre-school, early years to year 1, primary level, secondary level, technical or university). Quality weights (utilities) were estimated for age strata and SES, using the National Health Survey (ENS 2017). Utilities were calculated using the EQ-5D data of the ENS 2017 and the validated value set for Chile. We applied Sullivan´s method to adjust years lived and convert them into QALEs and HALEs. RESULTS LE at birth for Chile was estimated in 80.4 years, which is consistent with demographic national data. QALE and HALE at birth were 69.8 and 62.4 respectively. Men are expected to live 6.1% less than women. However, this trend is reversed when looking at QALEs and HALEs, indicating the concentration of higher morbidity in women compared to men. The distribution of all these metrics across SES showed a clear gradient in favour of a better-off population-based on education quintiles. The absolute and relative gaps between the lowest and highest quintile were 15.24 years and 1.21 for LE; 18.57 HALYs and 1.38 for HALEs; and 21.92 QALYs and 1.41 for QALEs. More pronounced gradients and higher gaps were observed at younger age intervals. CONCLUSION The distribution of LE, QALE and HALEs in Chile shows a clear gradient favouring better-off populations that decreases over people´s lives. Differences in LE favouring women contrast with differences in HALEs and QALEs which favour men, suggesting the need of implementing gender-focused policies to address the case-mix complexity. The magnitude of inequalities is greater than in other high-income countries and can be explained by structural social inequalities and inequalities in access to healthcare.
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Affiliation(s)
- Manuel Antonio Espinoza
- Departamento de Salud Pública, Pontificia Universidad Catolica de Chile, Diagonal Paraguay 362, Piso 2, Santiago, Chile.
- Unit of Health Technology Assessment, Pontificia Universidad Catolica de Chile, Santiago, Chile.
- Centro para la Prevención y Control del Cancer, Santiago, Chile.
| | - Rodrigo Severino
- Unit of Health Technology Assessment, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Carlos Balmaceda
- Unit of Health Technology Assessment, Pontificia Universidad Catolica de Chile, Santiago, Chile
- Centro para la Prevención y Control del Cancer, Santiago, Chile
- Center for Health Economics, University of York, York, UK
| | - Tomas Abbott
- Unit of Health Technology Assessment, Pontificia Universidad Catolica de Chile, Santiago, Chile
- Centro para la Prevención y Control del Cancer, Santiago, Chile
| | - Baltica Cabieses
- Centro para la Prevención y Control del Cancer, Santiago, Chile
- Centro de Salud Global Intercultural, Instituto de Ciencias e Innovación en Medicina, Universidad del Desarrollo, Santiago, Chile
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Shabani M, Amini-Tehrani M, Sadri M, Taheri-Kharameh Z, Khaljinia Z, Poorolajal J. Family function, social support and quality of life in community-dwelling older adults: the moderating role of gender. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04297-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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10
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Charlton RA, McQuaid GA, Wallace GL. Social support and links to quality of life among middle-aged and older autistic adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:92-104. [PMID: 35362329 PMCID: PMC9806477 DOI: 10.1177/13623613221081917] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
LAY ABSTRACT Social support can take many forms, such as practical help, time spent socially with others, or the satisfaction with personal relationships. Social support is known to affect quality of life (QoL) in both non-autistic older and autistic young adults. QoL reflects how satisfied an individual is with their life either overall or in a certain area. We know little about middle-aged and older autistic adults' experiences of social support or QoL. In this study, 388 adults aged 40-83 years old, completed online questionnaires asking about background such as age and sex, depression and anxiety symptoms, QoL (physical, psychological, social, environmental, and autism-specific), and different types of social support. Even after taking into account background, depression, and anxiety, social support was important for individuals' QoL. To our knowledge this is the first paper to examine the relationship between social support and QoL in middle-aged and older autistic adults. Improving social support may have a significant impact on the QoL of older autistic adults. Future studies should examine whether age-related changes in social support (size, content, and arrangement of social networks) that are common in non-autistic aging, also occur among older autistic adults.
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Affiliation(s)
- Rebecca A Charlton
- Goldsmiths, University of London,
UK,Rebecca A Charlton, Department of
Psychology, Goldsmiths University of London, New Cross, London SE14 6NW, UK.
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Ruppel EH, Child S, Fischer CS, Botchway M. Distinct aspects of human connection associated with subjective well-being. SSM - MENTAL HEALTH 2022; 2:100143. [PMID: 36644109 PMCID: PMC9835396 DOI: 10.1016/j.ssmmh.2022.100143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Affiliation(s)
| | | | - Claude S. Fischer
- University of California, Berkeley, USA,Corresponding author. Dept. of Sociology, #MC 1980, Berkeley, CA, 94720, USA. (C.S. Fischer)
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Leach MJ, Ward B, Kippen R, Quinn B, Agius PA, Sutton K, Peterson J, Dietze PM. Level and correlates of social support in a community-based sample of Australians who primarily smoke methamphetamine. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e4950-e4960. [PMID: 35833453 PMCID: PMC10946876 DOI: 10.1111/hsc.13907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 05/06/2022] [Accepted: 07/04/2022] [Indexed: 06/15/2023]
Abstract
Little is known about the level and correlates of social support amongst people who use methamphetamine. We aimed to describe, and determine characteristics associated with, social support amongst a community-recruited cohort of Australians who primarily smoked methamphetamine. A cross-sectional study was conducted with data from the Victorian Methamphetamine Cohort Study (VMAX). Adults (aged ≥18 years) who used methamphetamine were recruited from June 2016 to March 2020 across metropolitan and non-metropolitan areas using convenience, snowball, and respondent-driven sampling. Social support was measured using the seven-item Enhancing Recovery In Coronary Heart Disease (ENRICHD) Social Support Inventory (ESSI). Characteristics independently associated with ESSI quartiles were assessed via multivariable partial proportional odds regression. Overall, 718 participants were included for complete-case analysis. Their mean (standard deviation [SD]) age was 34.7 (9.7) years and 62% were male. The mean (SD) and median (lower quartile-upper quartile) ESSI scores were 22.6 (7.6) and 24 (16-29), respectively, on a scale of 8 to 34 where higher scores denote better self-perceived social support. Characteristics independently associated with lower ESSI included past-year homelessness (adjusted odds ratio [aOR] = 0.49, 95% confidence interval [CI] = 0.36-0.66), moderate/severe depression (aOR = 0.60, 95% CI = 0.42-0.86), increasing age relative to <30 years (aOR[30-39] = 0.61, 95% CI = 0.41-0.91; aOR[≥40] = 0.56, 95% CI = 0.35-0.91) and greater than fortnightly methamphetamine use (aOR = 0.69, 95% CI = 0.52-0.91). Characteristics independently associated with higher ESSI were employment (aOR = 1.51, 95% CI = 1.06-2.14) and female gender (aOR = 1.39, 95% CI = 1.00-1.92). Social support services for people who use methamphetamine could be targeted and tailored to subgroups defined by correlates of social support, such as those who experience homelessness, depression or unemployment.
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Affiliation(s)
| | - Bernadette Ward
- School of Rural HealthMonash UniversityMelbourneAustralia
- Behaviours and Health Risks ProgramBurnet InstituteMelbourneAustralia
| | - Rebecca Kippen
- School of Rural HealthMonash UniversityMelbourneAustralia
| | - Brendan Quinn
- Behaviours and Health Risks ProgramBurnet InstituteMelbourneAustralia
- School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
- Australian Institute of Family StudiesMelbourneAustralia
| | - Paul A. Agius
- Behaviours and Health Risks ProgramBurnet InstituteMelbourneAustralia
- School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
- Melbourne School of Population and Global HealthUniversity of MelbourneMelbourneAustralia
| | - Keith Sutton
- School of Rural HealthMonash UniversityMelbourneAustralia
- Behaviours and Health Risks ProgramBurnet InstituteMelbourneAustralia
| | | | - Paul M. Dietze
- Behaviours and Health Risks ProgramBurnet InstituteMelbourneAustralia
- School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
- National Drug Research InstituteCurtin UniversityMelbourneAustralia
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13
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Freak-Poli R, Ryan J, Tran T, Owen A, McHugh Power J, Berk M, Stocks N, Gonzalez-Chica D, Lowthian JA, Fisher J, Byles J. Social isolation, social support and loneliness as independent concepts, and their relationship with health-related quality of life among older women. Aging Ment Health 2022; 26:1335-1344. [PMID: 34219569 DOI: 10.1080/13607863.2021.1940097] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Objectives: To assess whether social isolation, social support, and loneliness are independently associated with health-related quality of life (HRQoL).Method: Retrospective analysis including 10,517 women aged 70-75 years from the Australian Longitudinal Study on Women's Health (ALSWH). Social isolation, social support (Duke Social Support Index), and loneliness (single item) were investigated for their association with standardised HRQoL (physical [PCS] and mental [MCS] components of the SF-36® questionnaire). Analyses were adjusted for sociodemographic variables and number of medical conditions.Results: Only 3% reported being socially isolated, having low social support and being lonely, and 34% reported being not socially isolated, high social support and not being lonely. Each construct was independently associated with HRQoL, with loneliness having the strongest inverse association (PCS: isolation -0.98, low support -2.01, loneliness -2.03; MCS: isolation -1.97, low support -4.79, loneliness -10.20; p-value < 0.001 for each). Women who were not isolated or lonely and with high social support had the greatest HRQoL (compared to isolated, low social support and lonely; MCS: 17 to 18 points higher, PCS: 5 to 8 points higher). Other combinations of social isolation, social support and loneliness varied in their associations with HRQoL.Conclusion: Ageing populations face the challenge of supporting older people to maintain longer, healthy, meaningful and community-dwelling lives. Among older women, social isolation, low social support and loneliness are distinct, partially overlapping yet interconnected concepts that coexist and are each adversely associated with HRQoL. Findings should be replicated in other cohorts to ensure generalisability across other age groups and men.
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Affiliation(s)
- Rosanne Freak-Poli
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia.,Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Joanne Ryan
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Thach Tran
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Alice Owen
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | | | - Michael Berk
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia.,IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia.,Orygen, The National Centre of Excellence in Youth Mental Health, the Department of Psychiatry and the Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, Australia
| | - Nigel Stocks
- Discipline of General Practice, The University of Adelaide, Adelaide, Australia
| | - David Gonzalez-Chica
- Discipline of General Practice, The University of Adelaide, Adelaide, Australia.,Adelaide Rural Clinical School, The University of Adelaide, Adelaide, Australia
| | - Judy A Lowthian
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia.,Bolton Clarke Research Institute, Bolton Clarke, Melbourne, Australia.,Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia
| | - Jane Fisher
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Julie Byles
- Research Centre for Generational Health and Ageing, University of Newcastle, Newcastle, Australia
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14
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Does social support prevent suicidal ideation in women and men? Gender-sensitive analyses of an important protective factor within prospective community cohorts. J Affect Disord 2022; 306:157-166. [PMID: 35304236 DOI: 10.1016/j.jad.2022.03.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/18/2022] [Accepted: 03/10/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Suicidal ideation and behavior constitute important public mental health issues. In this study, we examined whether social integration prevents suicidal ideation over time and whether gender modifies this association. METHODS Data from the Gutenberg Health Study (population-based representative community sample in midwest Germany) and the Study of Health in Pomerania (population-based cohort study in northeast Germany) were used. Participants reporting low social support were compared to those receiving middle or high social support. Within a longitudinal study design, we calculated multiple logistic regression models including interaction terms and relevant covariates to test whether gender modified the association of social support and suicidal ideation. RESULTS Suicidal ideation was present in 7.4% (N = 982) of the pooled cohorts' 13,290 participants. More women (8.6%, N = 565) than men (6.2%, N = 417) reported suicidal ideation. Middle or high social support was associated with a lower probability to report suicidal ideation five years later after controlling for sociodemographic factors, living situation, and cohort (OR = 0.42, 95%-CI = 0.34-0.52). Male gender was negatively related to suicidal ideation, but no statistically significant interaction of gender and social support was found (ratio of ORs = 1.00, 95%-CI = 0.73-1.35). LIMITATIONS The number of people reporting suicidal ideation in the SHIP study was small, especially for men. Suicidal ideation was measured using a single item. CONCLUSIONS Social support is an important protective factor in preventing suicidal ideation for both women and men. Future research should further clarify gender-specific effects of family variables in suicidal ideation and test similar predictive models of suicidal behavior.
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15
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Pavlidis G, Hansen T, Motel-Klingebiel A, Aartsen M. Network and solitude satisfaction as modifiers of disadvantages in the quality of life of older persons who are challenged by exclusion from social relations: a gender stratified analysis. APPLIED RESEARCH IN QUALITY OF LIFE 2022; 17:2859-2875. [PMID: 35342486 PMCID: PMC8934721 DOI: 10.1007/s11482-022-10045-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/07/2022] [Accepted: 02/13/2022] [Indexed: 06/14/2023]
Abstract
This study examined from a gender-sensitive perspective the associations of exclusion from social relations (ESR) with the quality of life (QoL) of excluded older persons. Being satisfied with existing relations (i.e., network satisfaction) may be particularly important for the QoL of older persons with small networks, whereas the QoL of "network-less" older persons may be associated with their perception of solitude (i.e., solitude satisfaction). This study examined the moderating role of network satisfaction (NS) in the gendered associations between network size and QoL, as well as the gendered associations of solitude satisfaction (SS) with the QoL of older "network-less" persons. In addition, the comparative disadvantages in the QoL of "network-less" older persons with low-to-high SS, compared to the QoL of socially embedded persons with low-to-high NS were examined. Cross-sectional gender stratified secondary analyses of data from participants (N = 72.433) in the Survey on Health, Aging and Retirement in Europe (SHARE) did not provide convincing evidence that a higher NS is particularly important for the QoL of older persons with smaller networks. Among older "network-less" persons, lower SS was associated with lower QoL, comparatively more so among older women. Older persons embedded in a social network with low NS, as well as older "network-less" persons with low SS, have comparatively the lowest levels of QoL. It was concluded that the subjective evaluation of social relations and the subjective evaluation of solitude are associated with gendered disadvantages in the QoL of older persons challenged by ESR.
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Affiliation(s)
- George Pavlidis
- Division of Ageing and Social Change, Department of Culture and Society, Linkoping University, Linkoping, Sweden
| | - Thomas Hansen
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
- Department for Ageing and Housing studies, Oslo Metropolitan University, Oslo, Norway
| | - Andreas Motel-Klingebiel
- Division of Ageing and Social Change, Department of Culture and Society, Linkoping University, Linkoping, Sweden
| | - Marja Aartsen
- Department for Ageing and Housing studies, Nova-Norwegian Social Research, Oslo, Norway
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16
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Hajek A, Brettschneider C, Mallon T, Kaduszkiewicz H, Oey A, Wiese B, Weyerer S, Werle J, Pentzek M, Fuchs A, Conrad I, Luppa M, Weeg D, Mösch E, Kleineidam L, Wagner M, Scherer M, Maier W, Riedel-Heller SG, König HH. Social support and health-related quality of life among the oldest old - longitudinal evidence from the multicenter prospective AgeCoDe-AgeQualiDe study. Qual Life Res 2021; 31:1667-1676. [PMID: 34939147 PMCID: PMC9098616 DOI: 10.1007/s11136-021-03070-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to examine the longitudinal within-association between social support and health-related quality of life among the oldest old. METHODS Longitudinal data (follow-up waves 7 to 9) were used from the multicenter prospective cohort study "Needs, health service use, costs and health-related quality of life in a large sample of oldest-old primary care patients (85 +)" (AgeQualiDe). n = 648 individuals were included in the analytical sample. At FU wave 7, mean age was 88.8 years (SD: 2.9 years, from 85 to 99 years). Social support was quantified using the Lubben Social Network Scale (6-item version). Health-related quality of life was assessed using the EQ-5D-3L including problems in five health dimensions, and its visual analogue scale (EQ VAS). It was adjusted for several covariates in conditional logistic and linear fixed effects regressions. RESULTS Intraindividual decreases in social support were associated with an increased likelihood of developing problems in 'self-care', 'usual activities', 'pain/discomfort' and 'anxiety/depression' (within individuals over time). In contrast, intraindividual changes in social support were not associated with intraindividual changes in the EQ VAS score. CONCLUSION Findings indicate a longitudinal intraindividual association between social support and problems, but only in some health dimensions. Further research in this area based on longitudinal studies among the oldest old (from different countries) is required.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Christian Brettschneider
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tina Mallon
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hanna Kaduszkiewicz
- Institute of General Practice, Faculty of Medicine, Kiel University, Kiel, Germany
| | - Anke Oey
- Institute of General Practice, Hannover Medical School, Hannover, Germany
| | - Birgitt Wiese
- Institute of General Practice, Hannover Medical School, Hannover, Germany
| | - Siegfried Weyerer
- Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | - Jochen Werle
- Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | - Michael Pentzek
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Angela Fuchs
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Ines Conrad
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Dagmar Weeg
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Edelgard Mösch
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Luca Kleineidam
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Michael Wagner
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Martin Scherer
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wolfgang Maier
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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17
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Driving status and health-related quality of life among the oldest old: a population-based examination using data from the AgeCoDe-AgeQualiDe prospective cohort study. Aging Clin Exp Res 2021; 33:3109-3115. [PMID: 32006387 PMCID: PMC8595225 DOI: 10.1007/s40520-020-01482-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 01/11/2020] [Indexed: 11/10/2022]
Abstract
Background It is almost unknown whether the driving status is associated with HRQOL among individuals in highest age. Aims Based on a multicenter prospective cohort study, the objective of this study was to examine whether the driving status is associated with health-related quality of life (HRQOL) among the oldest old in Germany. Methods Cross-sectional data from follow-up wave 9 (n = 544) were derived from the “Study on Needs, health service use, costs and health-related quality of life in a large sample of oldest-old primary care patients (85+)” (AgeQualiDe). Average age was 90.3 years (± 2.7; 86 to 101 years). The current driver status (no; yes) was used in our analysis. The EuroQoL EQ-5D questionnaire was used to assess HRQOL in this study. Results Regression analysis showed that being a current driver was associated with the absence of problems in ‘self-care’ [OR 0.41 (95%-CI 0.17 to 0.98)], and ‘usual activities’ [OR 0.48 (0.26 to 0.90)], whereas it was not significantly associated with problems in ‘pain/discomfort’ [OR 0.82 (0.47 to 1.45)] and ‘anxiety/depression’ [OR 0.71 (0.36 to 1.39)]. Being a current driver was marginally significantly associated with the absence of problems in ‘mobility’ [OR 0.60 (0.34 to 1.06)]. While being a current driver was not associated with the EQ-VAS in the main model, it was positively associated with the driving status (β = 5.00, p < .05) when functional impairment was removed from the main model. Discussion Our findings provide first evidence for an association between driving status and HRQOL among the oldest old. Conclusions Future longitudinal studies are required to evaluate a possible causal relationship between driving status and HRQOL in very old individuals.
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18
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Hajek A, Brettschneider C, Eisele M, Mallon T, Oey A, Wiese B, Weyerer S, Werle J, Fuchs A, Pentzek M, Gühne U, Röhr S, Weeg D, Bickel H, Kleineidam L, Wagner M, Scherer M, Maier W, Riedel-Heller SG, König HH. Social Support and Functional Decline in the Oldest Old. Gerontology 2021; 68:200-208. [PMID: 33979796 DOI: 10.1159/000516077] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 03/23/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Longitudinal studies investigating the link between social support and functional decline are limited among the oldest old. Thus, the aim of this study was to examine whether changes in social support are associated with functional decline among the oldest old longitudinally using panel regression models. METHODS Longitudinal data from 3 waves (waves 7, 8, and 9) of a multicenter prospective cohort study covering primary care patients aged ≥85 years were used. In the analytical sample, n equaled 624 individuals. The validated Lawton and Brody Instrumental Activities of Daily Living (IADL) scale and the well-established Barthel Index (ADL) were used to quantify functional status. The psychometrically sound Lubben Social Network Scale was used to measure social support. Several potential confounders such as age, marital status, cognitive decline, or depressive symptoms were included in the fixed effects (FE) regression models. RESULTS Linear FE regressions showed that a decrease in social support is associated with functional decline (IADL: β = 0.03, p < 0.05; ADL: β = 0.27, p < 0.05) in men but not in women. With IADL as outcome measure, the interaction term (sex × social support) achieved statistical significance (p < 0.01). With regard to covariates, functional decline (IADL and ADL) was consistently associated with increasing age, an increase in the number of chronic conditions (except for women [ADL]), and cognitive decline (except for men [ADL]). Furthermore, functional decline (ADL) was associated with an increase in depressive symptoms. DISCUSSION Our findings highlight the meaning of social support for functional status among the oldest old. Finding ways to sustain social support in highest age may be a promising approach in order to postpone functional decline.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Brettschneider
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marion Eisele
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tina Mallon
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anke Oey
- Institute of General Practice, Hannover Medical School, Hannover, Germany
| | - Birgitt Wiese
- Institute of General Practice, Hannover Medical School, Hannover, Germany
| | - Siegfried Weyerer
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Jochen Werle
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Angela Fuchs
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Michael Pentzek
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Uta Gühne
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Dagmar Weeg
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Horst Bickel
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Luca Kleineidam
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Michael Wagner
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Martin Scherer
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wolfgang Maier
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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19
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Cerletti P, Eze IC, Keidel D, Schaffner E, Stolz D, Gasche-Soccal PM, Rothe T, Imboden M, Probst-Hensch N. Perceived built environment, health-related quality of life and health care utilization. PLoS One 2021; 16:e0251251. [PMID: 33956884 PMCID: PMC8101743 DOI: 10.1371/journal.pone.0251251] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 04/22/2021] [Indexed: 11/28/2022] Open
Abstract
Previous research has shown that the built environment plays a crucial role for health-related quality of life (HRQoL) and health care utilization. But, there is limited evidence on the independence of this association from lifestyle and social environment. The objective of this cross-sectional study was to investigate these associations, independent of the social environment, physical activity and body mass index (BMI). We used data from the third follow-up of the Swiss study on Air Pollution and Lung and Heart diseases In Adults (SAPALDIA), a population based cohort with associated biobank. Covariate adjusted multiple quantile and polytomous logistic regressions were performed to test associations of variables describing the perceived built environment with HRQoL and health care utilization. Higher HRQoL and less health care utilization were associated with less reported transportation noise annoyance. Higher HRQoL was also associated with greater satisfaction with the living environment and more perceived access to greenspaces. These results were independent of the social environment (living alone and social engagement) and lifestyle (physical activity level and BMI). This study provides further evidence that the built environment should be designed to integrate living and green spaces but separate living and traffic spaces in order to improve health and wellbeing and potentially save health care costs.
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Affiliation(s)
- Paco Cerletti
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Ikenna C. Eze
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Dirk Keidel
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Emmanuel Schaffner
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Daiana Stolz
- Clinic for Respiratory Medicine and Pulmonary Cell Research, University Hospital Basel, Basel, Switzerland
| | | | - Thomas Rothe
- Department of Internal Medicine and Pneumology, Zuercher Hoehenklinik Davos, Davos, Switzerland
| | - Medea Imboden
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- * E-mail:
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20
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Lestari SK, de Luna X, Eriksson M, Malmberg G, Ng N. A longitudinal study on social support, social participation, and older Europeans' Quality of life. SSM Popul Health 2021; 13:100747. [PMID: 33644292 PMCID: PMC7892994 DOI: 10.1016/j.ssmph.2021.100747] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 01/23/2021] [Accepted: 01/25/2021] [Indexed: 11/19/2022] Open
Abstract
The association between quality of life (QoL) and social relationships is well established. This paper further analyses whether and how participation in social activities as well as providing and receiving social support, independently, are associated with QoL among the older population in 16 European countries. QoL was measured using the CASP-12 scale. The baseline data came from Wave 6 and the outcome from Wave 7 of the Survey of Health, Ageing and Retirement in Europe (SHARE). The associations of interest were analysed using multivariable linear regression. The effect of possible non-ignorable dropout was tested. Then, doubly robust estimation and sensitivity analyses for unobserved confounding were performed to evaluate the possible causal interpretation of the associations found. Our findings show that participation in at least one of the socially productive activities was positively associated with QoL at two-year follow-up (Average Causal Effect, ACE: 0.474; 95%CI: 0.361, 0.587). The association was stronger among women, people aged 75+, and those in the Southern European region. Providing social support had a positive association with QoL, but only among people aged 75+ (ACE: 0.410; 95%CI: 0.031, 0.789). Conversely, receiving social support had a negative association (ACE: -0.321; 95%CI: -0.448, -0.195) with QoL, especially for men, people aged 75+, and those in Eastern European countries. Sensitivity analyses for unobserved confounders showed that the associations found cannot be attributed to causal effects.
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Affiliation(s)
- Septi Kurnia Lestari
- Department of Epidemiology and Global Health, Umeå University, Umeå, 90187, Sweden
- Centre for Demographic and Ageing Research, Umeå University, Umeå, 90187, Sweden
| | - Xavier de Luna
- Umeå School of Business, Economics and Statistics, Umeå University, Umeå, 90187, Sweden
| | - Malin Eriksson
- Department of Social Work, Umeå University, Umeå, 90187, Sweden
| | - Gunnar Malmberg
- Centre for Demographic and Ageing Research, Umeå University, Umeå, 90187, Sweden
- Department of Geography, Umeå University, Umeå, 90187, Sweden
| | - Nawi Ng
- Department of Epidemiology and Global Health, Umeå University, Umeå, 90187, Sweden
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, 40530, Sweden
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21
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Jacobs S, Holtzer R. Predicting change in perceived social support in late life: The role of personality and gender. Aging Ment Health 2021; 25:107-117. [PMID: 31561708 DOI: 10.1080/13607863.2019.1671317] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Perceived social support (PSS) has a uniquely beneficial effect on physical and mental health in older adults, yet relatively little is known about patterns of change in PSS during late life. The purpose of this study was to identify risk factors related to individual-level change in PSS, with a focus on personality (specifically Neuroticism and Extraversion) and gender as primary variables of interest. METHOD The study sample consisted of 409 community-dwelling, healthy older adults (56.5% female) who were followed annually for up to five years. Personality traits were analyzed independently and as combined Neuroticism-Extraversion quadrants. Linear mixed effect models (LMEM) and Cox proportional hazards regression were used to examine continuous change and incidence of decline in PSS, respectively. Analyses were conducted for the entire sample and in stratified models in order to explore the potential moderating effect of gender. RESULTS Personality was identified as a significant predictor of PSS change, including personality quadrants and High Neuroticism alone. Stratified models revealed significant gender differences, with High Neuroticism-Low Extraversion and High Neuroticism alone consistently linked to PSS decline in males, while Low Neuroticism-Low Extraversion was linked to PSS decline in females. CONCLUSION Patterns in LMEM and Cox model results suggest that PSS decline in males is likely associated with High Neuroticism, while PSS decline in females may be associated instead with Low Extraversion. Future clinical implications include earlier identification of individuals who are at risk for decreased social support, and its related impact on health.
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Affiliation(s)
- Sydney Jacobs
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
| | - 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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22
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Fajardo-Bullón F, Pérez-Mayo J, Esnaola I, Anderson I, Knutagård M. Influence of Psychosocial Variables on the Health of People Living in Housing Exclusion. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8983. [PMID: 33276637 PMCID: PMC7730692 DOI: 10.3390/ijerph17238983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 11/25/2020] [Accepted: 12/01/2020] [Indexed: 12/16/2022]
Abstract
The aim of this study was to analyze the influence of some personal characteristics, health variables, and social support on the self-rated health of people in housing exclusion in Spain. For that purpose, we used the FOESSA Survey of Social Integration and Needs database, with a final sample of 1574 households. Being more educated and reporting a good life satisfaction stood out as the main factors preventing worse health status. Furthermore, results showed that being female, experiencing poverty-related food insecurity, not having health insurance, experiencing widowhood or partner bereavement, and having caring responsibilities for others or having a disabled person in the household are associated with increased reporting of regular or poor health. On the other hand, being young, having a diagnosed/long-term illness, and a big household size are preventive factors for good health. These results allowed identifying risk and prevention factors to inform interventions to improve the health of those living in housing exclusion. Promoting better education levels, social support, and overall life satisfaction could be important to improve health in this population. Developing social support policies for caring responsibilities and food insecurity must be a priority to improve the health of people living in housing exclusion.
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Affiliation(s)
- Fernando Fajardo-Bullón
- Department of Psychology, Faculty of Education and Psychology, University of Extremadura, Avenida de Elvas s/n, 06006 Badajoz, Spain
| | - Jesús Pérez-Mayo
- Department of Economics, University of Extremadura, 06006 Badajoz, Spain;
| | - Igor Esnaola
- Department of Development and Educational Psychology, Faculty of Education, University of the Basque Country, UPV/EHU, Avenida de Tolosa, 70, San Sebastián, 20018 Leioa, Spain
| | - Isobel Anderson
- Faculty of Social Sciences, University of Stirling, Stirling FK9 4LA, UK;
| | - Marcus Knutagård
- School of Social Work, Lund University, Box 23, 221 00 Lund, Sweden;
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23
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Yu ZB, Bao CZ, Wu MY, Jiang DJ, Zhang XC, Lin SJ, Jin MJ, Wang JB, Tang ML, Chen K. Regression-based normative data for social health scale for the elderly (short version) in eastern China. Health Qual Life Outcomes 2020; 18:54. [PMID: 32131839 PMCID: PMC7057499 DOI: 10.1186/s12955-020-01306-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Accepted: 02/21/2020] [Indexed: 11/21/2022] Open
Abstract
Backgrounds Social Health Scale for the Elderly short version (SHSE-S) is a psychometrically sound instrument that comprehensively assesses the social health status of older adults in China. The aim of the present study was to establish continuous normative data of SHSE-S. Methods We conducted a multicenter cross-sectional study among 31 communities in eastern China. Older adults aged 60 years and above were invited to participate in the study. Each participant was interviewed in-person to finish a structured questionnaire. The SHES-S score was calculated and standardized for each participant. We split the sample into generation and validation datasets and compared the distribution of SHSE-S score between two datasets. Multivariable linear regression was used to assess the SHSE-S score and demographic variables. Regression-based norms were built using a four-step process. Results A total of 6089 participants (51.2% females) aged 60 years old and above (mean age = 71.3, SD = 8.0) were enrolled as the normative sample. No significant difference was found between the distribution of SHSE-S standardized score in the generation (N = 2392) and validation (N = 3697) datasets. Multivariable linear regression showed that females, higher education levels were positive indicators while aging, living alone, divorced or never married, multimorbidity were negative factors. The regression-based norm which taking demographic factors into account was established and a user-friendly worksheet was also provided to facilitate the scoring and norming of the SHSE-S. Conclusions The population-based regression norm of SHSE-S can be a useful tool for assessing the social health status of the Chinese elderly population.
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Hajek A, König HH. How do cat owners, dog owners and individuals without pets differ in terms of psychosocial outcomes among individuals in old age without a partner? Aging Ment Health 2020; 24:1613-1619. [PMID: 31364868 DOI: 10.1080/13607863.2019.1647137] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Objectives: The purpose of this study was to identify whether cat owners, dog owners and individuals without pets differ in terms of depressive symptoms, loneliness and social isolation among individuals in old age without a partner.Method: For this study, data were used from a nationally representative sample of non-institutionalized older individuals (German Ageing Survey). We focused on older adults (>65 years) who did not have a partner. The outcome measures were quantified using validated scales. Multiple linear regressions were used.Results: Among the n = 1,160 individuals aged 65 years and over without a partner, 952 individuals (82.1%) did not own a pet. Moreover, 145 individuals (12.5%) owned one or more cat/s and 63 individuals (5.4%) owned one or more dog/s. Multiple linear regressions showed that dog owners were less socially isolated than individuals without pets. There were no differences between cat owners and individuals without pets in the outcome measures. While there were no differences observed in men, female dog owners were less socially isolated and less lonely than women without pets.Conclusion: Our study revealed an association between owning a dog and social isolation (total sample) as well as loneliness (total sample and women). Future research should focus on elucidating the underlying mechanisms. In addition, longitudinal studies are required to deepen our understanding of this association.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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25
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Fang CY, Handorf EA, Rao AD, Siu PT, Tseng M. Acculturative Stress and Depressive Symptoms Among Chinese Immigrants: the Role of Gender and Social Support. J Racial Ethn Health Disparities 2020; 8:1130-1138. [PMID: 33000431 DOI: 10.1007/s40615-020-00869-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/28/2020] [Accepted: 09/13/2020] [Indexed: 10/23/2022]
Abstract
The USA has among the largest immigrant population of any country in the world, and over the past few decades, the proportion of Chinese immigrants in the USA has increased significantly. Immigrants may experience substantial acculturative stress as they learn to navigate their new environment, and this stress can contribute to depressive symptoms and poor mental health. Social support can help mitigate the effects of stress on depressive symptoms, but the protective effects of social support have been reported to differ between men and women. Thus, the present study examined associations of acculturative stress and depressive symptoms among Chinese immigrants and explored whether the effects of social support on depressive symptoms varied by gender. Participants included 620 foreign-born Chinese men and women who completed questionnaires on acculturative stress, social support, and depressive symptoms. In nested regression analyses, acculturative stress was positively associated with depressive symptoms among both men and women. However, the interaction of social support and acculturative stress on depressive symptoms was statistically significant among men (β = - 0.89, p < 0.001), but not women (β = - 0.43, p = 0.21). These findings suggest that social support moderates the association of acculturative stress with depressive symptoms, but only among Chinese immigrant men. Future research should explore factors that can enhance resilience and mitigate acculturative stress effects on psychological well-being among Chinese immigrant women.
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Affiliation(s)
- Carolyn Y Fang
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, 19111, USA.
| | - Elizabeth A Handorf
- Department of Biostatistics and Bioinformatics, Fox Chase Cancer Center, Philadelphia, PA, 19111, USA
| | - Ajay D Rao
- Center for Metabolic Disease Research, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19140, USA
| | - Philip T Siu
- Nemours duPont Pediatrics, Media, PA, 19063, USA
| | - Marilyn Tseng
- Department of Kinesiology, California Polytechnic State University, San Luis Obispo, CA, 93407, USA
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Correlates of hospitalization among the oldest old: results of the AgeCoDe-AgeQualiDe prospective cohort study. Aging Clin Exp Res 2020; 32:1295-1301. [PMID: 31422564 DOI: 10.1007/s40520-019-01315-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 08/08/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Hospitalization is a key driver of health care costs. Thus far, there are only a few longitudinal studies investigating whether changes in explanatory variables lead to hospitalization. Moreover, these longitudinal studies did not focus on individuals in highest age. AIM The purpose of the current study was to examine the correlates of hospitalization among the oldest old in Germany longitudinally. METHODS A multicenter prospective cohort study ["Study on Needs, health service use, costs and health-related quality of life in a large sample of oldest-old primary care patients (85+)", AgeQualiDe]. Primary care patients ≥ 85 years took part [n = 861 at follow-up (FU) 7, average age of 89.0 years; 85-100 years]. Two waves were used. Hospitalization in the last 6 months was used as outcome measure. Well-established scales were used to quantify the independent variables such as Instrumental Activities of Daily Living Scale, Global Deterioration Scale or Geriatric Depression Scale. RESULTS Logistic random effects regressions showed that the probability of hospitalization in the preceding 6 months significantly increased with increases in the social network, more depressive symptoms, functional decline, and increase in chronic conditions, whereas it was not significantly associated with age, sex, marital status, education, and cognitive impairment. Social networks moderate the relationship between functional decline and hospitalization. DISCUSSION The results of the present longitudinal study emphasize the association of depressive symptoms, functional decline, more social networks, and chronic conditions with hospitalization among the oldest old. CONCLUSIONS Treatments with the aim to reduce or postpone these factors might also help to reduce hospitalization.
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Schneider A, Blüher S, Grittner U, Anton V, Schaeffner E, Ebert N, Jakob O, Martus P, Kuhlmey A, Wenning V, Schnitzer S. Is there an association between social determinants and care dependency risk? A multi-state model analysis of a longitudinal study. Res Nurs Health 2020; 43:230-240. [PMID: 32314415 DOI: 10.1002/nur.22022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 03/30/2020] [Accepted: 03/31/2020] [Indexed: 01/12/2023]
Abstract
Despite a growing body of knowledge about the morbidities and functional impairment that frequently lead to care dependency, the role of social determinants is not yet well understood. The purpose of this study was to examine the effect of social determinants on care dependency onset and progression. We used data from the Berlin Initiative Study, a prospective, population-based cohort study including 2,069 older participants living in Berlin. Care dependency was defined as requiring substantial assistance in at least two activities of daily living for 90 min daily (level 1) or 3+ hours daily (level 2). Multi-state time to event regression modeling was used to estimate the effects of social determinants (partnership status, education, income, and sex), morbidities, and health behaviors, characteristics, and conditions. During the study period, 556 participants (27.5%) changed their status of care dependency. Participants without a partner at baseline were at a higher risk to become care-dependent than participants with a partner (hazard ratio [HR], 95% confidence interval [CI]: 1.24 (1.02-1.51)). After adjustment for other social determinants, morbidities and health behaviors, characteristics, and conditions the risk decreased to a HR of 1.19 (95% CI: 0.79-1.79). Results indicate that older people without a partner may tend to be at higher risk of care dependency onset but not at higher risk of care dependency progression. Clinicians should inquire about and consider patients' partnership status as they evaluate care needs.
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Affiliation(s)
- Alice Schneider
- Institute of Biometry and Clinical Epidemiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.,Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Str. 2, 10178, Berlin, Germany.,Institute of Public Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Stefan Blüher
- Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Ulrike Grittner
- Institute of Biometry and Clinical Epidemiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.,Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Str. 2, 10178, Berlin, Germany
| | - Verena Anton
- Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Elke Schaeffner
- Institute of Public Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Natalie Ebert
- Institute of Public Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | | | - Peter Martus
- Institute of Clinical Epidemiology and Medical Biostatistics, Eberhard Karls-University, Tübingen, Germany
| | - Adelheid Kuhlmey
- Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | | | - Susanne Schnitzer
- Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
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28
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Pérez-Ros P, Martínez-Arnau FM, Tarazona-Santabalbina FJ. Risk Factors and Number of Falls as Determinants of Quality of Life of Community-Dwelling Older Adults. J Geriatr Phys Ther 2020; 42:63-72. [PMID: 29939905 DOI: 10.1519/jpt.0000000000000150] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE In older adults, the psychological impact and effects related to the loss of functional capacity are directly related to perceived quality of life (QOL). The predictors of better QOL are increased physical activity, lower prevalence of overweight, lower cases of depression, and lower rate of reported alcohol abuse. On the contrary, the predictors of decreased QOL are female gender, comorbidity, deficient nutritional condition, polypharmacy, loss of mobility, depression and dependency, poor economic conditions, and social isolation and loneliness. Furthermore, QOL in older adults is more dependent on the number of falls than comorbidity. The objective was to investigate the determinants of perceived QOL among independent community-dwelling older adults and to quantify the influence of number of falls and number of risk factors on QOL. METHODS This is a cross-sectional study of 572 older adults (>70 years of age) seen in 10 primary care centers in La Ribera, Valencia, Spain. Comprehensive geriatric assessment was done by 4 nurses in primary care centers. Functional status and sociodemographic and clinical variables were collected. Quality of life was assessed with the EQ-5D scale. RESULTS Females predominated (63.3%). Mean age (standard deviation) was 76.1 (3.9) years. The male gender (β = .09; 95% confidence interval [CI]: 0.05-0.13) was found to be predictive of better QOL, together with physical activity (β = .04; 95% CI: 0.02-0.06), while the use of drugs affecting the central nervous system (β = -.08; 95% CI: -0.12 to -0.03), overweight (β = -.06; 95% CI: 0.1 to - 0.02), comorbidity (β = -.09; 95% CI: -0.13 to -0.05), the presence of fall risk factors (β = -.02; 95% CI: -0.03 to 0.01), and the number of previous falls (β = -.03; 95% CI: -0.06 to 0.01) had a negative impact upon the EQ-5D Index score. CONCLUSIONS If perceived QOL is used as an indicator of the success of intervention programs, certain factors accompanying the adoption of measures for the prevention of falls may mask the results (failure or success) of the intervention. Because most determinants of QOL are modifiable and physical activity has the potential to improve QOL, this research suggests that physical activity programs should be a component of health care for older adults.
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Affiliation(s)
- Pilar Pérez-Ros
- Faculty of Nursing, Catholic University of Valencia San Vicente Martir, Valencia, Spain
| | - Francisco M Martínez-Arnau
- Faculty of Nursing, Catholic University of Valencia San Vicente Martir, Valencia, Spain.,Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Francisco J Tarazona-Santabalbina
- Faculty of Nursing, Catholic University of Valencia San Vicente Martir, Valencia, Spain.,Department of Geriatrics, De la Ribera University Hospital, Valencia, Spain
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Hajek A, Riedel-Heller SG, König HH. Perceived social isolation and cognitive functioning. Longitudinal findings based on the German Ageing Survey. Int J Geriatr Psychiatry 2020; 35:276-281. [PMID: 31755129 DOI: 10.1002/gps.5243] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 11/11/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVES There is a lack of longitudinal studies, which are both based on nationally representative samples and use standardized instruments to quantify social isolation. Thus, the purpose of this study was to determine the link between perceived social isolation and cognitive functioning longitudinally. METHODS/DESIGN Longitudinal data with n = 6420 from 2014 (wave 5) to 2017 (wave 6) were drawn from the German Ageing Survey (nationally representative sample of individuals aged 40 years and over). Perceived social isolation was assessed using a scale by Bude and Lantermann. Cognitive functioning was quantified using the established digit symbol test. To reduce the problem of unobserved heterogeneity, linear fixed effects regressions were used. RESULTS Regressions showed that increases in perceived social isolation were associated with decreases in cognitive functioning. With regard to covariates, decreases in cognitive functioning were associated with increases in aging and worsening self-rated health, whereas changes in marital status, employment status, income, physical functioning, and physical illnesses were not associated with the outcome measure. CONCLUSIONS Based on a nationally representative sample and exploiting the panel data structure, the study findings extend current knowledge by showing that increasing perceived social isolation contributes to decreases in cognitive functioning among individuals aged 40 years and over longitudinally. Future longitudinal studies based on panel data methods are required to validate the study findings.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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30
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Hajek A, König HH. Impact of informal caregiving on loneliness and satisfaction with leisure-time activities. Findings of a population-based longitudinal study in germany. Aging Ment Health 2019; 23:1539-1545. [PMID: 30328702 DOI: 10.1080/13607863.2018.1506739] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Objectives: Recent longitudinal studies have shown that informal caregiving increases depressive symptoms. However, little is known about the relation between informal caregiving and social ties as well as the evaluation of leisure-time activities longitudinally. Consequently, the aim of the current study was to investigate whether informal caregiving affects social ties as well as the perception of leisure-time activities. Method: Data were drawn from a population-based sample of community-dwelling individuals (≥40 years) in Germany from 2002 to 2014 (n = 21,762 observations). Social ties were assessed twofold: The number of important people in regular contact, and a six-item scale by Gierveld and van Tilburg. Furthermore, using a 5-point rating scale, satisfaction with leisure-time activities were quantified. Individuals were asked whether they provide informal care regularly. Results: Fixed effects regressions revealed that the onset of informal caregiving were not associated with changes in loneliness in the total sample and in both sexes. Besides, the onset of informal caregiving was associated with an increase in the number of individuals in regular contact in the total sample and in men, whereas it was associated with a decrease in satisfaction with leisure-time activities in the total sample and in both sexes. Conclusion: Data suggest that changes in informal caregiving were not associated with changes in loneliness. While the onset of informal caregiving was associated with an increase in the number of individuals in regular contact, it was associated with negative changes in satisfaction with leisure-time activities, emphasizing the variety of consequences that may unfold.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
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Abstract
BACKGROUND Inflammatory bowel disease (IBD) is an incurable autoimmune disease causing overwhelming physical distress and psychological adaptation. PURPOSE To explore the associations between foundational influences and personal characteristics predictors to the achievement of mastery of health in patients with IBD. THEORY Orem's Theory of Self-Care, Resnick's Theory of Self-Efficacy, and Pearlin and Schooler's study of the structure of coping guided this study. The conceptual framework used was the Functional Mastery of Health Ownership (FMHO) model. METHODS A predictive correlational study design using self-administered questionnaires was used. A convenience sample of 151 adults with a diagnosis of IBD for at least 1 year was recruited from the patient population of a gastroenterology medical practice. RESULTS Data were analyzed using multiple regression with standard entry factor loading. Portions of the model were found to be significant and account for 44% of the variance (p < .001; R 2 = .44, Adjusted R 2 = .41). Significant relationships were found among mastery and IBD self-efficacy, perception of mastery, and current health status. Females had higher mastery scores than males. SIGNIFICANCE These findings support the use of a modified FMHO model to predict needs that enable individualized stewardship of health for patients with IBD.
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Assari S, Smith J, Bazargan M. Depression Fully Mediates the Effect of Multimorbidity on Self-Rated Health for Economically Disadvantaged African American Men but Not Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1670. [PMID: 31091652 PMCID: PMC6572520 DOI: 10.3390/ijerph16101670] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 04/17/2019] [Accepted: 05/10/2019] [Indexed: 12/14/2022]
Abstract
Background. Although chronic medical conditions (CMCs), depression, and self-rated health (SRH) are associated, their associations may depend on race, ethnicity, gender, and their intersections. In predominantly White samples, SRH is shown to better reflect the risk of mortality and multimorbidity for men than it is for women, which suggests that poor SRH among women may be caused not only by CMCs, but also by conditions like depression and social relations-a phenomenon known as "the sponge hypothesis." However, little is known about gender differences in the links between multimorbidity, depression, and SRH among African Americans (AAs). Objective. To study whether depression differently mediates the association between multimorbidity and SRH for economically disadvantaged AA men and women. Methods. This survey was conducted in South Los Angeles between 2015 to 2018. A total number of 740 AA older adults (age ≥ 55 years) were enrolled in this study, of which 266 were AA men and 474 were AA women. The independent variable was the number of CMCs. The dependent variable was SRH. Age and socioeconomic status (educational attainment and marital status) were covariates. Depression was the mediator. Gender was the moderator. Structural Equation Modeling (SEM) was used to analyze the data. Results. In the pooled sample that included both genders, depression partially mediated the effect of multimorbidity on SRH. In gender specific models, depression fully mediated the effects of multimorbidity on SRH for AA men but not AA women. For AA women but not AA men, social isolation was associated with depression. Conclusion. Gender differences exist in the role of depression as an underlying mechanism behind the effect of multimorbidity on the SRH of economically disadvantaged AA older adults. For AA men, depression may be the reason people with multimorbidity report worse SRH. For AA women, depression is only one of the many reasons individuals with multiple CMCs report poor SRH. Prevention of depression may differently influence the SRH of low-income AA men and women with multimorbidity.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90095, USA.
| | - James Smith
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90095, USA.
| | - Mohsen Bazargan
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90095, USA.
- Department of Family Medicine, University of California Los Angeles (UCLA), Los Angeles, CA 90095, USA.
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Hajek A, Brettschneider C, Eisele M, van den Bussche H, Wiese B, Mamone S, Weyerer S, Werle J, Leve V, Pentzek M, Röhr S, Stein J, Bickel H, Mösch E, Heser K, Wagner M, Scherer M, Maier W, Riedel-Heller SG, König HH. Prevalence and determinants of driving habits in the oldest old: Results of the multicenter prospective AgeCoDe-AgeQualiDe study. Arch Gerontol Geriatr 2019; 82:245-250. [PMID: 30877986 DOI: 10.1016/j.archger.2019.03.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 03/05/2019] [Accepted: 03/06/2019] [Indexed: 12/01/2022]
Abstract
AIM To present data on the prevalence of driving habits and to identify the determinants of driving habits among the oldest old in Germany. METHODS Cross-sectional data were used from the "Study on Needs, health service use, costs and health-related quality of life in a large sample of oldest-old primary care patients (85+)" (AgeQualiDe), including primary care patients aged 85 years and above (n = 549 at FU 9, mean age was 90.3 years; 86-101 years). Driving habits were measured (driving a car; frequency of driving a car and driving duration). Correlates were quantified using widely established scales (e.g., Geriatric Depression Scale, Instrumental Activities of Daily Living Scale). Multiple regression models were used to identify the determinants of driving habits. RESULTS Sixteen percent (87 out of 549) drove a car. Among the car-drivers, about 80% drove at least several times a week and about two-thirds drove longer distances (>15 min). Multiple logistic regressions showed that among the oldest old being a male was more likely to be a current driver compared to being a female. Other significant factors were subjective memory impairment, severe visual impairment, functional and cognitive impairment. Correlates of frequency of driving a car and driving duration were further identified. CONCLUSION About one in six very old Germans is still a regular car driver. Several determinants of driving habits among the oldest old were identified. Future longitudinal studies are required to clarify the factors leading to changes in driving habits.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Christian Brettschneider
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marion Eisele
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hendrik van den Bussche
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Birgitt Wiese
- Institute of General Practice, Hannover Medical School, Hannover, Germany
| | - Silke Mamone
- Institute of General Practice, Hannover Medical School, Hannover, Germany
| | - Siegfried Weyerer
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Jochen Werle
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Verena Leve
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Michael Pentzek
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Janine Stein
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Horst Bickel
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Edelgard Mösch
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Kathrin Heser
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Michael Wagner
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany; DZNE, German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Martin Scherer
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wolfgang Maier
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany; DZNE, German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Schnitzer S, Blüher S, Teti A, Schaeffner E, Ebert N, Martus P, Suhr R, Kuhlmey A. Risk Profiles for Care Dependency: Cross-Sectional Findings of a Population-Based Cohort Study in Germany. J Aging Health 2019; 32:352-360. [PMID: 30658538 PMCID: PMC7322978 DOI: 10.1177/0898264318822364] [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] [Indexed: 12/04/2022]
Abstract
Background: Rising life expectancy in Western societies is accompanied by a rising incidence of care dependency (CD) among older people. Objective: The aim of the study was to examine which health-related and social determinants were associated with CD. Method: We used cross-sectional data from the first follow-up (N = 1,699) of a prospective, population-based cohort study of older participants (≥70 years). CD was assessed if participants required substantial assistance in at least two activities of daily living for 90+ minutes daily. Multivariate logistic regressions were applied. Results: Participants’ mean age was 82 years; 18.9% were care-dependent. CD was significantly associated with older age, urinary incontinence, stroke, falls, cancer, diabetes, education level, having no partner, limited mobility, and limited physical activity. Discussion: Our research highlights the importance of promoting mobility, even in care-dependent people. Further research should investigate the role of partnership in terms of the prevention and delay of CD.
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Affiliation(s)
| | | | | | | | | | - Peter Martus
- Universitätsklinikum Tübingen, Baden-Württemberg, Germany
| | - Ralf Suhr
- Zentrum für Qualität in der Pflege / Centre for Quality in Care (ZQP), Berlin
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Gyasi RM. Social support, physical activity and psychological distress among community-dwelling older Ghanaians. Arch Gerontol Geriatr 2018; 81:142-148. [PMID: 30590228 DOI: 10.1016/j.archger.2018.11.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 11/03/2018] [Accepted: 11/18/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Physical activity (PA) has often been linked with improved mental health outcomes among older people but the subject has received limited attention in sub-Saharan African context. This paper examines the moderating effect of social support (SS) on the association between PA and psychological distress (PD) among community-dwelling older persons in Ghana. METHODS Individuals 50 years or older (N = 1200) who participated in a 2016/2017 Aging, Health, Psychological Wellbeing and Health-seeking Behavior Study (AHPWHB) were included. PD outcome, measured by the Kessler Psychological Distress Scale (KPDS-K10) was regressed on PA levels, SS and the interaction term. RESULTS Findings suggest that regular PA (OR = 0.824; 95%CI: 0.610-0.913) and higher levels of SS (OR = 0.475; 95%CI: 0.360-0.626) were associated with reduced PD outcomes after adjusting for theoretically relevant confounding variables. More importantly, the inclusion of the interaction term (PA × SS) showed a significant negative relationship of regular PA with the PD outcome as SS levels increased (OR = 0.651; 95%CI: 0.376-0.727). CONCLUSIONS Although regular PA potentially contributes to reducing PD among older persons, the relationship is even stronger for those embedded in a higher constellation of SS. Policy and practical interventions seeking to improve regular PA engagement such as old-age friendly environment and psychological resources for socially isolated older persons are warranted.
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Affiliation(s)
- Razak M Gyasi
- African Population and Health Research Center (APHRC), Nairobi, Kenya; Center for Social Policy and Social Change, Lingnan University, Hong Kong.
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Gyasi RM, Phillips DR, Amoah PA. Multidimensional Social Support and Health Services Utilization Among Noninstitutionalized Older Persons in Ghana. J Aging Health 2018; 32:227-239. [DOI: 10.1177/0898264318816217] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objectives: This study examines multidimensional social supports as predictors of health services utilization among community-dwelling older Ghanaians. Method: Using data from a 2016/2017 Aging, Health, Psychological Wellbeing and Health-Seeking Behavior Study ( N = 1,200), Poisson regression models estimated the associations of aspects of informal social support and health facility utilization among older people. Results: Findings suggest that regular contacts with family/close friends (odds ratio [OR] = 1.299; 95% confidence interval [CI] = [1.111, 1.519]), social participation (OR = 1.021; 95% CI = [1.140, 1.910]), and remittances from adult children (OR = 1.091; 95%CI = [1.086, 1.207]) were associated with increased health services utilization with some gender variations. Having caregivers increased health care use generally (OR = 1.108; 95% CI = [1.016, 1.209]) and among men (OR = 1.181; 95% CI = [1.015, 1.373]). However, we found decrease in health care use among those who received pecuniary assistance (OR = 0.893; 95% CI = [0.805, 0.990]). Discussion: Perceived structural and functional social support domains appear influential in health care utilization among older adults in Ghana. The findings underscore the need for intervention programs and social policies targeted at both micro-factors and wider social factors, including the novel area of remittances to older adults.
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Affiliation(s)
- Razak M. Gyasi
- African Population and Health Research Center (APHRC), Nairobi, Kenya
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Hajek A, König HH. The association between obesity and social exclusion in middle-aged and older adults: findings from a nationally representative study in Germany. BMC Geriatr 2018; 18:258. [PMID: 30359233 PMCID: PMC6202845 DOI: 10.1186/s12877-018-0946-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 10/10/2018] [Indexed: 12/24/2022] Open
Abstract
Background There is a lack of studies that focus explicitly on the association between social exclusion and obesity. The aim of the present study was to identify whether social exclusion is associated with obesity in older adults, and whether this association is moderated by sex. Methods Data were derived from wave 5 (2014) of the German Ageing Survey - a representative sample of individuals residing in private households aged 40 and over in Germany. A validated scale developed by Bude and Lantermann was used to assess social exclusion. Individuals with body-mass-index ≥30 kg/m2 were classified as being obese. Multiple linear regressions were applied in this study. Results Linear regressions showed that social exclusion was not associated with obesity in the total sample and in men, whereas women with obesity were less socially excluded than women without obesity (β = −.06, p = .02). The corresponding interaction term (sex x obesity) achieved statistical significance (p = .03). Conclusions Our findings emphasize the negative association between social exclusion and obesity in women, but not men, highlighting the complex interplay between social factors and excess weight in individuals aged 40 and above. Future longitudinal studies are needed to clarify this relationship in further detail.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Joanovič E, Kisvetrová H, Nemček D, Kurková P, Švejdíková B, Zapletalová J, Yamada Y. Gender differences in improvement of older-person-specific quality of life after hearing-aid fitting. Disabil Health J 2018; 12:209-213. [PMID: 30241964 DOI: 10.1016/j.dhjo.2018.08.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 08/27/2018] [Accepted: 08/31/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Age-related hearing loss is the third most common reason for disability in the world and has a significant impact on quality of life (QoL) amongst older adults. OBJECTIVE To determine how the QoL assessment in older-person-specific domains differs between older men and women with age-related hearing loss before and after hearing-aid fittings. METHODS The present study was carried out with 105 hearing-impaired outpatients (aged ≥ 60 years) before and after hearing-aid fittings at the University Hospital Olomouc, Czech Republic. The instrument used was the World Health Organization Quality of Life-Older Adults module (WHOQOL-Old). It was completed before hearing-aid fittings and after the first check-up hearing-aid adjustment. The Wilcoxon paired test multiple logistic regression was used to evaluate changes in the QoL after hearing-aid fittings. The distributions of men a women into three subgroups, improved, unchanged, and worsened in each domain, were compared using Fisher's exact test. RESULTS A significant QoL improvement when fitting a hearing-aid in the area of Sensory abilities was confirmed in both men and women (p < 0.001). In Autonomy, a significant improvement was recorded only amongst men (p = 0.010). In Past, present and future activities and Social participation, a significant improvement was only recorded amongst women (p = 0.029; p = 0.001). Significant differences were revealed between men and women in changes for Sensory Abilities (p = 0.019), Social Participation (p = 0.036) and Intimacy (p = 0.002). CONCLUSIONS The findings of this study suggest that there are gender differences in QoL improvement amongst people with age-related hearing loss after hearing-aid fitting.
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Affiliation(s)
- Eva Joanovič
- Centre for Research and Science, Faculty of Health Sciences, Palacký University, Olomouc, Czech Republic
| | - Helena Kisvetrová
- Centre for Research and Science, Faculty of Health Sciences, Palacký University, Olomouc, Czech Republic
| | - Dagmar Nemček
- Department of Sport Educology and Sport Humanities, Faculty of Physical Education and Sports, Comenius University, Nábr. Arm. Gen. L. Svobodu 9, 814 69, Bratislava, Slovakia.
| | - Petra Kurková
- Department of Anthropology and Health Education, Faculty of Education, Palacký University, Olomouc, Czech Republic
| | - Barbora Švejdíková
- Centre for Research and Science, Faculty of Health Sciences, Palacký University, Olomouc, Czech Republic
| | - Jana Zapletalová
- Department of Medical Biophysics, Faculty of Medicine and Dentistry, Palacký University, Olomouc, Czech Republic
| | - Yukari Yamada
- Department of Healthcare Epidemiology, Graduate School of Medicine, Kyoto University, Japan
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Sex differences in relation patterns between health-related quality of life of older adults and its correlates: a population-based cross-sectional study in Madeira, Portugal. Prim Health Care Res Dev 2018; 20:e54. [PMID: 30208982 PMCID: PMC7008396 DOI: 10.1017/s1463423618000233] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
A population-based cross-sectional study aimed to examine sex differences in health-related quality of life (HRQoL) of older adults, and investigate whether the relation patterns between HRQoL and its correlates differed between sexes. A stratified proportional and representative sample included 802 volunteers, aged 60–79. HRQoL (36-item Short Form Health Survey), functional fitness (Senior Fitness Test), physical activity (PA) (Baecke questionnaire), demographic information and health features (questionnaires) were assessed. Men showed significantly higher HRQoL (P<0.001). Body mass index, body strength, aerobic endurance, PA, depressive symptoms, falls, and living alone were significantly related to HRQoL. With sex as moderator, these relations were not significant, except for PA (β=0.12, P=0.004). A significant interaction of sex with PA on HRQoL (β=0.08, P=0.037) was found, indicating that this relation was higher in men. A similar relation pattern was found for HRQoL physical component. HRQoL and its correlates differed between sexes, demanding a sex specific approach to promote HRQoL.
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Jalali-Farahani S, Amiri P, Karimi M, Vahedi-Notash G, Amirshekari G, Azizi F. Perceived social support and health-related quality of life (HRQoL) in Tehranian adults: Tehran lipid and glucose study. Health Qual Life Outcomes 2018; 16:90. [PMID: 29747652 PMCID: PMC5946411 DOI: 10.1186/s12955-018-0914-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 04/27/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Several studies have demonstrated the positive association between perceived social support and health-related quality of life (HRQoL) in certain groups; however, few studies have assessed this relationship in general population and between genders. This study aimed to investigate associations between socio-demographic factors, perceived social support and HRQoL among an urban Iranian population. METHODS The study population were 1036 adults who had participated in Tehran Lipid and Glucose Study (TLGS). Data on socio-demographic information, perceived social support and HRQoL were collected using standard questionnaires by trained interviewers. Perceived social support and HRQoL were assessed using Iranian versions of the Multidimensional Scale of Perceived Social Support (MSPSS) and Short-Form 12-Item Health Survey version 2 (SF-12v2) respectively. Data on sets of associations among socio-demographic factors, perceived social support and quality of life were analyzed using Structural Equation Modeling (SEM) with IBM SPSS AMOS software. RESULTS Mean ages were 50.3 ± 16.3 and 49.6 ± 14.0 years in men and women respectively and 40.9% of participants were male. In terms of perceived social support scores, except for family subscale scores (p = 0.003), there were no significant differences between men and women. However, men had significantly higher HRQoL scores, compared to women in all subscales. The findings of SEM analysis demonstrated that being married in both genders (p < 0.001) and lower age in men (p < 0.05) were significantly associated with higher level of perceived social support. In terms of physical HRQoL, being single and higher perceived social support in both genders and lower age and not having any chronic diseases, only in women were associated with higher physical HRQoL. However, for mental HRQoL, age and perceived social support had significant direct associations with mental HRQoL in both genders (p < 0.001); in women, being single (p < 0.05) and not having chronic diseases (p < 0.001) were also significantly associated with better mental HRQoL. CONCLUSION Perceived social support was found to be both directly and indirectly associated with physical and mental aspects of HRQoL in both genders. Current structural models provide beneficial information for planning health promotion programs aimed at improving HRQoL among Tehranian adults.
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Affiliation(s)
- Sara Jalali-Farahani
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box: 19395-4763, Tehran, IR, Iran
| | - Parisa Amiri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box: 19395-4763, Tehran, IR, Iran.
| | - Mehrdad Karimi
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box: 19395-4763, Tehran, IR, Iran.,Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Golnaz Vahedi-Notash
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box: 19395-4763, Tehran, IR, Iran
| | - Golshan Amirshekari
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Donovan M, Liu Y, Wang Z. Anxiety-like behavior and neuropeptide receptor expression in male and female prairie voles: The effects of stress and social buffering. Behav Brain Res 2018; 342:70-78. [PMID: 29355675 DOI: 10.1016/j.bbr.2018.01.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 12/23/2017] [Accepted: 01/15/2018] [Indexed: 12/15/2022]
Abstract
Strong social support can negate negative health outcomes - an effect defined as 'social buffering'. In the present study, using the socially monogamous prairie vole (Microtus ochrogaster), we examined whether the presence of a bonded partner during a stressful event can reduce stress responses. Adult, pair-bonded female and male voles were assigned into experimental groups that were either handled (Control), experienced a 1-h immobilization (IMO) stress alone (IMO-Alone), or experienced IMO with their partner (IMO-Partner). Thereafter, subjects were tested for anxiety-like behavior, and brain sections were subsequently processed for oxytocin receptor (OTR) and vasopressin V1a-type receptor (V1aR) binding. Our data indicate that while IMO stress significantly decreased the time that subjects spent in the open arms of an elevated plus maze, partner's presence prevented this behavioral change - this social buffering on anxiety-like behavior was the same for both male and female subjects. Further, IMO stress decreased OTR binding in the nucleus accumbens (NAcc), but a partner's presence dampened this effect. No effects were found in V1aR binding. These data suggest that the neuropeptide- and brain region-specific OTR alterations in the NAcc may be involved in both the mediation and social buffering of stress responses. Some sex differences in the OTR and V1aR binding were also found in selected brain regions, offering new insights into the sexually dimorphic roles of the two neuropeptides. Overall, our results suggest a potential preventative approach in which the presence of social interactions during a stressor may buffer typical negative outcomes.
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Affiliation(s)
- Meghan Donovan
- Department of Psychology and Program in Neuroscience, Florida State University, Tallahassee, FL, 32306, USA
| | - Yan Liu
- Department of Psychology and Program in Neuroscience, Florida State University, Tallahassee, FL, 32306, USA
| | - Zuoxin Wang
- Department of Psychology and Program in Neuroscience, Florida State University, Tallahassee, FL, 32306, USA.
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Hajek A, König HH. Does informal caregiving affect self-esteem? Results from a population-based study of individuals aged 40 and over in Germany from 2002 to 2014. Scand J Caring Sci 2017; 32:1047-1055. [PMID: 29193241 DOI: 10.1111/scs.12550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 11/05/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND While it is known that informal caregiving is associated with care-derived self-esteem cross-sectionally, little is known about the impact of informal caregiving on general self-esteem longitudinally. Thus, we aimed at examining whether informal caregiving affects general self-esteem using a longitudinal approach. METHODS Data were gathered from a population-based sample of community-dwelling individuals aged 40 and over in Germany from 2002 to 2014 (n = 21 271). General self-esteem was quantified using the Rosenberg scale. Individuals were asked whether they provide informal care regularly. RESULTS Fixed effects regressions showed no significant effect of informal caregiving on general self-esteem longitudinally. General self-esteem decreased with increasing morbidity, increasing age, decreasing social ties, whereas it was not associated with changes in employment status, marital status and body mass index. Additional models showed that decreases in self-esteem were associated with decreases in functional health and increases in depressive symptoms. CONCLUSION Our longitudinal study emphasises that the occurrence of informal caregiving did not affect general self-esteem longitudinally. Further research is needed in other cultural settings using panel data methods.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Hajek A, König HH. The association of falls with loneliness and social exclusion: evidence from the DEAS German Ageing Survey. BMC Geriatr 2017; 17:204. [PMID: 28874139 PMCID: PMC5584003 DOI: 10.1186/s12877-017-0602-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 08/24/2017] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND It remains an open question whether falls are related with social relations, covering subjective (e.g., perceived loneliness) and more objective dimensions (e.g., number of important individuals in regular contact). Consequently, we aimed at examining the association between falls and social ties comprehensively, including loneliness, social exclusion and the number of important people in regular contact. METHODS Cross-sectional data were used from a population-based sample of community-dwelling individuals aged 40 and over (n = 7808) in Germany. Self-rated loneliness was quantified using a short version of the De Jong Gierveld Loneliness Scale. Perceived social exclusion was measured using a scale developed by Bude and Lantermann. Furthermore and in contrast to the subjective outcome measures, the more objective number of important people in regular contact was also used as outcome variable. The experience of a fall in the preceding 12 months (yes; no) was assessed. RESULTS Controlling for various possible confounding variables, linear regressions showed that experiencing a fall in the past 12 months was associated with higher social exclusion (β = .08, p < .001), and increased loneliness (β = .08, p < .001), whereas it was not associated with the number of important people in regular contact. CONCLUSIONS Findings stress the relation between falls and feelings of loneliness and social exclusion, whereas falls were unrelated to the more objective measure of number of important people in regular contact, suggesting that falls are particularly related to subjective measures of social ties and relations. This underlines the importance of interventions to prevent falls. Preventing falls in turn might help to prevent loneliness and social exclusion.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
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Hajek A, Brettschneider C, Mallon T, van der Leeden C, Mamone S, Wiese B, Weyerer S, Werle J, Fuchs A, Pentzek M, Riedel-Heller SG, Stein J, Bickel H, Weeg D, Heser K, Wagner M, Maier W, Scherer M, Luck T, König HH. How does social support affect functional impairment in late life? Findings of a multicenter prospective cohort study in Germany. Age Ageing 2017; 46:813-820. [PMID: 28200085 DOI: 10.1093/ageing/afx012] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 12/13/2016] [Indexed: 11/13/2022] Open
Abstract
Objective to investigate how social support affects functional impairment (FI) in late life in a longitudinal approach. Methods in a multicenter prospective cohort study, subjects in old age (≥75 years at baseline) were interviewed every 1.5 years. Social support was quantified in the follow-up (FU) Waves 2 and 4 (FU Wave 2: n = 2,349; FU Wave 4: n = 1,484). FI was assessed by using the Lawton and Brody Instrumental Activities of Daily Living scale. Results fixed effects regressions showed that a decrease in social support is associated with FI in the total sample and in both sexes. The effect on FI was most pronounced with the dimension social integration, whereas changes in practical support only affected FI in the total sample and changes in emotional support only affected FI in men. Conclusions our findings emphasise the importance of social support for functional status in late life. Thus, strengthening social support in old age might be effective in maintaining functional abilities.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Brettschneider
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tina Mallon
- Department of General Practice, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carolin van der Leeden
- Department of General Practice, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Silke Mamone
- Hannover Medical School, Institute of General Practice, Hannover, Germany
| | - Birgitt Wiese
- Hannover Medical School, Institute of General Practice, Hannover, Germany
| | - Siegfried Weyerer
- Central Institute of Mental Health, Mannheim/Heidelberg University,Mannheim, Germany
| | - Jochen Werle
- Central Institute of Mental Health, Mannheim/Heidelberg University,Mannheim, Germany
| | - Angela Fuchs
- Department of General Practice, Heinrich-Heine-University of Düsseldorf, Düsseldorf, Germany
| | - Michael Pentzek
- Department of General Practice, Heinrich-Heine-University of Düsseldorf, Düsseldorf, Germany
| | - Steffi G. Riedel-Heller
- Occupational Medicine and Public Health, Institute of Social Medicine, University of Leipzig, Leipzig, Germany
| | - Janine Stein
- Occupational Medicine and Public Health, Institute of Social Medicine, University of Leipzig, Leipzig, Germany
| | - Horst Bickel
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Dagmar Weeg
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Kathrin Heser
- Department of Psychiatry, University of Bonn, Bonn, Germany
| | - Michael Wagner
- Department of Psychiatry, University of Bonn, Bonn, Germany
| | - Wolfgang Maier
- Department of Psychiatry, University of Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Martin Scherer
- Department of General Practice, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tobias Luck
- Occupational Medicine and Public Health, Institute of Social Medicine, University of Leipzig, Leipzig, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Hajek A, Brettschneider C, Mallon T, Ernst A, Mamone S, Wiese B, Weyerer S, Werle J, Pentzek M, Fuchs A, Stein J, Luck T, Bickel H, Weeg D, Wagner M, Heser K, Maier W, Scherer M, Riedel-Heller SG, König HH. The impact of social engagement on health-related quality of life and depressive symptoms in old age - evidence from a multicenter prospective cohort study in Germany. Health Qual Life Outcomes 2017; 15:140. [PMID: 28705225 PMCID: PMC5513118 DOI: 10.1186/s12955-017-0715-8] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 06/29/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Thus far, only a few longitudinal studies investigated the impact of social engagement on health-related quality of life (HRQoL) and depressive symptoms in old age. Therefore, we aimed to examine the impact of social engagement on HRQoL and depressive symptoms in late life. METHODS Individuals aged 75 years and over at baseline were interviewed every 1.5 years in a multicenter prospective cohort study in Germany. While HRQoL was quantified by using the Visual Analogue Scale (EQ VAS) of the EQ-5D instrument, depressive symptoms was assessed by using the Geriatric Depression Scale (GDS). Individuals reported the frequency ("never" to "every day") of social engagement (e.g., engagement in the church, as a volunteer, in a party, or in a club) in the last four weeks. Fixed effects regressions were used to estimate the effect of social engagement on the outcome variables. RESULTS After adjusting for age, marital status, functional status and chronic diseases, fixed effects regressions revealed that the onset of social engagement markedly increased HRQoL and considerably decreased depressive symptoms in the total sample and in women, but not men. CONCLUSIONS Our findings corroborate the relevance of social engagement for HRQoL and depressive symptoms in old age. Encouraging the individuals to start, maintain and expand social engagement in late life might help to maintain and improve HRQoL and decrease depressive symptoms.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Christian Brettschneider
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tina Mallon
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Annette Ernst
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Silke Mamone
- Institute of General Practice, Hannover Medical School, Hannover, Germany
| | - Birgitt Wiese
- Institute of General Practice, Hannover Medical School, Hannover, Germany
| | - Siegfried Weyerer
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Jochen Werle
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Michael Pentzek
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Angela Fuchs
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Janine Stein
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Tobias Luck
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Horst Bickel
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Dagmar Weeg
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Michael Wagner
- Department of Psychiatry, University of Bonn, Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Kathrin Heser
- Department of Psychiatry, University of Bonn, Bonn, Germany
| | - Wolfgang Maier
- Department of Psychiatry, University of Bonn, Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Martin Scherer
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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46
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Gender-related differences in the multi-pathway effect of social determinants on quality of life in older age-the COURAGE in Europe project. Qual Life Res 2017; 26:1865-1878. [PMID: 28258420 PMCID: PMC5486906 DOI: 10.1007/s11136-017-1530-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2017] [Indexed: 11/05/2022]
Abstract
Purpose Gender-related differences in life expectancy, prevalence of chronic conditions and level of disability in the process of ageing have been broadly described. Less is known about social determinants, which may have different impacts on quality of life in men and women. The investigation aims to reveal gender-related differences in social determinants on quality of life assessed by a multi-pathway model including health, social, demographic and living place characteristics. Methods The study group consisted of 5099 participants aged 50+ representing general populations of three different European regions (Finland, Poland, Spain) who participated in COURAGE in EUROPE Project. Standardized tools were used to measure quality of life (WHOQOL-AGE) and social determinants (COURAGE Social Network Index, OSLO-3 Social Support Scale, UCLA Loneliness Scale, participation scale and trust). A multipath model considering exogenous predictors (demographic, economic), mediators (social) and endogenous outcome (QOL) was created to reveal the role of determinants. Gender-related differences were investigated across three age categories: 50–64; 65–79 and 80+. Results The model (RMSEA = 0.058; CFI = 0.939) showed the effects of all of the investigated determinants. Gender-related differences in the association between social constructs and QOL were observed for social networks in the group of 80+, for social support in the group of 50–64 and 65–79 years, and for social participation in the group of 65–79 years. Males benefited more (in QOL) from social networks and social support, and women from social participation. Conclusions The research provides valuable knowledge about the role of social determinants in QOL considering complex relations between different social constructs. Additionally, the results showed gender-related differences in the associations between social networks, social support, social participation and QOL, suggesting that men might benefit more from the interventions in the first two. Although our research did not investigate the effects of interventions, the results show directions for future investigations, how to shape social interventions at the population level to improve quality of life of older adults, and thus help achieve successful ageing. Electronic supplementary material The online version of this article (doi:10.1007/s11136-017-1530-8) contains supplementary material, which is available to authorized users.
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Health-related Quality of Life as Studied by EORTC QLQ and Voice Handicap Index Among Various Patients With Laryngeal Disease. J Voice 2017; 31:251.e17-251.e26. [DOI: 10.1016/j.jvoice.2016.07.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 07/08/2016] [Accepted: 07/15/2016] [Indexed: 11/19/2022]
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Auer MK, Liedl A, Fuss J, Nieder T, Briken P, Stalla GK, Hildebrandt T, Biedermann SV, Sievers C. High impact of sleeping problems on quality of life in transgender individuals: A cross-sectional multicenter study. PLoS One 2017; 12:e0171640. [PMID: 28199359 PMCID: PMC5310898 DOI: 10.1371/journal.pone.0171640] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 01/25/2017] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Studies in the general population suggest that determinants of QoL are often sex-dependent. Sex-dependent analyses of QoL in transgender populations have not been performed so far. AIM To identify sex-specific and potentially modifiable determinants of QoL in transgender patients. METHODS In this cross-sectional multicentre study including 82 transwomen (TW) and 72 transmen (TM) at different treatment stages, we investigated potential determinants for QoL focusing on the impact of mood (BDI, STAI-X), sleep quality (PSQI), chronic pain (GPQ), body image (FBeK) and social support (SSS). MAIN OUTCOME MEASURE Health-related quality of life measured with the Short Form (36) Health Survey (SF-36). RESULTS The age-adjusted SF-36 total score and its subscales did not significantly differ between TM and TW. Using a multivariate regression analysis approach, we identified common but also sex-dependent determinants for QoL (Adjusted R2 = 0.228; 0.650 respectively). Accounting for general characteristics such as age, BMI and treatment status, sleep quality according to the PSQI was an independent and strong determinant of QoL in both sexes (β = -0.451, p = 0.003 TM; β = -0.320; p = 0.0029 TW). Chronic pain was a significant independent predictor of QoL in TM (β = -0.298; p = 0.042) but not in TW. In contrast, anxiety (β = -0.451; p< 0.001) being unemployed (β = -0.206; p = 0.020) and insecurity about the own appearance (FBeK) (β = -0.261; p = 0.01) were independent predictors of QoL in TW. The rate of those reporting high sleep disturbances (PSQI ≥5) was high with 79.2% in TW and 81.2% in TM. Accordingly, age-adjusted QoL was also significantly lower in those reporting poor sleep in both sexes. CONCLUSIONS Sleep strongly affected QoL in both genders, while other factors, like pain and body image, seem to be gender specific in transgender individuals.
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Affiliation(s)
- Matthias K. Auer
- Research Group Clinical Neuroendocrinology, Max Planck Institute of Psychiatry, Munich, Germany
| | - Anita Liedl
- Research Group Clinical Neuroendocrinology, Max Planck Institute of Psychiatry, Munich, Germany
| | - Johannes Fuss
- Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Timo Nieder
- Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Peer Briken
- Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Günter K. Stalla
- Research Group Clinical Neuroendocrinology, Max Planck Institute of Psychiatry, Munich, Germany
| | - Thomas Hildebrandt
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Erlangen, Germany
| | - Sarah V. Biedermann
- Clinic of Psychiatry and Psychotherapy, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Caroline Sievers
- Research Group Clinical Neuroendocrinology, Max Planck Institute of Psychiatry, Munich, Germany
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Machón M, Larrañaga I, Dorronsoro M, Vrotsou K, Vergara I. Health-related quality of life and associated factors in functionally independent older people. BMC Geriatr 2017; 17:19. [PMID: 28088178 PMCID: PMC5237562 DOI: 10.1186/s12877-016-0410-3] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 12/31/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health-related quality of life (HRQL) is a key indicator of elderly people's health status that can be affected by different factors. However, little is known about which variables are associated with it in functionally independent elderly people. The aim of this project was to study HRQL and a wide variety of health, lifestyle, social and contextual aspects and their relation to HRQL in a sample of functionally independent, non-cognitively impaired community-dwelling adults, over 65 years of age, from a northern region of Spain. METHODS A cross-sectional study for which data was collected by face-to-face interviews with the selected individuals. HRQL was measured with the EuroQol-5D scale, consisting of a 5 item descriptive system and a visual analogue scale (VAS). VAS values lower than 70 were considered poor HRQL. Binary logistic regression was used to identify factors related to the outcome. RESULTS Six hundred and thirty-four individuals were included in the study. The mean age was 74.8 (SD 6.7) years, 55% of the participants were women and 46% rated their HRQL as poor. Several variables were found to be significantly associated with a poor HRQL in the multivariate model, adjusted for age and sex: polypharmacy (OR: 2.32, 95% CI: 1.62-3.31), the presence of sensory impairment (OR: 1.83, 95% CI: 1.24-2.69), not being engaged in cognitively stimulating activities (OR: 2.51, 95% CI: 1.03-6.16), or in group social activities (OR: 1.57, 95% CI: 1.11-2.22), low level of social support (OR: 3.12, 95%CI: 1.78-5.46) and the presence of obstacles in the closest home environment (OR: 1.83, 95%CI: 1.11-3.02). CONCLUSIONS The study identified a set of health, social and contextual variables as strongly related to HRQL in functionally independent community-dwelling older people. The results highlight the multidimensional nature of HRQL. They also reveal the importance of a comprehensive assessment of HRQL when designing adequate health-related programmes aiming to enhance active and healthy ageing and delay the onset of dependence.
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Affiliation(s)
- Mónica Machón
- Unidad de Investigación de Atención Primaria-OSIS Gipuzkoa, Osakidetza, Instituto Biodonostia, Paseo Doctor Beguiristian s/n, San Sebastián, 20014, Spain. .,Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Bilbao, Spain. .,Instituto de Investigación Sanitaria Biodonostia, San Sebastián, Spain.
| | - Isabel Larrañaga
- Instituto de Investigación Sanitaria Biodonostia, San Sebastián, Spain.,Departamento de Salud, Delegación Territorial de Gipuzkoa, Gobierno Vasco, San Sebastián, Spain
| | - Miren Dorronsoro
- Instituto de Investigación Sanitaria Biodonostia, San Sebastián, Spain.,Dirección de Salud Pública y Adicciones, Gobierno Vasco, Vitoria, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Kalliopi Vrotsou
- Unidad de Investigación de Atención Primaria-OSIS Gipuzkoa, Osakidetza, Instituto Biodonostia, Paseo Doctor Beguiristian s/n, San Sebastián, 20014, Spain.,Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Bilbao, Spain.,Instituto de Investigación Sanitaria Biodonostia, San Sebastián, Spain
| | - Itziar Vergara
- Unidad de Investigación de Atención Primaria-OSIS Gipuzkoa, Osakidetza, Instituto Biodonostia, Paseo Doctor Beguiristian s/n, San Sebastián, 20014, Spain.,Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Bilbao, Spain.,Instituto de Investigación Sanitaria Biodonostia, San Sebastián, Spain
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50
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Hajek A, Brettschneider C, Lühmann D, Eisele M, Mamone S, Wiese B, Weyerer S, Werle J, Pentzek M, Fuchs A, Stein J, Luck T, Bickel H, Weeg D, Heser K, Jessen F, Maier W, Scherer M, Riedel-Heller SG, König HH. Does Visual Impairment Affect Social Ties in Late Life? Findings of a Multicenter Prospective Cohort Study in Germany. J Nutr Health Aging 2017; 21:692-698. [PMID: 28537334 DOI: 10.1007/s12603-016-0768-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To investigate how visual impairment affects social ties in late life longitudinally. DESIGN Population-based prospective cohort study. SETTING Individuals in old age were recruited via general practitioners' offices (at six study centers) in Germany. They were interviewed every 18 months. PARTICIPANTS Individuals aged 75 years and above at baseline. Follow-up wave 2 (36 months after baseline, n=2,443) and wave 4 (72 months after baseline, n=1,618) were used for the analyses presented here. MEASUREMENTS Social ties were assessed using the 14-item form of the questionnaire for social support (F-SozU K-14). Visual impairment was self-rated on a three level Likert scale (no impairment, mild visual impairment, or severe/profound visual impairment). RESULTS Adjusting for sociodemographic factors, hearing impairment and comorbidity, fixed effects regressions revealed that the onset of mild visual impairment decreased the social support score, in particular the emotional support score. Additionally, the onset of mild hearing impairment decreased the social support score in men. Moreover, increasing age decreased the social support score in the total sample and in both sexes. Loss of spouse and increasing comorbidity did not affect the social support score. CONCLUSION Our results highlight the importance of visual impairment for social ties in late life. Consequently, appropriate strategies in order to delay visual impairment might help to maintain social ties in old age.
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Affiliation(s)
- A Hajek
- Dr. André Hajek, University Medical Center, Hamburg-Eppendorf, Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, Telephone +49 40 7410 52877; Fax +49 40 7410 40261, E-mail:
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