Social support network, social support, self-efficacy, health-promoting behavior and healthy aging among older adults: A pathway analysis

Toward a Medication Information Literacy Indicator System for Older Adults: A Delphi Study

BACKGROUND

The safety of medication use among older adults is a growing concern, given the aging population. Despite widespread attention, the exploration of medication literacy in older adults, particularly from the perspective of information literacy, is in its nascent stages.

METHODS

This study utilized the existing literature to define medication information literacy (MIL) as a theoretical framework. A two-round Delphi survey was conducted to identify the essential components of a MIL indicator system for older adults. The analytic hierarchy process (AHP) was then used to assign weights to each indicator.

RESULTS

The study observed relatively high response rates in both rounds of the questionnaire, which, along with expert authority coefficients (Cr) of 0.86 and 0.89, underscores the credibility and expertise of the panellists. Additionally, Kendall's coefficient of concordance (Kendall's W) ranging from 0.157 to 0.33 (p < 0.05) indicates a consensus among experts on the identified indicators. Utilizing the Delphi process, a MIL indicator system for older adults was developed, comprising five primary and 23 secondary indicators. These indicators were weighted, with medication information cognition and acquisition emerging as pivotal factors in enhancing medication literacy among older adults.

CONCLUSIONS

This study developed a MIL indicator system tailored for older adults using the Delphi approach. The findings can inform healthcare professionals in providing customized medication guidance and assist policymakers in crafting policies to enhance medication safety among older adults.

PATIENT OR PUBLIC CONTRIBUTION

Patient and public engagement played a pivotal role in the development of our medication information literacy indicator system for older adults. Their involvement contributed to shaping research questions, facilitating study participation, and enriching evidence interpretation. Collaborations with experts in geriatric nursing, medicine, and public health, along with discussions with caregivers and individuals with lived experience, provided invaluable insights into medication management among older adults. Their input guided our research direction and ensured the relevance and comprehensiveness of our findings.

Prevalence and influencing factors of chronic diseases among the elderly in Southwest China: A cross-sectional study based on community in urban and rural areas

Objective

To explore the influencing factors affecting chronic diseases of elderly in Kunming.

Methods

Data were collected from November 2020 to August 2021.The crosssectional study based on community was adopted. And hierarchical random sampling was used. A face to face questionnaire survey was conducted among the respondents or family caregivers. The contents we collected mainly include general demographic characteristics and other related influencing factors, self-reported chronic diseases and disability status.

Results

1161 elderly were investigated in total. The percentage of non-communicable chronic disease among the rural elderly was higher than that of urban elderly. Binary logistic regression analysis showed that in urban areas, female (OR: 0.592;95 %CI:0.396 ∼ 0.885), not in marriage (OR:1.643;95 %CI:1.093 ∼ 2.470)and not very satisfied with family support (OR:1.858;95 %CI:1.115 ∼ 3.096) are the influencing factors of chronic disease, while in rural areas are not in marriage (OR:1.961;95 %CI:1.021 ∼ 3.763), more health-promoting behavior (OR:0.582;95%CI:0.350 ∼ 0.970), not very satisfied with family support (OR:1.858;95 %CI:1.115 ∼ 3.096), age 70-79 (OR:1.805;95 %CI:1.705 ∼ 3.031), age 80 and above (OR:2.081;95 %CI:1.010 ∼ 4.288), empty nest family (OR:0.389;95 %CI:0.186 ∼ 0.811)and personal monthly income 2001-3000 (OR:0.353;95CI%:0.180 ∼ 0.693). The influencing factors of urban-rural multimorbidity and non-communicable chronic disease with disability also exist differences at individual, family and social levels.

Conclusions

The prevalence rate of non-communicable chronic diseases among the elderly in Yunnan Province is not optimistic. Personal, family and social factors would affect the non-communicable chronic diseases of the elderly and there exist difference in influencing factor of non-communicable chronic disease between urban and rural areas.

Self-neglect as a mediator between family functioning and healthy aging in older adults living alone in rural China: A cross-sectional study

OBJECTIVE

This study aims to investigate the mediating role of self-neglect among older adults in the relationship between family functioning and healthy aging.

METHODS

A questionnaire survey was conducted between June and September 2023, involving 255 older adults living alone in rural China. The healthy ageing, self-neglect, and family functioning was assessed using the Healthy Aging Instrument;the Elderly Self-neglect Assessment (Rural);and Family Adaptation, Partnership, Growth, Affection, and Resolve (APGAR) scale.

RESULTS

Positive correlations were found between family functioning and healthy aging (r = 0.363, p < 0.05). Moreover, self-neglect was identified as a significant mediator, explaining 40.84 % of the total effect.

CONCLUSION

Among older adults living alone in rural China, family functioning is significantly associated with healthy aging, with self-neglect mediating this relationship. These findings suggest that community-based interventions aimed at improving family functioning and addressing self-neglect behaviors might be beneficial for promoting healthy aging in this population.

Influence of Economic Connectedness on Pediatric Obstructive Sleep Apnea Severity and Adenotonsillectomy Outcomes

OBJECTIVE

To examine the influence of economic connectedness (EC), a measure of social capital, on obstructive sleep apnea (OSA) severity and adenotonsillectomy outcomes in children.

STUDY DESIGN

Retrospective study.

SETTING

Single tertiary medical center.

METHODS

The study population included 286 children who were referred for full-night polysomnography for OSA and underwent adenotonsillectomy. The primary outcome was the relationship between EC and the presence of severe OSA, and secondary outcomes included postoperative emergency room visits and residual OSA after adenotonsillectomy. Linear regression, Kruskal-Wallis test, Pearson's χ2 test, and multiple logistic regression were used for categorical and continuous data as appropriate.

RESULTS

In this population, the median age was 9.0 (interquartile range [IQR] = 6.9-11.7) and 144 (50.3%) were male. The majority were white (176, 62.0%), black (60, 21.1%), and/or of Hispanic ethnicity (173, 60.9%). The median EC of this population was 0.64 (IQR = 0.53-0.86). Higher EC was associated with decreased odds of having severe OSA (odds ratio: 0.17, 95% confidence interval = 0.05-0.61). However, EC was not associated with either postoperative emergency room visits or residual OSA.

CONCLUSION

EC was significantly associated with severe OSA (ie, apnea-hypopnea index ≥ 10) but not with postoperative emergency room visits or residual OSA after adenotonsillectomy. Further research is needed to understand the effects of various social capital measures on pediatric OSA and adenotonsillectomy outcomes.

Social support, health behavior self-efficacy, and anxiety on physical activity levels among lung cancer survivors: a structural equation modeling

PURPOSE

The study aims to investigate the relationship among social support, health behavior self-efficacy, anxiety, and the physical activity (PA) levels of lung cancer survivors, and to analyze whether health behavior self-efficacy and anxiety mediate the relationship between social support and PA levels.

METHODS

In a cross-sectional study of 1128 lung cancer survivors from 16 Chinese hospitals, we collected demographic data and administered the Social Support Rating Scale (SSRS), Self-Rated Abilities for Health Practices Scale (SRAHP), Anxiety Scale (AS), and International Physical Activity Questionnaire (IPAQ). SPSS 25.0 was used for descriptive analyses, while the structural equation model in SPSS AMOS 24.0 was used to identify the direct, indirect, and total effects among variables.

RESULTS

There were significant correlations among SSRS, SRAHP, AS, and PA (P < 0.01). Model outcomes revealed a positive association between social support and health behavior self-efficacy (β = 0.732, P < 0.001). Health behavior self-efficacy positively correlated with PA levels (β = 0.228, P < 0.001) and negatively with anxiety (β=-0.252, P = 0.001). Moreover, health behavior self-efficacy was found to partially mediate the relationship between social support and PA (β = 0.174, P < 0.001).

CONCLUSIONS AND IMPLICATIONS FOR CANCER SURVIVORS

This study revealed a positive correlation between social support and health behavior self-efficacy, and between health behavior self-efficacy and PA levels among lung cancer survivors. Additionally, health behavior self-efficacy mediated the relationship between social support and PA levels. In future clinical practice, medical and nursing staff should assess social support and health behavior self-efficacy in lung cancer survivors to inform personalized PA interventions.

Social Cognitive Predictors of Health Promotion Self-Efficacy Among Older Adults During the COVID-19 Pandemic

PURPOSE

To examine the relative importance of social cognitive predictors (ie, performance accomplishment, vicarious learning, verbal persuasion, affective state) on health promotion self-efficacy among older adults during COVID-19.

DESIGN

Cross-sectional.

SETTING

Data collected online from participants in British Columbia (BC), Canada.

SUBJECTS

Seventy-five adults (n = 75) aged ≥65 years.

MEASURES

Health promotion self-efficacy was measured using the Self-Rated Abilities for Health Practices Scale. Performance accomplishment was assessed using the health directed behavior subscale of the Health Education Impact Questionnaire; vicarious learning was measured using the positive social interaction subscale of the Medical Outcomes Survey - Social Support Scale (MOS-SSS); verbal persuasion was assessed using the informational support subscale from the MOS-SSS; and affective state was assessed using the depression subscale from the Depression Anxiety Stress Scale (DASS-21).

ANALYSIS

Multiple linear regression was used to investigate the relative importance of each social cognitive predictor on self-efficacy, after controlling for age.

RESULTS

Our analyses revealed statistically significant associations between self-efficacy and performance accomplishment (health-directed behavior; β = .20), verbal persuasion (informational support; β = .41), and affective state (depressive symptoms; β = -.44) at P < .05. Vicarious learning (β = -.15) did not significantly predict self-efficacy. The model was statistically significant (P < .001) explaining 43% of the self-efficacy variance.

CONCLUSION

Performance accomplishment experiences, verbal persuasion strategies, and affective states may be the target of interventions to modify health promotion self-efficacy among older adults, in environments that require physical and social distancing.

Self-Efficacy's Mediating Role in the Relationship Between Self-Perceived Burden and Health-Related Quality of Life Among Older-Adult Inpatients in China: A Cross-Sectional Study

Purpose

This study investigated the current state of self-efficacy and the association between self-perceived burden (SPB) and health-related quality of life (HRQoL) among Chinese older-adult inpatients.

Methods

A cross-sectional study was conducted using convenience sampling to survey Chinese older-adult inpatients. Data regarding demographic characteristics, self-efficacy, SPB, and HRQoL were collected. Pearson's correlation analysis was used to examine the correlations among the research variables. SPSS® Statistics V26.0, and SPSS® PROCESS Macro Model 4 were used to analyze the available data. The bootstrap method was used to analyze the mediating role of self-efficacy.

Results

Survey participants included 514 older-adult inpatients, with a mean age of 72.28±5.58 years. Self-efficacy (r=0.471, p<0.01) was positively correlated with HRQoL, whereas self-efficacy (r=-0.891, p<0.01) and HRQoL (r=-0.516, p<0.01) were negatively correlated with SPB. The mediating effect analysis revealed that self-efficacy either completely or partially mediated the effect of SPB on HRQoL, with the indirect effect accounting for 30.2% of the total.

Conclusion

This study provides a mediating model suggesting that SPB exerts both direct and indirect effects on the HRQoL of older-adult inpatients through self-efficacy.

Socially-supported sleep in older adults aged 50 and older: a concept analysis

Introduction

The population of older adults is growing disproportionately, constituting 13% of the global population in 2022, and is expected to double by 2050. One of public health's priorities is healthy aging, the maintenance of functional ability aligned with well-being. As many as 50% of older adults report poor sleep quality, leading to an increased risk of morbidity and mortality. The quality and quantity of social relationships may broadly benefit sleep in older adults. However, the concept of socially-supported sleep is underdeveloped as a basis for intervention.

Methods

Existing literature was searched without time restriction in PubMed, CINAHL, PsycINFO, and Scopus ending in August 2022. Thematic analysis was used to determine the defining attributes, antecedents, and consequences of socially-supported sleep guided by Rodgers' evolutionary concept analysis.

Results

Twenty-nine articles written in English, peer-reviewed, and examined social support and sleep in participants aged ≥50 were included. The defining attributes reflect dimensions of sleep quality. The antecedents are safe and secure, belonging and connection, and warmth and comfort. The consequences of socially-supported sleep include improved regulatory capabilities, physical and emotional well-being, and quality of life.

Conclusion

Socially-supported sleep has the potential to inform interventions that promote sleep in older adults. Ongoing research is needed to address the antecedents and mechanisms through which socially-supported sleep may promote sleep quality for healthy aging.

Osteoporotic quality of life, self-efficacy, and fracture protection behaviors in postmenopausal women

It is important for postmenopausal women to acquire bone health protective behaviors to protect them from fractures. For this reason, it is necessary to evaluate bone health during menopause and to inform women.

PURPOSE

This study was conducted to examine osteoporotic fracture protection behaviors, quality of life, and self-efficacy in postmenopausal women.

METHODS

In the study, the data were evaluated with the socio-demographic data form, Osteoporotic Fracture Protection Scale, Osteoporosis Self-Efficacy-Efficacy Scale, European Osteoporosis Foundation Quality of Life Questionnaire-41, which includes introductory information on socio-demographic characteristics.

RESULTS

It was determined that the postmenopausal women included in our study were between the ages of 45-92; more than half of them had chronic diseases; their average BMI was 29; and their DEXA score was - 3.00 ± 0.41. Among the people included in our study, those with a history of fractures had lower self-efficacy scores. It was determined that the fracture prevention scale scores of the participants were above the average, and the average of the osteoporosis-related quality of life score was high. In addition, it was determined that there was a strong positive correlation between self-efficacy and fracture prevention scale.

CONCLUSION

It is important to determine behaviors to prevent osteoporotic fractures in postmenopausal women, to raise the necessary awareness and to inform patients about the precautions to be taken. It is thought that it will increase patients' quality of life by increasing their disease-related self-efficacy. Therefore, there is a need for research on providing education to op patients and examining the results.

The association between intergenerational relationships and depression among older adults: A comprehensive systematic literature review

OBJECTIVE

This systematic review aims to comprehensively examine the relationship between intergenerational relationships and depression among older adults in Eastern Asian countries.

METHODS

For this research, a systematic search was conducted on several electronic databases including PubMed, Scopus, Web of Science, ScienceDirect, and Google Scholar search engine up until June 2023.

RESULTS

Out of 953 articles initially identified, 33 met the inclusion criteria. Emotional support and financial support emerged as crucial factors that can significantly reduce depressive symptoms among older individuals. However, there are diverse and sometimes contradictory results regarding the impact of intergenerational instrumental support on depression in older adults.

CONCLUSION

Promoting positive intergenerational relationships and enhancing support systems can greatly benefit the mental health of older adults by addressing depression within this population. This review enhances our understanding of the complex relationship between intergenerational relationships and depression among older adults. The diverse findings on intergenerational instrumental support and depression in older adults suggest the need for further research to clarify this relationship and its nuances. This research may have practical implications for policies and interventions aimed at improving the mental well-being of older adults in Eastern Asian countries.

Multiple Trajectories and Predictors of Self-Esteem Change in Later Life: A Latent Growth Mixture Modeling Approach

Applying latent growth mixture modeling (GMM), this study delves into the examination of self-esteem trajectories in a sample of 5,597 older adults over a nine-year period. Four distinct patterns of self-esteem changes have emerged: low, decreasing, increasing, and high. Additionally, the study explores the relationships between each trajectory and various predictors encompassing demographic factors, socioeconomic status, health, and interpersonal relationships. The findings highlight the significance of these factors in predicting the likelihood of an individual following a specific self-esteem trajectory. Notably, maintaining employment, fostering satisfactory social relationships, and being free of frequent depressive feelings emerged as strong predictors for the stability and increase of high self-esteem. Intriguingly, an average or above-average income was unexpectedly associated with lower levels of self-esteem. The study emphasizes the contribution of GMM to advancing aging research.

Longitudinal assessment of the relationship between frailty and social relationships among Japanese older adults: a random intercept cross-lagged panel model

OBJECTIVES

This study aimed to explore the bidirectional association between frailty and social relationships in older adults while distinguishing between interpersonal and intrapersonal effects.

METHODS

A prospective cohort study of community-dwelling older adults was conducted in Japan in three waves spanning six years with follow-ups in every three years. Random intercept cross-lagged panel model was used to explore temporal associations between frailty and social relationships.

RESULTS

Data for 520 participants (mean age 73.02 [SD 6.38] years, 56.7% women) were analyzed. Across individuals, frailty was associated with social relationships (β = -0.514, p < 0.001). At the interpersonal level, frailty was cross-sectionally associated with social relationships separately at T1(β = -0.389, p < 0.01), T2 (β = -0.343, p < 0.001) and T3 (β = -0.273, p < 0.05). Moreover, social relationships were associated with subsequent increases in symptoms of frailty in all measurement waves (β = -0.332, p < 0.001; β = -0.169, p < 0.01) and vice versa (β = -0.149, p < 0.05; β = -0.292, p < 0.001).

CONCLUSIONS

The results suggest that frailty was associated with lower levels of social relationships. Frailty improvement programs can be combined with interventions to enhance social relationships, which will be beneficial in preventing frailty. The results emphasize the importance of combining clinical treatments of frailty with interventions to improve social relationships.

Social Determinants of Intrinsic Capacity: A National Cohort Study

INTRODUCTION

Intrinsic capacity (IC), a composite of physical and mental capacities, is a marker of healthy aging. Social determinants of health (SDOH), namely the economic and social environments across a lifespan, are the most fundamental factors influencing health outcomes and health disparities. However, there is limited evidence on the influence of the individual and combined burden of the SDOH on IC.

METHODS

Data were obtained from the China Health and Retirement Longitudinal Study (2011-2015), and data analysis was conducted in 2023. Linear mixed-effect regression was employed to investigate the association between SDOH and IC in a longitudinal analysis.

RESULTS

This study comprised 7,669 participants (mean [SD] age, 68.5 [7.1] years; 49.8% female; mean [SD] IC, 7.2 [1.6]). In the longitudinal analysis, all five SDOH domains were independently and significantly associated with IC. The absence of social association within the social and community context domain exhibited the weakest association with IC (β: -0.11 [95% CI -0.20, -0.02]), while illiteracy within the education access and quality domain demonstrated the strongest association with IC (β: -0.51 [95% CI -0.60, -0.42]). Furthermore, the adverse effects of SDOH on IC became more distinguishable with the cumulative number of SDOH variables (coefficient for 2 SDOH, -0.41 [-0.64, -0.19]; 3 SDOH, -0.70 [-0.93, -0.48]; ≥4 SDOH, -1.10 [-1.33, -0.88]) compared with those without any SDOH.

CONCLUSIONS

Certain SDOH levels were significantly and negatively associated with IC. Targeted interventions may be needed to improve SDOH in individuals at high risk of poor IC.

Influences of Faith on Rural Appalachian Older Adult Health: An Ethnonursing Study

INTRODUCTION

Rural Appalachian older adults (RAOAs) constitute a vulnerable population and experience significant health disparities. The combination of age, poverty, rural residence, health care provider shortages, and limited transportation increases risks for poor health outcomes. Spirituality enhances older adult health; however, little is known about spirituality-health linkages of RAOAs. Therefore, the purpose of this study was to discover the influences of spirituality on RAOA health.

METHODOLOGY

Culture Care Theory and ethnonursing method guided analysis of 32 RAOA interviews in community settings in East Tennessee.

RESULTS

"Faith" is an integral component of RAOA culture and health. Three themes were extrapolated: (a) Relationship with God is personal; (b) faith beliefs and practices influence health, illness, death, and dying; and [the need to] (c) "Open the door" for spiritual care.

DISCUSSION

Faith assessment and spiritual care recommendations contribute to culturally congruent care for RAOAs and may be transferable to care for other older adults.

Characterizing Aging-Related Health in Older Women with a History of Incarceration: Multimorbidity, Polypharmacy, Mortality, Frailty, and Depression

OBJECTIVE

To characterize aging-related health in women with past CLSI and compare with women with no-CLSI.

METHOD

Health and Retirement Study Wave 11 and 12 data from women age >50 with CLSI were compared with data from women age >50 with no-CLSI. Generalized linear models were estimated for aging-related health outcomes.

RESULTS

The group with CLSI (n = 230) was significantly younger than the no-CLSI group (n = 8035) yet had more physical, functional, and mental health challenges and fewer resources. Incarceration significantly predicted aging-related outcomes of multimorbidity, polypharmacy, mortality, frailty, and depression.

DISCUSSION

Earlier onset of physical and functional health conditions in women with past CLSI has implications for health education and promotion, clinical practice, and intervention design.

Content validation of the nursing diagnosis "inadequate social support network"

OBJECTIVE

To evaluate evidence of content validity of the nursing diagnosis "inadequate social support network".

METHOD

A methodological study of the content validation type, carried out with 23 judges who evaluated the adequacy of the title, definition, class and domain of the nursing diagnosis "inadequate social support network". The judges also assessed the relevance of 28 clinical indicators and 32 etiological factors, which were considered valid when the Content Validity Index was ≥ 0.9.

RESULTS

The judges agreed with the proposed title and suggested changes to the definition of the nursing diagnosis. They recommended its inclusion in Domain 7 - "Roles and relationships" and Class 3 - "Role performance" of the NANDA-I taxonomy. In addition, 19 clinical indicators and 27 etiological factors were considered relevant.

CONCLUSION

The nursing diagnosis "inadequate social support network" had its theoretical structure validated in terms of content, which can support the practice of nurses in the operationalization of the Nursing Process.

Soluble Klotho, a Potential Biomarker of Chronic Kidney Disease-Mineral Bone Disorders Involved in Healthy Ageing: Lights and Shadows

Shortly after the discovery of Klotho, interest grew in its potential role in chronic kidney disease (CKD). There are three isoforms of the Klotho protein: αKlotho, βKlotho and γKlotho. This review will focus on αKlotho due to its relevance as a biomarker in CKD. αKlotho is synthesized mainly in the kidneys, but it can be released into the bloodstream and urine as soluble Klotho (sKlotho), which undertakes systemic actions, independently or in combination with FGF23. It is usually accepted that sKlotho levels are reduced early in CKD and that lower levels of sKlotho might be associated with the main chronic kidney disease-mineral bone disorders (CKD-MBDs): cardiovascular and bone disease. However, as results are inconsistent, the applicability of sKlotho as a CKD-MBD biomarker is still a matter of controversy. Much of the inconsistency can be explained due to low sample numbers, the low quality of clinical studies, the lack of standardized assays to assess sKlotho and a lack of consensus on sample processing, especially in urine. In recent decades, because of our longer life expectancies, the prevalence of accelerated-ageing diseases, such as CKD, has increased. Exercise, social interaction and caloric restriction are considered key factors for healthy ageing. While exercise and social interaction seem to be related to higher serum sKlotho levels, it is not clear whether serum sKlotho might be influenced by caloric restriction. This review focuses on the possible role of sKlotho as a biomarker in CKD-MBD, highlighting the difference between solid knowledge and areas requiring further research, including the role of sKlotho in healthy ageing.

Relationship Between eHealth Literacy and Healthy Aging in Older Chinese People: The Mediating Effect of Health Behaviors

OBJECTIVES

Healthy aging is an important means of promoting the well-being of older individuals. However, no studies have examined the relationship between eHealth literacy and healthy aging or its mechanism. Therefore, this study aimed to examine the relationship between eHealth literacy and healthy aging and the mediating effect of health behaviors in older Chinese individuals.

DESIGN

Cross-sectional study.

SETTING AND PARTICIPANTS

We recruited 2144 older individuals from Jinan, Shandong Province, China.

METHODS

We used the eHealth Literacy Scale to assess eHealth literacy. Healthy aging was evaluated based on multimorbidity, functional limitations, mild cognitive impairment, depressive symptoms, and social isolation. Moreover, health behaviors were assessed using the Health-Promoting Lifestyle Profile. Logistic and linear regression models were used to analyze the relationships between eHealth literacy, healthy aging, and its components. Finally, a structural equation model was used to analyze the mediation.

RESULTS

High eHealth literacy was associated with all healthy aging components (P < .05), including the absence of multimorbidity [odds ratio (OR), 1.014; 95% CI, 1.002-1.025], no functional limitation (OR, 1.035; 95% CI, 1.022-1.047), no mild cognitive impairment (OR, 1.042; 95% CI, 1.024-1.061), no depressive symptoms (OR, 1.049; 95% CI, 1.027-1.072), and no social isolation (OR, 1.033; 95% CI, 1.018-1.048). In the adjusted model, eHealth literacy (β = 0.174; 95% CI, 0.132-0.217) was positively correlated with healthy aging. Health behaviors had a partial mediating effect on the relationship between eHealth literacy and healthy aging.

CONCLUSIONS AND IMPLICATIONS

Higher eHealth literacy was associated with better healthy aging in older Chinese individuals, and health behaviors mediated this relationship. Improving eHealth literacy may be an effective intervention for achieving healthy aging.

Comparative Analysis of Social Networks in Institutionalized Older Adults versus Aging-in-Place Scenarios

(1) Background: This research aims to compare social networks among institutionalized and aging-in-place (AIP) older adults through the validation of a new questionnaire. (2) Methods: The cross-sectional study included 100 older adults (mean age: 73.53 ± 5.49 years; age range: 65-85 years), with 48 institutionalized subjects and 52 AIP subjects. We developed, validated, and administered a new questionnaire, the Social Network Assessment for Older People Questionnaire (SNAOPQ), to assess older adults' social networks using descriptive and inferential statistical methods. (3) Results: The SNAOPQ demonstrated excellent internal consistency (Cronbach's alpha of 0.91 and McDonald's omega of 0.91). Statistical analysis revealed significant associations between variables, highlighting differences in social networks between institutionalized and AIP individuals (p ≤ 0.001). Sociodemographic factors like age, education, living arrangement status, and number of descendants significantly influenced SNAOPQ scores (p ≤ 0.001). Age and residence type notably impacted participants' scores, indicating reduced social network size with age. Tertiary education and living in a couple were associated with more extensive social networks, while a higher number of descendants correlated with social network expansion. (4) Conclusions: Our study highlights significant differences in social networks among older adults based on residence type, emphasizing the impact of sociodemographic factors such as age, education, living arrangement, and the number of descendants.

Effects of engagement, persistence and adherence on cognitive training outcomes in older adults with and without cognitive impairment: a systematic review and meta-analysis of randomised controlled trials

BACKGROUND

Limited understanding exists regarding the influences of engagement, persistence and adherence on the efficacy of cognitive training for age-related cognitive decline and neurodegenerative cognitive impairment.

METHODS

This study conducted a meta-analysis of randomised controlled trials (RCTs). We systematically searched MEDLINE, PubMed, Web of Science, Embase and CINAHL databases from 1 January 2012 to 13 June 2023, and included RCTs assessing the effects of cognitive training in older adults, both with and without cognitive impairment. Hedges' g with a 95% confidence interval (CI) was used to synthesise cognitive training effect sizes on various neuropsychological tests. Subgroup analyses were conducted based on variables including engagement, persistence, adherence and cognitive conditions of normal cognition, mild cognitive impairment (MCI) or neurodegenerative dementia.

RESULTS

This meta-analysis included 55 RCTs with 4,455 participants with cognitive conditions spanning normal cognition, MCI and neurodegenerative dementia. The mean age of participants was 73.9 (range: 65.7-84.5) years. Overall, cognitive training showed a significant cross-domain effect (Hedges' g = 0.286, 95% CI: 0.224-0.348). Training effects are significant when engagement or persistence rates exceed 60% or when adherence rates exceed 80%. Higher levels of persistence are required to achieve significant training effects in memory, visuospatial ability and reasoning than in executive function and attention and language. Higher persistence is also required for older adults with normal cognition to achieve significant training gains compared to those with cognitive impairment.

CONCLUSIONS

This systematic review highlights the critical roles of engagement, persistence and adherence in augmenting the efficacy of cognitive training.

Relationship between intrinsic capacity and health-related quality of life among community-dwelling older adults: the moderating role of social support

PURPOSE

To examine how social support might moderate the relationship between intrinsic capacity and health-related quality of life (HRQoL) based on the buffering model of social support.

METHODS

This was a cross-sectional study with a sample of 1181 Chinese community-dwelling older adults aged ≥ 60 years in 2016. Social support was assessed using the Social Support Rating Scale. Intrinsic capacity was assessed using the revised integrated care for older people screening tool. HRQoL was measured by the 12-item Short Form Health Survey. Hierarchical linear regression analysis was implemented to test the moderating effect of social support.

RESULTS

Support utilization attenuated the relationship between lower intrinsic capacity and poor physical HRQoL while subjective support attenuated the relationship between lower intrinsic capacity and poor mental HRQoL. However, objective support had no significant moderating effect on the relationship between intrinsic capacity and specific domains of HRQoL.

CONCLUSION

The moderating effects of social support on the association between intrinsic capacity and HRQoL vary by support types. Effective interventions should target the perception and utilization of available support among older adults with lower intrinsic capacity to maintain their physical and mental HRQoL.

The associations between social support, self-regulatory fatigue, and health-promoting behaviors among people with type 2 diabetes mellitus: a cross-sectional survey

Background

The prevalence of diabetes in China is increasing annually, posing a serious public health challenge. Health-promoting behaviors are crucial for enhancing the quality of life in individuals with type 2 diabetes. However, the relationship between self-regulatory fatigue in type 2 diabetes, social support, and health-promoting behaviors remains unclear.

Objective

This study aimed to explore the interconnections among social support, self-regulatory fatigue, and health-promoting behaviors, as well as to examine the mediating role of self-regulatory fatigue in patients with type 2 diabetes mellitus.

Methods

A cross-sectional design was employed using the Self-Regulatory Fatigue Scale (SRF-S), the Social Support Rating Scale (SSRS), and the Health Promotion Scale for People with Diabetes Mellitus (T2DHPS). These scales assessed social support, self-regulatory fatigue, and health-promoting behaviors in 316 patients with type 2 diabetes mellitus, exploring the relationships among these variables. SPSS and AMOS were used for statistical analysis to investigate the mediating effects.

Results

Social support in type 2 diabetes mellitus positively predicted health-promoting behaviors (β = 0.401, p < 0.001). The regression coefficients of self-regulatory fatigue in patients with type 2 diabetes mellitus social support (β = -0.502, p < 0.001), and health-promoting behaviors (β = -0.331, p < 0.001), both exhibiting significant differences. Self-regulatory fatigue mediated the relationship between social support and health-promoting behaviors in these patients, with a mediation effect of 0.166, consisting of 29.28% of the total effect.

Conclusion

A significant interplay exists among social support, self-regulatory fatigue, and health-promoting behaviors in patients with type 2 diabetes mellitus. The findings suggest that self-regulatory fatigue mediates the relationship between social support and health-promoting behaviors. Healthcare professionals should focus on enhancing patients' social support to mitigate self-regulatory fatigue and improve health behaviors.

Parental Self-Efficacy Among Israeli Older Adults

Parental self-efficacy (PSE) is a central aspect of parenting research. Although parenting continues in older ages, few studies have focused on PSE among older adults. In line with the parenting determinant model, the study examined the associations between psychological distress, social support, loneliness, and PSE in older age.The study used a quantitative cross-sectional survey, including 362 Israeli parents age 65 years and above. Participants were asked to complete questionnaires of psychological distress, social support, loneliness, PSE, and background information.Results revealed that higher PSE was associated with lower psychological distress, higher social support, and a lower sense of loneliness in older adults. The research model explained 36.9 per cent of the variance in PSE among older adults.Mental state and social conditions are important for PSE of older adults; therefore, professionals should ensure the availability of diverse solutions to enable, maintain, and promote well-being through social and familial engagement in this population.

Impactos psicosociales de la pandemia de COVID-19 en mujeres de asentamientos rurales: estudio longitudinal

Resumen Objetivo: analizar los impactos psicosociales de la pandemia de COVID-19 en mujeres brasileñas de asentamientos rurales. Método: se trata de un estudio longitudinal cuantitativo con 13 mujeres asentadas. Los datos se recolectaron entre enero de 2020 y septiembre de 2021 mediante cuestionarios sobre percepción del entorno social (calidad de vida, apoyo social, autoeficacia), síntomas de trastorno mental común y aspectos sociodemográficos. Los datos se analizaron mediante estadística descriptiva, análisis de conglomerados y análisis de varianza. Resultados: se identificaron condiciones de vulnerabilidad entrelazadas que posiblemente exacerbaron los desafíos impuestos por la pandemia. El dominio físico de la calidad de vida fluctuó de manera diferente e inversa de acuerdo a los síntomas del trastorno mental. En cuanto al dominio psicológico, al final del segmento, se identificó un aumento en el tiempo en toda la muestra, dado que la percepción de las mujeres era mejor que antes de la pandemia. Conclusión: hay que destacar el empeoramiento de la salud física de las participantes que, probablemente, puede estar relacionado con la dificultad para acceder a los servicios de salud durante ese período y el miedo al contagio. A pesar de eso, las participantes fueron resilientes emocionalmente durante todo el período e, inclusive, tuvieron signos de mejoría en los aspectos psicológicos, lo que sugiere un posible efecto de la organización comunitaria del asentamiento.

Incorporating Physical Activity Assessments and Behavior Change Techniques Into Geriatrics

Ninety-one percent of adults 65 years and older do not perform the recommended levels of physical activity (PA), resulting in increased risk of disability, morbidity, and mortality. Despite knowing the benefits of PA and acknowledging the importance of assessing and addressing inadequate PA levels, 50%-75% of health care providers do not incorporate behavior change techniques into clinical practice. This clinical gap can be explained by a lack of knowledge or confidence in (1) assessing PA levels; (2) addressing inadequate PA levels; and (3) justifying the time needed to use these techniques in clinical practice. In this special communication, we address this gap by providing a 3-step theoretical-based clinical decision pathway that guides health care providers on how to identify older adults with inadequate PA levels, determine readiness to increase PA, and empower patents to develop an action plan that will increase their PA levels. We also provide a conceptual model that supports the use of techniques that assess and address inadequate PA by tying PA to the Age-Friendly Health System's 4Ms (ie, What Matters to the older adult, Mentation, Mobility, and Medications).

Os impactos psicossociais da pandemia de COVID-19 entre mulheres assentadas: estudo longitudinal

Resumo Objetivo: analisar os impactos psicossociais da pandemia de COVID-19 entre mulheres brasileiras de assentamentos rurais. Método: trata-se de um estudo quantitativo longitudinal com 13 mulheres assentadas. Os dados foram coletados entre janeiro de 2020 e setembro de 2021 utilizando questionários sobre a percepção do ambiente social (qualidade de vida, apoio social, autoeficácia), sintomas de transtorno mental comum e aspectos sociodemográficos. Os dados foram analisados por meio de estatística descritiva, análise de agrupamento e de variância. Resultados: foram identificadas condições de vulnerabilidade interseccionadas que, possivelmente, exacerbaram os desafios decorrentes da pandemia. O domínio físico da qualidade de vida oscilou diferentemente e inversamente de acordo com os sintomas de transtorno mental. Quanto ao domínio psicológico, no final do segmento, identificou-se em toda a amostra um incremento ao longo do tempo, pois a percepção das mulheres estava melhor do que antes da pandemia. Conclusão: a piora na saúde física das participantes merece destaque e, provavelmente, pode estar relacionada à dificuldade de acesso aos serviços de saúde neste período bem como ao medo da contaminação. Apesar disso, as participantes apresentaram-se emocionalmente resilientes em todo o período, inclusive, com sinais de melhora em relação aos aspectos psicológicos, sugerindo um possível efeito da organização comunitária do assentamento.

The development of depressive symptoms in older adults from a network perspective in the English Longitudinal Study of Ageing

An increased understanding of the interrelations between depressive symptoms among older populations could help improve interventions. However, studies often use sum scores to understand depression in older populations, neglecting important symptom dynamics that can be elucidated in evolving depressive symptom networks. We computed Cross-Lagged Panel Network Models (CLPN) of depression symptoms in 11,391 adults from the English Longitudinal Study of Ageing. Adults aged 50 and above (mean age 65) were followed over 16 years throughout this nine-wave representative population study. Using the eight-item Center for Epidemiological Studies Depression Scale, we computed eight CLPNs covering each consecutive wave. Across waves, networks were consistent with respect to the strength of lagged associations (edge weights) and the degree of interrelationships among symptoms (centrality indices). Everything was an effort and could not get going displayed the strongest reciprocal cross-lagged associations across waves. These two symptoms and loneliness were core symptoms as reflected in strong incoming and outgoing connections. Feeling depressed was strongly predicted by other symptoms only (incoming but not strong outgoing connections were observed) and thus was not related to new symptom onset. Restless sleep had outgoing connections only and thus was a precursor to other depression symptoms. Being happy and enjoying life were the least central symptoms. This research underscores the relevance of somatic symptoms in evolving depression networks among older populations. Findings suggest the central symptoms from the present study (everything was an effort, could not get going, loneliness) may be potential key intervention targets to mitigate depression in older adults.

Health Social Networks of Black Women With Hypertension

BACKGROUND

The prevalence of hypertension is 55% among African American/Black women, who have a higher risk for poor health outcomes compared to women from other racial and ethnic groups, in part because of uncontrolled blood pressure. Previous research results suggest that peers may positively influence self-management of chronic conditions like hypertension. However, few studies have described the personal characteristics of peers in the health social networks of Black women.

OBJECTIVE

This substudy aimed to examine health social networks and describe the peers' characteristics, as reported by a convenience sample of Black women with hypertension.

METHODS

In this analysis of data from a larger study, 94 Black women with hypertension attending a church conference participated in a cross-sectional, descriptive study. Their mean age was 59 years, and their mean systolic blood pressure was 143 mm Hg. All participants completed a survey to gather data about (a) the characteristics of individuals they discussed health matters with (their peers or health social network) and (b) their perceptions about hypertension status and knowledge of hypertension among the peers in their health social network.

RESULTS

Collectively, participants from the larger study named a total of 658 peers who were part of their health social networks; the mean health social network size was six peers. The peers were mostly women, Black, family members, and, on average, 54 years old. The participants discussed hypertension with 71% of the peers, reported that 36% had hypertension, and felt that 67% were somewhat or very knowledgeable about the condition. A small, positive correlation existed between the participants' health social network size (number of peers named) and their systolic blood pressure levels.

DISCUSSION

The health social network peers were similar to those in the larger study, with most of the same gender, race, and age. The findings of this analysis may be used to help practitioners and scientists guide patients in building health social networks for support in self-managing hypertension and conducting future studies to examine the best strategies for developing and using health social networks to improve health outcomes and reduce health disparities.

The impact of using community home-based elderly care services on older adults' self-reported health: fresh evidence from China

Background

The rapid population aging in China, characterized by a higher prevalence of illnesses, earlier onset of diseases, and longer durations of living with ailments, substantially engenders challenges within the domain of older adults' healthcare. Community home-based elderly care services (CHECS) are a feasible solution to solve the problem of older adults' care and protect older adults' health. The aim of this study is to investigate the relationship, heterogeneity effects and influential mechanisms between older adults' use of CHECS and their self- reported health.

Methods

The study employs the Instrumental Variable technique and empirically investigates the relationship, heterogeneity effects and influential mechanisms between older adults using CHECS and their self-reported health using data from the China Longitudinal Aging Social Survey from 2018.

Results

The findings indicate, firstly, that using CHECS considerably improves older adults' self-reported health. Secondly, the heterogeneity test reveals that the effect is more pronounced for older adults who are under the age of 80, have functional disabilities, are free of chronic diseases, have never attended school, reside in lower-income households, are single, rarely interact with their children, and live in central urban or city/county regions. Thirdly, the mechanism test reveals that the "social network effect" and "family care effect" are the key influence channels of using CHECS.

Conclusion

An empirical foundation for the policy reform of community home-based care for seniors is provided by this study with the limitations to discuss the other socioeconomic aspects such as government health expenditure and discuss the specific services aspects such as health care. The findings carry substantial implications for improving the health of older individuals and provide suggestions for establishing a socialized aged care system in China.

Factors associated with eating behaviors in older adults from a socioecological model perspective

BACKGROUND

The eating behaviors of older adults are associated with multiple factors. To promote older adults' healthy diets, it is imperative to comprehensively study the factors associated with the eating behaviors of the aging population group. This study aimed to probe the associated factors of older adults' eating behaviors from a socioecological model (SEM) perspective.

METHODS

In 2021, a cross-sectional survey was performed to recruit participants in China. The survey data were analyzed using a multivariate generalized linear model to identify the factors associated with eating behaviors in older adults. Standardized regression coefficients (β) and 95% confidence intervals (CIs) were estimated using a multivariate generalized linear model.

RESULTS

The survey contained 1147 valid older adult participants. Multivariate generalized linear model results showed that older adults with older age [aged 71-80 (β = -0.61), ≥ 81 (β = -1.12)], conscientiousness personality trait (β = -0.27), and higher family health levels (β = -0.23) were inclined to have better eating behaviors. The older adults with higher education levels [junior high school and high school (β = 1.03), junior college and above (β = 1.71)], higher general self-efficacy (β = 0.09), more severe depression symptoms (β = 0.24), and employment (β = 0.82) tended to have poorer eating behaviors.

CONCLUSIONS

This study identified factors that are specifically associated with older adults' eating behaviors from an SEM perspective. The comprehensive multiple-angle perspective consideration may be a valuable idea for studying healthy eating behaviors in older adults.

Associated factors of health-promoting lifestyle of the elderly based on the theory of social ecosystem

OBJECT

To explore the factors related to health-promoting lifestyles of the elderly based on social-ecosystem theory.

DESIGN

A cross-sectional survey study was carried out to include 627 elderly people in communities in three cities of Hebei Province (Shijiazhuang, Tangshan, and Zhangjiakou) from October 2021 to January 2022 for questionnaire survey (601 validly returned cases).

VENUE

Three cities of Hebei Province (Shijiazhuang, Tangshan, and Zhangjiakou).

PARTICIPANTS

627 elderly people.

INTERVENTIONS

A cross-sectional survey study.

MAIN MEASUREMENTS

The questionnaire survey was conducted by using the general demographic data, health promotion life scale, frailty scale, general self-efficacy scale, health engagement scale, General Self-Efficacy Scale, The family Adaptability, Partnership, Growth, Affection, and Resolve scale, and Perceived Social Support Scale.

RESULTS

The total health promotion lifestyle score for the elderly was 100.20±16.21, which was at the lower limit of the good level, with the highest mean score for nutrition (2.71±0.51) and the lowest mean score for physical activity (2.25±0.56). Stepwise linear regression showed that exercise frequency (95% confidence interval (CI) 1.304-3.885), smoking status (95% CI -4.190 to -1.556), self-efficacy (95% CI 0.071-0.185), health management (95% CI 0.306-0.590), frailty (95% CI -3.327 to -1.162) in the microsystem, marital status (95% CI 0.677-3.660), children's attention to the elderly health (95% CI 4.866-11.305), family care in the mesosystem (95% CI 1.365-4.968), and pre-retirement occupation (95% CI 2.065-3.894), living area (95% CI 0.813-3.912), whether receive community-based chronic disease prevention and management services (95% CI 2.035-8.149), social support (95% CI 1.667-6.493) in the macrosystem were the main factors affecting health promotion of life in the elderly (P<0.05). Hierarchical regression analysis showed the microsystem accounted for 17.2%, the mesosystem accounted for 7.1%, and the macrosystem accounted for 11.4%.

CONCLUSION

The health promotion lifestyle of the elderly in Hebei Province was at the lower limit of good level. Among them, exercise frequency, children's attention to the elderly health, and pre-retirement occupation played a major role in relation to the health-promoting lifestyle of the elderly. Hence, it needs the joint action of individuals, families, and society to promote the elderly to adopt the health promotion lifestyle and realize healthy aging.

Predictors of post-stroke depression: the perspective from the social convoy model

BACKGROUND

Post-stroke depression (PSD) as one of the most common neuropsychiatric disorders after a stroke and is caused by many factors. However, the relationships among different factors and their potential contributions to PSD remain unclear.

METHODS

Two hundred and seventy-six patients were recruited into this study. The general information questionnaire, the Patient Health Questionnaire-9, the Perceived Social Support Scale, the Family Assessment Device, the General Well-Being Scale, the Barthel Index, and the modified Rankin Scale were used to assess the condition of patients. Subsequently, we identify the main causes associated with the PSD and then performed a path analysis to clarify the direct, indirect and total effects among the variables.

RESULTS

We found that age, stroke with coronary heart disease, neurological function, family function, social support, and general well-being had a significant impact on PSD (P < 0.05). Of these, neurological function had the largest total effect on PSD (β = 0.451), social support contributed the most as a direct effect (β = -0.306), and family function showed the largest indirect effect (β = -0.264).

CONCLUSION

Individual, disease, and social-psychological factors all contributed to the development of PSD. We should pay more attention to comprehensive assessment, especially for those with poor neurological function, and lacking family or social support. In addition, it would be preferable to provide them with necessary support and care strategies to reduce the incidence of PSD.

Avoiding threats, but not acquiring benefits, explains the effect of future time perspective on promoting health behavior

Promoting health behavior among the public is always a pressing issue. The present research systematically investigated the association between future time perspective and adherence to health behavior including dietary habits, physical activities, and substance use in a Chinese college student sample (N = 519). Results showed that individuals with stronger future time perspective were more likely to adhere to health behavior. Moreover, building upon the health belief model and the protection motivation theory, the present research further explored the underlying mechanisms. Results revealed that it is perceived threats of not carrying out health behavior, but not perceived benefits of carrying out health behavior, that asymmetrically explained the association between stronger future time perspective and greater adherence to health behavior. These findings contribute to both the future time perspective literature and the health behavior literature.

Examining the social networks of older adults receiving informal or formal care: a systematic review

PURPOSE

To address the care needs of older adults, it is important to identify and understand the forms of care support older adults received. This systematic review aims to examine the social networks of older adults receiving informal or formal care and the factors that influenced their networks.

METHODS

A systematic review was conducted by searching six databases from inception to January 31, 2023. The review included primary studies focusing on older adults receiving long-term care, encompassing both informal and formal care. To assess the risk of bias in the included studies, validated appraisal tools specifically designed for different study types were utilized. Network analysis was employed to identify the grouping of study concepts, which subsequently formed the foundation for describing themes through narrative synthesis.

RESULTS

We identified 121 studies relating to the formal and informal care of older adults' networks. A variety of social ties were examined by included studies. The most commonly examined sources of care support were family members (such as children and spouses) and friends. Several factors were consistently reported to influence the provision of informal care, including the intensity of networks, reciprocity, and geographical proximity. In terms of formal care utilization, older age and poor health status were found to be associated with increased use of healthcare services. Additionally, physical limitations and cognitive impairment were identified as factors contributing to decreased social engagement.

CONCLUSION

This review found that older people were embedded within a diverse network. The findings of this review emphasize the importance of recognizing and incorporating the diversity of social networks in care plans and policies to enhance the effectiveness of interventions and improve the overall well-being of older adults.

The Associations between Cognitive Function, Depressive Symptoms, and Contact with Adult Children in Older Couples

The aim of this study was to investigate the association between cognitive function and depressive symptoms in older couples while also examining the relationship between cognitive performance and the frequency of contact with adult children. A total of 96 couples volunteered for this study and provided their informed consent at enrollment. Participants completed a neuropsychological test battery consisting of five cognitive domains: attention, language and related functions, visuospatial functions, memory, and frontal/executive functions. Symptoms of depression were assessed using the short version of the Geriatric Depression Scale. The number of contacts with children was categorized into ≥1 per month and <1 per month. We found that the cognitive functions of husbands with depressed wives were significantly lower in the frontal/executive functions. In contrast, the wives' cognitive performance was not associated with the husbands' depressive symptoms. For couples who had contact with their adult children less than once a month, the odds of the husbands with lower cognitive performance were significantly higher, which was reflected in their scores in visuospatial and executive functions. Among older married couples, the cognitive functions of husbands may be influenced more by their wives' mental health and degree of contact with their adult children. This infers that wives and offspring may act as a buffer against the cognitive impairment of older married men.

Relationships among Square Dance, Group Cohesion, Perceived Social Support, and Psychological Capital in 2721 Middle-Aged and Older Adults in China

(1) Background: Aging is a global phenomenon, and China's aging is extensive and rapid and already at the middle to upper level worldwide. Promoting social interaction and increasing positive psychological qualities in individuals are key components in helping people adapt to the physical and mental changes of the aging process. Among them, how middle-aged and older adults improve their physical and mental health through physical activity is of great concern. (2) Methods: This study measured the physical activity of 2721 middle-aged and elderly square dance participants across China, and structural equation modeling was applied to explore the relationship between square dance exercise and group cohesion as well as the role of perceived social support and psychological capital. (3) Results: The results showed that (a) square dance exercise positively predicts group cohesion among middle-aged and older adults. (b) Perceived social support and psychological capital mediate the relationship between square dance exercise and group cohesion, and the mediating role consists of three pathways: perceived social support alone, psychological capital alone, and perceived social support-psychological capital chain mediation. (c) The mediating effect of psychological capital alone is greater than the mediating effect of perceived social support alone and the mediating effect of the perceived social support-psychological capital chain. (4) Conclusions: This study provides support for the theory and practice of square dance exercise and intervention guidance for increasing positive psychological qualities and group dynamic levels in middle-aged and older adults.

Association of intergenerational relationship and supports with cognitive performance in older adults: A systematic review

OBJECTIVE

As individuals age, cognitive decline can significantly impact their quality of life. This systematic review aims to investigate the potential association between parent-child relationships among older adults in Eastern Asian countries and their cognitive performance.

METHODS

For this research, a systematic search was conducted on several electronic databases including PubMed, Scopus, Web of Science, ScienceDirect, and Google Scholar search engine, up to March 2023.

RESULTS

Out of 418 articles, 6 were eligible for inclusion in the study. The findings suggest that intergenerational relationships, particularly emotional support and two-way financial communications, are associated with maintaining cognitive health in older adults.

CONCLUSIONS

Intergenerational relationships affect cognitive health in older adults, with implications for healthcare, social welfare, and the economy. Further research is required to investigate the effects of children's visits on cognitive health and explore the complexities of intergenerational relationships on cognitive health in aging populations.

Differences in Loneliness and Social Isolation among Community-Dwelling Older Adults by Household Type: A Nationwide Survey in Japan

(1) Background: Social isolation and loneliness are determinants of healthy longevity. However, previous research has focused on either social isolation or loneliness and has not considered household types. This study sought to clarify loneliness and social isolation among older adults using single-person (ST) or multi-person (MT) household types. (2) Methods: We administered a national, anonymous, self-administered survey to 5351 Japanese older adults aged 65 years or older. The survey included subjects' demographic characteristics and scores for loneliness (University of California Los Angeles (UCLA) Loneliness Scale version 3 (Cronbach's α = 0.790)), social isolation (Lubben Social Network Scale (LSNS-6) (Cronbach's α = 0.82)), and self-efficacy (GSES). (3) Results: After adjusting for age and gender, ST individuals had significantly lower LSNS-6 and significantly higher UCLA scores than MT individuals (p < 0.001). Lower LSNS-6 and higher UCLA scores were significantly associated with lower GSES scores, and the effect of GSES was greater for ST than for MT (LSNS-6, ST (β = 0.358, p < 0.001); MT (β = 0.295, p < 0.001)) (UCLA, ST (β = -0.476, p < 0.001); MT (β = -0.381, p < 0.001)). (4) Conclusions: Specific healthcare systems and programs based on self-efficacy should be developed by household type to reduce both social isolation and loneliness.

Individual and environmental factors associated with successful aging among Korean older adults: Multilevel analysis of cross-sectional nationwide survey data

PURPOSE

The importance of environmental influences on successful aging has recently been emphasized. However, existing studies that investigated environmental factors related to successful aging in older adults did not apply multi-level analysis while simultaneously examining individual and environmental factors related to successful aging. Therefore, this study aimed to determine the level of successful aging in older adults and the individual and environmental factors related to successful aging.

MATERIALS AND METHODS

Data from a nationwide survey were used. The study comprised a cross-sectional sample of 73,942 community-dwelling adults aged ≥65 years with individual-level data drawn from the 2019 Korea Community Health Survey. Community-level data of 255 local administrative districts (cities or counties) were extracted from the Community Health Determinant Database from 2017 to 2019. These data were merged and used in multi-level logistic regression analyses.

RESULTS

Generally, 27.1% of the participants achieved successful aging. Individual factors including sex, age, marital status, education level, job, monthly household income, smoking, physical activity, and body mass index were significantly associated with successful aging. Four environmental factors, urban residential area, social network, satisfaction with living environment, and air quality, were positively associated with successful aging at the community level; among them, high satisfaction with living environment (OR = 6.06, 95% CI: 2.43-15.12) was the most strongly associated factor with successful aging.

CONCLUSIONS

The findings suggest that environmental factors are essential for successful aging among older adults in addition to individual factors. Therefore, multiple strategies considering individual and environmental factors are needed to improve successful aging.

Effect of different types of social support on physical frailty development among community-dwelling older adults in Japan: Evidence from a 10-year population-based cohort study

PURPOSE

Social support is associated with multiple positive health outcomes and is negatively associated with frailty in older adults. However, most evidence came from cross-sectional research. This study aimed to longitudinally explore the relationship between different types of social support and incident physical frailty.

MATERIALS AND METHODS

A 10-year prospective cohort study data from the National Institute for Longevity Sciences - Longitudinal Study of Aging (NILS-LSA) database, from 2000 to 2012 on older adults aged ≥65 years were analyzed excluding those with physical frailty at baseline, missing data, or not attending follow-up. We measured three kinds of social support, whether from within or outside family members, including emotional, instrumental, and negative support. The generalized estimating equation (GEE) model was used to examine the longitudinal relationships between social support and subsequent frailty.

RESULTS

The final analysis included 466 participants, with an average age of 71.3 (standard deviation [SD], 4.3) years and 7.33 years of follow-up (SD, 3.11). GEE analysis showed that emotional and instrumental supports from within and outside family members were associated with a significantly lower risk of physical frailty (odd ratio (OR) and 95% confidence interval (CI): 0.80 [0.64-1.00] and 0.74 [0.58-0.95]; 0.77 [0.60-0.99] and 0.79 [0.63-0.99], respectively). Both negative support from within or outside family members had no significant relationship with the risk of physical frailty.

CONCLUSIONS

This longitudinal study suggested that emotional, and instrumental support both from within or outside family members can reduce future physical frailty among older adults.

How does social support interact with intrinsic capacity to affect the trajectory of functional ability among older adults? Findings of a population-based longitudinal study

BACKGROUND

The ecological model of health and ageing has proposed that functional ability (FA) is determined by the interaction between intrinsic capacity (IC) and environmental characteristics. This study empirically examined how social support, as an important social environmental resource, interacts with IC to affect FA trajectories among older adults.

METHODS

This was a prospective three-wave cohort study with a sample of 775 community-dwelling older adults. Social support, IC and FA were assessed using the Social Support Rating Scale, the revised Integrated Care for Older People screening tool and the Lawton Instrumental Activities of Daily Living Scale, respectively. Latent growth curve models (LGCM) were implemented to test their relationships.

RESULTS

FA significantly declined over 3 years, and the detrimental effect of impaired IC on the deterioration rate of FA was buffered by subjective support but was aggravated by support utilization and was not changed by objective support. FA decline among older adults with impaired IC was observed in those with low subjective support or with high support utilization but not in those with high subjective support or with low support utilization. Among older adults with intact IC, FA decline was observed in those with low support utilization but not in those with high support utilization or with low or high subjective support.

CONCLUSIONS

Subjective support may prevent FA decline among older adults with impaired IC, while support utilization may benefit older adults with intact IC but may be detrimental for those with impaired IC. Social support interventions to optimize FA trajectories should improve older adults' perceptions of support and bridge the gap in support utilization among older adults with impaired IC.

Latent profile analysis of depression among older adults living alone in China

BACKGROUND

The number of older adults living alone has increased significantly. Depression is one of the significant mental health problems they face; classifying depressive conditions into homogeneous subgroups can help discover hidden information.

METHODS

The data comes from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Latent profile analysis (LPA) was used to identify depression subgroups among elderly living alone, Chi-square tests and Kruskal-Wallis tests were used to univariate analysis, multinomial logistic regression was used to analyze the related factors.

RESULTS

1831 older adults living alone were identified and classified as low-level (30.4 %), moderate-level (55.3 %) and high-level (14.4 %). All variables, except age, were significant in the univariate analysis. Multinomial logistic regression showed that not participating in exercise, sometimes interacting with friends, anxiety symptoms, and impaired IADL were associated with the moderate- and high-level of depression in older adults living alone; good or fair self-rated health and life satisfaction were associated with the low-level of depression in older adults living alone. Anxiety symptoms were associated with high-level of depression in older adults living alone compared to moderate-level; good or fair self-rated health and life satisfaction were associated with moderate-level of depression in older adults living alone.

LIMITATIONS

The CES-D-10 cannot fully determine the presence of depression in elderly people living alone at high-level.

CONCLUSIONS

In future primary health care, it would be more meaningful to provide targeted interventions for different subgroups of depression in older adults living alone.

Associations between media use, self-efficacy, and health literacy among Chinese rural and urban elderly: A moderated mediation model

Objectives

The influence of media use on health literacy among urban and rural elderly has been unknown in China. This study aims to examine the association between media use and health literacy and to explore the mediating role of self-efficacy and the moderating role of urban-rural residency.

Methods

Based on the cross-sectional study of the Psychology and Behavior Investigation of Chinese Residents (PBICR) in 2022, a total of 4,070 Chinese old people aged 60 years and above were included. We adopted the simplified New General Self-Efficacy Scale (NGSES) and the simplified Health Literacy Scale-Short Form (HLS-SF) to measure self-efficacy and health literacy. Media use was measured using a self-administrated questionnaire.

Results

Results showed that Chinese urban elderly had a higher frequency of media use than rural ones in the aspects of social activities, self-presentation, social action, leisure and entertainment, information acquisition, and business transactions through media (P &lt; 0.001). Among all participants, self-presentation (B = 0.217, 95% CI: 0.040, 0.394), leisure and entertainment (B = 0.345, 95% CI: 0.189, 0.502), and information acquisition (B = 0.918, 95% CI: 0.761, 1.076) were significantly associated with health literacy. Self-efficacy partially mediated the effect of media use on health literacy (Bindirect = 0.045, 95% CI: 0.032, 0.058), accounting for 18.37% of the total effect. Urban-rural residency (B = 0.049, 95% CI: 0.024, 0.075) moderated the relationship between media use and self-efficacy significantly.

Conclusion

The urban-rural gap in health literacy requires more attention. The promotion of media use and self-efficacy may play a role in eliminating health disparities.

Limitations

As a cross-sectional study, it could not establish cause-effect relationships.

Impact of Social Support on Physical Activity in Adults With Heart Failure: The Mediating Effect of Resilience

This study aimed to evaluate the impact of resilience and social support on physical activity in adults with heart failure (HF) and to explore the mediating effect of resilience on the relationship between social support and physical activity. A cross-sectional study was conducted with 197 adults with HF (n = 197) from two outpatient departments for cardiovascular diseases. Resilience was assessed using the Connor-Davidson Resilience Scale, social support using the Social Support Rating Scale, and physical activity using the short form of the International Physical Activity Questionnaire. Social support and resilience were significantly associated with physical activity in adults with HF. Resilience partially mediated the relationship between social support and physical activity, and the mediating effect accounted for 25.93% of the total effect of social support on physical activity. These findings contribute to the development of tailored interventions by targeting these two factors to increase physical activity levels in adults with HF.

Factors Related to Physical Activity among Older Adults Who Relocated to a New Community after the Kumamoto Earthquake: A Study from the Viewpoint of Social Capital

Previous studies have shown an association between social capital and physical activity in older adults. Older adults who relocated after the Kumamoto earthquake may become physically inactive, and the extent of this inactivity may be buffered by social capital. Accordingly, this study applied the social capital perspective to examine factors that affect the physical activity of older adults who relocated to a new community after the Kumamoto earthquake. We conducted a self-administered mail questionnaire survey with 1494 (613 male, 881 female, mean age 75.12 ± 7.41 years) evacuees from temporary housing in Kumamoto City, aged 65 years and above, who relocated to a new community after the earthquake. We performed a binomial logistic regression to examine the factors affecting participants' physical activity. The results showed that physical inactivity (decreased opportunities for physical activity, decreased walking speed, and no exercise habits) was significantly associated with non-participation in community activities, lack of information about community activities, and being aged 75 years and over. Lack of social support from friends was significantly associated with lack of exercise habits. These findings encourage participation in community activities, alongside giving and receiving social support in health activities that target older adults who relocated to new communities after the earthquake.

Multidimensional Assessment of Subjective Well-Being and Risk of Dementia: Findings from the UK Biobank Study

This study aimed to examine the associations between subjective well-being (SWB) and risk of all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VD). We adopted a multidimensional approach to SWB that included the level and breadth of SWB, the latter indicating the extent to which SWB spreads across life domains. Participants (N=171,197; mean age=56.78; SD=8.16 years) were part of the UK Biobank and were followed up to 8.78 years. Domain-general and domain-specific SWB were measured by single items, and the breadth of SWB was indexed with a cumulative score of satisfaction across domains. Dementia incidence was ascertained through hospital and death records. Cox regression was used to examine the association between SWB indicators and risk of all-cause dementia, AD, and VD. General happiness, health and family satisfaction, and satisfaction breadth (satisfaction in multiple domains) were associated with lower risk of all-cause dementia. The associations held after accounting for socio-demographics, health, behavioral, and economic covariates, and depressive symptoms. Health satisfaction and the breadth of satisfaction were also associated with lower risk of AD and VD, with a pattern of slightly stronger associations for VD compared to AD. Some life domains (e.g., health) may be more fruitfully targeted to promote well-being and help protect against dementia, but it is also important to enhance well-being across multiple domains to maximize the protective effects.

Social Network Influence on Syphilis Testing for Black Sexual Minority Men in Baltimore, Maryland: A Cross-sectional Social Network Analysis

ABSTRACT

Black sexual minority men (BSMM), including those with HIV, have disproportionate rates of syphilis infection. This study examines the associations of social network characteristics on syphilis testing, given that social network approaches are well established as effective methods to establish health-promoting social norms. We analyzed baseline data from a sexual health behavioral intervention. Using multivariable logistic regression, we modeled individual and social network characteristics on syphilis testing. Of the 256 participants, 37% tested for syphilis in the past year. In the adjusted model controlling for individual factors, odds of syphilis testing increased 89% for each increase in network member participants being encouraged to get a syphilis test (95% confidence interval [1.19-3.00]). Feeling comfortable accompanying a friend for HIV/sexually transmitted infection testing was associated with 2.47 increased odds of syphilis testing. Encouraging and training individuals to discuss sexual health topics with their network members may lead to the establishment of testing in social networks of Black sexual minority men.

Psychosocial impacts of the COVID-19 pandemic among settled women: A longitudinal study

OBJECTIVE

to analyze the psychosocial impacts of the COVID-19 pandemic among Brazilian women from rural settlements.

METHOD

this is a quantitative and longitudinal study conducted with 13 settled women. The data were collected between January 2020 and September 2021 using questionnaires on the perception of the social environment (quality of life, social support, self-efficacy), common mental disorder symptoms and sociodemographic aspects. The data were analyzed using descriptive statistics, cluster analysis and variance analysis.

RESULTS

intersecting vulnerability conditions were identified that possibly intensified the challenges arising from the pandemic. The Quality of Life physical domain fluctuated differently and inversely according to the mental disorder symptoms. As for the psychological domain, at the end of the segment, an increase over time was identified in the entire sample, as the women's perception was better than before the pandemic.

CONCLUSION

worsening of the participants' physical health deserves to be highlighted and, probably, it can be related to the difficulty accessing health services in this period as well as to the fear of contamination. Despite this, the participants were emotionally resilient throughout the period, including signs of improvement in terms of psychological aspects, suggesting a possible effect of the community organization of the settlement.

The impact of infectious disease prevention behavior on quality of life: A moderated mediation model

Objective

To explore the mechanism of infectious disease prevention behavior on quality of life, and to investigate the mediating role of self-efficacy and the moderating role of family structure.

Methods

A total of 3015 subjects were selected by multistage stratified cluster sampling.

Results

Infectious disease prevention behavior had a significant positive predictive effect on the quality of life (β = 0.08, p < 0.001), The self-efficacy of family members had a partial mediating effect on the relationship between infectious disease prevention behavior and quality of life (β = 0.01, p < 0.001). Compared to nuclear family, conjugal family (β = 0.05, p < 0.001) and single-parent family (β = 0.04, p < 0.01) could regulate the relationship between infectious disease prevention behavior and the quality of life, stem family (β = -1.53, p < 0.05), conjugal family (β = 1.63, p < 0.05), and collective family (β = -1.37, p < 0.05) could regulate the relationship between infectious disease prevention behavior and self-efficacy, conjugal family (β = 0.00, p < 0.001) could regulate the relationship between self-efficacy and quality of life.

Conclusion

Infectious disease prevention behavior can affect the quality of life through self-efficacy. Different family structures play a regulatory role in different paths, and a regulatory mediation model is established.

Trajectories of Preventive Health Care Utilization Among Older Koreans: The Role of Social Relationships

Background

Receiving timely health screening is associated with important public health benefits among older adults. By focusing on the role of social relationships, the present study was aimed at examining longitudinal trajectories of health screening use among older adults in Korea, whose universal health care system provides free-of-charge health screening.

Methods

A nationally representative sample of 3,575 individuals aged 65 or older from wave one of the Korean Longitudinal Study of Aging (2006) was followed for 10 years (up to Wave 6, 2016). Mixed-effect logit models were used to investigate how an older adult’s social relationship characteristics (i.e., household composition, financial support from family, social group participation, and the frequency of contact with friends or relatives) were associated with their trajectories of participation in the national health screening program.

Results

Despite the low financial burden, only 49.7% of older adults in Korea reported receiving the recommended health screening at the baseline. Although the probability of receiving recommended health screening increased over the 10-year study period, the trajectories were significantly different by an older adult’s social relationship characteristics. All four social relationship characteristics were significantly associated with receiving health screening. However, those with more frequent social contacts and those who participated in social groups showed steeper increases in the probability of receiving health screening (i.e., significant interaction with time).

Conclusions

This study highlights the importance of social relationships and intervention approaches that accommodate socially isolated older adults to facilitate their timely receipt of recommended preventive care.