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Saha A, Govil D, Muhammad T, Thomas AR. Unveiling the dynamics of social engagement and subjective health in older adults: A gendered perspective. Exp Gerontol 2024; 193:112472. [PMID: 38821323 DOI: 10.1016/j.exger.2024.112472] [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: 03/20/2024] [Revised: 05/23/2024] [Accepted: 05/24/2024] [Indexed: 06/02/2024]
Abstract
OBJECTIVES As populations age globally, understanding the dynamics that influence the well-being of older individuals become increasingly crucial. The research employs a comprehensive approach to unravel the multifaceted interplay between social engagements and subjective health perceptions of older Indians, with a special focus on gender differences. SUBJECTS AND METHODS This study used data from the Longitudinal Aging Study in India (LASI) wave 1, 2017-18 with a total sample of 30,533 older adults aged 60 years and above. Bivariate analysis, chi-square tests and unadjusted and adjusted average marginal effects from logistic regression models were used to assess the relationship between social engagements and subjective health among older adults, stratified by gender. RESULTS The prevalence of poor health status decreased with higher frequency of social networks among both men (pp. (percentage point) = 6.1; CI (Confidence Interval): 10.6, 1.6) and women (pp. = 9.2; CI: 14.9, 3.4). The adjusted average marginal effects demonstrate that with an increase in the overall score of social engagement, the likelihood of poor health is almost reduced by half. For men, the prevalence of poor health was 9.8 pp. (95 % CI: 13.7, 5.8), while for women, it was 9.3 pp. (95 % CI: 15.2, 3.1). CONCLUSION Gendered perspectives unveil unique patterns, highlighting how societal expectations and roles assigned to each gender may influence the subjective health perceptions of older individuals. This study adds to the expanding knowledge base to enhance the well-being and fulfillment of aging populations, considering the complex interplay of social dynamics and gendered perspectives.
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Affiliation(s)
- Amiya Saha
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, - 400088, India.
| | - Dipti Govil
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, - 400088, India
| | - T Muhammad
- Department of Human Development and Family Studies, The Pennsylvania State University, PA- 16802, USA
| | - Arya Rachel Thomas
- School of Humanities and Social Sciences, Indian Institute of Technology, Madras, India
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Dillard LK, Matthews LJ, Dubno JR. Prevalence of self-reported hearing difficulty on the Revised Hearing Handicap Inventory and associated factors. BMC Geriatr 2024; 24:510. [PMID: 38867166 PMCID: PMC11167844 DOI: 10.1186/s12877-024-04901-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: 08/03/2023] [Accepted: 03/19/2024] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND Hearing loss is common in aging adults and is an important public health concern. Self-reported measures of hearing difficulty are often used in research and clinical practice, as they capture the functional impacts of hearing loss on individuals. However, little research has evaluated the prevalence or factors associated with self-reported hearing difficulty. Therefore, the purpose of this study was to determine the prevalence of self-reported hearing difficulty, measured by the Revised Hearing Handicap Inventory (RHHI), and associated factors. METHODS This study was conducted in a community-based cohort study based in Charleston, SC. We determined the prevalence of RHHI self-reported hearing difficulty (score ≥ 6 points) and evaluated associated factors with logistic regression models. Results are presented as odds ratios (OR) with corresponding 95% confidence intervals (95% CI). RESULTS There were 1558 participants included in this study (mean age 63.7 [SD 14.4], 56.9% female, 20.0% Minority race). The prevalence of RHHI self-reported hearing difficulty was 48.8%. In a multivariable model, older age (per + 1 year; OR 0.97 [95% CI 0.96, 0.98]), Minority (vs. White) race (OR 0.68 [95% CI 0.49, 0.94]), and speech-in-noise scores that are better than predicted (OR 0.99 [95% CI 0.98, 1.00]) were associated with lower odds of RHHI self-reported hearing difficulty. Furthermore, female (vs. male) sex (OR 1.39 [95% CI 1.03, 1.86]), higher PTA in the worse ear (per + 1 dB; OR 1.10 [95% CI 1.09, 1.12]), more comorbid conditions (vs. 0; 1 condition: OR 1.50 [95% CI 1.07, 2.11]; 2 conditions: OR 1.96 [95% CI 1.32, 2.93]; 3 + conditions: OR 3.00 [95% CI 1.60, 5.62]), noise exposure (OR 1.54 [95% CI 1.16, 2.03]), bothersome tinnitus (OR 2.16 [95% CI 1.59, 2.93]), and more depressive symptoms (OR 1.04 [95% CI 1.01, 1.07]) were associated with higher odds of RHHI self-reported hearing difficulty. CONCLUSIONS The prevalence of RHHI self-reported hearing difficulty is high, and associated factors included demographics, audiometric hearing and other hearing-related factors, and physical and mental health. The RHHI likely captures functional impacts of hearing loss that are not captured by audiometry alone. Study findings can support the correct interpretation of the RHHI in research and clinical settings.
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Affiliation(s)
- Lauren K Dillard
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, MSC 550, Charleston, SC, 29425, USA.
| | - Lois J Matthews
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, MSC 550, Charleston, SC, 29425, USA
| | - Judy R Dubno
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, MSC 550, Charleston, SC, 29425, USA
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Irshad C, Govil D, Sahoo H. Social frailty among older adults in India: Findings from the Longitudinal Ageing Study in India (LASI) - Wave 1. Exp Aging Res 2024; 50:331-347. [PMID: 36974668 DOI: 10.1080/0361073x.2023.2195291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 02/23/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND From an individual's perspective, social frailty may act as a key determinant of social capital, which is essential for meeting social needs and improvement of overall wellbeing. The present study aimed to understand the social frailty and its determining factors among Indian older adults. METHODS Data from the Longitudinal Ageing Study in India (LASI)-wave 1 was used. For the assessment of social frailty the study proposed a multidimensional Social Frailty Index (SFI) score ranging between 0 and 100 using 17 indicators. Bivariate analysis and quantile regression models were applied. RESULTS The study results indicated that on average female older adults (mean SFI = 63.7) are relatively more socially frail than male older adults (mean SFI = 59.0). Further, the quantile regression analysis revealed that at the 10th, 25th, 50th, and 75th percentiles, female older adults were significantly more likely to be socially frail than male older adults (β = 3.80, p < .01; β = 2.82, p < .01; β = 1.72, p < .01; and β = 2.62, p < .01, respectively). Educational attainment and better economic condition showed a protective effect against social frailty. CONCLUSIONS Investment to improve geriatric health status and socioeconomic conditions shall be a key focus to reduce social frailty prevalence among the older adults. A specific consideration is needed for addressing social frailty among female older adults.
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Affiliation(s)
- Cv Irshad
- School of Social Sciences and Languages, Vellore Institute of Technology, Vellore, India
| | - Dipti Govil
- Department of Family and Generations, International Institute for Population Sciences, Mumbai, India
| | - Harihar Sahoo
- Department of Family and Generations, International Institute for Population Sciences, Mumbai, Maharashtra, India
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Ong CH, Pham BL, Levasseur M, Tan GR, Seah B. Sex and gender differences in social participation among community-dwelling older adults: a systematic review. Front Public Health 2024; 12:1335692. [PMID: 38680931 PMCID: PMC11046488 DOI: 10.3389/fpubh.2024.1335692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 02/29/2024] [Indexed: 05/01/2024] Open
Abstract
Background Frequent social participation among older adults is associated with greater health. Although understanding how sex and gender influence social participation is important, particularly in developing sex-inclusive health promotion and preventive interventions, little is known about factors influencing engagement of older women and men in social activities. Aim This study thus aimed to examine factors influencing social activities of older women and men. Methods A mixed-method systematic review was conducted in nine electronic databases from inception to March 2023. The studies had to define social participation as activities with others and examine its influencing factors among community-dwelling older women and men. Data were analyzed using convergent synthesis design from a socio-ecological perspective. Results Forty-nine studies, comprising 42 quantitative, five qualitative and two mixed method design were included. Themes identified concerned: (a) sociodemographic factors, (b) personal assets, (c) interpersonal relationships and commitments, (d) physical environment, and (e) societal norms and gender expectations. The findings identified the heterogeneous needs, preferences and inequalities faced by older women and men, considerations on sociocultural expectations and norms of each gender when engaging in social activities, and the importance of having adequate and accessible social spaces. Overall, this review identified more evidence on factors influencing social participation among women than in men. Conclusion Special attention is needed among community care providers and healthcare professionals to co-design, implement or prescribe a combination of sex and gender-specific and neutral activities that interest both older women and men. Intersectoral collaborative actions, including public health advocates, gerontologists, policymakers, and land use planners, are needed to unify efforts to foster social inclusion by creating an age-friendly and sustainable healthy environment. More longitudinal studies are required to better understand social participation trajectories from a sex and gender perspective and identify factors influencing it. Systematic reviews registration http://www.crd.york.ac.uk/PROSPERO, identifier [CRD42023392764].
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Affiliation(s)
- Chuan Hong Ong
- Nursing Service, Tan Tock Seng Hospital, Singapore, Singapore
| | - Bang Linh Pham
- Nursing Service, National University Hospital, Singapore, Singapore
| | - Mélanie Levasseur
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Guang Rong Tan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Betsy Seah
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Chenhuichen C, O'Halloran AM, Lang D, Kenny RA, Romero-Ortuno R. The lived experience of frailty: beyond classification and towards a holistic understanding of health. Eur Geriatr Med 2024; 15:435-444. [PMID: 38196075 PMCID: PMC10997539 DOI: 10.1007/s41999-023-00909-4] [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: 08/13/2023] [Accepted: 11/27/2023] [Indexed: 01/11/2024]
Abstract
PURPOSE Frailty is characterised by decreased physiological reserves and vulnerability to stressors. Although scales, such as the Fried's Frailty Phenotype (FP), Frailty Index (FI), and Clinical Frailty Scale (CFS), are used to identify frailty, the lived experience of frailty remains understudied. METHODS This cross-sectional observational research involved participants aged 65 years and older from Wave 1 of The Irish Longitudinal Study on Ageing (TILDA). Participants were categorised into four independent groups: three frail groups based on the aforementioned scales and a non-frail group. Quantitative variables, including self-rated health, CASP-19 quality-of-life score, and frequency of social activities, were analysed and described. RESULTS The study encompassed 1999 participants with an average age of 72 years, of whom 51% were women. FP exclusively identified 1.6% as frail (n = 32), FI 11.7% (n = 233), and CFS 6.8% (n = 135). More than 60% of all those classified as frail reported their health as good, very good, or excellent, with the lowest proportion (64%) being among frail by FI participants. Frail by FI participants exhibited the lowest mean average CASP-19 score, yet it remained relatively high at 39 out of 57 points. Over 77% of all frail individuals engaged in active leisure activities at least once a month. CONCLUSION This study underscores the need to comprehend frailty holistically beyond its mere identification. It challenges the prevailing belief that frailty inevitably leads to impaired quality of life and limited social engagement. The findings advocate for a reassessment of how both the general public and healthcare professionals perceive frailty.
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Affiliation(s)
- Chenhui Chenhuichen
- Geriatrics Department, Hospital Universitario de Navarra, Pamplona, Navarra, Spain
| | - Aisling M O'Halloran
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College, Dublin, Ireland
- Discipline of Medical Gerontology, 6th Floor, School of Medicine, Trinity College, Mercer's Institute for Successful Ageing, St James's Hospital, Dublin 8, Ireland
| | - Deirdre Lang
- National Frailty Education Programme, Office of the Nursing & Midwifery Service Director (ONMSD), Health Service Executive, Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College, Dublin, Ireland
- Discipline of Medical Gerontology, 6th Floor, School of Medicine, Trinity College, Mercer's Institute for Successful Ageing, St James's Hospital, Dublin 8, Ireland
| | - Roman Romero-Ortuno
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College, Dublin, Ireland.
- Discipline of Medical Gerontology, 6th Floor, School of Medicine, Trinity College, Mercer's Institute for Successful Ageing, St James's Hospital, Dublin 8, Ireland.
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.
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Rai P, Sundarakumar JS. The role of gender in the relationship between social engagement and health outcomes. SSM Popul Health 2024; 25:101554. [PMID: 38260721 PMCID: PMC10801295 DOI: 10.1016/j.ssmph.2023.101554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/27/2023] [Accepted: 10/30/2023] [Indexed: 01/24/2024] Open
Affiliation(s)
- Pooja Rai
- Centre for Brain Research, Indian Institute of Science, Bangalore, 560012, India
| | - Jonas S Sundarakumar
- Centre for Brain Research, Indian Institute of Science, Bangalore, 560012, India
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Park H, Kim J. The use of assistive devices and social engagement among older adults: heterogeneity by type of social engagement and gender. GeroScience 2024; 46:1385-1394. [PMID: 37581756 PMCID: PMC10828457 DOI: 10.1007/s11357-023-00910-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/07/2023] [Indexed: 08/16/2023] Open
Abstract
Little is known about the relationship between the use of assistive devices for functional loss and social engagement. This study investigated whether wearing assistive devices (dentures and hearing aids) is associated with social engagement among older adults in South Korea. Potential heterogeneity by type of social engagement (informal social contact versus formal social activity) and gender was also examined. This study analyzed data from 3725 individuals aged 65 or older collected over the course of 6 waves of the Korean Longitudinal Study of Ageing (KLoSA) from 2008 to 2018 (2150 women and 1575 men). Individual fixed effects models were used to account for unobserved individual-level heterogeneity that could confound the relationship between wearing assistive devices and social engagement. The fixed effects estimates showed that wearing assistive devices is associated with a decrease in formal social activity (b = - 0.034 for dentures and b = - 0.077 for hearing aids), but not informal social contact. Gender-stratified fixed effects revealed that the association between wearing assistive devices and social engagement is statistically significant only for men. In men, wearing assistive devices is associated with a decrease in formal social activity (b = - 0.049 for denture and b = - 0.095 hearing aids). The findings of this study suggest that wearing assistive devices may reduce the formal social activity of older adults, particularly men. Policymakers should consider developing interventions to help older adults overcome the stigma associated with assistive devices, which can hinder their social integration.
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Affiliation(s)
- HyunJee Park
- Department of Health Policy and Management, Korea University, Room 367, B-Dong Hana-Science Building, 145 Anam-Ro, Seongbuk-Gu, Seoul, Republic of Korea
| | - Jinho Kim
- Department of Health Policy and Management, Korea University, Room 367, B-Dong Hana-Science Building, 145 Anam-Ro, Seongbuk-Gu, Seoul, Republic of Korea.
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea.
- Center for Demography of Health and Aging, University of Wisconsin-Madison, Madison, WI, USA.
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Zhao D, Chai S, Gao T, Li J, Zhou C. Physical Mobility, Social Isolation and Cognitive Function: Are There Really Gender Differences? Am J Geriatr Psychiatry 2023; 31:726-736. [PMID: 37147164 DOI: 10.1016/j.jagp.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/19/2023] [Accepted: 04/05/2023] [Indexed: 05/07/2023]
Abstract
OBJECTIVE This study aimed to examine the mediating role of social isolation between physical mobility and cognitive function, and whether there are gender differences in the above mediating effects among Chinese older adults. METHODS This is a prospective and cohort study. We obtained data from the 2011 (Time 1, T1), 2015 (Time 2, T2) and 2018 (Time 3, T3) waves of China Health and Retirement Longitudinal Study, including 3,395 participants aged 60 years or above. Cognition was evaluated by Telephone Interview of Cognitive Status, words recall, and figure drawing, which was widely used in previous research. We used a cross-lagged model to test the hypothesis that social isolation mediated the association between physical mobility and cognitive function among Chinese older adults. RESULTS The total effects of T1 physical mobility limitations on T3 cognitive function (β = -0.055, bootstrap p < 0.001) were significantly negative. Social isolation played a mediating role among both males and females (male: β = -0.008, bootstrap p = 0.012; female: β = -0.006, bootstrap p = 0.023), demonstrating that the mediating effect of social isolation between physical mobility and cognitive function was not gender specific. CONCLUSION This study confirmed that social isolation mediated the association between physical mobility and cognitive function among both Chinese male and female older adults. These findings indicate that reversing social isolation can be a priority intervention target for cognitive decline prevention and promote successful ageing, particularly among older adults with impaired physical mobility.
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Affiliation(s)
- Dan Zhao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine (DZ, SC, TG, JL, CZ), Shandong University, Jinan, China
| | - Shujun Chai
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine (DZ, SC, TG, JL, CZ), Shandong University, Jinan, China
| | - Tingting Gao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine (DZ, SC, TG, JL, CZ), Shandong University, Jinan, China
| | - Jie Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine (DZ, SC, TG, JL, CZ), Shandong University, Jinan, China
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine (DZ, SC, TG, JL, CZ), Shandong University, Jinan, China; NHC Key Lab of Health Economics and Policy Research (Shandong University) (CZ), Jinan, China; Institute of Health and Elderly Care, Shandong University (CZ), Jinan, China.
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Lee SE, Hong M, Casado BL. Alzheimer's disease (AD) knowledge in Korean Americans: identifying knowledge gaps and misconceptions and examining predictors of AD knowledge. ETHNICITY & HEALTH 2023; 28:431-445. [PMID: 35229696 DOI: 10.1080/13557858.2022.2045907] [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] [Indexed: 05/05/2023]
Abstract
OBJECTIVES This study examined Alzheimer's disease (AD) knowledge and its predictors among Korean Americans (KAs). DESIGN Convenience sampling was used to recruit KAs in the Greater Washington metropolitan area. A total of 268 KAs participated in the study and completed a cross-sectional survey in 2014. Using the Alzheimer's Disease Knowledge Scale (ADKS), overall and domain knowledge was assessed. Multiple regression analyses were conducted for overall and domain knowledge with predictors including exposure to AD, social engagement, sources and frequency of health-related information, stigmatic beliefs (pity, antipathy, and social distance), English proficiency, and education. RESULTS KAs reported a 59% accuracy in the overall AD knowledge. At the domain level, KAs were most knowledgeable about assessment and diagnosis and least knowledgeable about caregiving. Our regression analyses showed that having a college degree or higher is associated with a greater overall AD knowledge. Three domain models of life impact, risk factors, and caregiving turned out to be significant: Having a college degree or higher is a predictor of greater knowledge in all three domains. Having more pity stigmatic beliefs is related to greater knowledge in both life impact and caregiving domains while having less pity stigmatic beliefs is associated with more risk factor knowledge; having less social distance stigmatic beliefs is associated with greater life impact knowledge; and having less antipathy stigmatic beliefs is related to better caregiving knowledge. CONCLUSION Our findings revealed areas of misconceptions and knowledge gaps in KAs which need to be addressed in educational interventions. Different knowledge status across the domains demonstrates a multi-dimensional nature of AD knowledge. Multivariate findings confirmed the robust role of education in overall and domain AD knowledge. The effect of different AD stigmatic beliefs on certain AD knowledge domains suggests ways of how stigma change can be efficient for the purpose of increasing AD domain knowledge in KAs.
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Affiliation(s)
- Sang E Lee
- School of Social Work, San Jose State University, San Jose, CA, USA
| | - Michin Hong
- School of Social Work, Indiana University, Indianapolis, IN, USA
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Factors Associated With Social Isolation in Older Adults: A Systematic Review and Meta-Analysis. J Am Med Dir Assoc 2023; 24:322-330.e6. [PMID: 36549651 DOI: 10.1016/j.jamda.2022.11.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/05/2022] [Accepted: 11/09/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Social isolation is a global health issue that affects older adults throughout their lives. This study aimed to identify the factors associated with social isolation in older adults. DESIGN Systematic review and meta-analysis. SETTING AND PARTICIPANTS Adults aged 60 years and older. METHODS We searched for observational studies without language restrictions in 11 databases from inception to August 2022. Pooled odds ratio (OR) and 95% CI were calculated using the R software (version 4.2.1). The modified Newcastle-Ottawa Scale was used to evaluate the risk of bias. RESULTS Eighteen factors were grouped into 5 themes. The following 13 factors were statistically significant: (1) demographics theme: aged 80 years and older (OR: 2.41; 95% CI: 1.20-4.85), less than or equal to a high school degree (OR: 1.68; 95% CI: 1.44-1.97), smoking (OR: 1.43; 95% CI: 1.18-1.73), and male (OR: 1.38; 95% CI: 1.01-1.89); (2) environment theme: low social support (OR: 7.77; 95% CI: 3.45-17.50) and no homeownership (OR: 1.38; 95% CI: 1.25-1.51); (3) role theme: no social participation (OR: 3.18; 95% CI: 1.30-7.80) and no spouse (OR: 2.61; 95% CI: 1.37-4.99); (4) physical health: hearing loss (OR: 2.78; 95% CI: 1.54-5.01), activities of daily living impairment (OR: 2.38; 95% CI: 1.57-3.61), and poor health status (OR: 1.52; 95% CI: 1.32-1.74); and (5) mental health: cognitive decline (OR: 1.85; 95% CI: 1.40-2.45) and depression (OR: 1.72; 95% CI: 1.21-2.44). CONCLUSIONS AND IMPLICATIONS Social isolation in older adults is associated with various factors. Hence, focused intervention should be adopted for older adults. In addition, further longitudinal studies are required to confirm a direct link between multiple factors and social isolation.
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Folayan MO, Zuñiga RAA, Virtanen JI, Ezechi OC, Aly NM, Lusher J, Nguyen AL, El Tantawi M. Psychosocial Factors Associated with Memory Complaints during the First Wave of the COVID-19 Pandemic: A Multi-Country Survey. Brain Sci 2023; 13:brainsci13020249. [PMID: 36831792 PMCID: PMC9953835 DOI: 10.3390/brainsci13020249] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 01/28/2023] [Accepted: 01/31/2023] [Indexed: 02/04/2023] Open
Abstract
This study assessed the associations between psychosocial factors (social isolation, social support, financial support and emotional distress) and memory complaints during the COVID-19 pandemic. This was a secondary analysis of data extracted from the dataset of participants recruited from 151 countries for a COVID-19 related mental health and wellness study between June and December 2020. The dependent variable was memory complaint, measured using the Memory Complaint Questionnaire. The independent variables were perception of social isolation, social support, financial support, emotional distress and history of SARS-CoV-19 infection. Confounding variables were age, sex at birth, level of education, employment status, HIV status and country-income level. Multivariable logistic regression was used to determine the associations between the dependent and independent variables after adjusting for the confounders. Of the 14825 participants whose data was extracted, 2460 (16.6%) had memory complaints. Participants who felt socially isolated (AOR: 1.422; 95% CI: 1.286-1.571), emotionally distressed (AOR: 2.042; 95% CI: 1.850-2.253) and with history of SARS-CoV-19 infection (AOR: 1.369; 95% CI: 1.139-1.646) had significantly higher odds of memory complaints. Participants who perceived they had social and financial support had significantly lower odds of memory complaints (AOR: 0.655; 95% CI: 0.571-0.751). Future management of pandemics like the COVID-19 should promote access to social and financial support and reduce the risk of social isolation and emotional distress.
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Affiliation(s)
- Morenike Oluwatoyin Folayan
- MEHEWE Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- The Centre for Reproductive and Population Health Studies, Nigerian Institute of Medical Research, Yaba, Lagos 101212, Nigeria
| | - Roberto Ariel Abeldaño Zuñiga
- MEHEWE Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Postgraduate Department, University of Sierra Sur, Oaxaca 70805, Mexico
| | - Jorma I Virtanen
- MEHEWE Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Faculty of Medicine, University of Bergen, 5020 Bergen, Norway
| | - Oliver C Ezechi
- MEHEWE Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- The Centre for Reproductive and Population Health Studies, Nigerian Institute of Medical Research, Yaba, Lagos 101212, Nigeria
| | - Nourhan M Aly
- MEHEWE Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria 21527, Egypt
| | - Joanne Lusher
- MEHEWE Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Provost's Group, Regent's University, London E14 2BE, UK
| | - Annie L Nguyen
- MEHEWE Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Department of Family Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 91803, USA
| | - Maha El Tantawi
- MEHEWE Study Group, Obafemi Awolowo University, Ile-Ife 220282, Nigeria
- Provost's Group, Regent's University, London E14 2BE, UK
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Zhao B, Kim JE, Moon J, Nam EW. Social engagement and subjective health among older adults in South Korea: Evidence from the Korean Longitudinal Study of Aging (2006-2018). SSM Popul Health 2023; 21:101341. [PMID: 36845671 PMCID: PMC9950723 DOI: 10.1016/j.ssmph.2023.101341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/09/2022] [Accepted: 01/10/2023] [Indexed: 01/15/2023] Open
Abstract
Background Social engagement serves as the foundation for social connections by providing a sense of belonging, social identity, and fulfillment. Previous studies have mainly focused on the one-way relationship between social engagement and subjective health among older individuals, and little attention has been paid to their mutual relationship. Therefore, this study aimed to examine the mutual association relationship between social engagement and their subjective health in older Koreans. Methods Seven waves of data samples (aged ≥60 years) from 2006 to 2018 from the Korean Longitudinal Study of Aging (KLoSA) was used in this study. Descriptive analysis, chi-squared tests, 2-year lagged Generalized estimating equation (GEE) model, and cross-lagged panel model were performed to investigate the mutual association between social engagement and subjective health among six survey periods. Results Results of the GEE model revealed when controlling for other variables, older Koreans who reported good subjective health only had a higher OR (1.678 vs. 1.650, p < 0.001) of participating in social engagement than those who had bad subjective health in 2006-2008 period; the occurrence rate of more social engagement was significantly higher among older adults with good subjective health than among those with bad subjective health (five out six survey periods). Cross-lagged analysis showed similar results that coefficients of social engagement on subjective were relatively larger in three survey periods; coefficients of subjective health on social engagement were relatively larger in the other three survey periods. The impact of social engagement on subjective health might be greater than that of subjective health on social engagement. Conclusion All-around participation and engagement of older people in society have become a consensus among the international community. In view of the single social engagement activities and less relevant participation channels in Korea, government departments should consider not only regional but also local characteristics to create more social participation opportunities for older individuals.
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Affiliation(s)
- Bo Zhao
- Department of Health Administration, Graduate School, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do, South Korea,Yonsei Global Health Center, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do, South Korea
| | - Ji Eon Kim
- Department of Health Administration, Graduate School, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do, South Korea,Yonsei Global Health Center, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do, South Korea
| | - Jiyoung Moon
- Department of Preventive Medicine, Kangwon National University Hospital, Chuncheon, Gangwon-do, South Korea
| | - Eun Woo Nam
- Department of Health Administration, Graduate School, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do, South Korea,Yonsei Global Health Center, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do, South Korea,Corresponding author. Department of Health Administration, Graduate School, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do, South Korea.
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13
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Hong Y, Xu W, Zhao L. The impact of grandchild care on depressive symptoms of grandparents in China: The mediating effects of generational support from children. Front Public Health 2023; 11:1043969. [PMID: 37020818 PMCID: PMC10067760 DOI: 10.3389/fpubh.2023.1043969] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 03/02/2023] [Indexed: 04/07/2023] Open
Abstract
Objectives Despite extensive studies about the direct effect of grandchild care on caregiver depression in China, understanding of its internal influencing mechanism has been limited. After controlling for socioeconomic factors, this study investigated whether the experience of caring for grandchildren had a long-term impact on the depression levels of grandparents, either directly or indirectly through generational support from adult children. Methods The subjects of this study were a total of 9,219 adults over 45 who participated in the China Health and Retirement Longitudinal Surveys in 2015 and 2018. We adopted a lag-behind variable to examine the impact of grandchild care on depressive symptoms of grandparents. The proposed mediation model was analyzed using bootstrap modeling, and the KHB method was conducted further to examine differences in the effects of generational support. Results The experience of caring for grandchildren had a significant negative correlation with the depression level of Chinese grandparents. Moreover, children's support significantly mediated the impact of parenting experience on grandparents' depression. Significantly, instrumental support mediated the effect to the greatest extent, while emotional support from children contributed the least. The intermediary effect has urban-rural heterogeneity. Conclusion These findings indicated that grandchild care significantly inhibited the depression level of Chinese grandparents through increased intergenerational support from adult children. The implications of the study's findings were discussed.
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14
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Scerbe A, O'Connell ME, Astell A, Morgan D, Kosteniuk J, Panyavin I, DesRoches A, Webster C. Digital tools for delivery of dementia education for caregivers of persons with dementia: A systematic review and meta-analysis of impact on caregiver distress and depressive symptoms. PLoS One 2023; 18:e0283600. [PMID: 37196022 DOI: 10.1371/journal.pone.0283600] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/13/2023] [Indexed: 05/19/2023] Open
Abstract
Continuing education for dementia has been shown to be beneficial by improving informal caregiver knowledge, dementia care, management, and caregiver physical and mental health. Technology-based dementia education has been noted to have equivalent effects as in-person education, but with the added benefit of asynchronous and/or remote delivery, which increases accessibility. Using Cochrane review methodology, this study systematically reviewed the literature on technology-based dementia education and its impacts on caregivers. Technology-based delivery included dementia education delivered via the Internet, telephone, telehealth, videophone, computer, or digital video device (DVD). In the review, twenty-eight studies were identified with fourteen included in a meta-analysis, and these data revealed a significant small effect of technologically based dementia education on reducing caregiver depression, and a medium effect on reducing caregiver distress in response to caregivers' observations of behavioral problems displayed by persons with dementia. No evidence was found for a significant effect of the educational intervention on caregiver burden or self-efficacy, which are known to be gendered aspects of caregiving. None of the studies included in the meta-analysis reported separate outcomes for male and female care providers, which has implications for gendered caregiving norms and aspects of care. Registration number: PROSPERO 2018 CRD42018092599.
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Affiliation(s)
- Andrea Scerbe
- Department of Psychology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Megan E O'Connell
- Department of Psychology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Arlene Astell
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Debra Morgan
- College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Julie Kosteniuk
- College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Ivan Panyavin
- Department of Psychology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Andrea DesRoches
- Department of Psychology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Claire Webster
- Certified Alzheimer Care Consultant, Caregiver Crosswalk Inc., Montréal, Quebec, Canada
- McGill University Dementia Education Program, Montréal, Quebec, Canada
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15
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He X, Shek DTL, Du W, Pan Y, Ma Y. The Relationship between Social Participation and Subjective Well-Being among Older People in the Chinese Culture Context: The Mediating Effect of Reciprocity Beliefs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16367. [PMID: 36498439 PMCID: PMC9741060 DOI: 10.3390/ijerph192316367] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/03/2022] [Accepted: 12/04/2022] [Indexed: 06/17/2023]
Abstract
It is demonstrated that the subjective well-being (SWB) of older people greatly relies on their social participation. However, there are few studies on reciprocity beliefs as a mediating mechanism between social participation and SWB. In this study, 297 participants aged 60 and over in Chengdu, Sichuan Province, China, completed a questionnaire of social participation, reciprocity beliefs, and SWB. We used multiple linear regression and mediation analyses to verify the mediating effect of reciprocity beliefs. Results showed that social participation was positively relative to SWB and reciprocity beliefs, and reciprocity beliefs played an intermediary role in social participation and SWB. These findings suggest the importance of social participation for SWB, with reciprocity beliefs (behaviors) playing a positive mediating role, particularly in China. In conclusion, analysis of the mediating effect of reciprocity beliefs provides us with knowledge that could help in achieving a healthy old age. Additionally, this study opens up new perspectives of research.
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Affiliation(s)
- Xinyu He
- Humanities and Law School, Chengdu University of Technology, Chengdu 610059, China
| | - Daniel T. L. Shek
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
| | - Wenbin Du
- Research Institute of Social Development, Southwestern University of Finance and Economics, No. 555, Liutai Avenue, Wenjiang District, Chengdu 611130, China
| | - Yangu Pan
- Research Institute of Social Development, Southwestern University of Finance and Economics, No. 555, Liutai Avenue, Wenjiang District, Chengdu 611130, China
| | - Yin Ma
- School of Business, Sichuan Normal University, No. 5, Jingan Avenue, Jinjiang District, Chengdu 610101, China
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Leimer B, van Ewijk R. No "honeymoon phase": whose health benefits from retirement and when. ECONOMICS AND HUMAN BIOLOGY 2022; 47:101171. [PMID: 36030711 DOI: 10.1016/j.ehb.2022.101171] [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: 12/21/2021] [Revised: 07/20/2022] [Accepted: 07/31/2022] [Indexed: 06/15/2023]
Abstract
Does retirement lead to a short, transitory health boost, followed by a stable longer-run effect? The short-run effect has been hypothesized to be a kind of honeymoon effect, that is followed by a longer-run effect that may be either positive or negative. We examine the time path of the health effect of retirement and study effect heterogeneities between individuals along several dimensions. Moreover, we study a broad range of health outcomes, all in order to come to an understanding of the effect patterns that lie behind the diverse findings reported in previous research. For identification we use a fixed effects instrumental variable approach in which the normal and early retirement age thresholds serve as instruments. Using data for 10 countries from the Survey of Health, Retirement and Ageing in Europe (SHARE), we find that retiring both at the normal and early retirement eligibility ages significantly improves all the health aspects we consider. Other than hypothesized, results do not show a honeymoon phase-like transitory health boost. Instead, especially blue-collar workers go through an adjustment period after retiring, in which their health worsens. Afterwards, health stabilizes and improves, so that retirement has a health preserving effect in the longer run. This beneficial health effect of retirement occurs across all occupational groups, across a range of health outcomes, and for both sexes, though there are a number of heterogeneities between groups regarding which health outcomes are particularly affected.
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Affiliation(s)
- Birgit Leimer
- Faculty of Law and Economics, Johannes Gutenberg-University Mainz, Germany
| | - Reyn van Ewijk
- Faculty of Law and Economics, Johannes Gutenberg-University Mainz, Germany.
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The role of religiosity and religious participation in the relationship between depressive symptoms and cognitive impairment among older Indian adults. Sci Rep 2022; 12:11915. [PMID: 35831311 PMCID: PMC9279482 DOI: 10.1038/s41598-022-14744-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 06/13/2022] [Indexed: 02/04/2023] Open
Abstract
Due to different nature of social engagements of older adults in South Asian countries specially attributed to the traditional family-based care and support, beneficial effects of religiosity and religious involvement on mental health and cognitive function in older age might be different than those in the Western world. Yet, there is a paucity of research in these countries on the role of religion in moderating the relationship between late life depression and cognition. This study explored the association of depressive symptoms with cognitive impairment and the moderating effects of religiosity and religious participation in those associations among older Indian adults. A cross-sectional study was conducted on data that were drawn from the Longitudinal Ageing Study in India wave-1, collected during 2017-2018. The sample size comprised of 31,464 older adults aged 60 years and above. Shortened 10-item Centre for Epidemiologic Studies Depression Scale was used to measure depressive symptoms. Items from the Mini-Mental State Examination and the cognitive module of the China Health and Retirement Longitudinal Study and the Mexican Health and Aging Study were adapted for measuring cognitive impairment. Moderated multiple linear regression models were used to test the research hypotheses of the study. The proportion of older adults who reported religion as less important to them was 21.24%, whereas, only 19.31% of the respondents participated in religious activities. The mean score of cognitive impairment (on a scale of 0-43) in the current sample was 19.43 [confidence interval (CI): 19.32-19.53] among men and 23.55 [CI: 23.44-23.66] among women. Older adults with depressive symptoms had significantly higher likelihood of cognitive impairment [aCoef: 0.18, CI: 0.16-0.20] in comparison to older adults with no depressive symptoms. Older individuals who were religious were significantly less likely to have cognitive impairment [aCoef: - 0.43, CI: - 0.61 to - 0.25] than their non-religious counterparts. Compared to older adults who did not participate in religious activities, those who participated in religious activities were less likely [aCoef: - 0.52, CI: - 0.69 to - 0.34] to have cognitive impairment. Further, significant moderating effects of religiosity and religious participation in the relationship between depressive symptoms and cognitive impairment were observed. The current study contributes to advancing knowledge about the mental health benefits of religiosity and religious participation by focusing on older adults in India who culturally have limited chances to participate in social activities. The findings suggest that older adults with depressive symptoms may participate in religious activities which may reduce their chances of cognitive impairment. This protective effect of religiosity and religious participation on late life cognitive health has important implications for promoting alternative social support mechanisms for older adults in terms of enhancing their mental wellbeing and contributing to active aging.
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Okuno T, Iritani O, Kodera K, Hama D, Kane A, Morigaki K, Terai T, Maeno N, Morimoto S. Unexpected decline in glycated hemoglobin level after emergency COVID-19 measures in three robust older Japanese women with prediabetes/mild type-2 diabetes. Geriatr Gerontol Int 2022; 22:457-458. [PMID: 35322529 PMCID: PMC9111712 DOI: 10.1111/ggi.14377] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 03/03/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Tazuo Okuno
- Center for Comprehensive Care on Memory Disorders, Kanazawa Medical University, Ishikawa, Japan
| | - Osamu Iritani
- Center for Comprehensive Care on Memory Disorders, Kanazawa Medical University, Ishikawa, Japan
| | - Kumie Kodera
- Center for Comprehensive Care on Memory Disorders, Kanazawa Medical University, Ishikawa, Japan
| | - Daisuke Hama
- Center for Comprehensive Care on Memory Disorders, Kanazawa Medical University, Ishikawa, Japan
| | - Asami Kane
- Center for Comprehensive Care on Memory Disorders, Kanazawa Medical University, Ishikawa, Japan
| | - Kozue Morigaki
- Center for Comprehensive Care on Memory Disorders, Kanazawa Medical University, Ishikawa, Japan
| | - Toshio Terai
- Center for Comprehensive Care on Memory Disorders, Kanazawa Medical University, Ishikawa, Japan
| | - Norie Maeno
- Center for Comprehensive Care on Memory Disorders, Kanazawa Medical University, Ishikawa, Japan
| | - Shigeto Morimoto
- Center for Comprehensive Care on Memory Disorders, Kanazawa Medical University, Ishikawa, Japan
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Chen L, Zhang Z. Community Participation and Subjective Well-Being of Older Adults: The Roles of Sense of Community and Neuroticism. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063261. [PMID: 35328950 PMCID: PMC8953512 DOI: 10.3390/ijerph19063261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 03/03/2022] [Accepted: 03/08/2022] [Indexed: 01/27/2023]
Abstract
Participation in community affairs and activities is beneficial to the mental health of older adults. The current study attempted to confirm the mediating role of sense of community (SoC) between community participation (CP) and subjective well-being (SWB), and the moderating role of neuroticism between CP and SoC. A total of 465 older adults aged ≥65 years from China participated in both two-wave online surveys. The self-developed Community Participation questionnaire, the SoC scale, and the Neuroticism subscale were used to assess CP, SoC, and neuroticism, respectively. The four indicators of SWB were assessed by the Satisfaction with Life Scale, Positive Affect and Negative Affect Schedule, and the Center for Epidemiological Studies-Depression scale. The results revealed that CP was associated with three indicators of SWB including life satisfaction, positive affect, and depressive symptoms, SoC mediated the above associations, and neuroticism negatively moderated the association between CP and SoC, after controlling for age, sex, education, spouse status, monthly income, and physical health. CP enhances older adults’ SWB through increasing their SoC. When compared to those older adults with a higher score of neuroticism, the enhancing effect of CP on SoC is stronger for those with lower scores of neuroticism.
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Affiliation(s)
- Lanshuang Chen
- Key Laboratory of Behavioral Sciences, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China;
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Zhen Zhang
- Key Laboratory of Behavioral Sciences, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China;
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
- Correspondence: ; Tel.: +86-135-2289-5882
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20
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Stebbins RC, Yang YC, Reason M, Aiello AE, Belsky DW, Harris KM, Plassman BL. Occupational cognitive stimulation, socioeconomic status, and cognitive functioning in young adulthood. SSM Popul Health 2022; 17:101024. [PMID: 35071726 PMCID: PMC8762043 DOI: 10.1016/j.ssmph.2022.101024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Occupational characteristics are associated with late-life cognition. However, little is known about the association between occupational factors and cognition in early adulthood, especially when controlling for early life socioeconomic status (SES) and cognition in childhood. Importantly, sex may shape the impact of occupational characteristics that provide cognitive stimulation given that education, occupational status, and workplace experiences differ by sex. METHODS Using data on 12,129 participants ages 24-32 from the U.S.-based National Longitudinal Study of Adolescent to Adult Health, we investigated the association between four factors of occupational cognitive stimulation (repetition, freedom, analytic skills, and social interaction) and young-adult episodic and working memory independent of childhood and young-adult SES, using linear regression. We adjusted for confounding due to sex, race/ethnicity, age, childhood cognition, and education. We further investigated effect measure modification of this association by sex in stratified regression models. RESULTS Overall, 1-unit increases in both occupational analytic skills and social interaction were significantly associated with 0.101 (95%CI: 0.28, 0.173) and 0.096 (95%CI: 0.032, 0.160) SD higher memory, respectively. However, when sex-stratified, among men, a 1-unit increase on the social interaction scale was associated with 0.16 (95%CI: 0.05, 0.27) SD higher memory, while there was no association among women. CONCLUSION Our results indicate that even in adulthood, activities that stimulate the mind can contribute to improved cognitive function, and the most beneficial forms of occupational stimulation are those that use analytic skills and involve social interaction (particularly among young men).
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Affiliation(s)
- Rebecca C. Stebbins
- Social, Genetic, & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- Carolina Population Center, University of North Carolina-Chapel Hill, Carolina Square-Suite 210, 123 West Franklin St., Chapel Hill, NC, 27516, USA
| | - Yang Claire Yang
- Carolina Population Center, University of North Carolina-Chapel Hill, Carolina Square-Suite 210, 123 West Franklin St., Chapel Hill, NC, 27516, USA
- Department of Sociology, University of North Carolina-Chapel Hill, 155 Hamilton Hall, CB #3210, Chapel Hill, NC, 27599, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina-Chapel Hill, 450 West Drive, CB #7295, Chapel Hill, NC, 27599, USA
| | - Max Reason
- Carolina Population Center, University of North Carolina-Chapel Hill, Carolina Square-Suite 210, 123 West Franklin St., Chapel Hill, NC, 27516, USA
- Department of Sociology, University of North Carolina-Chapel Hill, 155 Hamilton Hall, CB #3210, Chapel Hill, NC, 27599, USA
| | - Allison E. Aiello
- Carolina Population Center, University of North Carolina-Chapel Hill, Carolina Square-Suite 210, 123 West Franklin St., Chapel Hill, NC, 27516, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, 135 Dauer Drive, CB #7400, Chapel Hill, NC, 27599, USA
| | - Daniel W. Belsky
- Butler Aging Center, Mailman School of Public Health, Columbia University, 722 West 168th St., New York, NY, 10032, USA
| | - Kathleen Mullan Harris
- Carolina Population Center, University of North Carolina-Chapel Hill, Carolina Square-Suite 210, 123 West Franklin St., Chapel Hill, NC, 27516, USA
- Department of Sociology, University of North Carolina-Chapel Hill, 155 Hamilton Hall, CB #3210, Chapel Hill, NC, 27599, USA
| | - Brenda L. Plassman
- Department of Psychiatry & Behavioral Science, School of Medicine, Duke University, Duke University Medical Center, Box 3950, Durham, NC, 27710, USA
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The Association between Social Participation and Loneliness of the Chinese Older Adults over Time-The Mediating Effect of Social Support. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020815. [PMID: 35055639 PMCID: PMC8775358 DOI: 10.3390/ijerph19020815] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/17/2021] [Accepted: 01/11/2022] [Indexed: 02/06/2023]
Abstract
Based on activity theory, this paper employed data from the 2013, 2015, and 2018 waves of the China Health and Retirement Longitudinal Survey, and adopted Hierarchical Linear Modeling and longitudinal mediation analysis to explore the temporal variation characteristics of loneliness and the influence of social participation on loneliness in Chinese Older Adults, as well as the mechanism of them. The study found that loneliness among older adults overall was at a moderate level from 2013 to 2018 and increased over time, which may be related to decreasing social participation from year to year. Decreased social participation was associated with increased loneliness over time (β = -0.060, p < 0.001) and lower social support (β = 0.109, p < 0.001), which was associated with more loneliness (β = -0.098, p < 0.001). In addition, social support played a significant mediating role in the realization of social participation in alleviating loneliness. Social participation can not only directly reduce loneliness, but also reduce loneliness by increasing social support.
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Abstract
Abstract
Although the active ageing concept generally has positive connotations, with expected benefits at the micro, meso and macro levels, the application of this concept in terms of policy making presents challenges and risks to be avoided (for instance, a predominantly productivist interpretation and a top-down imposition with limited possibilities for bottom-up exchanges; or a disregard for the risk of excluding older people with more disadvantaged backgrounds). Two crucial strategies to minimise risks are the implementation of policies by considering and respecting territorial diversity, and the involvement of all the relevant stakeholders in a participatory consultative and co-decisional approach. This paper entwines both strategies together by focusing on Italian in-country differences in terms of active ageing, and employing the Active Ageing Index for policy-making purposes. This activity is part of a governmental national pilot project aimed at promoting multilevel co-managed co-ordination of active ageing policies across Italy. The analysis identified five groups of regions that differ from the classical, geographic and socio-economic division between the North, Centre and South. Additional in-group analyses were conducted to investigate within-cluster differences. This study will inform a large multilevel stakeholder network for evidence-based policies and their monitoring at both the national and regional levels, in line with the perspective of mainstreaming ageing.
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Saito T, Nishita Y, Tange C, Nakagawa T, Tomida M, Otsuka R, Ando F, Shimokata H, Arai H. Association between intra-individual changes in social network diversity and global cognition in older adults: Does closeness to network members make a difference? J Psychosom Res 2021; 151:110658. [PMID: 34741873 DOI: 10.1016/j.jpsychores.2021.110658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 10/14/2021] [Accepted: 10/24/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Although qualitative aspects of interpersonal networks, such as diversity or closeness, can protect the health of older adults, their association with cognitive health remains unclear. This study examined the concurrent and time-lagged association between intra-individual changes in global cognition and social network diversity, while considering emotional closeness. METHODS In this 10-year study, we obtained six-wave, biennial data from the National Institute for Longevity Sciences, Longitudinal Study of Aging. Data from 808 community-dwelling, cognitively intact adults aged 65 or older at baseline were analyzed. Global cognition was assessed using the Mini-Mental State Examination (MMSE). Social network diversity scores were assessed using a social convoy model, comprising three closeness levels: inner (closest), middle (second closest), and outer (least close). RESULTS The mean age of the respondents was 72.0 ± 4.4 years at baseline, and 50.1% were male. A fixed-effects model showed that intra-individual change in total (coefficients, B: 0.10; standard error [SE]: 0.05; p = .042) and inner (B: 0.25; SE: 0.07; p < .001) social network diversity was significantly associated with MMSE score decline, even after adjusting for covariates. Yet, in time-lagged models, diversity and MMSE score changes were not significantly associated during the subsequent two years. CONCLUSION Older adults' global cognition declined when the diversity of their closest social network decreased. This may be a promising marker for early cognitive decline in older adults. Indeed, their closest networks are relatively unlikely to decline as part of normal aging or diseases except dementia.
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Affiliation(s)
- Tami Saito
- National Center for Geriatrics and Gerontology, Japan.
| | | | - Chikako Tange
- National Center for Geriatrics and Gerontology, Japan
| | | | - Makiko Tomida
- National Center for Geriatrics and Gerontology, Japan
| | - Rei Otsuka
- National Center for Geriatrics and Gerontology, Japan
| | - Fujiko Ando
- National Center for Geriatrics and Gerontology, Japan; Aichi Shukutoku University, Japan
| | - Hiroshi Shimokata
- National Center for Geriatrics and Gerontology, Japan; Nagoya University of Arts and Sciences, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Japan
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Abstract
Objectives: A wealth of literature has established risk factors for social isolation among older people; however, much of this research has focused on community-dwelling populations. Relatively little is known about how risk of social isolation is experienced among those living in long-term care (LTC) homes. We conducted a scoping review to identify possible risk factors for social isolation among older adults living in LTC homes. Methods: A systematic search of five online databases retrieved 1535 unique articles. Eight studies met the inclusion criteria. Results: Thematic analyses revealed that possible risk factors exist at three levels: individual (e.g., communication barriers), systems (e.g., location of LTC facility), and structural factors (e.g., discrimination). Discussion: Our review identified several risk factors for social isolation that have been previously documented in literature, in addition to several risks that may be unique to those living in LTC homes. Results highlight several scholarly and practical implications.
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Affiliation(s)
- Sheila A. Boamah
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Rachel Weldrick
- Faculty of Social Science, McMaster University, Hamilton, ON, Canada
| | - Tin-Suet Joan Lee
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Nicole Taylor
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
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Yang EZ, Kotwal AA, Lisha NE, Wong JS, Huang AJ. Formal and informal social participation and elder mistreatment in a national sample of older adults. J Am Geriatr Soc 2021; 69:2579-2590. [PMID: 34105769 DOI: 10.1111/jgs.17282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 05/05/2021] [Accepted: 05/05/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND/OBJECTIVES Older adults' susceptibility to mistreatment may be affected by their participation in social activities, but little is known about relationships between social participation and elder mistreatment. DESIGN Cross-sectional analysis. SETTING/PARTICIPANTS National probability sample of older community-dwelling U.S. adults interviewed in 2015-2016, including 1268 women and 973 men (mean age 75 years and 76 years, respectively; 82% non-Hispanic white). MEASUREMENTS Frequency of participation in formal activities (organized meetings, religious services, and volunteering) and informal social activities (visiting friends and family) was assessed by questionnaire. Elder mistreatment included emotional (four items), physical (two items), and financial mistreatment (two items) since age 60. Multivariable logistic regression examined associations between each type of social participation and elder mistreatment among men and women, adjusting for age, race/ethnicity, education, and comorbidity. RESULTS Forty percent of women and 22% of men reported at least one form of mistreatment (emotional, physical, or financial). Women reporting at least monthly engagement in formal social activities were more likely to report emotional mistreatment (adjusted odds ratio (AOR) 1.59, 95% confidence interval (CI) 1.09-2.33). Among men, monthly organized meeting attendance was associated with increased odds of emotional mistreatment (AOR 1.34, 95% CI 1.01-1.93). Weekly informal socializing was inversely associated with emotional mistreatment (AOR 0.59, 95% CI 0.44-0.78) and financial mistreatment (AOR 0.59, 95% CI 0.42-0.85) among women. CONCLUSION In this national cohort, older adults who were frequently engaged in formal social activities reported similar or higher levels of mistreatment than those with less frequent organized social participation. Older women with regular informal contact with family or friends were less likely to report some kinds of mistreatment. Strategies for detecting and mitigating elder mistreatment should consider differences in patterns of formal and informal social participation and their potential contribution to mistreatment risk.
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Affiliation(s)
- Emmy Z Yang
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ashwin A Kotwal
- Division of Geriatrics, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Nadra E Lisha
- Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Jaclyn S Wong
- Department of Sociology, University of South Carolina, Columbia, South Carolina, USA
| | - Alison J Huang
- Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA
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Ingram J, Hand CJ, Maciejewski G. Social isolation during COVID-19 lockdown impairs cognitive function. APPLIED COGNITIVE PSYCHOLOGY 2021; 35:935-947. [PMID: 34230768 PMCID: PMC8250848 DOI: 10.1002/acp.3821] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 03/12/2021] [Accepted: 03/15/2021] [Indexed: 02/04/2023]
Abstract
Studies examining the effect of social isolation on cognitive function typically involve older adults and/or specialist groups (e.g., expeditions). We considered the effects of COVID‐19‐induced social isolation on cognitive function within a representative sample of the general population. We additionally considered how participants ‘shielding’ due to underlying health complications, or living alone, performed. We predicted that performance would be poorest under strictest, most‐isolating conditions. At five timepoints over 13 weeks, participants (N = 342; aged 18–72 years) completed online tasks measuring attention, memory, decision‐making, time‐estimation, and learning. Participants indicated their mood as ‘lockdown’ was eased. Performance typically improved as opportunities for social contact increased. Interactions between participant sub‐groups and timepoint demonstrated that performance was shaped by individuals' social isolation levels. Social isolation is linked to cognitive decline in the absence of ageing covariates. The impact of social isolation on cognitive function should be considered when implementing prolonged pandemic‐related restrictive conditions.
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Affiliation(s)
- Joanne Ingram
- School of Education and Social Science University of the West of Scotland Paisley UK
| | | | - Greg Maciejewski
- School of Education and Social Science University of the West of Scotland Paisley UK
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Jose JP, Cherayi SJ, Sudhakar S. Age Identity and Social Exclusion of Older Persons: A Psychosocial Perspective. AGEING INTERNATIONAL 2021. [DOI: 10.1007/s12126-021-09409-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Toyama M, Fuller HR, Owino J. Longitudinal Implications of Social Integration for Age and Gender Differences in Late-Life Physical Functioning. Int J Aging Hum Dev 2020; 94:169-192. [PMID: 33307713 DOI: 10.1177/0091415020980755] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Social integration has documented benefits for late-life health; yet, little is known about its impacts on trajectories of physical functioning. This study examines age and gender differences in the longitudinal associations between social integration and activities of daily living (ADLs) using a hierarchical linear model with three waves of survey data collected over 4 years from the Social Integration and Aging Study (N = 400; baseline mean age = 80.3). Findings indicated some interaction effects of age, gender, and/or social integration on ADL trajectories. Among those of more advanced age, women showed greater increases in ADL limitations than men, and individuals with lower social integration experienced greater increases in ADL limitations than those with higher social integration. Neither of these patterns were found among younger older adults. This study highlights the benefits of longitudinal research on social integration and the need to explore practical interventions for promoting social integration particularly among the oldest older adults.
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Affiliation(s)
- Masahiro Toyama
- 3323 Division of Natural Sciences and Mathematics, University of the Ozarks, Clarksville, AR, USA
| | - Heather R Fuller
- 174543 Department of Human Development and Family Science, North Dakota State University, Fargo, ND, USA
| | - Jonix Owino
- 174543 Department of Human Development and Family Science, North Dakota State University, Fargo, ND, USA
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Olawa BD, Idemudia ES. Gender Differences in the Associations Between Forms of Social Engagements and Loneliness in a Sample of Nigerian Older Adults: A Cross-Sectional Survey. PSYCHOLOGICAL STUDIES 2020. [DOI: 10.1007/s12646-020-00579-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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Atalay K, Staneva A. The effect of bereavement on cognitive functioning among elderly people: Evidence from Australia. ECONOMICS AND HUMAN BIOLOGY 2020; 39:100932. [PMID: 33152583 PMCID: PMC7572370 DOI: 10.1016/j.ehb.2020.100932] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/27/2020] [Accepted: 10/05/2020] [Indexed: 06/11/2023]
Abstract
This paper explores the effects of experiencing the death of a spouse, relative or close friend on cognitive functioning of Australian elderly. Using rich longitudinal data, we show that experiencing a loss is associated with a modest decline in cognitive function. Our results show that on average the effects are more pronounced for males and the strongest effects are associated with the loss of the spouse or a close friend. These events have significant effects on working memory and speed of information processing. We show that the decrease in cognitive functioning is accompanied by decreases in engagement in cognitive activities and declines in socialization. Our results are suggestive that programmes to support grieving individuals, including support for socialization activities, and extending active aging programmes could be important for promoting successful cognitive aging for the growing population of older adults.
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Affiliation(s)
- Kadir Atalay
- School of Economics, University of Sydney, Sydney, NSW 2006, Australia.
| | - Anita Staneva
- Department of Accounting, Finance and Economics, Griffith University, Australia
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Heterogeneous Trajectory Classes of Social Engagement and Sex Differences for Older Adults in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228322. [PMID: 33187061 PMCID: PMC7696123 DOI: 10.3390/ijerph17228322] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/28/2020] [Accepted: 11/05/2020] [Indexed: 11/17/2022]
Abstract
This study aimed to identify the heterogeneous trajectory classes of social engagement among older adults in China and examine sex differences to determine how sociodemographic characteristics and health status impact these trajectory classes. A sample of 8117 participants aged ≥65 years from the Chinese Longitudinal Healthy Longevity Survey was included. Growth mixture modeling was conducted to estimate the trajectory classes of social engagement. Logistic regression was adopted to analyze the associations between individual characteristics and trajectory classes. Three trajectory classes of social engagement were identified: the high-decline (35.3%), medium-decline (57.6%), and low-increase (7.1%). Men were less likely to be in the medium-decline and low-increase classes than women. Older men benefited from economic factors more than women. Education exhibited a stronger protective effect on the high-decline class for older women. High physical functioning might enable older adults with the lowest initial level of social engagement to make efforts to engage in social activities, which was stronger for older men than women. For both men and women, a proper cognitive state and positive emotions were in favor of social engagement. These findings are valuable for achieving sex equity in social engagement development for healthy and active aging.
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Evans IEM, Martyr A, Collins R, Brayne C, Clare L. Social Isolation and Cognitive Function in Later Life: A Systematic Review and Meta-Analysis. J Alzheimers Dis 2020; 70:S119-S144. [PMID: 30372678 PMCID: PMC6700717 DOI: 10.3233/jad-180501] [Citation(s) in RCA: 234] [Impact Index Per Article: 58.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND There is some evidence to suggest that social isolation may be associated with poor cognitive function in later life. However, findings are inconsistent and there is wide variation in the measures used to assess social isolation. OBJECTIVE We conducted a systematic review and meta-analysis to investigate the association between social isolation and cognitive function in later life. METHODS A search for longitudinal studies assessing the relationship between aspects of social isolation (including social activity and social networks) and cognitive function (including global measures of cognition, memory, and executive function) was conducted in PsycInfo, CINAHL, PubMed, and AgeLine. A random effects meta-analysis was conducted to assess the overall association between measures of social isolation and cognitive function. Sub-analyses investigated the association between different aspects of social isolation and each of the measures of cognitive function. RESULTS Sixty-five articles were identified by the systematic review and 51 articles were included in the meta-analysis. Low levels of social isolation characterized by high engagement in social activity and large social networks were associated with better late-life cognitive function (r = 0.054, 95% CI: 0.043, 0.065). Sub-analyses suggested that the association between social isolation and measures of global cognitive function, memory, and executive function were similar and there was no difference according to gender or number of years follow-up. CONCLUSIONS Aspects of social isolation are associated with cognitive function in later life. There is wide variation in approaches to measuring social activity and social networks across studies which may contribute to inconsistencies in reported findings.
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Affiliation(s)
- Isobel E M Evans
- Centre for Research in Ageing and Cognitive Health (REACH), School of Psychology, University of Exeter, Exeter, UK
| | - Anthony Martyr
- Centre for Research in Ageing and Cognitive Health (REACH), School of Psychology, University of Exeter, Exeter, UK
| | - Rachel Collins
- Centre for Research in Ageing and Cognitive Health (REACH), School of Psychology, University of Exeter, Exeter, UK
| | - Carol Brayne
- Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Linda Clare
- Centre for Research in Ageing and Cognitive Health (REACH), School of Psychology, University of Exeter, Exeter, UK.,University of Exeter Medical School, Exeter, UK.,Wellcome Centre for Cultures and Environments of Health, University of Exeter, Exeter, UK.,Centre for Research Excellence in Promoting Cognitive Health, University of New South Wales, Sydney, Australia
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Read S, Comas-Herrera A, Grundy E. Social Isolation and Memory Decline in Later-life. J Gerontol B Psychol Sci Soc Sci 2020; 75:367-376. [PMID: 31781769 PMCID: PMC6963696 DOI: 10.1093/geronb/gbz152] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES To investigate associations between level and changes in social isolation and in memory in older men and women. METHODS The sample included 6,123 women and 5,110 men aged 50+ from the English Longitudinal Study of Aging (ELSA). Extended latent change score models from six measurement occasions every 2 years from 2002 were used to investigate associations between social isolation and memory. Models were adjusted for age, socioeconomic position, and health. RESULTS Social isolation increased and memory decreased over time. Among men an initially high level of social isolation was associated with a somewhat greater decrease in memory. Among women a greater increase in social isolation predicted a greater decrease in memory and a larger change in social isolation was associated with further larger changes in isolation, although when social isolation reached a higher level it subsequently decreased. CONCLUSIONS Results suggest that the association between social isolation and memory decline arises because social isolation is associated with increased memory decline rather than poor memory leading to increases in social isolation. Men with high levels of social isolation and women with accumulated social isolation over time are especially affected as these patterns of isolation were associated with more profound memory decline.
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Affiliation(s)
- Sanna Read
- Care Policy and Evaluation Centre, London School of Economics and Political Science, UK
| | - Adelina Comas-Herrera
- Care Policy and Evaluation Centre, London School of Economics and Political Science, UK
| | - Emily Grundy
- Institute for Social and Economic Research, University of Essex, Colchester, UK
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Lee H, Ang S. Productive Activities and Risk of Cognitive Impairment and Depression: Does the Association Vary by Gender? SOCIOLOGICAL PERSPECTIVES : SP : OFFICIAL PUBLICATION OF THE PACIFIC SOCIOLOGICAL ASSOCIATION 2020; 63:608-629. [PMID: 33402759 PMCID: PMC7781066 DOI: 10.1177/0731121419892622] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
We examine how labor together with social participation protects against cognitive impairment and depression, with a focus on gender differences. Data are drawn from four waves of the Korean Longitudinal Study of Aging (2006-2012). Both paid work and unpaid work are considered labor participation. Social participation includes the frequency of participation in formal social institutions, religious groups, grandparenting, and interactions with family and friends. Using growth curve models, we find that social and labor participation are independently associated with outcomes and effects vary by gender. Religious group activity was beneficial only for women, whereas inability to work was detrimental for men only. Informal social gatherings and labor participation, paid or unpaid, were beneficial for both genders. Findings on gender differences highlight how social identities can shape social roles and confine activity space, and productive engagement, affecting outcomes for mental health in later life.
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Affiliation(s)
- Haena Lee
- University of Southern California, Los Angeles, CA, USA
| | - Shannon Ang
- University of Michigan, Ann Arbor, MI, USA
- Nanyang Technological University, Singapore, Singapore
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35
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Okely JA, Deary IJ. Longitudinal Associations Between Loneliness and Cognitive Ability in the Lothian Birth Cohort 1936. J Gerontol B Psychol Sci Soc Sci 2020; 74:1376-1386. [PMID: 30053217 PMCID: PMC6777773 DOI: 10.1093/geronb/gby086] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Indexed: 02/05/2023] Open
Abstract
Objectives Loneliness is associated with poorer cognitive function in old age; however, the direction of this association is unknown. We tested for reciprocal associations between loneliness and the cognitive ability domains of processing speed, visuospatial ability, verbal memory, and crystallized ability. Method We used three triennial waves of longitudinal data from the Lothian Birth Cohort Study 1936, and tested for cross-lagged associations between loneliness and cognitive abilities using cross-lagged panel models. Results Better processing speed, visuospatial ability, or crystallized ability at age 73, was associated with less positive changes in loneliness between ages 73 and 76; however, these associations were not replicated between ages 76 and 79. Loneliness at ages 73 and 76 did not predict subsequent changes in cognitive abilities. Discussion Our findings indicate an association between cognitive ability and loneliness, such that individuals with lower cognitive abilities at age 73 may be at a slightly higher risk of becoming lonely. However, we did not find support for the hypothesis that loneliness causes a decline in cognitive health.
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Affiliation(s)
- Judith A Okely
- Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, UK
| | - Ian J Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, UK
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Lee SE, Hong M, Casado BL. Examining public stigma of Alzheimer's disease and its correlates among Korean Americans. DEMENTIA 2020; 20:952-966. [PMID: 32295415 DOI: 10.1177/1471301220918328] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This study examined public stigma associated with Alzheimer's disease (AD) among Korean Americans and identified factors affecting their public stigma. Data used in the study were collected using a cross-sectional survey with 268 Korean Americans. Guided by attribution theory, different domains of public stigma were assessed: pity, antipathy, and social distance. Hierarchical regression analyses were conducted to examine the effects of sociodemographic characteristics, exposure to AD, social networking, and AD knowledge on each stigma domain. The influence of emotional attributions (pity and antipathy) on behavioral attributions (social distance) in the stigma process suggested in attribution theory was also examined. Results show that pity is most prevalent followed by social distance and antipathy. Being more proficient in English, knowing fewer relatives/friends with AD, and knowing less about AD risk factors are associated with having more pity stigma. Being less socially engaged and knowing less about AD risk factors are related to having more antipathy stigma. Being younger and more proficient in English and having stronger antipathy stigma are associated with having more social distance stigma. Findings reveal multifaceted nature of public stigma associated with AD in Korean Americans and suggest that we need to work on both positive and negative sides of public stigma for stigma change. Findings of different factors associated with each public stigma domain can be considered when trying to foster and/or reduce certain stigmatic beliefs and behaviors associated with AD.
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Affiliation(s)
- Sang E Lee
- School of Social Work, San Jose State University, CA, USA
| | - Michin Hong
- School of Social Work, Indiana University, IN, USA
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Gender matters: Productive social engagement and the subsequent cognitive changes among older adults. Soc Sci Med 2019; 229:87-95. [DOI: 10.1016/j.socscimed.2018.08.024] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 07/12/2018] [Accepted: 08/22/2018] [Indexed: 10/28/2022]
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Lai DWL, Qin N. Extraversion personality, perceived health and activity participation among community-dwelling aging adults in Hong Kong. PLoS One 2018; 13:e0209154. [PMID: 30540853 PMCID: PMC6291235 DOI: 10.1371/journal.pone.0209154] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 12/02/2018] [Indexed: 11/18/2022] Open
Abstract
Activity participation is essential to the wellbeing of aging adults. Divergent levels of activity participation within aging populations have been explained from diverse perspectives, but the interaction effects of key determinants, such as personality and health, are often ignored. This study examines the effects of extravert personality on aging adults' activity levels by addressing its interaction with perceived physical health and mental health. A sample of 304 adults aged 50 and older was selected using systematic sampling from participants of an institute for promoting active aging at a university in Hong Kong in 2017. Data on socio-demographic characteristics, perceived physical and mental health, extraversion personality traits, and level of activity participation were collected using a telephone survey. Most participants (46.7%) reported moderate activity levels and over a quarter (26.6%) reported high or low activity levels. Multi-nominal logistic regression analyses show that extraversion was associated with an increased likelihood of reporting moderate (OR = 1.85, p = .036) but not high (p > .05) activity levels when adjusted for perceived physical and mental health and socio-demographics, with low activity levels being the constant comparison. Meanwhile, extraversion predicted both moderate (OR = 3.84, p = .014) and high (OR = 5.06, p = .032) activity levels for participants with poor or average perceived mental health. However, the interaction effects of extraversion with perceived physical health or mental health were not significant in predicting either moderate or high activity levels (p > .05). The implications for enhancing activity participation among aging adults are discussed in view of both personality and perceived health status.
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Affiliation(s)
- Daniel W. L. Lai
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Nan Qin
- School of Humanities and Communication, Guangdong University of Finance and Economics, Guangzhou, China
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Liao J, Muniz-Terrera G, Head J, Brunner EJ. Dynamic Longitudinal Associations Between Social Support and Cognitive Function: A Prospective Investigation of the Directionality of Associations. J Gerontol B Psychol Sci Soc Sci 2018; 73:1233-1243. [PMID: 27803025 PMCID: PMC6146756 DOI: 10.1093/geronb/gbw135] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 09/21/2016] [Indexed: 11/13/2022] Open
Abstract
Objective To investigate the reciprocity of social support and cognitive function in late life. Method Analyses were based on three parallel repeat measures of social support and cognition from the Whitehall II cohort, providing 10-year follow-up of 6,863 participants (mean age 55.8 years, SD 6.0 at baseline). Alternative hypotheses were evaluated via four bivariate dual change score models: Full coupling model estimated mutual influences of social support and cognition on subsequent changes in each other; social causation model assumed a unidirectional influence from social support onto changes in cognition, while the opposite assumption was tested by health selection model; last, no coupling model suggested independent growth of these two sets of variables. Results A better cognition at the preceding stage was related to less positive changes in confiding support and less negative changes in practical support. In contrast, influences from social support on subsequent changes in cognition were not detected. Discussion This empirical study provides some evidence for the health selection mechanism, such that cognition modified changes in social support. The hypothesized neuroprotective effect of social support was not detectable.
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Affiliation(s)
- Jing Liao
- Department of Epidemiology and Public Health, UCL, London, UK
| | | | - Jenny Head
- Department of Epidemiology and Public Health, UCL, London, UK
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Fu C, Li Z, Mao Z. Association between Social Activities and Cognitive Function among the Elderly in China: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E231. [PMID: 29385773 PMCID: PMC5858300 DOI: 10.3390/ijerph15020231] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 01/15/2018] [Accepted: 01/29/2018] [Indexed: 02/05/2023]
Abstract
Participation in social activities is one of important factors for older adults' health. The present study aims to examine the cross-sectional association between social activities and cognitive function among Chinese elderly. A total of 8966 individuals aged 60 and older from the 2015 China Health and Retirement Longitudinal Study were obtained for this study. Telephone interviews of cognitive status, episodic memory, and visuospatial abilities were assessed by questionnaire. We used the sum of all three of the above measures to represent the respondent's cognitive status as a whole. Types and frequencies of participation in social groups were used to measure social activities. Multiple linear regression analysis was used to explore the relationship between social activities and cognitive function. After adjustment for demographics, smoking, drinking, depression, hypertension, diabetes, basic activities of daily living, instrumental activities of daily living, and self-rated health, multiple linear regression analysis revealed that interaction with friends, participating in hobby groups, and sports groups were associated with better cognitive function among both men and women (p < 0.05); doing volunteer work was associated with better cognitive function among women but not among men (p < 0.05). These findings suggest that there is a cross-sectional association between participation in social activities and cognitive function among Chinese elderly. Longitudinal studies are needed to examine the effects of social activities on cognitive function.
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Affiliation(s)
- Chang Fu
- Department of Social Medicine and Health Management, School of Health Sciences, Wuhan University, No.115 Donghu Road, Wuhan 430071, China.
| | - Zhen Li
- Global Health Institute, Wuhan University, 115 Donghu Road, Wuhan 430071, China.
| | - Zongfu Mao
- Department of Social Medicine and Health Management, School of Health Sciences, Wuhan University, No.115 Donghu Road, Wuhan 430071, China.
- Global Health Institute, Wuhan University, 115 Donghu Road, Wuhan 430071, China.
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Liao J, Scholes S. Association of Social Support and Cognitive Aging Modified by Sex and Relationship Type: A Prospective Investigation in the English Longitudinal Study of Ageing. Am J Epidemiol 2017; 186:787-795. [PMID: 28520853 PMCID: PMC5860624 DOI: 10.1093/aje/kwx142] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 11/09/2016] [Indexed: 01/02/2023] Open
Abstract
We examined whether between-persons differences and within-person changes in levels of social support were associated with age-related cognitive decline and whether these associations varied by sex and by relationship type. Executive function and memory scores over 8 years (2002–2010) were analyzed by mixture models among 10,241 adults aged ≥50 years in the English Longitudinal Study of Ageing. Between-persons differences and within-person changes in positive social support and negative social support were independently associated with cognitive decline in different ways according to sex and relationship type. Among men, higher-than-average positive social support from a spouse/partner was associated with slower cognitive decline (for executive function, βperson-mean×time-in-study = 0.005, 95% CI: 0.001, 0.010; for memory, βperson-mean×time-in-study = 0.006, 95% CI: 0.000, 0.012); whereas high negative social support from all relationship types was associated with accelerated decline in executive function (for all relationships combined, βperson-mean×time-in-study = −0.005, 95% CI: −0.008, −0.002). For women, higher-than-average positive social support from children (β = 0.037, 95% CI: 0.010, 0.064) and friends (β = 0.115, 95% CI: 0.081, 0.150)—but not from a spouse/partner (β = −0.034, 95% CI: −0.059, −0.009) or extended family (β = −0.035, 95% CI: −0.064, −0.006)—was associated with higher executive function. Associations between social support and age-related cognitive decline vary across different relationship types for men and women.
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Affiliation(s)
- Jing Liao
- Correspondence to Dr. Jing Liao, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Second Road, Guangzhou 510080, People's Republic of China (e-mail: )
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La Fleur CG, Salthouse TA. Which Aspects of Social Support Are Associated With Which Cognitive Abilities for Which People? J Gerontol B Psychol Sci Soc Sci 2017; 72:1006-1016. [PMID: 26783016 PMCID: PMC5926984 DOI: 10.1093/geronb/gbv119] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 12/08/2015] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To assess the relations between 11 aspects of social support and five cognitive abilities (vocabulary, reasoning, spatial visualization, memory, and speed of processing) and to determine whether these relations between social support and cognition are moderated by age or sex. METHOD A sample of 2,613 individuals between the ages of 18 and 99 years completed a battery of cognitive tests and a questionnaire assessing aspects of social support. A measure of general intelligence was computed using principal components analysis. Multiple regressions were used to evaluate whether each aspect of support and/or its interactions with age or sex predicted each cognitive ability and g. RESULTS Several aspects of social support were significantly related to all five cognitive abilities and to g. When g was included as a predictor, there were few relations with specific cognitive abilities. Age and sex did not moderate any of the relations. DISCUSSION These results suggest that contact with family and friends, emotional and informational support, anticipated support, and negative interactions are related to cognition, whereas satisfaction with and tangible support were not. In addition, these aspects of support were primarily related to g, with the exception of family contact. Social support- cognition relations are comparable across the life span and the sexes.
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Pinto JM, Neri AL. Factors related to low social participation in older adults: findings from the Fibra study, Brazil. ACTA ACUST UNITED AC 2017. [DOI: 10.1590/1414-462x201700030300] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract Objective To investigate the factors related to low social participation in older adults. Method A hierarchical model was drawn using data from 2,251 participants of the Fibra study, aged 65 years or more, without cognitive impairment suggestive of dementia, who were living in seven Brazilian cities. Three blocks of variables were considered: macrostructural, socioeconomic and health conditions. Results Factors related to low social participation were low perceived social support (OR:2.18;CI:0.73-1.53; <0.001), vision impairment (OR:2.04; CI:1.16-3.61;0.014), age over 80 years (OR:2.03;CI:1.22-3.38;0.006), depressive symptoms (OR:1.86;CI:1.29-2.68; <0.001), low cognitive status (OR:1.85;CI:1.20-2.85;0.005) and slowness (OR:1.83;CI:1.26-2.65;0.001). Older adults with those conditions have higher odds to be less socially engaged than their counterparts. Conclusion Personal conditions, such as socioeconomic and health status were predictors of low social participation in older adults. Initiatives aiming at active aging promotion should focus primarily on vulnerable elderly, especially those with health and/or social disadvantages.
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Zhang W, Wu YY. Individual educational attainment, neighborhood-socioeconomic contexts, and self-rated health of middle-aged and elderly Chinese: Exploring the mediating role of social engagement. Health Place 2017; 44:8-17. [PMID: 28103493 DOI: 10.1016/j.healthplace.2016.12.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 12/21/2016] [Accepted: 12/28/2016] [Indexed: 10/20/2022]
Abstract
Analyzing the 2011-2013 China Health and Retirement Longitudinal Study with 14,507 respondents from 393 neighborhoods, and applying generalized linear mixed-effects model, this study examines how individual-level education and neighborhood-socioeconomic contexts affect health through social engagement. Findings reveal that measures of social engagement-social activity and productive activity-are significantly related to self-rated health and partially mediate the effects of individual-level education. Neighborhood-socioeconomic contexts have independent effects on self-rated health beyond individual socio-demographics, and social activity mediates the effects of neighborhood recreational facilities. This study is among the first to simultaneously explore the health effects of individual and neighborhood-level socioeconomic conditions.
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Affiliation(s)
- Wei Zhang
- Department of Sociology, College of Social Sciences, University of Hawaii at Mānoa, 2424 Maile Way, Saunders Hall 239, Honolulu, HI 96822, USA.
| | - Yan Yan Wu
- Office of Public Health Studies, University of Hawai'i at Mānoa, United States.
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Richardson LJ, Brown TH. (En)gendering Racial Disparities in Health Trajectories: A Life Course and Intersectional Analysis. SSM Popul Health 2016; 2:425-435. [PMID: 28111630 PMCID: PMC5240637 DOI: 10.1016/j.ssmph.2016.04.011] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 04/28/2016] [Accepted: 04/29/2016] [Indexed: 12/03/2022] Open
Abstract
Historically, intersectionality has been an underutilized framework in sociological research on racial/ethnic and gender inequalities in health. To demonstrate its utility and importance, we conduct an intersectional analysis of the social stratification of health using the exemplar of hypertension-a health condition in which racial/ethnic and gender differences have been well-documented. Previous research has tended to examine these differences separately and ignore how the interaction of social status dimensions may influence health over time. Using seven waves of data from the Health and Retirement Study and multilevel logistic regression models, we found a multiplicative effect of race/ethnicity and gender on hypertension risk trajectories, consistent with both an intersectionality perspective and persistent inequality hypothesis. Group differences in past and contemporaneous socioeconomic and behavioral factors did not explain this effect.
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Affiliation(s)
- Liana J. Richardson
- Department of Sociology, University of North Carolina at Chapel Hill, 155 Hamilton Hall, CB #3210, Chapel Hill, NC 27599-3210, USA
- Carolina Population Center, 206 W. Franklin Street, CB #8120, Chapel Hill, NC 27516-2524, USA
| | - Tyson H. Brown
- Department of Sociology, Duke University, 276 Soc/Psych Building, Box 90088, 417 Chapel Drive, Durham, NC 27708-0088, USA
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Abstract
Maintaining an active and engaged social life is a critical component of aging well, and women are generally more socially active than men. However, as women age their self-perceptions of their bodies may reduce social behaviors and consequently, increase depressive symptoms. Because little is known about how body image is associated with social engagement and depressive symptoms among aging women, four aspects of body image: satisfaction with cosmetic features, body function, physical appearance, and weight were assessed among women aged 65 and older (n = 123). Regression analyses indicated that cosmetic appearance, body function, and physical appearance were associated with depressive symptoms, whereas satisfaction with weight was unrelated. Further, both greater satisfaction with cosmetic features and body function were associated with higher levels of social engagement, and social engagement mediated the association between these aspects of body satisfaction and depressive symptoms. The findings indicate that specific age-relevant aspects of body satisfaction are linked to social behavior and depression among aging women, and reduced body satisfaction may lead to lower social engagement, and consequently aging women's health and well-being may be diminished.
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Affiliation(s)
- Natalie J Sabik
- a Health Studies Program , University of Rhode Island , Kingston , Rhode Island , USA
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Social Function and Cognitive Status: Results from a US Nationally Representative Survey of Older Adults. J Gen Intern Med 2016; 31:854-62. [PMID: 27130624 PMCID: PMC4945567 DOI: 10.1007/s11606-016-3696-0] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 03/09/2016] [Accepted: 03/28/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND An early sign of cognitive decline in older adults is often a disruption in social function, but our understanding of this association is limited. OBJECTIVE We aimed to determine whether those screening positive for early stages of cognitive impairment have differences across multiple dimensions of social function and whether associations differ by gender. DESIGN United States nationally representative cohort (2010), the National Social life, Health, and Aging Project (NSHAP). PARTICIPANTS Community-dwelling adults aged 62-90 years (N = 3,310) with a response rate of 76.9 %. MAIN MEASURES Cognition was measured using a survey adaptation of the Montreal Cognitive Assessment categorized into three groups: normal, mild cognitive impairment (MCI), and dementia. We measured three domains of social relationships, each comprised of two scales: network structure (size and density), social resources (social support and social strain), and social engagement (community involvement and socializing). We used multiple linear regression to characterize the relationship of each social relationship measure to cognition. KEY RESULTS Individuals screened as at risk for MCI and early dementia had smaller network sizes by 0.3 and 0.6 individuals (p < 0.001), and a 10 % and 25 % increase in network density (p < 0.001), respectively. For social resources, individuals at risk for MCI and dementia had 4 % and 14 % less social strain (p = 0.01), but only women had 3 % and 6 % less perceived social support (p = 0.013), respectively. For social engagement, individuals screened positive for MCI and dementia had 8 % and 19 % less community involvement (p = 0.01), but only men had 8 % and 13 % increased social involvement with neighbors and family members (p < 0.001), respectively. CONCLUSION Changes in social functioning provide an early indication to screen for cognitive loss. Recognition that early cognitive loss is associated with differences in social function can guide counseling efforts and help identify social vulnerabilities to ease the transition to overt dementia for both patients and caregivers.
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Kuiper JS, Zuidersma M, Zuidema SU, Burgerhof JG, Stolk RP, Oude Voshaar RC, Smidt N. Social relationships and cognitive decline: a systematic review and meta-analysis of longitudinal cohort studies. Int J Epidemiol 2016; 45:1169-1206. [PMID: 27272181 DOI: 10.1093/ije/dyw089] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Although poor social relationships are assumed to contribute to cognitive decline, meta-analytic approaches have not been applied. Individual study results are mixed and difficult to interpret due to heterogeneity in measures of social relationships. We conducted a systematic review and meta-analysis to investigate the relation between poor social relationships and cognitive decline. METHODS MEDLINE, Embase and PsycINFO were searched for longitudinal cohort studies examining various aspects of social relationships and cognitive decline in the general population. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using random effects meta-analysis. Sources of heterogeneity were explored and likelihood of publication bias was assessed. We stratified analyses according to three aspects of social relationships: structural, functional and a combination of these. RESULTS We identified 43 articles. Poor social relationships predicted cognitive decline; for structural (19 studies): pooled OR: 1.08 (95% CI: 1.05-1.11); functional (8 studies): pooled OR: 1.15 (95% CI: 1.00-1.32); and combined measures (7 studies): pooled OR: 1.12 (95% CI: 1.01-1.24). Meta-regression and subgroup analyses showed that the heterogeneity could be explained by the type of social relationship measurement and methodological quality of included studies. CONCLUSIONS Despite heterogeneity in study design and measures, our meta-analyses show that multiple aspects of social relationships are associated with cognitive decline. As evidence for publication bias was found, the association might be overestimated and should therefore be interpreted with caution. Future studies are needed to better define the mechanisms underlying these associations. Potential causality of this prognostic association should be examined in future randomized controlled studies.
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Affiliation(s)
- Jisca S Kuiper
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Marij Zuidersma
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sytse U Zuidema
- Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Johannes Gm Burgerhof
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Ronald P Stolk
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Richard C Oude Voshaar
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Nynke Smidt
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands .,Department of Geriatrics, University Medical Center Groningen, Groningen, The Netherlands
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Abstract
It has been widely recognised that poor health is one of the main barriers to participation in volunteer activities in older age. Therefore, it is crucial to examine the participation of older people in volunteering, especially those in poor health. Based on the resource theory of volunteering, the aim of this study is to better understand the correlates of volunteering among older people with different health statuses, namely those without health problems (neither multimorbidity nor disability), those with mild health problems (multimorbidity or disability), and those with severe health problems (multimorbidity and disability). Data were drawn from the fourth wave (2011-2012, release 1.1.1) of the Survey of Health, Ageing and Retirement in Europe, which includes European people aged 50 years or older. The results showed that variables linked to volunteering were generally similar regardless of health status, but some differences were nevertheless identified. For older people with mild or severe health problems, for instance, depressive symptoms were negatively associated with their involvement in volunteer activities. We found a positive association of being widowed (rather than married) with volunteering in older people with particularly poor health, whereas high income was associated with volunteering in the case of mild health problems only. These results demonstrate that variables associated with volunteer participation partially differ between older people depending on their health status. These differences should be considered by policy makers in their attempts to promote volunteering in older people, as a means of preventing their social exclusion.
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