Does community-level social capital mitigate the impact of widowhood & living alone on depressive symptoms?: A prospective, multi-level study

Predictive variables of depressive symptoms and anxiety in older adults from primary care: a cross-sectional observational study

BACKGROUND

By 2050, the number of people aged 60 years and older will have doubled worldwide and the most common mental disorders in this age group are currently depressive symptoms and anxiety. This study aimed to analyze the Basic and Instrumental Activities of Daily Living (BADLs and IADLs, respectively) in older adults; socio-demographic, clinical, lifestyle, and environmental variables; and cognitive impairment related to the appearance of depressive symptoms and anxiety.

MATERIAL AND METHODS

A cross-sectional observational study was conducted with 327 participants aged ≥65 years in primary care. The variables were Yesavage's Geriatric Depression Scale, the Goldberg Anxiety Subscale, socio-demographic, clinical, lifestyle, environmental variables, BADLs, IADLs, and the Spanish version of the Mini-Mental State Examination.

RESULTS

An analysis of variance was carried out for the predictive multiple linear regression models. '≥ 1 chronic pathology' and 'low dependency' in BADL are negatively associated with anxiety, while 'physical activity' and 'low dependency' in BADL are associated with positive factors for depressive symptoms.

CONCLUSIONS

Predictor variables could improve the early detection of anxiety and depressive symptoms by general practitioners and serve as a basis for future studies and personalised-adapted cognitive stimulation programs.

Social capital, food insecurity, and health outcomes in the US during the COVID-19 pandemic

AIMS

The purpose of this study was first, to investigate the harmful effects of food insufficiency on health outcomes - self-rated health (SRH) and self-assessed depressive symptoms - during the COVID-19 pandemic and, second, to test whether these effects fluctuated across the US in terms of state-level social capital.

METHODS

Data were drawn from the Census Household Pulse Survey (fielded between April 2020 and February 2021) consisting of community-dwelling American adults (N = 1.5M+). Social capital measures were taken from the 'Social Capital Project' sponsored by the US Congress. We estimated three-level mixed effects models to analyze multiple waves of repeated cross-sectional surveys.

RESULTS

Post-COVID-19 food insufficiency was significantly negatively associated with SRH and positively associated depression, adjusting for controls including food insufficiency prior to the onset of the pandemic. These relationships were also more pronounced in areas with higher aggregate social capital.

CONCLUSIONS

The health burdens of the new coronavirus disease have fallen disproportionately on the economically marginalized, as measured by food insufficiency. Contrary to the conventional literature, living in a state with a greater stock of social capital worsened its health effects.

Depression by gender and associated factors among older adults in India: implications for age-friendly policies

Inspite of implementing policies to control mental health problems, depression remains a severe health concern among older adults in India. We examined self-reported differences in the depression among older men and women in India and examined associated factors for gender differences in depression at the population level. We utilized nationally representative data from the Longitudinal Aging Study in India (LASI) wave I, for years 2017-2019. Our analytical sample comprised of 30,637 older adults ages 60 years and above (14,682 men and 15,655 women). We conducted descriptive statistics and Chi-Square tests followed by binary logistic regression and multivariate decomposition analyses to examine our study objectives. Depression was reported in - 7.4% (95% CI 7.0, 7.8) of older men and 9.5% (CI 9.1, 10.0) of older women. Poor self-rated health, multimorbidity status, physical activity, difficulty in activities of daily living (ADL) and instrumental ADL (IADL) were the significant health-related factors associated with depression among older men and women. Not being satisfied with one's life, not being satisfied with their present living arrangement, receiving any type of ill-treatment, and being widowed were the significant factors associated with depression among older men and women. We found gender disparity in self-reported depression. Marital status contributed-to 36.7% of the gender gap in depression among older adults. Additionally, ADL and IADL difficulties among men and women contributed to 17.6% and 34.0%, gender gap, self-rated health contributed to 18.8% gap, whereas not having equal social participation (4.4%) and not satisfied in present living arrangements (8.1%) were other factors that contributed to gender gap for depression in India. Depression is a critical and persistent public health problem among-older females in India. Our findings provide a broader framework for policymakers and health practitioners to focus on gender-specific strategies to mitigate this highly emergent problem.

The Role of Ethnic Community Social Capital in the Association between Acculturation and Psychological Distress among Older Korean Americans

Guided by the theories of social capital and stress-buffering, we examined how the association between low acculturation and poor mental health among older immigrants would be modified by social capital in ethnic communities (social cohesion, social engagement, perceived ethnic density, and the quality of social interaction). Using data from the Study of Older Korean Americans (N = 2,150, Mean age = 73.4), direct and interactive effect models were examined. Lower acculturation was associated with a greater level of psychological distress, and their link was modified by social cohesion (β = .19, p < .01) and negative social interactions (β =  - .97, p < .01). Findings suggest that the mental health risk associated with low acculturation could be intensified when older immigrants perceive low sense of cohesion in their ethnic communities or have negative interactions with ethnic community members.

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

BACKGROUND

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

METHODS

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

RESULTS

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

LIMITATIONS

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

CONCLUSIONS

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

Community-Level Social Support to Mitigate the Impact of Combined Frailty and Multimorbidity on Psychological Distress Among Rural Chinese Older Adults During the COVID-19 Pandemic: Multilevel Modeling Study

BACKGROUND

Accumulating research provides evidence that the psychological health of older people deteriorated from before to during the COVID-19 pandemic. Unlike robust individuals, coexisting frailty and multimorbidity expose older adults to more complicated and wide-ranging stressors. Community-level social support (CSS) is also an important impetus for age-friendly interventions, and it is 1 of the components of social capital that is seen as an ecological-level property. To date, we have not found research that examines whether CSS buffered the adverse impacts of combined frailty and multimorbidity on psychological distress in a rural setting during COVID-19 in China.

OBJECTIVE

This study explores the combined effect of frailty and multimorbidity on psychological distress in rural Chinese older adults during the COVID-19 pandemic and examines whether CSS would buffer the aforementioned association.

METHODS

Data used in this study were extracted from 2 waves of the Shandong Rural Elderly Health Cohort (SREHC), and the final analytic sample included 2785 respondents who participated in both baseline and follow-up surveys. Multilevel linear mixed effects models were used to quantify the strength of the longitudinal association between frailty and multimorbidity combinations and psychological distress using 2 waves of data for each participant, and then, cross-level interactions between CSS and combined frailty and multimorbidity were included to test whether CSS would buffer the adverse impact of coexisting frailty and multimorbidity on psychological distress.

RESULTS

Frail older adults with multimorbidity reported the most psychological distress compared to individuals with only 1 or none of the conditions (β=.68, 95% CI 0.60-0.77, P<.001), and baseline coexisting frailty and multimorbidity predicted the most psychological distress during the COVID-19 pandemic (β=.32, 95% CI 0.22-0.43, P<.001). Further, CSS moderated the aforementioned association (β=-.16, 95% CI -0.23 to -0.09, P<.001), and increased CSS buffered the adverse effect of coexisting frailty and multimorbidity on psychological distress during the COVID-19 pandemic (β=-.11, 95% CI -0.22 to -0.01, P=.035).

CONCLUSIONS

Our findings suggest that more public health and clinical attention should be paid to psychological distress among multimorbid older adults with frailty when facing public health emergencies. This research also suggests that community-level interventions prioritizing social support mechanisms, specifically improving the average levels of social support within communities, may be an effective approach to alleviate psychological distress for rural older adults who concurrently manifest frailty and multimorbidity.

Changes in social activities and the occurrence and persistence of depressive symptoms: Do type and combination of social activities make a difference?

OBJECTIVE

We aimed to explore the association between changes in social activities and the occurrence/persistence of depressive symptoms and investigate the difference in effect sizes among the types and combinations of social activities.

METHODS

The study adopted a valid 15-item Geriatric Depression Scale to assess depressive symptoms in 2480 community-dwelling adults aged 64/65 years. Changes in social-related, learning, and personal activities were classified into four categories: continued low frequency (CLF), increased frequency (IF), decreased frequency (DF), and continued regular frequency (CRF)¹. Relative ratios (RRs) and 95% confidence intervals (95% CI) were calculated using a modified Poisson regression model.

RESULTS

Those without depressive symptoms at baseline and who engaged in social-related (RR_IF = 0.56 (0.39, 0.81), RRC_RF= 0.55 (0.41, 0.74)), learning (RR_IF = 0.63 (0.44, 0.89), RR_CRF = 0.62 (0.46, 0.85)), and personal activities (RRIF = 0.37 (0.24, 0.57), RR_CRF = 0.41 (0.30, 0.56)) at IF or CRF were less likely to develop depressive symptoms. Those with depressive symptoms at baseline, engaging in personal activities at IF (RR=0.67 (0.51, 0.87)) and CRF (RR= 0.80 (0.65-1.00)) were less likely to have persistent depressive symptoms. Participation in all three activities consistently at a regular frequency was inversely associated with the occurrence/persistence of depressive symptoms.

CONCLUSIONS

The effect of personal activities was more manifest in preventing depressive symptoms than the other two kinds, regardless of depressive symptoms at baseline. Regularly engaging in a combination of all three activities at baseline and follow-up was associated with the occurrence and persistence of depressive symptoms.

Decreasing patterns of depression in living alone across middle-aged and older men and women using a longitudinal mixed-effects model

There is little evidence regarding the association between living arrangement and depression, and no studies have examined the age- and gender-specific differences in this association. The present study sought to examine the longitudinal changes in depression patterns between isolative living versus living in company among middle-aged and older men and women by obtaining data from waves 1-7 of the Korean Longitudinal Study of Aging (KloSA), which comprises a sample of persons at least 45 years of age in the Republic of Korea (2273 middle-aged and 1387 older men, 2805 middle aged and 1862 older women). Depression scores were based on the self-reported Center for Epidemiologic Studies Depression Scale (CES-D-10) short forms. Using mixed-effect linear regression models, we estimated depression patterns by living arrangement across age- and gender groups. Our findings from the mixed-effects model revealed that over a 14-year follow-up period, there were significant decreasing patterns of depression were among middle-aged men and women, and older men living alone compared to living with a spouse and living with others. However, living alone still had the highest depression compared to other living arrangement types. On the other hand, the depression of older women living alone changed to a level similar to those living with others during the follow-up period. In conclusion, these findings indicate that living alone significantly increases the risk of depression, but the risk decreases over time. Additionally, depression patterns by living arrangement proved to differ across age and gender groups.

Prevalence of and Factors Associated with Negative Psychological Symptoms among Elderly Widows Living Alone in a Chinese Remote Sample: A Cross-Sectional Study

(1) Background: Research indicates that most elderly widows are at a high risk of experiencing negative psychological symptoms. It is common for elderly women in rural and remote areas to live alone without family support to cope with stress due to the mass rural-to-urban migration of China’s youth labor force. Such a situation further worsens their psychological health and well-being. However, the prevalence of and risk factors associated with negative psychological symptoms (loneliness, depression, and anxiety) among remote elderly widows living alone in China are currently unclear; (2) Methods: A cross-sectional study was conducted in Hunan Province, China. The loneliness was assessed through the University of California at Los Angeles Loneliness Scale (ULS-8). The depression and anxiety were assessed with the Short Form Geriatric Depression Scale (GDS-15) and Generalized Anxiety Disorder Scale (GAD-7), respectively. The Chi-square test and correlation analysis were conducted to identify factors associated with negative psychological symptoms. Logistic regression was performed to predict risk and protective factors contributing to loneliness, depression, and anxiety symptoms. The significance level was set as p < 0.05; (3) Results: A total of 271 remote elderly widows living alone were enrolled in the present study. Additionally, 234 valid questionnaires were returned (valid response rate = 86.3%). The prevalence of loneliness, depression and anxiety was 8.1%, 44.0%, and 16.7%, respectively. Acute or chronic medical conditions, marital happiness, being the primary caregiver before widowhood and anticipating the death of the spouse differed significantly in the distribution of negative psychological symptoms. Logistic regression analysis predicted that participants who were satisfied with their marriage had a lower likelihood to experience loneliness, depression, and anxiety (p < 0.05). Being the spouse’s primary caregiver before widowhood was more likely to have symptoms of loneliness (p < 0.01). Those with various acute or chronic medical conditions were more likely to suffer from depression (p < 0.01); (4) Conclusions: Remote elderly widows living alone in China are prone to loneliness, depression, and anxiety symptoms. Being the primary caregiver before widowhood and having many acute or chronic medical conditions are risk factors for loneliness and depression, respectively. Marital happiness is the protective factor against negative psychological symptoms. To accomplish the goal of equitable access to mental health care in China, evidence-based policy and resource development to support psycho-social interventions that prevent and manage negative psychological symptoms for remote elderly widows living alone are urgently needed.

Gender differences in access to community-based care: a longitudinal analysis of widowhood and living arrangements

Persistent inequalities in access to community-based support limit opportunities for independent living for older people with care needs in Europe. Our study focuses on investigating how gender, widowhood and living arrangement associate with the probability of receiving home and community-based care, while accounting for the shorter-term associations of transitions into widowhood (bereavement) and living alone, as well as the longer-term associations of being widowed and living alone. We use comparative, longitudinal data from the Survey of Health, Ageing and Retirement in Europe (collected between 2004 and 2015 in 15 countries) specifying sex-disaggregated random-effects within-between models, which allow us to examine both cross-sectional and longitudinal associations among widowhood, living arrangements and community-based care use. We find widowhood and living alone are independently associated with care use for both older women and men, while bereavement is associated with higher probability of care use only for women. Socio-economic status was associated with care use for older women, but not for men in our sample. The gender-specific associations we identify have important implications for fairness in European long-term care systems. They can inform improved care targeting towards individuals with limited informal care resources (e.g. bereaved older men) and lower socio-economic status, who are particularly vulnerable to experiencing unmet care needs. Gender differences are attenuated in countries that support formal care provision, suggesting gender equity can be promoted by decoupling access to care from household and family circumstances.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10433-022-00717-y.

Examining the Complex (Curvilinear and Contingent) Associations between Social Distancing Compliance and Subjective Health during a Global Health Crisis

OBJECTIVES

This study investigated a potential curvilinear link between social distancing behavior and subjective health in later life. It also evaluated whether food insecurity and community social capital moderated the focal relationship.

METHODS

Data were drawn from three waves of the COVID Impact Survey (N = 19,234). Mixed-effects models were fitted.

RESULTS

Social distancing has a non-monotonic (U-shaped) relationship with subjective health, i.e., individuals with low and high levels of social distancing show relatively better health. Moreover, the negative linear relationship between social distancing and health is weaker among people suffering from food insecurity as well as those living in communities with lower stocks of social capital.

DISCUSSION

This study sheds new light on the health implications of social distancing during the pandemic. Our findings dovetail with the steeling hypothesis, i.e., that social distancing is less harmful for U.S. older adults exposed to prior stressful or vulnerable conditions.

Less Social Participation Is Associated With a Higher Risk of Depressive Symptoms Among Chinese Older Adults: A Community-Based Longitudinal Prospective Cohort Study

OBJECTIVE

We aimed to examine the association between social participation and depressive symptoms among Chinese older people aged 65 years or above to supplement limited studies in China on this topic.

METHODS

This community-based longitudinal prospective cohort study used the data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS, baseline in 2014 and a follow-up in 2018). Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale. Social participation was assessed using a composite index by considering the frequency for the two types of social activity: organized social activities and informal activities. Pearson's χ² test was used to correlate the characteristics of participants with social participation or depressive symptoms. Log-binomial regression models were used to assess the association between social participation and the risk of depressive symptoms.

RESULTS

The incidence of depressive symptoms was 28.8% among 2,200 participants in 2018 after a 4-year follow-up. Participants with no social participation (32.6%), organized social activities (30.6%), or informal social activities (31.2%) were more likely to have depressive symptoms. After the adjustment of demographic factors, socioeconomic status, lifestyle habits, and health status, in comparison with older people who often engaged in social participation, organized social activities, and informal social activities, the risk of depressive symptoms was 45% [adjusted risk ratio (aRR): 1.45, 95% CI: 1.16-1.82], 42% (aRR: 1.45, 95% CI: 1.02-2.00), and 29% (aRR: 1.29, 95% CI: 1.02-1.99) higher among older people with no social participation and who never engaged in organized social activities and informal social activities, respectively.

CONCLUSIONS

This study showed that the lack of social participation, including organized social activities and informal social activities, was associated with a higher risk of depressive symptoms after 4 years among older adults in China. Our findings shed lights into the feasibility of promoting social participation to reduce the risk of depressive symptoms and promote longevity and healthy aging among older adults.

How Do Perceived Social Support and Community Social Network Alleviate Psychological Distress During COVID-19 Lockdown? The Mediating Role of Residents' Epidemic Prevention Capability

Aim

Following the outbreak of the COVID-19 epidemic, China adopted community isolation management measures. During the "lockdown" period, urban communities were the most basic prevention and control unit for the epidemic. The effectiveness of community epidemic prevention directly affects the spread of the virus and social stability. Therefore, the aim of this study was to explore the status quo and influencing factors of psychological distress.

Methods

For this study, 1,430 community households were randomly selected in key cities affected by the epidemic, and a questionnaire survey was administered during the lockdown period. A structural equation model was used to analyse the influencing factors of community epidemic prevention effects. A total of 1,326 valid questionnaires were collected, with a valid response rate of 92.73%.

Results

In this study, the differences in psychological distress among different community types were statistically significant (t = 58.41, P < 0.01). The results showed that epidemic prevention capability played a mediating role. The results of the high-order structural equation model analysis showed that perceived social support (β = -0.275, P = 0.000) and community social network (β = -0.296, P < 0.01) were significantly negatively correlated with psychological distress.

Conclusions

Community social support indirectly relieves psychological anxiety and improves the effect of epidemic prevention by enhancing residents' ability to prevent epidemics. The community social network help residents reduce the risk of outbreaks and indirectly alleviate psychological distress.

Multi-Level Social Capital and Subjective Wellbeing Among the Elderly: Understanding the Effect of Family, Workplace, Community, and Society Social Capital

Background

Maintaining the subjective wellbeing of the elderly people is one of the major concerns in promoting health aging. This study concerned the influence of multi-level social capital on subjective welling and explored the affecting path among the elderly.

Methods

A total of 1,078 elderly individuals anonymously and effectively surveyed in 2018, data was collected including their family, workplace, community, society social capital and subjective wellbeing, we used the structural equation modeling to test the hypothesis relationships among the variables.

Results

We found that the total score of subjective wellbeing among the aging participants was 72.36 ± 10.08 on a range of 0–100. Family (β = 0.151, P &lt; 0.001), workplace (β = 0.090, P &lt; 0.001), community (β = 0.163, P &lt; 0.001) social capital had a direct positive effect on subjective wellbeing. Society social capital had a direct positive effect on family (β = 0.253, P &lt; 0.001), workplace (β = 0.585, P &lt; 0.001), community (β = 0.438, P &lt; 0.001) social capital. And society social capital had an indirect positive effect on subjective wellbeing through the mediating role of family, workplace, and community social capital.

Conclusion

The research demonstrated that all the micro, meso and macro levels of social capital have protective effects for subjective wellbeing through direct or indirect way, inspiring to provide continuous improvement measures for multi-level social capital aimed at the elderly people.

Keeping up with the Wangs: individual and contextual influences on mental wellbeing and depressive symptoms in China

Background

In recent decades, China has experienced dramatic changes to its social and economic environment, which has affected the distribution of wellbeing across its citizens. While several studies have investigated individual level predictors of wellbeing in the Chinese population, less research has been done looking at contextual effects. This cross-sectional study looks at the individual and contextual effects of (regional) education, unemployment and marriage (rate) on individual happiness, life satisfaction and depressive symptomatology.

Methods

Data were collected from over 29,000 individuals (aged 18 to 110, 51.91% female) in the China Family Panel Studies, and merged with county level census data obtained from the 2010 China Population Census and Statistical Yearbook. To explore contextual effects, we used multilevel models accounting for the hierarchical structure of the data.

Results

We found that a one-year increase in education was associated with a 0.17% increase in happiness and a 0.16% decrease in depressive symptoms. Unemployed men were 1% less happy, 1% less satisfied with life and reported 0.84% more depressive symptoms than employed men while minimal effects were seen for women. Single, divorced and widowed individuals had worse outcomes than married individuals (ranging from 2.96 to 21% differences). We found interaction effects for education and employment. Less educated individuals had greater happiness and less depressive symptoms in counties with higher average education compared to counterparts in less educated counties. In contrast, more educated individuals were less satisfied with life in more educated counties, an effect that is possibly due to social comparison. Employed individuals had lower life satisfaction in areas of high unemployment, while levels were constant for the unemployed. A 1% increase in county marriage rate was associated with 0.33 and 0.24% increases in happiness and life satisfaction respectively, with no interactions. We speculate that this effect could be due to greater social cohesion in the neighbourhood.

Conclusions

Our results show that policies designed to improve employment and marriage rates will be beneficial for all, while interventions to encourage positive social comparison strategies may help to offset the negative effects of increasing neighbourhood average education on the highly educated.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-12869-8.

Psychosocial trajectories before and after spousal loss: Does gender matter?

RATIONALE

Prior studies have suggested that spousal loss can have negative impacts on widowed persons' lives. However, few studies have examined whether time since spousal loss is related to changes in psychosocial outcomes and there are gender differences in psychosocial trajectories in response to spousal loss.

OBJECTIVE

This study examines the psychosocial trajectories (depressive symptoms and social engagement) of widowed individuals before and after spousal death. This study also investigates whether psychosocial adjustment trajectories, among individuals who experienced spousal loss, are gendered.

METHODS

This study uses data from 685 middle- and older-aged adults over seven waves (4284 person-observations) of the Korean Longitudinal Study of Ageing spanning 12 years between 2006 and 2018. This study estimates fixed effects models to account for observed and unobserved individual-level heterogeneity. Gender-stratified fixed effects regression models are used to investigate whether psychosocial changes associated with spousal loss differ by gender.

RESULTS

Psychosocial adjustment to spousal loss is strikingly gendered. Among men, depressive symptoms began to increase within the first year following spousal loss and continued through the fourth and subsequent years. In contrast, depressive symptoms among widows did not change significantly during and after bereavement. Similar patterns were found for social engagement. Among men, a decrease in frequency of social interactions and participation in social activities was found from the first year of spousal loss to the fourth and subsequent years. No such patterns were found for women.

CONCLUSION

Spousal loss is a life event that spurs tremendous psychosocial changes for widowed people. This study suggests that spousal loss-associated psychosocial changes occur over a long period of time and are greater in men than in women.

Methodological challenges in harmonisation of the variables used as indicators of social capital in epidemiological studies of ageing – results of the ATHLOS project

The present article aims to highlight methodological aspects related to understanding and conceptualising social capital for the purposes of population research as well as describing the key challenges in the harmonisation process of indicators of social capital. The study was conducted in the frame of the Ageing Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) project. After a review of social capital theories developed in social science and a subsequent review of the documentation of 18 international cohorts, decision trees of the harmonisation of social variables were developed. The known-group validity was verified. The results focused on generalised trust, civic engagement and social participation are presented. The summary of the availability of any indicators of these concepts is classified in seven domains (generalised trust, political participation, religious participation, senior-specific participation, participation in sport groups, participation in volunteer/charity group activities, any participation) across surveys. The results of the analysis for known-group validity support the construct validity of the harmonised variables.

The association of widowhood and living alone with depression among older adults in India

Widowhood is a catastrophic event at any stage of life for the surviving partner particularly in old age, with serious repercussions on their physical, economic, and emotional well-being. This study investigates the association of marital status and living arrangement with depression among older adults. Additionally, the study aims to evaluate the effects of factors such as socio-economic conditions and other health problems contributing to the risk of depression among older adults in India. This study utilizes data from the nationally representative Longitudinal Ageing Study in India (LASI-2017-18). The effective sample size was 30,639 older adults aged 60 years and above. Descriptive statistics and bivariate analysis have been performed to determine the prevalence of depression. Further, binary logistic regression analysis was conducted to study the association between marital status and living arrangement on depression among older adults in India. Overall, around nine percent of the older adults suffered from depression. 10.3% of the widowed (currently married: 7.8%) and 13.6% of the older adults who were living alone suffered from depression. Further, 8.4% of the respondents who were co-residing with someone were suffering from depression. Widowed older adults were 34% more likely to be depressed than currently married counterparts [AOR: 1.34, CI 1.2-1.49]. Similarly, respondents who lived alone were 16% more likely to be depressed compared to their counterparts [AOR: 1.16; CI 1.02, 1.40]. Older adults who were widowed and living alone were 56% more likely to suffer from depression [AOR: 1.56; CI 1.28, 1.91] in reference to older adults who were currently married and co-residing. The study shows vulnerability of widowed older adults who are living alone and among those who had lack of socio-economic resources and face poor health status. The study can be used to target outreach programs and service delivery for the older adults who are living alone or widowed and suffering from depression.

Community-Level Participation in Volunteer Groups and Individual Depressive Symptoms in Japanese Older People: A Three-Year Longitudinal Multilevel Analysis Using JAGES Data

BACKGROUND

The current study aimed to investigate the contextual effect of volunteer group participation on subsequent depressive symptoms in older people.

METHODS

We analyzed the longitudinal data of 37,552 people aged 65 years and older in 24 municipalities surveyed in the Japan Gerontological Evaluation Study. Volunteer group participation of older people was assessed in 2013 by one question and depressive symptoms were assessed by the Geriatric Depression Scale 15 in 2016. To investigate a contextual effect, we aggregated individual-level volunteer group participation by each residence area as a community-level independent variable. We conducted a two-level multilevel Poisson regression analysis using the Random Intercepts and Fixed Slopes Model.

RESULTS

The average proportion of community-level volunteer group participation was 10.6%. The results of the Poisson regression analysis showed that community-level volunteer group participation reduced the risk for the onset of depressive symptoms by 13% with a 10 percentage point increase in participation, after adjusting for sex, age, population density, total annual sunshine hours and annual rainfall (incident rate ratio, 0.87; 95% confidence interval, 0.78-0.98).

CONCLUSIONS

Older people living in areas with higher volunteer group participation had a lower risk of developing depressive symptoms regardless of whether or not they participated in a volunteer group.

Income Inequality, Neighbourhood Social Capital and Subjective Well-Being in China: Exploration of a Moderating Effect

With the continuous global rise in inequality and the growing importance of subjective welfare, the relationship between income inequality and subjective well-being has received increasing attention. This paper focuses on neighbourhood social capital, measured at the individual and community levels, to explore its moderating effect on the association between income inequality and subjective well-being in the context of China, an issue few studies have examined. Using data from the China Labour-force Dynamics Survey and multilevel models, the results show that income inequality measured using three different indicators had a stable and negative association with subjective well-being in China, after controlling for various individual characteristics and aggregate-level factors. Although neighbourhood social capital at the individual level has been proven to promote subjective well-being, a dark side of social capital is also found at the community level. More notably, neighbourhood social capital at the individual level can attenuate the negative impact of income inequality on subjective well-being, especially for vulnerable groups, such as those with low income or low education. How to reasonably guide the community to develop social capital is an important policy implication to attenuate the negative psychological experience of income inequality.

Association of late-life depression with cognitive impairment: evidence from a cross-sectional study among older adults in India

BACKGROUND

Late-life depression (LLD) is considered as a prodrome to dementia and plays a major role in the development of long-term cognitive disabilities. We aimed to estimate the prevalence and correlates of LLD and cognitive impairment and to explore their associations among older adults in India.

METHODS

Data for this study was derived from the Longitudinal Ageing Study in India (LASI) Wave 1 (2017-18). The total sample included 31,464 (15,098 male and 16,366 female) older individuals aged 60 years and above. Cognitive impairment measured from various domains derived from the cognitive module of the Health and Retirement Study (HRS), and major depression measured by the CIDI-SF (Composite International Diagnostic Interview- Short Form) were the outcome variables. Descriptive, bivariate, and multivariable analyses were performed to fulfill the objectives of the study.

RESULTS

The overall prevalence of LLD and cognitive impairment for the current sample was 8.7% and 13.7 % respectively. Among older individuals who have rated their health status as poor were 2.59 times more likely to suffer from LLD [OR: 2.59, CI: 2.24-2.99] as compared to their counterparts. The older adults who had difficulty in activities of daily living (ADL) and instrumental activities of daily living (IADL) were 74% and 69 % more likely to suffer from LLD. Similarly, older adults who were depressed had higher odds of cognitive impairment [OR: 1.22, CI: 1.01-1.48] compared to their counterparts. Also, older adults who were depressed and belonged to rural areas were 2.58 times [AOR: 2.58, CI: 1.95-3.41] more likely to be cognitively impaired than those who were not depressed and resided in urban areas.

CONCLUSIONS

Depression is linked to an increased risk of cognitive decline and dementia; therefore, failing to diagnose and treat LLD in later life may have significant health implications. Moreover, treatment under the care of a cognitive neurologist or geriatric psychiatrist is recommended for people with LLD and cognitive disability due to both the disorders' complex existence.

Transport policymaking that accounts for COVID-19 and future public health threats: A PASS approach

The novel coronavirus 2019 (COVID-19) outbreak has had wide-reaching and unprecedented impacts on the transport sector worldwide. At present, there is no globally agreed timeframe for when this pandemic will end. The current and near-future potential impacts must be addressed in a relatively comprehensive and seamless way. The present study proposed a PASS (P: Prepare-Protect-Provide; A: Avoid-Adjust; S: Shift-Share; S: Substitute-Stop) approach for policymaking that accounts for COVID-19 and future public health threats. The PASS approach was illustrated conceptually, and then policy measures were recommended by referring to the past and ongoing best practices. Policymaking challenges and research issues were discussed.