Self-image and intergenerational relationships as correlates of life satisfaction in Chinese older adults: will gender make a difference?

The Association of Self-Perception of Aging and Quality of Life in Older Adults: A Systematic Review

BACKGROUND AND OBJECTIVES

Self-perception of aging is an important psychosocial factor that can influence quality of life in older age. This review aimed to synthesize findings on the association between self-perception of aging and quality of life among older adults aged 60 and above.

RESEARCH DESIGN AND METHODS

A systematic search was conducted in 4 electronic databases (Ovid Medline, PsycInfo, CINAHL, and Web of Science). Studies conducted in English and including measures on the perception of aging and quality of life were included in this review. A total of 32 observational studies (21 cross-sectional, 8 longitudinal, 2 mixed-method, and 1 qualitative) met the inclusion criteria. Outcomes reported in the included studies were quality of life, physical health and functioning, psychological health, mental health, and general well-being.

RESULTS

Overall, 20 quantitative studies indicated a strong association between positive perception of aging and increased quality of life. Similarly, 9 quantitative studies demonstrated that negative perception of aging is associated with lower quality of life. Results of the mixed-method and qualitative studies indicated that older adults with higher morale and good physical capability had more positive perceptions of health.

DISCUSSION AND IMPLICATIONS

These results suggest that promoting a positive perception of aging and a self-care attitude would help to enhance older adults' quality of life and should be incorporated into future health promotions and interventions.

The moderating effect of intergenerational relationships on the association between Internet engagement and mental well-being

OBJECTIVE

This study examined the moderating effect of intergenerational relationships on the association between Internet engagement and older Chinese adults' mental well-being and whether this relationship and the moderating role of intergenerational relationships differs by age.

METHODS

We collected survey data from 1,162 participants aged 60 and older. Using the Satisfaction with Life Scale (SWLS) to measure life satisfaction, the Chinese version of the De Jong Gierveld Loneliness Scale to evaluate loneliness, and the Intergenerational Relationship Quality Scale for Aging Chinese Parents (IRQS-AP) to assess intergenerational relationship quality. Two-stage least squares regression with interaction terms was used to examine the moderating effect of intergenerational relationships on the association between Internet engagement and mental well-being in different age groups.

RESULTS

Higher levels of Internet engagement were significantly associated with better life satisfaction and lower loneliness in older adults, particularly for the young-old. Furthermore, the positive association between Internet engagement and mental well-being was stronger for older adults with conflicted or detached intergenerational relationships.

CONCLUSIONS

Encouraging and training older adults to use the Internet to shrink the digital divide, developing a sound Internet infrastructure, providing low-cost Internet services, particularly for the young-old with conflicted or detached intergenerational relationships, and the old-old.

Is living alone beneficial to older adults during the COVID-19 pandemic? Examining associations between living arrangements and life satisfaction by gender in Korea

OBJECTIVES

This study examines associations between living arrangements and life satisfaction and the associated effects of gender among Korean older adults during the pandemic.

METHOD

Data were drawn from the 2020 National Survey of Older Koreans-a nationally representative survey. Living arrangements were categorized into four groups: living alone; living with spouse only; living with family and spouse; and living with family without spouse. Logistic regression analyses were used to examine associations between living arrangements and life satisfaction measured as a binary outcome.

RESULTS

Older adults living alone were more likely to be satisfied with life compared with those who lived with a spouse only. However, living alone became nonsignificant after controlling for social contact with friends or neighbors and social participation. Interestingly, there was a significant interaction between living arrangements and gender, showing that living alone was beneficial to older women but not to men. Subsample analysis by gender confirmed that older women living alone had a greater likelihood of being satisfied with life than those living with a spouse only, whereas men living alone had lower life satisfaction.

CONCLUSION

Findings suggest that living alone is not always deleterious to older adults, particularly women. During the pandemic, older Korean women living with their spouse and/or family might be less satisfied with life due to the dual burden of family care and housework, associated with traditional gendered norms and social context.

Perception of dignity in older men and women in the early stages of dementia: a cross-sectional study

BACKGROUND

Dementia is a serious problem in old age, that impacts an individual's ability to function and may threaten personal dignity. Given the variable features of the illness and the diversity of life experiences, many factors may contribute to the perception of dignity by men and women with dementia. The purpose of the study was to explore the factors that contribute to dignity and its domains in men and women with dementia.

METHODS

This cross-sectional study involved 316 community-dwelling patients with early-stage dementia (aged ≥ 60) (PwD). We assessed the participants' sociodemographic and social involvement characteristics, health-related variables (pain, depression, physical performance, visual and hearing impairments), attitude to aging, and self-sufficiency in the activities of daily living (ADL). These factors were investigated as independent variables for the perception of dignity and of its domains in men and women.

RESULTS

Multivariate regression analysis showed that PwD experienced minor dignity problems in the early stages of dementia. In both men and women higher rates of depression, negative attitudes to aging, and pain were associated with reductions in the perception of dignity. In men, but not in women visual impairment had a negative effect on overall dignity, and on the associated domains of 'Loss of Autonomy' and 'Loss of Confidence'. In women, lowered self-sufficiency in ADL contributed to reduced self-perception of dignity and in the associated domains of 'Loss of Purpose of Life', 'Loss of Autonomy', and 'Loss of Confidence'. Sociodemographic and social involvement characteristics, hearing impairment, and physical performance did not influence the participants' self-perception of dignity.

CONCLUSION

The results suggested that several common factors (depression, attitudes to aging, and pain) contribute to the perception of dignity in both men and women. Other factors, visual impairments in men, and self-sufficiency in ADL in women, appear to be more gender specific. These differences might relate to their specific gender roles and experiences. The self-perception of dignity in PwD can be helped by supporting the individual, to the extent that their illness allows, in maintaining activities that are important to their gender roles, and that preserve their gender identity.

TRIAL REGISTRATION

NCT04443621.

Intergenerational relationship quality, sense of loneliness, and attitude toward later life among aging Chinese adults in Hong Kong

A positive attitude toward later life is crucial for wellbeing among older adults. Maintaining a healthy relationship with adult children can help reduce older parents’ sense of loneliness and nurture a positive life attitude. This study aimed to investigate the associations between multidimensional intergenerational relationship quality and attitudes toward later life among aging Chinese adults in Hong Kong and examine the mediating effects of a sense of loneliness. Representative survey data were collected from 801 participants (aged 50 years and over) with at least one adult child. Multiple linear regression was employed to investigate the associations between overall intergenerational relationship quality with a sense of loneliness as well as the attitude toward later life. To examine the mediating effects of a sense of loneliness, causal mediational analyses were performed. Results demonstrated that overall intergenerational relationship quality was positively associated with aging parents’ attitude toward later life, and this relationship could be partially mediated by a sense of loneliness. Among the four subdomains of intergenerational relationship quality, the influences of structural-associational solidarity and intergenerational conflict on attitude toward later life were almost fully mediated by a sense of loneliness, whereas the influences of consensual-normative solidarity and affectual closeness were partially mediated. These findings contributed to an improved understanding of the relationship between intergenerational relationship quality, sense of loneliness, and attitude toward later life, and could inform future policies and service programs that promote aging adults’ social integration and positive aging.

A Quasi-Experimental Study on the Effect of an Outdoor Physical Activity Program on the Well-Being of Older Chinese People in Hong Kong

Active participation in physical activity by older people is effective in improving their health. This research aims to examine the positive effects of participation in vigorous outdoor physical activities by older Chinese people in Hong Kong, and whether such effects would vary with socioeconomic background. A quasi-experimental, nonequivalent group design was used. A total of 22 participants were randomly assigned to participate in an outdoor physical activity program. Another 14 participants took part as a control group. The 14-item Self-Image of Aging Scale for Chinese Elders and the four-item self-report Subjective Happiness Scale were used to measure participants’ self-image and overall happiness level. All participants completed the assessment before and after the program. Happiness level was enhanced in participants in the experimental group (p = 0.037) and their level of overall mental health also improved (p = 0.031, η²p = 0.129). Demographics did not have any significant effect on well-being outcomes. A structured outdoor physical activity program could be a viable choice for future practice to enhance the mental well-being of older Chinese people.

The contribution of alternative types of care on life satisfaction among disabled older persons in China

Long-term care given to disabled older adults takes many forms, with each impacting life satisfaction through different ways. Drawing data from the 2011–2018 China Health and Retirement Longitudinal Survey, this article explores the effects of various care types on life satisfaction, with a particular focus on disabled older persons. Estimates derived from a fixed effects model with propensity score matching show that compared with formal care, informal care has significant positive effects on life satisfaction for disabled older adults. In addition, informal care has its greatest positive effect on life satisfaction on those who are mildly disabled, men and rural residents compared to their counterparts, while formal care addresses the needs of individuals with severe disability. We find that the main channels of effect occur through reduced loneliness and unhappiness, increased participation in social activities and improved physical health. This work contributes to the existing literature by demonstrating how various care types affect life satisfaction in China where filial piety, the central pillar of the Confucian ethics, is one of the common shared values among residents. These findings highlight the benefits derived from policies that promote and support the provision of informal care for older individuals. Moreover, there is a pressing need to buttress the formal care provision as a supplement to support severely disabled older adults in China.

Relationship between Children's Intergenerational Emotional Support and Subjective Well-Being among Middle-Aged and Elderly People in China: The Mediation Role of the Sense of Social Fairness

This study explored the relations between children's intergenerational emotional support and subjective well-being (SWB) among Chinese middle-aged (45-60 years old) and elderly people (over 60 years old) and the mediation effect of the sense of social fairness between such associations. Using the 2017 Chinese General Social Survey dataset, a nationally representative survey, we selected 2413 middle-aged and elderly people who are 45 years and older, who suited the study requirements with 1097 males and 1316 females, which accounts for 45.5% and 54.5%, respectively. The average of age was 61.62 years old (SD = 10.45). The mediation analyses were conducted by multivariate regression and the SPSS macro PROCESS program. The results indicated that there was a significant association between children's intergenerational emotional support and subjective well-being of middle-aged and elderly people (β = 0.0819, p < 0.001). Children's intergenerational emotional support also had an indirect impact on subjective well-being through one path: the mediating role of the sense of social fairness (0.012). Direct effect (0.0699) and mediation effect (0.012) accounting for the total effect proportion was 85.35% and 14.65%, respectively. The findings may offer some meaningful implications for improving subjective well-being of middle-aged and elderly people. Future research should pay attention to the aforementioned factors with more detailed and comprehensive studies.

To be or not to be: relationship between grandparent status and health and wellbeing

Background

It is common for older people to become grandparents in later life. However, the impacts of grandparenting on their health and well-being remain ambiguous, especially in Chinese society, where the family is in the core of culture. The current study explored the relationship between grandparenthood and Chinese older people’s health and psychological well-being in Hong Kong.

Methods

Cross-sectional data were collected from a sample of 1208 Hong Kong Chinese older people aged 55 and above through a telephone survey conducted in 2019. Participants were grouped into three categories: current grandparents (n = 507), grandparents-to-be (n = 275), and grandparents-not-to-be (n = 426). Multivariate linear regressions were performed to examine the relationship between grandparenting status and health and well-being outcomes, including self-rated physical health, mental health, resilience, and happiness. The potential moderating roles of older adults’ demographic characteristics, including age, sex, education, marital status, financial status, were also examined.

Results

Bivariate analyses suggested statistically significant differences between health and well-being across the three groups of participants. Regression models showed that, compared with grandparents-not-to-be, being a current grandparent was associated with a significantly higher happiness level. Being a future grandparent was associated with significantly higher levels of happiness, resilience, and self-rated physical health. Moderating analyses showed that age, marital status, and educational level could moderate the relationship between grandparent status and resilience and self-rated mental health.

Conclusions

The current study offers preliminary insights into the significant relationship between grandparenthood and older adults’ health and well-being. It calls for future studies to further explore the mechanisms between grandparenthood and the healthy ageing of different subgroups of older adults.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-021-02052-w.

Life satisfaction among older adults in urban China: does gender interact with pensions, social support and self-care ability?

In urban China, the social welfare system and the family structure have changed dramatically, while gender norms are still deep-rooted, particularly among older adults. Under this social, demographic and cultural context, this study aims to take a gender-specific perspective to investigate whether and how gender moderates the roles of pensions, social support and self-care ability on older adults’ life satisfaction. Based on the survey data collected from 2,047 older adults aged 65 years and over in urban China in 2018, multiple linear regressions were applied to explore the moderation effects. The results show that the pension is important to older adults’ life satisfaction regardless of gender. For social support, the association between family support and life satisfaction is stronger for older men than for older women; interdependent social support, especially being a confidant, matters more to women than to men. The interaction between self-care ability and gender reveals some interesting patterns: self-care ability is found to have a positive association with women's life satisfaction but a negative association with men's. This study contributes to the existing literature by demonstrating how gender intertwines with the most important factors of older adult's life satisfaction in China – a society with strong gender norms and a patriarchal culture. These findings could be relevant to other Asian societies.

Reciprocal effects of depressive symptoms and life satisfaction among Chinese older married couples from 2010 to 2014: evidence from the China Family Panel Studies

Objectives: Depressive symptoms and life satisfaction are closely related among the older adults. However, investigation of the dyadic influence of depressive symptoms and life satisfaction among Chinese older married couples is limited. The current study aimed to investigate the reciprocal effects of life satisfaction and depressive symptoms longitudinally among a sample of Chinese older married couples.Method: The current sample consisted of 1,877 older married couples from the China Family Panel Studies (CFPS). Depressive symptoms and life satisfaction were measured at the 2010 baseline and the 2014 assessment. Age, income, education, physical health, and length of marriage measured at baseline were included as the controlled variables. Data was analyzed with the longitudinal actor-partner interdependence models.Results: One's life satisfaction and depressive symptoms were significantly associated with his/her own life satisfaction and depressive symptoms longitudinally. In addition, higher levels of wives' depressive symptoms in 2010 were associated with higher levels of depressive symptoms and lower levels of life satisfaction among their husbands in 2014. Higher levels of husbands' life satisfaction in 2010 were associated with higher levels of wives' life satisfaction in 2014.Conclusion: The current study found both actor and partner effects in the long-term association between depressive symptoms and life satisfaction. Among these older married couples, husbands were the 'receivers' of their wives' depressive symptoms and the 'senders' of life satisfaction. Practitioners aiming to promote the well-beings of older married adults need to consider the dyadic influences given the significant partner effects found in the current study.

Gender Differences in the Impact of Intergenerational Support on Depressive Symptoms among Older Adults in Korea

Background: This study examined the relationship between intergenerational support patterns and depressive symptoms among older men and women in Korea. Methods: A nationally representative survey of non-institutionalized, community-dwelling older adults in Korea was used. A total of 7531 older adults (3592 men and 3939 women) was included in the analysis. Results: We observed gender differences in the impact of financial support exchanges on depressive symptoms. A lack of mutual financial support significantly increased the risk of depressive symptoms by 3.83 times (95% CI 2.34–6.24) in men and 1.73 times (95% CI 1.06–2.83) in women. Men who received financial support were more likely to experience depressive symptoms (OR (Odds Ratio), 1.81, 95% CI 1.36–2.42), whereas women who provided financial support were more likely to experience depressive symptoms (OR 2.82, 95% CI 1.21–6.56). The lack of an exchange of emotional support was significantly associated with depressive symptoms in both men (OR 1.49, 95% CI 1.17–1.90) and women (OR 1.87, 95% CI 1.50–2.34). Conclusions: We discuss the evidence of gender differences in intergenerational support exchange patterns and their impact on depressive symptoms within the context of Korean cultures and suggest that future research should be conducted on gender differences in the impact of intergenerational support on mental health across diverse societies.

The Impact of Intergenerational Relationship on Health and Well-Being of Older Chinese Americans

BACKGROUND/OBJECTIVES

Among older adults, intergenerational support can help to improve well-being. This study examines the correlation between intergenerational relationships and the subjective well-being among older Chinese immigrants in the United States.

DESIGN

Hierarchical multiple regression analyses were applied to test the association between intergenerational relationships and self-rated well-being. The mediating effects of sense of control and the moderation effects of support from friends were also tested.

SAMPLE

A cross-sectional sample of 2717 older Chinese immigrants, aged 60 years and older, with children and grandchildren was drawn from the Population Study of Chinese Elderly.

MEASUREMENTS

Study measures included four items concerning intergenerational relationships: the Pearlin Mastery Scale, two items on seeking support from friends, and single items measuring self-rated health status and quality of life.

RESULTS

Only the feeling of closeness with children was positively linked with subjective well-being, while coresidence and frequency of talking were not. Support from friends moderated the association with self-rated health status, while sense of control partially mediated the association between feeling of closeness and both self-rated health status and quality of life.

CONCLUSION

A stronger sense of closeness with children correlates to self-rated health status and quality of life among older Chinese immigrants. The effects of sociocultural changes affecting Chinese American families, and potential implications for older adults' health, could be addressed through strategies to develop emotional closeness with their families and to support sense of control and well-being among older Chinese adults. J Am Geriatr Soc 67:S557-S563, 2019.

Social media usage, social support, intergenerational relationships, and depressive symptoms among older adults

Many older adults are unable to use social media, which may affect their social support and intergenerational relationships and cause depression. To examine this impact on older Taiwanese adults, we used purposive sampling, a cross-sectional, correlational study design, and a structured questionnaire to collect data on participants' characteristics, social media usage, social support, intergenerational relationships, and depressive symptoms. We studied 153 older adults (aged 60 years and above) and found higher levels of depressive symptoms among participants who took medication, did not exercise regularly or participate in leisure activities, experienced poor health and sleep quality, and had poorer functional ability compared to their counterparts. Depressive symptoms were significantly associated with social media usage, social support, and intergenerational relationships. We recommend considering risk factors and offsetting depressive symptoms by promoting the use of social media and regular exercise to increase social interactions, social support, and intergenerational relationships among older adults.

Hong Kong Chinese aging adults voice financial care expectations in changing family and sociocultural contexts: implications for policy and services

Despite being one of the world's wealthiest cities, approximately one-third of Hong Kong older adults live below the poverty line. Innovatively using the Photovoice research method, this study invited 36 Hong Kong Chinese aging adults to photograph images and voice their concerns and expectations regarding financial care. Insufficient government support, diminishing family support, insecurity and fear regarding future finances, and strong desire for self-sufficiency through early preparation and bridge employment were recurring themes observed in the participants' photographs and narratives. The shifting of the participants' financial care expectations from informal to formal sources in changing family and sociocultural contexts indicated that older people are in urgent need of policy reform from a needs-based to rights-based approach to foster empowerment and fulfill older people's rights of financial security, dignity and participation. Improving the retirement protection system should go hand in hand with encouraging family support and caregiving and creating age-friendly working environment for older residents. The findings of this study may have crucial policy implications for Hong Kong and other aging societies, especially those that share similar filial piety values and have seemingly ungenerous welfare systems.