Marital status, childlessness, and social support among older Canadians

Exploring the relationship between marital quality and cognitive function: A systematic review

Cognitive function is an important indicator of healthy aging as it is central to maintaining functional independence, performing job-related tasks, decision-making, and improving quality of life. Therefore, researchers seek to identify biopsychosocial factors that can help preserve cognitive function in aging individuals. One such factor is the maintenance of good quality marital relationships. Research has consistently shown that married individuals fare better in terms of both physical and psychological health compared to their unmarried counterparts. However, being married is not universally beneficial - the quality of a marriage is also important to consider. To explore the issue further, we conducted a systematic review to examine the association between marital quality and cognitive function. PubMed, PsycINFO, and Scopus were searched for eligible articles examining any measure of marital quality and any cognitive outcome from the inception of each database to January 9th, 2024. Following two levels of citation screening by two independent reviewers, we included 15 articles representing 11 unique studies. Data were synthesized narratively following the Synthesis without Meta-Analysis guidelines and a risk of bias assessment was conducted using the Joanna Briggs Institute checklist. Most articles had a low risk of bias. Although some findings suggested more positive marital quality was associated with improved cognitive function, the results were not uniformly positive; some results were inverse or null, depending upon factors such as differences in study designs and measures of marital quality or cognition. This review is the first attempt to synthesize the literature on this topic. Our findings highlight that any examination of marital status and cognition should also consider contextual factors such as marital quality.

Investigation of COVID-19 vaccination among maintenance hemodialysis patients in Sichuan, China

AIM

To investigate the current status of COVID-19 vaccination in maintenance hemodialysis (MHD) patients and its influencing factors.

METHODS

In total, 585 patients undergoing regular hemodialysis in Sichuan Province of China from January to March 2022 were selected to complete a questionnaire survey on their knowledge, attitudes and practices regarding COVID-19 vaccination. Independent t tests and logistic multivariate analysis were used to analyze the influencing factors of COVID-19 vaccination in hemodialysis patients.

RESULTS

The survey showed that 37.44% of MHD patients had been vaccinated with the COVID-19 vaccine. Being married was associated with COVID-19 vaccination in patients with MHD (odds ratio [OR] = 1.969 95% CI 0 .870 ~ 4.453). MHD patients living in county areas have higher rates of COVID-19 vaccination (OR = 0.572 95% CI 0.301 ~ 1.087). Family /relatives/friends who are healthcare workers are associated with COVID-19 vaccination for MHD patients (OR = 1.840 95% CI 1.140 ~ 2.970). Other vaccination history within 5 years was a factor in COVID-19 vaccination for MHD patients (OR = 5.592 95% CI 2.997 ~ 10.434). Attitude (OR = 0.885 95% CI 0.808 ~ 0.905), and practice (OR = 0.756 95% CI 0.697 ~ 0.819) scores on the COVID-19 vaccination knowledge and practice questionnaire were related to the vaccination status of MHD patients.

CONCLUSIONS

MHD patients had lower rates of COVID-19 vaccination. Marital status, living environment, whether family/relatives/friends were medical workers, and the score of the COVID-19 vaccine knowledge and practice questionnaire were the factors influencing their vaccination status. Clinical attention should be given to the adverse reactions of COVID-19 vaccination in MHD patients to improve the awareness of primary medical staff on hemodialysis, and families and society should pay more attention to COVID-19 vaccination in MHD patients.

Childlessness and social and emotional loneliness in middle and later life

Despite theoretical accounts asserting the importance of children for the wellbeing of individuals as they age, research evidence suggests that children may be inconsequential when it comes to loneliness. Yet, there is reason to expect some subgroups may be more vulnerable to the impact of childlessness than others and this may also differ depending on the type of loneliness being assessed. This paper addresses the relationship between childlessness and social and emotional loneliness in middle and later life, including differential vulnerability associated with age, gender and marital/partner status. The study drew on data from three waves (2007, 2012 and 2018) of the Canadian General Social Survey for a nationally representative sample of adults aged 45 and older (N = 49,892). In general, childlessness assumed greater importance with regard to social than emotional loneliness. Women reported lower levels of social loneliness in conjunction with childlessness than men. Further, childlessness was associated with higher levels of overall and social loneliness among older than middle-aged adults. Fewer interactions were evident between marital/partner status and childlessness. Among women specifically, those who were co-habiting, separated/divorced or never married reported lower levels of social loneliness than their married counterparts. In contrast, childlessness was linked to greater emotional loneliness only among separated/divorced men and widowed women. Overall, our results suggest that having children available does matter for feelings of loneliness in middle and later life but that the relationship varies and is contingent on the social contexts (age, gender, marital/partner status) and the type of loneliness (social, emotional) involved.

Perceived Social Support and Associated Factors Among Community-Dwelling Older Adults With Frailty and Pre-frailty in Hangzhou, China

OBJECTIVES

The present study aimed to explore the social support among community-dwelling older adults with frailty and pre-frailty and to ascertain associated factors.

METHODS

The frailty status of the participant was assessed via the Chinese FRAIL Scale. The dependent variable, level of social support, was evaluated using the Social Support Rating Scale (range: 12-66). This study explored the influencing factors from three aspects containing sociodemographic characteristics, family environment, and community environment. Independent-sample t-test, Analysis of Variance, and multiple linear regression analyses were conducted to examine determinants of social support.

RESULTS

There were significant differences in overall social support between non-frail, pre-frail, and frail participants [38.01 (SD = 6.48) vs. 33.62 (SD = 6.25) vs. 30.50 (SD = 6.68), F = 62.157, p < 0.001]. Older adults with frailty and pre-frailty who were single would have lower levels of overall social support. In the pre-frail group, living alone was associated with lower overall social support. In contrast, the relationship with children and the availability of recreational activities were associated factors for the frail group.

CONCLUSIONS

The level of social support among frail and pre-frail community-dwelling older adults was lower than the robust older adults and influenced by different factors according to the frailty category, which suggests taking targeted measures for social support improvement.

Alternatives to Aging Alone?: "Kinlessness" and the Importance of Friends Across European Contexts

OBJECTIVES

Increasing numbers of older adults cross-nationally are without children or partners in later life and therefore likely have greater reliance on nonkin (e.g., friends). This pattern may be particularly pronounced in country contexts that emphasize friendship. This article hypothesizes that those who lack kin (e.g., children, partners) and/or who live in countries with a stronger emphasis on friendship have more friends in their networks. Although these hypothesized patterns are consistent with interdisciplinary literatures, they have not been tested empirically and therefore remain overlooked in current "aging alone" narratives.

METHOD

This study combines individual-level data from the Survey of Health, Ageing, and Retirement in Europe (Wave 6) with nation-level data from the European Values Survey to estimate multilevel negative binomial models exploring number of friends among those aged more than 50 years who lack kin across 17 countries.

RESULTS

Older adults who lack kin or whose kin are unavailable report more friends in their networks, particularly in countries with a higher percentage of people who believe that friends are "very important" in life.

DISCUSSION

This article challenges dominating assumptions about "aging alone" that rely heavily on lack of family as an indicator of "alone." Future studies of "kinlessness" should consider the extent to which friendship is correlated with lack of kin, particularly in more socioeconomically developed countries. Previous research on "aging alone" may have overestimated risk in more privileged countries that already emphasize friendship, but underestimated risk in family-centered countries where "kinlessness" and alternative sources of support are less common.

Social support and the self-rated health of older people: A comparative study in Tainan Taiwan and Fuzhou Fujian province

The lack of social support in elderly populations incurs real societal costs and can lead to their poor health. The aim of this study is to investigate the self-rated health (SRH) and social support among older people as well as its associated factors.We conducted a cross-sectional study among 312 urban community-dwelling elderly aged 65 to 90 years in Tainan Taiwan and Fuzhou Fujian Province from March 2012 to October 2012. A Spearson correlation test, independent t test, a Pearson χ test, a linear regression analysis, and a multiple-level model were performed to analyze the results.The participants identified children as the most important source of objective and subjective support, followed by spouse and relatives. Tainan's elderly received more daily life assistance and emotional support, showed stronger awareness of the need to seek help, and maintained a higher frequency of social interactions compared with the elderly in Fuzhou. The mean objective support, subjective support, and support utilization scores as well as the overall social support among Tainan's elderly were significantly high compared with the scores among Fuzhou's elderly. Further, Tainan's elderly rated better SRH than Fuzhou's elderly. Correlation analysis showed that social support was significantly correlated with city, age, living conditions, marital status, and SRH. Multiple linear regression analysis, with social support as a dependent variable, retained the following independent predictors in the final regression model: city (4.792, 95% confidence interval [CI]: 3.068-6.516, P = 0.000), age (-0.805, 95% CI: -1.394 to -0.135, P = 0.013), marital status (-1.260, 95% CI: -1.891 to -0.629, P = 0.000), living conditions (4.069, 95% CI: 3.022-5.116, P = 0.000), and SRH -1.941, 95% CI: -3.194 to -0.688, P = 0.003). The multiple-level model showed that city would impact older people's social support (χ = 5.103, P < 0.001). Marital status (-2.133, 95% CI: -2.768 to -1.499, P = 0.000), education (1.697, 95% CI: 0.589-2.805 P = 0.003), living conditions (4.20, 95% CI: 1.762-6.638, P = 0.000), and SRH (-3.144, 95% CI: -4.502 to -1.727, P = 0.000) were the associated factors. Thus, city, age, marital status, education, living conditions, and SRH might be the associated factors for social support among older people.This study presents some feasible implications for social support improvement in China and in other nations worldwide.

The effect of offspring on depressive disorder among old adults: Evidence from the Korean Longitudinal Study of Aging from 2006 to 2012

OBJECTIVE

To investigate whether having an offspring protects against or increases the risk of depressive disorders.

METHODS

Data from the Korean Longitudinal Study of Aging (KLoSA) from 2006 and 2012 was assessed using longitudinal data analysis. We have included 10,149 research subjects at baseline and estimated the prevalence of depressive disorders for those with children.

RESULTS

The number of offspring was from zero to five or more, and the composition of offspring is from zero boys and zero girls to two or more boys and two or more girls. For parents with zero offspring, the estimate for depressive disorder was 0.464 higher (SE: 0.123, p-value: 0.000, OR: 1.389; 95% CI: 1.176-1.640) and for parents with five or more offspring, the estimate for depressive disorder was 0.1 higher (SE: 0.104, p-value: 0.013, OR: 1.315; 95% CI: 1.150-1.504) compared to parents with two offspring. For parents with zero boys and zero girls, the estimate for depressive disorder was 0.599 higher (SE: 4.750, p-value: <0.0001, OR: 1.539; 95% CI: 1.298-1.825), and for parents with two or more boys and two or more girls, the estimate for depressive disorder was 1.328 higher (SE: 3.820, p-value: 0.000, OR: 1.328; 95% CI: 1.189-1.482) compared to parents with one boy and one girl.

CONCLUSIONS

Our results indicate that there is a large effect of offspring on the prevalence of depressive disorder, with significant positive effects for mothers. Fathers are at lower risk for depressive disorder than mothers, and the graph was U-shaped.