The role of social capital in the relationship between physical constraint and mental distress in older adults: a latent interaction model

Exploratory graph analysis on the Connor-Davidson Resilience Scale (CD-RISC) among older adults in China

It is important for healthy aging to understand resilience in depth. This study aims to examine the dimensional structure underlying the Connor-Davidson Resilience Scale (CD-RISC) among Chinese older adults. Exploratory Graph Analysis (EGA) was used to evaluate the dimensional structure of CD-RISC in two large samples: training sample (n = 11,493) and cross-validation sample (n = 7662). Then, Confirmatory Factor Analysis (CFA) was used to compare the fit of the theoretical dimensions with the EGA dimensions. Finially, Generalized Linear Model was used to examine the association between resilience scores and self-rated health (SRH) after controlling other covariates in order to evaluate the predictive value of the EGA dimensions. The EGA indicated two demensions(named foresight and self-adjustment) of the 25-item CD-RISC. The CFA comparison found that the two-demension structure of CD-RISC fit significantly better than the theoretical three-demension structure. After controlling for sociodemographic characteristics, generalized linear model showed that the EGA dimensions has better protective value with SRH. Compared with older adults with lowest quartile of foresight, those with second (odds ratio, OR = 0.68, 95% CI = 0.62 ~ 0.75), third (OR = 0.50, 95% CI = 0.45 ~ 0.56) and fourth quartile (OR = 0.42, 95% CI  =  0.37 ~ 0.48) of foresight had lower odds ratio of poor SRH. Similarly, older adults with the second (OR = 1.11, 95% CI = 1.01 ~ 1.23) and fourth (OR = 0.79, 95% CI = 0.69 ~ 0.90) quartile of self-adjustment also had lower OR of poor SRH than those with lowest quartile of self-adjustment. These findings show that EGA outperforms the traditional methods, which may be helpful to understand resilience deeply. CD-RISC should be interpreted into two aspects among community-dwelling older adults in China, highlighting the significance of the practical value and cultural context of resilience.

Access to Information and Communication Technology, Digital Skills, and Perceived Well-Being among Older Adults in Hong Kong

Population aging is a major concern worldwide. Active aging should be promoted by increasing the social participation of older adults and enabling them to remain involved in the community. Research has demonstrated the utility of digital resources for addressing the needs of older adults, which include networking, entertaining, and seeking health-related information. However, the digital divide among older adults (i.e., the "gray digital divide") is increasingly being recognized as a social problem that may be related to poor well-being. To obtain updated local data on the prevalence of Internet access and usage and their relationship with perceived well-being, we conducted telephone interviews with a random sample of 1018 older adults in Hong Kong from January to July 2021 (This research has received funding support from the Interdisciplinary Research Matching Scheme, Hong Kong Baptist University). We found that only 76.5% of the participants had Internet access at home, a mobile phone data plan, or both, whereas 36.3% had never used Internet services and 18.2% had no digital devices. A younger age, male gender, higher education level, living with others, and higher self-perceived social class were associated with material access to digital devices and everyday use of Internet services. Participants who accessed the Internet every day had higher levels of life satisfaction and self-rated physical and mental health than those who rarely or never used the Internet. Hierarchical multiple regression analysis revealed that digital skills were significantly associated with self-rated mental health even when controlling for demographic variables (including age, gender, education level, and self-perceived social class). This study contributes to the limited body of literature on the relationship between Internet use, digital skills, and perceived well-being. Our findings highlight the importance of addressing the digital divide even in cities with high penetration of information and communication technology, such as Hong Kong. We also discuss our insights into the use of timely interventions for older adults to address the gray digital divide.

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.

Enhancing Older Adults' Well-Being and Quality of Life through Purposeful Activity: A Systematic Review of Intervention Studies

BACKGROUND AND OBJECTIVES

Population aging represents a significant challenge for health and social care services. Older adults who engage in activities that offer a sense of purpose have significantly better physical and psychological health outcomes. However, age-related functional limitations and losses of social roles can present barriers to engaging in purposeful activity, especially for those older adults within the 'oldest old' age range (i.e. 80 years and over). This review aimed to determine the nature and effectiveness of purposeful activity interventions in older adults, aged ≥80 years, with respect to well-being and quality of life outcomes.

RESEARCH DESIGN AND METHODS

Three databases were searched from their inception to April 2020. The search yielded 8,916 records, which resulted in eight eligible studies.

RESULTS

The interventions were divided into two groups: (1) interventions that gave participants a specific functional role, such as volunteer or mentor (n=5); (2) interventions that supported participants to develop a new skill (n=3). The quality of the evidence was variable. The strongest evidence was for interventions that assigned a functional role, which appeared to be somewhat effective in improving well-being outcomes.

DISCUSSION AND IMPLICATIONS

There is preliminary evidence that purposeful activity interventions, particularly those that involved taking on a functional role, can improve well-being and quality of life outcomes in older adults aged 80 years and over. These findings have implications for professionals and carers to support older adults to access more purposeful social roles and create opportunities for helping and reciprocation.

Association between social trust and the risk of cardiovascular disease in older adults in Korea: a nationwide retrospective cohort study

Background

Although social capital has been shown to be one of the important social determinants of health, the association between social trust and the risk of cardiovascular disease (CVD) is not clear yet. We aimed to investigate the association of social trust with CVD risk using a large Korean population based data.

Methods

The data of this study was derived from the Korean National Health Insurance Service database. Community-level social trust was determined from the Korean Community Health Survey. The study population consisted of 2,156,829 participants. According to social trust index measured in the area of residence during 2011, participants were followed-up from 1 January 2012 to 31 December 2016. Multivariate Cox proportional hazards regression was used to determine the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for CVD risk according to quintiles of social trust.

Results

Compared to participants with the lowest quintile of social trust, those within the highest quintile had lower risk for CVD (aHR 0.91, 95% CI = 0.89 to 0.93), CHD (aHR 0.92, 95% CI = 0.89 to 0.95), and stroke (aHR 0.90, 95% CI = 0.87 to 0.93). The risk-reducing association of high social trust on CVD risk was preserved after additional adjustments for lifestyle behaviors including smoking, alcohol consumption, and physical activity.

Conclusion

Higher social trust was associated with reduced risk of CVD even after considering lifestyle behaviors. Social trust in a community level is an important determinant of CVD and enhancing social trust may lead to reduced risk of CVD.

Association between social capital and depression among older people: evidence from Anhui Province, China

BACKGROUND

To examine the relationship between social capital and depression among community-dwelling older adults in Anhui Province, China.

METHODS

A cross-sectional study was conducted among older people selected from three cities of Anhui Province, China using a multi-stage stratified cluster random sampling method. Data were collected through questionnaire interviews and information on demographic characteristics, social capital, and depression was collected. The generalized linear model and classification and regression tree model were employed to assess the association between social capital and depression.

RESULTS

Totally, 1810 older people aged ≥60 years were included in the final analysis. Overall, all of the social capital dimensions were positively associated with depression: social participation (coefficient: 0.35, 95% CI: 0.22-0.48), social support (coefficient:0.18, 95% CI:0.07-0.28), social connection (coefficient: 0.76, 95% CI:0.53-1.00), trust (coefficient:0.62, 95% CI:0.33-0.92), cohesion (coefficient:0.31, 95% CI:0.17-0.44) and reciprocity (coefficient:0.30, 95% CI:0.11-0.48), which suggested that older people with higher social capital had a smaller chance to develop depression. A complex joint effect of certain social capital dimensions on depression was also observed. The association with depression and the combinative effect of social capital varied among older adults across the cities.

CONCLUSIONS

Our study suggests that improving social capital could aid in the prevention of depression among older adults.

Low socioeconomic status, parental stress, depression, and the buffering role of network social capital in mothers

BACKGROUND

Pathways underlying the stress-depression relationship in mothers, and the factors that buffer this relationship are not well understood.

AIMS

Drawing from the Stress Process model, this study examines (1) if parental stress mediates the association between socioeconomic characteristics and depressive symptoms, and (2) if social support and network capital moderate these pathways.

METHOD

Data came from 101 mothers from Montreal. Generalized structural equation models were conducted, with depressive symptoms (CES-D scores) as the outcome, socioeconomic stressors as independent variables, parental stress as the mediator, and social support and network social capital as moderators.

RESULTS

Parental stress partially mediated the association between household income and depressive symptoms (indirect effect: β = -0.09, Bootstrap SE = 0.03, 95% CI = -0.15 to -0.03 p = 0.00). Network diversity moderated the relationship between parental stress and depressive symptoms (β = -0.25, 95% CI = -0.42 to -0.09, p = 0.00); at high levels of stress, mothers with high compared to low network diversity reported fewer symptoms.

CONCLUSION

Findings highlight the role that socioeconomic factors play in influencing women's risk of depression and shaping the benefits that ensue from social resources. Addressing these factors requires interventions that target the social determinants of depression.

Perspectives of older adults, caregivers, and healthcare providers on frailty screening: a qualitative study

BACKGROUND

Screening is an important component of understanding and managing frailty. This study examined older adults', caregivers' and healthcare providers' perspectives on frailty and frailty screening.

METHODS

Fourteen older adults and caregivers and 14 healthcare providers completed individual or focus group interviews. Interviews were audio recorded, transcribed verbatim, and analyzed using line-by-line emergent coding techniques and inductive thematic analysis.

RESULTS

The interviews yielded several themes with associated subthemes: definitions and conceptualizations of frailty, perceptions of "frail", factors contributing to frailty (physical,, cognitive, social, pharmaceutical, nutritional), and frailty screening (current practices, tools in use, limitations, recommendations).

CONCLUSION

Older adults, caregivers and healthcare providers have similar perspectives regarding frailty; both identified frailty as multi-dimensional and dynamic. Healthcare providers need clear "next steps" to provide meaning to frailty screening practices, which may improve use of frailty-screening tools.

Mediating Effect of Cognitive Social Capital on the Relationship Between Physical Disability and Depression in Elderly People of Rural Pakistan

Cognitive social capital is crucial for mental wellbeing and physical disability in order to avoid late-life depression. The objective of this study was to investigate the mediating effect of cognitive social capital (interpersonal trust and reciprocity) on the relationship between physical disability and depression in elderly people of rural Pakistan. For this purpose, 146 respondents aged 60 years or above and residents of rural areas of district Muzaffargarh (Punjab, Pakistan) were approached for data collection. The questionnaire includes socio-demographic variables (gender, age, education, marital status, family system, living status, household income, and number of chronic diseases); the geriatric depressive symptoms scale (GDS-15) was used to measure depression, physical disability was evaluated through ADL and IADL scales, and cognitive social capital, which includes interpersonal trust and reciprocity, was measured using single-item questions. It was found that interpersonal trust, reciprocity, depression, and physical disability were significantly correlated with each other and physical disability was directly associated with depression. In mediation analysis, reciprocity mediated the relationship between physical disability and depression. Our findings highlight the need to enhance cognitive social capital interventions and develop policies to promote mental and physical health of rural elderly.

Health outcomes associated with participating in community care centres for older people in Taiwan

Community care centres (CCCs) are widespread across Taiwan and have provided health promotion and social activities for older people in communities since 1995. The purpose of this study was to describe the status of the delivery and management of CCCs for older people, and to explore the effects of individual factors and the organisational factors on the health-related outcome of older people's participation in CCCs. The sample was taken from participants at CCCs in Taichung, Taiwan. Twenty-five CCCs participated in the study. The managers and the elderly participants of CCCs underwent face-to-face interviews. In total, 417 elderly participants and 25 chiefs completed the face-to-face interviews. The participants reported that self-reported health, sleep quality, memory, family relationships, care for health, and health literacy improved after they participated in the programme. There were no consistent organisational factors related to the outcomes. However, management style was related to sleep quality improvement and staffing getting paid was related to family relationship improvement. Policy recommendations are provided.

Social Mind and Long-Lasting Disease: Focus on Affective and Cognitive Theory of Mind in Multiple Sclerosis

The role of social cognition, including theory of mind (ToM), in affecting quality of life (QoL) along the course of diseases has been reported. This is a considerable aspect in chronic pathologies, such as multiple sclerosis (MS), in which supporting and maintaining QoL is of crucial importance. We aimed to investigate the relation between ToM, clinical variables and neuropsychological profile in a cohort of adults with long lasting disease, such as different clinical MS phenotypes (Relapsing Remitting -RR- versus Progressive -Pr). In particular, our study focuses on (1) how (affective and cognitive) ToM impairment occurs in different phenotypes, (2) whether MS ToM impairment is secondary to or independent from cognitive deficit and (3) whether ToM deficit impacts QoL. 42 adults with MS (18 M: 24 F, 52.38 ± 10.31 mean age, 21.24 ± 10.94 mean disease duration, 26 RR and 16 Pr) and 26 matched healthy controls (HC) (7 M: 19 F, 51.35 ± 12.42 mean age) were screened with a neuropsychological and ToM battery, assessing both affective and cognitive components. We found statistically significant groups differences in cognitive but not affective ToM, with a lower performance in PrMS than those with a RRMS disease course. Also, significant predictive effects of neuropsychological tests on ToM were identified in MS group. Finally, MS people with different level of affective ToM differed significantly in QoL. ToM deficit in moderately disabled people with MS involves cognitive but not affective ToM components with implications on QoL. It also appears to be related to cognitive performance. As neurological and neurocognitive profiles influence mentalizing in MS, ToM evaluation should be considered for inclusion in clinical screening.