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Li YP, Fan SY, Hu FW, Liu CY. Mediating effect of social support on the relationship between social activity and depressive symptoms among older widows in Taiwan. J Women Aging 2024:1-14. [PMID: 39052503 DOI: 10.1080/08952841.2024.2370646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 04/18/2024] [Accepted: 06/17/2024] [Indexed: 07/27/2024]
Abstract
The purpose of this study was to investigate the mediating effect of social support on the relationship between social activity and depressive symptoms among older widows in Taiwan. A cross-sectional study was conducted that recruited 256 older widows in southern Taiwan. Data were collected on demographic characteristics, self-rated health, instrumental activities of daily living, social activity, social support, and depression. Multiple linear regressions performed examined whether social activities and social support were significantly associated with depressive symptoms and which types of social activity were significantly related to social support and depressive symptoms. Mediation analyses performed tested the mediation effect of social support between the number of different types of social activities performed (termed "number of activities" in this study) and depression. Overall, 17.2% of the participants reported having at least two depressive symptoms. The total effect of the number of activities on depressive symptoms was significant (p < .001). The direct pathway from the number of activities to depressive symptoms remained significant (p < .001), and the mediation pathway (from the number of activities to depressive symptoms through social support) was also significant (Bootstrap CI = -.072, -.003). These findings demonstrated that older widows had more social support when they participated in more social activities, which could then decrease depressive symptoms. In addition, informal community group activities and religious group activities were the most effective at increasing social support and reducing depressive symptoms among the older Taiwanese widows.
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Affiliation(s)
- Yueh-Ping Li
- Department of Nursing, National Tainan Junior College of Nursing, Tainan City, Taiwan
| | - Sheng-Yu Fan
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Fang-Wen Hu
- School of Nursing, College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chieh-Yu Liu
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
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Hawes FM, Tavares JL. Religious Involvement and the Impact on Living Alone and Depression: An Examination of Gendered Pathways Post-Widowhood. J Appl Gerontol 2024; 43:870-880. [PMID: 38174723 DOI: 10.1177/07334648231225355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024] Open
Abstract
This study analyzed data from the nationally representative Health and Retirement Study (HRS) to examine the association between widowhood and depression. The results revealed that both men and women experienced increased depression after widowhood, with women exhibiting a better recovery pattern over time. Religiosity, especially attending religious services, was found to be a beneficial coping mechanism for both genders, although men were less religious than women. Living alone was a significant factor associated with depression in widowhood for both men and women. High religious service attendance moderated the association between living alone and depression for women, while both high and moderate religious service attendance moderated this association for men. These findings emphasize the importance of considering gender differences and the potential benefits of religious involvement in addressing depression during widowhood, highlighting the need for tailored interventions and support services for widows and widowers, particularly those living alone.
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Affiliation(s)
- Frances M Hawes
- Department of Health Care Administration, University of Wisconsin Eau Claire, Eau Claire, WI, USA
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Lee G, Nemmers N, Russell D. Pre-widowhood social support is linked to loneliness patterns: a growth mixture model using the health and retirement study. Aging Ment Health 2024:1-8. [PMID: 38919075 DOI: 10.1080/13607863.2024.2367045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 06/06/2024] [Indexed: 06/27/2024]
Abstract
OBJECTIVES The first aim of the study is to compare loneliness levels between widowed and non-widowed older adults. The second aim is to identify distinct loneliness patterns among widowed individuals and explore the impact of pre-spousal loss social support on loneliness during and after bereavement. METHOD Data from the Health and Retirement Study were utilized to compare loneliness levels between widowed (n = 137) and non-widowed (n = 2361) older adults (Mage = 69.01). T-tests and latent growth curve models were conducted to compare loneliness levels between the two groups. Growth mixture models were computed to identify distinct loneliness patterns among the widowed individuals. A multinomial logistic regression analysis was conducted to determine how pre-widowhood social support was associated with the obtained classes. RESULTS The results revealed that widowed individuals reported significantly higher levels of loneliness at T2. Among widowed individuals, three distinct loneliness patterns were identified: Increased Loneliness (IL) group (n = 32); Low and Stable Loneliness (LSL) group (n = 88); and Decreased Loneliness (DL) group (n = 17). The IL and DL group were less likely to receive social support from spouse, children, and friends compared to the LSL group. CONCLUSION This study provides evidence of the protective effect of pre-widowhood social support on the psychological well-being of older adults after spousal loss.
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Affiliation(s)
- Gina Lee
- Center for Demography of Health and Aging, University of Wisconsin-Madison, WI, USA
| | - Natasha Nemmers
- Institute of Gerontology, Wayne State University, Detroit, MI, USA
| | - Daniel Russell
- Human Development and Family Studies, Iowa State University, Ames, IA, USA
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Kapelle N, Monden C. Transitory or Chronic? Gendered Loneliness Trajectories over Widowhood and Separation in Older Age. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2024; 65:292-308. [PMID: 38279812 PMCID: PMC11144354 DOI: 10.1177/00221465231223719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2024]
Abstract
We investigate how loneliness develops over the marital dissolution process in older age (i.e., transition at or after age 50) while paying close attention to heterogeneities by the dissolution pathway-widowhood and separation-and gender. Using data from over 8,000 Household, Income and Labour Dynamics in Australia survey respondents, we assess the association of interest using fixed effects regressions. Findings indicate that loneliness increased in the year before widowhood or separation among both women and men. Levels spiked in the year of dissolution, particularly for widowhood but less for separation. Widowed men were substantially more affected than widowed women, and gender differences were negligible for separation. Although loneliness levels gradually declined, widowed men remained vulnerable for remarkably long periods. Such chronic loneliness might be linked to other health disadvantages. These findings highlight the importance of long-term and gender-specific approaches to social support and integration after marital dissolution.
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Affiliation(s)
- Nicole Kapelle
- Humboldt-Universität zu Berlin, Berlin, Germany
- Nuffield College, Oxford, UK
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Pollak C, Verghese J, Blumen HM. Loneliness predicts decreased physical activity in widowed but not married or unmarried individuals. Front Public Health 2024; 12:1295128. [PMID: 38756882 PMCID: PMC11096491 DOI: 10.3389/fpubh.2024.1295128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 04/09/2024] [Indexed: 05/18/2024] Open
Abstract
Background Physical activity is associated with improved health and function in older adults, yet most older adults are sedentary. Loneliness is associated with decreased physical activity at the cross-section, but longitudinal studies are scarce. We examined longitudinal associations between loneliness and physical activity-and whether they were modified by marital status and network size (the number of children, relatives, and friends a person interacts with at least once a month). Methods We analyzed data from 1,931 older adults without dementia at baseline from the Rush Memory and Aging Project with a mean follow-up of 4.8 years (mean age 79.6 ± 7.7, 74.9% women). Loneliness was assessed using the de Jong Gierveld Loneliness Scale. Physical activity was assessed as the frequency with which participants engaged in five categories of activities (e.g., walking, gardening, calisthenics, bicycling, and swimming). Linear mixed effects models examined associations between baseline loneliness and change in physical activity over time after adjusting for demographics, depressive symptoms, global cognition, disability, network size, marital status, social support, and social and cognitive activities. We assessed for effect modification by marital status and network size. Results Associations between loneliness and physical activity differed by marital status. In widowed individuals, baseline loneliness was associated with a 0.06 h/week greater decrease in physical activity per year compared to those who were not lonely (p = 0.005, CI -0.1, 0.02)-which equaled a 150% decrease in physical activity per year. Loneliness did not predict a statistically significant decrease in physical activity in married or unmarried individuals. Discussion Loneliness is associated with decreased physical activity in widowed older adults and should be considered in the design of interventions to prevent or slow the decline in physical activity and promote healthy aging.
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Affiliation(s)
- Chava Pollak
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Joe Verghese
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Helena M. Blumen
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
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Cecchini V, Agahi N. Does losing family members in midlife matter for late-life mental and cognitive health? A longitudinal study of older Swedes spanning 30 years. Aging Ment Health 2024:1-9. [PMID: 38644675 DOI: 10.1080/13607863.2024.2341877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 04/05/2024] [Indexed: 04/23/2024]
Abstract
OBJECTIVES Mental and cognitive health is crucial to ensure well-being in older age. However, prolonged periods of stress, grief, and bereavement might compromise mental health balance, leading to profound changes. This study investigated the sex-stratified associations between midlife bereavement experiences (e.g. sibling loss, spousal loss, and multiple losses) and late-life depression (LLD) and cognitive impairment. METHOD Linked data from the Swedish Level-of-Living Survey and the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) were used. Multiple logistic regressions were performed to examine the associations between midlife bereavement and LLD (n = 1078) and cognitive impairment (n = 995), separately. RESULTS Sibling loss and multiple losses in midlife were associated with lower odds of LLD, especially among women. Among men, sibling loss in midlife was associated with lower odds of cognitive impairment, while the experience of two losses among women suggested an increased (but non-significant) risk of cognitive impairment. Interaction analyses did not show significant effects between bereavement and gender on LLD and cognitive impairment. CONCLUSION Midlife bereavement might have gendered implications on LLD and cognitive impairment, but associations need to be confirmed by well-powered studies. Further research is warranted to elucidate the association between multiple midlife losses and reduced LLD risk.
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Affiliation(s)
- Valeria Cecchini
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Neda Agahi
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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You S, Kim G. Types of bereavement and depressive symptoms among older adults: Does race/ethnicity matter? Geriatr Gerontol Int 2024; 24 Suppl 1:266-272. [PMID: 38317574 DOI: 10.1111/ggi.14817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/26/2023] [Accepted: 01/05/2024] [Indexed: 02/07/2024]
Abstract
AIM To explore racial/ethnic differences in relation between types of bereavement and depressive symptoms among older adults in the USA. METHODS The sample limited to racially/ethnically diverse adults aged ≥55 (n = 879) was drawn from the third wave of the National Social Life, Health, and Aging Project (NSHAP). The NSHAP provides self-identified racial/ethnic categories (non-Hispanic Whites, Blacks, and Hispanics) of respondents who were categorized into three groups by experience of bereavement: non-loss, spousal loss, and parental loss. Using the weights, a two-way analysis of covariance with Bonferroni post-test was conducted to explore the main effect of types of loss and race/ethnicity and their interaction effects on depressive symptoms. RESULTS Spousal loss reported higher levels of depressive symptoms than non-loss or parental loss. Based on the interaction between types of loss and race/ethnicity; however, distinctive patterns were observed. Blacks and Hispanics who lose a parent reported significantly higher levels of depressive symptoms than non-Hispanic Whites did. CONCLUSIONS An increase in depressive symptoms after bereavement manifested distinctively based on racial/ethnic background and the relationship with the deceased. This implies that it is necessary to develop coping strategies concerning race/ethnicity and whom they lose. Geriatr Gerontol Int 2024; 24: 266-272.
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Affiliation(s)
- Suha You
- Department of Psychology, Chung-Ang University, Seoul, South Korea
| | - Giyeon Kim
- Department of Psychology, Chung-Ang University, Seoul, South Korea
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Wang SH, Wu H, Hsu LY, Lin MC, Fan CC, Chen PC, Hsu CC, Wu CS. Widowhood and mortality risk in Taiwan: a population-based matched cohort study. Int J Epidemiol 2024; 53:dyae034. [PMID: 38553032 DOI: 10.1093/ije/dyae034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 02/17/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Studying the causes of death among deceased spouses and surviving partners may provide insights into the underlying mechanisms of the association between widowhood and mortality. This study investigated the mortality risk of widowhood in Taiwan, examined the association of the cause of death between widowed individuals and their deceased spouses and explored potential modifying effects by age, gender and duration after widowhood. METHODS This matched cohort study utilized Taiwan's National Health Insurance claims database and National Death Registry. In total, 204 010 widowed men and 596 136 widowed women were identified with a mean follow-up period of 6.9 and 7.9 years, respectively, and 816 040 comparison men and 2 384 544 comparison women were selected. RESULTS Widowhood was associated with an increased mortality risk, with widowed men having a 1.32 increased risk and widowed women having a 1.27 increased risk. Age at spousal death and duration modified the associations after widowhood. The widowed individuals are more likely to die by the same cause as the deceased spouse if they died by suicide, accident, endocrine, gastrointestinal disorders or infection. CONCLUSIONS The study suggests that healthcare policies and interventions should be developed to improve widowed individuals' health and overall welfare.
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Affiliation(s)
- Shi-Heng Wang
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Miaoli, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Huijing Wu
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Miaoli, Taiwan
| | - Le-Yin Hsu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Graduate Program of Data Science, National Taiwan University and Academia Sinica, Taipei, Taiwan
| | - Mei-Chen Lin
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Miaoli, Taiwan
| | - Chun-Chieh Fan
- Center for Population Neuroscience and Genetics, Laureate Institute for Brain Research, Tulsa, OK, USA
- Department of Radiology, School of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Pei-Chun Chen
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Miaoli, Taiwan
| | - Chih-Cheng Hsu
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Miaoli, Taiwan
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Chi-Shin Wu
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Miaoli, Taiwan
- Department of Psychiatry, National Taiwan University Hospital, Yunlin Branch, Yunlin, Taiwan
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Chami JM, Pooley JA. Widowed Young: The Role of Stressors and Protective Factors for Resilience in Coping with Spousal Loss. OMEGA-JOURNAL OF DEATH AND DYING 2023; 88:477-504. [PMID: 34541943 DOI: 10.1177/00302228211047088] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
While distressing, late life spousal loss is considered a normative life event and most demonstrate resilient recovery from grief. However, for 5-7% of the population spousal loss comes early, before the age of 50, and little is known about the factors that influence adjustment in this population. We used the DPM integrative framework to examine correlates and predictors of mental wellbeing and grief intensity in an international sample of 603 young widows and widowers. Contrary to existing bereavement research, loss-orientated stressors (e.g., expectedness and cause of death) did not predict bereavement outcomes. Employment and financial wellbeing were the only statistically significant restoration-orientated stressors associated with coping, mental wellbeing and grief intensity. We found no significant associations between parental status and coping or bereavement outcomes. Loss-orientated coping, followed by inter and intrapersonal protective factors for resilience and financial wellbeing were the greatest predictors of grief intensity. Loss-orientated coping was highest in early bereavement, the greatest predictor of grief intensity and associated with being unemployed, financial insecurity and decreased protective factors for resilience. Restoration-orientated coping was highest in later bereavement, was a weak predictor of grief intensity and associated with being employed, increased financial wellbeing and protective factors for resilience. Overall, we found the young-widowed population is at heightened risk of poor adjustment. Almost two-thirds reported decreased functioning, probable depression with high rates of psychological distress. Nearly half met diagnostic criteria for prolonged grief disorder. We discuss implications for research and clinical practice.
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Affiliation(s)
- Jane Marie Chami
- Department of Psychology and Social Science, Edith Cowan University, Perth, Australia
| | - Julie Ann Pooley
- Department of Psychology and Social Science, Edith Cowan University, Perth, Australia
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Mahat Shamir M, Leichtentritt RD. Navigating the paradox: Strategies utilized by pregnant widows in an attempt to reconcile life and death. DEATH STUDIES 2023; 48:836-846. [PMID: 38009254 DOI: 10.1080/07481187.2023.2283454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2023]
Abstract
Losing a spouse is a traumatic experience, especially at a younger age. This experience is arguably more intense and complex if the woman becomes a widow while pregnant. In the current study, we examined the strategies Israeli women who became widows while pregnant utilized to reconcile life and death. Twelve adult women who became widows while pregnant participated in this study, which involved in-depth semi-structured interviews. A thematic analysis of the interview content revealed four main strategies utilized to reconcile their simultaneous paradoxical experience of both life and death: Passiveness - focusing on neither life nor death; Segregation - focusing on either life or death; Continuum - perceiving life and death are the same; and Integration - coming to terms with both life and death. The women commonly utilized multiple strategies while navigating this paradox, with most participants using all four at some point during their attempted reconciliation process.
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Nilaweera D, Gurvich C, Freak-Poli R, Woods RL, Owen A, McNeil J, Nelson M, Stocks N, Ryan J. The association between adverse events in later life and mortality in older individuals. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2023; 16:100210. [PMID: 37753199 PMCID: PMC10518669 DOI: 10.1016/j.cpnec.2023.100210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 09/12/2023] [Indexed: 09/28/2023] Open
Abstract
Background Stress can have adverse impacts on health, particularly when it is chronic or resulting from major adverse events. Our study investigated whether relatively common adverse events in older individuals were associated with an increased risk of death, as well as cause-specific death and potential gender differences. Methods Participants were 12896 community-dwelling Australians aged ≥70 years at enrolment into the ASPREE (ASPirin in Reducing Events in the Elderly) study and without known life-limiting disease. A questionnaire administered in the year after enrolment, collected information on ten adverse events experienced in the past year. Mortality status was verified by multiple sources including health records and the National Death Index across a maximum of 10 years. Underlying causes of death were determined using clinical information by two adjudicators. Cox-proportional hazards regression models were used to estimate mortality risk. Results Two of the ten adverse events were associated with an increased risk of mortality in fully adjusted models. A 69% increased risk of mortality was observed in participants who reported their spouse/partner had recently died (95% CI: 1.19-2.39, P < 0.01). Cancer-related but not cardiovascular deaths also increased. Participants with a seriously ill spouse/partner also had a 23% increased risk of mortality (HR: 1.23, 95% CI: 1.02-1.48, P = 0.03). There was a tendency for these associations to be stronger among men than women. Limitations Perceived stress and cortisol were not measured, thus limiting our understanding of the psychological and physiological impacts of adverse events. Conclusions Experiencing adverse events in later-life, especially the death of a spouse/partner, may be a risk factor for earlier mortality. These findings may increase public health awareness and better inform initiatives for particular groups, including bereaved men.
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Affiliation(s)
- Dinuli Nilaweera
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Caroline Gurvich
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Rosanne Freak-Poli
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
| | - Robyn L. Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Alice Owen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - John McNeil
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Mark Nelson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Nigel Stocks
- Discipline of General Practice, Adelaide Medical School, University of Adelaide, South Australia, Australia
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Zhang Y, Chen X, Sun Y, Feng S, Wang F, Gu H, Jia H, Zhang Q, Ding W, Lu H, Zhang J. Relationship of widowhood with pulse pressure, fasting blood glucose, and mental health in older adults: a propensity matching score analysis. Front Public Health 2023; 11:1257133. [PMID: 37954046 PMCID: PMC10634533 DOI: 10.3389/fpubh.2023.1257133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/29/2023] [Indexed: 11/14/2023] Open
Abstract
Background Transitioning from marriage to widowhood presents inevitable and significant challenges for many older adults. This study explored the impact of widowhood on a range of mental health outcomes, including pulse pressure and fasting blood glucose levels, among older adults in nursing homes. Methods This cross-sectional study utilized cluster random sampling to recruit participants, with data analyzed from 388 older Chinese adults. Psychosocial traits were assessed using the Perceived Social Support from Family scale (PSS-Fa) for family support, the Generalized Anxiety Disorder 7-item scale (GAD-7) for anxiety symptoms, and the 9-item Patient Health Questionnaire (PHQ-9) for depressive symptoms and suicidal ideation. Propensity score matching (PSM) was employed to control for confounding factors. A multivariate linear regression analysis was performed to explore the relationship between widowhood, mental health outcomes, pulse pressure, and fasting blood glucose levels. Results After applying PSM, the sample size was refined to 268 (N = 134 for both married and widowed groups) from the initial 388, excluding 120 unmatched cases. Widowed older adults were found to have notably lower family support (β = -0.81, p = 0.002), increased depressive symptoms (β = 1.04, p = 0.043), elevated pulse pressure (β = 8.90, p < 0.001), and higher fasting blood glucose levels (β = 3.22, p = 0.027). These associations exhibited greater beta values compared to pre-matching analysis. Conclusion Our findings revealed that widowed participants had reduced family support, an increased risk of depressive symptoms, heightened pulse pressure, and elevated fasting blood glucose in comparison to their married counterparts. Interventions focusing on social support, mental health, and cardiovascular well-being could be advantageous for this at-risk group.
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Affiliation(s)
- Yi Zhang
- Department of Science and Education, Nantong First People's Hospital, Nantong, China
| | - Xiangfan Chen
- Department of Biobank, Nantong First People's Hospital, Nantong, China
| | - Yimei Sun
- Finance Department, Nantong First People's Hospital, Nantong, China
| | - Sujuan Feng
- Blood Dialysis Room of Nantong First People’s Hospital, Nantong, China
| | - Fang Wang
- Department of Science and Education, Nantong First People's Hospital, Nantong, China
| | - Haiyan Gu
- Nursing Department of Nantong First People’s Hospital, Nantong, China
| | - Hanyu Jia
- Department of Science and Education, Nantong First People's Hospital, Nantong, China
| | - Quanxing Zhang
- Department of Science and Education, Nantong First People's Hospital, Nantong, China
| | - Wenbin Ding
- The President's Office, Nantong First People's Hospital, Nantong, China
| | - Hongjian Lu
- Department of Science and Education, Nantong First People's Hospital, Nantong, China
| | - Jidong Zhang
- Department of Science and Education, Nantong First People's Hospital, Nantong, China
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Rauf T. Differential sensitivity to adversity by income: Evidence from a study of Bereavement. SOCIAL SCIENCE RESEARCH 2023; 115:102920. [PMID: 37858363 DOI: 10.1016/j.ssresearch.2023.102920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 10/21/2023]
Abstract
Adverse life events are often understood as having negative consequences for mental health via objective hardships, which are worse for persons with less income. But adversity can also affect mental health via more subjective mechanisms, and here, it is possible that persons with higher income will exhibit greater psychological sensitivity to negative events, for various reasons. Drawing on multiple sociological literatures, this article theorizes potential mechanisms of increasing sensitivity with income. The proposition of differential sensitivity is tested using the strategic case of spousal and parental bereavement among older US adults. The analyses find consistent evidence of increasing sensitivity of depressive symptoms with income. A series of robustness checks indicate that findings are not due to endogenous or antecedent selection. Further, exploratory analyses of mechanisms suggest that higher sensitivity among the affluent was driven by greater expectations and better relationship quality with the deceased. These findings problematize the conceptualization and assessment of human suffering in economically stratified societies.
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Affiliation(s)
- Tamkinat Rauf
- Department of Sociology, University of Wisconsin-Madison, 1180 Observatory Drive, Madison, WI, 53706, USA.
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Meulman I, Loef B, Stadhouders N, Moger TA, Wong A, Polder JJ, Uiters E. Estimating healthcare expenditures after becoming divorced or widowed using propensity score matching. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2023; 24:1047-1060. [PMID: 36251142 PMCID: PMC10406688 DOI: 10.1007/s10198-022-01532-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 09/28/2022] [Indexed: 06/16/2023]
Abstract
Becoming divorced or widowed are stressful life events experienced by a substantial part of the population. While marital status is a significant predictor in many studies on healthcare expenditures, effects of a change in marital status, specifically becoming divorced or widowed, are less investigated. This study combines individual health claims data and registered sociodemographic characteristics from all Dutch inhabitants (about 17 million) to estimate the differences in healthcare expenditure for individuals whose marital status changed (n = 469,901) compared to individuals who remained married, using propensity score matching and generalized linear models. We found that individuals who were (long-term) divorced or widowed had 12-27% higher healthcare expenditures (RR = 1.12, 95% CI 1.11-1.14; RR = 1.27, 95% CI 1.26-1.29) than individuals who remained married. Foremost, this could be attributed to higher spending on mental healthcare and home care. Higher healthcare expenditures are observed for both divorced and widowed individuals, both recently and long-term divorced/widowed individuals, and across all age groups, income levels and educational levels.
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Affiliation(s)
- Iris Meulman
- Center for Health and Society, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands.
- Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.
| | - Bette Loef
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Niek Stadhouders
- Scientific Center for Quality of Healthcare, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Tron Anders Moger
- Department of Health Management and Health Economics, University of Oslo, Oslo, Norway
| | - Albert Wong
- Department of Statistics, Informatics and Modeling, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Johan J Polder
- Center for Health and Society, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands
- Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Ellen Uiters
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
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Mellencamp KA. Gender Differences in Depressive Symptoms Following Child Death in Later Life. J Gerontol B Psychol Sci Soc Sci 2023; 78:1591-1603. [PMID: 36462213 PMCID: PMC10461527 DOI: 10.1093/geronb/gbac189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Indexed: 08/29/2023] Open
Abstract
OBJECTIVES This study examined short- and long-term psychological adjustment to parental bereavement in later life for mothers and fathers. METHODS Using 9 waves of data from the United States (1998-2014 Health and Retirement Study), I estimated trajectories of mothers' and fathers' depressive symptoms surrounding child death in later life, highlighting gender differences in adjustment. Moderation analyses were performed to uncover heterogeneous trajectories across parental characteristics. RESULTS Mothers were more likely to experience child death and reported higher depressive symptoms prior to parental bereavement than fathers. Mothers and fathers who lost a child reported an increase in depressive symptoms that diminished over time. The short-term elevation in depressive symptoms was marginally greater for mothers than fathers, but depressive symptoms declined at a faster rate for mothers than fathers in the years following the death. These counterbalancing changes resulted in mothers and fathers returning to their respective prebereavement levels of depressive symptoms between 2 and 4 years postbereavement. Parental age moderated trajectories distinctly by gender, and the presence of surviving children buffered the impact of child death on depressive symptoms for mothers but not fathers. DISCUSSION Mothers more often experience child death in later life and their adjustment process differs from that of fathers, underscoring the salience of gender in shaping how older parents respond to the death of a child. Older parents and mothers without surviving children are vulnerable to prolonged elevations in depressive symptoms following the death of a child in later life.
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Affiliation(s)
- Kagan A Mellencamp
- Department of Sociology, Bowling Green State University, Bowling Green, Ohio, USA
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16
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Guo X, Meng Y, Lian H, Li Y, Xu Y, Zhang R, Xu J, Wang H, Xu S, Cai W, Xiao L, Su T, Tang Y. Marital status and living apart affect sleep quality in male military personnel: a study of the China's Navy during COVID-19. Front Psychiatry 2023; 14:1178235. [PMID: 37575585 PMCID: PMC10412872 DOI: 10.3389/fpsyt.2023.1178235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 07/14/2023] [Indexed: 08/15/2023] Open
Abstract
Background Marital status is a robust sociodemographic predictor of sleep. Having to live apart from spouse may have different implications than those of cohabitants or singles, especially in military personnel. Further research on this group will help provide knowledge in advance and facilitate early targeted interventions. Methods An online questionnaire study was conducted from July to November 2021. A total of 1,832 male military personnel completed the questionnaire. The marital status was measured by a self-reported single choice question. Pittsburgh sleep quality index (PSQI), Epworth Sleepiness Scale (ESS) and The Dysfunctional Beliefs and Attitudes about sleep scale (DBAS-16) were used to measure sleep-related outcomes. Inverse probability weighting (IPW) was applied to reduce the effects of confounding. Logistic regression was used to analyze the relationship between marital status and sleep and explore the impact of living together or not. Results After inverse probability weighting, the prevalence of poor sleep quality, sleepiness and dysfunctional beliefs were 16.1, 20.1 and 7.1%, respectively. One-way ANOVA results for the means of both groups were statistically significantly different, except for the sleep latency and sleep disturbance dimensions of PSQI. Participants who were married were more likely to have poor sleep quality (OR: 1.408, 95% CI: [1.10, 1.80]), to have daytime sleepiness (OR: 1.560, 95% CI: [1.27, 1.92]) and to develop dysfunctional beliefs and attitudes (OR: 2.497, 95% CI: [1.65, 3.80]) than those who were unmarried. Further analysis showed that the odds of developing poor sleep quality and DBAS in participants who married but living apart were significantly bigger than those unmarried (OR: 1.548 and 3.991, respectively.), while there were no significant differences in the odds of daytime sleepiness (OR: 0.738, p = 0.050). Age was a protective factor for the development of bad sleep outcomes, while family economic was an independent risk factor. Conclusion Marital status appear important for sleep quality, daytime sleepiness and sleep beliefs. The effect of living apart or not should be considered separately as an important predictor of sleep.
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Affiliation(s)
- Xin Guo
- Department of Medical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Yao Meng
- Department of Medical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
- Department of Diving and Hyperbaric Medical Research, Naval Medical Center, Naval Medical University, Shanghai, China
| | - Hao Lian
- Department of Medical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Yinan Li
- Department of Medical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Ying Xu
- Department of Medical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Ruike Zhang
- Department of Medical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Jingzhou Xu
- Department of Medical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Hao Wang
- Department of Medical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Shuyu Xu
- Department of Medical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Wenpeng Cai
- Department of Medical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Lei Xiao
- Department of Medical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Tong Su
- Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Yunxiang Tang
- Faculty of Psychology, Naval Medical University, Shanghai, China
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Li Q, Smith JP, Zhao Y. Understanding the Effects of Widowhood on Health in China: Mechanisms and Heterogeneity. JOURNAL OF THE ECONOMICS OF AGEING 2023; 25:100458. [PMID: 37389325 PMCID: PMC10306321 DOI: 10.1016/j.jeoa.2023.100458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
This paper analyzes the impact of widowhood on the health of mid-aged and older individuals in China using data from the China Health and Retirement Longitudinal Study (CHARLS) data. Our results show that widowhood significantly increases the risk of depression, chronic diseases, and body pain while reducing cognitive function, sleeping time, and daily activity functions. The effects on depression and daily functions are immediate, that on chronic diseases is lagged, and the effects on cognitive function and sleeping hours persist over time. We find that rural widows are particularly vulnerable to negative health outcomes due to their weaker economic positions, for whom widowhood leads to more grandchild care responsibility and corresponding workforce and social withdrawals. Moreover, rural widows' income loss is not compensated by children, either by co-residence or financial transfers, leading to reduced living standards. Overall, our findings suggest that China needs to strengthen economic security for older people, especially among rural women, in order to avoid significant negative consequences of widowhood.
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Affiliation(s)
- Qin Li
- South China Agricultural University, Guangzhou, China
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18
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Tang D, Mair CA, Hu Q. Widowhood, social networks, and mental health among Chinese older adults: The moderating effects of gender. Front Psychol 2023; 14:1142036. [PMID: 37077844 PMCID: PMC10106722 DOI: 10.3389/fpsyg.2023.1142036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 03/06/2023] [Indexed: 04/05/2023] Open
Abstract
ObjectivesThis study aimed to examine the three-way interaction between widowhood, social ties, and gender and its effects on older adults’ mental health, including depressive symptoms and life satisfaction, in the context of China.MethodsParticipants were 7,601 Chinese older adults. Their social network was divided between family and friendship ties, and their mental health was measured by depressive symptoms and life satisfaction. Linear regression was employed to analyze the associations between widowhood, social networks, and mental health, as well as to explore the moderating effect of gender.ResultsWidowhood is associated with more depressive symptoms, but not with life satisfaction, while family and friendship ties are associated with less depressive symptoms and greater life satisfaction. Furthermore, the lack of family ties is associated with more depressive symptoms for widowed men compared to married older men, while it is associated with lower life satisfaction for widowed women compared to married older women.ConclusionFamily ties are the most important social support resource for Chinese older adults, especially for the widowed group. The vulnerability of older widowed men who lack family ties in China deserves public concern and attention.
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Affiliation(s)
- Dan Tang
- Center for Population and Development Studies, Institute of Gerontology, Family and Gender Study Center, Renmin University of China, Beijing, China
| | - Christine A. Mair
- Department of Sociology, Anthropology and Public Health, University of Maryland, Baltimore County, Baltimore, MD, United States
| | - Qing Hu
- Institute of Gerontology, Renmin University of China, Beijing, China
- *Correspondence: Hu Qing,
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19
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Kobayashi E, Harada K, Okamoto S, Liang J. Living Alone and Depressive Symptoms Among Older Japanese: Do Urbanization and Time Period Matter? J Gerontol B Psychol Sci Soc Sci 2023; 78:718-729. [PMID: 36548947 PMCID: PMC10413811 DOI: 10.1093/geronb/gbac195] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Previous research has suggested cross-national differences in the association between living alone and well-being among older adults. This study examined whether the association varied across social contexts within the country, Japan, in terms of varying degree of urbanization and differential time periods. METHODS Data were obtained from a nine-wave nationwide longitudinal survey with a probability sample of Japanese adults aged 60 years and over. Respondents belonged to one of the three periods (around 1990, 2000, and 2015) according to the year they commenced participation. As many as 4,655 individuals from 575 municipalities provided 9,016 observation sets of two consecutive waves (t - 1 and t). Within a framework of the Hierarchical Generalized Linear Model, depressive symptoms at t were predicted based on changes in living arrangements from t - 1 to t and their cross-level interactions with gender, level of urbanization, and time period, controlling for various covariates at t - 1. RESULTS In general, older adults living alone continuously as well as those who started living alone between the waves showed more depressive symptoms than those coresiding with someone continuously. However, this tendency was more prominent among rural residents than their urban counterparts, especially for men. Moreover, the effect of continuously living alone on depressive symptoms became smaller in Period 2015 than that in Period 1990, because of the increase in depressiveness in coresident older adults. DISCUSSION Our findings indicate that living alone has a differential effect on older adults' well-being depending on the social context where residents' preferences for living arrangements and availability of formal services could vary.
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Affiliation(s)
- Erika Kobayashi
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, Japan
| | - Ken Harada
- Faculty of Humanities and Social Sciences, Jissen Women’s University, Shibuya-ku, Tokyo, Japan
| | - Shohei Okamoto
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, Japan
| | - Jersey Liang
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
- Department of Health Care Management and Healthy Aging Research Center, Chang Gung University, Taoyuan City, Taiwan
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20
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Lamba N. Without Spouse: Phenomenology of Widowhood among Hindu Young Widows. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231153252. [PMID: 36650937 DOI: 10.1177/00302228231153252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
When a woman is widowed, it is a traumatic moment in her life. The pain would aggravate a widowed woman whose husband died at a younger age. This paper attempts to depict the lived experience of widowhood from the perspective of young Hindu widows by using a descriptive phenomenological approach guided by Husserlian philosophy. The selected widows for this study were under 45 years old when they had lost their husbands. This paper excerpts from the author's empirical study for his doctoral thesis. The article will focus on four major themes that emerged from analysing the transcribed data collected from seventieth widows through personal face-to-face interviews. These themes are grief, restrictiveness, suspiciousness, and loneliness, which will discuss elaborately throughout this article. The article advocates that researching the lived experience through a phenomenological approach can enhance understanding of any traumatic phenomenon humans encounter. This way, specific initiatives can be taken by the community, non-governmental organisations, etc., for better counselling and redressing widows' mental issues.
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Affiliation(s)
- Narendra Lamba
- Department of Sociology, Central University of Haryana, Mahendergarh, India
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21
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The impact of widowhood on mental health of older adults. Geriatr Nurs 2023; 50:38-43. [PMID: 36640517 DOI: 10.1016/j.gerinurse.2022.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 01/15/2023]
Abstract
Widowhood is identified as a risk factor for older adults' mental health, however, the underlying mechanisms and protective factors in this association has not been fully revealed. In order to add to the current knowledge, this study investigates the mediating roles of economic, social and psychological resources and the moderating role of community support in the relationship between widowhood and mental health. A sample of 7913 Chinese older people (Mean age = 71.14, SD = 7.19) is obtained from the 2018 wave of China Longitudinal Aging Social Survey. Results indicates that widowhood is negatively associated with older adults' mental health. Economic, social and psychological resources partially mediate the above association. Furthermore, the effect of widowhood is weaker for older people with more rather than less community support. This study not only illuminates the potential mechanisms of how widowhood influence mental health theoretically, but also provides valuable implications.
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Decreasing patterns of depression in living alone across middle-aged and older men and women using a longitudinal mixed-effects model. Soc Sci Med 2023; 317:115513. [PMID: 36450172 DOI: 10.1016/j.socscimed.2022.115513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/23/2022] [Accepted: 11/03/2022] [Indexed: 11/22/2022]
Abstract
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.
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You H, Wang Y, Xiao LD, Liu L. Prevalence of and Factors Associated with Negative Psychological Symptoms among Elderly Widows Living Alone in a Chinese Remote Sample: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010264. [PMID: 36612585 PMCID: PMC9819587 DOI: 10.3390/ijerph20010264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/15/2022] [Accepted: 12/21/2022] [Indexed: 06/12/2023]
Abstract
(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.
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Affiliation(s)
- Hui You
- Department of Midwifery, Xiangya School of Nursing, Central South University, Changsha 410013, China
| | - Yao Wang
- Department of Midwifery, Xiangya School of Nursing, Central South University, Changsha 410013, China
| | - Lily Dongxia Xiao
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5042, Australia
| | - Li Liu
- Department of Community Nursing, Xiangya School of Nursing, Central South University, Changsha 410013, China
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Jennings EA, Chinogurei C, Adams L. Marital experiences and depressive symptoms among older adults in rural South Africa. SSM - MENTAL HEALTH 2022; 2:100083. [PMID: 36277994 PMCID: PMC9581082 DOI: 10.1016/j.ssmmh.2022.100083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
This paper advances the understanding of how marital transitions may influence mental health by investigating these associations among a population of rural, Black South Africans aged 40+ that was directly impacted by apartheid. Using two waves of data from 4,176 men and women in Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI), we investigated associations between marital experiences and depressive symptoms, by gender, and explored whether economic resources is a moderator of these associations. We found that experiencing a marital dissolution was associated with more depressive symptoms than remaining married for both men and women. We also found that men, but not women, report greater depressive symptoms if they remained separated/divorced, remained widowed, or remained never married between waves. We found no evidence that a decline in wealth moderated the impact of marital dissolution on depressive symptoms for women or men. These findings suggest that the documented benefits of marriage for mental health, and differences by gender in those benefits, may extend to older, rural South Africans, despite the unique experiences of this population.
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Affiliation(s)
- Elyse A. Jennings
- Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, USA
- Corresponding author.
| | - Chido Chinogurei
- School of Public Health and Family Medicine, University of Cape Town, South Africa
| | - Leslie Adams
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Tian H, Chen J. Comparing the impact of social support on the life satisfaction of widowed and non-widowed elders. Front Psychol 2022; 13:1060217. [DOI: 10.3389/fpsyg.2022.1060217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 10/31/2022] [Indexed: 11/18/2022] Open
Abstract
AimTo compare differences in life satisfaction between widowed and non-widowed elders based on social support.MethodsA total of 4,560 widowed and 3,655 non-widowed elders were selected from the Chinese Longitudinal Healthy Longevity Survey (CLHLS-2018). Ordinal logistic regression models and t-tests were performed using SPSS v20.ResultsBoth widowed and non-widowed elders had high levels of life satisfaction. Personal characteristics had a significant impact on the life satisfaction of both widowed and non-widowed elders. Endowment insurance, social trust, residence, self-rated health, and living with family had a significant impact on the life satisfaction of widowed elders (p < 0.001), while endowment insurance, government subsidy, and self-rated health significantly impacted non-widowed elders (p < 0.001). Self-rated health had the greatest impact on the life satisfaction of widowed and non-widowed elders (OR = 4.62/4.45), followed by endowment insurance (OR = 1.24/1.32).ConclusionSocial support can significantly improve life satisfaction, but its impact is heterogeneous. Informal social support plays a greater role in improving the life satisfaction of widowed elders, but formal social support plays a greater role in the life satisfaction of non-widowed elders.
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Jennings EA, Farrell M, Liu Y, Montana L. Associations between cognitive function and marital status in the U.S., South Africa, Mexico, and China. SSM Popul Health 2022; 20:101288. [DOI: 10.1016/j.ssmph.2022.101288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/11/2022] [Accepted: 11/09/2022] [Indexed: 11/19/2022] Open
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Recksiedler C, Cheval B, Sieber S, Orsholits D, Stawski RS, Cullati S. Linking widowhood and later-life depressive symptoms: Do childhood socioeconomic circumstances matter? Aging Ment Health 2022; 26:2159-2169. [PMID: 34494920 PMCID: PMC8901780 DOI: 10.1080/13607863.2021.1972930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 08/16/2021] [Indexed: 01/25/2023]
Abstract
Objectives: Widowhood and adverse childhood socioeconomic circumstances (CSC) have both been linked to increased levels of depressive symptoms in old age. Beyond their independent impact on depressive symptoms, experiencing adverse CSC may also trigger a cascade of cumulative adversity and secondary stressors across the life course that shapes how individuals weather stressful life events later on.Method: We examine whether exposure to adverse CSC moderates the relationship between later-life widowhood and depressive symptoms using data from the Survey of Health, Ageing and Retirement in Europe (2004-2017).Results: Mixed-effects models revealed that both widowhood and adverse CSC were associated with increased levels of depressive symptoms among men and women. Associations between widowhood and depressive symptoms, however, were not moderated by CSC for both genders.Conclusion: Persisting differences in the levels of mental health in response to later-life widowhood did not further widen in the presence of disparities experienced early in the life course. This may reflect the life-altering impact of this age-normative, yet stressful life event across the social strata.
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Affiliation(s)
- Claudia Recksiedler
- Department of Social Monitoring and Methodology, German Youth Institute, Munich, Germany
| | - Boris Cheval
- Swiss NCCR “LIVES - Overcoming Vulnerability: Life Course Perspectives”, University of Geneva, Geneva, Switzerland
- Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
| | - Stefan Sieber
- Swiss NCCR “LIVES - Overcoming Vulnerability: Life Course Perspectives”, University of Geneva, Geneva, Switzerland
| | - Dan Orsholits
- Swiss NCCR “LIVES - Overcoming Vulnerability: Life Course Perspectives”, University of Geneva, Geneva, Switzerland
| | - Robert S. Stawski
- School of Social and Behavioral Health Sciences, Oregon State University, Corvallis, OR, USA
| | - Stéphane Cullati
- Swiss NCCR “LIVES - Overcoming Vulnerability: Life Course Perspectives”, University of Geneva, Geneva, Switzerland
- Population Health Laboratory, University of Fribourg, Fribourg, Switzerland
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28
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Can the internet mitigate the negative effect of widowhood on Quality of Life? A gender analysis. JOURNAL OF POPULATION AGEING 2022. [DOI: 10.1007/s12062-022-09373-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
AbstractWidowhood often reduces the Quality of Life of individuals of advanced ages by negatively affecting their social network ties. Yet conversely, the Internet has also created new opportunities for communication and interaction, thus contributing to improved Quality of Life. This research analyses the role of the Internet in the relationship between widowhood and Quality of Life from a gender perspective.This study focuses on 31,814 individuals aged 65 or over residing in 17 European countries who participated in Wave 6 of SHARE – the Survey of Health, Ageing and Retirement in Europe.The linear regression analyses highlighted that the role of the Internet in the relationship between widowhood and Quality of Life varies according to gender. More specifically, in Europe, the Quality of Life for widowed women aged 65+ using the Internet is .414 higher (CI=.006 to .0822) than widows who do not use the Internet and married women or women in a de facto relationship whether or not they use the Internet. The results have relevant implications for the development of social policies and suggest a need to develop digital inclusion projects targeting older people, particularly widows, to help promote their Quality of Life.
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Umberson D, Lin Z, Cha H. Gender and Social Isolation across the Life Course. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2022; 63:319-335. [PMID: 35856404 PMCID: PMC10409601 DOI: 10.1177/00221465221109634] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Social isolation has robust adverse effects on health, well-being, dementia risk, and longevity. Although most studies suggest similar effects of isolation on the health of men and women, there has been much less attention to gendered patterns of social isolation over the life course-despite decades of research suggesting gender differences in social ties. We build on theoretical frames of constrained choice and gender-as-relational to argue that gender differences in isolation are apparent but depend on timing in the life course and marital/partnership history. Results indicate that boys/men are more isolated than girls/women through most of the life course, and this gender difference is much greater for the never married and those with disrupted relationship histories. Strikingly, levels of social isolation steadily increase from adolescence through later life for both men and women.
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Anderson E, Van Vuuren J, Bennett KM, Soulsby LK. Exploring the process of adjustment following partner death in younger, widowed individuals: A qualitative systematic review. DEATH STUDIES 2022; 47:606-617. [PMID: 35946577 DOI: 10.1080/07481187.2022.2101075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Age influences the experience of widowhood and the likelihood of adverse outcomes. This review synthesizes 13 qualitative studies that explored adjustment following the death of a partner at a younger age, within a Western-cultural context. Thematic synthesis identified six analytical themes: unique challenges; identity changes; levels of distress; coping; support; and adapting following the loss. Bereavement challenges younger widow(er)'s life expectations, identity, and friendships. Social support, faith, and access to age-specific support may facilitate positive adjustment. The findings inform the development of effective interventions to support positive adjustment in younger widowhood.
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Affiliation(s)
- Ellen Anderson
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Julie Van Vuuren
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Kate M Bennett
- Department of Psychology, University Liverpool, Liverpool, UK
| | - Laura K Soulsby
- Department of Psychology, University Liverpool, Liverpool, UK
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Zhang Z, Liu H, Zhang Y. Marital Loss and Cognitive Function: Does Timing Matter? J Gerontol B Psychol Sci Soc Sci 2022; 77:1916-1927. [PMID: 35512289 PMCID: PMC9535775 DOI: 10.1093/geronb/gbac069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES This study examines the association between age at marital loss (i.e., divorce or widowhood) and cognitive function in later life and whether the association differs by gender. METHODS We used mixed-effects models, drawing on longitudinal data from the Health and Retirement Study (1998-2016). The analytical samples included older adults aged 51 and older who had ever been widowed (N=5,639 with 25,537 person-waves) or divorced (N=10,685 with 50,689 person-waves). RESULTS We find that those who were widowed at younger ages had lower cognitive function than their counterparts who were widowed at older ages, for both men and women, after controlling for covariates. Household income and health-related factors partially accounted for the positive association between age at widowhood and cognitive function. Those who divorced at younger ages also had lower cognitive function than their counterparts who divorced at older ages, but this association was only present among men, not women. Health-related factors partially accounted for the associations between age at divorce and cognitive function among men. DISCUSSION Findings highlight the importance of considering the role of timing of marital loss in cognitive health among older adults.
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Affiliation(s)
- Zhenmei Zhang
- Address correspondence to: Zhenmei Zhang, PhD, Department of Sociology, Michigan State University, 509 East Circle Drive, 316 Berkey Hall, East Lansing, MI 48824-1111, USA. E-mail:
| | - Hui Liu
- Department of Sociology, Michigan State University, East Lansing, Michigan, USA
| | - Yan Zhang
- Center for Demography of Health and Aging, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Muhammad T, Maurya P. Social support moderates the association of functional difficulty with major depression among community-dwelling older adults: evidence from LASI, 2017-18. BMC Psychiatry 2022; 22:317. [PMID: 35509005 PMCID: PMC9066756 DOI: 10.1186/s12888-022-03959-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 04/22/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND This study aimed to examine the potential independent association of functional disability with major depression and moderating effects of social support variables including marital status, living arrangement and social participation in such associations. METHODS Data for the study were drawn from the Longitudinal Ageing Study in India (LASI) wave 1 that was collected during 2017-18 including a sample of 31,464 individuals aged 60 years and above. Descriptive statistics and results from bivariate analysis have been reported. Further, moderated multivariable logistic regression models were used to fulfil the study objective. Major depressive disorder was assessed using the scale of the Short Form Composite International Diagnostic Interview (CIDI-SF). RESULTS It was found that 8.67% of older participants were depressed in this study. Older adults who had difficulty in basic activities of daily living (BADL) (15.34%), difficulty in instrumental activities of daily living (IADL) (12.06%), unmarried (10.13%), separate living (9.67%) and socially inactive (10.09) were having higher prevalence of major depression compared to their respective counterparts. The adjusted model-1 revealed that older adults who had difficulty in BADL and IADL were 2.53 times [AOR: 2.53, CI: 2.17-2.95] and 2.27 times [AOR: 2.27, CI: 1.97-2.64] more likely to have major depression than those with no difficulty in BADL and IADL respectively. Further, interaction analyses found that currently unmarried status, separate living and being socially inactive have moderation effects in the observed associations and exacerbate the likelihood of major depression among older adults who are functionally impaired. CONCLUSIONS The findings highlight the importance of integrating social participation in the daily life of older adults and developing initiatives that promote a healthy surrounding such as social connectedness, co-residential living and special care for those who are physically disabled to protect against late-life depression.
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Affiliation(s)
- T. Muhammad
- Department of Family and Generations, International Institute for Population Sciences, Deonar, Mumbai, Maharashtra India 400088
| | - Priya Maurya
- Department of Population and Development, International Institute for Population Sciences, Mumbai, Maharashtra India 400088
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Rackoff GN, Newman MG. Distinct Psychological Characteristics Predict Resilience and Recovery Throughout Widowhood. Behav Ther 2022; 53:428-439. [PMID: 35473647 PMCID: PMC9046682 DOI: 10.1016/j.beth.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 11/02/2021] [Accepted: 11/10/2021] [Indexed: 11/26/2022]
Abstract
The dual-process model proposes that early and later bereavement involves different types of stressors and adaptation processes (Stroebe & Schut, 1999, 2010). It is thus possible that different factors facilitate adaptation during the early months versus subsequent years following widowhood. Elevated depressive symptoms, though prevalent after widowhood, may indicate problematic adaptation, as they are associated with poor long-term physical and mental health outcomes. We predicted that neutral death acceptance would be associated with less increase in depression during early widowhood (when confronted with loss-oriented stressors), whereas perceived control would predict depressive symptom decline during later widowhood (when adapting to controllable restoration-oriented stressors). Older adults (N = 265) reported on neutral death acceptance, perceived control, and depression before widowhood and on depression 0.5, 1.5, and 4.0 years after the death of their spouse. Bilinear spline growth modeling revealed that, on average, depressive symptoms increased from before to 0.5 years after spouse death and fell from 0.5 to 4.0 years after spouse death. Neutral death acceptance predicted a smaller increase in depression from before to 0.5 years after spouse death, as well as a smaller subsequent decrease in depression from 0.5 to 4.0 years after spouse death. Perceived control predicted a larger decrease in depression from 0.5 to 4.0 years after spouse death. Neutral death acceptance and perceived control had unique associations with resilience and recovery throughout early and later widowhood. These variables may be fruitful targets in interventions for depression throughout the full course of widowhood.
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Anderson E, Bennett KM, Van Vuuren J, Soulsby LK. Partner bereavement when parenting dependent children: What factors influence adjustment? DEATH STUDIES 2022; 47:239-248. [PMID: 35298362 DOI: 10.1080/07481187.2022.2048281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Little is known about those who are widowed while raising dependent children. This study aimed to explore the factors which influence adjustment to partner death. Seven fathers and five mothers were interviewed, and constructivist grounded theory was used. Three interrelated themes were identified: Interpersonal influences, Intrapersonal influences, and Contextual influences. Dependent children meant sole responsibility and increased demands, yet ultimately provided widowed parents a purpose. Participants highlighted the need for increased awareness of young widowhood at a systemic and cultural level, to improve communication around death and young widowhood. Implications included social, financial and therapeutic interventions.
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Affiliation(s)
- E Anderson
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, United Kingdom
| | - K M Bennett
- Department of Psychology, University Liverpool, Liverpool, United Kingdom
| | - J Van Vuuren
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, United Kingdom
| | - L K Soulsby
- Department of Psychology, University Liverpool, Liverpool, United Kingdom
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Lam J, Vuolo M. Later-life transitions and changes in prescription medication use for pain and depression. BMC Geriatr 2022; 22:222. [PMID: 35300602 PMCID: PMC8931979 DOI: 10.1186/s12877-022-02921-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 03/09/2022] [Indexed: 11/28/2022] Open
Abstract
Background Over the past two decades, prescription medication use for pain and depression increased dramatically. Most studies consider the early life course, despite a similar increase among those in later life. In this paper, we examine whether and how later life transitions may relate to changes in medication use. Methods We draw on data from the Health and Retirement Study and fixed-effects models to examine whether work, family, and civic transitions in later life are related to changes in the usage of prescription pain and depression medication. Results Results show that individuals had higher odds of regularly using prescription pain and depression medications in periods when out of the labor market. Higher odds of depression medication use were also associated with periods of widowhood, and lower odds of use when frequently volunteering. Such relations persist adjusting for reported levels of pain and depression. Conclusion Our findings call attention to the importance of social ties and the presence of actors that may regulate health behaviors, as well as a change in social context, that may shape medication use in later life. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02921-y.
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Affiliation(s)
- Jack Lam
- Institute for Social Science Research, Life Course Centre - University of Queensland, Level 2, Cycad Building (1018), 80 Meiers Road, Indooroopilly, QLD, 4068, Australia.
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Ruan H, Shen K, Chen F. Negative Life Events, Social Ties, and Depressive Symptoms for Older Adults in China. Front Public Health 2022; 9:774434. [PMID: 35127620 PMCID: PMC8810507 DOI: 10.3389/fpubh.2021.774434] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 12/27/2021] [Indexed: 11/17/2022] Open
Abstract
Although it is widely acknowledged that older adults who have gone through negative life events are more likely to develop depression, there is limited evidence on whether and which type of social ties moderate this perceived relationship. Based on 2016 and 2018 waves of Chinese Longitudinal Aging Social Survey (4,466 individuals, 8,932 observations), we apply linear fixed effects models and confirm that negative life events are associated with depressive symptoms for older adults (Coef. = 0.35; 95% CIs 0.11–0.61), and social ties are negatively associated with depression (Coef. = −0.08; 95% CIs −0.10 to −0.07). Our study further suggests that the association between negative life events and depressive symptoms is significantly moderated by friendship ties (Coef. = −0.18, 95% CIs −0.30 to −0.07), rather than family ties (Coef. = −0.03, 95% CIs −0.09 to 0.15). Moreover, the buffering effects of friendship ties are more prominent for the less resilient and less privileged groups, namely male, rural, and less educated older adults. Our findings point to the importance of expanding and strengthening social networks for Chinese older adults in promoting their psychological health.
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Affiliation(s)
- Hangqing Ruan
- Department of Sociology, University of Maryland, College Park, MD, United States
| | - Ke Shen
- School of Social Development and Public Policy, Fudan University, Shanghai, China
- *Correspondence: Ke Shen
| | - Feinian Chen
- Department of Sociology, University of Maryland, College Park, MD, United States
- School of Social Development and Public Policy, Fudan University, Shanghai, China
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Lee HJ, Han SH, Boerner K. Psychological and Physical Health in Widowhood: Does Marital Quality Make a Difference? Res Aging 2022; 44:54-64. [PMID: 33511917 PMCID: PMC10704404 DOI: 10.1177/0164027521989083] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We investigate how preloss marital quality is associated with changes in psychological distress and physical health among older widow(er)s. Using prospective data with a 2-year follow-up from the Health and Retirement Study, we selected 546 respondents who transitioned into widowhood. Respondents were classified as supportive, ambivalent, aversive, or neutral groups. The supportive and ambivalent group experienced greater increase in depressive symptoms compared to the aversive group, in widowhood. The aversive group showed greater increase in chronic conditions compared to the supportive group. Findings indicated that spousal loss may result in more psychological distress for those with supportive and ambivalent marital relationship. Yet, those with mostly negative accounts of their marriage may experience worsened physical health, albeit no increase in psychological distress. Understanding different benefits and challenges facing older individuals after a positive or negative marriage may help direct support and interventions efforts toward older couples during marriage and in widowhood.
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Affiliation(s)
- Hyo Jung Lee
- Department of Sociology, School of Social Sciences, Nanyang Technological University, Boston, Singapore
| | - Sae Hwang Han
- Department of Human Development and Family Sciences, School of Human Ecology, University of Texas at Austin, TX, USA
| | - Kathrin Boerner
- Department of Gerontology, John W. McCormack Graduate School of Policy and Global Studies, University of Massachusetts Boston, MA, USA
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Tucker JE, Bishop N, Wang K, Phillips F. Marital Transitions, Change in Depressive Symptomology, and Quality of Social Relationships in Midlife and Older U.S. Adults: An Analysis of the Health and Retirement Study. Int J Aging Hum Dev 2021; 95:349-371. [PMID: 34873955 DOI: 10.1177/00914150211066551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Preventing negative health outcomes following marital transitions can promote personal recovery and well-being. We used the Health and Retirement Study (HRS) (2012, 2014) to test whether social relationship quality moderated the association between marital transition and change in depressive symptomology among U.S. adults aged 50 and older (n = 3,705). Marital status transitions between 2012 and 2014 included remained married/partnered, divorced/separated, and widowed. Depressive symptomology was measured using the Center for Epidemiological Studies Depression Scale 8 Short Form (CES-D 8). Social support, social contact, and social strain were indicators of social relationship quality. Change in depressive symptomology was modeled using autoregressive multiple regression. Social relationship quality appeared to influence depressive symptomatology for those experiencing divorce/separation. Compared to individuals who remained married/partnered, depressive symptomatology in those experiencing separation/divorce decreased among those reporting low social support, increased among those reporting high social support, and increased among those who reported low social strain. Limitations and clinical implications are discussed.
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Affiliation(s)
- Julia E Tucker
- Department of Human Development and Family Sciences, 12330The University of Texas at Austin, Austin, TX, USA
| | - Nicholas Bishop
- Department of Human Development and Family Sciences, 7174Texas State University, San Marcos, TX, USA
| | - Kaipeng Wang
- Graduate School of Social Work, 2927University of Denver, Denver, CO, USA
| | - Farya Phillips
- Department of Human Development and Family Sciences, 7174Texas State University, San Marcos, TX, USA
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Guo Y, Ge T, Mei L, Wang L, Li J. Widowhood and Health Status Among Chinese Older Adults: The Mediation Effects of Different Types of Support. Front Public Health 2021; 9:745073. [PMID: 34869158 PMCID: PMC8637908 DOI: 10.3389/fpubh.2021.745073] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 10/25/2021] [Indexed: 11/28/2022] Open
Abstract
Although many studies have suggested that widowhood is related to worse health conditions among older adults, few have examined the mediation effects of social support between widowhood and health. Employing mediation analysis to a sample of data from the 2014 wave of China Longitudinal Aging Social Survey (CLASS), this study examined the mediation effects of social support, including emotional support, instrumental support, and companionship, in the widowhood-health association among older adults. The results indicated that the negative effect of widowhood on older adults' health was in part attributable to decreased emotional support and companionship. Specifically, emotional support exerted a significant role in the widowhood-mental health association, and companionship exerted a significant role in widowhood-physical health and widowhood-mental health associations. In the subsample analysis, the mediation effects were only significant among female older adults, and among rural older adults. Our findings highlight the importance of emotional support and companionship in maintaining health among widowed older adults and strategies should pay more attention to female and rural widowed older adults.
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Affiliation(s)
- Yu Guo
- School of Public Policy and Administration, Institute for Population and Development Studies, Xi'an Jiaotong University, Xi'an, China
| | - Tingshuai Ge
- School of Public Policy and Administration, Institute for Population and Development Studies, Xi'an Jiaotong University, Xi'an, China
| | - Li Mei
- School of Public Policy and Administration, Institute for Population and Development Studies, Xi'an Jiaotong University, Xi'an, China
| | - Lina Wang
- School of Public Policy and Administration, Institute for Population and Development Studies, Xi'an Jiaotong University, Xi'an, China
| | - Jingbo Li
- School of Labor Economics, Capital University of Economics and Business, Beijing, China
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Srivastava S, Debnath P, Shri N, Muhammad T. The association of widowhood and living alone with depression among older adults in India. Sci Rep 2021; 11:21641. [PMID: 34737402 PMCID: PMC8568934 DOI: 10.1038/s41598-021-01238-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 10/26/2021] [Indexed: 11/25/2022] Open
Abstract
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.
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Affiliation(s)
- Shobhit Srivastava
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - Paramita Debnath
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - Neha Shri
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - T. Muhammad
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
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Yang F, Gu D. Widowhood, widowhood duration, and loneliness among older adults in China. Soc Sci Med 2021; 283:114179. [PMID: 34225038 DOI: 10.1016/j.socscimed.2021.114179] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 06/07/2021] [Accepted: 06/24/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Widowhood is a distressful life event that is associated with loneliness in older adults. However, widowhood is not a binary event, and little is known about the role of widowhood duration in loneliness and about the relationship between widowhood duration and loneliness in different age and sex groups. Given the increases in aging population and in widowed older adults in China, we examined whether and how widowhood and widowhood duration were associated with loneliness in different age and sex groups among Chinese older adults. METHODS Five waves of Chinese Longitudinal Healthy Longevity Survey 2002-2014 were used. The analysis included 34,440 sampled individuals aged 65 and above. Random intercept ordered logistic models were used to examine relations between widowhood, its duration and loneliness in the entire sample and by age and sex groups. RESULTS Results show that with a wide set of covariates controlled for, widowhood was a significant correlate of loneliness in older adults (OR = 2.34, p < .001); and those who were remarried after widowhood were less likely to be lonely compared to their not-remarried counterparts (OR = 0.47, p < .001). In addition, widowhood was associated with more than twice greater odds of loneliness in the first couple of years following bereavement of spouse (OR = 3.09, p < .001) compared to the currently married older adults. The increased odds ratio of loneliness slightly decreased with the length of widowhood, but it was still significant, even after 40 years of bereavement (OR = 1.96, p < .001). CONCLUSIONS These findings are mostly consistent across age and sex groups. In conclusion, this study sheds light on the relationship between widowhood duration and loneliness and the role of remarriage in widowed older adults' loneliness based on a nationwide survey in China. Widowhood has an acute and long-lasting effect on loneliness in older adults. Remarriage after widowhood could largely reduce or offset the risk of loneliness.
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Affiliation(s)
- Fang Yang
- Department of Social Work, School of Sociology and Political Science, Shanghai University, China. Building 2, #231, Nanchen Road 333, Baoshan District, Shanghai, PR China.
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Förster F, Luppa M, Pabst A, Heser K, Kleineidam L, Fuchs A, Pentzek M, Kaduszkiewicz H, van der Leeden C, Hajek A, König HH, Oey A, Wiese B, Mösch E, Weeg D, Weyerer S, Werle J, Maier W, Scherer M, Wagner M, Riedel-Heller SG. The Role of Social Isolation and the Development of Depression. A Comparison of the Widowed and Married Oldest Old in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136986. [PMID: 34210083 PMCID: PMC8297151 DOI: 10.3390/ijerph18136986] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/22/2021] [Accepted: 06/28/2021] [Indexed: 11/16/2022]
Abstract
Widowhood is common in old age, can be accompanied by serious health consequences and is often linked to substantial changes in social network. Little is known about the impact of social isolation on the development of depressive symptoms over time taking widowhood into account. We provide results from the follow-up 5 to follow-up 9 from the longitudinal study AgeCoDe and its follow-up study AgeQualiDe. Depression was measured with GDS-15 and social isolation was assessed using the Lubben Social Network Scale (LSNS-6). The group was aligned of married and widowed people in old age and education through entropy balancing. Linear mixed models were used to examine the frequency of occurrence of depressive symptoms for widowed and married elderly people depending on the risk of social isolation. Our study shows that widowhood alone does not lead to an increased occurrence of depressive symptoms. However, "widowed oldest old", who are also at risk of social isolation, have significantly more depressive symptoms than those without risk. In the group of "married oldest old", women have significantly more depressive symptoms than men, but isolated and non-isolated do not differ. Especially for people who have lost a spouse, the social network changes significantly and increases the risk for social isolation. This represents a risk factor for the occurrence of depressive symptoms.
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Affiliation(s)
- Franziska Förster
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, 04103 Leipzig, Germany; (M.L.); (A.P.); (S.G.R.-H.)
- Correspondence: ; Tel.: +49-341-97-15482
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, 04103 Leipzig, Germany; (M.L.); (A.P.); (S.G.R.-H.)
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, 04103 Leipzig, Germany; (M.L.); (A.P.); (S.G.R.-H.)
| | - Kathrin Heser
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, 53127 Bonn, Germany; (K.H.); (L.K.); (W.M.); (M.W.)
| | - Luca Kleineidam
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, 53127 Bonn, Germany; (K.H.); (L.K.); (W.M.); (M.W.)
- German Center for Neurodegenerative Diseases, DZNE, 53127 Bonn, Germany
| | - Angela Fuchs
- Medical Faculty, Institute of General Practice, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, Germany; (A.F.); (M.P.)
| | - Michael Pentzek
- Medical Faculty, Institute of General Practice, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, Germany; (A.F.); (M.P.)
| | - Hanna Kaduszkiewicz
- Medical Faculty, Institute of General Practice, Kiel University, 24105 Kiel, Germany;
| | - Carolin van der Leeden
- Center for Psychosocial Medicine, Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (C.v.d.L.); (M.S.)
| | - André Hajek
- Hamburg Center for Health Economics, Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (A.H.); (H.-H.K.)
| | - Hans-Helmut König
- Hamburg Center for Health Economics, Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (A.H.); (H.-H.K.)
| | - Anke Oey
- Work Group Medical Statistics and IT-Infrastructure, Institute for General Practice, Hannover Medical School, 30625 Hannover, Germany; (A.O.); (B.W.)
| | - Birgitt Wiese
- Work Group Medical Statistics and IT-Infrastructure, Institute for General Practice, Hannover Medical School, 30625 Hannover, Germany; (A.O.); (B.W.)
| | - Edelgard Mösch
- Department of Psychiatry, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (E.M.); (D.W.)
| | - Dagmar Weeg
- Department of Psychiatry, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany; (E.M.); (D.W.)
| | - Siegfried Weyerer
- Central Institute of Mental Health, Medical Faculty, Mannheim/Heidelberg University, 68159 Mannheim, Germany; (S.W.); (J.W.)
| | - Jochen Werle
- Central Institute of Mental Health, Medical Faculty, Mannheim/Heidelberg University, 68159 Mannheim, Germany; (S.W.); (J.W.)
| | - Wolfgang Maier
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, 53127 Bonn, Germany; (K.H.); (L.K.); (W.M.); (M.W.)
- German Center for Neurodegenerative Diseases, DZNE, 53127 Bonn, Germany
| | - Martin Scherer
- Center for Psychosocial Medicine, Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (C.v.d.L.); (M.S.)
| | - Michael Wagner
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, 53127 Bonn, Germany; (K.H.); (L.K.); (W.M.); (M.W.)
- German Center for Neurodegenerative Diseases, DZNE, 53127 Bonn, Germany
| | - Steffi G. Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, 04103 Leipzig, Germany; (M.L.); (A.P.); (S.G.R.-H.)
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Abstract
This study aimed to understand how marital status and marital transitions were related to sleep quality in mid to late life and whether these findings differed by gender. Data from 2,872 participants 50-74 years old from the ORANJ BOWLSM, a longitudinal panel study in New Jersey, were used. Marital status and sleep quality were examined in two waves that were approximately 10 years apart. Individuals in a significant romantic relationship and women had worse sleep quality than those in other marital status groups and men. Compared to individuals who remained married, individuals who remained divorced or widowed or who became widowed had better sleep quality, whereas those who became divorced had worse sleep quality; individuals who transitioned into marriage had better sleep quality than those who remained divorced or widowed. Marital status and gender appear important for at least some indices of sleep quality, an important predictor of late-life health.
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Affiliation(s)
- Kristin J August
- Department of Psychology and Health Sciences Center, Rutgers University, Camden, NJ, USA
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Johannesen EJD, Róin Á. Transition to Widowhood Among Older Adults in Rural Areas: A Study From the Faroe Islands. OMEGA-JOURNAL OF DEATH AND DYING 2021; 87:519-533. [PMID: 34128418 DOI: 10.1177/00302228211024119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Studies have shown that losing a spouse can cause both physical and mental suffering for the bereaved. This qualitative study aimed to gather knowledge about how men and women in the Faroe Islands, a small-scale society in the North Atlantic Ocean, managed the transition to widowhood. Five women and three men were interviewed, their age varying from 67 to 74 years. A hermeneutic analytic method was applied. Our findings showed that managing the transition to widowhood followed two tracks, namely the process of loss and the process of restoration. For participants locked in either process, the transition caused severe disruption in daily living, while participants who managed to oscillate between the two processes appeared to manage the transition to widowhood and get on with their lives. Our findings, and those from other studies, point to the need to offer structured individual support for people who have lost their life partner.
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Affiliation(s)
- Elsa J D Johannesen
- Department of Health and Nursing Science, University of the Faroe Islands, Tórshavn, Faroe Islands
| | - Ása Róin
- Department of Health and Nursing Science, University of the Faroe Islands, Tórshavn, Faroe Islands
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45
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Zhang Y, Axinn WG. Marital Experiences and Depression in an Arranged Marriage Setting. AJS; AMERICAN JOURNAL OF SOCIOLOGY 2021; 126:1439-1486. [PMID: 34720111 PMCID: PMC8550576 DOI: 10.1086/714272] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Understanding the consequences of marital experiences for individual mental health provides insight into how social relationships shape individual wellbeing. Using newly available, clinically validated diagnostic interviews with more than 10,000 respondents integrated with the longitudinal Chitwan Valley Family Study (CVFS), we assess the associations between marital experiences, intimate partner violence (IPV), and mental health and how they differ by gender in a setting of universal marriage-Nepal. Particularly novel, we integrate measures of arranged marriage, IPV, and marital quality into a single comprehensive analysis of the marital experiences shaping subsequent depression. This study reveals that becoming married can be positively associated with major depressive disorder (MDD) for women. IPV is a strong and independent risk factor for depression, but it only mediates a small portion of the consequences of marriage on depression. Among women, having no say at all in the selection of a spouse is also a strong and independent risk factor for depression, and IPV can only mediate a small portion of the consequences of arranged marriage on depression. We also investigate the associations between the positive (i.e., husband-wife emotional bond) and negative (i.e., spousal criticism and disagreement) dimensions of marital quality and depression. Frequent spousal disagreement significantly increases depression for women, but strong husband-wife emotional bond is not significantly associated with depression. Overall, the associations between marital experiences and mental health should be understood as contingent on both gender and the social contexts of marriage. Depending on these factors, specific marital experiences have the potential to increase transitions to depression, not just protect from depression.
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Affiliation(s)
- Yang Zhang
- Department of Sociology, and Population Studies Center, University of Michigan
| | - William G. Axinn
- Department of Sociology and Public Policy, Population Studies Center, and Survey Research Center, University of Michigan
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46
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Blanner C, Elliott A, Hjorth P, Søndergaard J, Mattisson C, Andersen K. Experiences of becoming widowed in old age - a cross-countries study with qualitative interviews from Denmark and quantitative measures of association in a Swedish sample. Int J Qual Stud Health Well-being 2021; 16:1871181. [PMID: 33541253 PMCID: PMC8725736 DOI: 10.1080/17482631.2020.1871181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Purpose: Becoming widowed is a stressful health-threatening event causing major life changes. We explored how widowed people experience becoming widowed and examined if these experiences are quantitatively associated with widowhood. Methods: A multi-methods study using an exploratory sequential mixed-methods approach including a qualitative descriptive study with widowed people from Denmark and a Swedish cohort study. Qualitative interviews (n = 9) were analysed using qualitative content analysis, describing experiences as explained by the widowed people. The quantitative association of the experiences was examined by identifying proxies for the qualitative experiences of widowhood in the cohort study and examining the occurrence in widowed people compared to married people (n = 1,095). Results: Six categories of experiences emerged: the circumstances around spousal death, mental health and well-being, physical health, social relations, activities and practicalities. The quantitative examination showed a significant association with widowhood regarding mental and physical health problems. Conclusion: The circumstances around spousal death and the time before spousal death, in general, were important to how participants felt being widowed. Being ill negatively affected mental health and well-being, partly because of the inability to participate in activities and social relations. This is important, as health problems are more common among widowed people than married people.
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Affiliation(s)
- Christina Blanner
- Department of Mental Health Odense, Mental Health Services in the Region of Southern Denmark , Odense, Denmark.,Department of Clinical Research, University of Southern Denmark , Odense, Denmark
| | - Anja Elliott
- Department of Psychiatry, Mental Health Services in the Region of Southern Denmark , Esbjerg, Denmark
| | - Peter Hjorth
- Department of Regional Health Research, University of Southern Denmark , Odense, Denmark.,Centre for Psychiatric Nursing and Health Care Research , Odense, Denmark
| | - Jens Søndergaard
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark , Odense, Denmark
| | - Cecilia Mattisson
- Division of Psychiatry, Department of Clinical Sciences Lund, Faculty of Medicine, Lund University , Lund, Sweden
| | - Kjeld Andersen
- Department of Mental Health Odense, Mental Health Services in the Region of Southern Denmark , Odense, Denmark.,Department of Clinical Research, University of Southern Denmark , Odense, Denmark
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47
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Gendered experiences of widowhood and depression across Europe: The role of loneliness and financial resources from a longitudinal perspective. J Affect Disord 2021; 280:114-120. [PMID: 33207283 DOI: 10.1016/j.jad.2020.11.091] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 05/09/2020] [Accepted: 11/08/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study analyses the gendered experiences of widowhood and its relation to depressive symptoms in four European regions. A special focus lies on the question whether loneliness and reduced financial contribute to the detrimental effect of widowhood on mental health. METHODS Using waves 5,6 and 7 of the Survey of Health. Ageing and Retirement in Europe (SHARE), this study estimates fixed-effects linear regression models for the effect of widowhood on depressive symptoms with and without adjustment for potential mediating factors. RESULTS There were no gender differences in the mental health consequences of widowhood irrespective of the regional context. Whereas loneliness was a major pathway through which widowhood exerts its negative consequences on mental health, reduced financial resources did not play a substiantial role. Moreover, the magnitude of the widowhood effect on depressive symptoms differed between European regions with stronger increases in Southern Europe. These regional differences were attenuated when accounting for inequalities in financial resources and loneliness. DISCUSSION The findings support Attachment Theory, which postulates that it's mainly the loss of such an emotionally strong tie as one's spouse that leads to psychological distress following widowhood. Moreover, one can conclude that some contexts in Europe provide conditions that buffer the negative effect of widowhood on mental health at least to some extent.
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48
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Wei YC, Huang LY, Lin C, Shyu YC, Chen CK. Taiwanese Depression Questionnaire and AD8 Questionnaire for Screening Late-Life Depression in Communities. Neuropsychiatr Dis Treat 2021; 17:747-755. [PMID: 33727818 PMCID: PMC7955745 DOI: 10.2147/ndt.s298233] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 02/18/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Major depressive disorder (MDD) presents with emotional and somatic symptoms and sometimes subjective cognitive complaints (SCCs). This study developed a collaborative method to integrate SCC assessment for evaluating late-life MDD. METHODS Residents aged >50 years in the Community Medicine Research Center of Keelung Chang Gung Memorial Hospital in Taiwan during 2017-2018 were prospectively recruited in this study. The participants were asked to report their depressive tendency and SCCs using the Taiwanese Depression Questionnaire (TDQ) and the AD8, respectively, and were administered psychiatric evaluation through the Mini-International Neuropsychiatric Interview (MINI). The participants were divided into elderly (age≥65 years) and older adult (age 50-65) groups. The MDD predictive powers were assessed using logistic regression and receiver operating characteristic (ROC) curve analyses. RESULTS Of the 118 enrolled participants (mean age: 64.81±4.99, female-to-male ratio: 1.62), 9, 21, and 88 were categorized as those with current MDD, past MDD, and non-MDD on the basis of the MINI results, respectively. After adjustments for age, sex, and sleep quality, the TDQ score (odds ratio: 1.152, p=0.003) and AD8 score (odds ratio: 1.710, p=0.020) were used individually to predict current MDD. Overall, the TDQ individually predicted current MDD well with area under the ROC curve (AUC) of 0.835 (p=0.001). However, in the elderly group (N=63), the TDQ score did not identify current MDD well (AUC: 0.780, p=0.063). After co-considering SCCs, the linear combination of the sum of the TDQ score and four folds of the AD8 score could effectively distinguished elderly people with current MDD from those without it (AUC: 0.875, p=0.013)-with the cutoff of the aforementioned combined score being ≥32. CONCLUSION The self-reported response to the TDQ is a feasible approach of identifying MDD in community-dwelling people. Combining TDQ and AD8 scores further improved depression detection in elderly people.
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Affiliation(s)
- Yi-Chia Wei
- Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Neurology, Chang Gung Memorial Hospital, Keelung, Taiwan.,Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan
| | - Li-Yuan Huang
- Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Nursing, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Chemin Lin
- Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Psychiatry, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Yu-Chiau Shyu
- Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Taiwan.,Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Chih-Ken Chen
- Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Psychiatry, Chang Gung Memorial Hospital, Keelung, Taiwan
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49
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Bulanda JR, Yamashita T, Brown JS. Marital quality, gender, and later-life depressive symptom trajectories. J Women Aging 2020; 33:122-136. [PMID: 33308042 DOI: 10.1080/08952841.2020.1818538] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We analyze six waves of data (2006-2016) from the Health and Retirement Study (n = 4,342) to examine how marital quality is associated with depressive symptom trajectories among a group of continuously married older adults. Results show gender parity in how own perceptions of positive and negative dimensions of marital quality are related to depressive symptom trajectories. In addition, spousal perceptions of negative marital quality are positively associated with growth in depressive symptomatology regardless of gender. Spousal perceptions of positive marital quality, however, are associated with lower depressive symptoms only for women.
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Affiliation(s)
| | - Takashi Yamashita
- Department of Sociology, Anthropology and Health Administration and Policy, University of Maryland, Baltimore County, Baltimore, Maryland, USA
| | - J Scott Brown
- Department of Sociology and Gerontology, Miami University, Oxford, Ohio, USA
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50
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Roth AR. Social networks and health in later life: a state of the literature. SOCIOLOGY OF HEALTH & ILLNESS 2020; 42:1642-1656. [PMID: 32643785 DOI: 10.1111/1467-9566.13155] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Late life is a period frequently marked by decline in personal health and heightened need for social support. Consequently, the social networks in which individuals are embedded assume an increasingly central role in the health and wellbeing of older adults. In the present article, I review the state of the literature on social networks and health in later life. By drawing on insights from the sociology of ageing and the life course, I address new developments and current challenges within the field. Chief among these developments and challenges is the recognition that the ageing process does not occur in a vacuum. Rather, individuals are consistently exposed to numerous changes to their social lives which have strong implications for current and future health outcomes. Upon highlighting the latest innovations within the field of networks and health, I conclude with useful directions for future research.
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Affiliation(s)
- Adam R Roth
- Department of Sociology, Indiana University, Bloomington, IN, USA
- Indiana University Network Science Institute, Bloomington, IN, USA
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