Living arrangements and metabolic syndrome: a national cross-sectional study in the Republic of Korea

BACKGROUND

This study investigated the relationship between living arrangements and metabolic syndrome (MetS) risk in the adult population in the Republic of Korea.

METHODS

The samples were derived from the data collected during the second year of the seventh Korea National Health and Nutrition Examination Survey. The study targeted a total of 6,265 adults who were aged 20 years and above, and multiple logistic regression analysis was conducted. Living arrangements were classified into 4 categories: single-person households, 1-generation households, 2-generation households, and other family types. MetS was identified by the presence of at least 3 out of the 5 National Cholesterol Education Program Adult Treatment Panel III criteria.

RESULTS

For men, the odds ratio (ORs) for MetS in 1- and 2-generation households, compared to single-person households, were 0.92 (95% confidence interval [CI], 0.55-1.54) and 0.97 (95% CI, 0.58-1.62), respectively. The OR for other types of households was 0.96 (95% CI, 0.79-1.17). For women, the OR for MetS in 1- and 2-generation households, compared to single-person households, were 1.52 (95% CI, 1.15-2.01) and 1.29 (95% CI, 1.01-1.67), respectively.

CONCLUSION

Our study suggests that a national strategy involving tailored interventions for women living in high-risk conditions is necessary to reduce the risk of MetS in Korean women.

Social Prescription Interventions Addressing Social Isolation and Loneliness in Older Adults: Meta-Review Integrating On-the-Ground Resources

BACKGROUND

Social prescription programs represent a viable solution to linking primary care patients to nonmedical community resources for improving patient well-being. However, their success depends on the integration of patient needs with local resources. This integration could be accelerated by digital tools that use expressive ontology to organize knowledge resources, thus enabling the seamless navigation of diverse community interventions and services tailored to the needs of individual users. This infrastructure bears particular relevance for older adults, who experience a range of social needs that impact their health, including social isolation and loneliness. An essential first step in enabling knowledge mobilization and the successful implementation of social prescription initiatives to meet the social needs of older adults is to incorporate the evidence-based academic literature on what works, with on-the-ground solutions in the community.

OBJECTIVE

This study aims to integrate scientific evidence with on-the-ground knowledge to build a comprehensive list of intervention terms and keywords related to reducing social isolation and loneliness in older adults.

METHODS

A meta-review was conducted using a search strategy combining terms related to older adult population, social isolation and loneliness, and study types relevant to reviews using 5 databases. Review extraction included intervention characteristics, outcomes (social [eg, loneliness, social isolation, and social support] or mental health [eg, psychological well-being, depression, and anxiety]), and effectiveness (reported as consistent, mixed, or not supported). Terms related to identified intervention types were extracted from the reviewed literature as well as descriptions of corresponding community services in Montréal, Canada, available from web-based regional, municipal, and community data sources.

RESULTS

The meta-review identified 11 intervention types addressing social isolation and loneliness in older adults by either increasing social interactions, providing instrumental support, promoting mental and physical well-being, or providing home and community care. Group-based social activities, support groups with educational elements, recreational activities, and training or use of information and communication technologies were the most effective in improving outcomes. Examples of most intervention types were found in community data sources. Terms derived from the literature that were the most commonly congruent with those describing existing community services were related to telehealth, recreational activities, and psychological therapy. However, several discrepancies were observed between review-based terms and those addressing the available services.

CONCLUSIONS

A range of interventions found to be effective at addressing social isolation and loneliness or their impact on mental health were identified from the literature, and many of these interventions were represented in services available to older residents in Montréal, Canada. However, different terms were occasionally used to describe or categorize similar services across data sources. Establishing an efficient means of identifying and structuring such sources is important to facilitate referrals and help-seeking behaviors of older adults and for strategic planning of resources.

Home Alone: Widows' Well-Being and Time

Using data from the Survey of Health, Ageing and Retirement in Europe (SHARE, 2004-17) and time diaries from Poland (2013), the U.S. (2006-16), the U.K. (2014-15) and France (2009-10), we examine differences between widowed and partnered older women in well-being and its development in widowhood. Most importantly, our analysis accounts for time use, an aspect which has not been studied previously. We trace the evolution of well-being of women who become widowed by comparing them with their matched non-widowed 'statistical twins' and examine the role of an exceptionally broad set of potential moderators of widowhood's impact on well-being. We confirm a dramatic decrease in mental health and life satisfaction after the loss of partner, followed by a slow partial recovery over a 5-year period. An extensive set of controls recorded prior to widowhood, including detailed family ties and social networks, provides little help in explaining the deterioration in well-being. Unique data from time-diaries kept by older women in several European countries and the U.S. tell us why: the key factor behind widows' reduced well-being is increased time spent alone.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10902-023-00622-w.

Sociodemographic dynamics and age trajectories of depressive symptoms among adults in mid- and later life: a cohort perspective

OBJECTIVES

This study explored the age trajectories of depressive symptoms across multiple cohort groups who were in middle and late adulthood; examined sociodemographic differences in these trajectories; and investigated how relevant factors contributed to depressive symptoms trends of different cohorts.

METHODS

Drawing on data from the 1994-2016 Health and Retirement Study (HRS), we used growth curve models to examine the age patterns of depressive symptoms, changes in sociodemographic gaps in depressive symptoms trajectories, and predictors of changes in depressive symptoms.

RESULTS

In general, adults' depressive symptoms started high in middle-adulthood, declined in young-old life, increased moderately in mid-old life, and peaked in old-old life; In detail, more nuanced cohort-specific age trajectories of depressive symptoms were observed, challenging the prevailing assumption of a common age trajectory of depressive symptoms. Later-born cohorts displayed higher levels of depressive symptoms than earlier-born cohorts at observed ages. Second, we found intra-cohort sociodemographic differences in levels of depressive symptoms, but these differences' growth rates varied by specific factors. Regardless of the cohort group, as people age, the gender gap in depressive symptoms persisted but the partnership gap reduced. A widening educational gap across cohorts was observed, but it declined with age in some cohorts.

CONCLUSION

Results suggest more evidence for the persistent inequality and age-as-leveler hypotheses rather than the cumulative (dis-)advantage hypothesis.

Supplemental data for this article can be accessed online at https://doi.org/10.1080/13607863.2021.2010182 .

Widowhood Status and Cognitive Function in Community-Dwelling Older Adults from the Mexican Health and Aging Study (MHAS)

We aimed to determine the association between the duration of widowhood and cognition decline. We compared the decline observed in widowed people compared with married, single, or separated persons using the scores obtained in the cognitive assessment of memory, learning, and visual exploration by adults and older adults in Mexico. The Mexican Health and Aging Study (MHAS) provides the base for this paper. This study is an analysis of the fourth data wave (2015), except for the independent variable: marital status. Marital status was built longitudinally with information from the four surveys (2001, 2003, 2012, and 2015). The sample comprised 6898 adults aged 50 and over. Cognition was assessed with an adapted Cross-Cultural Cognitive Examination (CCCE). Confounders include sociodemographic characteristics (sex, age, schooling, self-perception of economic status, and whether the individual worked or not), multimorbidity, functionality, support networks, and psychological characteristics. Of the total sample, 4094 (59.3%) were women. The mean age was 70.86 years (SD = 7.4). The baseline of the study is 2001. In 2001, 8.7% (n = 600) were widows or widowers. People widowed by 2001 scored -0.158 points in cognition while divorced participants scored - 0.095 points.

Widowhood and depression among Chinese older adults: examining coping styles and perceptions of aging as mediators and moderators

Objectives: Based on the stress-coping framework, this study examined the role of coping styles and perceptions of aging in the relationship between widowhood and depression through two alternative pathways-mediation and moderation-with a national probability sample of older adults in China.Method: The data came from the baseline wave of the China Longitudinal Aging Social Survey of 2014. Our final sample featured 8,404 older adults.Results: The results of structural equation modeling showed a good fit for the total sample (NFI = .909, IFI = .916, GFI = .963, RMSEA = .038) and indicated the significant direct impact of widowhood on depression among Chinese older adults. Moreover, the findings of mediating effects found compared with a married group, widowed older adults used less problem-focused coping and had more negative perceptions of aging, which in turn, predicted higher depression; they were also more likely to use emotion-focused coping, which in turn, predicted lower depression. The results of moderation analysis demonstrated that a higher level of negative perceptions of aging significantly worsened the adverse effects of widowhood on depression.Conclusion: Overall, our findings highlight the importance of a cognitive approach to targeting programs for widowed older adults in China, with a focus on strengthening their abilities to alter maladaptive copings styles and reauthor their life narratives.

Perceptions of the General Public About Health-related Quality of Life and the EQ-5D Questionnaire: A Qualitative Study in Korea

OBJECTIVES

The aim of this qualitative study was to investigate how members of the general public in Korea interpret the concept of health, and which dimensions of health are most important to them. We also explored their perceptions of the EuroQoL 5-Dimension (EQ-5D), including the EuroQoL visual analogue scale (EQ-VAS).

METHODS

We conducted face-to-face, in-depth interviews with 20 individuals from the general population, using a semi-structured interview guide. Content analysis was performed with verbatim transcripts and field notes to identify codes and categorize them according to their similarities and associations.

RESULTS

In total, 734 different codes were derived and classified into 4 categories. Participants cited the importance of both the mental and physical aspects of health, although they emphasized that the physical aspects appeared to play a larger role in their conceptualization of health. Participants noted that the EQ-5D has the advantage of being composed of 5 dimensions that are simple and contain both physical and mental areas necessary to describe health. However, some of them mentioned the need to add more dimensions of mental health and social health. Participants showed great satisfaction with the visually well-presented EQ-VAS. However, participants opined that the EQ-VAS scores might not be comparable across respondents because of different ways of responding to the scale.

CONCLUSIONS

While physical health is a fundamental aspect of health, mental and social aspects are also important to Koreans. The content of the EQ-5D broadly matched the attributes of health considered important by Koreans.

The Negative Impact of Adult Children's Marital Dissolution on Older Parents' Mental Health in South Korea

OBJECTIVE

Little is known about whether and the extent children's marital dissolution deteriorates older parents' mental health. This study examines the association of children's marital dissolution with parents' mental health, and whether children's gender and intergenerational contact and support moderate such an association in South Korea, where family lives are strongly linked under the Confucian collectivistic legacy.

METHODS

We apply fixed effects models on 15,584 parent-child dyads nested in 5,673 older parents (45-97 years in Wave 1) participating in the four waves of the Korean Longitudinal Study of Aging (KLoSA), conducted from 2006 to 2012.

RESULTS

In South Korea, a son's transition to marital dissolution is associated with higher levels of parents' depressive symptoms. Frequent parent-son contacts of at least once a week, living with a son, and increasing financial transfers from parents to a son tend to reduce the negative association of the son's marital dissolution with parents' depressive symptoms.

DISCUSSION

The findings imply that a son's transition to marital dissolution, as a later-life stressor, is detrimental to parents' mental health in a patrilineal Asian cultural context. The study also highlights the importance of intergenerational bonding in mitigating the negative impact of children's marital dissolution upwardly transmitted to their older parents.

Cohort matters: The relationships between living arrangements and psychological health from the Korean Longitudinal Study of Aging (KLoSA)

BACKGROUND

Little is known about cohort variations in the relationships between living arrangements and psychological health among older adults. The current study evaluated whether cohort differences in the intergenerational support affect the differences in the mental health benefits of multigenerational living arrangements, and how they do so.

METHODS

Using panel regression models with lagged variables based on South Korean data, we compared the shape of the relationships between living arrangements and psychological conditions of two cohorts of older adults.

RESULTS

The study found birth cohort differences in older adults' psychological well-being. Among older adults in recent cohorts, living in a multigenerational household was positively associated with depression and negatively linked with life satisfaction. The cohort variations were partly explained by children's marital status and home ownership.

CONCLUSION

The birth cohort variations in psychological health implications of living arrangements may reflect the changing patterns of intergenerational support and family values.

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

OBJECTIVES

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Widowhood and Health Status Among Chinese Older Adults: The Mediation Effects of Different Types of Support

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.

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

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.

Health in widowhood: The roles of social capital and economic resources

A sizeable literature has demonstrated strong negative associations between widowhood and health, but longitudinal evidence on moderating factors has been mixed. This study assesses the roles of pre-existing social capital and wealth in moderating changes in health in the event of spousal death. Samples of widowed individuals (n = 796) and matched married controls (n = 8233) are employed from 17 consecutive waves of the Household, Income and Labour Dynamics in Australia Survey (2001-2017). Individual-level fixed-effects models are used to estimate changes in physical and mental health before and after spousal death, in reference to one's own health more than two years before widowhood. Results show a temporary physical health improvement in the year of spousal death, and a decline in mental health beginning up to two years before spousal death, lasting up to two years after spousal death. Using social capital-from children, club membership or volunteering status, and social connections-observed earlier than two years before spousal death, this study finds that widowed individuals with higher social capital show poorer mental health than those with less capital. This negative moderating role is more marked among widowed males than females. In contrast, greater wealth, particularly from non-financial assets, is associated with earlier psychological adjustment among males. For females, mental health in widowhood shows little difference by wealth. These findings suggest that social capital may not be sufficient to protect deteriorations in mental health among widowed individuals, and that the pursuit of alternative avenues may be especially important among the less wealthy.

Widowhood and Depression in a Cross-National Perspective: Evidence from the United States, Europe, Korea, and China

Objectives

We explore marital and depression trajectories over time for men and women, and distinguish between mood and somatic depression across contexts.

Method

We use longitudinal data from 2002 to 2013 from the United States, England, Europe, Korea, and China to explore depression among individuals married at baseline and follow their trajectories into widowhood with married as the reference group. We use random effects models to estimate these trajectories using the Center for Epidemiologic Studies Depression Scale (CES-D) or EURO-D scales for men and women.

Results

Depression peaks within the first year of widowhood for men and women, but women recover to levels comparable to married counterparts in all countries. Men sustain high levels of depression even 6-10 years post-widowhood everywhere except Europe. Widowed women have higher somatic depression compared to men, who have higher mood depression. Family plays differential roles in mediating depression across countries.

Discussion

Our research shows the complex global relationship between widowhood and depression. Studies that do not compare depression trajectories over time may make incorrect inferences about the persistence of depression by gender and country. Interventions should target different components of depression: mood-related symptoms for men and somatic-related symptoms for women for most effective recovery.

Care inequality: care received according to gender, marital status, and socioeconomic status among Korean older adults with disability

Background

We sought to identify the types of care and care resources available to older Korean adults with disabilities, and document the inequality in care received according to gender, marital status, and socioeconomic status.

Method

Data were derived from the sixth wave of the Korean Longitudinal Study of Ageing. The sample consisted of 946 men and women who were disabled in ADL and IADL. Generalized linear models and analyses of covariance were used to evaluate group differences in types of care received and care resources. The outcome variables were main primary caregivers, the total number of available caregivers, hours of care received per day, number of days of care, and fees paid to caregivers.

Results

In total, 41.7% of men with ADL/IADL disabilities reported that they did not receive formal or informal care from any source, compared with 30.7% of women. Almost half (49.2%) of men without a spouse were in a state of care deficit (vs. 30.8% in women without a spouse, P < 0.001). Among care recipients, men reported receiving higher average days of care per month than women (25.6 vs. 21.2 days, P < 0.01). Both men and women received care primarily from their spouse, but adult children were more frequently care providers for older women than men. A combination of care from spouse and paid caregiver was more frequent among women. Dependent older people with high household incomes had a higher likelihood of receiving care There was the clear gradient in rate of paid formal caregivers use by household income (higher income = higher use) among women but not men.

Conclusions

Care types and resources among disabled older adults appeared to be different by gender, marital status and socioeconomic status under the cultural phenomenon and contextual circumstances in the aging Korean population.

Aging Together: Self-Perceptions of Aging and Family Experiences Among Korean Baby Boomer Couples

Background and Objectives

Korean baby boomers (born 1955-1963) comprise the largest segment of the population approaching old age in Korea, and the majority is married or partnered. However, little is known about how couples share subjective aging experiences and how their self-perceptions of aging are associated with family experiences in midlife.

Research Design and Methods

We analyzed 727 couples from the Korean Baby Boomer Panel Study. Using Actor-Partner Interdependence Model, we investigated whether major health problems within a family and marital quality were associated with perceptions of aging and future time.

Results

We found substantial within-couple similarity in self-perceptions of aging among Korean baby boomers. Own health problems were associated with more time limitation for both spouses, but family members' health problems (i.e., parents, spouse, and children) were associated with wives' self-perceptions of aging only. Furthermore, higher spousal support was associated with more positive self-perceptions of aging for both husbands and wives. Both own and partner reports of spousal strain were associated with husbands' higher levels of aging anxiety.

Discussion and Implications

Given the significance of family events and marital quality on perceptions of aging among Korean baby boomer couples, both intergenerational and spousal contexts should be considered in examining subjective aging experiences in midlife.

Factors that influence the health of older widows and widowers-A systematic review of quantitative research

AIM

To examine factors that influence the health of older widows and widowers. The review question was: What is the evidence of the relationship between widowhood and health in older adults?

DESIGN

Systematic review.

DATA SOURCES

Academic Search Elite, CINAHL, Medline (Ovid) and PubMed were searched for articles published between January 2013-December 2017.

REVIEW METHODS

A systematic review of quantitative research with a qualitative thematic analysis.

RESULTS

The selection process resulted in 12 studies. One of the themes that emerged was: emotional challenges related to experiences of bereavement, depression and anxiety, which was based on the sub-theme social support as the main strategy for coping with emotional pain and suffering. The second theme was: struggling with poor physical health. The findings indicate that healthcare professionals need knowledge and skills to deal with the health consequences of widowhood in old age. Building community teams can prevent emotional and physical health problems, as well as reduce mortality.

Risk and Resiliency in the Relationship Between Widowhood and Depressive Symptoms Among Older Mexican Americans

This study examined the association between widowhood and depressive symptoms and the extent to which the association is contingent upon risk and resiliency, including immigration status, functional limitations, financial strains, and intergenerational support, among older Mexican Americans. The sample included 344 parent-child pairs reported by 83 respondents. Clustered regression analysis showed that widowhood elevated risks for depressive symptoms. We found that having some functional limitations, having more children and living in the same city with children exacerbated the adverse effects of widowhood on depressive symptoms. We also found that living in the same city with children increased the detrimental effects of widowhood on the depressive symptoms in men, whereas we did not find this pattern in women. The findings highlight the heterogeneity within the widowed Mexican American older adults. Implications for future research and practice are discussed.

The Relationship between Handgrip Strength and Cognitive Function in Elderly Koreans over 8 Years: A Prospective Population-Based Study Using Korean Longitudinal Study of Ageing

Background

Decreased physical performance, such as weakened handgrip strength and cognitive decline, is associated with disability and premature death in old age. We investigated the association between handgrip strength and cognitive impairment in Korean elderly adults with normal cognitive function.

Methods

This prospective study used the database from the Korean Longitudinal Study of Ageing. The participants included 2,378 adults aged 65 years or older with normal cognitive function (Korean Mini-Mental Status Evaluation [K-MMSE] score ≥21). Using a mixed-effects model, we examined the associations at baseline and over an 8-year follow-up period between handgrip strength and K-MMSE score. We investigated handgrip strength as a predictor of change in cognitive function.

Results

This study included 1,138 women (mean maximum handgrip strength 19.2 kg, mean K-MMSE score 25.1) and 1,240 men (mean maximum handgrip strength 30.7 kg, mean MMSE score 26.2). The baseline handgrip strength was positively associated with the baseline K-MMSE score (b=0.18, P<0.001). Using a mixed-effects model, we found that higher handgrip strength at baseline can predict MMSE scores positively over time (b=0.14, P<0.001) and the change of handgrip strength over time was a predictor of high MMSE scores over the study period (b=0.01, P<0.01).

Conclusion

We observed significant associations between baseline handgrip strength and baseline and change of cognition, as well as the longitudinal influence of handgrip strength on the change of cognitive function in elderly Korean adults with normal cognitive function.

Patterns in quality of life according to employment among the older adults: the Korean longitudinal study of aging (2008-2014)

Background

Korea is becoming an aged society. Accordingly, it is very meaningful to investigate the impact of job retention on quality of life (QOL) for older adults. We aimed to understand the pattern of changes over time in QOL of older adults aged 65 years or older based on employment status using the national data, the Korean Longitudinal Study of Aging (KLoSA).

Methods

Data from the KLoSA during 2008–2014 were used. QOL was measured with the question, “How is your overall quality of life when compared to that of your peers in the same age group?” A total of 526 older adults were selected from 2008, including 267 who retained their jobs without change (job retention group) and 259 who lost their jobs by 2014 (job loss group). In order to analyze the factors affecting the QOL between 2008 and 2014, linear mixed models were used.

Results

The average age of participants was 70 years. In men, the QOL was significantly higher in the job retention group than the job loss group (β = 7.751, p < .001). According to time, the QOL in 2012 (β = − 3.805, p = .003) and 2014 (β = − 4.254, p < .001) was significantly lower than that in 2008. In addition, the groups of retention or loss of job showed a significant difference in the change in QOL over time; the QOL was significantly lower in 2010 (β = − 3.570, p = .027) and 2014 (β = − 5.604, p = .003).

Conclusions

This study found that employment is an important factor affecting the QOL. In order to improve the QOL of the older adults, tailored programs are needed to understand the characteristics of the elderly and to create suitable jobs for them.

Impact of Living Alone on Depressive Symptoms in Older Korean Widows

We examined the relationship between living alone and the prevalence of depressive symptoms in older Korean widows and assessed the individual contributions of health, social ties, and socioeconomic factors to the development of depressive symptoms. The study was a secondary analysis using data from widows, 65 years of age and older, who participated in the Living Profiles of Older People Survey (LPOPS). A logistic regression analysis was used to evaluate the contributions of health, social ties, and socioeconomic factors to the development of depressive symptoms. Working status and equivalent household income were significantly associated with depressive symptoms in both those living with others and those living alone. Adjustment for health status and social ties did not change the impact of living alone on the prevalence of depressive symptoms. However, adjustment for equivalent household income eliminated the negative association between living alone and depressive symptoms. Our findings indicate that economic resources are more important than health and social ties for alleviating the negative impact of living alone on the development of depressive symptoms in older widows.

Impact of family characteristics by marital status of cohabitating adult children on depression among Korean older adults

AIM

To identify the association between different living arrangements of intergenerational household composition and depression in older adults.

METHODS

Data from the Korea Longitudinal Study of Aging, the first to fourth waves, were used. Using the first wave as baseline, our analysis included 5046 participants aged ≥60 years with at least one living child. Depression was measured using the 10-item Center for Epidemiological Studies Depression scale. Factors investigated included living arrangements according to household composition and the marital status of a cohabiting adult child. A generalized estimating equation with the logit link for binary outcomes was used to examine the association between living arrangements and depression.

RESULTS

Compared with the older adults living with a married child and grandchildren, those living alone, those living with an unmarried child, and those living with an unmarried child and grandchildren were more likely to have depression (OR 1.41, 95% CI 1.13-1.75; OR 1.40, 95% CI 1.18-1.66; OR 1.60, 95% CI 1.27-2.01). In particular, women were more likely to have depression than men in the association between living arrangements and depression.

CONCLUSIONS

Efforts should be made to provide social services for older adults living alone and those living with an unmarried child in a two-/three-generation family, in particular, for those who are female. Geriatr Gerontol Int 2017; 17: 2527-2536.

Experiences of Depression in Low Income Elderly Women

PURPOSE

The purpose of this qualitative research was to understand the meaning of the depression in low income elderly women.

METHODS

Participants were 15 elderly women, aged between 60 and 80 who were registered in two senior welfare centers in Seoul. Data were collected from June to December, 2012 after having obtained consent from participants. In-depth interviews were done with open-ended questions about their depression experiences, which were audio-taped and transcribed with verbatim. Data were analyzed using qualitative content analysis to discover the categories considering their relationships and abstractness.

RESULTS

Depressions of aged women were a part of the their life throughout their long lived hardship and was implied unhealed wounds within the relationship. Participants did not know how to manage with depression symptoms that they tried to overcome individually but due to decreased activities and interpersonal relationships, their depressions were tended to continue. They have tried to get out from depressive symptoms, but it still remains unseen shadow of mind.

CONCLUSION

This results suppose that social support and aged welfare policy included reliving the economical difficulty and improving relationships will be provided to manage the depression for low income elderly women.

The impact of living arrangements on quality of life among Korean elderly: findings from the Korean Longitudinal Study of Aging (2006-2012)

PURPOSE

To investigate the impact of different living arrangements on quality of life (QoL) and health-related quality of life (HRQoL) in the elderly.

METHODS

We used data from the first to fourth wave of the Korean Longitudinal Study of Aging. Using the first wave as a baseline, the data included 5050 individuals aged 60 years and older with at least one living child. QoL and HRQoL were measured using a visual analogue scale developed by the Korean Labor Institute that bears similarity to the EQ-VAS. Living arrangements were categorized based on household composition (single household, one-generation household, two-generation household, and three-generation household) and the marital status of a cohabiting adult child. A generalized estimating equation was used to examine the association between living arrangements and QoL/HRQoL.

RESULTS

Compared to elderly individuals living in three-generation families with a married child, those in a single household (QoL: β = -2.67 [P = 0.001]; HRQoL: β = -2.24 [P = 0.007]), those living in a three-generation family with an unmarried adult child (QoL: β = -5.19 [P < 0.0001]; HRQoL: β = -3.41 [P < 0.0001]), and those living in a two-generation family with an unmarried adult child (QoL: β = -2.88 [P < 0.0001]; HRQoL: β = -2.80 [P < 0.0001]) were more likely to have lower QoL and HRQoL. These associations were particularly strong for women and individuals in the lowest equivalent household income group.

CONCLUSION

It is necessary to devise government programs not only for elderly individuals living alone, but also for those living with an unmarried adult child; elderly persons who are female and part of the lowest equivalent household income group must receive particular attention.

Which type of social activities may reduce cognitive decline in the elderly?: a longitudinal population-based study

Background

Previous studies have found that social activities are beneficial for the reduction of cognitive decline (CD) in the elderly. However, knowledge regarding the types of social activities that reduce CD in later life is limited. The aim of this study is to examine which type of social activities reduce CD 4 years later among young-old (Y-O) and old-old (O-O) adults.

Methods

We conducted a secondary analysis using data from cognitively intact adults 65 years of age or older who participated in the Korean Longitudinal Study of Aging (KLoSA). Cognitive function was assessed using the Korean version of the Mini-Mental State Examination (MMSE). We computed CD between 2008 and 2012 by subtracting the Wave 4 MMSE score from the Wave 2 MMSE score. Multivariate linear regression analysis was conducted regarding the effects of social activities on CD after adjusting for age, sex, education, income, marital status, activities of daily living (ADL), instrumental activities of daily living (IADL), chronic diseases, quality of life, depressive symptom, change in depressive symptom, and cognitive functioning at baseline.

Results

Subjects who participated in senior citizen clubs or senior centers at baseline had a lower risk of CD 4 years later than those who did not in Y-O adults. Frequent contact with offspring by phone or letters was associated with reduced CD in O-O adults. Frequent face-to-face contact with offspring was positively associated with CD in O-O adults. Participating in two or more formal social activities was associated with reduced CD compared with nonparticipation in O-O adults.

Conclusion

Encouraging older adults to participate in senior citizen clubs or to have frequent contacts with adult children by phone or letters may help reduce CD in later life among older adults. Participation in a variety of formal social activities may also have a beneficial effect on preventing CD in older adults.

Electronic supplementary material

The online version of this article (doi:10.1186/s12877-016-0343-x) contains supplementary material, which is available to authorized users.

Prevalence of frailty and associated factors in Korean older women: The KLoSA study

The purpose of this study was to identify the prevalence of frailty in older women and its associated factors using data from the Korean Longitudinal Study of Aging (KLoSA). The level of frailty was moderate/severe in 20.2% of the women. Age, socioeconomic status, and depressive symptoms were significantly associated with all levels of frailty. Sensory function and grip strength were associated with both mild and moderate/severe frailty. The only factors associated with moderate/severe frailty were marriage status and regular exercise. Understanding the risk factors of frailty may help health care providers to deliver tailored interventions to prevent this condition and its adverse outcomes.

The Relationship between Neuroticism, Hopelessness, and Depression in Older Korean Immigrants

PURPOSE

This study aimed to investigate the relationship between neuroticism, hopelessness, and depression among older Korean immigrants. To extend this line of research, this study aimed to examine the effects of neuroticism and hopelessness in predicting depression among older Korean immigrants.

METHODS

Data for this study came from a survey of 220 first generation Korean immigrants aged 65 years or older in Los Angeles County in 2012. Data were collected by face-to-face interviews with trained social workers using a structured questionnaire translated into Korean. All interviews were conducted in Korean. The neuroticism sub-scale of the Eysenck Personality Questionnaire was used to assess neuroticism (EPQN). Hopelessness was measured by the Beck Hopelessness Scale (BHS). Depression was measured by the 20-item Center of Epidemiological Studies Depression (CES-D) scale.

RESULTS

The study found that age (β = .26, p< .01), gender (β = -.13, p< .01), income (β = -.13, p< .01), neuroticism (β = .51, p< .01), and hopelessness (β = .15, p< .01) were significant predictors of depression.

CONCLUSION

The study provides preventive strategies that would help in the development of depression-reduction services or programs for the population, especially for those living with neuroticism and hopelessness.