1
|
Yang H, Xu L, Qin W, Hu F, Li L, Chen C, Tang W. Gender differences in the modifying effect of living arrangements on the association of sleep quality with cognitive function among community-dwelling older adults: a cross-sectional study. Front Public Health 2023; 11:1142362. [PMID: 37213633 PMCID: PMC10196399 DOI: 10.3389/fpubh.2023.1142362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 03/28/2023] [Indexed: 05/23/2023] Open
Abstract
Background Sleep quality is considered to be associated with cognitive function for older adults, but little is known about whether living with others can buffer mild cognitive impairment in older adults with poor sleep quality. The objective of this study was to examine the role of living arrangements in sleep quality and cognitive function among older adults aged 65 and over. Methods 2,859 older adults over 65 years old were selected by using multi-stage stratified sampling method. Cognitive function and sleep quality were measured using Mini-Mental State Examination (MMSE) and Pittsburgh Sleep Quality Index (PSQI). Binary logistic regression was performed to examine the relationship between sleep quality and mild cognitive impairment, and the interaction effects of sleep quality and living arrangements on mild cognitive impairment stratified by gender. Results Poor sleep quality was associated with mild cognitive impairment among men and women regardless of living arrangements. The significantly protective role of living with others in reducing the incidence of mild cognitive impairment was found in men with poor sleep quality, but not in women. Conclusion Targeted support for older adults with poor sleep quality may be effective in preventing mild cognitive impairment, and gender differences should be taken into account when promoting cohabitations.
Collapse
Affiliation(s)
- Haifeng Yang
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, Shandong, China
| | - Lingzhong Xu
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, Shandong, China
- *Correspondence: Lingzhong Xu,
| | - Wenzhe Qin
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, Shandong, China
| | - Fangfang Hu
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, Shandong, China
| | - Lei Li
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, Shandong, China
| | - Chenhui Chen
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, Shandong, China
| | - Wenlong Tang
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, Shandong, China
| |
Collapse
|
2
|
Miyazaki R, Abe T, Yano S, Okuyama K, Sakane N, Ando H, Isomura M, Yamasaki M, Nabika T. Associations between physical frailty and living arrangements in Japanese older adults living in a rural remote island: The Shimane CoHRE study. J Gen Fam Med 2022; 23:310-318. [PMID: 36093222 PMCID: PMC9444019 DOI: 10.1002/jgf2.544] [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: 12/18/2021] [Revised: 03/03/2022] [Accepted: 03/25/2022] [Indexed: 11/06/2022] Open
Abstract
Background Living arrangements have been known to be associated with physical frailty. However, the prevalence of frailty and its risk factors in remote islands is not understood. We examined the association between living arrangements and objectively measured frailty among older adults living in a remote island of Japan. Methods Among older people living in Okinoshima, 656 older adults (75.6 ± 6.4 years) were analyzed. Physical frailty (robust, prefrailty, or frailty) was assessed using the 5-item frailty phenotype (unintentional weight loss, self-reported exhaustion, weakness, slow walking speed, and low physical activity). Physical functions (muscle mass, gait speed, and grip strength) were measured objectively. Results The prevalence of frailty and prefrailty was 6.6% and 43.8%, respectively. Living with a spouse resulted in a significantly lower prevalence of frailty (p < 0.001) compared with other living arrangements. All objectively measured physical functions among those who lived with a spouse were significantly superior to those who lived with family or alone (p < 0.001). Multinomial logistic regression showed that living alone was significantly associated with frailty (odds ratio [OR] 2.36, 95% confidence interval [CI] 1.07-5.24) and prefrailty (OR 1.75, 95% CI 1.14-2.69) after adjusting for all covariates. Conclusion The prevalence of frailty on remote islands seemed similar to that in urban areas. Older people living in remote islands might be able to maintain their physical health. Furthermore, living alone may correlate with increased risks of frailty and prefrailty. Among elderly individuals on remote islands, living with a spouse might be desirable to prevent (pre)frailty.
Collapse
Affiliation(s)
- Ryo Miyazaki
- Faculty of Human SciencesShimane UniversityMatsue‐shiJapan
- Center for Community‐Based Healthcare Research and Education (CoHRE), Organization for Research and Academic InformationShimane UniversityIzumo‐shiJapan
| | - Takafumi Abe
- Center for Community‐Based Healthcare Research and Education (CoHRE), Organization for Research and Academic InformationShimane UniversityIzumo‐shiJapan
| | - Shozo Yano
- Center for Community‐Based Healthcare Research and Education (CoHRE), Organization for Research and Academic InformationShimane UniversityIzumo‐shiJapan
| | - Kenta Okuyama
- Center for Community‐Based Healthcare Research and Education (CoHRE), Organization for Research and Academic InformationShimane UniversityIzumo‐shiJapan
- Center for Primary Health Care ResearchLund UniversityMalmöSweden
| | - Naoki Sakane
- Division of Preventive Medicine, Clinical Research Institute for Endocrine and Metabolic Disease, Kyoto Medical CenterNational Hospital OrganizationKyotoJapan
| | - Hitoshi Ando
- Department of Cellular and Molecular Function AnalysisKanazawa University Graduate School of Medical SciencesKanazawaJapan
| | - Minoru Isomura
- Faculty of Human SciencesShimane UniversityMatsue‐shiJapan
- Center for Community‐Based Healthcare Research and Education (CoHRE), Organization for Research and Academic InformationShimane UniversityIzumo‐shiJapan
| | - Masayuki Yamasaki
- Faculty of Human SciencesShimane UniversityMatsue‐shiJapan
- Center for Community‐Based Healthcare Research and Education (CoHRE), Organization for Research and Academic InformationShimane UniversityIzumo‐shiJapan
| | - Toru Nabika
- Center for Community‐Based Healthcare Research and Education (CoHRE), Organization for Research and Academic InformationShimane UniversityIzumo‐shiJapan
| |
Collapse
|
3
|
Byles JE, Princehorn EM, Forder PM, Rahman MM. Housing and Care for Older Women in Australia. Front Public Health 2021; 9:566960. [PMID: 34222159 PMCID: PMC8249770 DOI: 10.3389/fpubh.2021.566960] [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: 05/29/2020] [Accepted: 04/28/2021] [Indexed: 12/02/2022] Open
Abstract
Background: Housing is essential for healthy ageing, being a source of shelter, purpose, and identity. As people age, and with diminishing physical and mental capacity, they become increasingly dependent on external supports from others and from their environment. In this paper we look at changes in housing across later life, with a focus on the relationship between housing and women's care needs. Methods: Data from 12,432 women in the 1921–26 cohort of the Australian Longitudinal Study on Women's Health were used to examine the interaction between housing and aged care service use across later life. Results: We found that there were no differences in access to home and community care according to housing type, but women living in an apartment and those in a retirement village/hostel were more likely to have an aged care assessment and had a faster rate of admission to institutional residential aged care than women living in a house. The odds of having an aged care assessment were also higher if women were older at baseline, required help with daily activities, reported a fall, were admitted to hospital in the last 12 months, had been diagnosed or treated for a stroke in the last 3 years, or had multiple comorbidities. On average, women received few services in the 24 months prior to admission to institutional residential aged care, indicating a potential need to improve the reach of these services. Discussion: We find that coincident with changes in functional capacities and abilities, women make changes to their housing, sometimes moving from a house to an apartment, or to a village. For some, increasing needs in later life are associated with the need to move from the community into institutional residential aged care. However, before moving into care, many women will use community services and these may in turn delay the need to leave their homes and move to an institutional setting. We identify a need to increase the use of community services to delay the admission to institutional residential aged care.
Collapse
Affiliation(s)
- Julie E Byles
- Centre for Women's Health Research, The University of Newcastle, Callaghan, NSW, Australia.,School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
| | - Emily M Princehorn
- Centre for Women's Health Research, The University of Newcastle, Callaghan, NSW, Australia.,School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
| | - Peta M Forder
- Centre for Women's Health Research, The University of Newcastle, Callaghan, NSW, Australia.,School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
| | - Md Mijanur Rahman
- Centre for Health Service Development, University of Wollongong, Wollongong, NSW, Australia
| |
Collapse
|
4
|
Loneliness, social dislocation and invisibility experienced by older men who are single or living alone: accounting for differences across sexual identity and social context. AGEING & SOCIETY 2020. [DOI: 10.1017/s0144686x20000914] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractAcross literature on loneliness and ageing, little attention is given to the intersection of ageing, sexuality and masculinities, and how this shapes the social connections of older men. We report findings from a qualitative study of older men's experiences of loneliness and social participation, focusing on perspectives from two groups who are single and/or living alone: men identifying as (a) heterosexual and (b) gay (not bisexual). We present findings generated from semi-structured interviews with 72 men residing in England (65–95 years). We discuss three prominent themes: (a) loneliness, loss and social dislocation; (b) diverging life-events that trigger loneliness; and (c) variations in visibility and exclusion across social settings. Embedded within men's descriptions of loneliness is a running theme of social dislocation that speaks to a wider sense of social separation and estrangement. Unique to gay men's accounts are the ways in which experiences of loneliness and social isolation are compounded by living in heteronormative social environments and their encounters with ageism in gay social settings. Older men's accounts convey anxieties about visibility and anticipated exclusion across social settings shared with other men that vary according to sexual identity and context. We discuss how sexuality and being single and/or living alone impact on older men's social participation as we seek to move beyond a heterocentric understanding of loneliness.
Collapse
|
5
|
Sims J, Cornell V. Is an Australian's home their castle? The challenges of ageing in place. Australas J Ageing 2020; 39:5-8. [PMID: 32153109 DOI: 10.1111/ajag.12786] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 02/09/2020] [Accepted: 02/10/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Jane Sims
- Department of General Practice, School of Primary and Allied Health Care, Monash University, Melbourne, Vic., Australia.,General Practice, Melbourne Medical School, University of Melbourne, Melbourne, Vic., Australia
| | | |
Collapse
|
6
|
Joe A, Dickins M, Enticott J, Ogrin R, Lowthian J. Community-Dwelling Older Women: The Association Between Living Alone and Use of a Home Nursing Service. J Am Med Dir Assoc 2020; 21:1273-1281.e2. [PMID: 31889634 DOI: 10.1016/j.jamda.2019.11.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 11/10/2019] [Accepted: 11/12/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate the use of home nursing by community-dwelling older women to determine the nature of services required by those living alone. DESIGN A retrospective cohort study using routinely collected data. SETTING AND PARTICIPANTS Women aged 55 years and older living in metropolitan Melbourne who received an episode of nursing care from a large community home-based nursing service provider between January 1, 2006 and December 31, 2015. METHODS Descriptive and inferential statistical analyses were used to examine the relationship between client- and service-related factors and use of community nursing services. The primary outcome of interest was the hours of service received in a care episode. RESULTS A total of 134,396 episodes of care were analyzed, in which 51,606 (38.4%) episodes involved a woman who lived alone. The median hours of care per episode to women who lived alone was almost 70% more than that for women who lived with others. Multivariable regression identified factors influencing the amount of service use: living alone status, cognitive health status, and number of required home nursing activities. After adjusting for confounding and interactions, living alone was associated with at least 13% more hours of care than is provided to those not living alone. Compared with women who lived with others, women living alone required almost double the amount of assistance with medication management and were 30% more likely to experience a deterioration in their condition or be discharged from home nursing care into an acute hospital. From 2006 to 2015, for all women there was a trend toward fewer hours of nursing service provided per episode. CONCLUSIONS AND IMPLICATIONS Community-dwelling older women who live alone have greater service needs and higher rates of discharge to hospital. This knowledge will help guide provision of services and strategies to prevent clinical deterioration for this population.
Collapse
Affiliation(s)
- Angela Joe
- Bolton Clarke Research Institute, Bolton Clarke, Bentleigh, Victoria, Australia.
| | - Marissa Dickins
- Bolton Clarke Research Institute, Bolton Clarke, Bentleigh, Victoria, Australia; Southern Synergy, Department of Psychiatry at Monash Health, Southern Clinical School, Monash University, Dandenong, Victoria, Australia
| | - Joanne Enticott
- Southern Synergy, Department of Psychiatry at Monash Health, Southern Clinical School, Monash University, Dandenong, Victoria, Australia; Department of General Practice, School of Primary and Allied Health Care, Monash University, Notting Hill, Victoria, Australia
| | - Rajna Ogrin
- Bolton Clarke Research Institute, Bolton Clarke, Bentleigh, Victoria, Australia; Department of International Business and Asian Studies, Griffith University, Gold Coast, Queensland, Australia; Biosignals for Affordable Healthcare, Royal Melbourne Institute of Technology University, Melbourne, Victoria, Australia; Austin Health Department of Medicine, University of Melbourne, Heidelberg, Victoria, Australia
| | - Judy Lowthian
- Bolton Clarke Research Institute, Bolton Clarke, Bentleigh, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Queensland, Australia; Institute of Future Environments, Queensland University of Technology, Brisbane, Queensland, Australia
| |
Collapse
|