Mediating effect of decline in social activities on urinary incontinence and negative mood: Do sex and marital differences exist?

Effects of tai chi, ba duan jin, and walking on the mental health status of urban older people living alone: the mediating role of social participation and the moderating role of the exercise environment

With the global trend of aging, lacking of interpersonal communication and spiritual support and companionship have had a great impact on the mental health of older people living alone. This study examines the multifaceted impacts of engaging in tai chi, ba duan jin, and walking on the mental wellbeing of older people residing alone in urban areas. Additionally, this research aims to explore the association between tai chi, ba duan jin, and walking, and the mental health status of urban older people living alone, by considering the mediating influence of social participation and the moderating influence of the exercise environment. To do so, 1,027 older people living alone in six Chinese cities were investigated using the Physical Activity Rating Scale (PARS-3), the Geriatric Health Questionnaire (GHQ-12), the Social Participation Indicator System Scale, and the Exercise Environment Scale. SPSS 25.0 was utilized for conducting mathematical statistical analysis, specifically for doing linear regression analysis. Additionally, AMOS was employed to develop the study model. We found that a significant negative correlation between tai chi, ba duan jin, and walking and mental health status; among these, tai chi had the greatest impact on the mental health status of urban older people living alone. Social participation mediated the relationship between tai chi, ba duan jin, walking, and mental health status, and the exercise environment had a moderating effect on this relationship. The findings of this study indicate that tai chi, ba duan jin, and walking have a positive impact on the mental health of urban older people living alone, which can be influenced by the mediating efficacy of social participation and the moderating effect of the exercise environment.

Assessment of Environmental Demands of Age-Friendly Communities from Perspectives of Different Residential Groups: A Case of Wuhan, China

Age-friendly communities (AFCs) are an important measure for fostering active aging. The key to achieving an age-friendly living environment is to construct or renovate it according to the residents’ demands. To date, very few studies have attempted to delve into the AFCs’ environmental demand from different groups’ perspectives. Based on the theory of place attachment, the aim of this paper is to explore the demand diversity of different groups for the AFC environment. This study employs the nonparametric test and the Ordinal Priority Approach (OPA) to investigate the demands from the residents’ perspectives, and is enhanced by incorporating experts’ opinions. The empirical analysis shows that residents have a high level of demand for the physical environment (indoor and outdoor) and social environment (community services and social participation). At the same time, experts advocate the importance of using digital technologies to support people aged 45–65 who have higher requirements for a community environment than older adults. The findings also show that other backgrounds, such as gender, living arrangements, and year of the community establishment, lead to different demands. However, the impact of residents’ education level, occupation, income, and self-care ability on the environmental demands is low. Based on the research findings, the paper provides some practical suggestions for the future design and development of AFCs.

Urinary Incontinence and Depressive Symptoms: The Mediating Role of Physical Activity and Social Engagement

OBJECTIVES

This study investigates longitudinal within-person associations between urinary incontinence (UI) and depressive symptoms among older women. Drawing on activity theory, this study also adds to limited knowledge about the mediating role of physical activity and social engagement in the association between UI and depressive symptoms.

METHODS

Using 6 waves of a nationally representative longitudinal study of older adults in Korea between 2008 and 2018, this study examined the relationship between UI and depressive symptoms among women aged 70 and older. Fixed effects models were estimated to account for unobserved time-invariant confounding factors. Sobel mediation tests were conducted to formally test for mediation.

RESULTS

Fixed effects estimates showed that, after adjusting for a wide array of time-varying covariates, having UI is positively associated with depressive symptoms among older women (b = 0.238, p < .05). Results revealed that individuals who begin to experience UI tend to have less frequent social interactions and participate in fewer social activities. UI, however, is only marginally associated with a decrease in physical activity. Reductions in physical activity, social connections, and social activities jointly explain about 22% of the association between UI and depressive symptoms, rendering it statistically insignificant.

DISCUSSION

UI poses a threat to psychological well-being among older women. This is partly explained by a decrease in physical activity and disruption in social engagement. This study reaffirms the significance of the programs that promote physical and social activity among older adults.

Do Social Pension Schemes Promote the Mental Health of Rural Middle-Aged and Old Residents? Evidence From China

As China experiences rapid aging, the mental health of older rural adults has become a major public health concern. Among other social insurance programs, the New Rural Social Pension (NRSP) scheme was established to replace part of the income for old-age rural residents in China. This article employs survey data from the China Health and Retirement Longitudinal Study (CHARLS) in 2015 and 2018 to investigate the impact of a pension on depression in middle-aged and old residents. Our results show that the pension scheme not only reduces the depressive symptoms of the rural residents but keeps down the prevalence rate of depression. Among the subscribers of the pension scheme, the pensioners benefit more from enrolling in the pension scheme than the contributors in terms of depression alleviation. The impact of pension on depression displays heterogeneity; female residents, residents in central China, and/or those from lower income households are found to be positively affected. It is also confirmed that a pension scheme contributes to easing depression via reduced labor supply, better family support, and more consumption expenditure.

JEL Classification: H55, I18, I38.

Social participation and urban-rural disparity in mental health among older adults in China

OBJECTIVE

This study aimed to explore the effect of social participation on disparity in mental health among urban and rural older adults in China.

METHODS

The data used in this study was sourced from the 2014 wave of Chinese Longitudinal Healthy Longevity Survey (CLHLS). Furthermore, multiple linear regression model was adopted to analyze the effect of social participation on mental health. Moreover, Oaxaca-Blinder decomposition for linear model was applied to explore the effect of social participation on urban-rural disparity in mental health.

RESULTS

The regression result indicates that social participation significantly improved cognitive ability and psychological health for urban and rural older adults, and its health effect was significantly stronger for rural older adults. Furthermore, the Oaxaca-Blinder decomposition result reveals that approximately 18% of cognitive ability disparity could be attributed to urban-rural disparity in social participation. Moreover, urban-rural disparity in social participation could explain about 11% of psychological health disparity.

CONCLUSION

Urban older adults had better mental health than their rural counterparts. Furthermore, social participation was beneficial for mental health for urban and rural older adults. Urban-rural disparity in social participation made an important contribution to mental health disparity between urban and rural older adults. The results of this study emphasized the importance of social participation of older adults.

Incontinence and loneliness among Chinese older adults with multimorbidity in primary care: A cross-sectional study

OBJECTIVE

To evaluate the associations between incontinence and loneliness among the Chinese elderly with multimorbidity in primary care, with the specific aim to look into the relationship of incontinence with social and emotional subdomains of loneliness.

METHODS

This cross-sectional study included older patients with multimorbidity in public primary care clinics in Hong Kong. Loneliness was assessed by the De Jong Gierveld Loneliness Scale (DJGLS). Tobit models were used to evaluate the association between incontinence and loneliness before and after adjustment for socio-demographics, lifestyle behaviors, physical and psychological conditions, social support and living status.

RESULTS

A total of 741 patients were included. Before adjustment, incontinence was associated with higher levels of emotional loneliness (coefficient = 0.74, 95% CI = 0.43-1.06, p < .001) and higher levels of overall loneliness (coefficient = 0.81, 95% CI = 0.34-1.27, p = .001), but not social loneliness (coefficient = 0.34, 95% CI = -0.41 - 1.09, p = .38). After adjustment, incontinence was still significantly associated with higher levels of emotional loneliness (coefficient = 0.35, 95% CI = 0.07-0.64, p = .01).

CONCLUSION

Incontinence is independently associated with emotional loneliness. Healthcare professionals should pay special attention to emotional loneliness among older patients with incontinence. Further studies are needed to look into the potential mechanisms and interventions.

Extraversion personality, perceived health and activity participation among community-dwelling aging adults in Hong Kong

Activity participation is essential to the wellbeing of aging adults. Divergent levels of activity participation within aging populations have been explained from diverse perspectives, but the interaction effects of key determinants, such as personality and health, are often ignored. This study examines the effects of extravert personality on aging adults' activity levels by addressing its interaction with perceived physical health and mental health. A sample of 304 adults aged 50 and older was selected using systematic sampling from participants of an institute for promoting active aging at a university in Hong Kong in 2017. Data on socio-demographic characteristics, perceived physical and mental health, extraversion personality traits, and level of activity participation were collected using a telephone survey. Most participants (46.7%) reported moderate activity levels and over a quarter (26.6%) reported high or low activity levels. Multi-nominal logistic regression analyses show that extraversion was associated with an increased likelihood of reporting moderate (OR = 1.85, p = .036) but not high (p > .05) activity levels when adjusted for perceived physical and mental health and socio-demographics, with low activity levels being the constant comparison. Meanwhile, extraversion predicted both moderate (OR = 3.84, p = .014) and high (OR = 5.06, p = .032) activity levels for participants with poor or average perceived mental health. However, the interaction effects of extraversion with perceived physical health or mental health were not significant in predicting either moderate or high activity levels (p > .05). The implications for enhancing activity participation among aging adults are discussed in view of both personality and perceived health status.

Social participation and depressive symptoms among Chinese older adults: A study on rural-urban differences

BACKGROUND

Although studies conducted in developed countries have reported a negative relationship between social participation and depressive symptoms, few studies have examined rural-urban differences in the relationship between participation in various types of social activities and depressive symptoms among Chinese older adults.

OBJECTIVES

This study examined the association between participation in paid work, political, and voluntary activities and depressive symptoms among Chinese older adults in urban and rural areas.

METHODS

Data were obtained from the China Longitudinal Ageing Social Survey conducted in 2014, and bivariate linear regression and multivariable linear regression analyses were conducted.

RESULTS

The prevalence of depressive symptoms was significantly higher among older adults residing in rural areas than among older adults in urban areas. Participation in paid work activities was significantly associated with fewer depressive symptoms among older adults in urban and rural areas, whereas participation in political or voluntary activities was negatively associated with depressive symptoms only among older adults in urban areas. Older adults who participated in two or three types of activities (paid work, political, and voluntary activities) tended to have fewer depressive symptoms both in urban and rural areas.

LIMITATIONS

Because this study comprised a cross-sectional design, causality could not be established between social participation and depressive symptoms.

CONCLUSIONS

Social participation plays a protective role against depressive symptoms among Chinese older adults, especially among those in urban areas. Urban-rural differences exist between participation in different types of social activities and depression symptoms.

The Incontinence Praying Ability and the Incontinence Quality of Life Questionnaires for Muslim Women: A Confirmatory Study of the Malay Language Versions

BACKGROUND

The aim of the present study was to determine the validity and reliability of the Malay versions of the Incontinence Praying Ability (I-PA) and the Incontinence Quality of Life (I-QoL) questionnaires among childbearing-aged Muslim women.

METHODS

This cross-sectional study included 338 childbearing-aged Muslim women (mean age: 31.1 years; SD = 5.57) who attended clinics at Hospital Universiti Sains Malaysia. Confirmatory factor analysis was conducted to determine the construct validity of the Malay versions of the I-PA and the I-QoL, while composite reliability was used to examine their internal consistency reliability.

RESULTS

The hypothesised models of the I-PA and the I-QoL consisted of 10 items with one latent variable and 22 items with three latent variables, respectively. The hypothesised models of the I-PA and the I-QoL did not have good fit. Modifications included co-varying the residual terms for items within the subscales, which resulted in improved fit indices for the I-PA (CFI = 0.976 TLI = 0.961, RMSEA = 0.068) and the I-QoL (CFI = 0.948, TLI = 0.938, RMSEA = 0.063). The composite reliability of the I-PA was 0.93, and the I-QoL ranged from 0.91 to 0.94.

CONCLUSION

The Malay versions of the I-PA and I-QoL were considered to be valid, reliable questionnaires measuring incontinence QoL among Muslim women of childbearing age.