Leisure activity moderates the relationship between living alone and mental health among Japanese older adults

The effects of occupational disruption during COVID-19 lockdowns on health: a cross-sectional study

The disruption in daily activity performance during COVID-19 lockdowns is widely understood to have impacted health, but a better understanding of how restricted performance of specific activities are associated with health is needed. This cross-sectional study answers the following question: How were changes in the performance of 16 daily activities associated with health during COVID-19 lockdowns? A total of 116 participants completed an online survey rating their health before and during COVID-19 lockdowns and comparing their recollection of the performance of 16 activities before COVID-19 with their performance during lockdowns. Multiple stepwise linear regression analysis was used to estimate the relationship between self-reported changes in activities during lockdowns and concurrent (during-lockdown) health status, while controlling for pre-COVID-19 health status. Only changes in activities that were uniquely and significantly associated with lockdown health status were retained in the final model. Health before COVID-19 accounted for 3.7% (P = 0.039) of the variance in health during COVID-19 lockdowns. After controlling for health before COVID-19, five types of activity were significantly and uniquely predictive of health during lockdowns, together accounting for 48.3% of the variance. These activities and the variances they accounted for were rest and sleep (29.5%, P < 0.001), play and recreational activities (8%, P < 0.001), work (4.8%, P = 0.002), personal hygiene (3.2%, P = 0.01), and healthy eating (2.8%, P = 0.013). The study suggests that these five types of activity should be prioritized in policy or interventions when participation in activity is constrained by lockdowns or comparable factors.

Leisure Participation for Mental Health Promotion in Later Life: A Six-Year Longitudinal Study

Engaging in leisure activities is essential for mental health in older adults. This longitudinal study (n = 1,101, mean age = 69.20 ± 6.23 years at baseline) examined the associations between leisure participation and mental health over 6 years in three waves: 2016, 2018, and 2020. Pearson's correlation analyses and generalized estimating equations were performed for data analyses. The frequency of participation in physical and social activities was significantly positively associated with happiness, life satisfaction, and self-rated health, and significantly negatively associated with depression. Passive activities were significantly positively associated with happiness, life satisfaction, and self-rated health but not with depression. The time effect had no significant association with any mental health outcomes. These findings highlight the importance of leisure activities in promoting mental health among older adults. Policy makers should encourage older adults to engage in physical and social leisure activities.

The effects of living arrangements and leisure activities on depressive symptoms of Chinese older adults: Evidence from panel data analysis

BACKGROUND

Livable environment and ways, as the necessary conditions for the elderly to enjoy their old age, have a significant impact on their mental health and happiness. It's crucial to understand how living arrangements affect depressive symptoms in China. Studies on how various leisure activities modify this association are yet limited.

METHODS

This study relies on panel data derived from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), collected during waves spanning 2008/2009, 2011/2012, 2014, and 2018. The primary objective is to examine the relationship between living arrangements, leisure activities, and depressive symptoms of elderly individuals. Linear mixed-effects models were used to analyze the data.

RESULTS

A total of 26,342 observations aged 65 and over were included in this paper. Older adults living alone (β = 0.66, 95 % CI: 0.55, 0.76) or living in institutions (β = 0.69, 95 % CI: 0.40, 0.98) had more depressive symptoms than those living with family. Leisure activities were negatively associated with depressive symptoms (β = -0.16, 95 % CI: -0.18, -0.15). Moreover, there was significant interactions between living arrangements and leisure activities. No matter which kind of living arrangements, participating in physical, productive or social activity was associated with a lower risk of depressive symptoms.

LIMITATIONS

Study design might introduce bias, and it cannot establish causality between the tested variables.

CONCLUSIONS

Older adults living alone or in institutions have more possibility to develop depressive symptoms than those living with family, and such a relationship among Chinese older adults can be moderated by participating in leisure activities.

Effects of choir singing on physiological stress in Japanese older adults: its relationship with cognitive functioning and subjective well-being

BACKGROUND

Leisure activities are believed to contribute to healthy ageing. We compared the effects of choir singing and go playing on cortisol levels in Japanese older adults. We also examined its relevance to the older adults' emotional affect and cognitive performance.

METHODS

Thirty-six older adults participated either in choir or go playing, within a 2 (groups)×2 (time points) design. Dependent measures included levels of salivary cortisol, as well as key psychological, cognitive, and neuropsychological measures.

RESULTS

A significant two-way interaction was observed, showing that levels of salivary cortisol decreased for the choir but increased for the go groups. The decrease in salivary cortisol for the choir group correlated with the participant's negative affect and their degree of cognitive impairment.

CONCLUSION

Choir singing has the potential to reduce Japanese older adults' physiological stress. The decreases can be seen more prominently for people with stronger negative affect and cognitive impairment. Further research is required to replicate these effects.

The impact of neighborhood mental health on the mental health of older adults

BACKGROUND

In this article, we use cross-sectional data obtained from the 2018 China Health and Aging Tracking Survey (CHARLS) to examine the impact of neighborhood mental health at the community level on the mental health of older adults aged 60 years and older.

METHODS

NMH is the average mental health of older adults in the same community, excluding the older adults themselves. The explained variable mental health in this paper was measured using the simple CES-D depression scale. The mediating variables were social connectedness, social participation and social inclusion, and the instrumental variables were physical exercise and amusement. regression analysis was conducted using OLS regression models, two-stage least squares (IV-2SLS) instrumental variables to address the two-way causality of NMH and MH, and KHB decomposition was used to investigate the effect mechanism.

RESULTS

Baseline regressions showed that the neighborhood mental health effect positively influenced the mental health of older adults (Coef. = 0.356, 95% CI 0.315,0.397). The neighborhood mental health effect estimated by IV-2SLS (Coef. = 0.251, 95% CI 0.096,0.405) was higher than the OLS regression, indicating endogeneity. The mediated effects of KHB showed total (Coef. = 0.356, 95% CI 0.314,0.398), direct (Coef. = 0.281, 95% CI 0.232,0.330), and indirect effects (Coef. = 0.075, 95% CI 0.049,0.101). While the total effect was 1.266 times higher than the direct effect, 21.03% of the total effect came from mediating variables.

CONCLUSIONS

First, the neighborhood mental health effect has a positive impact on the mental health of older adults, but there are heterogeneous differences based on gender, age, and place of residence. Second, the results of the IV-2SLS estimation showed that the effect of the neighborhood mental health effect was underestimated if endogenous problems were not controlled for. Third, the effect of neighborhood mental health on older adults' mental health was tested to be stable. Moreover, social connectedness, social participation, and social interaction are important mediating mechanisms for the effect of neighborhood mental health on older adults' mental health. This study provides new perspectives and ideas for an in-depth understanding of the mental health of older adults in the context of social transformation in China.

Sleep, physical activity, and sedentary behaviors as factors related to depression and health-related quality of life among older women living alone: a population-based study

BACKGROUND

Although the number of older women living alone (OWLA) has risen steadily in aging societies, and research has been conducted on depression and health-related quality of life (HRQoL) among older adults, research is scarce on the health behaviors of OWLA, including their sleep, physical activity, and sedentary behaviors. Hence, we aimed to identify factors related to depression and HRQoL among this subset of the population, focusing on their health behaviors, using Andersen's model as a research framework.

METHODS

Data for secondary analysis were from the Korean National Health and Nutritional Examination Survey (2014, 2016, 2018, and 2020). The inclusion criteria were (1) women aged 65 and older and (2) those living alone. We included 794 older South Korean women living alone from 31,051 respondents. We used hierarchical regression analysis, considering sampling weight and a complex sample design, to identify factors related to depression and HRQoL.

RESULTS

Among the health behavior factors of Andersen's model as a research framework, sleep was associated with depression, whereas physical activity and sedentary behaviors were related to HRQoL. Subjective health status, limited activity, and perceived stress were associated with both depression and HRQoL. Household income, as an enabling factor, was only associated with HRQoL. The final regression model explained 39% of the variance in depression (p < 0.001) and 37% of the variance in HRQoL (p < 0.001).

CONCLUSIONS

Our study highlights the importance of strategies to improve specific healthy behaviors that affect depression and HRQoL in OWLA. Appropriate interventions that target increasing physical activity and quality of sleep, and decreasing sedentary behaviors, will be effective to enhance the well-being of OWLA. Healthcare providers should comprehensively understand the characteristics of OWLA and pay more attention to enabling, need, and health behavior factors.

Association of Co-Living and Age on the Type of Sports Practiced by Older People

Introdution: The environment and the type of co-living of older people are crucial to understanding how the nature of their context influences a healthy lifestyle. However, no studies have investigated to what extent their type of co-living may be associated with the sports and the profile practice according to their age. Objective: This study aimed to assess the association between the types of co-living and the age of the physically active elderly and the sports they practice. Hypothesis: It is thought that the age, situation, and satisfaction with the way of living in physically active older people differ according to the type of sport they practice. Methods: Cross-sectional study. We included 358 individuals aged between 61 and 93 years old (M = 69.66, SD = 4.74). Type of co-living was classified as living alone or living with others. The sports activities evaluated were: gym, dance, water activities, and yoga/pilates. Differences in the type of co-living and sports practiced were evaluated by ANOVA or Chi2. Results: Among the elderly who practice gymnastics, most of them live alone and in a tight core (p < 0.001) (Phi = 0.244). Furthermore, those who practice aquatic activities are more frequently the youngest (p < 0.001) (Phi = 0.198). Conclusion: Older people who do gymnastics have smaller living groups, those under 69 opt for gymnastics and aquatic activities, while those aged 70 and over prefer dance, yoga, and pilates.

Living alone is associated with a higher prevalence of psychiatric morbidity in a population-based cross-sectional study

Background

Living alone has been linked to poor mental health, however large-scale epidemiological studies on the association between living alone and psychiatric morbidity including depression and anxiety are lacking. The aim of this study was to investigate this issue in a large Taiwanese cohort.

Methods

In this cross-sectional study, we enrolled 121,601 volunteers from 29 community recruitment stations in Taiwan and divided them into two groups based on whether or not they lived alone. Psychiatric morbidity was defined as a Generalized Anxiety Disorder 2-item score ≥ 3, Patient Health Questionnaire 2-item score ≥ 3, or self-reported depression. Logistic regression was used to explore the associations between living alone and psychiatric morbidity.

Results

The participants who lived alone had a higher prevalence of psychiatric morbidity [odds ratio (OR) = 1.608, 95% confidence interval (CI) = 1.473 to 1.755] after adjusting for potential confounders. In a subgroup analysis, married subjects who lived alone and divorce/separation (OR = 2.013, 95% CI = 1.763 to 2.299) or widowing (OR = 1.750, 95% CI = 1.373 to 2.229) were more likely to have psychiatric morbidity than those who were married and not living alone.

Conclusions

Our findings suggest that living alone is a risk factor for psychiatric morbidity, especially for married subjects who live alone in concordance with divorce, separation, or the death of a spouse.

Can leisure and entertainment lifestyle promote health among older people living alone in China?-A simultaneous equation approach

Objectives

With the surging number of older people living alone, their lifestyles and health status have aroused increasing concern. This study aims to investigate whether a leisure and entertainment lifestyle (LEL) can improve the multidimensional health among older people living alone and try to identify the latent mechanisms among them.

Method

For this purpose, we extracted data from the Chinese General Social Survey (CGSS) and established a simultaneous equations model, comprising ordinary least square regression (OLS), two-stage least squares (2SLS), and the mediating effect model.

Results

Older people living alone in China reported relatively better mental health status (3.64 ± 1.07), followed by physical health (3.41 ± 1.26) and social health (2.75 ± 1.18). In the OLS model, LEL significantly improved the social health of older people living alone (β = 0.054, P < 0.01), followed by physical health (β = 0.042, P < 0.01) and mental health (β = 0.027, P < 0.01). After endogenous tests from 2SLS model and robustness tests, we found that more active LEL was associated with higher levels of physical health and mental health. However, LEL had no significant effect on the improvement of the social health of the older people living alone. Using the mediation analysis, exercise efficacy partially mediated the relationship of LEL with physical health and mental health, and the ratios were 19.75 and 24.85%, respectively. Similarly, positive life attitudes partially mediated the relationship between LEL and physical health, and LEL and mental health, with ratios of 10.65 and 26.83%, respectively.

Conclusion

Our findings suggested that LEL is significantly associated with better physical and mental health for older people living alone in China, and the association is mediated by exercise efficacy and positive attitudes toward life. Promoting more leisure and recreational activities, upgrading exercise efficacy, and encouraging positive life attitudes are necessary health promotion measures in active aging policies for the wellbeing of older people living alone.

The effect of living alone on the mental health of the economically active floating population during the COVID-19 pandemic

Background

The Coronavirus disease 2019 (COVID-19) pandemic broke out at the end of 2019 in China. Through a strict Zero-Tolerant strategy, the pandemic was nearly controlled in the first half of 2020, and production resumed in most regions of China. A survey was performed to explore the effect of living alone on the mental health of the economically active floating population (EAFP) in developed regions of China during the COVID-19 pandemic.

Methods

The online cross-sectional survey was conducted in work resumed time in the first half of 2020 in several developed regions of China. The 12-item General Health Questionnaire (GHQ-12) is used to assess the mental health status. The Multi-level ordinary least squares regression was performed on a total of 4,405 samples to examine the relationships between living alone and the participants' mental health.

Results

Many participants lived alone during the COVID 19 pandemic. Living alone is negatively associated with mental health (p < 0.01) for EAFP. The effect of living alone on mental health is stronger for females than males and for people with a lover than those without a lover. It is also stronger for the seniors (aged 56-70) than younger ones (aged 16-35), and has no significant influence on the middle-aged population (36-55). The effect is significant for self-employed people and employees, and is not significant for unemployed ones. Furthermore, the right amount of online entertainment can lower the effect of living alone on mental health.

Conclusion

The results show that living alone strongly affected the mental health of EAFP during the COVID 19 pandemic. Moreover, this effect has generated new inequalities among different groups. In addition, to provide more public services to support people against the pandemic, the government should provide more psychological support to those who live alone and guide them to establish a correct view of marriage and love to reduce living alone negative effect and prevent them from mental health problems.

The Impact of Leisure Activities on the Mental Health of Older Adults: The Mediating Effect of Social Support and Perceived Stress

As the aging continues, China has become the country with the largest older population. In order to ensure the well-being of older adults in their later years, the whole society is increasingly concerned about the mental health of older adults. In 2019, we conduct a questionnaire survey in Shaanxi Province. Stratified random sampling is used to select three representative cities, and 677 samples are selected from the survey results for research. By using the structural equation model, we aim to reveal the mechanism of leisure activities' influence on mental health of the older adults and verify whether social support and perceived stress play a mediating role. The study finds that the older adults' leisure activities have no significant direct impact on mental health. Social support has a significant mediating effect between leisure activities and mental health of the older adults. Leisure activities indirectly affect the mental health of the older adults through social support, and participation in leisure activities can improve the social support of the older adults, thus improving the mental health level of the older adults. Perceived stress plays a significant mediating role between leisure activities and mental health of the older adults. By participating in leisure activities, the perceived stress of the older adults will be reduced, thus improving their mental health. Social support and perceived stress play a sufficient mediating role in the influence of leisure activities on mental health.