1
|
Iacono A, Oremus M, Maxwell CJ, Tyas SL. Functional social isolation mediates the association between depression and executive function in older women: findings from the Canadian Longitudinal Study on Aging Comprehensive cohort. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2024; 31:661-681. [PMID: 37350151 DOI: 10.1080/13825585.2023.2226855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/13/2023] [Indexed: 06/24/2023]
Abstract
Depression and social isolation increase risk for executive function declines and are among the top five modifiable risk factors for dementia. However, the interrelationships between depression, social isolation and executive function are not well established. Further evidence is needed to inform strategies to promote executive function and independence in older age. We examined whether social isolation mediated the association between depression and executive function in community-dwelling middle-aged and older adults and whether this association was modified by age and sex. Adults aged 45 to 85 years from the Canadian Longitudinal Study on Aging (CLSA) Comprehensive cohort were followed over three years (complete case analysis, n = 14,133). Baseline depressive symptoms, a history of clinical depression, and functional social isolation (perceived lack of social support) were self-reported. Executive function at follow-up was a composite measure of five cognitive tests. Conditional process analysis assessed the mediating effects of functional social isolation across age group and sex, adjusted for sociodemographic and health covariates. Functional social isolation significantly mediated the association of depressive symptoms (proportion mediated [PM] = 8.0%) or clinical depression (PM = 17.5%) with executive function only among women aged 75+ years. Functional social isolation explains a proportion of the total effect of depressive symptoms or clinical depression on executive function in women aged 75 and older. Although reverse causation cannot be ruled out, our findings suggest that interventions that reduce functional social isolation or depression in older women may promote executive function.
Collapse
Affiliation(s)
- Anita Iacono
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Mark Oremus
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Colleen J Maxwell
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
- School of Pharmacy, University of Waterloo, Waterloo, Ontario, Canada
| | - Suzanne L Tyas
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| |
Collapse
|
2
|
Luo J, Li B, Li J, Ren Z. Examining the impact of Co-residence with a daughter-in-law on older adult health in China: Evidence from a frailty index-based study. SSM Popul Health 2024; 26:101649. [PMID: 38516530 PMCID: PMC10955668 DOI: 10.1016/j.ssmph.2024.101649] [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: 12/12/2023] [Revised: 01/28/2024] [Accepted: 03/01/2024] [Indexed: 03/23/2024] Open
Abstract
Background The increasing geriatric population and variation in the disease spectrum among older adults in China contribute to a growing demand for more aged adult care in Chinese society. Relevant studies have shown that living arrangements with various family members have variable impacts on the older adult's health. This study employs the Frailty Index as a unified measurement standard to assess the overall health levels, integrating the specific "in-law relationships" into the research on living arrangements and the health of older adults. Methods This study used data from the China Longitudinal Aging Social Survey 2016-2018. OLS and Quantile Regression were used to investigate the in-law relationship on older adult health and whether this impact is homogeneous across older individuals with varying infirmity levels. The study used a lag model and propensity score matching to compensate for potential endogeneity concerns. Results The study found that residing with a daughter-in-law (20.22%) had a significant positive correlation with the frailty index (β=0.0088, P<0.001), indicating that the relationship between parents-in-law and daughters-in-law can influence the health of the older adult. This impact is nonlinear and non-homogeneous for older adult people with various levels of frailty, exhibiting an approximately decreasing and then increasing U-shaped distribution, which denotes that older adult people with different health conditions have distinct demands for intergenerational care. In addition, this impact varies among older adult groups of disparate genders, urban and rural areas, and age groups. Conclusion This study investigates the impact of "in-law relationships" within living arrangements on the health of older adults. It shows that co-residing with a daughter-in-law has adverse effects on the health of older adults. Therefore, the study suggests that when the health and economic conditions of the elderly permit, a "live-near-but-not-with" living arrangement with their children can be considered.
Collapse
Affiliation(s)
- Juan Luo
- School of Management, Shanghai University of Engineering Science, 333 Longteng Road, 201620, Shanghai, China
| | - Ben Li
- School of Management, Shanghai University of Engineering Science, 333 Longteng Road, 201620, Shanghai, China
| | - Jiarong Li
- School of Management, Shanghai University of Engineering Science, 333 Longteng Road, 201620, Shanghai, China
| | - Zhenpeng Ren
- School of Management, Shanghai University of Engineering Science, 333 Longteng Road, 201620, Shanghai, China
| |
Collapse
|
3
|
Fowler Davis S, Benkowitz C, Holland C, Gow A, Clarke C. A Scoping Review on the Opportunities for Social Engagement and Cognitive Frailty in Older Adults. Public Health Rev 2024; 45:1606494. [PMID: 38389543 PMCID: PMC10882720 DOI: 10.3389/phrs.2024.1606494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 01/15/2024] [Indexed: 02/24/2024] Open
Abstract
Cognitive frailty (CF) is defined as the clinical syndrome of the combination of physical frailty and cognitive impairment, without dementia. Numerous risk factors for CF have been previously identified but this scoping review focusses on the critical need for social engagement and the association with cognition. The focus of this scoping review on the opportunity for social engagement rather than on perception or experience of loneliness. Based on the results of 55 studies were synthesised into four social engagement categories, namely participation, household, network, and habitat. Social engagement is associated with maintaining or improving cognition, particularly through active participation in social roles. Habitat (i.e., rural or urban settings) also influences cognition and the challenge is to enable social participation.
Collapse
Affiliation(s)
- Sally Fowler Davis
- Faculty of Allied Health and Social Care, Anglia Ruskin University, Cambridge, United Kingdom
| | - Charlotte Benkowitz
- Centre for Applied Health and Social Care Research, Sheffield Hallam University, Sheffield, United Kingdom
| | - Carol Holland
- Division of Health Research, Centre for Ageing Research, Lancaster University, Lancaster, United Kingdom
| | - Alan Gow
- Department of Psychology, School of Social Sciences, Heriot-Watt University, Edinburgh, United Kingdom
| | - Charlotte Clarke
- Faculty of Social Science & Health, Durham University, Durham, United Kingdom
| |
Collapse
|
4
|
Wang Y, Chen X, Hu Y. Relationship between social support and 7-year trajectories of cognitive decline: results from the China Health and Retirement Longitudinal Study. J Epidemiol Community Health 2023; 77:578-586. [PMID: 37316167 DOI: 10.1136/jech-2022-219733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 06/04/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND Social support is associated with cognitive function at an older age, but how distinct dimensions of social support affect trajectories of cognitive decline in older Chinese adults remains unclear. METHODS Using longitudinal data (waves 1-4) from the China Health and Retirement Longitudinal Study, 7-year trajectories of cognitive decline by various social support markers, including family support, financial support, public support and perceived support, were estimated using latent growth curve modelling for adults aged 60 and over (N=6795). RESULTS After adjusting for baseline sociodemographics, behaviours, body mass index and health conditions, all social support markers were associated with baseline cognitive function, except for living with spouse. Participants living with spouse experienced a slower cognitive decline (0.069 per year, 95% CI 0.006, 0.133) than those who were not. A faster cognitive decline was associated with co-residing with children (-0.053 per year, 95% CI -0.104, -0.003), receiving ≥¥5000 from children (-0.095 per year, 95% CI -0.179, -0.011), receiving financial support from others (-0.108 per year, 95% CI -0.208, -0.008) and perceived support (-0.068 per year, 95% CI -0.123, -0.013). When all markers were mutually adjusted for, the associations of living with spouse and receiving financial support from others with cognitive decline disappeared. Stratifying by rural-urban residence, medical insurance and meeting children 1-3 times per month were associated with a slower rate of cognitive decline in urban residents but not in rural residents. CONCLUSION Overall, our findings confirm that the effects of distinct domains of social support on cognitive decline vary. More equally good social security systems should be established in urban and rural China.
Collapse
Affiliation(s)
- Yuran Wang
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Xuanji Chen
- Chengdu High-tech Development Zone Center for Disease Control and Prevention, Chengdu, China
| | - Yaoyue Hu
- School of Public Health, Chongqing Medical University, Chongqing, China
| |
Collapse
|
5
|
Peng W, Miyawaki CE, Okoye SM, Wang W, Luo Y, Mo C, Liu M. Mediating role of homebound status between depressive symptoms and cognitive impairment among community-dwelling older adults in the USA: a cross-sectional analysis of a cohort study. BMJ Open 2022; 12:e065536. [PMID: 36316068 PMCID: PMC9628545 DOI: 10.1136/bmjopen-2022-065536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Depressive symptoms are known modifiable factors of cognitive impairment in older adults. However, the pathway through which depressive symptoms lead to cognitive impairment is not well understood. This study aimed to investigate whether homebound status (defined as usually unable to leave home unassisted) mediates the association between depressive symptoms and cognitive impairment in community-dwelling older adults in the USA. DESIGN A secondary analysis of cross-sectional data. SETTINGS Communities in the USA. PARTICIPANTS Community-dwelling older adults (N=7537) from the 2011 National Health and Aging Trends Study, a nationally representative survey of Medicare Beneficiaries in the USA. MAIN OUTCOME MEASURES Participants' cognitive impairment status was classified using a composite measure. Depressive symptoms were assessed using Patient Health Questionnaire-2. Homebound status was determined by the frequency, difficulty and needing help in getting outdoors. We used logistic regression and the Paramed command in STATA to analyse whether homebound mediated the association between depressive symptoms and cognitive impairment. RESULTS Participants were on average, 77.7 years old, female (58.3%) and non-Hispanic white (68.1%). About 26% of the participants were classified as having cognitive impairment, 16% reported depressive symptoms and 25% were homebound. Depressive symptoms (adjusted OR, 1.60; 95% CI 1.36 to 1.89) and homebound status (adjusted OR, 1.58; 95% CI 1.34 to 1.86) were independently associated with cognitive impairment. Homebound significantly mediated 12.5% of the total effect between depressive symptoms and cognitive impairment, with significant indirect effect (OR, 1.07; 95% CI 1.04 to 1.10), direct effect (OR, 1.61; 95% CI 1.36 to 1.91) and total effect (OR, 1.72; 95% CI 1.46 to 2.03). CONCLUSIONS This study supports a mediating role of homebound status in the relationship between depressive symptoms and cognitive impairment. Interventions to promote outdoor mobility should be studied for their ability to delay cognitive impairment for older adults with depressive symptoms.
Collapse
Affiliation(s)
- Wenting Peng
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China
| | | | - Safiyyah M Okoye
- Johns Hopkins School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yuqian Luo
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China
| | - Cen Mo
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China
| | - Minhui Liu
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China
| |
Collapse
|
6
|
Lin Y, Zhang Q, Wang T, Zeng Z. Effect of living arrangements on cognitive function in Chinese elders: a longitudinal observational study. BMJ Open 2022; 12:e050410. [PMID: 36202581 PMCID: PMC9540837 DOI: 10.1136/bmjopen-2021-050410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To examine how living arrangement as a social contextual factor can affect Chinese elders' cognitive function. SETTING AND PARTICIPANTS Our sample consists of 2486 Chinese elders from two waves (2014 and 2018) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) that was administered in 22 of China's 31 provinces using a multi-stage, disproportionate, purposive random sampling method. The CLHLS aims to better understand the determinants of healthy longevity in China and collects extensive data on a large population of fragile elders aged 80-112 in China. OUTCOME MEASURES Cognitive function was measured by the Mini-Mental State Examination (MMSE). Living arrangement was divided into living in an institution, living alone and living with household members. Generalised linear regressions were carried out to examine the associations between baseline characteristics and cognitive function, while controlling age, gender and residential area. RESULTS A total of 2486 participants were included in the study at baseline in 2014. Of these, 1162 (46.7%) were men and 1324 (53.3%) were women. The mean age at baseline was 75.07 (±8.31) years. The mean years of schooling were 2.86 (±3.68). The number (proportion) of the three living arrangements (lived in institutions, lived alone and lived with household members) were 93 (3.8%), 463 (18.6%) and 1930 (77.6%), respectively. Among all participants, cognitive function declined over time. Those who lived alone presented with the highest MMSE scores at baseline and showed the lowest decline after 4 years. Living arrangements had significant effects on decreasing cognitive function. CONCLUSION Chinese elders living in institutions were most vulnerable to cognitive decline. Living alone was not a risk condition in itself for the elderly in terms of cognitive decline. In addition, the benefits of living with household members to support cognitive function were not found in our study.
Collapse
Affiliation(s)
- Yanwei Lin
- Department of Health Sociology, School of Humanities and Management, Guangdong Medical University, Dongguan, Guangdong, China
- Institute of Public Health and Wellness, Guangdong Medical University, Dongguan, Guangdong, China
| | - Qi Zhang
- School of Community and Environmental Health, Old Dominion University, Norfolk, Virginia, USA
| | - Tingxian Wang
- School of public health, Guangdong Medical University, Dongguan, Guangdong, China
| | - Zhirong Zeng
- Institute of Public Health and Wellness, Guangdong Medical University, Dongguan, Guangdong, China
| |
Collapse
|
7
|
Nicholas SO, Koh EJ, Wee SL, Eikelboom RH, Jayakody DMP, Lin F, Ng TP, Heywood RL. Peripheral Hearing Loss and Its Association with Cognition among Ethnic Chinese Older Adults. Dement Geriatr Cogn Disord 2021; 50:394-400. [PMID: 34592737 DOI: 10.1159/000519291] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 08/05/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Many studies on hearing loss (HL) and cognition are limited by subjective hearing assessments and verbally administered cognition tests, the majority of the document findings in Western populations. This study aimed to assess the association of HL with cognitive impairment among ethnic Chinese Singaporean older adults using visually presented cognitive tests. METHODS The hearing of community-dwelling older adults was assessed using pure tone audiometry. Cognitive function was assessed using the Computerized Cambridge Cognitive Test Battery (CANTAB). Multiple regression analyses examined the association between hearing and cognitive function, adjusted for age, education, and gender. RESULTS HL (pure-tone average [PTA] of thresholds at 0.5, 1, 2, and 4 kHz in the better ear, BE4PTA) was associated with reduced performance in delayed matching and multitasking tasks (β = -0.25, p = 0.019, and β = 0.02, p = 0.023, respectively). Moderate to severe HL was associated with reduced performance in delayed matching and verbal recall memory tasks (β = -10.6, p = 0.019, and β = -0.28, p = 0.042). High-frequency HL was associated with reduced performance in the spatial working memory task (β = 0.004, p = 0.022). All-frequency HL was associated with reduced performance in spatial working memory and multitasking (β = 0.01, p = 0.040, and β = 0.02, p = 0.048). CONCLUSION Similar to Western populations, HL among tonal language-speaking ethnic Chinese was associated with worse performance in tasks requiring working memory and executive function.
Collapse
Affiliation(s)
| | - Emily Jiali Koh
- Geriatric Education and Research Institute (GERI), Singapore, Singapore
| | - Shiou Liang Wee
- Geriatric Education and Research Institute (GERI), Singapore, Singapore.,Singapore Institute of Technology, Health and Social Sciences Cluster, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore
| | - Robert H Eikelboom
- Ear Science Institute Australia, Subiaco, Washington, Australia.,Ear Sciences Centre, Medical School, The University of Western Australia, Subiaco, Washington, Australia.,Department of Speech Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Dona M P Jayakody
- Ear Science Institute Australia, Subiaco, Washington, Australia.,Ear Sciences Centre, Medical School, The University of Western Australia, Subiaco, Washington, Australia
| | - Frank Lin
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Departments of Otolaryngology, Medicine, Mental Health, and Epidemiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Tze Pin Ng
- Geriatric Education and Research Institute (GERI), Singapore, Singapore.,Department of Psychological Medicine, Gerontology Research Program, National University of Singapore (NUS), Singapore, Singapore
| | - Rebecca L Heywood
- Ear Science Institute Australia, Subiaco, Washington, Australia.,Ear Sciences Centre, Medical School, The University of Western Australia, Subiaco, Washington, Australia.,Department of Otolaryngology, Ng Teng Fong General Hospital, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| |
Collapse
|
8
|
Greater Risk of Negative Health Outcomes of Older Adults Living Alone in Vietnam: A Community Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111115. [PMID: 34769635 PMCID: PMC8583075 DOI: 10.3390/ijerph182111115] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 10/16/2021] [Indexed: 11/24/2022]
Abstract
In modern Asian societies, there has been a shift in the living arrangements of older adults away from living with others. Knowing the health characteristics of individuals living alone can help identify high-risk groups. This cross-sectional study aimed to describe characteristics of the Vietnamese older adults and to investigate the association between living alone and their reported health outcomes by utilizing survey data of individuals aged ≥60 years in Vietnam in 2018. The community survey included questions about sociodemographic factors, living arrangement, and self-reported physical functional status. Multivariate logistic regression was used to examine whether or not living alone was a predictor of health outcomes. Of 725 study participants, 8.9% lived alone. These participants were more likely to be female, aged 70–79 years, living in rural areas, and currently single or previously married. After adjusting for covariates, older adults who were living alone were more likely to have arthritis (adjusted odds ratio [AOR] = 1.95, 95% confidence interval [CI]: 1.10–3.45), a history of falling (AOR = 2.44, 95% CI: 1.02–5.82), visual difficulties (AOR = 1.89, 95% CI: 1.04–3.41), feelings of loneliness (AOR = 1.95, 95% CI: 1.10–3.47), and high fear of falling (AOR = 1.88, 95% CI: 1.02–3.46). Older adults living alone in Vietnam were at greater risk of negative health consequences than those living with others. Screening and providing adequate social support for this specific population is important in preventing the adverse effects of solitary living among these older adults.
Collapse
|
9
|
Lin MH, Chen LJ, Huang ST, Meng LC, Lee WJ, Peng LN, Hsiao FY, Chen LK. Age and sex differences in associations between self-reported health, physical function, mental function and mortality. Arch Gerontol Geriatr 2021; 98:104537. [PMID: 34649184 DOI: 10.1016/j.archger.2021.104537] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/23/2021] [Accepted: 09/26/2021] [Indexed: 01/15/2023]
Abstract
OBJECTIVES To explore how age and sex affect the impacts of self-rated health, self-reported physical activities, physical function, and depressive symptoms on long-term mortality among community-dwelling middle-aged and older adults using a nationally representative population-based cohort study. METHODS Data from 1550 study participants from the Social Environment and Biomarkers of Aging Study (SEBAS) were retrieved for analysis, and all participants were divided into four groups based on their age and gender. Middle aged participants were aged 53 to 64 years, and elderly subjects were ≥ 65 years old. Multivariate logistic regression models were applied to investigate the associations between age, sex, and self-reported disabilities of physical activities, physical function (activities of daily living (ADL) and instrumental activities of daily living (IADL) and depression. RESULTS Although the self-reported health status was similar across different age- and sex-stratified subgroups, older women were at the highest risk in self-reported difficulty with physical activities (aOR 2.58 [1.55-4.28]) and difficulty with IADL (aOR 3.32 [2.20-5.03]) compared to men. After adjusting for living arrangement, residence locale, education levels, occupation, socioeconomic status, self-reported health, multimorbidity, impairments in daily activities, and depressive symptoms, older men were found to display the highest risk of mortality (aHR 2.06 [95% CI 1.45-2.93]). CONCLUSIONS Although self-reported health was similar across different age and sex stratified subgroups, women (particularly older women) are significantly more likely to have worse physical and functional health than men. After adjusting for all confounding factors, men are at substantially greater risk for mortality despite reporting better health and functional performance.
Collapse
Affiliation(s)
- Ming-Hsien Lin
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Li-Ju Chen
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Shih-Tsung Huang
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Lin-Chieh Meng
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Wei-Ju Lee
- Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, Yi-Lan, Taiwan
| | - Li-Ning Peng
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Fei-Yuan Hsiao
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan.
| | - Liang-Kung Chen
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan; Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan.
| |
Collapse
|
10
|
Lee YH, Lin CH, Chang JR, Liu CT, Shelley M, Chang YC. Transition of Living Arrangement and Cognitive Impairment Status among Chinese Older Adults: Are They Associated? MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57090961. [PMID: 34577884 PMCID: PMC8467768 DOI: 10.3390/medicina57090961] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 09/08/2021] [Indexed: 01/23/2023]
Abstract
Background and Objectives: Living arrangement is a crucial factor for older adults' health. It is even more critical for Chinese older adults due to the tradition of filial piety. With the aging of China's population, the prevalence of cognitive impairment among older adults has increased. This study examines the association between living arrangement transition and cognitive function among Chinese older adults. Materials and Methods: Using three waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS; 2008-2009, 2011-2012, and 2014), we analyzed data for older adults (age ≥ 65) who lived with other household members and reported good cognitive function or mild cognitive impairment when they participated in the survey. Multistate Cox regression was employed to study changes in cognitive function. Results: Older adults who transitioned to living alone had lower risk of cognitive impairment (hazard ratio (HR) = 0.66, 95% CI: 0.52, 0.83; p < 0.01), compared with those who continued to live with other household members. Moving into an institution was also not associated with cognitive impairment. Conclusions: With older adults' transition to living alone, public health practitioners or social workers might educate them on the benefits of such a living arrangement for cognitive function.
Collapse
Affiliation(s)
- Yen-Han Lee
- Department of Public Health and Sports Medicine, McQueary College of Health and Human Services, Missouri State University, Springfield, MO 65897, USA
- Correspondence: (Y.-H.L.); (Y.-C.C.)
| | - Chia-Hung Lin
- Department of Nursing, Taipei Veterans General Hospital, Taipei City 112, Taiwan; (C.-H.L.); (J.-R.C.)
| | - Jia-Ren Chang
- Department of Nursing, Taipei Veterans General Hospital, Taipei City 112, Taiwan; (C.-H.L.); (J.-R.C.)
| | - Ching-Ti Liu
- Department of Biostatistics, School of Public Health, Boston University, Boston, MA 02118, USA;
| | - Mack Shelley
- Department of Political Science, Iowa State University, Ames, IA 50011, USA;
- Department of Statistics, Iowa State University, Ames, IA 50011, USA
| | - Yen-Chang Chang
- Center for General Education, National Tsing Hua University, Hsinchu City 300, Taiwan
- Correspondence: (Y.-H.L.); (Y.-C.C.)
| |
Collapse
|
11
|
Peng S, Lai X, Qiu J, Du Y, Yang J, Bai Y, Jia Y, Meng L, Wang K, Zhang X. Living With Parents-In-Law Increased the Risk of Postpartum Depression in Chinese Women. Front Psychiatry 2021; 12:736306. [PMID: 34987424 PMCID: PMC8721192 DOI: 10.3389/fpsyt.2021.736306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 12/02/2021] [Indexed: 11/17/2022] Open
Abstract
Background: A variety of psychological and socioeconomic factors contribute to the development of postpartum depression (PPD). However, the relationship between maternal living arrangements and PPD is unclear. Objective: To assess the relationship between maternal living arrangements and PPD in Chinese population. Methods: A cross-sectional survey was conducted among puerperal women delivered in Baoan Maternal and Child Health Hospital in Shenzhen, China. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess PPD. A score of ≥10 was used as the threshold for postpartum depression. Results: A total of 4,813 women were recruited, of whom 2,535 (52.7%) lived only with their husbands, 664 (13.8%) lived with their parents, and 1,614 (33.5%) lived with their parents-in-law. Compared with women who lived with husbands, puerperal women who lived with their parents-in-law were more likely to be positive for PPD screening (14.1 vs. 10.5%, P < 0.001). After adjusting for other influencing factors, living with parents-in-law was significantly associated with the risk of PPD (OR = 1.38, 95% CI, 1.12-1.70). Additionally, stratification analyses showed that the association between living with parents-in-law and the presence of PPD was more significant in women with anxiety during pregnancy (P for interaction <0.05). Conclusions and Relevance: Our data confirms that the maternal living arrangements affect the risk of PPD, especially among women with anxiety during pregnancy. Therefore, more targeted preventive measures should be taken for postpartum depression in women who live with their parents-in-law.
Collapse
Affiliation(s)
- Songxu Peng
- Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, China
| | - Xin Lai
- Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, China
| | - Jun Qiu
- Department of Children's Intensive Research Center, Hunan Children's Hospital, Changsha, China
| | - Yukai Du
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Yang
- Department of Public Health, Baoan Maternal and Child Health Hospital, Jinan University, Shenzhen, China
| | - Ying Bai
- Department of Public Health, Baoan Maternal and Child Health Hospital, Jinan University, Shenzhen, China
| | - Yanhong Jia
- Department of Public Health, Baoan Maternal and Child Health Hospital, Jinan University, Shenzhen, China
| | - Liping Meng
- Department of Public Health, Baoan Maternal and Child Health Hospital, Jinan University, Shenzhen, China
| | - Kewei Wang
- Department of Children's Intensive Research Center, Hunan Children's Hospital, Changsha, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| |
Collapse
|