Health and wellbeing among the empty nest and non-empty nest elderly in China-Results from a national cross-sectional study

BACKGROUND

The number of empty nest elderly in China has gradually increased in recent years. There is growing concern about the physical and mental health of this population as empty nest elderly are commonly at the risk of compromising health, home safety and quality of life. This study reported the health and well-being of empty nest elderly with regards to their health status, depression and satisfaction, lifestyle as compared to non-empty nest elderly in China.

METHODS

Data was collected from the 2018 follow-up interviews of China Health and Retirement Longitudinal Survey. We included 4,630 empty nest elderly and 6,188 non-empty nest elderly. Chi-square Test and Logistic Regression were used to compare the differences between these two groups.

RESULTS

As compared to the non-empty nest elderly, there was higher proportion of empty nest elderly who suffered from dyslipidemia, diabetes, chronic lung diseases, heart attack (27.0% vs. 25.0%; 16.6% vs. 15.1%; 19.4% vs. 16.4%; 26.3% vs. 23.4%, P < 0.05). The empty nest elderly had higher proportion of participants who drank more than once a month (25.3% vs. 23.9%, P < 0.05), who felt satisfied with their marriage (71.6% vs. 66.2%, P < 0.001), who were satisfied with their children's relationship (85.2% vs. 83.2%, P < 0.001). However, these significances disappeared in the Logistic Regression analysis (P > 0.05).

CONCLUSION

Our study showed that significant between-group difference was found between empty nest elderly and non-empty nest elderly in their health and wellbeing. However, disappearance of such difference in the multivariable analysis may indicate improved health and wellbeing among the empty nest elderly. Even though our study still suggested the importance of improving the health, lifestyles and family dynamics of the elderly and promoting the integration of health and social care for the elderly, especially among the empty nest elderly.

Aging together in the aftermath of war: marital adjustment and subjective age of veterans and their spouses

OBJECTIVES

Trauma has long-term effects on those directly exposed to it, but it also impacts those closest to them, particularly one's spouse, as the marital relationship is of central importance for late-life development. Furthermore, traumatic experiences have been shown to be involved in an acceleration of aging, whether through physical health, or via psychological pathways, through an older subjective age. The present work seeks to examine the mutual connections between marital adjustment and the psychological accelerated aging of both spouses among military veterans of the Israeli 1973 Yom Kippur War.

METHOD

Data from two assessments were drawn from a larger longitudinal study. In 2008 (T1) and again in 2015 (T2), 247 veterans and their wives were interviewed on their subjective age, marital adjustment, and PTSD symptoms.

RESULTS

An actor-partner interdependence model combined with an autoregressive cross-lagged model, controlling for T1 PTSD symptoms revealed that men's subjective age at T1 was associated with women's subjective age at T2, and women's subjective age at T1 was associated with men's subjective age at T2. Women's marital adjustment at T1 was associated with men's marital adjustment at T2 but not the other way around.

CONCLUSION

Spousal relationships are an important arena in the lives of older adult veterans. The present study contributes new knowledge regarding the paths that predict subjective age by taking account of the subjective age of one's spouse, as well as levels of marital adjustment. Insights regarding secondary traumatization, as well as gender differences, for the aging process are discussed.

Efficacy of path-oriented psychological self-help interventions to improve mental health of empty-nest older adults in the Community of China

BACKGROUND

China has the world's largest aging population and the number of empty-nest older adults is on the rise. In comparison to the aging population in general, empty-nest older adults have a lower level of subjective well-being and poorer mental health status due to a lack of emotional support from their children. The aim of this study is to conduct an empirical study to evaluate the efficacy of the 'Path-oriented Psychological Self-help Intervention' (P-oPSI) led by nurses on the mental health of empty-nest older adults in the community, to provide a scientific foundation for improving their quality of life.

METHODS

A Quasi-Experimental controlled intervention study was conducted from 2015 to 2017. A total of 76 empty-nest older adults from 2 districts were recruited using a convenience sampling and assigned to 2 groups based on their residential communities in the city of Chifeng in the Inner Mongolia Autonomous Region, China. The wait list control group participated in a mental health lecture to gain knowledge and learn techniques of mental health promotion. The intervention group additionally received 1 month of training in a nurse-led 'P-oPSI' for a month. Both groups were followed-up for 3 months. Mental health status, coping styles, and psychological self-help ability of the participating empty nest older adults were assessed at the baseline, 1 month, and 3-months follow up, respectively. Two-way analysis of variance and a simple effect test were used to analyse the differences of the two groups.

RESULTS

The P-oPSI yielded a greater benefit for the mental health status, coping styles, and psychological self-help ability of the participants in the intervention group. Combined with a simple effect test, the scores of the mental health status, positive coping style, and psychological self-help ability of those in the intervention group significantly increased at 1 month after the baseline (F _{mental health status} = 7.59, F _{positive coping style} = 7.24, F _{psychological self-help ability} = 7.07); and the sustainable effect of this program lasted for 3 months after the intervention (F _{mental health status} = 13.24, F _{positive coping style} = 10.42, F _{psychological self-help ability} = 10.45), which reached statistical significance (P < 0.01).

CONCLUSIONS

The P-oPSI program significantly improved the level of mental health of empty-nest older adults in China. This intervention provides a new approach of self-management to improve mental health of older adults in community settings.

TRIAL REGISTRATION

chictr.org.cn: ChiCTR1900025552. Retrospectively registered 1 September 2019.