Which wound cuts deeper: loss of an only child or loss of a spouse? An examination of bereavement in older adults within a Chinese cultural context

OBJECTIVES

This study aimed to examine whether the loss of spouse had similar impacts on psychological well-being as the loss of the only child, and whether the presence of one mitigated the absence of the other.

METHODS

We used data from a 2013 survey conducted in Shanghai, China. The sample included 1,200 older adults aged 60+, and 200 adults aged 45+ who lost their only child. Psychological well-being consisted of three dimensions: depression, loneliness, and life satisfaction. We applied logistic regression models to assess the impact of loss of spouse or children on psychological well-being. We further tested whether the impact differed by gender and whether social support mediated the relationship.

RESULTS

Participants who have at least one living child but lost their spouse had less psychological distress than those who have a living spouse but lost their only child. This effect appeared to be stronger in women than in men. Social support mediated the relationship between bereavement and loneliness among women.

CONCLUSION

The findings suggested the loss of the only child is a more devastating event than the loss of spouse in Chinese adults. The loss of the only child is a major chronic stressor that has cumulative negative effect on psychological well-being.

Differing determinants of disability trends among men and women aged 50 years and older

Background

Researchers have emphasized the importance of examining how different factors affect men’s and women’s functional status over time. To date, the literature is unclear about whether sex affects the rate of change in disability in middle to older age. Researchers have further emphasized the importance of examining how different factors affect men’s and women’s functional status over time. We examined (a) sex differences in disability trends and (b) the determinants of the rate of change in disability for men and women 50 years and older.

Methods

This study utilized the Taiwan Longitudinal Study on Aging Survey, a nationally representative database (four waves of survey data 1996–2007, N = 3429). We modeled and compared the differences in disability trends and the influences of determinants on trends among men and women using multiple-indicator and multiple-group latent growth curves modeling (LGCM). Equality constraints were imposed on 10 determinants across groups.

Results

Once disability began, women progressed toward greater disability 18% faster than men. Greater age added about 1.2 times the burden to the rate of change in disability for women than men (p < 0.001). More comorbidities also added significantly more burden to baseline disability and rate of change in disability among women than men (p < 0.001), but women benefited more from higher education levels in lower baseline disability and slower rate of change. Having a better social network was associated with lower baseline disability among women only (p < 0.05). For both men and women, physically active leisure-time activities were beneficial in lower baseline disability (p_{men and women} < 0.001) and rate of change in disability (p_men < 0.01; p_women < 0.05), with no significant differences between groups.

Conclusions

Age may widen the sex gap in the rate of change in disability. However, both sexes benefit from participating in leisure-time activities. Promoting health literacy improves health outcomes and physical function among women.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-021-02574-3.

Leisure activity and cognitive function among Chinese old adults: The multiple mediation effect of anxiety and loneliness

BACKGROUND

Most countries in the world, including China, are experiencing serious aging problems. The decline of cognitive function seriously affects the quality of life of the elderly in their later years and brings an inevitable heavy burden to the family and society. Therefore, in order to achieve successful aging, the purpose of this study is to test the serial multiple mediation effect of anxiety and loneliness between leisure activity and cognitive function in Chinese elderly population.

METHODS

Using 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS) dataset, we finally selected 6,525 Chinese elderly people over 65 years old after screening. Firstly, we described the basic social demographic information of the sample population. Secondly, Spearman correlation analysis was used to determine whether there is a correlation between leisure activity, anxiety, loneliness and cognitive function in Chinese elderly. Finally, the serial multiple mediation analysis was completed using the SPSS macro PROCESS program.

RESULTS

Leisure activity, anxiety, loneliness and cognitive function were significantly correlated (p<0.01). Leisure activity can not only have a direct positive impact on the cognitive function of the elderly (effect=0.2231; SE=0.0122; 95%CI: LL=0.1992, UL=0.2470), but also have an indirect impact on the cognitive function through three paths: the independent mediating role of anxiety (effect=0.0028; SE=0.0015; 95%CI: LL=0.0001, UL=0.0059), the independent mediating role of loneliness (effect=0.0032; SE=0.0016; 95%CI: LL=0.0002, UL=0.0065), and the chain mediating role of anxiety and loneliness (effect=0.0008; SE=0.0004; 95%CI: LL=0.0001, UL=0.0017).

LIMITATIONS

All items were self-reported and some results may have biased. In the future, it may be more instructive to explore the impact of specific leisure activity on the cognitive function of the elderly.

CONCLUSIONS

The study suggests that leisure activity can improve cognitive function through decreasing anxiety and loneliness among the Chinese elderly. Diversified interventions aimed at increasing leisure activity participation in older adults would be beneficial for their mental health and cognitive function.

Is Engagement in Intellectual and Social Leisure Activities Protective Against Dementia Risk? Evidence from the English Longitudinal Study of Ageing

Background:

Studies have suggested that mentally stimulating activities and socially engaged lifestyles may reduce dementia risk; however, it is unclear which activities are more beneficial.

Objective:

We investigated intellectual and social leisure activities in relation to dementia incidence and explored the modifying role of sex and marital status in these associations.

Methods:

The sample was comprised of 8,030 participants aged 50+ from the English Longitudinal Study of Ageing, who joined at wave 1 (2002-2003), or waves 3 (2006-2007), or 4 (2008-2009). The end of the study period was wave 8 (2016-2017). Subdistribution hazard models investigated the role of leisure activities grouped into intellectual and social domains in relation to dementia while accounting for the risk of death. Subsequent analyses were conducted with individual leisure activities.

Results:

During the study period of up to 15 years, 412 participants developed dementia, and 2,192 died. We found that increased engagement in the intellectual activities’ domain was associated with a decreased dementia incidence (SHR 0.85, 95% CI 0.76–0.96, p = 0.007), independent of the risk of death in married individuals, but not in those who were single, divorced, or widowed. Individual analyses for each leisure activity showed independent associations for reading newspapers in females (SHR 0.65, 95% CI 0.49–0.84, p = 0.001), mobile phone usage in males (SHR 0.61, 95% CI 0.45–0.84, p = 0.002), and having hobbies for married individuals (SHR 0.70, 95% CI 0.51–0.95, p = 0.02).

Conclusion:

We found that intellectual leisure activities contribute to lower dementia risk in a representative population of English adults, suggesting intervention opportunities.

Development and preliminary validation of the Meaningful and Enjoyable Activities Scale (MEAS) in mild dementia

BACKGROUND

Engaging in meaningful activity is an important contributor to well-being in late life. This study aimed to develop a new measure of meaningful and enjoyable activities in people living with mild dementia.

METHODS

The study consisted of four phases: (a) a review of measures of meaningful activity in older people; (b) interviews with people with dementia and their carers (n = 32), (c) expert opinion; and (d) feasibility testing in a pilot randomised controlled trial (n = 63).

RESULTS

The development process resulted in a 20-item questionnaire. The Meaningful and Enjoyable Activities Scale (MEAS) evidenced appropriate levels of internal consistency (α = .79). Higher scores correlated with higher functional independence (r = -.605, P < .001), patient (r = .330, P = .010) and carer-rated patient quality of life (r = .505, P < .001). Multiple regression analyses showed that functional independence made a significant independent contribution in predicting higher levels of meaningful activity (F[7,45] = 6.75, P < .001, R2 = .512; β = -.444, P = .001). Confirmatory factor analysis indicated that a revised three-factor 9-item model provided good fit for the data (X2 = 22.74, P = .54, GFI = 0.93, RMSE = 0.00), with leisure-time physical activity, social engagement and mentally stimulating activities as the key dimensions.

CONCLUSION

Our study provides support for the construct of meaningful activity in people with mild dementia. Although we find preliminary evidence that the MEAS has adequate psychometric properties, future large scale studies are required to test its validity further and responsiveness to change.