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Pan C. Bidirectional and Dynamic Relationships Between Social Isolation and Loneliness Among Older Adults in China. J Am Med Dir Assoc 2024; 25:105003. [PMID: 38670171 DOI: 10.1016/j.jamda.2024.03.114] [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: 10/26/2023] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVES This study aimed to investigate the bidirectional associations and temporal dynamics between social isolation (SI) and loneliness among older adults. DESIGN This is a prospective cohort study. SETTING AND PARTICIPANTS With the global phenomenon of population aging, there has been a significant increase in the prevalence of SI and loneliness among older adults. These factors exert substantial impacts on the health and well-being of this population. Consequently, it is imperative to implement more effective interventions targeting SI and combating loneliness in order to enhance the overall health and well-being of older adults. METHODS Data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) were analyzed, focusing on individuals aged 65 and older. Generalized Cross-Lagged Modeling (GCLM) was used to assess these associations. RESULTS The findings reveal significant cross-lagged effects between SI and loneliness over the course of 16 years. Higher levels of SI at 1 time point predict increased loneliness scores in subsequent periods, and greater levels of loneliness at 1 time point predict higher SI scores in future periods. Notably, the impact of SI on loneliness is found to be larger and more enduring compared to the influence of loneliness on SI. These cross-lagged effects persist over an extended period, indicating a long-term reciprocal relationship between SI and loneliness among older adults. CONCLUSIONS AND IMPLICATIONS This study provides valuable insights into the bidirectional associations between SI and loneliness among older adults. Given that the effect of SI dominates, the findings suggest that public health strategies aimed at promoting health and well-being should prioritize interventions that enrich older adults' social networks. Emphasizing early interventions aimed at enhancing social networks is essential for promoting healthy aging and overall well-being.
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Affiliation(s)
- Chaoping Pan
- College of Medical Humanities and Management, Wenzhou Medical University, Wenzhou, Zhejiang, China.
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Ge H, Dong S, Su W, Guan W, Yu Q, Liu Y, Qi Y, Sun X, Zhang H, Ma G. Relationship between social participation and depressive symptoms in patients with multimorbidity: the chained mediating role of cognitive function and activities of daily living. BMC Public Health 2024; 24:1844. [PMID: 38987791 PMCID: PMC11234698 DOI: 10.1186/s12889-024-19157-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 06/14/2024] [Indexed: 07/12/2024] Open
Abstract
OBJECTIVE The potential mechanisms linking social participation and depressive symptoms in Chinese individuals with multimorbidity are not yet fully understood. This study aims to explore how cognitive function and activities of daily living (ADLs) mediate the relationship between social participation and depressive symptoms in individuals with multimorbidity. METHODS We selected 3782 participants with multimorbidity from the 2018 China Health and Retirement Longitudinal Study. Data related to social participation, cognitive function, ADLs, and depressive symptoms were extracted. Regression and Bootstrap analyses were used to explore the sequential mediating effects of social participation, cognitive function, ADLs, and depressive symptoms. RESULTS (1) There was a significant correlation between social participation, cognitive function, activities of daily living, and depressive symptoms (p < 0.01). (2) Social participation directly affected depressive symptoms (β = -0.205, p < 0.05). (3) Cognitive function (β = -0.070, p < 0.01) and activities of daily living (β = -0.058, p < 0.01) played separate mediating roles in the effect of social participation on depressive symptoms. (4) Cognitive function and activities of daily living had a chain-mediated role in the relationship between social participation and depressive symptoms in patients with multimorbidity (β = -0.020, p < 0.01). CONCLUSION A chained mediating effect was found between cognitive function, ADLs, social participation, and depressive symptoms in patients with multimorbidity. Social participation was found to improve the cognitive function of patients with multimorbidity, which in turn enhanced their daily life activities and ultimately alleviated their depressive symptoms.
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Affiliation(s)
- Huaiju Ge
- School of Public Health, Shandong Second Medical University, Weifang, Shandong, China
| | - Shihong Dong
- School of Public Health, Shandong Second Medical University, Weifang, Shandong, China
| | - Wenyu Su
- School of Public Health, Shandong Second Medical University, Weifang, Shandong, China
| | - Weimin Guan
- School of Public Health, Shandong Second Medical University, Weifang, Shandong, China
| | - Qing Yu
- School of Public Health, Shandong Second Medical University, Weifang, Shandong, China
| | - Yan Liu
- Shandong Cancer Research Institute (Shandong Tumor Hospital), Jinan, Shandong, China
| | - Yuantao Qi
- Shandong Cancer Research Institute (Shandong Tumor Hospital), Jinan, Shandong, China
| | - Xialing Sun
- School of Public Health, Shandong Second Medical University, Weifang, Shandong, China
| | - Huiqing Zhang
- The First Affiliated Hospital of Shandong Second Medical University (Weifang People's Hospital), Weifang, Shandong, China.
| | - Guifeng Ma
- School of Public Health, Shandong Second Medical University, Weifang, Shandong, China.
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Pan C, Yu L, Cao N. Reciprocal and Dynamic Associations between Social Isolation, Loneliness, and Disability among Chinese Older Adults. J Am Med Dir Assoc 2024; 25:104975. [PMID: 38583487 DOI: 10.1016/j.jamda.2024.02.013] [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: 11/28/2023] [Revised: 02/23/2024] [Accepted: 02/23/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVES This study aimed to examine reciprocal and dynamic associations between Social Isolation (SI), loneliness, and disability among Chinese older adults. DESIGN This is a prospective cohort study. SETTING AND PARTICIPANTS The global trend of population aging has resulted in a significant rise in the prevalence of disabilities, SI, and loneliness among older adults. These factors can severely impact the health and well-being of older adults. Therefore, it is crucial to implement more efficient interventions aimed at reducing disabilities, addressing SI, and combating loneliness among older adults in order to improve their overall health and well-being. METHODS Using a large, nationally representative sample spanning 16 years, we employed the general cross-lagged panel model to explore the relationships among 50,348 older adults with a mean age of 81.83 at baseline. Disability was measured by a comprehensive index tool that incorporated multiple dimensions. SI was measured using an SI index, and loneliness was evaluated using a single-item measure. RESULTS SI emerged as a stronger predictor of disability than loneliness. Longitudinal analysis revealed accumulative disadvantages in the association between SI and disability. Additionally, disability was found to contribute to increased SI and loneliness. However, our study did not detect any variance in the strength of the cross-lagged effects between social isolation and disability. CONCLUSIONS AND IMPLICATIONS The findings suggest that reducing SI is crucial for reducing disability among older adults. Initiating early interventions to minimize initial SI could aid in preventing later-life disability. Additionally, addressing disabilities may positively impact the reduction of loneliness and SI within this population.
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Affiliation(s)
- Chaoping Pan
- College of Medical Humanities and Management, Wenzhou Medical University, Wenzhou City, Zhejiang Province, China
| | - Linwei Yu
- College of Medical Humanities and Management, Wenzhou Medical University, Wenzhou City, Zhejiang Province, China.
| | - Na Cao
- College of Medical Humanities and Management, Wenzhou Medical University, Wenzhou City, Zhejiang Province, China; School of Public Health, Wuhan University, Wuhan City, Hubei Province, China.
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Cooper C, Linden M, Kerr C. Social participation in adults with cerebral palsy: a systematic review of the evidence-base. Disabil Rehabil 2024; 46:2720-2733. [PMID: 37497638 DOI: 10.1080/09638288.2023.2236026] [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: 06/28/2022] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 07/28/2023]
Abstract
PURPOSE To identify and synthesise the current evidence on social participation in adults with cerebral palsy (CP). METHODS Four databases (PubMed, CINAHL Plus, PsycINFO, Web of Science) were systematically searched between December 2021 and February 2022. Pre-specified eligibility criteria were applied to all identified studies resulting in the inclusion of 16 articles. Data extraction was performed using a standardised tool and quality appraisal was assessed using the Mixed Methods Appraisal Tool. A narrative synthesis approach was taken for data analysis. RESULTS The 16 included studies were rated as high (n = 11) and medium quality (n = 5). Numbers of participants included in the studies ranged from 7 to 335. Definitions of social participation were discussed. Common themes were identified: the impact of home and work environments on social participation, the importance of age-appropriate support and interventions, and the impact of limited autonomy on social participation. CONCLUSIONS Adults with CP experience limited social participation due to lack of appropriate support in childhood, issues across the lifespan including physical limitations when ageing, and factors such as societal expectations and inaccessible environments which limit opportunities for autonomy. Social participation may be improved by supporting families to provide opportunities in childhood, providing timely interventions, and by enhancing autonomy.
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Affiliation(s)
- Claire Cooper
- School of Nursing & Midwifery, Queen's University Belfast, Belfast, United Kingdom of Great Britain and Northern Ireland
| | - Mark Linden
- School of Nursing & Midwifery, Queen's University Belfast, Belfast, United Kingdom of Great Britain and Northern Ireland
| | - Claire Kerr
- School of Nursing & Midwifery, Queen's University Belfast, Belfast, United Kingdom of Great Britain and Northern Ireland
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Wen C, Sun S, Huang L, Guo Y, Shi Y, Qi S, Ding G, Wen Z, Wang J, Ruan Y, Zhao Q. Effect of social participation on the trajectories of activities of daily living disability among community-dwelling older adults: a 7-year community-based cohort. Aging Clin Exp Res 2024; 36:104. [PMID: 38713318 PMCID: PMC11076373 DOI: 10.1007/s40520-024-02758-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 04/16/2024] [Indexed: 05/08/2024]
Abstract
INTRODUCTION Studies examining the effects of social participation on activities of daily living (ADL) disability are still scarce. AIM To assess the reciprocal relationship between ADL disability trajectories and social participation among older Chinese people aged ≥ 60 years. METHODS This study included 2976 participants aged ≥ 60 years in six waves of a community-based survey from 2015 to 2022. Basic activities of daily living (BADL) and instrumental activities of daily living (IADL) were used to assess the ADL disability in each survey. Social participation was assessed by involvement in four social activities and an extensive social participation score. Group-based trajectory modeling was used to identify potential heterogeneity in longitudinal changes over 7 years and explore associations between baseline predictors of group membership and these trajectories. RESULTS Two BADL disability trajectories were identified: stable (94.8%) and increase (5.2%). Additionally, three IADL disability trajectories were distinguished: stable (73.2%), moderate (20.2%), and increase (6.6%). After controlling for the potential covariates, each point increase in the extensive social participation score correlated with a 17% decrease in the odds of older individuals belonging to the increase BADL trajectory group (OR = 0.83, 95% CI = 0.68-1.00). For IADL, it decreased the odds of being assigned to the moderate trajectory group by 16% (OR = 0.84, 95% CI = 0.75-0.95) and to the increase trajectory group by 23% (OR = 0.77, 95% CI = 0.64-0.93). CONCLUSIONS Higher levels of social participation among older individuals were more likely to be classified as stable trajectories in both BADL and IADL. Increased participation in social activities by community-dwelling elderly adults may promote healthy aging.
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Affiliation(s)
- Cai Wen
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Shuangyuan Sun
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Limei Huang
- Songjiang Center of Disease Prevention and Control, Shanghai, China
| | - Yanfei Guo
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Yan Shi
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Shige Qi
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Guomei Ding
- Zhongshan Community Health Care Center, Songjiang District, Shanghai, China
| | - Zhiqin Wen
- Yexie Community Health Service Center, Songjiang District, Shanghai, China
| | - Jiaqi Wang
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Ye Ruan
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China.
| | - Qi Zhao
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China.
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Hao H, Kim M. Moderating role of depression in the association between leisure activity and cognitive function among the disabled older people. Front Public Health 2024; 12:1345699. [PMID: 38680930 PMCID: PMC11045938 DOI: 10.3389/fpubh.2024.1345699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 04/01/2024] [Indexed: 05/01/2024] Open
Abstract
Background This study delves into the complex interaction between leisure activities and cognitive function in older people with disabilities, with a particular emphasis on the moderating influence of depression. Despite the well-documented cognitive benefits of leisure activities among the older people, the intricate relationship between depression and the association between leisure activities and cognitive function in this specific demographic has been rarely reported. Methods Drawing on data from the 2017-2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS), this study meticulously examined a cohort of 713 participants aged 65-89 years. We constructed a moderation model to examine the impact of leisure activity on cognitive function in older people with disabilities, with depression levels as a moderating variable. Results We found a positive association between engagement in leisure activities and cognitive function, highlighting the potential cognitive advantages associated with leisure engagement among disabled older people. However, the present analysis also reveals a significant moderation effect of depression on this relationship, shedding light on the nuanced nature of this association. Specifically, elevated levels of depression emerge as a critical moderator, attenuating the otherwise favorable impact of leisure activities on cognitive function among older people contending with disabilities. Conclusion In conclusion, the findings provide a compelling rationale for tailored interventions that comprehensively target both leisure activity engagement and concurrent depression management, effectively fostering improvements in cognitive function among the cohort of disabled older people.
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Affiliation(s)
| | - Miok Kim
- Department of Social Welfare, Jeonbuk National University, Jeonju, Republic of Korea
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Zhu L, Wang Y, Wu Y, Wilson A, Zhou H, Li N, Wang Y. Longitudinal associations between the frequency of playing Mahjong and cognitive functioning among older people in China: evidence from CLHLS, 2008-2018. Front Public Health 2024; 12:1352433. [PMID: 38550318 PMCID: PMC10973127 DOI: 10.3389/fpubh.2024.1352433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 03/01/2024] [Indexed: 04/02/2024] Open
Abstract
Background Cognitive decline is prevalent among older adults, often resulting in decreased capabilities for self-care and a diminished quality of life. Mahjong, a culturally cherished and extensively played intellectual game in China, demands considerable cognitive function. While the cognitive benefits of playing Mahjong have been widely accepted, this study investigates an under explored aspect and aimed to ascertain the game's potential contributions toward bolstering self-care abilities, enhancing overall quality of life, and mitigating against rising societal healthcare costs. Methods The data analyzed in the study is collected from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) with cognitive functioning being assessed through the Mini-Mental State Examination (MMSE). The frequency of playing Mahjong was measured through a self-reported questionnaire. Multiple linear regression models, latent variable growth models, and cross-lagged models were used to investigate the longitudinal relationship between game frequency and cognitive function in older people. Results Of the 7,535 participants, the mean (SD) age was 81.96 (10.53) years. There were 7,308 (97%), 4,453 (59%), and 1,974 (26%) participants in 2011, 2014, and 2018, respectively. The results showed that Mahjong players had significantly higher MMSE scores compared to non-players from 2008 to 2018 (β = 0.893; p < 0.001), and non-players had significantly lower scores in 2011, 2014, and 2018 than in 2008 (β = -1.326, -0.912, -0.833; Ps > 0.05). Moreover, the frequency of playing Mahjong was associated with improved various cognitive domains. The declining frequency of playing Mahjong was substantially associated with the declining rate of MMSE scores (r = 0.336; p < 0.001). Mahjong frequency showed positive effects on MMSE scores, while the influence of Mahjong on MMSE scores were not significant. Conclusion Playing Mahjong has a positive influence on the cognitive functioning among older people. It can help buffer against the decline in cognitive function and maintain cognitive function levels. The higher frequency of playing Mahjong is associated with improved reaction, attention and calculation, and self-coordination. A decline in the frequency of playing Mahjong was associated with a declining rate of cognitive function. The higher frequency of playing Mahjong among older people unilaterally influenced the improvement of cognitive function levels in older people in China.
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Affiliation(s)
- Lan Zhu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yixi Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yuju Wu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Amanda Wilson
- Faculty of Health and Life Sciences, De Montfort University, Leicester, United Kingdom
| | - Huan Zhou
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Ningxiu Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China
- Guangdong Key Laboratory of Mental Health and Cognitive Science, Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
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Gao Y, Chen L, Jia Z, Zhao L, Yang Y, Liu C. Social participation and health in middle-aged and older empty nesters: A study on gender differences. SSM Popul Health 2024; 25:101641. [PMID: 38440107 PMCID: PMC10910328 DOI: 10.1016/j.ssmph.2024.101641] [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: 06/12/2023] [Revised: 02/19/2024] [Accepted: 02/19/2024] [Indexed: 03/06/2024] Open
Abstract
Background The growing population of middle-aged and older empty nesters is characterized by poorer health, and social participation (SP) has been shown to improve this situation. However, few studies have investigated specific performance and gender differences between SP and health. The present study aims to address these issues. Methods A total of 1207 middle-aged and older empty nesters over 45 years old were selected from the China Health and Retirement Longitudinal Study (CHARLS, 2011-2018). Random-effects analyses were used to explore the association between changes in SP (diversity, frequency, type) and changes in health status. Health status include physical health, mental health, self-reported health (SRH). Results Female middle-aged and olderly empty nesters have significantly poorer health and participate in SP more frequently. The higher the diversity of SP, the better the health of middle-aged and olderly empty nesters, while higher frequency is beneficial to SRH. Female's participation in sports and Internet had better mental health and SRH, and mahjong helped female's mental health. Clubs are helpful for male's SRH. Conclusions This study reveals the specifics of the association between SP and health status of middle-aged and older empty nesters. Therefore, all aspects of SP and gender differences should be taken into account when predicting and improving the health status. Help the government to better formulate policies to better cope with the increasing empty nest phenomenon and build a harmonious and stable society.
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Affiliation(s)
- Yan Gao
- School of Physical Education, Shandong University, No. 17923, Jingshi Road, Lixia District, Jinan City, shandong Province, 250061, China
| | - Lu Chen
- School of Physical Education, Shandong University, No. 17923, Jingshi Road, Lixia District, Jinan City, shandong Province, 250061, China
| | - Zhihao Jia
- School of Sports Science and Physical Education, Nanjing Normal University, No. 1, Wenyuan Road, Qixia District, Nanjing, Jiangsu Province, 210023, China
| | - Liangyu Zhao
- School of Physical Education, Shandong University, No. 17923, Jingshi Road, Lixia District, Jinan City, shandong Province, 250061, China
| | - Yuke Yang
- School of Physical Education, Shandong University, No. 17923, Jingshi Road, Lixia District, Jinan City, shandong Province, 250061, China
| | - Chenchen Liu
- School of Medical Information Engineering, Jining Medical University, No 133 Hehua Road, Jining City, shandong Province, 272067, China
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Zhou Z, Fu J, Shen Z, Qiu Y, Yang J, Chen X, Li Y, Zheng H. Activities of daily living and non-exercise physical activity in older adults: findings from the Chinese Longitudinal Healthy Longevity Survey. BMJ Open 2024; 14:e074573. [PMID: 38388507 PMCID: PMC10884219 DOI: 10.1136/bmjopen-2023-074573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 01/31/2024] [Indexed: 02/24/2024] Open
Abstract
OBJECTIVES Studies have shown that good cognitive function can moderate the relationship between non-exercise physical activity (NEPA) and activities of daily living (ADLs) disability to some extent, and this study mainly explores the relationship between ADL and NEPA and cognitive function in Chinese older adults. SETTING AND PARTICIPANTS Data came from a nationally representative sample of 2471 Chinese old adults (aged 65+) from the 2011, 2014 and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey. PRIMARY AND SECONDARY OUTCOME MEASURES A cross-lagged panel model combined with mediation analysis was used to determine the relationship between ADL and NEPA and the mediating effect of cognitive function on the ascertained ADL-NEPA relationship. RESULTS The more frequently people over the age of 65 in China participate in NEPA, the lower the risk of ADL disability. Cognitive function partially mediated this expected relationship, accounting for 9.09% of the total NEPA effect on ADL. CONCLUSION Participating in more NEPA could reduce the risk of ADL disability, and participating in NEPA may reduce the risk of ADL disability through cognitive function to some extent.
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Affiliation(s)
- Zhengcheng Zhou
- School of Public Health, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Key Laboratory of Preventive Medicine, Jiangxi Medical College,Nanchang University, Nanchang, Jiangxi, China
- The 4th Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Jiehui Fu
- School of Public Health, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Key Laboratory of Preventive Medicine, Jiangxi Medical College,Nanchang University, Nanchang, Jiangxi, China
| | - Ziyang Shen
- School of Public Health, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Key Laboratory of Preventive Medicine, Jiangxi Medical College,Nanchang University, Nanchang, Jiangxi, China
| | - Yuexin Qiu
- School of Public Health, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Key Laboratory of Preventive Medicine, Jiangxi Medical College,Nanchang University, Nanchang, Jiangxi, China
| | - Junsai Yang
- School of Public Health, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Key Laboratory of Preventive Medicine, Jiangxi Medical College,Nanchang University, Nanchang, Jiangxi, China
| | - Xiaoyun Chen
- School of Public Health, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Key Laboratory of Preventive Medicine, Jiangxi Medical College,Nanchang University, Nanchang, Jiangxi, China
| | - Yue Li
- School of Public Health, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Key Laboratory of Preventive Medicine, Jiangxi Medical College,Nanchang University, Nanchang, Jiangxi, China
| | - Huilie Zheng
- School of Public Health, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Key Laboratory of Preventive Medicine, Jiangxi Medical College,Nanchang University, Nanchang, Jiangxi, China
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Pan C, Yu L. Bidirectional and dynamic relationships between social isolation and activities of daily living among older adults in China. J Glob Health 2024; 14:04031. [PMID: 38275090 PMCID: PMC10811563 DOI: 10.7189/jogh.14.04031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024] Open
Abstract
Background Social isolation and disability in performing activities of daily living are increasingly recognised as significant public health concerns globally. We aimed to investigate their bidirectional associations and the related temporal dynamics in Chinese older adults. Methods We retrieved data from the six waves of the Chinese Longitudinal Healthy Longevity Survey (2002-18) and used generalised cross-lagged modelling (GCLM) to assess the bidirectional associations between social isolation and disability in performing activities of daily living. Results We found that higher levels of social isolation were predictive of increased scores in disabilities in performing activities of daily living. Conversely, disabilities in performing activities of daily living showed less predictive power in relation to social isolation. The temporal dynamics analysis indicated a peak in the bidirectional associations after approximately six years, followed by decreasing trends. Conclusions Our results indicate that social isolation is dominant in the bidirectional relationship. Efforts focusing on reducing it can potentially minimise disabilities in performing activities of daily living among older adults. Reinstating preventive interventions beyond the six-year mark could help maintain their effectiveness.
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Shan Y, Zhao W, Hao W, Kimura T, Ukawa S, Ohira H, Kawamura T, Wakai K, Ando M, Tamakoshi A, Wang C. Five-year changes of social activity and incident long-term care needs among depressed older adults: A 15-year follow up. Arch Gerontol Geriatr 2024; 116:105163. [PMID: 37633161 DOI: 10.1016/j.archger.2023.105163] [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: 06/28/2023] [Revised: 08/17/2023] [Accepted: 08/18/2023] [Indexed: 08/28/2023]
Abstract
OBJECTIVES To examine the effects of changes in individual/multiple social activities between 65 and 70 years of age on incident long-term care (LTC) needs between 70 and 80 in older adults with depressive symptoms. METHODS Participants were recruited from the New Integrated Suburban Seniority Investigation Project, an ongoing prospective cohort study. A total of 525 older adults with depressive symptoms were included. The validated 15-item Geriatric Depression Scale was used to assess depressive symptoms. A self-report questionnaire was used to measure social activities (social-related, learning, and personal). LTC needs was defined according to Japan's Long-term Care Insurance System. A competing risk model and a Laplace regression model were used to estimate the hazard ratios of LTC needs incidence and the 25th percentile difference in LTC-needs-free survival time and their 95% confidence intervals. RESULTS Out of 4314 person-years of mild LTC needs, 108 individuals developed it. Participants who increased their frequency of learning activities have a lower risk of developing mild LTC needs. Increasing the frequency could also prolong LTC-needs-free survival time by approximately 2.61 years. Out of 4535 person-years for severe LTC needs, 54 individuals developed it. Participants with a continuous regular frequency of learning activities had a lower risk of developing severe LTC needs. However, the association between this frequency and LTC-needs-free survival time for severe LTC needs was insignificant in the multivariable models. CONCLUSIONS Increased frequency of learning activities reduced the risk of LTC needs among older adults with depressive symptoms and prolonged their LTC-needs-free survival time.
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Affiliation(s)
- Yifan Shan
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Institute for Hospital Management of Henan Province, Zhengzhou, China; Department of Public Health, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15 Jo Nishi 7 Chome, Kita-ku, Sapporo, Hokkaido 060-8638, Japan
| | - Wenjing Zhao
- Department of Public Health, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15 Jo Nishi 7 Chome, Kita-ku, Sapporo, Hokkaido 060-8638, Japan; School of Public Health and Emergency Management, Southern University of Science and Technology, Guangdong, China
| | - Wen Hao
- Department of Public Health, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15 Jo Nishi 7 Chome, Kita-ku, Sapporo, Hokkaido 060-8638, Japan
| | - Takashi Kimura
- Department of Public Health, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15 Jo Nishi 7 Chome, Kita-ku, Sapporo, Hokkaido 060-8638, Japan
| | - Shigekazu Ukawa
- Research Unit of Advanced Interdisciplinary Care Science, Osaka Metropolitan University Graduate School of Human Life and Ecology, Osaka, Japan
| | - Hideki Ohira
- Department of Psychology, Graduate School of Informatics, Nagoya University, Nagoya, Japan
| | | | - Kenji Wakai
- Department of Preventive Medicine, Graduate School of Medicine, Nagoya University, Japan
| | - Masahiko Ando
- Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan
| | - Akiko Tamakoshi
- Department of Public Health, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15 Jo Nishi 7 Chome, Kita-ku, Sapporo, Hokkaido 060-8638, Japan.
| | - Chengzeng Wang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Institute for Hospital Management of Henan Province, Zhengzhou, China.
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12
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Pan C, Cao N. Patterns of Social Isolation and Low Social Support and Frailty Trajectories Among Chinese Older Adults. J Appl Gerontol 2023; 42:2325-2334. [PMID: 37585676 DOI: 10.1177/07334648231194508] [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] [Indexed: 08/18/2023] Open
Abstract
Objectives: This study aims to identify patterns of social isolation and low social support, and discover their associations with frailty trajectories among Chinese older adults. Methods: The paper used five waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS, 2005-2018). The latent class analysis, multi-trajectory modeling, and the multinomial logistic regression approaches were used to perform the analysis. Results: The paper identified five types of social isolation and low social support, and three typical frailty trajectories. Patterns of social isolation and low social support were associated with frailty trajectories among older adults. Conclusions: Distinct patterns of social isolation and low social support were significantly correlated with frailty trajectories. To improve frailty trajectories among older adults, interventions such as Healthy China 2030 should prioritize addressing the interplay between social isolation and low social support.
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Affiliation(s)
- Chaoping Pan
- School of Public Health and Management, Wenzhou Medical University, Wenzhou City, China
| | - Na Cao
- School of Public Health and Management, Wenzhou Medical University, Wenzhou City, China
- School of Public Health, Wuhan University, Wuhan City, China
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Yılmaz M, Uyanık G, Ağartıoğlu Kundakçı G, Subaşı Baybuğa M, Altay B, Cingil D, Bakan AB, Aktaş B, Çapık C, Erol S, Pehlivan Ş, Fidan G. Social Participation of Older Adults in Rural and Urban Areas: A Cross-Sectional Survey in Turkey. J Aging Soc Policy 2023:1-18. [PMID: 38007621 DOI: 10.1080/08959420.2023.2286162] [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: 12/12/2022] [Accepted: 07/06/2023] [Indexed: 11/27/2023]
Abstract
Social participation is important in terms of active aging and quality of life during old age. This cross-sectional study aimed to determine the social participation of older adults in rural and urban areas in Turkey. Related factors were similarly identified. The sample comprised 1,224 people over the age of 60, with a mean of 69.78 ± 7.48 years. Among the participants, 61.4% live in urban areas. The data were collected in family health centers through face-to-face interview and the Interview Form, Social Participation Assessment Form, and Social Participation Dimension of the Turkish Version of the Aging Module of the World Health Organization Quality of Life (WHOQOL) Scale. The scores obtained from the social participation dimension of the scale among the elderly in urban areas were higher than those obtained among the elderly in rural areas (p = .002). In addition, older adults in the urban areas who talked on the phone several times a month (p = .025), went to concerts, theater/cinema, museum/exhibition, various visual/musical shows (p = .046), and engaged in gardening (p = .032) obtained higher scores in the social participation dimension than the other participants. Health care professionals should take an advocacy role in building relationships with policy makers and create suitable socialization opportunities for older adults in urban and rural areas.
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Affiliation(s)
- Medine Yılmaz
- Public Health Nursing Department, Izmir Katip Celebi University, Izmir, Turkey
| | - Gülçin Uyanık
- Public Health Nursing Department, Izmir Katip Celebi University, Izmir, Turkey
| | | | | | - Birsen Altay
- Public Health Nursing Department, Ondokuz Mayis University, Samsun, Turkey
| | - Dilek Cingil
- Public Health Nursing Department, Necmettin Erbakan University, Konya, Turkey
| | | | - Betül Aktaş
- Public Health Nursing Department, Izmir Katip Celebi University, Izmir, Turkey
| | - Cantürk Çapık
- Public Health Nursing Department, Ataturk University, Erzurum, Turkey
| | - Saime Erol
- Public Health Nursing Department, Marmara University, Istanbul, Turkey
| | - Şenay Pehlivan
- Public Health Nursing Department, Alanya Alaaddin Keykubat University, Antalya, Turkey
| | - Gülfer Fidan
- Public Health Nursing Department, Mugla Sıtkı Kocman University, Mugla, Turkey
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14
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Li Y, Liu X. The Effect of Home Care Poverty on the Activities of Daily Living among Older Adults in China: A Propensity Score Matching Study. IRANIAN JOURNAL OF PUBLIC HEALTH 2023; 52:2325-2332. [PMID: 38106844 PMCID: PMC10719699 DOI: 10.18502/ijph.v52i11.14032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 05/21/2023] [Indexed: 12/19/2023]
Abstract
Background In the context of home care being valued by the Chinese government and the increasing number of disabled older adults, it is of great significance to explore the effect of home care poverty of the older adults on their ability to perform activities of daily living. Methods A research sample of 2583 older adults from the Chinese Longitudinal Healthy Longevity Survey data in 2018 was adopted. There were 422 participants in the treatment group and 2161 participants in the control group. According to the framework of counterfactual analysis, the kernel matching method was used to match the treatment and control groups to calculate the values of average treatment effects on treated (ATT). Results The results of the kernel matching method showed that the factual ADL score of the treatment group was 6.886, the counterfactual ADL score of the control group was 8.520, and the ATT value was -1.634 (P<0.05). There were gender and urban-rural differences in the relationship between home care poverty and activities of daily living among older people. In gender samples, there was a significant correlation between the two, and the absolute value of ATT in male samples was higher than that in female samples (P<0.05). In the rural samples, there was a significant correlation between the two variables (P<0.05). But in the urban samples, there was no significant correlation between the two variables. Conclusion Home care poverty could significantly reduce the ability to perform activities of daily living among older adults in China. Based on the conclusions, the study puts forward several suggestions to solve the home care poverty for the older adults in China.
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Affiliation(s)
- Yuee Li
- School of Humanities and Law, Northeastern University, Shenyang, China
| | - Xiaohui Liu
- School of Humanities and Law, Northeastern University, Shenyang, China
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15
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Ali T, Elliott MR, Antonucci TC, Needham BL, Zelner J, de Leon CFM. Network Types and Functional Health in Old Age: It is Not Just the Size of the Network That Matters. J Aging Health 2023:8982643231209351. [PMID: 37863092 PMCID: PMC11031614 DOI: 10.1177/08982643231209351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2023]
Abstract
OBJECTIVES Findings on the effect of network size and support on functional health are mixed. We examine whether network types, that simultaneously incorporate multiple network characteristics, are associated with functional health in late life. METHODS Data are from the National Social Life, Health, and Aging Project (N = 3005). We estimated the longitudinal effect of membership in five multidimensional network types on disability in six activities of daily living using negative binomial regression, and on mobility (assessed using a timed walk test) using a generalized linear mixed model. RESULTS Compared to those in the large without strain network, older adults in the small, restricted, high contact network had fewer disabilities but worse mobility, while those in the large network with strain also had worse mobility. DISCUSSION Care plans focusing on function and mobility should consider multiple aspects of older adults' social networks including network size, diversity, and relationship strain.
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Affiliation(s)
- Talha Ali
- Department of Community Health, Tufts University, Medford, MA, USA
| | - Michael R. Elliott
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Toni C. Antonucci
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Belinda L. Needham
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Jon Zelner
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor, MI, USA
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Ping R, Oshio T. Educational inequalities in self-rated health and their mediators in late adulthood: Comparison of China and Japan. PLoS One 2023; 18:e0291661. [PMID: 37713366 PMCID: PMC10503706 DOI: 10.1371/journal.pone.0291661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 09/03/2023] [Indexed: 09/17/2023] Open
Abstract
Education has an impact on health, but the magnitude of the impact may vary across countries. This cross-sectional study compared educational inequalities in health and their mediators in late adulthood between China and Japan, which both face rapid population aging. We studied the same age cohort (63-72 years) based on two nationwide population-based surveys in 2018: the China Health and Retirement Longitudinal Study (N = 5,277) and Japan's Longitudinal Survey of Middle-Age and Elderly Persons (N = 20,001). The relative index of inequality (RII) in education was used to measure educational inequality in self-rated health (SRH). We then examined the extent to which income, smoking, leisure-time physical activity, and social participation mediated educational inequalities in SRH. In both countries, a lower educational level was associated with a higher risk of poor SRH; in China, however, the gradient was flatter. In China, the RII of education was 1.69 (95% confidence interval [CI]: 1.20-2.39) for men and 1.47 (95% CI: 1.06-2.05) for women. In Japan, meanwhile, RII was 2.70 (95% CI: 2.21-3.28) for men and 2.60 (95% CI: 2.13-3.18) for women. Our mediation analysis based on logistic regression models with bootstrapping also found that social participation was a key mediator of educational inequalities in health in both countries. In all, the results underscore that one's relative position in educational inequalities is a reliable predictor of subjective health in late adulthood in both China and Japan.
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Affiliation(s)
- Ruru Ping
- Graduate School of Economics, Hitotsubashi University, Tokyo, Japan
| | - Takashi Oshio
- Institute of Economic Research, Hitotsubashi University, Tokyo, Japan
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17
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Ide K, Tsuji T, Kanamori S, Watanabe R, Iizuka G, Kondo K. Frequency of social participation by types and functional decline: A six-year longitudinal study. Arch Gerontol Geriatr 2023; 112:105018. [PMID: 37043839 DOI: 10.1016/j.archger.2023.105018] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 04/01/2023] [Accepted: 04/03/2023] [Indexed: 04/14/2023]
Abstract
Social participation is effective for preventing functional decline in older people. However, researchers have not fully explored how different frequencies of social participation by type. We aimed to clarify the relationship between the frequency of social participation by type and functional decline. We used data from the Japan Gerontological Evaluation Study, which consists of individuals aged 65 years and older who were not eligible to receive public long-term-care insurance benefits. From 13 municipalities, 51,968 respondents who met the criteria were included in the analysis. We used a sex-stratified Cox proportional hazards model. The outcome was the new incidence of functional decline during a six-year follow-up, and the exposure was the frequency of social participation of one of the following six types: sports, hobbies, volunteering, neighborhood, senior clubs, and industry groups. The frequency was categorized as "never," "a few times a year," "once or twice a month," and "once a week or more." We set non-participation in each activity as the reference, and we adjusted for 12 potential confounders (i.e., sociodemographic and health-related factors). After we adjusted for confounders, participation in sports and hobbies once or twice a month, once a week or more was protectively associated with functional decline. We found a similar association for participation in neighborhood a few times a year. Our findings demonstrate the importance of considering the effects of different types and frequencies of activities when promoting social participation among older people as part of public health policies.
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Affiliation(s)
- Kazushige Ide
- Center for Preventive Medical Sciences, Chiba University, Inage-ku, Chiba, Japan; Department of Community General Support, Hasegawa Hospital, Yachimata, Chiba, Japan.
| | - Taishi Tsuji
- Center for Preventive Medical Sciences, Chiba University, Inage-ku, Chiba, Japan; Faculty of Health and Sport Sciences, University of Tsukuba, Bunkyo-ku, Tokyo, Japan
| | - Satoru Kanamori
- Graduate School of Public Health, Teikyo University, Itabashi-ku, Tokyo, Japan; Department of Preventive Medicine and Public Health, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Ryota Watanabe
- Center for Preventive Medical Sciences, Chiba University, Inage-ku, Chiba, Japan; Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Gemmei Iizuka
- Center for Preventive Medical Sciences, Chiba University, Inage-ku, Chiba, Japan; Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Inage-ku, Chiba, Japan; Family Medicine Residency, Seibo International Catholic Hospital, Shinjuku-ku, Tokyo, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Inage-ku, Chiba, Japan; Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
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18
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Lin J, Xiao J, Li Q, Cao L. Association between all-cause mortality and trajectories across quality and duration of sleep and cognitive function: based on Group-Based Multivariate Trajectory modeling. BMC Geriatr 2023; 23:528. [PMID: 37648983 PMCID: PMC10468863 DOI: 10.1186/s12877-023-04231-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 08/10/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Sleep duration and quality are associated with cognition, but the interaction of the 3 indicators and their association with all-cause mortality is unclear. METHODS We used data from the Chinese Longitudinal Healthy Longevity Survey from 2005-2018 to identify latent trajectories of sleep duration, sleep quality, and cognitive function. Secondly, the multinomial logistic model was adopted to determine predictors of trajectory groups. Finally, the Cox regression model was used to examine the association between these trajectory groups and all-cause mortality. RESULTS A total of 5046 adults (49% women) with an average age of 76.34 were included in the study. The median follow-up period was 11.11 years, during which 1784 (35%) participants died. We identified 4 latent groups among older adults: 'Good-performance' (51%), 'Decreasing' (26%), 'Oversleep & cognitive impairment' (12%), and 'Sleep-deprived' (11%). Individuals in the 'Decreasing' had a 51% increased risk of all-cause mortality (HR = 1.51, 95% CI: 1.25 - 1.81, p < .001). Individuals in the 'Oversleep & cognitive impairment' had a 170% increased risk of all-cause mortality (HR = 2.7 95% CI: 2.13 - 3.43, p < .001). Women had a higher risk of all-cause mortality regardless of trajectory group (47-143% men VS. 74-365% women). Both urban and rural areas have a similarly increased risk of all-cause mortality (48-179%). CONCLUSIONS Our study reveals the latent trajectories across sleep duration, sleep quality, and cognitive function in older Chinese and further explores their association with death. These findings provide a rational basis for cognitive interventions and reduce all-cause mortality.
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Affiliation(s)
- Jianlin Lin
- International School of Public Health and One Health, Hainan Medical University, No. 3 Xueyuan Road, Longhua District, Haikou, Hainan, 571199, China
- Department of Oral and Maxillofacial Surgery, Stomatological Center, Peking University Shenzhen Hospital, Shenzhen, China
- Guangdong Provincial High-Level Clinical Key Specialty, Shenzhen, China
- Guangdong Province Engineering Research Center of Oral Disease Diagnosis and Treatment, Shenzhen, China
| | - Jian Xiao
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, 210003, China
| | - Qiao Li
- International School of Public Health and One Health, Hainan Medical University, No. 3 Xueyuan Road, Longhua District, Haikou, Hainan, 571199, China.
| | - Li Cao
- International School of Public Health and One Health, Hainan Medical University, No. 3 Xueyuan Road, Longhua District, Haikou, Hainan, 571199, China.
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Kumari N, Saikia N, Subramanian SV. The puzzle of underreporting disability among tribal population in India: is it a statistical artifact or reality? GeroScience 2023; 45:2387-2403. [PMID: 36746893 PMCID: PMC10651585 DOI: 10.1007/s11357-023-00736-2] [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: 11/07/2022] [Accepted: 01/17/2023] [Indexed: 02/08/2023] Open
Abstract
India is undergoing a demographic transition, and so is the tribal population of India. The outcome of this is ageing, and ageing is associated with disability. The tribals are the most vulnerable and marginalized section, despite being significant in numbers, there has not been much exploration of disability among tribals and non-tribals. We used secondary data from the nationally representative, Longitudinal Ageing Study in India (2017-2018). Our sample size consisted of 64,417 adults ages 45 years and older. We defined the disability as having functional limitations. Regression analysis was done to examine the association between disability and caste. Further, to eliminate selection bias, we employed the propensity score matching. Also, lifestyle factors that may have a positive and negative impact on the functional health were analyzed. The results of the study found that the prevalence of functional limitation is lower among the tribal population. After controlling other socio-economic variables, we found that scheduled tribes have lower likelihood of functional limitations. Further, the propensity score matching was done to control for the observable group differences with respect to socioeconomic characteristics; the results still held true. We also found that the positive lifestyle was more prevalent among the tribal groups, which may have impacted their healthy living. The study empirically found that tribal population have lower disability in comparison to the non-tribal population in India. The tribal are more active physically and socially, which may reduce the level of functional disability.
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Affiliation(s)
- Neha Kumari
- International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India
| | - Nandita Saikia
- International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India.
| | - S V Subramanian
- Harvard Center for Population and Development Studies, Cambridge, MA, USA
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Duan Y, Jiang S, Yin Z, Wang S, Gao J, Yang M, Chen C, Fu H, Wang C. Association of social isolation and cognitive performance: a longitudinal study using a four-wave nationwide survey. BMC Public Health 2023; 23:1409. [PMID: 37481576 PMCID: PMC10362697 DOI: 10.1186/s12889-023-16274-7] [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: 01/11/2023] [Accepted: 07/09/2023] [Indexed: 07/24/2023] Open
Abstract
BACKGROUND This study aimed to examine the bidirectional relationship between social isolation and cognitive performance among Chinese middle-aged and older adults. METHODS We used four waves of data from the China Health and Retirement Longitudinal Study. A latent growth model (LGM) was applied to examine the association between social isolation and cognitive performance across different characteristics. RESULTS In the analysis, we ultimately included 9,367 participants after excluding respondents with missing key variables. Social isolation and cognitive performance showed significant differences across time. After adjusting for the confounders, there was a significant association between higher social isolation and poor cognitive performance (β = -1.38, p < 0.001), and higher levels of social isolation resulted in a more pronounced decline in cognition over time (β = 0.17, p < 0.001). Additionally, the path coefficient between the initial level of cognition at baseline and the slope of social isolation was - 0.07 (p < 0.001) and 0.01 (p = 0.021), respectively. For the correlation between slopes, our study found that females' cognition scores were more susceptible to social isolation (β = - 2.78, p < 0.001). Similarly, regarding cognition scores, the influence of social isolation was greater among people with education below the primary level (β = - 2.89, p = 0.002) or a greater number of chronic diseases (β = - 2.56, p = 0.001). CONCLUSION Our findings support the bidirectional association between social isolation and cognition. Specifically, higher baseline social isolation and its rate of increase over time contribute to an intensification of cognitive decline at follow-up. Besides, poorer cognitive performance predicted higher social isolation.
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Affiliation(s)
- Yanran Duan
- The First Affiliated Hospital of Zhengzhou University, 450000, 1 Jianshe Road, Henan Province, Zhengzhou, China
- Institute for Hospital Management of Henan Province, Zhengzhou, China
| | - Shuai Jiang
- The First Affiliated Hospital of Zhengzhou University, 450000, 1 Jianshe Road, Henan Province, Zhengzhou, China
- Institute for Hospital Management of Henan Province, Zhengzhou, China
| | - Zhao Yin
- The First Affiliated Hospital of Zhengzhou University, 450000, 1 Jianshe Road, Henan Province, Zhengzhou, China
- Institute for Hospital Management of Henan Province, Zhengzhou, China
| | - Sufan Wang
- The First Affiliated Hospital of Zhengzhou University, 450000, 1 Jianshe Road, Henan Province, Zhengzhou, China
- Institute for Hospital Management of Henan Province, Zhengzhou, China
| | - Jinghong Gao
- The First Affiliated Hospital of Zhengzhou University, 450000, 1 Jianshe Road, Henan Province, Zhengzhou, China
- Institute for Hospital Management of Henan Province, Zhengzhou, China
| | - Mengyu Yang
- Zhengzhou University School of Public Health, Zhengzhou, China
| | - Changying Chen
- The First Affiliated Hospital of Zhengzhou University, 450000, 1 Jianshe Road, Henan Province, Zhengzhou, China
- Institute for Hospital Management of Henan Province, Zhengzhou, China
| | - Hang Fu
- The First Affiliated Hospital of Zhengzhou University, 450000, 1 Jianshe Road, Henan Province, Zhengzhou, China.
- Institute for Hospital Management of Henan Province, Zhengzhou, China.
| | - Chengzeng Wang
- The First Affiliated Hospital of Zhengzhou University, 450000, 1 Jianshe Road, Henan Province, Zhengzhou, China.
- Institute for Hospital Management of Henan Province, Zhengzhou, China.
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Rosa M, Scassellati C, Cattaneo A. Association of childhood trauma with cognitive domains in adult patients with mental disorders and in non-clinical populations: a systematic review. Front Psychol 2023; 14:1156415. [PMID: 37425159 PMCID: PMC10327487 DOI: 10.3389/fpsyg.2023.1156415] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 06/01/2023] [Indexed: 07/11/2023] Open
Abstract
Although the association between cognitive performances and the onset of psychiatric disorders has been widely investigated, limited research on the role of childhood trauma or early life stress (CT/ELS), and whether this role differs between clinical and non-clinical cohorts is available. This systematic review aims at filling this gap, testing whether the occurrence of CT/ELS and its subtypes are associated with cognitive domains (general cognitive ability, executive functions, working memory, attention, processing speed, verbal/visual memory) in patients with psychiatric disorders and in non-clinical populations. This study followed the PRISMA 2020 guidelines and the Newcastle-Ottawa scale for quality assessment. The search was performed until May 2022. Seventy-four studies were classified as eligible. The graphical representations of the results reported an association between exposure to CT/ELS and worse general cognitive ability, verbal/visual memory, processing speed and attention in patients affected by anxiety, mood and psychotic disorders, and that specific CT/ELS subtypes (physical neglect, physical/sexual abuse) can differentially influence specific cognitive abilities (executive functions, attention, working memory, verbal/visual memory). In non-clinical cohorts we found associations between CT/ELS exposure and impairments in executive functions, processing speed and working memory, while physical neglect was related to general cognitive ability and working memory. Concerning the emotional abuse/neglect subtypes in both populations, the results indicated their involvement in cognitive functioning; however, the few studies conducted are not enough to reach definitive conclusions. These findings suggest an association of CT/ELS with specific cognitive deficits and psychopathology.
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Affiliation(s)
- Melissa Rosa
- Laboratory of Biological Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Catia Scassellati
- Laboratory of Biological Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Annamaria Cattaneo
- Laboratory of Biological Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
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22
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Li X, Gao L, Qiu Y, Zhong T, Zheng L, Liu W, Li G, Chen L. Social frailty as a predictor of adverse outcomes among older adults: a systematic review and meta-analysis. Aging Clin Exp Res 2023:10.1007/s40520-023-02421-y. [PMID: 37219756 DOI: 10.1007/s40520-023-02421-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 04/24/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND With the aging of the population, frailty has attracted much attention, and the social dimension of frailty, namely social frailty, has also attracted attention. Studies have shown that social frailty can bring some adverse effects to the elderly, such as physical and cognitive function. AIMS To explore the risk of adverse health outcomes in older adults with social frailty compared with older adults with non-social frailty. METHODS Five databases were systematically searched from inception to February 28, 2023. Screening, data extraction and quality assessment were conducted independently by two researchers. The included studies were longitudinal studies of adverse outcomes in community-dwelling socially frail older adults, and the quality of each study was assessed using the Newcastle‒Ottawa Scale. RESULTS A total of 15 studies were included based on the inclusion criteria, of which 4 were subjected to meta-analysis. The mean age of the included population ranged from 66.3 to 86.5 years. According to existing research, social frailty was predictive of some adverse outcomes, such as incident disability, depressive symptoms, and reduced neuropsychological function. The meta-analysis showed that social frailty had a significant predictive effect on mortality among older adults [HR = 2.27, (95% CI = 1.03-5.00)]. CONCLUSION In community-dwelling older adults, social frailty was a predictor of mortality, incident disability, depressive symptoms and other adverse outcomes. Social frailty had a negative impact on older adults, so it was necessary to strengthen the screening of social frailty to reduce the incidence of adverse outcomes.
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Affiliation(s)
- Xin Li
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, 130021, Jilin, China
| | - Lan Gao
- The First Hospital of Jilin University, No.71 Xinmin Street, Changchun, 130021, Jilin, China
| | - Yiming Qiu
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, 130021, Jilin, China
| | - Tangsheng Zhong
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, 130021, Jilin, China
| | - Lufang Zheng
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, 130021, Jilin, China
| | - Wei Liu
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, 130021, Jilin, China
| | - Guichen Li
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, 130021, Jilin, China.
| | - Li Chen
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, 130021, Jilin, China.
- Department of Pharmacology, College of Basic Medical Sciences, Jilin University, Changchun, China.
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Shi L, Tao L, Chen N, Liang H. Relationship between socioeconomic status and cognitive ability among Chinese older adults: the moderating role of social support. Int J Equity Health 2023; 22:70. [PMID: 37095501 PMCID: PMC10124054 DOI: 10.1186/s12939-023-01887-6] [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: 01/15/2023] [Accepted: 04/06/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Understanding the causes and pathways of cognitive decline among older populations is of great importance in China. This study aims to examine whether the discrepancy in socioeconomic status (SES) makes a difference to the cognitive ability among Chinese older adults, and to disentangle the moderating role of different types of social support in the process in which SES influences cognition. METHODS We utilized a nationally representative sample from the 2018 Chinese Longitudinal Healthy Longevity Survey. A cumulative SES score was constructed to measure the combined effect of different socioeconomic statuses on the cognitive ability of the elderly. We further examined the moderating role of two types of social support, including emotional support, and financial support. Hierarchical regression analysis was applied to test the direct effect of SES on cognitive ability, and to investigate the moderating role of social support on the association of the SES with the dependent variables. RESULTS The results showed that the higher SES of older adults was significantly associated with better cognitive ability (β = 0.52, p < 0.001) after controlling for age, sex, marital status, living region, Hukou, health insurance, lifestyle factors, and physical health status. Emotional support and financial support were moderated the relationship between SES score and cognitive ability. CONCLUSION Our results reveal the importance of considering social support in buffering the effects of SES and the associated cognitive ability for aging populations. It highlights the importance of narrowing the socioeconomic gap among the elderly. Policymakers should consider promoting social support to improve the cognitive ability among older adults.
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Affiliation(s)
- Leiyu Shi
- Johns Hopkins Primary Care Policy Center, 624 N Broadway, Baltimore, USA
| | - Lei Tao
- Department of Public and International Affairs, City University of Hong Kong, Hong Kong SAR, China
| | - Nanqian Chen
- Department of Sociology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Hailun Liang
- School of Public Administration and Policy, Renmin University of China, 59 Zhongguancun, Beijing, China.
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Gallardo-Peralta LP, Raymond É, Gálvez-Nieto JL. Ageing in Context: An Ecological Model to Understand Social Participation Among Indigenous Adults in Chile. Res Aging 2023; 45:332-346. [PMID: 35698297 DOI: 10.1177/01640275221108502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The social participation of older adults occupies a central position in international discourse regarding ageing, the ecological model makes it possible to examine and assess the different factors that influence the understanding of what encourages social participation by older adults. This study used the ecological model to analyse how personal, community and environmental factors are related to satisfaction with social participation among Chilean older adults, a majority of whom are indigenous, living in rural areas (n = 800). The results confirmed that satisfaction with social participation was related to personal factors (feelings of depression, functioning into basic activities of daily living (ADL) and autonomy), community factors (perceived social support from social group) and environmental factors (accessibility of physical setting within the village). Our findings confirmed a high level of social participation among indigenous adults, with rural and indigenous surroundings appearing to be a factor that protects and promotes social integration.
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Affiliation(s)
| | - Émilie Raymond
- School of Social Work and Criminology, 4440Université Laval, Quebec, Canada
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Yeshanew YT, Xu T, Yuan W. Perceptions on Their Own Social Participation: A Qualitative Exploration of Ethiopian Secondary Students with Visual Impairments. Healthcare (Basel) 2023; 11:healthcare11040605. [PMID: 36833141 PMCID: PMC9956288 DOI: 10.3390/healthcare11040605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/15/2023] [Accepted: 02/15/2023] [Indexed: 02/22/2023] Open
Abstract
Social participation is a vital part of life and has multifaceted positive outcomes on personal health and wellbeing. Social participation or the lack thereof might have more profound psychological impacts on individuals in a collectivist culture than its counterpart. The current study explored personal and environmental barriers that have hindered the effective social participation of secondary students with visual impairments. Exploration addressed various activities in and outside school settings in Ethiopia and discussed findings in relation to the prevailing cultural orientation. In-depth semi-structured interviews were conducted to gather qualitative data on barriers to social participation of 17 secondary students with visual impairments in Addis Ababa, Ethiopia. The qualitative data were analysed thematically, yielding four major themes and identifying twenty sub-themes that limited the social participation of students with visual impairments, such as personal, attitudinal, sociocultural, and practical barriers. The study showed a range of barriers that participants experienced related to social participation, the criticality of cultural orientation in providing context to understand the impacts of social participation, and the need for future research in the area.
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Choi K, Ko Y. Cross sectional association between cognitive frailty and disability among community-dwelling older adults: Focus on the role of social factors. Front Public Health 2023; 11:1048103. [PMID: 36844816 PMCID: PMC9947827 DOI: 10.3389/fpubh.2023.1048103] [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: 09/19/2022] [Accepted: 01/23/2023] [Indexed: 02/11/2023] Open
Abstract
Background This study aimed to investigate the prevalence of cognitive frailty and the influence of social factors on the association between different levels of cognitive frailty and disability. Methods A nationally representative survey of non-institutionalized community-dwelling older adults in Korea was used. A total, 9,894 older adults were included in the analysis. We assessed the effects of social factors using social activities, social contacts, living arrangements, emotional support, and satisfaction with friends and neighbors. Results The prevalence of cognitive frailty was 1.6%, which was consistent with other population-based studies. Hierarchical logistic analysis demonstrated that the association between different levels of cognitive frailty and disability was attenuated when social participation, social contact, and satisfaction with friends and community were included in the model, and the magnitude of these effects differed across the levels of cognitive frailty. Discussion Considering the influence of social factors, interventions to enhance social relationships can help slow down the progression of cognitive frailty to disability.
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Affiliation(s)
- Kyungwon Choi
- Department of Nursing, Korea National University of Transportation, Chungju, Chungbuk, Republic of Korea
| | - Young Ko
- College of Nursing, Gachon University, Incheon, Republic of Korea,*Correspondence: Young Ko ✉
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Wan LP, Yang GM, Dong HY, Liang XX, He Y. Perceived participation and autonomy structural relationships among related factors in patients with stroke and hypertension in China: A ISM model approach. Front Public Health 2023; 10:1070998. [PMID: 36711350 PMCID: PMC9874123 DOI: 10.3389/fpubh.2022.1070998] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 12/16/2022] [Indexed: 01/13/2023] Open
Abstract
Aims To explore the structural relationship between perceived participation and autonomy among older adults with stroke and hypertension in home and community-based services (HCBSs) in the eastern coastal region of China. Design An explorative cross-sectional study. Methods From July to September 2021, a total of 714 respondents were reported to have stroke and hypertension, and their information was used in the analysis of this study. A multiple linear regression analysis was used to explore the factors influencing factors older adults' perceived participation and autonomy. Using the ISM model, we analyzed the factors affecting social participation in patients with stroke and hypertension and explained the logical relationships and hierarchy among the factors. Results The mean score of perceived participation was 58.34 ± 27.57. Age, marital status, health insurance, living status, number of children, chronic diseases, sleep time, frequency of outings, and health utility value were significant factors affecting perceived participation and autonomy with stroke and hypertension patients. Among them, health insurance is the direct factor on the surface, age, number of children, chronic diseases, sleep time, frequency of outings, and health utility value are the intermediate indirect factors, and marital status and living status are the deep-rooted factors. Conclusion By the study that the hierarchical structure provides a visualization of interrelationships and interdependences among the influencing factors of perceived participation and autonomy. It also may be a significant complement to traditional variable-entered approaches and construct an optimized multidimensional perspective of participation and autonomy. Future research should focus on optimizing the living environment of older adults with stroke and hypertension to explore the model of rehabilitative intervention and help patients successfully reintegrate into their families/societies.
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Affiliation(s)
| | | | | | | | - Yan He
- College of Public Health, Zhengzhou University, Zhengzhou, China
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Yang L, Guo D, Zheng J, Guo Y, Li Z. Association between Social Participation and Remaining Teeth and Urban-Rural Difference among Older Adults in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1283. [PMID: 36674039 PMCID: PMC9859502 DOI: 10.3390/ijerph20021283] [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: 10/18/2022] [Revised: 12/11/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
Oral health is an important part of older adults' general health. The study examined the association between social participation (formal and informal) and remaining teeth and the urban-rural difference based on a national survey of older adults in China. The data of older adults were extracted from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) and analyzed. A total of 11,948 respondents were ultimately involved, including 6836 urban respondents and 5112 rural respondents. Informal social participation and formal social participation were used to assess social participation. The number of remaining natural teeth was measured. Social participation was significantly associated with remaining teeth among older adults, after adjusting for confounders, a one-level increase in the informal social participation was associated with a decrease in natural teeth by 0.152 (95% CI = -0.274; -0.030) and a one-level increase in the formal social participation was associated with a decrease in natural teeth by 0.370 (95% CI = -0.585; -0.156). In addition, the association between social participation (formal and informal) and remaining teeth was observed among urban older adults, but not rural older adults. A high level of social participation may effectively decrease the risk of oral-health problems for the Chinese older adults. The findings suggest recommendations for an older adults-targeted policy and the practice of oral-health promotion. However, the urban-rural difference should be taken into full consideration in social-participation-driven oral-health promotion interventions.
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Affiliation(s)
- Le Yang
- School of Management, Shanxi Medical University, 56 Xinjian South Road, Taiyuan 030001, China
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Pan C, Cao N, Kelifa MO, Luo S. Age and cohort trends in disability among Chinese older adults. Front Public Health 2023; 11:998948. [PMID: 36969644 PMCID: PMC10031081 DOI: 10.3389/fpubh.2023.998948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 02/03/2023] [Indexed: 03/29/2023] Open
Abstract
Objective This study aimed to examine age and cohort trends in disability among Chinese older adults and explore the disablement process factors that may explain the cohort trends in disability. Methods This study used data from five waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). A hierarchical logistic growth model was used to analyze the A-P-C effects and the contributors of cohort trends. Results ADL, IADL, and FL among Chinese older adults showed increasing age and cohort trends. FL was more likely to result in IADL disability than ADL disability. Among the disablement process factors, gender, residence, education, health behavior, disease, and family income contributed to most of the cohort trends in disability. Conclusions As older adults face increasing disability trends, it is necessary to distinguish age and cohort trends and develop more effective interventions according to relative contributors to prevent disability among them.
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Affiliation(s)
- Chaoping Pan
- School of Public Health, Wuhan University, Wuhan, Hubei, China
| | - Na Cao
- School of Public Health, Wuhan University, Wuhan, Hubei, China
- Na Cao
| | | | - Shuren Luo
- The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- *Correspondence: Shuren Luo
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Lei Y, Lao J, Liu J. Participation in community seniors' organizations and mental health among retired adults in urban China: The mediating role of interpersonal needs. Front Public Health 2022; 10:1045948. [PMID: 36620246 PMCID: PMC9812490 DOI: 10.3389/fpubh.2022.1045948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 11/14/2022] [Indexed: 12/24/2022] Open
Abstract
Purpose This study aimed to investigate the association between participation in community seniors' organizations (CSOs) and mental health among retired adults in urban China, and illustrate the causal mechanism. Methods We collected data on participation from a community seniors' organization and mental health survey in Shenzhen City, China, in July 2022. The survey used a two-stage cluster sample design, based on administrative divisions as the primary sampling unit and communities as the second sampling unit, where retired adults were randomly sampled. The inclusion criteria were individuals >60 years old (the mandatory age for retirement in China) or women who retired early at the age of 45 years. We used three multivariable regression models to estimate the effects of participation in CSOs on mental health. Furthermore, we used structural equation models to examine the mediator of acquired interpersonal needs in the association between CSOs participation and mental health. Results The study examined the values of CSOs, generated explicitly for older adults and explained how participation in such organizations benefits retired adults' mental health. Mental health is defined in three dimensions: aggregate mental health, positive emotions, and negative emotions. The results show that constituting social networks with like-minded individuals and perceiving interpersonal needs are the two main benefits of CSOs on mental health. The retired individual who participated in CSOs with a higher level of diversity and frequency, joined specific types such as health- and study-related CSOs, could receive more interpersonal needs and were probably mentally healthier. The mediating mechanism of interpersonal needs associated with participation in mental health was significant. Besides, mental health is generally affected by physical health, sleep quality, and socioeconomic status. Conclusion This study suggested that CSOs have expanded the social interaction channels of retired adults and affected their mental health by providing basic interpersonal needs such as inclusion, dominance, and affection. Among the types of CSOs, health and study organizations might enhance mental health most effectively, while semi-official organizations have no effect.
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Liao Z, Zhou H, He Z. The mediating role of psychological resilience between social participation and life satisfaction among older adults in China. BMC Geriatr 2022; 22:948. [PMID: 36482364 PMCID: PMC9733394 DOI: 10.1186/s12877-022-03635-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 11/18/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND A significant correlation has been discovered between social participation and older adults' life satisfaction, but the relationships among social participation, psychological resilience, and life satisfaction remain to be confirmed. Therefore, this study aims to identify the relationship between social participation and life satisfaction for Chinese older adults and to analyse the possible mediating role of psychological resilience between these two aspects. METHODS Data on 15,779 people aged 65 years and above were extracted from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Social participation was classified into two levels: low-level involvement activities and high-level involvement activities. Hierarchical regression analysis was applied to analyse the correlations between the two levels of social participation and older adults' life satisfaction as well as the mediating effects of psychological resilience on this association. RESULTS The results indicate that two levels of social participation were each positively correlated with life satisfaction. Specifically, high-level involvement activities (β = 0.070, P < 0.001) were more strongly associated with life satisfaction than low-level involvement activities (β = 0.051, P < 0.001). Moreover, psychological resilience was found to partially mediate the association between low-level involvement activities and high-level involvement activities and life satisfaction. CONCLUSION A higher level of life satisfaction for older adults is related to participation in high-level involvement activities. Psychological resilience has a mediating effect on the association between two levels of older adults' social participation and life satisfaction. These findings suggest that the government and society should establish a more concrete understanding of the psychological resilience of older adults.
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Affiliation(s)
- Zhiliu Liao
- School of Public Affairs, Fujian Province, Xiamen University, Xiamen City, People's Republic of China
| | - Hanmeng Zhou
- School of Public Affairs, Fujian Province, Xiamen University, Xiamen City, People's Republic of China
| | - Zhifei He
- School of Politics and Public Administration, Southwest University of Political Science and Law, Chongqing, People's Republic of China.
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Xu J, Xu J, Chen Y, Wang Y, Qin G, Gao J. Associations between trajectories of social participation and functional ability among older adults: Results from the China Health and Retirement Longitudinal Study. Front Public Health 2022; 10:1047105. [PMID: 36530681 PMCID: PMC9751478 DOI: 10.3389/fpubh.2022.1047105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 11/15/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction Functional ability (FA) and social participation (SP) are important indicators of healthy aging, both their trajectories are heterogeneous. It is little known about how the SP trajectories affects FA trajectories. Methods FA was assessed by 20 items covering the ability of meeting basic needs and mobility. SP was assessed by frequency of participating in 10 social activities. Group-based trajectory modeling (GBTM) was used to identify the trajectories of FA and SP of the participants. Results Two FA trajectories were identified: low baseline-decline tendency (16.1%) and high baseline-stable tendency (83.9%) trajectories. Two SP trajectories were also identified: low baseline-stable tendency (58.5%) and high baseline-increase tendency (41.5%) trajectories. After controlling for the potential covariates, participants among the high baseline-increase tendency SP trajectory group also had significantly higher odds ratios to be belonged in high baseline-stable tendency FA trajectory group (ORs = 2.64, 95%CI = 1.98-3.05). Conclusions High-increasing social participation had a protective effect to maintain high baseline-stable tendency functional ability among older adults. These findings suggest social participation appears to have great benefits on promoting healthy aging in China.
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Affiliation(s)
- Jiaqin Xu
- School of Public Health, Fudan University, Shanghai, China
| | - Jixiang Xu
- School of Public Health, Fudan University, Shanghai, China
| | - Yingwei Chen
- School of Public Health, Fudan University, Shanghai, China
| | - Yujie Wang
- School of Public Health, Fudan University, Shanghai, China
| | - Guoyou Qin
- School of Public Health, Fudan University, Shanghai, China
| | - Junling Gao
- School of Public Health, Fudan University, Shanghai, China
- Collaborative Innovation Cooperative Unit of National Clinical Research Center for Geriatric Diseases, Shanghai, China
- Core Unit of Shanghai Clinical Research Center for Geriatric Diseases, Shanghai, China
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Zhou Y, He T, Lin F. The Digital Divide Is Aging: An Intergenerational Investigation of Social Media Engagement in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12965. [PMID: 36232259 PMCID: PMC9566613 DOI: 10.3390/ijerph191912965] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/30/2022] [Accepted: 10/08/2022] [Indexed: 06/16/2023]
Abstract
The aging-based digital divide has gained increased research attention in recent years. This research focused on two important aspects of the aging society, the digital divide and the intergenerational differences, with regard to social media usage in China. The data were collected through a household interview, using a nationally representative sample (n= 3790) from 58 cities in mainland China. The present study investigated the association between differentiated social media usage with demographic characteristics, social economic status, physical and mental health, and social media perceptions. The results show a significant digital divide and generational differences. The existing socio-economic inequalities and demographic variance largely explained older adults' social media access and diversity of social media engagement. Social media perceptions play more essential roles in the intensity of social media engagement for each generation group. This study contributes a better understanding of the manner in which different factors are associated with different generations' social media engagement. A discussion is included regarding the necessity to close the aging-based digital gap in order to cope with the issue of rapid aging.
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Affiliation(s)
- Yuqiong Zhou
- School of Media and Communication, Shenzhen University, Shenzhen 518060, China
| | - Tao He
- Depart of Educational Technology, College of Education, Shenzhen University, Shenzhen 518060, China
| | - Feng Lin
- School of Media and Communication, Shenzhen University, Shenzhen 518060, China
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Ren Z, Zhang X, Li Y, Li X, Shi H, Zhao H, He M, Zha S, Qiao S, Pu Y, Liu H. Relationships of leisure activities with physical and cognitive functions among Chinese older adults: A prospective community-based cohort study. Aging Ment Health 2022; 27:736-744. [PMID: 35696367 DOI: 10.1080/13607863.2022.2084502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVES Based on a prospective design, this study aimed to investigate the relationships of leisure activities with physical and cognitive functions among Chinese older adults. METHODS The respondents aged 65 years or more were selected from the 2014-2018 of the Chinese Longitudinal Healthy Longevity Survey. Physical function measurement indicators were reflected by activities of daily living (ADL), instrumental activities of daily living (IADL), and physical performance (PP), while cognitive function was assessed by Mini-Mental State Examination. Fine-Gray competing risk regression models were used to analyze the data. RESULTS Using the figures for 2014 as a baseline for the study, we included 6047, 6216, 5951, and 5916 respondents in the ADL, IADL, PP, and cognitive function analyses, respectively. The prospective results showed that keeping domestic animals or pets was related to a lower risk of ADL disability of respondents after adjustment (SHR: 0.619, 95% CI: 0.486, 0.788). Similarly, taking part in social activities (SHR: 0.781, 95%CI: 0.658, 0.929) and reading books or newspapers (SHR: 0.793, 95% CI: 0.656, 0.958) were associated with a lower risk of IADL disability. Playing cards or mahjong was correlated with a lower risk of cognitive impairment (SHR: 0.669, 95% CI: 0.507, 0.882), while keeping domestic animals or pets was related to a higher risk of cognitive impairment (SHR: 1.279, 95% CI: 1.047, 1.562). CONCLUSION Participation in leisure activities moderately may decrease the risk of a decline in physical and cognitive functions among Chinese older adults.
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Affiliation(s)
- Zheng Ren
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Xiumin Zhang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Yuyu Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Xiangrong Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Hong Shi
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Hanfang Zhao
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Minfu He
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Shuang Zha
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Shuyin Qiao
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Yajiao Pu
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Hongjian Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
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Yamamoto T, Hikichi H, Kondo K, Osaka K, Aida J. Community intervention programs prolong the onset of functional disability among older Japanese. Geriatr Gerontol Int 2022; 22:465-470. [PMID: 35451194 PMCID: PMC9167703 DOI: 10.1111/ggi.14385] [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: 10/07/2021] [Revised: 02/28/2022] [Accepted: 03/15/2022] [Indexed: 11/27/2022]
Abstract
Aim This study examined the effects of a “community‐based center” intervention to prevent the onset of functional disability among residents in disaster‐affected areas. Methods We used data from a prospective cohort study conducted from 2010 to 2016 in Iwanuma City, Japan. Participants were community‐dwelling independent adults aged ≥65 years. The exposure variable was the experience of using a community‐based center. The outcome variable was functional disability onset. The average treatment effect on the treated (ATET) was estimated by adjusting for possible confounders. Additional analysis stratified by sex was conducted considering the sex differences in social participation rates. Results Among 3794 participants (mean ± SD age = 72.9 ±5.3 years, 46.0% men), 196 (5.2%) used the community‐based center, and 849 (22.4%) exhibited disability onset. Of those with functional disabilities, 40 (20.4%) used the community‐based center, while 809 (22.5%) did not. The ATET for functional disability onset with community‐based center activities across all participants were not significant (ATET: 0.51 years [95% confidence interval [CI] = −0.23; 1.27]). However, the direction of the effect of community‐based center activities differed by sex (ATET: −0.14, 95% CI = −2.59; 2.31 for men [n = 18], and 0.66, 95% CI = 0.18; 1.16 for women [n = 178]). Women exhibited a 15.63% (95% CI = 3.58; 27.68) increase in the time until functional disability onset. Conclusions The use of community‐based centers was associated with a longer period without functional disability in women. Geriatr Gerontol Int 2022; 22: 465–470.
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Affiliation(s)
- Takafumi Yamamoto
- Department of Health Promotion, National Institute of Public Health, Saitama, Japan
| | - Hiroyuki Hikichi
- Division of Public Health, Kitasato University School of Medicine, Sagamihara, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan.,Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Arieli M, Kizony R, Gil E, Agmon M. Many Paths to Recovery: Comparing Basic Function and Participation in High-Functioning Older Adults After Acute Hospitalization. J Appl Gerontol 2022; 41:1896-1904. [PMID: 35543173 DOI: 10.1177/07334648221089481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Function after acute hospitalization is mostly operationalized by Basic Activities of Daily Living (BADL), a limited concept that overshadows a wide range of instrumental, social, and recreational activities, otherwise referred to as participation. Participation is important for patients' health and quality of life after hospitalization. This study focuses on high-functioning older adults, examining functional recovery after hospitalization by comparing BADL assessment with assessment of participation at one and three months following discharge relative to pre-hospitalization. Quantitative data were collected from 72 participants divided into two age groups of hospitalized older adults (age 65-74, n = 38; age ≥75, n = 34), followed by home visits after 1 month and telephone interviews 3 months after discharge. Both groups experienced a significantly greater decline in participation, compared with BADL, which were mostly preserved. A comprehensive assessment of participation better captures functional changes in high-functioning older adults. Early identification of participation withdrawal is crucial for preventing disability.
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Affiliation(s)
- Maya Arieli
- Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Israel
| | - Rachel Kizony
- Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Israel.,Department of Occupational Therapy, Sheba Medical Center, Tel Hashomer, Israel
| | - Efrat Gil
- Geriatric Unit, Clalit Health Services, Haifa and West Galilee.,Faculty of Medicine, Technion, Haifa, Israel
| | - Maayan Agmon
- The Cheryl Spencer Department of Nursing, Faculty of Social Welfare and Health Science, University of Haifa, Israel
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Du M, Dai W, Liu J, Tao J. Less Social Participation Is Associated With a Higher Risk of Depressive Symptoms Among Chinese Older Adults: A Community-Based Longitudinal Prospective Cohort Study. Front Public Health 2022; 10:781771. [PMID: 35223728 PMCID: PMC8863664 DOI: 10.3389/fpubh.2022.781771] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 01/10/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE We aimed to examine the association between social participation and depressive symptoms among Chinese older people aged 65 years or above to supplement limited studies in China on this topic. METHODS This community-based longitudinal prospective cohort study used the data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS, baseline in 2014 and a follow-up in 2018). Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale. Social participation was assessed using a composite index by considering the frequency for the two types of social activity: organized social activities and informal activities. Pearson's χ2 test was used to correlate the characteristics of participants with social participation or depressive symptoms. Log-binomial regression models were used to assess the association between social participation and the risk of depressive symptoms. RESULTS The incidence of depressive symptoms was 28.8% among 2,200 participants in 2018 after a 4-year follow-up. Participants with no social participation (32.6%), organized social activities (30.6%), or informal social activities (31.2%) were more likely to have depressive symptoms. After the adjustment of demographic factors, socioeconomic status, lifestyle habits, and health status, in comparison with older people who often engaged in social participation, organized social activities, and informal social activities, the risk of depressive symptoms was 45% [adjusted risk ratio (aRR): 1.45, 95% CI: 1.16-1.82], 42% (aRR: 1.45, 95% CI: 1.02-2.00), and 29% (aRR: 1.29, 95% CI: 1.02-1.99) higher among older people with no social participation and who never engaged in organized social activities and informal social activities, respectively. CONCLUSIONS This study showed that the lack of social participation, including organized social activities and informal social activities, was associated with a higher risk of depressive symptoms after 4 years among older adults in China. Our findings shed lights into the feasibility of promoting social participation to reduce the risk of depressive symptoms and promote longevity and healthy aging among older adults.
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Affiliation(s)
- Min Du
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Wanwei Dai
- Peking University Third Hospital, Beijing, China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Institute for Global Health and Development, Peking University, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Jing Tao
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
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Tomioka K, Shima M, Saeki K. Age differences in the association of physical leisure activities with incident disability among community-dwelling older adults. Environ Health Prev Med 2022; 27:16. [PMID: 35354710 PMCID: PMC9251618 DOI: 10.1265/ehpm.21-00018] [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] [Indexed: 11/21/2022] Open
Abstract
Background The relationship between leisure activities (LA) in old age and prevention of disability has not been fully investigated, and age and gender differences of these relationships are unknown. This study aimed to investigate whether physical and cognitive LA predicted incident disability among community-dwelling older adults by age and gender. Methods We prospectively observed 8,275 residents aged 65 or above without disability at baseline for 3 years. Incident disability was defined as a new certification of the public long-term care insurance system. LA were classified into two types: physical LA and cognitive LA. The frequency of LA was categorized into frequent (i.e., once a week or more), moderate (i.e., monthly or yearly), and non-engagement. Covariates included age, gender, family number, education, perceived economic situation, body mass index, chronic medical conditions, alcohol consumption, smoking status, regular dental visits, depression, cognitive functioning, and social participation. Multivariable Poisson regression models were used to estimate adjusted cumulative incidence ratio (CIR) and 95% confidence interval (CI) for incident disability. We performed stratified analyses by age groups (i.e., the young-old aged 65–74 and the old-old aged 75–97) and gender (i.e., men and women). Results The 3-year cumulative incidence of disability was 7.5%. After adjustment for covariates and mutual adjustment for both types of LA, a significant dose-response relationship between more frequent LA and lower risk of incident disability was found in young-old physical LA (P-trend < 0.001), in old-old cognitive LA (P-trend = 0.012), in male cognitive LA (P-trend = 0.006), and in female physical LA (P-trend = 0.030). Compared with people without LA, adjusted CIR (95% CI) of frequent LA was 0.47 (0.30–0.74) in young-old physical, 0.75 (0.58–0.96) in old-old cognitive, 0.65 (0.46–0.89) in male cognitive, and 0.70 (0.52–0.95) in female physical. Regarding the effect modification according to age and gender, only interaction between age and physical LA significantly prevented incident disability (P for interaction = 0.019). Conclusion We found age differences in the association of physical LA with incident disability among community-dwelling older adults. An effective measure to prevent long-term care in the community would be to recommend frequent physical LA for the young-old. Supplementary information The online version contains supplementary material available at https://doi.org/10.1265/ehpm.21-00018.
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Affiliation(s)
- Kimiko Tomioka
- Nara Prefectural Health Research Center, Nara Medical University
| | - Midori Shima
- Nara Prefectural Health Research Center, Nara Medical University
| | - Keigo Saeki
- Nara Prefectural Health Research Center, Nara Medical University
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Steppe J, Ramos MD, Falvai R. The Role of Social Engagement in Older Adults' Health. Res Gerontol Nurs 2022; 15:152-160. [PMID: 35357981 DOI: 10.3928/19404921-20220324-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The purpose of the current study was to explore the association between social engagement and the health status, cognition, and perceived well-being of older adults using data from the National Health and Aging Trends Study. Descriptive statistics, clustering, and regression modeling were performed to analyze the data. We used the regression model to identify statistically significant relationships between the representative variables and the extent to which participants participated in social activities. The most representative variable for each of the three clusters was selected and fitted to the regression model, which consists of (1) acute health problems and events, (2) cognitive and communication barriers, and (3) chronic conditions contributing to long-term health status. A regression model found that two factors-cognitive and communication barriers and chronic conditions contributing to long-term health status-were statistically significant in determining social engagement in older adults. Health care providers should consider various factors in planning and implementing social programs that can positively engage older adults. [Research in Gerontological Nursing, xx(x), xx-xx.].
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40
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Zhang Y, Su D, Chen Y, Tan M, Chen X. Effect of socioeconomic status on the physical and mental health of the elderly: the mediating effect of social participation. BMC Public Health 2022; 22:605. [PMID: 35351078 PMCID: PMC8962021 DOI: 10.1186/s12889-022-13062-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 03/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous studies have demonstrated the effect of socioeconomic status on the health status of the elderly. Nevertheless, the specific dimensions of the effect and the mechanism await further investigation. In this study, socioeconomic status was divided into three dimensions and we used social participation as the mediation variable to investigate the specific path of effect. METHODS Using the 2018 Waves of Chinese Longitudinal Healthy Longevity Survey (CLHLS) dataset, a total of 10,197 effective samples of the elderly over 65 years old were screened out. Socioeconomic status included income, education level, and main occupation before retirement. The physical health and mental health of the elderly was measured by the Instrumental Activities of Daily Living Scale and the Minimum Mental State Examination, respectively. The social participation of the elderly was the mediation variable, including group exercise, organized social activities and interacting with friends. Omnibus mediation effect analysis was adopted to examine the mediation effect and mediation analysis was completed using the SPSS PROCESS program. RESULTS First, the results showed that when the income gap between the elderly reached a certain level, there was a significant difference in health status. Significant differences existed in health status amongst with different education levels. There was no sufficient evidence to show that occupation has a significant effect on the physical health. But when the dependent variable was mental health, the effect was significant. Second, group exercise mediated 64.11% (aib = 0.24, 95% CI [0.17,0.3]) and up to 20.44% (aib = 0.12, 95% CI [0.07,0.17]) of the disparity in physical and mental health due to income gap, respectively. And it could mediate the effect up to 56.30% (aib = 0.62, 95% CI [0.52,0.73]) and 17.87% (aib = 0.50, 95% CI [0.4,0.61]) of education on physical and mental health status, respectively. The proportion of relative mediation effect of occupation was up to 28.74% (aib = 0.19, 95% CI [0.13,0.25]) on mental health. Interacting with friends mediated only on the path that the education affected the health status of the elderly. The proportion was up to 33.72% (aib = 0.29, 95% CI [0.16,0.44]). The relative mediation effect of organized social activities on the health gap caused by income or education level gap was significant at some levels. The proportion was up to 21.20% (aib = 0.33, 95% CI [0.26,0.4]). CONCLUSION The SES of the elderly including relatively large income gap, different education levels and occupational categories could indeed have a significant effect on health status of the elderly, and the reason why this effect existed could be partly explained by the mediation effect of social participation. Policymakers should pay more attention to the social participation of the elderly.
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Affiliation(s)
- Yunfan Zhang
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Dai Su
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yingchun Chen
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China. .,Research Centre for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan, China.
| | - Min Tan
- First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xinlin Chen
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
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Liu H, Wang M. Socioeconomic status and ADL disability of the older adults: Cumulative health effects, social outcomes and impact mechanisms. PLoS One 2022; 17:e0262808. [PMID: 35143499 PMCID: PMC8830695 DOI: 10.1371/journal.pone.0262808] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 01/06/2022] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION Socioeconomic status (SES) is one of the important indicators affecting individual's social participation and resource allocation, and it also plays an important role in the health shock of individuals. Faced by the trend of aging society, more and more nations across the world began to pay attention to prevent the risk of health shock of old adults. METHODS Based on the data of China Health and Retirement Longitudinal Study (CHARLS) in 2013, 2015 and 2018, this study uses path analysis and ologit model to empirically estimate the effects of SES and health shock on the activities of daily living (ADL) disability of old adults. RESULTS As a result, first, it was found that SES has significant impact on the disability of old adults. Specifically, economic conditions (income) plays dominant role. Economic status affects the risk of individual disability mainly through life security and health behavior. Secondly, SES significantly affecting health shock, with education and economic status showing remarkable impact, and there is an apparent group inequality. Furthermore, taking high education group as reference, the probability of good sight or hearing ability of the low education group was only 49.76% and 63.29% of the high education group, respectively, while the rates of no pain and severe illness were 155.50% and 54.69% of the high education group. At last, the estimation of path effect of SES on ADL disability indicates evident group inequality, with health shock plays critical mediating role. CONCLUSIONS SES is an important factor influencing residents' health shock, and health shocks like cerebral thrombosis and cerebral hemorrhage will indirectly lead to the risk of individual ADL disability. Furthermore, among the multi-dimensional indicators of SES, individual income and education are predominant factors affecting health shock and ADL disability, while occupation of pre-retirement have little impact.
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Affiliation(s)
- Huan Liu
- School of Public Administration, Zhejiang University of Finance & Economics, Hang Zhou, Zhejiang Province, China
| | - Meng Wang
- School of Public Administration, Zhejiang University of Finance & Economics, Hang Zhou, Zhejiang Province, China
- * E-mail:
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42
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Chaoping P, Cen W, Kelifa MO, Xuyang L, Wang P. Gender disparity in disability among Chinese oldest-old: Age and cohort trends. J Women Aging 2022; 35:243-258. [PMID: 35201970 DOI: 10.1080/08952841.2022.2031711] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study aimed at exploring gender disparity in disability and identifying related disablement process factors among Chinese oldest-old. Data came from eight waves of the Chinese Longitudinal Healthy Longevity Study (CLHLS). A hierarchical logistic Age-Period-Cohort (A-P-C) model was used to estimate the trend of gender disparity, and related disablement process factors were further decomposed by the Oaxaca-Blinder decomposition. Our results found that women had higher disabilities than men. The age-based trend of gender disparity in Instrumental Activities of Daily Living (IADL) continued to decline; that in Functional Limitation (FL) increased at first and then declined. The cohort-based trend of gender disparity in IADL showed a decreasing trend with each subsequent cohort; that in FL showed an increasing trend. Among the disablement process factors, health behaviors and social supports were the most important contributors to gender disparity in disability. The disability was higher for women than men, and the gender differences were attenuated at very old ages. To reduce gender disparities in disability, more attention should be paid to relevant factors of gender disparity in disability.
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Affiliation(s)
- Pan Chaoping
- School of Public Health, Wuhan University, Wuhan, China
| | - Wang Cen
- School of Public Health, Wuhan University, Wuhan, China
| | | | - Li Xuyang
- School of Public Health, Wuhan University, Wuhan, China
| | - Peigang Wang
- School of Public Health, Wuhan University, Wuhan, China
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D’Oliveira A, De Souza LC, Langiano E, Falese L, Diotaiuti P, Vilarino GT, Andrade A. Home Physical Exercise Protocol for Older Adults, Applied Remotely During the COVID-19 Pandemic: Protocol for Randomized and Controlled Trial. Front Psychol 2022; 13:828495. [PMID: 35185739 PMCID: PMC8855123 DOI: 10.3389/fpsyg.2022.828495] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 01/12/2022] [Indexed: 12/15/2022] Open
Abstract
The emergence of the new coronavirus (COVID-19) at the beginning of 2020, considered a public health emergency due to its high transmission rate and lack of specific treatment, led many countries to adhere to social isolation. Although necessary, social isolation causes important psychological changes, negatively affecting the health of the population, including the older population. The aim of this study is to propose a 4-week, home-based physical exercise protocol for older people in social isolation and evaluate whether will promote positive changes in psychological variables such as anxiety, mood, depression, and stress, and in the variables sleep, quality of life, and physical capacities in the older adults. The sample will be selected in a probabilistic way from individuals aged 60 years or more from the city of Itajaí (Santa Catarina, Brazil). Of these, half will perform a home-based resistance training protocol, with 3 weekly sessions, for 4 consecutive weeks. For group allocation, patients will be randomized with a computer-generated 1:1 allocation to the physical exercise (PE) group or control group. Outcomes will be depressive symptoms, sleep quality, quality of life, stress, mood states, anxiety, and functional capacity, evaluated at baseline, after 4 weeks, and after 15 days of follow-up. This study will offer a home-based exercise protocol for older adults, with load progression and remote monitoring, thus filling a gap in the provision of PE in this population. The results will be able to identify possible improvements not only in physical health, but also in quality of life and mental health. Clinical Trial Registration: The trial registration was carried out in the Brazil Clinical Trials Registry (RBR-5qh6f3v). (https://ensaiosclinicos.gov.br/rg/RBR-5qh6f3v).
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Affiliation(s)
- Anderson D’Oliveira
- Health and Sports Science Center – CEFID/Santa Catarina State University, UDESC, Florianópolis, Brazil
- Laboratory of Sports and Exercise Psychology – LAPE, Florianópolis, Brazil
| | - Loiane Cristina De Souza
- Health and Sports Science Center – CEFID/Santa Catarina State University, UDESC, Florianópolis, Brazil
- Laboratory of Sports and Exercise Psychology – LAPE, Florianópolis, Brazil
| | - Elisa Langiano
- Department of Human Sciences, Society and Health/University of Cassino and Southern Lazio, Cassino, Italy
| | - Lavinia Falese
- Department of Human Sciences, Society and Health/University of Cassino and Southern Lazio, Cassino, Italy
| | - Pierluigi Diotaiuti
- Department of Human Sciences, Society and Health/University of Cassino and Southern Lazio, Cassino, Italy
| | - Guilherme Torres Vilarino
- Health and Sports Science Center – CEFID/Santa Catarina State University, UDESC, Florianópolis, Brazil
- Laboratory of Sports and Exercise Psychology – LAPE, Florianópolis, Brazil
| | - Alexandro Andrade
- Health and Sports Science Center – CEFID/Santa Catarina State University, UDESC, Florianópolis, Brazil
- Laboratory of Sports and Exercise Psychology – LAPE, Florianópolis, Brazil
- *Correspondence: Alexandro Andrade,
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Raina P, Ali MU, Joshi D, Gilsing A, Mayhew A, Thompson M, Griffith LE. Associations of functional disability and behavioural risk factors with social participation of older adults: a cross-sectional analysis from the Canadian Longitudinal Study on Aging. BMJ Open 2022; 12:e052173. [PMID: 35045997 PMCID: PMC8772424 DOI: 10.1136/bmjopen-2021-052173] [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: 12/03/2022] Open
Abstract
OBJECTIVES To examine: (1) the associations of functional disability and behavioural risk factors with social participation; and (2) whether the association between functional disability and social participation is modified by co-occurrence of behavioural risk factors. DESIGN A cross-sectional analysis of data from the Canadian Longitudinal Study on Aging. SETTING A national stratified sample of 51 388 individuals living in the 10 Canadian provinces at the time of baseline data collection (2011-2015). PARTICIPANTS Participants included men and women aged 45-85 years and residing in the communities in the 10 Canadian provinces. OUTCOME MEASURES Social participation was assessed using frequency of participant involvement in eight different social activities in the past 12 months. Responses for each category were converted into number of days per month. Total social participation score (range: 0-180) was based on summing frequencies over all eight activities representing number of social activities per month. RESULTS Functional disability was associated with participating in fewer social activities (difference in mean total social participation score, b=-1.1, 95% CI -1.5 to -0.7). In comparison to no behavioural risk factors, presence of any one (b=-2.7, 95% CI -3.1 to -2.3), any two (b=-4.6, 95% CI -5.0 to -4.2), any three (b=-6.3, 95% CI -6.8 to -5.9) and all four (b=-7.8, 95% CI -9.0 to -6.6) behavioural risk factors was associated with lower social participation. The association between functional disability and social participation was modified by the presence of behavioural risk factors with the lowest social participation observed for adults with disability and all four behavioural risk factors (b=-4.3, 95% CI -7.5 to -1.2). CONCLUSIONS Individuals with functional disabilities and behavioural risk factors are more likely to experience restrictions in social participation. Public health interventions that encourage healthy lifestyle behaviours may help mitigate the impact of functional disabilities on social participation in the ageing population.
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Affiliation(s)
- Parminder Raina
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Muhammad Usman Ali
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Divya Joshi
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Anne Gilsing
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Alexandra Mayhew
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Mary Thompson
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Lauren E Griffith
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
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Sandoval MH, Portaccio MA, Albala C. Social participation and 5-year all-cause mortality in older Chilean people. CAD SAUDE PUBLICA 2022; 38:e00124921. [DOI: 10.1590/0102-311x00124921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 12/10/2021] [Indexed: 11/22/2022] Open
Abstract
We aimed to examine the degree to which social participation is associated with mortality risk in older adults in Chile. We used the Chilean National Survey on Elderly Dependency, which is linked to vital statistics, in order to obtain death records. Four proportional risk regression models were estimated. Even with controlled sociodemographic, economic, family, and health variables, older adults who participate in social activities had a 22% lower risk of death than those who do not participate. We concluded that social participation is a strong and significant protective factor for mortality in Chilean older adults. Social participation should thus be promoted from a life course perspective considering its effect on mortality in older adults who maintained an active social life.
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Yang L, Cheng J, Wang H. Place of Residence and Cognitive Function in Older Adults in China: The Mediating Role of Social Participation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010013. [PMID: 35010273 PMCID: PMC8750759 DOI: 10.3390/ijerph19010013] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 12/15/2021] [Accepted: 12/17/2021] [Indexed: 05/17/2023]
Abstract
Background: Cognitive impairment is a severe health problem faced by older adults and their families, as well as the countries in which they live. Differences in place of residence may contribute to differences in the cognitive function of older adults, and the mediating effect of social participation has rarely been studied in China. Methods: A total of 10,014 older adult participants were included, using data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Place of residence was described as either a city, town, or rural area. The frequency of participation in organized social activities and visits and interactions with friends was used to assess both formal and informal social participation. The Chinese version of a Mini-Mental State Examination (MMSE) was used as a measure of cognitive function. The mediation analysis was conducted using Hayes' process version 3.4 on SPSS (IBM, Armonk, NY, USA). Results: Place of residence had a negative effect on cognitive function in older adults. The mediating functions of both informal (a1b1 = 0.199) and formal (a2b2 = -0.056) social participation indicate a suppression effect on the part of informal social participation and a partial mediation effect on the part of formal social participation in terms of the association between place of residence and cognitive function in older adults. Promoting both informal and formal social participation seems to be an important strategy for preventing a decline in the cognitive function of older adults, especially for those living in rural areas.
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Affiliation(s)
- Le Yang
- School of Management, Shanxi Medical University, 56 Xinjian South Road, Taiyuan 030001, China;
- Correspondence: ; Tel.: +86-15513037212
| | - Jingmin Cheng
- School of Management, Shanxi Medical University, 56 Xinjian South Road, Taiyuan 030001, China;
| | - Hongman Wang
- School of Health Humanities, Peking University, 38 Xueyuan Road, Beijing 100191, China;
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Abe T, Seino S, Tomine Y, Nishi M, Hata T, Shinkai S, Fujiwara Y, Kitamura A. Identifying the specific associations between participation in social activities and healthy lifestyle behaviours in older adults. Maturitas 2021; 155:24-31. [PMID: 34876246 DOI: 10.1016/j.maturitas.2021.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 09/21/2021] [Accepted: 10/07/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To examine the longitudinal association between participation in social activities and healthy lifestyle behaviours. STUDY DESIGN This 2-year follow-up study used data from 6168 older adults (73.5 ± 5.3 years; 49% men). We studied participation in five types of social activities at baseline: participation in volunteer, sports, hobbies, senior clubs, and neighbourhood-association groups. MAIN OUTCOME MEASURES The healthy lifestyle behaviours were physical activity (time spent walking: ≥150 min/week; or less), eating habits (dietary variety score: ≥4 points; or less), and intellectual activity (subcomponents of the Tokyo Metropolitan Institute of Gerontology Index of Competence: 4 points; or less). RESULTS In the follow-up survey, 19% of participants were physically inactive, 53% had unfavourable eating habits, and 34% had diminished intellectual activity. Multilevel modified Poisson regression analysis showed that participation in sports groups was associated with a lower relative risk (RR) of physical inactivity (RR=0.82 [0.72, 0.93]) and unfavourable eating habits (RR=0.95 [0.90, 1.00]). Participation in hobby groups reduced the RR of unfavourable eating habits (RR=0.93 [0.90, 0.97]) and diminished intellectual activity (RR=0.90 [0.85, 0.96]). Participation in volunteering was associated with a lower RR of diminished intellectual activity (RR=0.84 [0.75, 0.95]). Relative to non-participation, participating in two or more social activities was associated with a 9% (95% CI: 0.83, 1.00) lower RR for physical inactivity, a 12% (95% CI: 0.82, 0.95) lower RR for unfavourable eating habits, and a 17% (95% CI: 0.77, 0.89) lower RR for diminished intellectual activity. CONCLUSIONS Both the nature and the number of social activities determine the longitudinal effects of social participation on healthy lifestyle behaviours.
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Affiliation(s)
- Takumi Abe
- Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae, Itabashi, Tokyo 173-0015, Japan; Centre for Urban Transitions, Swinburne University of Technology, Melbourne, VIC 3122, Australia.
| | - Satoshi Seino
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae, Itabashi, Tokyo 173-0015, Japan
| | - Yui Tomine
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae, Itabashi, Tokyo 173-0015, Japan
| | - Mariko Nishi
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae, Itabashi, Tokyo 173-0015, Japan
| | - Toshiki Hata
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae, Itabashi, Tokyo 173-0015, Japan; Department of Food and Nutritional Science, Graduate School of Applied Bioscience, Tokyo University of Agriculture, Setagaya, Tokyo 156-8502, Japan
| | - Shoji Shinkai
- Department of Nutrition, Kagawa Nutrition University, 3-9-21 Chiyoda, Sakado City, Saitama prefecture 350-0288, Japan
| | - Yoshinori Fujiwara
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae, Itabashi, Tokyo 173-0015, Japan
| | - Akihiko Kitamura
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae, Itabashi, Tokyo 173-0015, Japan
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Yen HY, Chi MJ, Huang HY. Social engagement for mental health: An international survey of older populations. Int Nurs Rev 2021; 69:359-368. [PMID: 34874057 DOI: 10.1111/inr.12737] [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: 05/11/2021] [Accepted: 11/07/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Social engagement is an important active aging strategy to promote older adults' mental health. The purposes of this study were to compare social engagement in older populations around the world and explore associations with mental health outcomes. MATERIALS AND METHODS An international cross-sectional survey was conducted from 2017 to 2019. Data were retrieved from The International Social Survey Programme for a secondary data analysis across 30 countries. This study applied the Taxonomy of Social Activities and its six levels as operational definitions for a consistent concept of social engagement for international comparisons. RESULTS In total, 9403 older adults with a mean age of 72.85 ± 6.40 years responded. The highest levels of older adults' social engagement were found in Switzerland, Thailand, and New Zealand. Older adults of a higher age, with a lower educational level, who were permanently sick or disabled, who had no partner, who were widowed or whose civil partner had died, who lived alone, and who had lower self-placement in society had significantly lower social engagement than did their counterparts. In the regression model, older adults' social engagement positively predicted general health, self-accomplishment, and life satisfaction, but negatively predicted loneliness and depression. CONCLUSIONS In aging societies worldwide, encouraging older adults' social engagement would be beneficial to promote mental health. IMPLICATIONS FOR NURSING PRACTICE AND HEALTH POLICIES Community professional nurses can develop strategies of social engagement based on the needs and sociodemographic factors of older adults to improve their mental health. Developing efficient strategies and local policies by learning from successful experiences in other countries is important to promote social engagement in aging societies.
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Affiliation(s)
- Hsin-Yen Yen
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Mei-Ju Chi
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Master Program in Long-term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Hao-Yun Huang
- Intensive Care Unit, Gold Coast University Hospital, Southport, Australia
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Fan Z, Lv X, Tu L, Zhang M, Yu X, Wang H. Reduced social activities and networks, but not social support, are associated with cognitive decline among older chinese adults: A prospective study. Soc Sci Med 2021; 289:114423. [PMID: 34597879 DOI: 10.1016/j.socscimed.2021.114423] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 09/19/2021] [Accepted: 09/22/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Social relationships consist of distinct dimensions. The literature on the effect of specific social relationship subdomains on cognitive function is limited. This large-scale, prospective cohort study examined the associations of social relationships with cognitive decline and further explored which subdomains of social relationships were predictive of cognitive decline among elderly Chinese individuals. METHODS A total of 3314 older Chinese adults aged 65-110 years from the 2011-2012 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) were included. Cognitive decline was defined based on the Chinese version of the Mini-Mental State Examination (MMSE). Social relationships were divided into three subdomains: social activities, social networks, and social support. Linear and binary logistic regression analyses were conducted to assess the effect of social relationships and the social relationship subdomains on cognitive decline after adjusting for age, sex, education, residence, exercise, drinking, smoking, activities of daily living, chronic diseases, depression, and baseline cognitive function. RESULTS Seven hundred and sixty-eight participants (23.17%) developed greater cognitive decline during the 3-year follow-up. The social relationships score was negatively associated with cognitive decline. Binary adjusted odds ratios showed that after potential covariates were controlled, social relationships, activities, and networks significantly reduced the risk of cognitive decline. When all social relationships variables were entered simultaneously with all covariates, the effect of social activities and networks on the risk of greater cognitive decline remained significant. However, we did not observe a significant association between social support and the risk of greater cognitive decline. CONCLUSION Our findings suggest that social relationships and the subdomains of social activities and networks, but not social support, have a protective effect against greater cognitive decline in older adults. This implies that structural dimensions of social relationships might be more important than functional dimensions in preserving cognitive health among elderly Chinese individuals.
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Affiliation(s)
- Zili Fan
- Dementia Care and Research Center, Peking University Institute of Mental Health, Beijing Dementia Key Lab, Beijing, 100191, China; National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, NHC, Beijing, 100191, China
| | - Xiaozhen Lv
- Dementia Care and Research Center, Peking University Institute of Mental Health, Beijing Dementia Key Lab, Beijing, 100191, China; National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, NHC, Beijing, 100191, China
| | - Lihui Tu
- Dementia Care and Research Center, Peking University Institute of Mental Health, Beijing Dementia Key Lab, Beijing, 100191, China; National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, NHC, Beijing, 100191, China
| | - Ming Zhang
- Dementia Care and Research Center, Peking University Institute of Mental Health, Beijing Dementia Key Lab, Beijing, 100191, China; National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, NHC, Beijing, 100191, China
| | - Xin Yu
- Dementia Care and Research Center, Peking University Institute of Mental Health, Beijing Dementia Key Lab, Beijing, 100191, China; National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, NHC, Beijing, 100191, China.
| | - Huali Wang
- Dementia Care and Research Center, Peking University Institute of Mental Health, Beijing Dementia Key Lab, Beijing, 100191, China; National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, NHC, Beijing, 100191, China.
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50
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Joint trajectories of disability and related factors among older adults in China. Public Health 2021; 199:96-102. [PMID: 34583202 DOI: 10.1016/j.puhe.2021.08.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 08/07/2021] [Accepted: 08/23/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVES This study aimed to identify disability trajectories and discover early disablement process factors associated with disability trajectories among older adults in China. STUDY DESIGN This is a prospective cohort study. METHODS Data were obtained from five waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS, 2005 to 2018). The multitrajectory modelling approach was used to estimate the joint trajectories of activity of daily living (ADL) disability and instrumental activity of daily living (IADL) disability. A multinomial regression model was used to investigate how baseline disablement process factors among individuals aged 65-95 years are related to joint disability trajectory groups. RESULTS We identified three typical joint ADL and IADL disability trajectories. Demographic characters, social participation, community services, disease, impairment and functional limitations can all impact the disability trajectories among older adults. CONCLUSIONS The joint ADL and IADL disability trajectories of older adults are increasing, and the Chinese government should pay more attention to disability process elements to improve disability interventions among older adults.
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