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Lai ETC, Chau AKC, Ho IYY, Hashimoto H, Kim CY, Chiang TL, Chen YM, Marmot M, Woo J. The impact of social isolation on functional disability in older people: A multi-cohort study. Arch Gerontol Geriatr 2024; 125:105502. [PMID: 38876082 DOI: 10.1016/j.archger.2024.105502] [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: 04/25/2024] [Revised: 05/23/2024] [Accepted: 05/27/2024] [Indexed: 06/16/2024]
Abstract
OBJECTIVES We assessed the relationship between social isolation and functional disability in older people. DESIGN Comparison of longitudinal cohort studies. SETTING AND PARTICIPANTS Harmonised longitudinal datasets from the United States, England, European countries, Japan, Korea, China and Hong Kong. METHODS Social isolation was operationalised as a composite score with five domains, such as marital status, living alone, and social contact with others. Functional disability was defined as whether the cohort participant had any difficulty in activities of daily living (ADL). In each dataset, we used robust Poisson regression models to obtain the relative risks (RRs) and the corresponding 95 % confidence intervals (CI). We combined the RRs to synthesize a pooled estimate using meta-analysis with random-effects models. RESULTS Overall, the social isolation composite score was not associated with ADL disability (pooled RR = 1.05, 95 % CI [0.97-1.14], n = 40,119). Subgroup analysis suggested social isolation composite score was associated with ADL disability in Asian regions (pooled RR = 1.09, 95 % CI [1.02, 1.16], but not in Western regions (pooled RR = 1.01, 95 % CI [0.96, 1.07]). The relationships between different domains of social isolation and ADL disability were heterogeneous, except that no participation in any social clubs or religious groups was consistently associated with ADL disability (pooled RR = 1.12, 95 % CI [1.04, 1.21]). CONCLUSION Targeting social isolation may prevent decline in functional abilities in older adults, providing an avenue to active and healthy ageing. Nonetheless, interventions tackling social isolation should tailor to the unique cultural and social underpinnings. A limitation of the study is that reverse causality could not be ruled out definitively.
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Affiliation(s)
- Eric Tsz-Chun Lai
- Institute of Health Equity, Chinese University of Hong Kong, Shatin, Hong Kong; Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Shatin, Hong Kong.
| | - Anson Kai Chun Chau
- Institute of Health Equity, Chinese University of Hong Kong, Shatin, Hong Kong; School of Psychology, University of New South Wales, Sydney, Australia
| | - Irene Yuk-Ying Ho
- Institute of Health Equity, Chinese University of Hong Kong, Shatin, Hong Kong
| | - Hideki Hashimoto
- Department of Health and Social Behavior, School of Public Health, University of Tokyo, Tokyo, Japan
| | - Chang-Yup Kim
- School of Public Health, Department of Health Policy and Management, Seoul National University, Seoul, South Korea
| | - Tung-Liang Chiang
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ya-Mei Chen
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Michael Marmot
- Department of Epidemiology and Public Health, Institute of Health Equity, University College London, London, UK
| | - Jean Woo
- Institute of Health Equity, Chinese University of Hong Kong, Shatin, Hong Kong; Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Shatin, Hong Kong
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Zeng Q, Zhu L, He Z. Who can Benefit From Volunteer Participation? Analysis of Wellbeing Heterogeneity in Volunteer Participation of Older People. J Appl Gerontol 2024:7334648241273387. [PMID: 39165167 DOI: 10.1177/07334648241273387] [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: 08/22/2024] Open
Abstract
The basic premise of this study is that the traditional method to treating all older people as coming from the same distribution misspecifies the true model and ignores potentially important information in wellbeing outcomes of social participation. Using data from the China Longitudinal Aging Social Survey (CLASS), this paper proposes a finite mixture model (FMM) to identify the heterogeneous relationship between volunteer participation and older people's subjective well-being (SWB) and then explore the determinants of wellbeing heterogeneity in volunteer participation. The results reveal that older people can be classified into two latent subgroups, that is the volunteering beneficiary group (accounting for about 42%) and the volunteering non-beneficiary group (accounting for about 58%). The FMM is therefore more appropriate in estimating the complex impact of volunteering. Rural older people with poorer health, weaker social networks, better economic status, and better community environments are more likely to benefit from volunteer participation. Our findings have suggested some practical implications to increase the probability of benefit from volunteer participation.
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Affiliation(s)
- Qiyan Zeng
- Research Academy for Rural Revitalization of Zhejiang Province, Zhejiang A & F University, Hangzhou, China
- College of Economics and Management, Zhejiang A & F University, Hangzhou, China
| | - Lining Zhu
- College of Economics and Management, Zhejiang A & F University, Hangzhou, China
| | - Zhipeng He
- College of Economics and Management, China Agricultural University, Beijing, China
- Beijing Food Safety Policy & Strategy Research Base, China Agricultural University, Beijing, China
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Zuo X, Tang Y, Chen Y, Zhou Z. Effects of Electronic Serious Games on Older Adults With Alzheimer's Disease and Mild Cognitive Impairment: Systematic Review With Meta-Analysis of Randomized Controlled Trials. JMIR Serious Games 2024; 12:e55785. [PMID: 39083796 PMCID: PMC11324188 DOI: 10.2196/55785] [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: 12/24/2023] [Revised: 02/19/2024] [Accepted: 06/26/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Serious games (SGs) are nonpharmacological interventions that are widely applied among older adults. To date, no evidence has been published regarding the effect of digital SGs on cognitive ability, daily behavioral capacity, or depression in older adults with Alzheimer's disease (AD) and mild cognitive impairment (MCI). OBJECTIVE This study aimed to assess the effect of SGs on older adults with AD and MCI by summarizing and pooling the results of previous studies. METHODS This meta-analysis examined the effectiveness of digital SGs in improving cognitive ability, enhancing daily behavioral capacity, and alleviating depression in older adults with AD and MCI. We searched the following databases up to December 31, 2023, to identify relevant high-quality randomized controlled trials (RCTs): PubMed, Embase, Web of Science, Scopus, and Cochrane Library. Stata 15.1 and Review Manager 5.3 were used to screen the 14 studies, extract data, code the data, and perform meta-analysis. Mean differences and standardized mean differences (SMDs) with 95% CIs were used to calculate continuous variables. The Cochrane risk-of-bias assessment tool was used to evaluate the risk of bias. Eligibility criteria were developed in accordance with the Population, Intervention, Comparison, Outcomes, and Study Design framework: (1) population (older adults with AD and MCI), (2) intervention (digital SG intervention), (3) comparison (digital SG intervention vs routine health care), (4) outcomes (cognitive ability, daily behavioral capacity, and depression), and (5) study or research design (RCT). Sensitivity analysis was performed, and a funnel plot was constructed. RESULTS From January 2017 to December 2023, we enrolled 714 individuals across 14 RCTs, with 374 (52.4%) in the severe game group using digital SGs and 340 (47.6%) in the control group using traditional methods. The results of our meta-analysis indicated that using digital SGs in older adults with AD and MCI is more effective than traditional training methods in several key areas. Specifically, digital SG therapy significantly increased cognitive ability, as found in the Mini-Mental State Examination (SMD 2.11, 95% CI 1.42-2.80; P<.001) and the Montreal Cognitive Assessment (SMD 2.75, 95% CI 1.98-3.51; P<.001), significantly increased daily behavioral capacity (SMD 0.53, 95% CI 0.06-0.99; P=.03), and significantly reduced depression (SMD -2.08, 95% CI -2.94 to -1.22; P<.001) in older adults with AD and MCI. No publication bias was detected based on the results of Begg and Egger tests. CONCLUSIONS Digital SGs offer a viable and effective nonpharmacological approach for older adults with AD and MCI, yielding better results compared to traditional formats. However, caution is warranted in interpreting these findings due to limited RCTs, small sample sizes, and low-quality meta-analyzed evidence. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews: CRDCRD42023486090; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=486090.
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Affiliation(s)
- Xinyi Zuo
- Sociology Department, School of Government, Shenzhen University, Shenzhen, Guangdong, China
| | - Yong Tang
- Sociology Department, School of Government, Shenzhen University, Shenzhen, Guangdong, China
| | - Yifang Chen
- Institution of Policy Studies, Lingnan University, Tuen Mun, Hong Kong SAR, China (Hong Kong)
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Ma X, Kawakami A, Inui T. Impact of Long Working Hours on Mental Health Status in Japan: Evidence from a National Representative Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:842. [PMID: 39063419 PMCID: PMC11276854 DOI: 10.3390/ijerph21070842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 06/19/2024] [Accepted: 06/24/2024] [Indexed: 07/28/2024]
Abstract
Using the 2010-2019 Comprehensive Survey of Living Conditions (CSLC) conducted in Japan, we examined the impact of long working hours on mental health in Japan while addressing the endogeneity issue arising from non-random selection bias. We assessed the variations in the effects of long working hours on mental health across different groups. The results show that first, individuals working longer hours (55 h or more per week) exhibited a higher likelihood of developing mental illness than those working regular hours or fewer hours. Second, the negative effect of long working hours on mental health is more pronounced among non-regular workers than among regular workers. Third, the effect of long working hours on mental health varies among different demographic groups, with a greater impact observed among women, managers, non-regular workers, employees in small- or large-sized firms, and those in smaller cities compared to their counterparts. Thus, to enhance worker productivity, the Japanese government should address the issue of long working hours to improve employees' mental well-being. Initiatives aimed at promoting work-life balance, family-friendly policies, and measures to ameliorate working conditions are expected to help mitigate the challenges associated with long working hours and mental health issues, especially among non-regular workers.
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Affiliation(s)
- Xinxin Ma
- Faculty of Economics, Hosei University, 4342 Machita-shi Aiharamachi, Tokyo 194-0298, Japan
| | - Atushi Kawakami
- Faculty of Economics, Toyo University, Tokyo 112-8606, Japan;
| | - Tomohiko Inui
- Faculty of International Social Sciences, Gakushuin University, Tokyo 171-8588, Japan;
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Huang S, Zhong W, Cheng Q, Shuai Y, Zhu J, Diao J. Instrumental activities of daily living function and cognitive status among Chinese older adults: a serial multiple mediation model. Front Public Health 2024; 12:1378979. [PMID: 38756886 PMCID: PMC11096471 DOI: 10.3389/fpubh.2024.1378979] [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: 01/30/2024] [Accepted: 04/18/2024] [Indexed: 05/18/2024] Open
Abstract
Objective This study aimed to develop and validate a serial multiple mediation model to investigate the association between instrumental activities of daily living (IADL) function and cognitive status among older adults while exploring the underlying mechanisms. Methods This cross-sectional study involved 3,665 individuals aged 60 years and older who participated in the China Health and Retirement Longitudinal Survey (CHARLS). A serial multiple mediation model was utilized to explore the direct and indirect relationship between IADL function and cognitive status and whether sleep duration, social engagement, and depressive symptoms mediated this relationship. Results Decreased IADL function was associated with worse cognitive status [effect = -0.620, 95% CI: (-0.692, -0.540)]. Sleep duration, social participation (SP), and depressive symptoms all acted as mediators in the relationship between IADL function and cognitive status. Conclusion This study found both direct and indirect associations between IADL function and cognitive status, providing new insights into the effective prevention and intervention of cognitive decline among older adults.
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Affiliation(s)
| | - Wenjuan Zhong
- School of Medicine and Health, Wuhan Polytechnic University, Wuhan, China
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Elena MG, Pablo MA. Sociocultural interactions and self-perception of health in older adults from an active participation centre: A qualitative study. Geriatr Nurs 2024; 57:73-79. [PMID: 38598906 DOI: 10.1016/j.gerinurse.2024.04.001] [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: 01/02/2024] [Revised: 03/04/2024] [Accepted: 04/03/2024] [Indexed: 04/12/2024]
Abstract
INTRODUCTION Promoting healthy ageing is a global priority. Active Participation Centres are potentially key in fostering psychosocial and emotional health, contributing to a fulfilling and active lifestyle for older adults. AIMS The study explores self-perceived health, perceptions of sociocultural participation, emotions that emerged when sociocultural participation, and preferences among older adults engaged in community socio-cultural activities from an Active Participation Centre. METHODS We realised a hermeneutic study; interviews with nine older participants were conducted. Hermeneutic considerations were employed for data analysis. RESULTS Findings reveal the centre's significance as a therapeutic space, positively influencing emotional well-being, fostering social connections, and offering diverse activity preferences. CONCLUSION This study underscores the nuanced interplay between sociocultural engagement and self-perceived health, emphasising the need for holistic approaches to promote well-being among older adults attending Active Participation Centres.
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Affiliation(s)
- Marín-García Elena
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Córdoba (UCO), 14004 Córdoba, Andalucía, Spain
| | - Martínez-Angulo Pablo
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Córdoba (UCO), 14004 Córdoba, Andalucía, Spain; Research Group HUM 380 ("Interdisciplinary Research in Discourse Analysis"), Spain.
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Wu B, Xiong G, Zhang P, Ma X. Effects of tai chi, ba duan jin, and walking on the mental health status of urban older people living alone: the mediating role of social participation and the moderating role of the exercise environment. Front Public Health 2024; 12:1294019. [PMID: 38389938 PMCID: PMC10881673 DOI: 10.3389/fpubh.2024.1294019] [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: 09/19/2023] [Accepted: 01/29/2024] [Indexed: 02/24/2024] Open
Abstract
With the global trend of aging, lacking of interpersonal communication and spiritual support and companionship have had a great impact on the mental health of older people living alone. This study examines the multifaceted impacts of engaging in tai chi, ba duan jin, and walking on the mental wellbeing of older people residing alone in urban areas. Additionally, this research aims to explore the association between tai chi, ba duan jin, and walking, and the mental health status of urban older people living alone, by considering the mediating influence of social participation and the moderating influence of the exercise environment. To do so, 1,027 older people living alone in six Chinese cities were investigated using the Physical Activity Rating Scale (PARS-3), the Geriatric Health Questionnaire (GHQ-12), the Social Participation Indicator System Scale, and the Exercise Environment Scale. SPSS 25.0 was utilized for conducting mathematical statistical analysis, specifically for doing linear regression analysis. Additionally, AMOS was employed to develop the study model. We found that a significant negative correlation between tai chi, ba duan jin, and walking and mental health status; among these, tai chi had the greatest impact on the mental health status of urban older people living alone. Social participation mediated the relationship between tai chi, ba duan jin, walking, and mental health status, and the exercise environment had a moderating effect on this relationship. The findings of this study indicate that tai chi, ba duan jin, and walking have a positive impact on the mental health of urban older people living alone, which can be influenced by the mediating efficacy of social participation and the moderating effect of the exercise environment.
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Affiliation(s)
- Baoyuan Wu
- School of Wushu, Chengdu Sports University, Chengdu, China
| | - Guoyan Xiong
- School of Wushu, Chengdu Sports University, Chengdu, China
| | - Peng Zhang
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Xiujie Ma
- School of Wushu, Chengdu Sports University, Chengdu, China
- Chinese Guoshu Academy, Chengdu Sports University, Chengdu, China
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Yan Z, Luan X, Meng L, Wu Y, Qu W, Zhang S, Wei H, Wu S. Longitudinal relationship between social participation, depressive symptoms, and activity impairment among older patients with arthritis: a moderated mediation analysis. BMC Geriatr 2024; 24:139. [PMID: 38326792 PMCID: PMC10851568 DOI: 10.1186/s12877-024-04735-6] [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: 06/06/2023] [Accepted: 01/22/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Arthritis primarily affects older people and is a prominent cause of their activity impairment. This study aimed to examine the mediating role of depressive symptoms in the relationship between social participation and activity impairment, as well as to determine whether sex moderated the mediating effect. METHODS A total of 2247 older patients with arthritis were included from the China Health and Retirement Longitudinal Study between 2015 and 2018. We first examined a simple mediation model where depressive symptoms were a mediator between social participation and activity impairment. Furthermore, sex was systematically integrated into the model as a moderator. The mediation model and moderated mediation model were analyzed using PROCESS macro. RESULTS Mediation analysis revealed that the association between social participation and activity impairment was partially mediated by depressive symptoms (B = -0.10, 95% CI = [-0.14, -0.06]) with intermediary effect of 28.6%. Moderated mediation analysis indicated that mediation model was moderated by sex. The indirect effect of social participation on activity impairment among female patients (B = -0.15, 95% CI = [-0.21, -0.09]) was stronger than male patients (B = -0.04, 95% CI = [-0.09, -0.01]). CONCLUSION Social participation was the key protective factor associated with depressive symptoms and activity impairment among arthritis patients. Encouraging arthritis patients to social participation and improving the depressive symptoms might avoid activity impairment, especially for female patients.
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Affiliation(s)
- Zeping Yan
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
- Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China
- University of Health and Rehabilitation Sciences, Qingdao, China
| | | | - LiJun Meng
- Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China
| | - Yu Wu
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
- Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China
- University of Health and Rehabilitation Sciences, Qingdao, China
| | - Wenran Qu
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Simeng Zhang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Huimin Wei
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Shicai Wu
- Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China.
- University of Health and Rehabilitation Sciences, Qingdao, China.
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Wu M, Zeng S. Exploring factors influencing farmers' health self-assessment in China based on the LASSO method. BMC Public Health 2024; 24:333. [PMID: 38297267 PMCID: PMC10829402 DOI: 10.1186/s12889-024-17809-2] [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: 10/24/2023] [Accepted: 01/18/2024] [Indexed: 02/02/2024] Open
Abstract
As the main force and practice subject of rural revitalisation, farmers' health is intricately linked to agricultural production and the rural economy. This study utilizes open data from the 2015 China Nutrition and Health Survey and employs the Least Absolute Shrinkage and Selection Operator (LASSO) method to explore the factors influencing farmers' self-assessment of health. The findings reveal that education level, proactive nutrition knowledge seeking, healthy dietary preferences and habits, and the use of clean cooking fuel positively impact farmers' health self-assessment. Conversely, age, history of illness or injury, and participation in medical insurance negatively affect their self-assessment. Furthermore, factors influencing farmers' health self-assessment exhibit heterogeneity across regions. Our findings suggest that promoting health education, disseminating nutritional dietary knowledge, and enhancing rural household infrastructure play an important role in improving farmers' self-evaluation of health. Therefore, policymakers should design more targeted health interventions and infrastructure improvement plans based on farmers' self-assessment of health and the level of regional economic development.
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Affiliation(s)
- Mingze Wu
- College of Economics and Management, South China Agricultural University, Guangzhou, 510642, China
| | - Shulin Zeng
- Qidong Hospital of Traditional Chinese Medicine, Nantong, 226200, Jiangsu, China.
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Liu Y, Li T, Ding L, Cai Z, Nie S. A predictive model for social participation of middle-aged and older adult stroke survivors: the China Health and Retirement Longitudinal Study. Front Public Health 2024; 11:1271294. [PMID: 38283296 PMCID: PMC10810982 DOI: 10.3389/fpubh.2023.1271294] [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: 08/02/2023] [Accepted: 12/29/2023] [Indexed: 01/30/2024] Open
Abstract
Objective This study aims to develop and validate a prediction model for evaluating the social participation in the community middle-aged and older adult stroke survivors. Methods The predictive model is based on data from the China Health and Retirement Longitudinal Study (CHARLS), which focused on individuals aged 45 years or older. The study utilized subjects from the CHARLS 2015 and 2018 wave, eighteen factors including socio-demographic variables, behavioral and health status, mental health parameters, were analyzed in this study. To ensure the reliability of the model, the study cohort was randomly split into a training set (70%) and a validation set (30%). The Least Absolute Shrinkage and Selection Operator (LASSO) regression analysis was used to identify the most effective predictors of the model through a 10-fold cross-validation. The logistic regression model was employed to investigate the factors associated with social participation in stroke patients. A nomogram was constructed to develop a prediction model. Calibration curves were used to assess the accuracy of the nomogram model. The model's performance was evaluated using the area under the curve (AUC) and decision curve analysis (DCA). Result A total of 1,239 subjects with stroke from the CHARLS database collected in 2013 and 2015 wave were eligible in the final analysis. Out of these, 539 (43.5%) subjects had social participation. The model considered nineteen factors, the LASSO regression selected eleven factors, including age, gender, residence type, education level, pension, insurance, financial dependence, physical function (PF), self-reported healthy,cognition and satisfaction in the prediction model. These factors were used to construct the nomogram model, which showed a certain extent good concordance and accuracy. The AUC values of training and internal validation sets were 0.669 (95%CI 0.631-0.707) and 0.635 (95% CI 0.573-0.698), respectively. Hosmer-Lemeshow test values were p = 0.588 and p = 0.563. Calibration curves showed agreement between the nomogram model and actual observations. ROC and DCA indicated that the nomogram had predictive performance. Conclusion The nomogram constructed in this study can be used to evaluate the probability of social participation in middle-aged individuals and identify those who may have low social participation after experiencing a stroke.
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Affiliation(s)
- Yan Liu
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, China
| | - Tian Li
- Department of Coronary Heart Disease, Renmin Hospital of Wuhan University, Wuhan, China
| | - Linlin Ding
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - ZhongXiang Cai
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, China
| | - Shuke Nie
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
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Lin J, Zhang Y, Wang K, Xia H, Hua M, Lu K, Zheng W, Chen R. Long-term impact of PM 2.5 exposure on frailty, chronic diseases, and multimorbidity among middle-aged and older adults: insights from a national population-based longitudinal study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:4100-4110. [PMID: 38097844 DOI: 10.1007/s11356-023-31505-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/08/2023] [Indexed: 01/19/2024]
Abstract
Particulate Matter 2.5 (PM2.5) is a significant risk factor for frailty and chronic diseases. Studies on the associations between PM2.5 and frailty, chronic diseases, and multimorbidity are scarce, especially from large cohort studies. We aimed to explore the potential association between PM2.5 exposure and the risk of frailty, chronic diseases, and multimorbidity. We collected data from a national cohort (CHARLS) with a follow-up period of 11-18 years, totaling 13,366 participants. We obtained PM2.5 concentration data from the Atmospheric Composition Analysis Group at Dalhousie University. PM2.5 exposure is based on the average annual concentration in the prefecture-level city where residents live. We define frailty as the comprehensive manifestation of declining various body functions, characterized by a frailty index of 0.25 or greater, and multimorbidity as the presence of at least two or more chronic conditions. Cox proportional hazards regression was used to estimate the hazard ratio (HR) with its 95% confidence interval (95%CI). A 10-μg/m3 increase for PM2.5 was significantly associated with an increased risk of frailty (HR = 1.289, 95%CI = 1.257-1.322, P < 0.001). A 10-μg/m3 increase for PM2.5 was significantly associated with the elevated risk for most chronic diseases. Compared to those with no morbidity or only single morbidity, a 10-μg/m3 increase for PM2.5 was significantly associated with the elevated risk for multimorbidity (HR = 1.220, 95%CI = 1.181-1.260, P < 0.001). Ambient PM2.5 exposure is a significant risk factor for frailty, chronic diseases, and multimorbidity, and some measures need to be taken to reduce PM2.5 concentration and prevent frailty and chronic diseases.
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Affiliation(s)
- Junjie Lin
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Yu Zhang
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Kunyi Wang
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Huilin Xia
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Minxia Hua
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Kexin Lu
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Weijun Zheng
- Department of Medical Statistics, School of Public Health, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou City, 310053, Zhejiang Province, China
| | - Rucheng Chen
- Department of Medical Statistics, School of Public Health, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou City, 310053, Zhejiang Province, China.
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Lin J, Wang K, Zhang Y, Lu K, Xia H, Hua M, Zheng W, Chen R. Frailty index trajectories in Chinese older adults with diverse levels of social participation: findings from a national population-based longitudinal study. Aging Clin Exp Res 2023; 35:3105-3114. [PMID: 37948011 DOI: 10.1007/s40520-023-02617-2] [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: 08/29/2023] [Accepted: 11/01/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Aging and frailty pose significant challenges globally, placing a substantial burden on healthcare and social services due to their adverse consequences. AIM The primary objective of this study was to investigate the relationship between social participation and development of frailty transition and trajectory. METHODS This study utilized data from the CLHLS Cohort, a 10-year follow-up study involving 6713 participants, to investigate the association between social participation and development of frailty. Frailty reflects a comprehensive decline in various body functions. The study employed a group-based trajectory model to analyze the development trajectory of the frailty index and used logistic regression to assess the odds ratio (OR) of frailty risk. RESULTS We identified two distinct groups of frailty progression trajectories: the "stable development group" and the "rapid growth group." Individuals who engaged in social activities at least once a month, but not daily, exhibited a significant association with an increased risk of transitioning into the "rapid growth group" (OR 1.305, 95% CI 1.032-1.649). Those with social participation less than once a month had an even greater risk (OR 1.872, 95% CI 1.423-2.463). Moreover, low social participation frequency (occasionally/never) has a more pronounced impact on frailty progression in males. CONCLUSION A higher frequency of social participation is associated with a lower risk of being classified into the "rapid growth group" and a slower rate of frailty index progression. Preventing the progression of frailty can contribute to enhanced support for healthy aging among older adults.
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Affiliation(s)
- Junjie Lin
- School of Public Health, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, 310053, Zhejiang Province, China
| | - Kunyi Wang
- School of Public Health, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, 310053, Zhejiang Province, China
| | - Yu Zhang
- School of Public Health, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, 310053, Zhejiang Province, China
| | - Kexin Lu
- School of Public Health, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, 310053, Zhejiang Province, China
| | - Huilin Xia
- School of Public Health, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, 310053, Zhejiang Province, China
| | - Minxia Hua
- School of Public Health, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, 310053, Zhejiang Province, China
| | - Weijun Zheng
- Department of Medical Statistics, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Rucheng Chen
- School of Public Health, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, 310053, Zhejiang Province, China.
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Wen W, Zhang Y, Shi W, Li J. Association Between Internet Use and Physical Health, Mental Health, and Subjective Health in Middle-aged and Older Adults: Nationally Representative Cross-sectional Survey in China. J Med Internet Res 2023; 25:e40956. [PMID: 36943368 PMCID: PMC10131878 DOI: 10.2196/40956] [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: 07/13/2022] [Revised: 12/20/2022] [Accepted: 02/24/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Internet use is an important means of accessing health-related information. Identifying the associations between internet use and health outcomes could provide insight into strategies for improving public health among middle-aged and older adults (45 years and up). OBJECTIVE This study aimed to examine the relationship between internet use and health outcomes in middle-aged and older adults. METHODS Data were obtained from the 2018 China Health and Retirement Longitudinal Study. Physical, mental, and subjective health were assessed using the Activities of Daily Living (ADL) Scale, the 10-item Center for Epidemiologic Studies Depression Scale, and the 3-level Self-Rated Health Scale, respectively. The chi-square test and rank sum test were used to explore whether internet use was associated with health status. A multivariate logistic regression model was used to determine this association further after controlling for the confounding factors. RESULTS Overall, 13% (1752/13,474) of the participants used the internet. Regression analyses revealed that the prevalence of depression (odds ratio [OR] 0.59, 95% CI 0.52-0.68; P<.001), negative self-rated health (OR 0.68, 95% CI 0.61-0.76; P<.001), and difficulty with ADL (OR 0.48, 95% CI 0.39-0.60; P<.001) in the participating middle-aged and older adult was lower in those using the internet than nonusers. After controlling for confounding factors, internet use was found to be negatively associated with difficulty with ADL (urban: OR 0.44, 95% CI 0.32-0.61; P<.001 vs rural: OR 0.55, 95% CI 0.41-0.75; P<.001), depression (urban: OR 0.69, 95% CI 0.57-0.84; P<.001 vs rural: OR 0.52, 95% CI: 0.43-0.63; P<.001), and self-rated health status (urban: OR 0.70, 95% CI 0.61-0.81; P<.001 vs rural: OR 0.67, 95% CI 0.57-0.78; P<.001) among middle-aged and older adults in both urban and rural areas. CONCLUSIONS Internet use had a positive effect on the physical and mental health of middle-aged and older adults who participated in this study. However, the internet usage rate remains low among older Chinese people. Therefore, the internet penetration rate should be a priority.
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Affiliation(s)
- Wen Wen
- School of Public Health, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China
| | - Yaru Zhang
- School of Public Health, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China
| | - Wenjie Shi
- School of Public Health, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China
| | - Jiajia Li
- School of Public Health, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China
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Su Q, Wang H, Fan L. The impact of home and community care services pilot program on healthy aging: A difference-in-difference with propensity score matching analysis from China. Arch Gerontol Geriatr 2023; 110:104970. [PMID: 36842402 DOI: 10.1016/j.archger.2023.104970] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 02/05/2023] [Accepted: 02/19/2023] [Indexed: 02/26/2023]
Abstract
BACKGROUND Home and community care service (HACCS) is an important policy response worldwide to the growing and unmet care needs of the aging population. In China, the government also started to implement a HACCS pilot program in 2016. This study aims to evaluate the association of HACCS utilization with healthy aging in Chinese older adults. METHODS This study followed a quasi-experimental design and derived data from the nationwide China Health and Retirement Longitudinal Study (CHARLS) in 2015 and 2018. We employed the propensity score matching with difference-in-difference approach (PSM-DID) to examine the association between HACCS and healthy aging indicators. RESULTS A total of 8345 older adults were incorporated for a final sample. The results indicated that HACCS utilization was associated with significantly reduced functional limitations (β for BADL=-0.124, β for IADL=-0.210; P<0.01) and depression (β=-0.386, P<0.05) as well as improved cognitive function (β=0.609, P<0.001), life satisfaction (β=0.083, P<0.01) and social participation (β=0.105, P<0.01) in older people, although its association with reduced disability was non-significant (β=-0.005, P = 0.676). The heterogeneous tests further found that rural older adults and older adults aged<80 were more likely than their counterparts to benefit from the HACCS utilization in specific healthy aging indicators such as cognitive function. CONCLUSIONS The implementation of the HACCS program benefited a range of healthy aging domains among older adults in China. Policymakers are encouraged to further expand the program implementation and also continue to improve the services list and care quality of HACCS.
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Affiliation(s)
- Qing Su
- School of Public Health, Southeast University, No.87 Dingjiaqiao, Nanjing 210009, China.
| | - Hang Wang
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
| | - Lijun Fan
- School of Public Health, Southeast University, No.87 Dingjiaqiao, Nanjing 210009, China.
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15
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Ma X. Impact of Long Working Hours on Mental Health: Evidence from China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1641. [PMID: 36674394 PMCID: PMC9866749 DOI: 10.3390/ijerph20021641] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/06/2023] [Accepted: 01/13/2023] [Indexed: 05/21/2023]
Abstract
Although previous studies have examined the impact of long working hours on mental health in China, they have not addressed the initial value and reverse causality issues. To bridge this gap in the literature, I conducted a dynamic longitudinal analysis to investigate the association between long working hours and the risk of mental illness nationwide. Using three-wave longitudinal data from the China Family Panel Studies conducted in 2014, 2016, and 2018, I adopted dynamic regression models with lagged long working hours variables to examine their association with the risk of mental illness. The results indicate that long working hours have positive and significant (p < 0.01 or p < 0.05) associations with the risk of mental illness (OR: 1.12~1.22). The effect is more significant for women, white-collar workers, and employees in micro-firms, compared with their counterparts (i.e., men, pink- and blue-collar workers, employees of large firms, and self-employed individuals). The results provide empirical evidence of the effects of long working hours on mental health in China, confirming the need to enforce the regulations regarding standard working hours and monitor regulatory compliance by companies, as these factors are expected to improve mental health.
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Affiliation(s)
- Xinxin Ma
- Faculty of Economics, Hosei University, 4342 Machita-shi Aiharamachi, Tokyo 194-0298, Japan
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16
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Decomposition analysis of health inequalities between the urban and rural oldest-old populations in China: Evidence from a national survey. SSM Popul Health 2022; 21:101325. [PMID: 36618546 PMCID: PMC9816804 DOI: 10.1016/j.ssmph.2022.101325] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 12/15/2022] [Accepted: 12/18/2022] [Indexed: 12/25/2022] Open
Abstract
The number of Chinese oldest-old (aged 80+) is growing rapidly and some studies have shown that the health status is unequal among older persons in different regions. However, to the best of our knowledge, no study to date has analyzed health inequalities among the oldest-old in urban and rural areas in China. This study therefore aimed to examine the correlation between health inequalities among the oldest-old in urban and rural areas of China. From the 8th wave of the Chinese Longitudinal Health Longevity Survey (CLHLS), we selected 8124 oldest-old participants who met the requirements of the study. Chi-square tests were used to analyze the distribution characteristics of indicators and a logistic model was performed to determine the factors associated with different self-rated health (SRH). The Fairlie model was adopted to decompose the causes and related contributions to health inequality. Our results found that of the Chinese oldest-old, 46.57% were in good health. Urban residents reported significantly better SRH than rural residents (50.17% vs. 45.13%). Variables associated with good and poor SRH had different distribution characteristics. The logistic model suggested that marital status, alcohol consumption, and annual income were important factors underlying the SRH differences. Our decomposition analysis indicated that 76.64% of the SRH differences were caused by observational factors, and validated that the difference in SRH between urban and rural areas was significantly (P<0.05) associated with exercise status (45.44%), annual income (37.64%), social activity status (3.75%), age (-5.27%), and alcohol consumption (-2.66%). Therefore, socioeconomic status and individual lifestyle status were the main factors underlying the health inequality between urban and rural Chinese oldest-old.
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17
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Guo H, Feng S, Liu Z. The temperature of internet: Internet use and depression of the elderly in China. Front Public Health 2022; 10:1076007. [PMID: 36620285 PMCID: PMC9811204 DOI: 10.3389/fpubh.2022.1076007] [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: 10/21/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction Depression has become one of the most prevalent mental illnesses affecting the elderly in aging countries, i. e., in countries of the world whose population is slowly aging. It has become an important topic for scientists and policymakers to analyze how best to improve the elderly's mental health and save them from depression. The aim of this paper was to investigate whether and to what extent internet use may affect depression in the elderly. The heterogeneous effects of internet use on the elderly's depression across age, gender, and occupation were also investigated. Methods The data used in the present study were gathered from the China Health and Retirement Longitudinal Study that was conducted in 2018. The propensity score matching technique and the endogenous switch regression model were employed in this study to address potential endogeneity caused by both observed and unobserved factors. Results The results of the present study show that the elderly who are relatively young, male, well educated, live in an urban area, or have a small family are more likely to use the internet. The elderly who have healthy eyes or good eyesight, those who are not employed in the agricultural sector, or those who are retired, and those who are not eligible to receive any subsistence allowance or drink wine have a higher probability of using the internet. We also find that internet use significantly reduces the elderly's depression status by 3.370 points, which is roughly equivalent to a reduction of 37.19%. Heterogeneity analysis on internet use reveals that the health effect is particularly effective for agricultural workers, female, or the older elderly. Conclusion The results of the present study highlight the significant welfare effects brought about by the development of internet infrastructure. To improve the mental health of the elderly, the government should encourage them to adopt the internet. In particular, the needs of the elderly who are older, female, or have agricultural work should be paid more attention to motivate them to use the internet more to alleviate depression.
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Affiliation(s)
- Hongwang Guo
- School of Public Administration and Policy, Renmin University of China, Beijing, China
| | - Shuyi Feng
- China Resources, Environment and Development Academy, Nanjing Agricultural University, Nanjing, China
| | - Ziming Liu
- School of Social and Public Administration, East China University of Science and Technology, Shanghai, China,*Correspondence: Ziming Liu ✉
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18
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Saha A, Rahaman M, Mandal B, Biswas S, Govil D. Rural urban differences in self-rated health among older adults: examining the role of marital status and living arrangements. BMC Public Health 2022; 22:2175. [PMID: 36434537 PMCID: PMC9700952 DOI: 10.1186/s12889-022-14569-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 11/07/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The rural-urban gap in socioeconomic and morbidity status among older adults is prevalent in India. These disparities may impact the levels and factors of self-rated health (SRH). The objective of the study is to compare the levels and determinants of SRH between rural and urban areas by considering the moderating effects of marital status and living arrangements. SUBJECTS AND METHODS The present study used data from the Longitudinal Ageing Study in India (LASI) wave 1 (2017-18). A total sample of 30,633 older adults aged 60 years and above were selected for the study. Descriptive statistics, bivariate chi-square test, the interaction effect of living arrangements and marital status, and logistic estimation were applied to accomplish the study objectives. RESULTS The prevalence of poor SRH was found 7% higher in rural areas compared to urban counterparts. A substantial rural-urban disparity in the patterns of poor SRH was also observed. The interaction effect of marital status and living arrangement on self-rated health suggested that older adults who were currently unmarried and living alone were 38% more likely to report poor SRH than those who were currently married and co-residing in rural India. In addition to marital status and living situation, other factors that significantly influenced SRH include age, socio-cultural background (educational attainment and religion), economic background (employment status), health status (ADLs, IADLs, multi-morbidities), and geographic background (region). CONCLUSION The present study's findings demonstrated that, notwithstanding local variations, marital status and living circumstances significantly influenced SRH in India. In the present study, unmarried older people living alone were more susceptible to poor SRH in rural areas. The present study supports the importance of reinforcing the concepts of care and support for older individuals. There is a need for special policy attention to older individuals, particularly those unmarried and living alone. Although older individuals had difficulty performing ADLs and IADLs and had multi-morbidities, they reported poorer health. Therefore, offering them social support and top-notch medical assistance is crucial.
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Affiliation(s)
- Amiya Saha
- grid.419349.20000 0001 0613 2600Department of Family & Generations, International Institute for Population Sciences, Mumbai, 400088 India
| | - Margubur Rahaman
- grid.419349.20000 0001 0613 2600Department of Migration & Urban Studies, International Institute for Population Sciences, Mumbai, 400088 India
| | - Bittu Mandal
- grid.450280.b0000 0004 1769 7721School of Humanities and Social Sciences, Indian Institute of Technology, Indore, 453552 India
| | - Sourav Biswas
- grid.419349.20000 0001 0613 2600Department of Population & Development, International Institute for Population Sciences, Mumbai, 400088 India
| | - Dipti Govil
- grid.419349.20000 0001 0613 2600Department of Family & Generations, International Institute for Population Sciences, Mumbai, 400088 India
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19
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Wei X, Liu H, Yang L, Gao Z, Kuang J, Zhou K, Xu M. Joint developmental trajectories and temporal precedence of physical function decline and cognitive deterioration: A longitudinal population-based study. Front Psychol 2022; 13:933886. [PMID: 36312122 PMCID: PMC9597508 DOI: 10.3389/fpsyg.2022.933886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 09/09/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivesPrevious studies primarily explored the unidirectional impact of cognition on physical function. However, the interplay between physical function and cognition and the temporal precedence in their predictive relationships have not been elucidated. We explored the bidirectional mechanism between physical function and cognition in a longitudinal dataset.Materials and methodsA total of 1,365 participants in the Chinese Longitudinal Healthy Longevity Survey assessed physical function and cognition in 2011 (T1), 2014 (T2), and 2018 (T3) by the Katz scale and the Chinese version of the Mini-Mental State Examination scale, respectively. Changes in the trajectories of physical function and cognition were examined using the latent growth model. The correlational and reciprocal relationships between physical function and cognition were examined using the parallel process latent growth model and autoregressive cross-lagged (ARCL) models.ResultsCognition and physical function decreased by an average of 0.096 and 0.017 points per year, respectively. Higher physical function was associated with better cognition at baseline (r = 0.237, p < 0.05), and longitudinal changes in physical function and cognition were positively correlated (r = 0.756, p < 0.05). ARCL analysis indicated that physical function at T1 positively predicted T2 cognitive function. However, this predictive relationship reversed between T2 and T3, whereby cognitive function at T2 predicted physical function at T3.ConclusionBoth physical function and cognition declined over time. Early identification and intervention in physical dysfunction among older adults could be critical to prevent further cognitive impairment and maintain functional independence. Hence, regular functional assessment and individualized care plans are required to achieve healthy aging.
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Yangming H, Rengui G, Long Z. Neighborhood health effects on the physical health of the elderly: Evidence from the CHRLS 2018. SSM Popul Health 2022; 20:101265. [PMID: 36281247 PMCID: PMC9587335 DOI: 10.1016/j.ssmph.2022.101265] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/24/2022] [Accepted: 10/10/2022] [Indexed: 11/13/2022] Open
Abstract
Background There are more than 26 million elderly people in China, and due to the Health China strategy proposed in 2020, “Elderly Health” has become an important topic of concern for all sectors of society. Neighborhoods provide important social relationships. However, Chinese researchers have not extensively explored the impact of these relationships on the physical health of the elderly. Methods Based on the data from the 2018 China Health and Retirement Longitudinal Study (CHARLS), we constructed a comprehensive research framework integrating ordinary least square (OLS) regression, heterogeneity analysis, IV-2SLS, robustness testing, and Karlson–Holm–Breen (KHB) mediating effect analysis, which can be used to thoroughly examine neighborhood health effects (NHEs) in relation to the physical health of the elderly. Results The OLS results showed that the NHEs (B = 0.4689, p < 0.01) had a positive influence on the physical health of the elderly, and were lower than the NHEs estimated by IV-2SLS (B = 0.5018, p < 0.01). The mediating effects of social networks and social relationships were analyzed using KHB, and both the total (B = 0.6056, p < 0.01) and indirect (B = 0.0800, p < 0.01) effects on neighborhood health were significant, with the total effect being 10 times larger than the direct effect and 13.24% of the total effect coming from the mediating variable. Conclusions Firstly, the NHEs positively influence the physical health of elderly persons, but there are heterogeneous differences. Secondly, the IV-2SLS estimation results suggest that not controlling for endogeneity leads to underestimation of the role of the NHEs. Thirdly, using the county-level NHEs, self-rated health, and health changes to replace variables, and grouping by smokers (small sample) and never smoked (large sample), the influence of the NHEs on the physical health of the elderly is robust. Finally, social networks and social relationships are important transmission mechanisms of the NHEs when it comes to the physical health of the elderly. NHEs are robust and significant in the Chinese social background. Community (county) level NHEs are positive for the positive health of the elderly. NHEs have a positive impact on self-rated health and health changes in older adults. Endogenous issues would underestimate the role of NHEs. •Social networks and social relationships are transmission mechanisms of the NHEs.
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Luo D, Yu S, Wang J, Zhu Y, Yang L, Bai R, Rao Q, Zhang Q, Wu D, Wang F, Zhao Q, Xiao M. Social participation of community-dwelling older adults in western China: A latent profile analysis. Front Public Health 2022; 10:874204. [PMID: 36081484 PMCID: PMC9446436 DOI: 10.3389/fpubh.2022.874204] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 07/06/2022] [Indexed: 01/21/2023] Open
Abstract
Objective Social participation has become a policy framework to address population aging. However, little is known about the social participation of older adults in western China, and extensive, multicenter, regional research is lacking. This research investigated the profiles of social participation of older adults in western China and explored the characteristics and factors influencing social participation. Method This cross-sectional study was conducted in 3 provinces (Chongqing, Sichuan, and Inner Mongolia) in western China from March 2021 to December 2021 and included 3,456 participants aged 60 years or older. Social participation was assessed using the Chinese version of the Impact on Participation and Autonomy Questionnaire (IPA). Latent profile analysis (LPA) was performed to extract latent classes of social participation among older adults in western China. The chi-square test and multinomial regression analyses were used to identify differences between these classes. Results Three social participation classes were identified by LPA: high social participation (25.2%), moderate social participation (55.1%), and low social participation (19.7%). Being older, having a primary school education level, having mobility or speaking impairment, using assistive devices, and having a chronic disease were highly associated with the low social participation class (P < 0.05). Furthermore, older adults with no dependence (OR = 0.018, 95% CI = 0.005-0.062) or mild dependence (OR = 0.039, 95% CI = 0.011-0.139) in activities of daily living (ADLs) were less likely to be in the low social participation class. Older adults who were cared for by non-spouse primary caregivers were more likely to be assigned to the moderate social participation group (OR = 2.097, 95% CI = 1.501-2.930) than to the high social participation group. Conclusions Most older adults in western China have a moderate level of social participation. Advanced age, reduced ADL ability, reduced speech ability, reduced mobility, and non-spouse care are related to the level of social participation. Healthcare professionals should pay attention to the predictors for different classes, identifying high-risk groups as early as possible.
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Affiliation(s)
- Di Luo
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shiqi Yu
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jun Wang
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ying Zhu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lining Yang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ruonan Bai
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qianyi Rao
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qiang Zhang
- Service Center of Rehabilitation Assistive Technology of Sichuan Province, Sichuan, China
| | - Di Wu
- Inner Mongolia Autonomous Region Rehabilitation Assistive Device Center, Inner Mongolia, China
| | - Feng Wang
- Panzhihua Wuyue Technology Co., Ltd, Pan Zhihua, China
| | - Qinghua Zhao
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mingzhao Xiao
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China,*Correspondence: Mingzhao Xiao
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22
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Li C, Han Q, Hu J, Han Z, Yang H. Impact of intergenerational support and medical expenditures on depression: Evidence from rural older adults in China. Front Public Health 2022; 10:840864. [PMID: 35937247 PMCID: PMC9354659 DOI: 10.3389/fpubh.2022.840864] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Globally, depression has become a major health issue among older adults, who experience poor physical health and high medical expenditures. In Asian countries, older adults are greatly dependent on their children. This study assessed the impact of different types of intergenerational support and medical expenditures on depression among older adults in rural China. Method A three-phase balanced panel was constructed based on data from 1,838 rural older adults with comparable scores on the Center for Epidemiologic Studies Depression Scale (CES-D) from the China Family Panel Studies in 2012, 2016, and 2018. A fixed-effects model was used to analyze the impact of intergenerational support and medical expenditures on CES-D score and of intergenerational support on medical expenditures. The propensity score-matching model was used to test the regression results' robustness. Results The findings were as follows. First, different types of intergenerational support had a heterogeneous impact on depression among rural older adults. Emotional support had a significantly negative impact on CES-D score, although too much care-based support had a positive impact on CES-D score. Low-level economic support had no significant effect on CES-D score. Second, medical expenditures impacted depression; among these, non-inpatient medical expenditure had a significant and positive impact on CES-D score. Third, CES-D scores among rural older adults were associated with chronic diseases and per capita family income. Fourth, care-based support was associated with reduced non-inpatient medical expenditures, and the sub-sample regression results indicated that the impact was significant for older adults with no chronic diseases and those younger than 75 years. Conclusion Intergenerational emotional support and non-inpatient medical expenditures directly affected rural older adults' CES-D scores. The mediating role of medical expenditures between intergenerational support and CES-D score was not significant. Measures should be taken to encourage intergenerational emotional support and reduce the pressure on children's economic and care-based support. Further, the medical insurance reimbursement policy, as formal support, should be improved to alleviate depression among rural older adults when children's support is limited.
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Affiliation(s)
- Congrong Li
- School of Public Administration, Xi'an University of Architecture and Technology, Xi'an, China
- *Correspondence: Congrong Li
| | - Qing Han
- School of Public Administration, Xi'an University of Architecture and Technology, Xi'an, China
| | - Jinrong Hu
- School of Public Administration, Xi'an University of Architecture and Technology, Xi'an, China
| | - Zeyu Han
- School of Public Administration, Xi'an University of Architecture and Technology, Xi'an, China
| | - Hongjuan Yang
- Institute of Sociology, Shaanxi Academy of Social Sciences, Xi'an, China
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Zagic D, Wuthrich VM, Rapee RM, Wolters N. Interventions to improve social connections: a systematic review and meta-analysis. Soc Psychiatry Psychiatr Epidemiol 2022; 57:885-906. [PMID: 34796368 DOI: 10.1007/s00127-021-02191-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 10/31/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE The importance of both frequent and high-quality social connections is widely recognised. Previous reviews of interventions for promoting social connections found mixed results due to the inclusion of uncontrolled studies and merging of objective and subjective dimensions of social connections. This study aimed to compare the effectiveness of interventions designed to promote 'objective social contact' and the 'quality of social connections'; and compare the effectiveness of interventions from different theoretical orientations on these social dimensions through a systematic review and meta-analysis of controlled trials. METHODS A systematic search of electronic databases Medline, Embase, PsycINFO and PubMed was conducted to identify randomised controlled trials of interventions for social isolation, loneliness, social participation and/or social connectedness in adults. Data were analysed using Stata V.16.0. RESULTS Fifty-eight studies met inclusion criteria (mean age = 62 years). Overall, interventions led to significant improvements in objective social contact (Hedges' g = 0.43) and perceived quality of social connections (Hedges' g = - 0.33). Increasing access to other people was the most effective strategy for promoting objective social contact (Hedges' g = 0.67). Providing adults with skills to manage maladaptive attributional biases, fear-related avoidance of social situations, and barriers to social contact, was the most effective strategy for addressing deficits in perceived quality of social connections (Hedges' g = - 0.53). CONCLUSION In summary, different interventions had differential effects on the frequency and quality of social relationships and associated emotional distress. Psychological interventions hold the most promise for increasing meaningful social connections and reducing distress.
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Affiliation(s)
- Dino Zagic
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia. .,Department of Psychology, Centre for Ageing, Cognition and Wellbeing, Macquarie University, Sydney, Australia.
| | - Viviana M Wuthrich
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia.,Department of Psychology, Centre for Ageing, Cognition and Wellbeing, Macquarie University, Sydney, Australia
| | - Ronald M Rapee
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia
| | - Nine Wolters
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia.,Faculty of Psychology, University of Amsterdam, Amsterdam, The Netherlands
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Piao X, Managi S. Long-term improvement of psychological well-being in the workplace: What and how. Soc Sci Med 2022; 298:114851. [PMID: 35272248 DOI: 10.1016/j.socscimed.2022.114851] [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] [Received: 03/11/2021] [Revised: 02/05/2022] [Accepted: 02/21/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The World Health Organization states that by 2030, mental illness will become the leading global disease burden. Thus, investigations of job stress might require more heterogeneous and innovative solutions. Existing literature demonstrates that good workplace environments have favorable effects on employees' psychological well-being. However, studies on long-term effects are scarce. This study examined the long-term impact of comprehensive workplace characteristics and employee responses to stress (coping strategies) on job stress in Japan. METHODS Under a large-scale 3-year longitudinal study, 1,021,178 observations collected from employees in 390 companies from 2017 to 2019 were used. Employee job stress trends were confirmed based on company-fixed-effects linear regression. The relationship between one-year or two-year lagged comprehensive workplace characteristics or coping strategies, and employee job stress was estimated using linear regression. Favorable effects of the work environment and coping strategy improvement were illustrated based on the regression results simulation. RESULTS First, job stress appeared to be steadily worsening among the employees of Japanese companies from 2017 to 2019. Second, low job and psychological demand, high job control, a high level of support from the people around, balanced effort-reward, strong job security, and strong interpersonal relationship have favorable long-term effects on employee job stress. Third, employees' coping strategies, such as positive thinking, changing mood, requiring help from other people, reduced negative thinking, and avoiding inappropriate emotional divergence have long-term effects on mitigating job stress. Particularly, thinking positively, changing mood, and avoiding directing feelings of anger and frustration toward others reduce high stress in 46% of respondent employees. CONCLUSIONS A comprehensive well-organized workplace environment and appropriate responses to stress have a long-term favorable effect on employee job stress. These results provide policy measures for improving the workplace environment and for employees to adopt coping strategies to enhance their psychological well-being in the long term.
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Affiliation(s)
- Xiangdan Piao
- Faculty of Humanities and Social Science, Iwate University, 3-18-34 Ueda, Morioka, Iwate, 020-8550, Japan; Urban Institute, Kyushu University, 744 Motooka Nishi-ku, Fukuoka, 819-0395, Japan.
| | - Shunsuke Managi
- Urban Institute & Department of Civil Engineering, School of Engineering, Kyushu University, 744 Motooka Nishi-ku, Fukuoka, 819-0395, Japan.
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Piao X, Xie J, Managi S. Environmental, social, and corporate governance activities with employee psychological well-being improvement. BMC Public Health 2022; 22:22. [PMID: 34991539 PMCID: PMC8740338 DOI: 10.1186/s12889-021-12350-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 11/29/2021] [Indexed: 11/23/2022] Open
Abstract
Background Environmental, social, and governance (ESG) engagement is expected to benefit corporations in terms of their efficiency and sustainability. The transformative change in management practices would not only provide support for employees but also bring about additional workload, which may affect employee psychological well-being. However, the examination of the relationship between corporate ESG activities and occupational stress is scarce; hence, this study aims to fill this knowledge gap. Methods In total, 110,351 observations were collected from 41,998 employees regarding occupational stress to reflect employee psychological well-being. The data were derived from 11 corporations in Japan from 2017 to 2019. Data on ESG activities were collected from the MSCI ESG database from 2015 to 2017. The effect of 1-year lagged corporate ESG activities on employee psychological well-being was investigated using a lagged variable linear regression model. Results Positive and negative relationships were found between corporate environmental activities and occupational stress. Activities that reduce water stress during operation and adopt clean technology were found to benefit employees’ psychological well-being. On the contrary, the program for reducing toxic emissions and waste lowered employees’ occupational stress levels significantly. Regarding corporate social activities, the improvement of job satisfaction or work-life balance was associated with occupational stress. However, corporate governance activities were found to have unfavorable effects on employees’ psychological well-being. Conclusion The effects of corporate ESG activities on employees’ psychological well-being are found. The managerial implications suggest that caring for employees’ occupational stress during the implementation of environmental activities is necessary, and the adoption of social activities could enhance employees’ psychological well-being. Notably, corporate governance activities are a stressor for employees; top management teams should pay attention to it.
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Affiliation(s)
- Xiangdan Piao
- Urban Institute & Faculty of Humanities and Social Science, Iwate University, 3-18-34 Ueda, Morioka, Iwate, 020-8550, Japan.
| | - Jun Xie
- Urban Institute & Department of Civil Engineering, Kyushu University, 744 Motooka Nishi-ku, Fukuoka, 819-0395, Japan
| | - Shunsuke Managi
- Urban Institute & Department of Civil Engineering, Kyushu University, 744 Motooka Nishi-ku, Fukuoka, 819-0395, Japan
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An R, Li S, Li Q, Luo Y, Wu Z, Liu M, Chen W. Oral Health Behaviors and Oral Health-Related Quality of Life Among Dental Patients in China: A Cross-Sectional Study. Patient Prefer Adherence 2022; 16:3045-3058. [PMID: 36387048 PMCID: PMC9651070 DOI: 10.2147/ppa.s385386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 10/21/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND AND PURPOSE Oral health plays an important role in overall health. But little is known about the problems with oral health behaviors and oral health-related quality of life (OHRQoL) among dental patients in China. This study aimed to investigate oral health behaviors and OHRQoL, as well as to examine the effects of oral health behaviors and associated factors on OHRQoL among dental patients. METHODS This cross-sectional study was conducted from June 2022 to July 2022 in the Department of Stomatology of the First Mobile General Hospital of Armed Police, Hebei, China. The five-item short form of the Oral Health Impact Profile (OHIP-5) was used to evaluate OHRQoL. Oral health behaviors were assessed by a 16-items oral health behavior questionnaire, and socio-demographic data were collected by a socio-demographic questionnaire. The t-test, one-way ANOVA, and multiple linear regression analysis were used to investigate the associations between the study variables. RESULTS 186 participants were included in the study. The average age of the participants was 24.62 years (SD = 10.67). The mean OHIP-5 score was 4.31 (SD =3.35). Oral health-related quality of life differed significantly by smoking history, history of alcohol consumption, work status, economic pressure, self-rated oral health status, daily brushing frequency, dental caries condition, and whether they take the initiative to learn about oral health. Multivariate analysis found that the self-rated oral health status and work status were significantly associated with the OHIP scores. The retired people and those with poor self-rated oral health displayed poor OHRQoL. CONCLUSION In general, dental patients' oral health needs to be improved, the majority of patients reported practicing poor oral health behaviors, among which the retired population and hose with poor self-rated oral health showed poor OHRQoL. OHRQoL in dental patients is a complex issue associated with social and behavioral factors.
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Affiliation(s)
- Ran An
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital Central South University
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Siyu Li
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People’s Republic of China
| | - Qianqian Li
- The First Mobile Corps Hospital of the Chinese People’s Armed Police Force, Baoding, Hebei Province, People’s Republic of China
| | - Yuan Luo
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Zitong Wu
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital Central South University
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Meizi Liu
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Wenfeng Chen
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital Central South University
- Correspondence: Wenfeng Chen, Teaching and Research Section of Clinical Nursing, Xiangya Hospital Central South University, No. 87 Xiangya Road, Kaifu District, 410008, Email
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Goto R, Ozone S, Kawada S, Yokoya S. Gender-Related Differences in Social Participation Among Japanese Elderly Individuals During the COVID-19 Pandemic: A Cross-Sectional Survey. J Prim Care Community Health 2022; 13:21501319221111113. [PMID: 35818674 PMCID: PMC9280796 DOI: 10.1177/21501319221111113] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introduction/Objectives: The health of elderly individuals is known to benefit from maintaining societal involvement and relationships with other people, such as through social participation. We aimed to determine trends in the percentage of Japanese elderly people who engaged in social participation before and during the coronavirus disease 2019 (COVID-19) pandemic in one municipality in Japan, and compared differences in this status by gender. Methods: We conducted a cross-sectional questionnaire survey. Questionnaires were sent by mail to 3000 people aged 65 to 85 years who were randomly selected by the administrative staff of the city. Participant characteristics (age, gender, working status, residential status) and their economic status, daily physical activity, and social participation status were obtained at 3 time points: (1) before the COVID-19 pandemic in January 2020; (2) immediately prior to the declaration of a state of emergency in April 2020; and (3) in January 2021, 1 year after (1). Results: A total of 1301 people responded to the survey. The mean age was 73.3 (SD 5.5) years, and 690 (53.0%) were women. There were significant gender differences in terms of living alone, employment status, and amount of physical activity. The number of people reporting social participation gradually decreased from 543 respondents (41.7%) at (1) to 319 (24.5%) at (2) and 251 (19.3%) at (3). Women were more likely to demonstrate reduced social participation. Conclusions: Elderly individuals, particularly women, reported decreased social participation during the pandemic.
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Affiliation(s)
- Ryohei Goto
- Family Medicine, General Practice and Community Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Sachiko Ozone
- Family Medicine, General Practice and Community Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Shogo Kawada
- Family Medicine, General Practice and Community Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Shoji Yokoya
- Family Medicine, General Practice and Community Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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Shimatani K, Komada MT, Sato J. Impact of the Changes in the Frequency of Social Participation on All-Cause Mortality in Japanese Older Adults: A Nationwide Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:270. [PMID: 35010529 PMCID: PMC8751209 DOI: 10.3390/ijerph19010270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 12/18/2021] [Accepted: 12/24/2021] [Indexed: 06/14/2023]
Abstract
Previous studies have shown that more frequent social participation was associated with a reduced risk of mortality. However, limited studies have explored the changes in the frequency of social participation in older adults. We investigated the impact of the changes in the frequency of social participation on all-cause mortality in Japanese older adults aged 60 years and older. The current study, conducted as a secondary analysis, was a retrospective cohort study using open available data. The participants were 2240 older adults (45.4% male and 54.6% female) sampled nationwide from Japan who responded to the interview survey. Changes in the frequency of social participation were categorized into four groups (none, initiated, decreased, and continued pattern) based on the responses in the baseline and last surveys. The Cox proportional-hazards model showed a decreased risk of all-cause mortality in decreased and continued patterns of social participation. Stratified analysis by sex showed a decreased risk of mortality in the continued pattern only among males. The results of the current study suggest that the initiation of social participation at an earlier phase of life transition, such as retirement, may be beneficial for individuals.
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Effect of social participation on the development of physical frailty: Do type, frequency and diversity matter? Maturitas 2021; 151:48-54. [PMID: 34446279 DOI: 10.1016/j.maturitas.2021.06.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 05/13/2021] [Accepted: 06/28/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Little is known about the longitudinal association between social participation and incident frailty in community-dwelling older adults in general and particularly in China. This study examined the impact of type, frequency and diversity of social participation on incident physical frailty at two-year follow-up. METHOD Longitudinal data from three waves of the China Health and Retirement Longitudinal Study were used. Older adults who were non-frail and aged 60 years or more at baseline and had information on physical frailty at follow-up were included. Frailty was measured using the modified frailty phenotype criteria. Social participation was measured as the type, frequency and diversity of engagement in social activities, including interacting with friends, playing group games, participating in sports clubs, community-related organizations, and voluntary activities. RESULTS A total of 6959 eligible respondents were included. Playing group games (OR=0.73, 95%CI=0.55-0.96) or participating in the activities of sports clubs (OR=0.54, 95%CI=0.34-0.85) once or more times per week led to a decreased risk of developing frailty in two years whereas participating in voluntary activities occasionally (OR=0.50, 95%CI=0.30-0.84) had a protective effect on the development of frailty. More diverse social participation was significantly associated with lower risk of incident frailty at two-year follow-up. CONCLUSIONS The association between social participation and onset of physical frailty differed by the specific type and frequency of the activities that older adults engaged in. Promoting social participation of various types and at an appropriate frequency may be a promising way to mitigate the burden associated with physical frailty among older adults.
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Tavares DMDS, Oliveira NGN, Marmo FAD, Meneguci J. Using structural equation modeling in the understanding of functional disability in older adults. Rev Lat Am Enfermagem 2021; 29:e3451. [PMID: 34190942 PMCID: PMC8253352 DOI: 10.1590/1518-8345.4555.3451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 11/12/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to analyze functional disability and its associated factors among community-dwelling older adults. METHOD a cross-sectional study, conducted with 1,635 older adults distributed in the following age groups: 60 to 69, 70 to 79, and 80 years old or more, living in a health macro-region of the state of Minas Gerais. Descriptive and trajectory analysis was carried out (p<0.05). The parameters were estimated by the Maximum Likelihood method. RESULTS the highest percentage was female, with a monthly income of 1 minimum wage and living with a companion. In the age groups from 60 to 69 and from 70 to 79 years old, older adults with a partner predominated; and, among those aged 80 years old or more, widowed individuals prevailed. In the three groups, functional disability occurred hierarchically. Lower schooling, frailty and depressive symptomatology were factors directly associated with functional disability in the advanced activities; frailty and sedentary behavior were directly associated with functional disability in the instrumental activities. In the older adults aged between 60 and 69 years old and from 70 to 79 years old, sedentary behavior was associated with greater dependence on the basic activities. CONCLUSION the expanded understanding of the factors in the functional disability of the older adults, according to age group, helps the health professional in the development of preventive measures for this disease.
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Affiliation(s)
| | | | - Flavia Aparecida Dias Marmo
- Universidade Federal do Triângulo Mineiro, Departamento de
Enfermagem em Educação e Saúde Comunitária, Uberaba, MG, Brazil
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Zimmer C, McDonough MH, Hewson J, Toohey A, Din C, Crocker PRE, Bennett EV. Experiences With Social Participation in Group Physical Activity Programs for Older Adults. JOURNAL OF SPORT & EXERCISE PSYCHOLOGY 2021; 43:335-344. [PMID: 34167084 DOI: 10.1123/jsep.2020-0335] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 02/23/2021] [Accepted: 04/06/2021] [Indexed: 06/13/2023]
Abstract
Little is known about how social participation can be facilitated among older adults in group physical activity and its psychosocial benefits that contribute to successful aging. This study aimed to understand older adults' experiences with social participation in group physical activity programs. Using interpretive description methodology, 16 observations, eight focus groups, and two interviews with participants unable to attend focus groups were conducted with adults 55 years and older attending programs across four recreation facilities. Group programs were found to influence social participation through (a) a meaningful context for connecting and (b) instructors' expectations of social interaction. Social participation in these programs addressed psychosocial needs by (c) increasing social contact and interaction, (d) fostering social relationships and belonging, and (e) promoting regular engagement. Training for instructors should include balancing the physical aspects of program delivery with the social, while also considering older adults' diverse needs and preferences for social interaction.
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彭 顺, 付 茜, 冯 星. [Association between education and the onset of disability in activities of daily living in middle-aged and older Chinese adults: The mediator role of social participation]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2021; 53:549-554. [PMID: 34145859 PMCID: PMC8220058 DOI: 10.19723/j.issn.1671-167x.2021.03.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To investigate the association between educational attainment and the onset of disability in activities of daily living (ADL), and to explore the mediating effect of social participation on such association. METHODS A longitudinal dataset was drawn from the China Health and Retirement Longitudinal Study (CHARLS, 2015 to 2018). The measurements of educational attainment, social participation and other covariates were identified from 2015, while the outcome measurement of ADL disability was constructed with data from survey 2018. Descriptive analyses were conducted, and basic characteristics and social engagement of the respondents were compared between illiterates and non-illite-rates using Chi-square test. Logistic regression was used to investigate the associations of educational attainment and social participation on the onset of ADL disability. Mediation analysis was employed to examine the mediator role of the social participation on the linkage from being illiterate to the ADL disability onset. RESULTS A total of 11 359 adults aged 45 years and above were included in the sample, of whom 3 222 were illiterates. The incidence of the onset of ADL disability of illiterates and non-illiterates were 10.4% and 6.2%, respectively. Among these respondents, only half of them were involved in social activities. Of all the 8 social activities, the percentage of interacting with friends (34. 1%) was the highest, and the lowest percentage was observed in participating in an educational or training course (0.6%). Moreover, the percentages of participation in all these 8 social activities among illiterates were significantly lower than that of their educated counterparts (all P < 0.001). The illiterate middle-aged and older adults were less likely to develop ADL disability in the follow-up period [adjusted odds ratio (aOR)=1.22, 95%CI: 1.02-1.45], and social participation was significantly associated with ADL disability onset (aOR=0.73, 95%CI: 0.63-0.85). Findings from mediation analysis illustrated that social participation accounted for 12.22% of the adverse effect of being illiterate on ADL disability onset. CONCLUSION Social participation could buffer the negative effect of being illiterate on ADL disability onset in middle-aged and older adults, suggesting that engagement in social activities might have impact on prevention of impairments in physical function, especially for middle-aged and older illiterates.
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Affiliation(s)
- 顺壮 彭
- />北京大学公共卫生学院卫生政策与管理系,北京 100191Department of Health Policy and Management, Peking University School of Public Health, Beijing 100191, China
| | - 茜茜 付
- />北京大学公共卫生学院卫生政策与管理系,北京 100191Department of Health Policy and Management, Peking University School of Public Health, Beijing 100191, China
| | - 星淋 冯
- />北京大学公共卫生学院卫生政策与管理系,北京 100191Department of Health Policy and Management, Peking University School of Public Health, Beijing 100191, China
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Tang S, Xu Y, Li Z, Yang T, Qian D. Does Economic Support Have an Impact on the Health Status of Elderly Patients With Chronic Diseases in China? - Based on CHARLS (2018) Data Research. Front Public Health 2021; 9:658830. [PMID: 33959585 PMCID: PMC8095396 DOI: 10.3389/fpubh.2021.658830] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 03/15/2021] [Indexed: 12/07/2022] Open
Abstract
Objective: The economic support of elderly patients with chronic diseases may affect their health status. This study assessed the impact of economic support on the health status of elderly patients with chronic diseases in China and explored the relationship between regional economic differences and the impact of economic support on health status. Methods: This study used the data of 3,416 elderly patients with chronic diseases from the China Health and Retirement Longitudinal Study (CHARLS) in 2018. Logit model and stepwise regression method were used to analyze and compare the influence of economic support on self-rated health, mental health, and activities of daily living (ADL) of elderly patients with chronic diseases. Sub-regional comparison was used for the research of regional differences in the impact of economic support on health. Results: we find that economic support has a positive effect on the health status of elderly patients with chronic diseases in China. Socioeconomic support has a positive effect on self-rated health and mental health of elderly patients with chronic diseases, and the effect on activities of daily living (ADL) is no longer significant after the gradual inclusion of control variables. Family economic support has no significant impact on the health dimensions of elderly patients with chronic diseases. With respect to regional differences, socioeconomic support can improve mental health in central China and improve self-rated health in western China, while it can improve overall health status in eastern China. The influence of family economic support on different health dimensions in different regions is still insignificant. Conclusions: The health status of elderly patients with chronic diseases is affected by socioeconomic support in China. In order to improve the health of elderly patients with chronic diseases, it is necessary to increase socioeconomic support. Meanwhile, it is also essential to pay attention to the differences in economic support between different regions and increase the socioeconomic support for elderly patients with chronic diseases in undeveloped regions so as to improve their health status.
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Affiliation(s)
- Shaoliang Tang
- School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yun Xu
- School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhengjun Li
- School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, China
| | - Tongling Yang
- School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, China
| | - David Qian
- Swinburne Business School, Swinburne University of Technology, Melbourne, VIC, Australia
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Yang L, Wang L, Dai X. Rural-urban and gender differences in the association between community care services and elderly individuals' mental health: a case from Shaanxi Province, China. BMC Health Serv Res 2021; 21:106. [PMID: 33516212 PMCID: PMC7847576 DOI: 10.1186/s12913-021-06113-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 01/24/2021] [Indexed: 11/21/2022] Open
Abstract
Background While community care services have been developing rapidly as a new way to meet the growing demands of elderly individuals in China, their health benefits are virtually unknown. Thus, the aim of this study was to examine the Chinese elderly individuals’ utilisation of community care services and its association with the mental health with comparing rural-urban and gender differences. Methods For this 2019 cross-sectional study, 687 elderly people from 7 counties (districts) of China’s Shaanxi province were enrolled. Respondents’ mental health level was assessed using a self-reported mental health measure. Four categories of community care services utilisation were examined: daily care services, medical care services, social and recreational services and spiritual comfort services. The binary logistic regression model was used in examining the association between community care services utilisation and mental health. Results Our results showed that there was a noted difference in mental health level between the male and female groups. Utilisation of medical care services and social and recreational services was significantly higher in the rural group than that in the urban group. Regression analysis showed that utilisation of daily care services (β = 0.809, p = 0.008) and social and recreational service (β = 0.526, p = 0.035) was significantly and positively associated with elderly individuals’ mental health level. Specifically, daily care services utilisation predicted a better mental health of the rural elderly (β = 1.051, p = 0.036) and the male elderly (β = 1.133, p = 0.053), while social and recreational services utilisation predicted a better mental health of the urban elderly (β = 0.927, p = 0.008) and the female elderly (β = 0.864, p = 0.007). Conclusions Our findings indicated varied levels of community care services utilisation and mental health are common among the elderly people in China. Community care services utilisation has a positive, albeit selective, association with elderly individuals’ mental health. Further policies should strengthen the equitable development of high-quality community care services in urban and rural areas to improve the mental health of elderly individuals, and focus more on gender differences in terms of community care services needs. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06113-z.
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Affiliation(s)
- Liu Yang
- School of Public Policy and Administration, Xi'an Jiaotong University, No 28 Xianning West Road, Xi'an, 710049, Shaanxi, China
| | - Lijian Wang
- School of Public Policy and Administration, Xi'an Jiaotong University, No 28 Xianning West Road, Xi'an, 710049, Shaanxi, China.
| | - Xiuliang Dai
- School of Public Policy and Administration, Xi'an Jiaotong University, No 28 Xianning West Road, Xi'an, 710049, Shaanxi, China
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Wang Y, Zhang R, Peng S. Cognitive Differences and Influencing Factors of Chinese People's Old-Age Care Responsibility against the Ageing Background. Healthcare (Basel) 2021; 9:72. [PMID: 33466631 PMCID: PMC7828671 DOI: 10.3390/healthcare9010072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 11/16/2022] Open
Abstract
With the rapid increase in the ageing population (60+) in China since 1999, the problem of supporting the aged is facing increasingly severe challenges. Based on the 2072 valid samples from the Chinese General Social Survey (CGSS) of 2017, a non-sequential multinomial logistic regression model was established to analyse the changing trends and micro-influencing factors of Chinese people's cognition of old-age care responsibility (COACR). The result shows that offspring responsibility still is a common COACR, but this concept has been gradually weakened and been replaced by the responsibility of the government and the aged. Individual characteristics and relationships with relatives in the models all significantly affect people's COACR. It is obviously unrealistic for China to completely rely on government and society to provide for the aged. The traditional ethical role of inter-generational responsibility in providing for the aged should be brought into play. Reshaping the inter-generational responsibility ethics of old-age care requires the joint efforts of government, society, families, individuals and other responsible subjects to construct a diversified old-age care service system.
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Affiliation(s)
- Yan Wang
- School of Public Administration, Hohai University, Nanjing 211100, China; (Y.W.); (S.P.)
| | - Ruilian Zhang
- Sustainable Minerals Institute, The University of Queensland, Brisbane 4072, Australia
| | - Shengping Peng
- School of Public Administration, Hohai University, Nanjing 211100, China; (Y.W.); (S.P.)
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Ma X, Oshio T. The impact of social insurance on health among middle-aged and older adults in rural China: a longitudinal study using a three-wave nationwide survey. BMC Public Health 2020; 20:1842. [PMID: 33261609 PMCID: PMC7709307 DOI: 10.1186/s12889-020-09945-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 11/19/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Many studies have examined the impact of social insurance on health, but the results have generally been mixed, presumably because they have not fully addressed potential biases related to the study's cross-sectional design. In this study, we conducted a longitudinal analysis to investigate how participation in two social insurance programs in China-the New Rural Social Pension Insurance (NRSPI) and the New Rural Cooperative Medical Scheme (NRCMS)-was associated with health outcomes among middle-aged and older adults in rural China. METHODS Using three-wave longitudinal data from the China Health and Retirement Longitudinal Study conducted in 2011, 2013, and 2015, we estimated the dynamic fixed-effects regression models to examine the association between participation in the NRCMS/NRSPI and six types of health outcomes. RESULTS Participation in the NRSPI was positively associated with some health outcomes, but the associations were relatively modest and were observed only for some specific age and household income groups. Participation in NRCMS was not associated with any health outcomes. CONCLUSIONS The results provide limited evidence of the positive impact of social insurance on health among middle-aged and older adults in rural China. Thus, social insurance programs should be reformed to enhance their positive impact on health.
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Affiliation(s)
- Xinxin Ma
- Faculty of Social Sciences, University of Toyama, 3190 Gofuku, Toyama, 930-8555 Japan
| | - Takashi Oshio
- Institute of Economic Research, Hitotsubashi University, 2-1 Naka, Kunitachi-shi, Tokyo, 186-8603 Japan
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Feng Z, Cramm JM, Jin C, Twisk J, Nieboer AP. The longitudinal relationship between income and social participation among Chinese older people. SSM Popul Health 2020; 11:100636. [PMID: 32802932 PMCID: PMC7419328 DOI: 10.1016/j.ssmph.2020.100636] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/23/2020] [Accepted: 07/25/2020] [Indexed: 12/20/2022] Open
Abstract
The vital role of active social participation in older people's lives is widely acknowledged. The maintenance of adequate levels of social participation is an essential element of successful aging. Low income may inhibit older people from engaging in social activities. Given its recent rapid economic growth, China provides a unique setting for the study of changes in income and social participation among older people over time. In this study, the longitudinal relationship between income and social participation among Chinese older people was investigated using a nationally representative dataset from three waves of the China Health and Retirement Longitudinal Study (CHARLS). At baseline, a total of 3863 participants with a mean age of 60.4 years (range: 50-89) were included in our study; 49.9% of the participants were female, and 64.4% lived in rural areas. Generalized estimating equations were used to analyze the longitudinal relationship between income and social participation, with and without adjustment for background variables (age, gender, marital status, educational level, empty-nest status, area of residence, and multimorbidity). The results of unadjusted and adjusted analyses clearly showed a longitudinal association between income and social participation. People from the highest income group were almost two times more likely to participate in social activities than were those from the lowest income group. People with a higher educational level are also more likely to participate in social activities compared to people with a lower educational level. Being married and living with children decreased the odds of social participation. Social participation is also less likely among older aged and those living in rural areas. Our findings indicate that higher income levels are associated positively with social participation over time among older people in China.
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Affiliation(s)
- Zeyun Feng
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, P.O. Box 1738, 3000, DR. Rotterdam, the Netherlands
- Department of Health Technology Assessment, Shanghai Health Development Research Center (Shanghai Medical Information Center), Jianguo Road 602, Shanghai, 200031, China
| | - Jane Murray Cramm
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, P.O. Box 1738, 3000, DR. Rotterdam, the Netherlands
| | - Chunlin Jin
- Shanghai Health Development Research Center (Shanghai Medical Information Center), Jianguo Road 602, Shanghai, 200031, China
| | - Jos Twisk
- Department of Epidemiology and Data Science, Amsterdam UMC, Amsterdam, the Netherlands
| | - Anna Petra Nieboer
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, P.O. Box 1738, 3000, DR. Rotterdam, the Netherlands
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