Ability, disability, and the oldest old

Oldest old's travel mode choice and new mobility technology acceptance: case in America and China

Introduction

The oldest olds (aged 85 and over) are the fastest-growing age segment. However, our understanding of their mobility is limited. To address this gap, we invited 19 U.S. and 30 Chinese "oldest old" to take part in focus groups and complete a mobility questionnaire. We focus on travel mode choice, which includes changes in travel modes, frequency of usage, and perceptions of comfort.

Methods

Older adults' familiarity and acceptance of new mobility technologies (e.g., ridesharing, carsharing, and autonomous vehicles) were measured by questionnaire and focus group. Word clouds were also used to illustrate people's reasons for choosing their primary mode of transportation.

Results and discussion

The results show that both panels of older adults similarly feel some extent of travel limitations. But the responses among the two groups differ: 18 American participants chose "drive myself" as their primary option a decade ago, while 11 chose it now; no Chinese participants selected it either a decade ago or now. Both currently and 10 years ago, there was a significant difference in mode choice between participants in China and the United States. However, this gap has narrowed over the past decade. Participants in China have significantly changed their transportation preferences compared to 10 years ago, while participants in the US have remained nearly unchanged. American respondents consider "ease" as an important factor, while Chinese respondents pay more attention to "safety" and "no other option to get around" when making travel mode choices. Compared to Chinese participants, American participants were more comfortable with driving an autonomous vehicle. These differences may result from the various developmental stages and transportation policies of the two countries. This study supports the development of new mobility technologies for the oldest old to improve their quality of life.

The Expected Demand for Elderly Care Services and Anticipated Living Arrangements Among the Oldest Old in China Based on the Andersen Model

Objective: The first aim of this study was to explore expected demands of the oldest old and their determinants for different types of elderly care services. The second aim was to investigate preferred choices of living arrangements among the oldest old and the influencing factors.

Methods: Data of 4,738 participants aged ≥80 years were extracted from the Chinese Longitudinal Health Longevity Survey carried out in 2014. Using the Andersen model as the analysis framework, a multiple logistic regression analysis was performed to analyze the relationship between the expected elderly care services and living arrangements and other influencing factors. The odds ratios were calculated to indicate the relationship between the influencing factors and the dependent variables.

Results: From the descriptive analysis results, we found that the oldest old showed high anticipated needs for home visits (83.5%) and health education (76.4%). Further, there existed a huge imbalance between the supply and demand of care services for the aged. Living with children is still the most important way of providing for the oldest old. The regression results showed that the expected demands for elderly care services and anticipated living arrangements among the oldest old in China are influenced by age, residence, housing property rights, economic status, loneliness, and activities of daily living (ADLs). The oldest old who are older without housing property rights, childless, and have restricted ADLs were more frequently observed to live in long-term care institutions.

Conclusions: There is an inequality of the supply and expected demand for elderly care services, and living with children is still a preferred choice of the Chinese oldest old. Our findings indicate that when planning how to promote elderly care services among the oldest old, it is important to consider their expectations, especially for the subgroup that is relatively disadvantaged. Related policies should be developed to offer incentives to family caregivers when they live with the oldest old.

Health capital in everyday life of the oldest old living in their own homes

As more people experience old age as a time of growth and productivity, more research is needed that explores how they master everyday life. This paper reports on a qualitative study that explored how ten older women age 90 years or more experience and cope with the challenges of everyday life with a salutogenic perspective. The findings suggest that health resources such as positive expectation, reflection and adaptation, function and active contribution, relations and home, contribute to the health capital of women. These health resources were of importance for the women's experience of comprehensibility, manageability and meaningfulness in daily life. Health capital is a meaningful concept for understanding coping in everyday life by older people.

Reflections of men and women in advanced old age on being born the other sex

The study reported in this paper is part of the Umeå 85+ project in Sweden. The aim was to investigate gender perspectives among ‘the oldest old’, by asking men and women in advanced old age living in a sparsely populated area of northern Sweden to reflect on how life might have been if they had been born the other sex. Thematic narratives from nine men and seven women were analysed using qualitative content analysis. The content of these narratives was resolved into eight categories in two domains, respectively men's and women's reflections about being born the opposite sex. The narratives of both the men and women indicated that they were satisfied with their actual birth sex. The men were aware that if they had been born female, they would probably have experienced more hard work and had a more restricted life, and they were conscious of both women's relative powerlessness and their greater ability to manage and organise work within the home. The women's narratives described a femininity characterised by longing for a state of being unconcerned when young, and their narratives also displayed awareness of women's physical strength and that men's lives had also been hard.

Constructions of Various Femininities Among the Oldest Old Women

This study forms part of the Umeå 85+ Study, and the aim was to explore various gendered constructions of femininities among the oldest old women. Femininities are seen as various ways of shaping oneself as a woman in relation to the impact of historical, social, and cultural circumstances. Thematic narratives were analyzed using qualitative content analysis. Through interpreting these narratives in the light of gender theories, we were able to discern four femininities: "being connected," "being an actor," "living in the shadow of others," and "being alienated." The oldest old women displayed complex outlooks on femininities, and no femininity was interpreted as being in the center related to the other femininities. Further research is needed in order to disclose the complexity of femininities related to factors such as social class, ethnicity, and financial situation among the oldest old, and to acquire a greater knowledge of various femininities.

Resilience, sense of coherence, purpose in life and self-transcendence in relation to perceived physical and mental health among the oldest old

Different concepts have been presented which denote driving forces and strengths that contribute to a person's ability to meet and handle adversities, and keep or regain health. The aim of this study, which is a part of The Umeå 85+ study, was to describe resilience, sense of coherence, purpose in life and self-transcendence in relation to perceived physical and mental health in a sample of the oldest old. The study sample consisted of 125 participants 85 years of age or older, who ranked themselves on the Resilience Scale, Sense of Coherence Scale, Purpose in Life Scale and Self-Transcendence Scale and answered the SF-36 Health Survey questionnaire. The findings showed significant correlations between scores on the Resilience Scale, the Sense of Coherence Scale, the Purpose in Life Test, and the Self-Transcendence Scale. Significant correlations were also found between these scales and the SF-36 Mental Health Summary among women but not among men. There was no significant correlation between perceived physical and mental health. The mean values of the different scales showed that the oldest old have the same or higher scores than younger age groups. Regression analyses also revealed sex differences regarding mental health. The conclusions are that, the correlation between scores on the different scales suggests that the scales measure some dimension of inner strength and that the oldest old have this strength at least in the same extent as younger adults. Another conclusion is that the dimensions that constitute mental health differ between women and men.

Disability status differentials across fifteen Asian and Pacific Islander groups and the effect of nativity and duration of residence in the U.S

This study examines disparities in disability status across 15 Asian and Pacific Islander American (API) subpopulations and how nativity and duration in the U.S. influence these differences. Employing three disability questions (work limitations, mobility limitations, and self-care limitations) from the 1990 PUMS, the authors find substantial heterogeneity in disability status across API subgroups: while Japanese American adults have the most favorable outcomes, Other Southeast Asian adults (Laotians, Hmong, and Cambodians), followed by Vietnamese and Pacific Islander adults, suffer from a high risk of disabilities. Many of the disparities in disability status across API subpopulation adults are attributable to differentials in demographic characteristics and SES. The inclusion of an interaction term of age and nativity/duration of residence in the U.S. in multivariate regression analyses demonstrates that the effect of nativity/duration plays a different role across age, net of demographic, and SES risk factors. The overall findings are also consistent with previous studies on the relationship between immigrant health and nativity/duration. That is, immigrants with short duration in the U.S. have superior health status, measured by risk of disability, than longer-term immigrants and their U.S.-born counterparts.

Regional assessment of elderly disability in the U.S

This study examines regional variation of elderly disability in the United States. Elderly disability measurements are derived from two newly available questions on mobility and self-care limitations in the 1990 census. Substantial regional differences in elderly disability rates exist, with a higher prevalence of disability in the Southeast. These differences persist after controlling for age and socioeconomic status (SES). The study findings suggest that some public health policy should be regionally formulated and some government actions should be devoted to reduce the excessive elderly disability in the South.