Widowhood and Life Satisfaction Among Chinese Elderly Adults: The Influences of Lifestyles and Number of Children

Quality of Life and Socioeconomic Status in Northwest of Iran: First Wave of the Persian Traffic Cohort Study

This study aimed to evaluate the association between Quality of Life (QOL) and independent factors, emphasizing Socio Economic Status (SES) in northwestern Iran. A population-based cross-sectional study was performed within the Persian Traffic safety and health Cohort in 2020. Participants were chosen using stratified random sampling method. The majority of participants (69%) were aged between 30 and 65. Around half of the participants were males (54.44%). Most of the female respondents were categorized as very low and medium levels of SES Based on multiple linear regression analysis, the QOL among females was lower compared to males (β: - 0.92, 95% CI - 1.82 to - 0.22). There was a negative association between SES and QOL; individuals with low and very low levels of SES had a lower QOL than those with a medium level of SES (β: - 4.38, 95% CI - 5.9 to - 2.86) (β: - 2.65, 95% CI - 4.08 to - 1.22). The current study highlights that higher SES and educational levels are positively associated with higher QOL. Conversely, older age, females, and widowed individuals are linked with lower QOL.

An analysis of factors influencing cognitive dysfunction among older adults in Northwest China based on logistic regression and decision tree modelling

BACKGROUND

Cognitive dysfunction is one of the leading causes of disability and dependence in older adults and is a major economic burden on the public health system. The aim of this study was to investigate the risk factors for cognitive dysfunction and their predictive value in older adults in Northwest China.

METHODS

A cross-sectional study was conducted using a multistage sampling method. The questionnaires were distributed through the Elderly Disability Monitoring Platform to older adults aged 60 years and above in Northwest China, who were divided into cognitive dysfunction and normal cognitive function groups. In addition to univariate analyses, logistic regression and decision tree modelling were used to construct a model to identify factors that can predict the occurrence of cognitive dysfunction in older adults.

RESULTS

A total of 12,494 valid questionnaires were collected, including 2617 from participants in the cognitive dysfunction group and 9877 from participants in the normal cognitive function group. Univariate analysis revealed that ethnicity, BMI, age, educational attainment, marital status, type of residence, residency status, current work status, main economic source, type of chronic disease, long-term use of medication, alcohol consumption, participation in social activities, exercise status, social support, total scores on the Balanced Test Assessment, total scores on the Gait Speed Assessment total score, and activities of daily living (ADL) were significantly different between the two groups (all P < 0.05). According to logistic regression analyses, ethnicity, BMI, educational attainment, marital status, residency, main source of income, chronic diseases, annual medical examination, alcohol consumption, exercise status, total scores on the Balanced Test Assessment, and activities of daily living (ADLs) were found to influence cognitive dysfunction in older adults (all P < 0.05). In the decision tree model, the ability to perform activities of daily living was the root node, followed by total scores on the Balanced Test Assessment, marital status, educational attainment, age, annual medical examination, and ethnicity.

CONCLUSIONS

Traditional risk factors (including BMI, literacy, and alcohol consumption) and potentially modifiable risk factors (including balance function, ability to care for oneself in daily life, and widowhood) have a significant impact on the increased risk of cognitive dysfunction in older adults in Northwest China. The use of decision tree models can help health care workers better assess cognitive function in older adults and develop personalized interventions. Further research could help to gain insight into the mechanisms of cognitive dysfunction and provide new avenues for prevention and intervention.

Impact of lifestyle and psychological resilience on survival among the oldest-old in China: a cohort study

Introduction

Healthy lifestyles and psychological resilience are important factors influencing the life expectancy of the oldest-old (≥80 years). Stratified by urban and rural groups, this study used a 10-year cohort to examine the mechanism of lifestyle and psychological resilience on the survival of the oldest-old in China.

Methods

This study used the China Longitudinal Healthy Longevity Survey datasets spanning from 2008 to 2018, and 9,250 eligible participants were included. The primary outcome variable was all-cause mortality, and independent variables included healthy lifestyle index and psychological resilience. Six covariates were included in the survival analysis and moderation-mediation model, such as gender and annual household income.

Results

This study found that the oldest-old with five healthy lifestyles had the longest survival time, averaging 59.40 months for urban individuals and 50.08 months for rural individuals. As the lifestyle index increased, the survival rate significantly increased. The Cox regression showed that for the urban oldest-old, the lifestyle index served as a protective factor for survival outcomes. However, this effect lost statistical significance among rural oldest-old individuals. For urban oldest-old individuals, psychological resilience significantly mediated and moderated the effect of the lifestyle index on survival status, but the moderating effect was not statistically significant for the rural ones.

Discussion

Overall, healthy lifestyles and psychological resilience can be effective in enhancing the survival of the oldest-old, and there are differences between urban and rural population, so different interventions should be adopted for urban and rural areas to achieve longer life in China.

Relationship of widowhood with pulse pressure, fasting blood glucose, and mental health in older adults: a propensity matching score analysis

Background

Transitioning from marriage to widowhood presents inevitable and significant challenges for many older adults. This study explored the impact of widowhood on a range of mental health outcomes, including pulse pressure and fasting blood glucose levels, among older adults in nursing homes.

Methods

This cross-sectional study utilized cluster random sampling to recruit participants, with data analyzed from 388 older Chinese adults. Psychosocial traits were assessed using the Perceived Social Support from Family scale (PSS-Fa) for family support, the Generalized Anxiety Disorder 7-item scale (GAD-7) for anxiety symptoms, and the 9-item Patient Health Questionnaire (PHQ-9) for depressive symptoms and suicidal ideation. Propensity score matching (PSM) was employed to control for confounding factors. A multivariate linear regression analysis was performed to explore the relationship between widowhood, mental health outcomes, pulse pressure, and fasting blood glucose levels.

Results

After applying PSM, the sample size was refined to 268 (N = 134 for both married and widowed groups) from the initial 388, excluding 120 unmatched cases. Widowed older adults were found to have notably lower family support (β = -0.81, p = 0.002), increased depressive symptoms (β = 1.04, p = 0.043), elevated pulse pressure (β = 8.90, p < 0.001), and higher fasting blood glucose levels (β = 3.22, p = 0.027). These associations exhibited greater beta values compared to pre-matching analysis.

Conclusion

Our findings revealed that widowed participants had reduced family support, an increased risk of depressive symptoms, heightened pulse pressure, and elevated fasting blood glucose in comparison to their married counterparts. Interventions focusing on social support, mental health, and cardiovascular well-being could be advantageous for this at-risk group.

Satisfaction With Children's Achievements and Health Outcomes in a Sample of Community Older Adults in Nigeria

Background and Objectives

In most African societies with little or no social welfare services for older adults, many parents regard their children as personal investments and security for the future. As a result, satisfaction with children's achievements may be necessary for older parents' physical and mental health. This study examined the association between satisfaction with adult children's achievements (SACA) and health outcomes (regarding somatic health, self-rated health, anxiety, and depression) in a sample of Nigerian older adults.

Research Design and Methods

By using the multistage sampling technique in a cross-sectional survey, 465 older adults (mean age = 74.18 ± 9.42) consisting of 294 women were selected from 14 rural communities in a State in Nigeria. Data were collected using validated instruments and analyzed using multiple linear regression and multigroup analyses in SPSS AMOS.

Results

High SACA was significantly associated with low somatic health problems, positive self-rated health, and low levels of anxiety and depression, even after controlling for sociodemographic factors, children's support, social engagement, and loneliness. Further analyses indicated that the relationship between SACA and depression was only significant in women and more robust in the widowed. Also, SACA was associated with somatic health among the married but not the widowed. The level of children's support was not a significant moderator.

Discussion and Implications

Parents can experience positive emotions and, consequently, good health from being satisfied with their children's achievements regardless of perceived children's support. Assessing SACA may aid in better diagnoses and formulation of a more effective clinical intervention to improve the well-being of older adults in developing societies.

The impact of widowhood on mental health of older adults

Widowhood is identified as a risk factor for older adults' mental health, however, the underlying mechanisms and protective factors in this association has not been fully revealed. In order to add to the current knowledge, this study investigates the mediating roles of economic, social and psychological resources and the moderating role of community support in the relationship between widowhood and mental health. A sample of 7913 Chinese older people (Mean age = 71.14, SD = 7.19) is obtained from the 2018 wave of China Longitudinal Aging Social Survey. Results indicates that widowhood is negatively associated with older adults' mental health. Economic, social and psychological resources partially mediate the above association. Furthermore, the effect of widowhood is weaker for older people with more rather than less community support. This study not only illuminates the potential mechanisms of how widowhood influence mental health theoretically, but also provides valuable implications.

Comparing the impact of social support on the life satisfaction of widowed and non-widowed elders

Aim

To compare differences in life satisfaction between widowed and non-widowed elders based on social support.

Methods

A total of 4,560 widowed and 3,655 non-widowed elders were selected from the Chinese Longitudinal Healthy Longevity Survey (CLHLS-2018). Ordinal logistic regression models and t-tests were performed using SPSS v20.

Results

Both widowed and non-widowed elders had high levels of life satisfaction. Personal characteristics had a significant impact on the life satisfaction of both widowed and non-widowed elders. Endowment insurance, social trust, residence, self-rated health, and living with family had a significant impact on the life satisfaction of widowed elders (p &lt; 0.001), while endowment insurance, government subsidy, and self-rated health significantly impacted non-widowed elders (p &lt; 0.001). Self-rated health had the greatest impact on the life satisfaction of widowed and non-widowed elders (OR = 4.62/4.45), followed by endowment insurance (OR = 1.24/1.32).

Conclusion

Social support can significantly improve life satisfaction, but its impact is heterogeneous. Informal social support plays a greater role in improving the life satisfaction of widowed elders, but formal social support plays a greater role in the life satisfaction of non-widowed elders.

The Widowhood Effect on Mortality in Older Patients with Hip Fracture

Objective

Widowed people have increased mortality than married people of the same age, a phenomenon known as the widowhood effect. This study aimed to investigate whether this effect exists in older patients with hip fracture.

Methods

Using our own hip fracture database, a total of 1101 hip fracture patients were consecutively included from January 2014 to December 2021. Marital status was stratified as married (n = 793) and widowed (n = 308). Patients survival status was obtained from medical records or telephone follow-ups, and the outcomes were all-cause mortality at 30 days, 1 year and at latest follow-up. Univariate and multivariate Cox proportional hazard models were used to assess the association between marital status and mortality, and subgroup analyses according to sex were also conducted.

Results

Compared with married patients, widowed patients were more likely to be older, female and intertrochanteric fracture, and were less likely to be urban area, smoking, drinking, and surgical treatment (P < 0.05). After a median follow-up of 37.1 months, the 30-day mortality was 4.3% (n = 47), 1-year mortality was 19.3% (n = 178), and total mortality was 34.2% (n = 376). Multivariate Cox analysis showed that widowed marital status remained an independent risk factor for 1-year mortality (HR = 1.437, 95% CI: 1.054–1.959, P = 0.022), and total mortality (HR = 1.296, 95% CI: 1.038–1.618, P = 0.022), whereas this association was not found in 30-day mortality (HR = 1.200, 95% CI: 0.607–2.376, P = 0.599). Moreover, subgroup analyses also found that the widowhood effect on mortality was present in both male and female.

Conclusion

Widowed marital status seems to be an independent risk factor for long-term mortality in older patients with hip fracture.