Association between Socioeconomic Status, Physical Health and Need for Long-term Care among the Chinese Elderly

Internet use and health status among older adults: The mediating role of social participation

Background

The acceleration of population aging and the arrival of the informatization make more and more older adults use the Internet, and its use is having an impact on their health. However, the relationship between internet use and the health of older adults and the mechanism of the effect of internet use on the health are not very clear.

Methods

Multiple linear regression models to explore the correlation between internet use and health status in the 3,141 individuals aged ≥60 years were used. Propensity score matching (PSM) method was used to test the robustness of the regression results. In addition, sequential recursive models was used to examine the mediating effect of social participation on the relationship between internet use and health status.

Results and discussion

We found a significant positive relationship between internet use and health status, and social participation mediated the relationship between internet use and health status. In addition, the effect of internet use on health status was different among older adults in rural and urban areas.

Conclusions

The development and application of internet products adapted to the development of an aging society should be accelerated to meet their needs for continued socialization. The forms and activities of social participation for the elderly groups should be enriched and public service internet usage training seminars should be conducted to improve internet skills.

Correlates of cognitive impairment in the elderly in China: A cross-sectional study

Background

To identify correlates of the incidence of cognitive impairment among older Chinese populations through the use of logistic regression analysis-based decision tree approaches.

Methods

Correlates of cognitive impairment among older Chinese adults were identified through logistic regression analyses, with significant variables subsequently being incorporated into a decision tree analysis, with the CHAID method being employed for pre-pruning.

Results

The risk score derived from the combination of logistic regression and decision tree analyses (0.237) was lower than that derived from a decision tree analysis alone (0.389). The primary factors related cognitive impairment in this patient population included age, gender, residence status, physical health status, and caring for grandchildren.

Conclusion

A combination of logistic regression and decision tree analyses can lower predicted risk scores, enabling the subdivision of populations with different characteristics and providing intuitive and specific insight regarding the effects of individual variables on predictive analyses. Overall, these results suggest that older adults in rural areas of China should be the focus of further cognitive impairment screening and interventions, particularly for older women.

The Impact of Family Socioeconomic Status on Elderly Health in China: Based on the Frailty Index

China is about to enter a moderate aging society. In the process of social and economic development, the family socioeconomic status and health status of the elderly have also changed significantly. Learning the impact of family socioeconomic status on elderly health can help them improve family socioeconomic status and better achieve healthy and active aging. Using the data of the Chinese Longitudinal Healthy Longevity Survey in 2018, this study firstly analyzed the impact of family socioeconomic status on elderly health using the multivariate linear regression model and quantile regression model, the heterogeneity of different elderly groups using subsample regression, and the mediation effects of three conditions associated with the family socioeconomic status of the elderly. The results show that family socioeconomic status has a negative effect on the frailty index, that is, it has a positive impact on elderly health. Family socioeconomic status has a higher positive impact on the health status of the middle and lower age elderly and rural elderly. Overall living status and leisure and recreation status both have mediation effects, while health-care status has no mediation effect.

The Impact of Leisure Activities on the Mental Health of Older Adults: The Mediating Effect of Social Support and Perceived Stress

As the aging continues, China has become the country with the largest older population. In order to ensure the well-being of older adults in their later years, the whole society is increasingly concerned about the mental health of older adults. In 2019, we conduct a questionnaire survey in Shaanxi Province. Stratified random sampling is used to select three representative cities, and 677 samples are selected from the survey results for research. By using the structural equation model, we aim to reveal the mechanism of leisure activities' influence on mental health of the older adults and verify whether social support and perceived stress play a mediating role. The study finds that the older adults' leisure activities have no significant direct impact on mental health. Social support has a significant mediating effect between leisure activities and mental health of the older adults. Leisure activities indirectly affect the mental health of the older adults through social support, and participation in leisure activities can improve the social support of the older adults, thus improving the mental health level of the older adults. Perceived stress plays a significant mediating role between leisure activities and mental health of the older adults. By participating in leisure activities, the perceived stress of the older adults will be reduced, thus improving their mental health. Social support and perceived stress play a sufficient mediating role in the influence of leisure activities on mental health.

Association between depressive symptoms and objective/subjective socioeconomic status among older adults of two regions in Myanmar

Low objective socioeconomic status (SES) has been correlated with poor physical and mental health among older adults. Some studies suggest that subjective SES is also important for ensuring sound physical and mental health among older adults. However, few studies have been conducted on the impact of both objective and subjective SES on mental health among older adults. This study examines whether objective or subjective SES is associated with depressive symptoms in older adults in Myanmar. This cross-sectional study, conducted between September and December, 2018, used a multistage sampling method to recruit participants from two regions of Myanmar, for face-to-face interviews. The Geriatric Depression Scale (GDS) was used to evaluate the depressive symptoms. Participants were classified as having no depressive symptom (GDS score <5) and having depressive symptoms (GDS score ≥5). Objective and subjective SES were assessed using the wealth index and asking participants a multiple-choice question about their current financial situation, respectively. The relationship between objective/subjective SES and depressive symptoms was examined using a multivariable logistic regression analysis. The mean age of the 1,186 participants aged 60 years and above was 69.7 (SD: 7.3), and 706 (59.5%) were female. Among them, 265 (22.3%) had depressive symptoms. After adjusting for objective SES and other covariates, only low subjective SES was positively associated with depressive symptoms (adjusted odds ratio, AOR: 4.18, 95% confidence interval, CI: 2.98-5.87). This association was stronger among participants in the rural areas (urban areas, AOR: 2.10, 95% CI: 1.08-4.05; rural areas, AOR: 5.65, 95% CI: 3.69-8.64). Subjective SES has a stronger association with depressive symptoms than objective SES, among older adults of the two regions in Myanmar, especially in the rural areas. Interventions for depression in older adults should consider regional differences in the context of subjective SES by reducing socioeconomic disparities among the communities.

Assessing the Accessibility of Home-Based Healthcare Services for the Elderly: A Case from Shaanxi Province, China

With the rapid increase of the elderly population in China, healthcare services for the elderly have gradually become an important welfare resource. However, the healthcare service for the elderly still has problems such as mismatched supply and demand and unbalanced resources. In order to effectively eliminate the path barriers to match supply and demand, and improve the accessibility of healthcare services, this paper introduces the sustainability of the healthcare service based on the accessibility theory, and constructs an index system from the three dimensions of potential accessibility, realized accessibility, and sustainable accessibility of healthcare services for the elderly. Then, the paper makes a practice application of the index system based on survey data of healthcare services from Shaanxi province, China. Finally, the paper finds that the total accessibility and sustainable accessibility of healthcare services for the elderly in Shaanxi Province are at an average level. The score of potential accessibility is high, indicating that elderly people have greater opportunities to use healthcare services. The realized accessibility score is low, which indicates that the actual use of healthcare services for the elderly presents low satisfaction.

Field-testing of a rapid survey method to assess the prevalence and causes of hearing loss in Gao'an, Jiangxi province, China

BACKGROUND

The Rapid Assessment of Hearing Loss (RAHL) survey protocol aims to measure the prevalence and causes of hearing loss in a low cost and rapid manner, to inform planning of ear and hearing services. This paper reports on the first field-test of the RAHL in Gao'an County, Jiangxi Province, China. This study aimed to 1) To report on the feasibility of RAHL; 2) report on the estimated prevalence and causes of hearing loss in Gao'an.

METHODS

A cross-sectional population-based survey was conducted in September-October 2018. Forty-seven clusters in Gao'an County were selected using probability-proportionate-to-size sampling. Within clusters, compact segment sampling was conducted to select 30 people aged 50+. A questionnaire was completed covering sociodemographics, hearing health, and risk factors. Automated pure-tone audiometry was completed for all participants, using smartphone-based audiometry (hearTest), at 0.5, 1, 2, 4 kHz (kHz). All participants had their ears examined by an Ear Nose and Throat (ENT) doctor, using otoscopy, and probable causes of hearing loss assigned. Prevalence estimates were age and sex standardised to the Jiangxi population. Feasibility of a cluster size of 30 was examined by assessing the response rate, and the proportion of clusters completed in 1 day.

RESULTS

1344 of 1421 eligible participants completed the survey (94.6%). 100% of clusters were completed in 1 day. The survey was completed in 4.5 weeks. The prevalence of moderate or greater hearing loss (pure-tone average of 0.5, 1, 2, 4 kHz of > = 41dBHL in the better ear) was 16.3% (95% CI = 14.3, 18.5) and for any level of hearing loss (pure-tone average of > = 26dBHL in the better ear) the prevalence was 53.2% (95% CI = 49.2, 57.1). The majority of hearing loss was due to acquired sensorineural causes (91.7% left; 92.1% right). Overall 54.0% of the population aged 50+ (108,000 people) are in need of diagnostic audiology services, 3.4% were in need of wax removal (7000 people), and 4.8% were in need of surgical services (9500 people). Hearing aid coverage was 0.4%.

CONCLUSION

The RAHL survey protocol is feasible, demonstrated through the number of people examined per day, and the high response rate. The survey was completed in a much shorter period than previous all-age surveys in China. Some remaining challenges included assignment of causes of probable sensorineural loss. The data obtained from this survey can be used to scale-up hearing services in Gao'an.