Psychological Distress of Older Chinese: Exploring the Roles of Activities, Social Support, and Subjective Social Status

Intergenerational Support and Subjective Well-Being of Older Adults in China

This study examines intergenerational support (IGS) and its impact on the subjective well-being of older adults in Chinese families, focusing on both upward and downward support. Data from the 2018 China Family Panel Studies show considerable mutual support between parents and children. Support from children to parents significantly improves the well-being of older adults, while support from parents to children has less impact. Contrary to expectations, the interaction between upward and downward support does not significantly affect the well-being of older adults. We categorized IGS into four family types and found that families with upward-IGS reported higher well-being than those with no IGS. Our findings underscore the central role of financial support and caregiving activities in enhancing the subjective well-being of older adults. These findings also suggest a policy recommendation for refining social eldercare systems in China to alleviate family pressures associated with eldercare responsibilities.

Downward Intergenerational Support and Well-Being in Older Chinese Adults

Life satisfaction, as an important indicator of subjective well-being, is crucial for older adults. This study aims to examine the effects of downward intergenerational financial and practical support on life satisfaction among older adults in China, while exploring the mediating role of self-esteem and the potential differences across gender. Data were collected from 507 older adults aged 60 and above in China. The findings indicate that both financial and practical support provided by older adults positively predict their life satisfaction. Mediation analysis reveals that self-esteem partially mediates the relationship between downward intergenerational support and life satisfaction. This suggests that helping their children enhances older adults' sense of self-worth, which in turn improves their overall well-being. Gender differences were also observed: financial support had a stronger impact on life satisfaction for men, while practical support was more significant for women. These results highlight the influence of traditional gender roles and cultural expectations on the dynamics of intergenerational support in contemporary Chinese families.

The effects of living arrangements and leisure activities on depressive symptoms of Chinese older adults: Evidence from panel data analysis

BACKGROUND

Livable environment and ways, as the necessary conditions for the elderly to enjoy their old age, have a significant impact on their mental health and happiness. It's crucial to understand how living arrangements affect depressive symptoms in China. Studies on how various leisure activities modify this association are yet limited.

METHODS

This study relies on panel data derived from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), collected during waves spanning 2008/2009, 2011/2012, 2014, and 2018. The primary objective is to examine the relationship between living arrangements, leisure activities, and depressive symptoms of elderly individuals. Linear mixed-effects models were used to analyze the data.

RESULTS

A total of 26,342 observations aged 65 and over were included in this paper. Older adults living alone (β = 0.66, 95 % CI: 0.55, 0.76) or living in institutions (β = 0.69, 95 % CI: 0.40, 0.98) had more depressive symptoms than those living with family. Leisure activities were negatively associated with depressive symptoms (β = -0.16, 95 % CI: -0.18, -0.15). Moreover, there was significant interactions between living arrangements and leisure activities. No matter which kind of living arrangements, participating in physical, productive or social activity was associated with a lower risk of depressive symptoms.

LIMITATIONS

Study design might introduce bias, and it cannot establish causality between the tested variables.

CONCLUSIONS

Older adults living alone or in institutions have more possibility to develop depressive symptoms than those living with family, and such a relationship among Chinese older adults can be moderated by participating in leisure activities.

Is intergenerational care associated with depression in older adults?

Background

It has become an alarming issue that older adults in China are facing mental health issues, causing severe depression. In this context, intergenerational care, in which grandparents care for young children instead of the young parents, is gaining importance. This study aims to explore the correlation between intergenerational care and depression among older adults, seeking alternative approaches to enhancing their quality of life. This study concludes that intergenerational care is an effective strategy for promoting active aging.

Methods

This study used multiple linear regression, propensity score matching, and additional analysis of heterogeneity, mediation, and moderation effects, with data from the 2018 CHARLS survey.

Results

The results indicated a negative correlation between intergenerational care and depression among older adults. The correlation was stronger for females and younger older adults people. Additionally, social activities served as a mediator between intergenerational care and depression among older adults, and health satisfaction positively moderated this relationship.

Conclusion

This study posits that intergenerational care serves as an effective approach for promoting active aging. It emphasizes the necessity for supportive government policies and community-family collaborations to encourage intergenerational care and its beneficial impact on mental health among older adults.

Social activities and long-term depressive-symptoms trajectories among middle-aged and older adults in China: a population-based cohort study

Background

The association between social activities and depressive symptoms remains unclear. This study aimed to explore the relationship between social activities at baseline and the long-term depressive-symptoms trajectories among a cohort of middle-aged and older adults in China.

Methods

This study included 13,258 participants aged 45 years and older from the China Health and Retirement Longitudinal Study (CHARLS). Depressive symptoms across four waves from 2011 to 2018 were evaluated using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10). Four types of social activities were assessed at baseline by self-report: (1) interacting with friends; (2) playing Mahjong, chess, and cards or attending a community club; (3) providing help to family, friends, or neighbors; and (4) attending a sporting or social event or club. Group-based trajectory modeling (GBTM) was used to map depressive-symptoms trajectories during the follow-up period.

Results

Not interacting with friends at baseline was associated with an increased risk of increasing (adjusted odds ratio [aOR]: 1.21, 95% confidence interval [CI]: 1.03, 1.41) and severe-stable (aOR: 1.35, 95% CI: 1.10, 1.65) depressive-symptoms trajectories. Participants who did not play Mahjong, cards, or chess and did not attend a sporting or social event or club at baseline were more likely to have mild-stable, decreasing, increasing, and severe-stable depressive-symptoms trajectories.

Conclusion

Social activities play an important role in long-term depressive-symptoms trajectories in middle-aged and older Chinese adults. Interacting with friends, attending sports, or social clubs may prevent depressive symptoms.

Relationships of work stress and interpersonal needs with industrial workers' mental health: a moderated mediation model

OBJECTIVES

This study explores whether feelings of defeat (i.e., a sense of failed struggle and losing rank; referred to as defeat for simplicity) mediated the effect of work stress on depression/anxiety, the effect of interpersonal needs on depression/anxiety for Chinese industrial workers, and the possible moderating role of social support.

METHOD

A cross-sectional study was conducted in Shenzhen, China in 2019, in total, 2023 industrial workers (of 2700 invited; response rate = 75%) completed a self-administered survey consisted of Job Stress Scale, Interpersonal Needs Questionnaire, Defeat Scale, Centre for Epidemiological Studies Depression Scale, Generalized Anxiety Disorder Scale, two face-valid questions for social support, as well as sociodemographic information. Moderated mediation model was tested and loop plots were applied to probe into the conditional effects of work and interpersonal stress on depression and anxiety symptoms.

RESULT

Both the direct and indirect effect of work stress on depression and anxiety through defeat were significant (Work stress→ Depression: B = 0.035, p < .001, Work stress→ Defeat→ Depression: B = 0.034, p < .001; Work stress→ Anxiety: B = 0.038, p < .001, Work stress→ Defeat→ Anxiety: B = 0.045, p < .001). Meanwhile, defeat mediated the relationship of interpersonal needs with depression partially and the relationship of interpersonal needs with anxiety totally (Interpersonal needs→ Anxiety: B = 0.133, p < .001, Interpersonal needs→ Defeat→ Anxiety: B = 0.010, p = .537). Social support moderated the indirect path between interpersonal needs and depression/anxiety and buffered the effect.

CONCLUSION

The mediating role of defeat and the moderator role of social support in the relationship between stress and depression/anxiety were confirmed in industrial workers. Workers who reported more work and interpersonal stress would report more defeat feelings, and then exhibited more depression and anxiety symptoms; this mediation effect was stronger for those who had lower social support, respectively.

Association between Tai Chi Yuttari Exercise and Longevity and Prevention of Long-Term Care Need: Survival Analysis in Kitakata City, Japan

This study examined whether participation in Tai Chi Yuttari exercise is associated with a delay in the death and new certification for long-term care need of older adults. Individuals who participated in Tai Chi Yuttari exercise classes in 2011-2015 (participation group) were compared with individuals from the Basic Resident Register of Kitakata City (non-participation group). Death and new certification for long-term care need were selected to evaluate the effectiveness of participation in Tai Chi Yuttari exercise classes. The periods from the start date of the observation to each person's date of occurrence of events were calculated. The Kaplan-Meier method and log-rank test were used to compare survival curves between the groups. A total of 105 and 202 individuals in the participation and non-participation groups, respectively, were observed. Survival duration (χ2 = 8.782, p = 0.003) and the period before receiving certification for long-term care (χ2 = 5.354, p = 0.021) were longer in the participation group than in the non-participation group. In the stratified analysis by sex, survival duration was longer in the participation group in men only (χ2 = 7.875, p = 0.005). Participation in Tai Chi Yuttari exercise might be effective in delaying death, especially in men, and new certification for long-term care.

Grandchild care and life satisfaction of older adults: Empirical evidence from China

Background

In China, grandchild care plays an important social role later in life. The effects of grandchild care on physical health and depression in older adults have been illustrated. However, there is a gap in research on grandchild care and life satisfaction of older adults specifically based on the Chinese experience.

Method

Based on 7,079 individuals' data from 2018 China Longitudinal Aging Social Survey (CLASS), this study explored the impact of grandchild care on older adults' life satisfaction by using Ordinary Least Squares (OLS), Propensity Score Matching (PSM), and instrumental variables (IV) models.

Results

The empirical results indicated that (1) life satisfaction was significantly higher for older adults who undertook grandchild care compared to those who did not; (2) non-coresiding grandparents showed higher life satisfaction than those non-carers, and this effect was not found in custodial grandparents or three-generation household grandparents; (3) higher life satisfaction of grandchild caregivers was achieved through reduced loneliness, enhanced self-efficacy, and increased emotional support from children, with the latter being the greatest contribution; and (4) the improving effect of grandchild care on life satisfaction was found mainly in the group of older adults who were male and in rural households.

Conclusion

There was a significant difference in life satisfaction between older Chinese adults who provided grandchild care and those who did not. Efforts in terms of old age policy protection and family relationships should be made to enhance the subjective well-being of older adults.

The effect of reverse intergenerational support on the happiness of Chinese older adults: A moderating effect analysis based on role conflict

Intergenerational support is bidirectional, and reverse intergenerational support refers to parents providing financial support, time support, and spiritual support to their offspring. The emergence of reverse intergenerational support has created role conflicts among different groups of older adults. Based on survey data from 3,170 elderly people in eight sample provinces in China, this paper empirically investigates the relationship between reverse intergenerational support and the happiness of the elderly in contemporary China and the moderating effect of role conflict in it, using an ordered logit model. It was found that, first, reverse economic support reduces the happiness of the elderly, and reverse time support and reverse spiritual support can significantly enhance the happiness of the elderly. Second, in the presence of role conflict, the effect of reverse time support and reverse spiritual support on the enhancement of older adults' happiness was suppressed; in the presence of role enhancement, the effect of reverse economic support on the reduction of older adults' happiness was mitigated. The above findings provide new empirical evidence for understanding the relationship between reverse intergenerational support and the happiness of the elderly, which is prevalent in contemporary China, and offer new insights for enhancing happiness.

The Myth of Social Mobility: Subjective Social Mobility and Mental Health

A common assumption is that upward mobility produces positive psychological outcomes. However, status-based identity framework and social class worldview model propose that perceived social mobility in either direction will lead to increased distress. Based on this claim, we examined relations among subjective social mobility, life satisfaction, and mental health using polynomial regression with response surface mapping. In Study 1, groups that experienced both subjective downward and upward mobility reported more depressive symptomatology than groups that remained in middle or upper social statuses in a sample of 567 adults. We did not find significant relations between subjective social mobility and life satisfaction. In Study 2, both groups that experienced subjective downward and upward mobility reported more depressive and academic distress symptomatology than groups that remained in middle or upper social social statuses in a sample of 7,598 clients from college counseling center data. The results provide insights relevant to multicultural counseling and training.

Can leisure and entertainment lifestyle promote health among older people living alone in China?-A simultaneous equation approach

Objectives

With the surging number of older people living alone, their lifestyles and health status have aroused increasing concern. This study aims to investigate whether a leisure and entertainment lifestyle (LEL) can improve the multidimensional health among older people living alone and try to identify the latent mechanisms among them.

Method

For this purpose, we extracted data from the Chinese General Social Survey (CGSS) and established a simultaneous equations model, comprising ordinary least square regression (OLS), two-stage least squares (2SLS), and the mediating effect model.

Results

Older people living alone in China reported relatively better mental health status (3.64 ± 1.07), followed by physical health (3.41 ± 1.26) and social health (2.75 ± 1.18). In the OLS model, LEL significantly improved the social health of older people living alone (β = 0.054, P < 0.01), followed by physical health (β = 0.042, P < 0.01) and mental health (β = 0.027, P < 0.01). After endogenous tests from 2SLS model and robustness tests, we found that more active LEL was associated with higher levels of physical health and mental health. However, LEL had no significant effect on the improvement of the social health of the older people living alone. Using the mediation analysis, exercise efficacy partially mediated the relationship of LEL with physical health and mental health, and the ratios were 19.75 and 24.85%, respectively. Similarly, positive life attitudes partially mediated the relationship between LEL and physical health, and LEL and mental health, with ratios of 10.65 and 26.83%, respectively.

Conclusion

Our findings suggested that LEL is significantly associated with better physical and mental health for older people living alone in China, and the association is mediated by exercise efficacy and positive attitudes toward life. Promoting more leisure and recreational activities, upgrading exercise efficacy, and encouraging positive life attitudes are necessary health promotion measures in active aging policies for the wellbeing of older people living alone.

Social isolation transitions and psychological distress among older adults in rural China: A longitudinal study before and during the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic could increase the number of older adults who are socially isolated including community-dwelling older adults, and result in the secondary damage of mental health. This study aimed to examine the longitudinal association between social isolation transitions and psychological distress among the community-dwelling older adults before and during the COVID-19 pandemic in rural China.

METHODS

A total of 2749 community-dwelling older adults aged 60 years and older in rural Shandong, China were included. We used the generalized estimating equations (GEE) model to estimate the impact of social isolation transitions on psychological distress before and during the COVID-19 pandemic.

RESULTS

The percentage of high and very high psychological distress (K10 ≥ 22) was 23.54% and 31.36% before and during the COVID-19 pandemic, respectively, indicating a 7.82% increase (P < 0.001). Compared with the group remaining nonisolated, "became socially isolated" and "remained isolated" groups were more likely to have a deterioration of psychological distress after experiencing the COVID-19 pandemic (became socially isolated: b = 0.92, P < 0.001; remained isolated: b = 0.98, P < 0.001).

LIMITATIONS

The main variables in this study were measured by self-report information, which might result in recall bias.

CONCLUSIONS

During the COVID-19 pandemic, psychological distress increased among the community-dwelling older adults in rural China. There was a significant risk of psychological distress among those who had transitioned from nonisolation before the pandemic to social isolation after experiencing the pandemic, thus intervention on social isolation process during the pandemic may be important to protect older adults' mental health.

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.

Towards Ethically and Medically Sustainable Care for the Elderly: The Case of China

An enormous challenge facing China is how to provide sustainable care for its rapidly-increasing elderly population. Its recent policy directives include three medical forms-the institution-cooperation-form, the institution-medical-form, and the family-physician-form-to integrate medical care into ordinary care for the elderly. This essay indicates that China will not be able to maintain sustainable elderly care unless it places emphasis on the family-physician-form that focuses on family physicians and the use of primary care services. The essay constructs arguments for this policy suggestion based on China's long-standing Confucian ethical resources of filial piety and family-based concerns for elderly care.

Relationship Between the Needs of Turkish Relatives of Patients Admitted to an Intensive Care Unit and Their Coping Styles

Admission to an intensive care unit is a traumatic event for many patients' relatives. Also, the relatives may be subject to many requirements to during this process. Therefore, it is very important to determine their requirements and coping styles. This study used a descriptive, relational design. The sample of the research consisted of 247 relatives of patients staying in six intensive care units. It was found that, 65.2% of the patients' relatives were women, and their mean age was 37.25 ± 12.7 years. What they mostly needed was support, proximity, information, assurance and comfort. In that order; among the coping styles it was found that they usually used the following approaches: self-confident approach, an problem-focused coping method; was found to be used by relatives most frequently, followed by helpless approach, an emotion-focused coping style. Requirements: Assurance, information, support and comfort sub-dimension scores and problem-focused coping style; self-confident approach and social support search approach sub-dimension scores between statistically positive, significant relationship was found. Information, proximity, support and comfort sub-dimension scores and emotion-focused coping style; helpless approach and submissive sub-dimension scores between statistically positive, significant relationship was found (p<0.05). It was found that patients' relatives used the helpless approach and submissive approach to cope with stres: during this process their information needs increased and upon fulfillment of requirements, they started using self-confident approach and the social support approach, which are problem-focused coping styles.

Social participation and the combination of future needs for long-term care and mortality among older Japanese people: a prospective cohort study from the Aichi Gerontological Evaluation Study (AGES)

OBJECTIVES

Our study aimed to examine the longitudinal association between social participation and both mortality and the need for long-term care (LTC) simultaneously.

DESIGN

A prospective cohort study with 9.4 years of follow-up.

SETTING

Six Japanese municipalities.

PARTICIPANTS

The participants were 15 313 people who did not qualify to receive LTC insurance at a baseline based on the data from the Aichi Gerontological Evaluation Study (AGES, 2003-2013). They received a questionnaire to measure social participation and other potential confounders. Social participation was defined as participating in at least one organisation from eight categories.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcomes were classified into three categories at the end of the 9.4 years observational period: living without the need for LTC, living with the need for LTC and death. We estimated the adjusted OR (AOR) using multinomial logistic regression analyses with adjustment for possible confounders.

RESULTS

The primary analysis included 9741 participants. Multinomial logistic regression analysis revealed that social participation was associated with a significantly lower risk of the need for LTC (AOR 0.82, 95% CI 0.69 to 0.97) or death (AOR 0.78, 95% CI 0.70 to 0.88).

CONCLUSIONS

Social participation may be associated with a decreased risk of the need for LTC and mortality among elderly patients.

Melancholy or mahjong? Diversity, frequency, type, and rural-urban divide of social participation and depression in middle- and old-aged Chinese: A fixed-effects analysis

The potential benefit of social participation (SP) to one's mental health has been widely acknowledged. Nevertheless, the specific type and amount of SP that is associated with improved depressive symptoms in middle- and old-aged Chinese awaits further investigation. This study aimed to understand the patterns of depression and SP by comparing urban vs rural China, and according to which, measure the associations between changes in SP and that in depressive symptoms. A total of 10,988 community residents aged 45 years and above were selected from wave 1 (2011), wave 2 (2013), and wave 4 (2015) of the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative survey. The fixed-effects analysis was used to explore the association between the changes in diversity, frequency, and type of SP and the changes in depressive symptoms. The results indicated that rural respondents suffered from a significantly higher risk of depression and took less SP than their urban counterparts. Transitioning from no SP to 1 or more types of SP or to a once a week or higher frequency was associated with a decline in depressive symptoms. For urban respondents, playing mah-jong or cards and joining sports or social clubs predicted a decline in depressive symptoms. For rural residents, interacting with friends regularly was associated with fewer depressive symptoms. In conclusion, more diverse and higher frequency of SP was associated with better mental health, while the social significance of SP varied across different types of SP and between rural and urban areas.

Urban-rural differences in factors associated with willingness to receive eldercare among the elderly: a cross-sectional survey in China

OBJECTIVE

Willingness to receive eldercare is an important factor affecting the reasonable allocation of resources and appropriate development of eldercare services. This study aimed to investigate the differences in willingness to receive eldercare and the influencing factors in urban and rural areas.

DESIGN

Cross-sectional survey.

SETTING

Research was conducted in the urban and rural areas of three cities (Harbin, Qiqihar and Jiamusi) in Heilongjiang province, China.

PARTICIPANTS

A total of 1003 elderly were selected through multistage sampling in Heilongjiang province, including 581 in urban areas and 422 in rural areas.

MAIN OUTCOME MEASURES

Descriptive statistics were reported for socioeconomic and demographic status, physical health, life satisfaction and social support in urban and rural areas. Mean differences were examined using t-tests, and categorical variable differences were examined using χ² tests. The factors influencing willingness to receive eldercare in urban and rural areas were analysed using logistic regression.

RESULTS

The results showed that 51.6% of urban elderly and 59.0% of rural elderly preferred family eldercare. Factors that influenced willingness to receive eldercare for urban elderly were age (OR 2.791, 95% CI 1.644 to 4.737), house property (OR 0.494, 95% CI 0.329 to 0.740) and objective support (OR 0.764, 95% CI 0.681 to 0.858). For rural elderly, the factors were having children (OR 0.368, 95% CI 0.146 to 0.930), house property (OR 0.371, 95% CI 0.231 to 0.596) and living arrangement (OR 3.361, 95% CI 1.436 to 7.866).

CONCLUSION

More attention should be paid to improving the functioning of family eldercare and promoting the development of varied eldercare services. Investments and targeted policies should be undertaken for different subgroups of urban and rural elderly.

Individual educational attainment, neighborhood-socioeconomic contexts, and self-rated health of middle-aged and elderly Chinese: Exploring the mediating role of social engagement

Analyzing the 2011-2013 China Health and Retirement Longitudinal Study with 14,507 respondents from 393 neighborhoods, and applying generalized linear mixed-effects model, this study examines how individual-level education and neighborhood-socioeconomic contexts affect health through social engagement. Findings reveal that measures of social engagement-social activity and productive activity-are significantly related to self-rated health and partially mediate the effects of individual-level education. Neighborhood-socioeconomic contexts have independent effects on self-rated health beyond individual socio-demographics, and social activity mediates the effects of neighborhood recreational facilities. This study is among the first to simultaneously explore the health effects of individual and neighborhood-level socioeconomic conditions.

Social participation, willingness and quality of life: A population-based study among older adults in rural areas of China

AIM

The present study aimed to reflect the current situation of social participation in rural areas of China, willingness to participate in social activities, association between health-related quality of life and social participation, and factors related to social participation.

METHODS

A total of 2644 rural adults aged 60 years and older were randomly selected and surveyed with a self-rating questionnaire. We used the unified definition of social participation in our study. The Medical Outcomes Study Short-Form Health Survey was used to measure health-related quality of life.

RESULTS

The overall engagement of social activities was 26%. Those who participated in social activities were more likely to have high scores of health-related quality of life. Older men with a high educational level (OR 1.59, 95% CI 1.01-2.29) living alone or with a spouse (OR 1.51, 95% CI 1.08-2.12), high objective social support (OR 1.08, 95% CI 1.00-1.17) and high support utilization (OR 1.13, 95% CI 1.07-1.21) were inclined to engage in social participation. Older women with high individual income (OR 1.74, 95% CI 1.25-2.43), single marital status (OR 1.53, 95% CI 1.11-2.10), normal weight (OR 1.92, 95% CI 1.10-3.34), overweight (OR 2.28, 95% CI 1.24-4.19), living alone or with a spouse (OR 1.55, 95% CI 1.20-2.00), objective social support (OR 1.11, 95% CI 1.04-1.18) and subjective social support (OR 1.15, 95% CI 1.10-1.20) were more willing to engage in social participation.

CONCLUSIONS

Engagement in social activities is relatively low in rural areas, and associations of willingness and health-related quality of life with social participation were found. Policy-makers and government workers should make appropriate types of encouragement policies around social participation for older adults in rural areas. Geriatr Gerontol Int 2017; 17: 1593-1602.

Socioeconomic status, frailty, and subjective well-being: A moderated mediation analysis in elderly Chinese

The study examined the mechanisms underlying the link between socioeconomic status and subjective well-being and explored the role of social activities using a representative sample of older adults ( N = 2773) in Shanghai, China. Results show that frailty mediated the relationship between socioeconomic status and subjective well-being, and social activities moderated the model, such that the mediation effect of frailty was significant only when social activities were lower. Moreover, the moderated mediation model was significant only for women, not for men. Findings highlight the importance of addressing frailty of older adults and promoting social activities (especially for elderly women) in future interventions.

Social support and the self-rated health of older people: A comparative study in Tainan Taiwan and Fuzhou Fujian province

The lack of social support in elderly populations incurs real societal costs and can lead to their poor health. The aim of this study is to investigate the self-rated health (SRH) and social support among older people as well as its associated factors.We conducted a cross-sectional study among 312 urban community-dwelling elderly aged 65 to 90 years in Tainan Taiwan and Fuzhou Fujian Province from March 2012 to October 2012. A Spearson correlation test, independent t test, a Pearson χ test, a linear regression analysis, and a multiple-level model were performed to analyze the results.The participants identified children as the most important source of objective and subjective support, followed by spouse and relatives. Tainan's elderly received more daily life assistance and emotional support, showed stronger awareness of the need to seek help, and maintained a higher frequency of social interactions compared with the elderly in Fuzhou. The mean objective support, subjective support, and support utilization scores as well as the overall social support among Tainan's elderly were significantly high compared with the scores among Fuzhou's elderly. Further, Tainan's elderly rated better SRH than Fuzhou's elderly. Correlation analysis showed that social support was significantly correlated with city, age, living conditions, marital status, and SRH. Multiple linear regression analysis, with social support as a dependent variable, retained the following independent predictors in the final regression model: city (4.792, 95% confidence interval [CI]: 3.068-6.516, P = 0.000), age (-0.805, 95% CI: -1.394 to -0.135, P = 0.013), marital status (-1.260, 95% CI: -1.891 to -0.629, P = 0.000), living conditions (4.069, 95% CI: 3.022-5.116, P = 0.000), and SRH -1.941, 95% CI: -3.194 to -0.688, P = 0.003). The multiple-level model showed that city would impact older people's social support (χ = 5.103, P < 0.001). Marital status (-2.133, 95% CI: -2.768 to -1.499, P = 0.000), education (1.697, 95% CI: 0.589-2.805 P = 0.003), living conditions (4.20, 95% CI: 1.762-6.638, P = 0.000), and SRH (-3.144, 95% CI: -4.502 to -1.727, P = 0.000) were the associated factors. Thus, city, age, marital status, education, living conditions, and SRH might be the associated factors for social support among older people.This study presents some feasible implications for social support improvement in China and in other nations worldwide.

Social Engagement and Health

What are the social factors that matter most to the health of elderly Chinese? Are there any gender and age differences? Using a representative sample of elderly Chinese in Shanghai, the most developed city in China with the nation’s largest proportion of elderly residents, this study found that economic conditions, chronic health status, living arrangements, social activity participation, and caring for grandchildren are factors that are most important to the health of elderly Chinese. This is true for both self-rated health and psychological well-being. The beneficial effects of participation in social activities are particularly salient for elderly women and for the old–old, whereas the salutary effects of caring for grandchildren are more substantial for elderly men and for the young–old. Our findings suggest the importance of social engagement in promoting health and successful aging of elderly Chinese and disclose the moderating roles of gender and age in this focal relationship.