Pathways to healthy aging - Exploring the determinants of self-rated health in older adults

Associations between self-rated health and depressive symptoms among middle-aged and older adults in China: A cross-lagged panel analysis (2011-2020)

BACKGROUND

As the aging of the population accelerates, mental health is important to the quality of life of middle-aged and older people, as well as to the healthcare system and the economy. This study focuses on the relationship between depressive symptoms and self-rated health in middle-aged and older people, as well as whether this relationship differs between urban and rural China.

METHODS

Data from the China Health and Retirement Longitudinal Study (CHARLS). The final analysis included 10503 participants aged 45 years or above. The longitudinal cross-lagged panel analysis was used to assess the relationship between self-rated health and depressive symptoms.

RESULTS

The model revealed a bidirectional relationship between self-rated health and depressive symptoms. Self-rated health at each time point had a significant effect on subsequent depressive symptoms, and vice versa. However, no urban-rural disparities in these relationships.

CONCLUSION

Self-rated health and depressive symptoms were interrelated over time among middle-aged and older adults. To ensure the mental health and quality of life in later life of middle-aged and older adults, it is essential to assess and manage both self-rated health and depressive symptoms.

Factors contributing to self-rated health in community-dwelling independent 75-year-old Finns: a population-based cross-sectional cohort study

BACKGROUND

Self-rated health (SRH) reflects biological, social, and functional aspects of an individual, incorporating personal and cultural beliefs as well as health behaviours. A deeper understanding of the structure of SRH can help health professionals focus on patients' personal health and functional goals and guide preventive health policies. This study aimed to examine the associations between SRH and independent factors by gender.

METHODS

The population-based, cross-sectional cohort study included 2,539 community-dwelling 75-year-old Finns who participated in the Turku Senior Health Clinic study. Data were collected through clinical examinations, questionnaires, and interviews, which included assessments of SRH, sociodemographic factors (living arrangements, education, self-rated financial status), psychosocial factors (sense of life meaningfulness, satisfaction with relationships, loneliness), health-related behaviours (smoking, alcohol use, physical activity), physical functioning (use of a mobility device, self-rated ability to walk 400 m, history of falls), and health conditions (pain, depressive symptoms, central obesity, vision, sleep quality, and number of self-reported diseases). A backward logistic regression analysis with an inclusion criterion of p < 0.001 was used to identify independent variables associated with SRH.

RESULTS

Fifty percent of both men and women reported having a poor SRH. There were no significant interactions between gender and independent variables regarding SRH. Independent variables associated with poor SRH were experiencing difficulties in walking 400 m (odds ratio 7.45, 95% confidence interval 4.91-11.30), being multimorbid (≥ 6 diseases 6.00, 4.11-8.75; 2-5 diseases 2.97, 2.18-4.06), poor self-rated financial status (3.46, 2.82-4.24), lower levels of life meaningfulness (2.53, 2.07-3.11), having poor (2.34, 1.70-3.21) or moderate (1.58, 1.26-1.98) sleep quality, experiencing depressive symptoms (2.08, 1.57-2.77), reporting at least moderate (2.01, 1.59-2.54) or mild (1.31, 1.01-1.70) pain, and vision impairment (1.50, 1.21-1.86). The area under the curve of this model was 0.842.

CONCLUSIONS

Our findings support early and proven prevention strategies for the most disabling chronic diseases, as well as promoting self-care management, physical activity, and muscle strength. Additionally, a balanced treatment approach that addresses vision impairments and manages symptoms such as pain, poor sleep, and depression is important for older adults' health.

TRAIL REGISTRATION

The study is registered in ClinicalTrials.gov (Identifier: NCT05634239). Retrospectively registered.

Understanding mental health in older adults: exploring the interplay of wisdom, perceived poor health, and attitudes toward aging

OBJECTIVES

Late adulthood is marked by challenges that impact well-being. While perceived health, wisdom, and positive attitudes toward aging correlate with better mental health in later life, their interrelations are not well understood. This study explored if three-dimensional wisdom could buffer the negative impact of poor physical health on mental health, and if positive attitudes toward aging mediated the effects of wisdom and poor health on mental health.

METHOD

A survey of 500 Polish older adults aged 60-86 included the Personal Wellbeing Index, Geriatric Depression Scale, Three-Dimensional Wisdom Scale, Attitudes to Aging Questionnaire, perceived health, and sociodemographic questions.

RESULTS

Wisdom buffered the negative association between poor physical health on mental health and had a significantly stronger effect on mental health if perceived physical health was very poor. The relations of wisdom, poor health, and the interaction between wisdom and poor health on mental health were partially mediated by attitudes toward aging.

CONCLUSION

Wisdom seems to mitigate the negative effects of poor health on mental health, and wise older adults tend to have more positive attitudes toward aging, leading to better mental health outcomes. Those findings support the important role played by wisdom and attitudes toward aging in healthy aging interventions.

A study of the predictive value of different health indicators on the risk of all-cause mortality in older adults living in communities

OBJECTIVES

Intrinsic capacity(IC), self-rated health (SRH), and hand grip strength (HGS) reflect the health status from different aspects. This study aimed to investigate the relationship between IC, SRH, SRH combined with HGS and all-cause mortality among Chinese older adults living in communities.

METHODS

This study used data from the 2011 (baseline), 2013, 2015, 2018, and 2020 waves of the China Health and Retirement Longitudinal Study (CHARLS). We evaluated IC, SRH, and HGS using questionnaires. We assessed baseline levels of IC, SRH, and SRH combined HGS. Using the COX proportional hazards model, we investigated the associations between baseline IC, SRH, and SRH combined HGS and all-cause mortality. We used receiver operating characteristic curves (ROC) curves to compare the predictive effects of IC, SRH, and SRH combined HGS on all-cause mortality among Chinese older adults living in communities.

RESULTS

At baseline (2011), the study included a total of 4095 participants. The multifactorial Cox regression analysis results showed that older adults had a much higher risk of death from any cause compared to those who said they were in good health and had a normal hand grip strength, those who said they were in fair health and had a low hand grip strength [HR = 3.959, 95 % CI (2.892-5.421)], those who said they were in bad health and had a normal hand grip strength [HR = 3.150, 95 % CI (2.392-4.148)], and those who said they were in bad health and had a low hand grip strength [HR = 4.189, 95 % CI (3.123-5.618)]. The study looked at older adults who lived in the community. The area under the ROC curves (AUC) for IC and SRH combined HGS to predict death from any cause was 0.726 [95 % CI (0.708-0.744)] and 0.704 [95 % CI (0.683-0.725)], respectively.

CONCLUSION

Combining SRH and HGS improves older adults' health management by more accurately predicting the risk of all-cause mortality.

Subjective and objective health according to the characteristics of older adults: Using data from a national survey of older Koreans

As society rapidly ages, older adults are becoming an important national issue. Health is a multidimensional concept and both objective and subjective health must be managed. This study investigated factors that influence the subjective and objective health of older adults. This study analyzed the data of 9391 people aged ≥65 years using raw data from a 2020 survey of senior citizens. The relationships among the characteristics of older adults, such as demographic variables, lifestyle, external activities, environment, physical function, depression, cognition, activities of daily living, satisfaction with life and health, perceived health level, and number of diseases, were investigated. Older adults who drink and do not exercise generally have good objective health but poor subjective health. Older adults who mainly engage in external activities tend to have poor subjective health despite good objective health. The factors affecting subjective health in older adults were depression, cognition, physical factors, activities of daily living, and satisfaction. This study identified the differences between subjective and objective health based on the characteristics of older adults. As many variables affecting the health of older adults have been identified, these basic data will help prepare various programs to promote a healthy life for older adults.

Effects of Wisdom on Mental Health in Old Age: Exploring the Pathways Through Developmental Tasks Attainment and Self-Rated Health

Purpose

A number of studies indicate a relationship between wisdom and mental health in older adults, which can be explained by different pathways. However, the role of developmental task accomplishment, and of self-rated health in the relationships between wisdom and mental health in later life remain unclear. The aim of the current study is to explore the structure of the relationships between wisdom, developmental task attainment, self-rated health, and positive and negative mental health outcomes (viz. wellbeing and depressive symptoms) in older adults.

Methods

The study included 381 Polish older adults aged 60-86 (M= 67.33; SD = 5.08). The respondents completed the Personal Wellbeing Index, Geriatric Depression Scale, Three-Dimensional Wisdom Scale, Developmental Tasks Attainment Questionnaire for Seniors, self-rated health scale and sociodemographic survey.

Results

Three-dimensional wisdom, developmental task attainment and self-rated health scores were positive predictors of personal wellbeing and negative predictors of depressive symptoms in older adults. Structural equation modelling revealed that developmental tasks attainment and self-rated health partially mediated the relations between wisdom and mental health in older adults.

Conclusion

It can be assumed that wise older adults implement developmental tasks more efficiently and assess their subjective health more favorably, which may strengthen their personal wellbeing and prevent depression. The findings suggest that wisdom plays an important role in healthy aging.

The relationships between wisdom, positive orientation and health-related behavior in older adults

The concept of healthy ageing, i.e. maintaining health in late life, is closely connected with the role of health behavior. Although health behavior is determined by personal factors, little is known about its relationships with wisdom and positive orientation. Therefore, the aim of the study was to establish relationships between sociodemographic and health factors, personal resources (wisdom and positive orientation) and health-related behavior in late life. The study included 353 Polish seniors aged 60-99 (M = 71.95; SD = 1.45). The respondents completed the Health-Related Questionnaire for Seniors, Three Dimensional Wisdom Scale, Positive Orientation Scale and a sociodemographic survey. Wisdom and positive orientation were associated with general health behavior and all of its factors. Among the sociodemographic variables, attendance in nonformal education courses had the strongest predictive role for health behavior. A hierarchical regression model demonstrated that personal resources significantly determined healthy lifestyle, after controlling for sociodemographic factors. Additionally, mediational analyses revealed that positive orientation acted as a partial mediator between wisdom and health behavior. Our findings extend knowledge about the factors enhancing healthy lifestyle in older adults, indicating that both wisdom and positive orientation may represent valuable personal resources for health-related behavior.

Development of a composite healthy ageing score: evidence from middle-to-older aged Australians

We developed and validated a composite healthy ageing score (HAS) to address the absence of a definitive composite score comprising multiple health domains that measure healthy ageing in epidemiology. The HAS is developed from 13 health domains reported to influence healthy ageing. Data to measure these domains was extracted from the 45 and Up Study baseline. We applied best practices for scale validation and development. Physical functioning, cognitive function, mental health, sleep, quality of life, balance, social connections and overall health were retained. Functional capacity and resilience were uncovered as underlying latent structures. The HAS ranges from 0 to 16 with higher scores indicating a better health profile. This research contributes a comprehensive measuring tool, HAS, It enables examination and comparison of individual or collective health profiles and the investigation of the factors that influence their chances of living healthy for longer.

Cognition in older adults with healthy aging: analysis of the Mexican Health and Aging Study 2012-2015

Introduction

Maintaining older adults' health and well-being can be achieved through the optimization of physical and mental health, while preserving independence, social participation, and quality of life. Cognitive change has been described as a normal process of aging and it involves domains such as processing speed, attention, memory, language, visuospatial abilities, and executive functioning, among others.

Objective

To describe cognitive changes in older adults with healthy aging.

Methods

This is a study that involved data from 14,893 and 14,154 individuals aged >60 years or older from the 2012 and 2015 waves, respectively, who participated in the Mexican Health and Aging Study (MHAS). Participants with healthy aging were identified and described in the MHAS-2012 wave and followed to 2015. Eight cognitive domains evaluated in the Cross-Cultural Cognitive Evaluation (CCCE,) as well as sociodemographic and health characteristics, were described. Criteria for healthy aging involved the following: CCCE ≥ -1.5 standard deviations above the mean on reference norms, independence on basic and instrumental activities of daily living, self-reported "life close to ideal," and preserved functional and social performance.

Results

From a total of n = 9,160 older adults from the MHAS-2012 wave, n = 1,080 (11.8%) had healthy aging. In the healthy aging group, the median age was 67 years (IQR: 63-73), 58.1% were female and the median for education was 6 (IQR: 3-8) years. The mean CCCE score was 57 (SD: 16.9) points. In the MHAS-2012 cross-sectional analysis, except for orientation, visuospatial abilities, and verbal fluency, all cognitive domain scores were lower with passing age. When comparing cognitive domain scores in the 225 older adults identified with healthy aging between the 2012 and 2015 MHAS waves, there were almost no observable differences.

Conclusion

In the cross-sectional analysis, Mexican adults with healthy aging had lower scores in the verbal learning memory, visual scanning, numeracy, visual memory, and verbal recall domains', as well as lower global cognitive scores in the higher age groups. There were no cognitive changes in the 3 year follow-up, except for a lower gradient of scores in the verbal recall memory domain. Longer prospective studies are needed to characterize greater cognitive changes.

Lifestyles of Spanish elders from supervened SARS-CoV-2 variant onwards: A correlational research on life satisfaction and social-relational praxes

Objective

This study aimed to analyze the influence and measurement of the relationship and interaction between the elderly lifestyles after the appearance of the SARS-CoV-2 variant and the factors analyzed comprised life satisfaction levels, social relationships, and daily-life activities.

Methods

The study population was ≥ 65 in Castile-La Mancha (N = 390,221). The research design was quantitative and arose from primary data collected via an ad hoc survey carried out through the Computer Assisted Telephone Interview system by randomly stratified sampling. The sample size was made up of 1,065 cases, and the participants were selected through a random sampling stratified by gender quotas (55.40% women; 44.60% men), age (x¯ = 76.56), province, and habitat size.

Results

The results obtained revealed two main lifestyles, from which a notable behavioral change in personal relationships led to infer toward alternative lifestyles.

Conclusion

Notwithstanding the variation in lifestyles of the elderly after the pandemic, certain relationships remained unaltered. Thus, from the analyzed variables, relatives and friends relationships were scarcely influenced by the supervened incident.