The effect of having a partner on activities of daily living in men and women aged 82-87 years

The impact of neighborhood mental health on the mental health of older adults

BACKGROUND

In this article, we use cross-sectional data obtained from the 2018 China Health and Aging Tracking Survey (CHARLS) to examine the impact of neighborhood mental health at the community level on the mental health of older adults aged 60 years and older.

METHODS

NMH is the average mental health of older adults in the same community, excluding the older adults themselves. The explained variable mental health in this paper was measured using the simple CES-D depression scale. The mediating variables were social connectedness, social participation and social inclusion, and the instrumental variables were physical exercise and amusement. regression analysis was conducted using OLS regression models, two-stage least squares (IV-2SLS) instrumental variables to address the two-way causality of NMH and MH, and KHB decomposition was used to investigate the effect mechanism.

RESULTS

Baseline regressions showed that the neighborhood mental health effect positively influenced the mental health of older adults (Coef. = 0.356, 95% CI 0.315,0.397). The neighborhood mental health effect estimated by IV-2SLS (Coef. = 0.251, 95% CI 0.096,0.405) was higher than the OLS regression, indicating endogeneity. The mediated effects of KHB showed total (Coef. = 0.356, 95% CI 0.314,0.398), direct (Coef. = 0.281, 95% CI 0.232,0.330), and indirect effects (Coef. = 0.075, 95% CI 0.049,0.101). While the total effect was 1.266 times higher than the direct effect, 21.03% of the total effect came from mediating variables.

CONCLUSIONS

First, the neighborhood mental health effect has a positive impact on the mental health of older adults, but there are heterogeneous differences based on gender, age, and place of residence. Second, the results of the IV-2SLS estimation showed that the effect of the neighborhood mental health effect was underestimated if endogenous problems were not controlled for. Third, the effect of neighborhood mental health on older adults' mental health was tested to be stable. Moreover, social connectedness, social participation, and social interaction are important mediating mechanisms for the effect of neighborhood mental health on older adults' mental health. This study provides new perspectives and ideas for an in-depth understanding of the mental health of older adults in the context of social transformation in China.

Leisure activities and instrumental activities of daily living: A 3-year cohort study from the Japan Gerontological Evaluation Study

AIM

We prospectively examined the association between leisure activities and changes in instrumental activities of daily living (IADL) among participants of the Japan Gerontological Evaluation Study (JAGES).

METHODS

We analyzed data collected from 49 732 JAGES participants (23 359 men and 26 373 women), aged ≥65 years, from 24 municipalities in Japan.

MEASUREMENTS

Baseline data were obtained for 25 types of leisure activities in which the cohort members participated. Baseline (2010) and follow-up (2013) data on IADL were collected - the outcome indicated changes in IADL scores from 2010 to 2013. We regressed changes in IADL scores from the 2010 to 2013 to the number of leisure activities.

RESULTS

Older adults who engaged in more leisure activities had higher changes in IADL scores than those who engaged in fewer leisure activities: the β values (95% confidence interval [CI]) of the IADL scores were 0.001 [-0.04-0.04], 0.04 [0.01-0.08], 0.09 [0.05-0.13], 0.09 [0.05-0.14], 0.08 [0.02-0.13], and 0.13 [0.07-0.18] for having one, two, three, four, five, and more than six types of leisure activities (P for trend <0.001), respectively. Similar associations were found for different types of leisure activities, including predominantly physical and cultural activities. Statistically significant linear trends were obtained among the group, solitary, and other leisure activity subgroups (P for trend <0.05).

CONCLUSIONS

Encouraging engagement in leisure activities may promote maintenance of IADL among older populations. Different types of leisure activities appear to have similar positive impacts on IADL. Geriatr Gerontol Int 2021; ••: ••-••.

Work-family life courses and psychological distress: Evidence from three British birth cohort studies

This study uses multi-channel sequence analysis to characterize work-family life course types between the ages of 16 and 42, and multivariable logistic regression to examine their association with psychological distress at age 42/43 for men and women in three nationally-representative British birth cohorts born in 1946 (N = 2,858), 1958 (N = 9,140), and 1970 (N = 7,095). We hypothesised that work-family life courses characterized by weaker links to employment and earlier transitions to partnerships and parenthood would be associated with a greater probability of psychological distress at age 42, and that this association would be become more pronounced across cohorts. Levels of psychological distress were higher amongst men and women with weaker long-term ties to employment, although these were largely explained by early life factors. Teen mothers had higher levels of psychological distress in the two later-born cohorts, and this remained unexplained in adjusted models for the 1970 cohort.

Gender Differences in State Anxiety Related to Daily Function Among Older Adults During the COVID-19 Pandemic: Questionnaire Study

BACKGROUND

The COVID-19 pandemic poses a challenge to people's day-to-day functioning and emotional and physical health, especially among older adults.

OBJECTIVE

The aim of this study is to analyze gender differences in state anxiety, daily functional self-actualization, and functional cognition as well as the relationships among those factors in older adults during the COVID-19 pandemic lockdown.

METHODS

We collected data on the web from a sample of 204 people (102 men and 102 women) aged 60 years and older. In addition to a demographic questionnaire, we used the State-Trait Personality Inventory to assess state anxiety, the Daily Functional Actualization questionnaire to evaluate daily functional self-actualization, and the Daily Living Questionnaire to measure functional cognition.

RESULTS

Significant gender differences were found for state anxiety (t₂₀₂=-2.36, P=.02); daily functional self-actualization (t₂₀₂=2.15, P=.03); and the functional cognition components: complex tasks (Z=-3.07, P=.002); cognitive symptoms that might be interfering (Z=-2.15, P=.028); executive functions (Z=-2.21, P=.024); and executive function monitoring (Z=-2.21, P=.027). Significant medium correlations were found between both state anxiety level and daily functional self-actualization (r=-0.62, P<.001) and functional cognition (r=0.37-0.40, P<.001). Gender predicted 3% of the variance in state anxiety level, while daily functional self-actualization predicted 41% and complex activities (Daily Living Questionnaire) predicted an additional 3% (F_3,200=58.01, P<.001).

CONCLUSIONS

In older adults, anxiety is associated with cognitive decline, which may harm daily functional abilities and lead to social isolation, loneliness, and decreased well-being. Self-awareness and knowledge of gender differences and relationships between common available resources of daily functional self-actualization and functional cognition with anxiety may be strengthening factors in crisis periods such as the COVID-19 pandemic.

Health Status and Functional Abilities of Elderly Males Visiting Primary Health-care Centers in Khamis Mushait, Saudi Arabia

Background

There is an aging population all over the world, and Saudi Arabia is no exception to it. An aging population poses several challenges to the health-care sector.

Aim

The aim of this study was to examine the health status and functional abilities of elderly people visiting primary health-care centers in Khamis Mushait, Saudi Arabia.

Methods

This cross-sectional study involved elderly male Saudi nationals aged 60 years and above. Self-rated health status and body pain, functional status, geriatric review of systems and other relevant data were collected using the Geriatric Health Questionnaire of University of Iowa Health Care. All statistical analyses were performed using SPSS version 21.

Results

The study results showed that the overall health of the elderly was either good (32.9%) or very good (32.3%), while 14.2% rated their health as excellent. Only two participants rated their health as poor. The majority of the participants (71.9%) had no functional impairment in basic activities of daily living (BADL), while 35.7% had mild impairment in instrumental activities of daily living (IADL). Only two participants were found to have total impairment in IADL. The most common limitation among BADL was walking (21.1%) and among IADL was doing the housework. The notable factors associated with functional impairment in BADL and IADL were old age (≥80 years), poor eyesight, memory impairment, having trouble with control of bladder, falls twice or more, taking more than two medications, being sexually inactive, poor self-rated general health and severe self-rated body pain (all P<0.05) among others.

Conclusion

The majority of the elderly were able to perform BADL independently and to a lesser extent IADL; the overall self-rated general health was found to be good. Further research in the field of geriatrics is warranted to plan better, and design public health policies and provide efficient care to elderly patients.

Which patients with type 2 diabetes mellitus are perceived as 'difficult' by general practitioners?

AIMS

To find factors that are associated with a general practitioner's (GP's) subjective impression of a patient being 'difficult' within a sample of patients with type 2 diabetes mellitus (T2DM).

METHODS

Secondary cross-sectional analysis of a cohort of GP patients with T2DM. GP questionnaire on clinical data and GPs' subjective ratings of patient attributes (including 'patient difficulty'). Patient questionnaire on sociodemographics and illness perceptions. Bivariate and multivariate analyses, adjusted for cluster-effect of GP practice.

RESULTS

Data from 314 patients from 49 GPs could be analysed. Independent associations with higher GP-rated difficulty were found for (odds ratio; 95% confidence interval): male patients from male GPs (1.27; 1.06-1.53), unmarried men (1.25; 1.04-1.51), men with non-German nationality (1.80; 1.24-2.61), patients perceiving more problems with diabetes (1.17; 1.04-1.30), patients with higher BMI (1.01; 1.00-1.02) and HbA1c values (1.06; 1.02-1.10), patients being perceived by the GP as less adherent (1.34; 1.22-1.46) and less health-literate (1.19; 1.04-1.35).

CONCLUSIONS

The impact of patients' gender and illness perception yield new insights into GP-perceived complexity of care. Culturally and gender-sensitive communication techniques for adapting health care goals to patients' problems (rather than norm values) may alleviate GPs' work.

Inequalities in long term health-related quality of life between partnered and not partnered breast cancer survivors through the mediation effect of social support

OBJECTIVE

To compare long-term quality of life outcomes by marital status among women living with breast cancer, and to test the mediation effects of social support as an underlying factor.

METHODS

Data are drawn from 1996 to 2010 of the Australian Longitudinal Study on Women's Health. The sample included 505 women with breast cancer with six years of follow-up data. Social support was measured by the Medical Outcomes Study Social Support Survey (MOS-SSS). Physical and mental health-related quality of life (HRQOL) was measured using the Short-Form Health Survey (SF-36).

RESULTS

Breast cancer survivors who did not have a partner, compared to those who had a partner, had significantly lower levels of social support, which was associated with poorer HRQOL. Social support mediated the relationship between not having a partner and poorer HRQOL. Results were consistent after taken into consideration socio-demographic characteristics, which included age, highest level of education, country of birth, and area of residence.

CONCLUSIONS

Women recovering from breast cancer who do not have partners have poorer physical and mental HRQOL, than those with partners, with a lack of social support as an underlying inequality. Partners of breast cancer survivors are importance sources in the provision of social support to help them maintain well-being and quality of life. Copyright © 2016 John Wiley & Sons, Ltd.

Preventing Loss of Basic Activities of Daily Living and Instrumental Activities of Daily Living in Elderly: Identification of Individual Risk Factors in a Holistic Perspective

This study investigated the association between physical functioning and activities of daily living (ADL) of elderly people, taking into account the role of cognitive, psychological, and social factors. We administered physical, cognitive, psychological, and social instruments to investigate the level of basic and instrumental activities of daily living (BADL and IADL). The analysis showed that physical functioning was the only individual factor that was significantly linked with the level of BADL and IADL. This study underlines that physical functioning is the main individual characteristic directly associated with the level of BADL and IADL in old age.

Partner status and mental and physical health of independently living men aged 70 years and older

AIM

To describe and compare the mental health and physical functioning of community-dwelling men aged 70 years and over who live alone, and those who live with their partner/spouse.

METHOD

Data were obtained from the baseline survey of the New South Wales 45 and Up Study. Mental health was measured using the Kessler Psychological Distress Scale and physical health was measured using the Medical Outcome Short Form 36 physical functioning scale.

RESULTS

37 690 community-dwelling men aged 70 years or over were included in the analyses. Men living alone were more likely to have high psychological distress scores and lower physical functioning scores compared to men living with a spouse/partner within each age group, except those 85 and over.

CONCLUSIONS

Specific health and welfare programs targeted to the increasing number of older men living alone may be needed to address their higher levels of psychological distress and lower levels of physical functioning.

Behavioral correlates of anxiety in well-functioning older adults

BACKGROUND

Research on the behavioral correlates of anxiety in older adults is sparse. The aim of this study was to explore the association of anxiety with behavioral patterns defined by health, activity, emotional and social variables.

METHODS

A convenience sample of 395 older adults completed measures of health, activity, emotions, social variables and experiential avoidance. Cross-sectional data were analysed using cluster analysis.

RESULTS

Five clusters were identified: active healthy, healthy, active vulnerable, lonely inactive and frail lonely. Participants in the active healthy and healthy clusters showed the highest scores on health variables (vitality and physical function), and adaptive scores on the rest of variables. They also reported the lowest scores on anxiety and included the lowest number of cases with clinically significant anxiety levels. Active vulnerable showed high scores on social support, leisure activities and capitalization on them but low scores in vitality and physical functioning. Participants in the lonely inactive cluster reported the highest mean score in experiential avoidance and high scores on boredom and loneliness, and low scores on social support, leisure activities capitalizing on pleasant activities and health variables. Frail lonely represent a particularly vulnerable profile of participants, similar to that of lonely inactive, but with significantly lower scores on health variables and higher scores on boredom and hours watching TV.

CONCLUSIONS

Anxiety in older adults is not only linked to poor health, but also to dysfunctional social behavior, loneliness, boredom and experiential avoidance. Maladaptive profiles of older adults with regard to these variables have been identified.

A funcionalidade dos mais idosos (>75 anos): conceitos, perfis e oportunidades de um grupo heterogêneo

OBJETIVOS: Conhecer a funcionalidade de dois grupos de idosos (75-84 anos e >85 anos) e sua associação com idade e gênero. MÉTODOS: Trata-se de estudo observacional do tipo analítico e transversal, cuja amostra foi constituída por indivíduos de ambos os sexos com idade >75 anos. Foi recolhida informação relativa a condição de saúde e funcionalidade pré-morbilidade. Os instrumentos de coleta de dados foram um questionário de caracterização sociodemográfica e o Método de Avaliação Biopsicossocial. RESULTADOS: A amostra foi constituída por 262 idosos com média de idade de 82,9 ± 4,86 anos, dos quais 161 (61,5%) eram mulheres. Os mais velhos (>85 anos) viviam mais isolados (p=0,020) e tinham menores habilitações literárias (p=0,027), apresentando mais limitações em utilizar escadas (p=0,015), no banho (p=0,008), na continência fecal (p=0,015) e em todas as atividades instrumentais (p<0,031). As mulheres apresentavam maior vulnerabilidade no estado civil (p<0,001) e no status econômico (p=0,009), enquanto os homens tinham piores resultados nas quedas (p=0,003) e nos comportamentos de risco (p<0,001). O desempenho na locomoção e nas atividades básicas e instrumentais era semelhante entre os sexos. CONCLUSÕES: As variáveis de natureza social apresentaram-se diferentes quanto à idade e ao gênero. As componentes da funcionalidade -locomoção, atividades diárias básicas e atividades instrumentais - apresentaram maiores limitações nos idosos com idade > 85 anos, sobretudo as instrumentais. Não se encontraram diferenças na funcionalidade em relação ao gênero.