Work and mental health: the case of older men living in underprivileged communities in Lebanon

Adulthood Employment Trajectories and Later Life Mental Health before and after the Onset of the COVID-19 Pandemic

BACKGROUND

This life course study has two aims. First, to explore how diverse employment trajectories across adulthood are related to older people's mental health in Chile, a country with no research in this field, and second, to analyze these associations before and after the onset of the COVID-19 pandemic.

METHODS

We use data from the nationally-representative and longitudinal 'Chilean Social Protection Survey' sequence analysis to reconstruct employment trajectory types, and bivariate and multivariate analyses to measure their association with depressive symptoms.

RESULTS

Our findings indicate that formal labor force patterns in adulthood show the lowest burden of depressive symptomology before and after the onset of the overwhelming COVID-19 pandemic when controlling for traditional risk factors.

CONCLUSION

We emphasize that policymakers in both the labor market and public health domains must consider the relationship between informal employment pathways in adulthood and poorer mental health in old age. Public policies should improve the conditions and quality of jobs during adulthood and promote more formalization in the labor market to address the high uncertainty involving low social protection, which is strongly associated with severe mental health problems in later life.

Social participation and depressive symptoms in community-dwelling older adults: Emotional social support as a mediator

Previous studies have documented the protective effects of social participation on depression in older adults. In this study, we investigated the association between social participation and depressive symptoms and the associated gender difference in older adults. In addition, we explored the mediating role of emotional social support in the association between social participation and depressive symptoms. We collected data from 4751 community-dwelling adults aged 60 and above from the Korean Retirement and Income Study (KReIS) conducted in 2017 and 2018. The relationship between social participation (participation in different types of activities, frequency of participation, and the number of activities participated) and the risk for depressive symptoms was examined. Older adults who participated in social activity, volunteer work, and donation had decreased risk of depressive symptoms. More frequent and more diverse participation in activities further reduced the risk. Overall, women benefited more from social participation than men. Importantly, emotional social support significantly mediated the relationship between social participation and depressive symptoms. Social participation was associated lower odds for depression in older adults, particularly in older women. Our findings provided one of very few pieces of evidence that documents the mediating role of emotional social support in the relationship between social participation and depression among the elderly.

Public Pension, Labor Force Participation, and Depressive Symptoms across Gender among Older Adults in Rural China: A Moderated Mediation Analysis

Due to insufficient financial support and unceasing work, the rural elderly in China experience a range of mental disorders, and the most common one is depression. This study aims to investigate the association between public pension, labor force participation (LFP), and depressive symptoms for older men and women in rural China. A moderated mediation analysis is conducted using data in the 2015 wave extracted from the China Health and Retirement Longitudinal Study (CHARLS), a continuous national social survey. A total of 2709 available surveys were obtained in our analysis. Using PROCESS, results revealed that the income from China’s New Rural Pension Scheme (NRPS) was directly negatively related to depressive symptoms. However, LFP did not mediate the link between pension income (PI) and depressive symptoms in the total study population. The results of moderated mediation estimates indicated that gender significantly moderated the relationship between LFP and depressive symptoms. Specifically, for older women, the indirect effect of PI on depressive symptoms via LFP was significant, but not for the opposite sex. In order to improve the mental health of older adults in rural China, the policy makers and mental health therapists need to pay attention to the aforementioned factors.

Correlates associated with mental health and nutritional status in Lebanese older adults: A cross-sectional study

OBJECTIVE

To assess correlates of mental and nutritional health among elderly in Lebanon, inside nursing homes compared to their private homes.

METHODS

This cross-sectional study was conducted between June and August 2016 on 500 elderly.

RESULTS

Higher somatic (Beta = 0.259) and cognitive anxiety (Beta = 0.508), increased age (Beta = 0.174) were significantly associated with higher depression, whereas having a secondary (Beta = -4.006) and a university (Beta = -6.829) levels of education compared to illiteracy, living home (Beta = -2.557) compared to living in a nursing home and male gender (Beta = -1.280) were significantly associated with lower depression. Increased BMI (Beta = 0.056), a married (Beta = 0.687) and a widowed (Beta = 1.022) status compared to a single status were associated with a better nutritional status, whereas an increased somatic anxiety (Beta = -0.061), secondary (Beta = -0.79) and university (Beta = -1.196) educational levels compared to illiteracy were significantly associated with a worse nutritional status. Increased cognitive (Beta = 1.160) and affective (Beta = 0.788) anxiety and age (Beta = 0.191) were associated with higher stress, whereas a primary (Beta = -6.991), secondary (Beta = -11.812) and university (Beta = -13.927) educational levels, male gender (Beta = -2.015) were significantly associated with lower stress compared to females. A significantly higher mean depression score was found in patients living in nursing homes compared to those living at home (13.74 vs. 11.18). No difference was found between the two groups concerning the nutritional status and stress score.

CONCLUSION

Living in nursing homes was associated with more malnutrition and depression. An increased awareness of the personnel working in nursing homes and family members of these older adults can help improve their psychological status.

Social participation and depressive symptoms among Chinese older adults: A study on rural-urban differences

BACKGROUND

Although studies conducted in developed countries have reported a negative relationship between social participation and depressive symptoms, few studies have examined rural-urban differences in the relationship between participation in various types of social activities and depressive symptoms among Chinese older adults.

OBJECTIVES

This study examined the association between participation in paid work, political, and voluntary activities and depressive symptoms among Chinese older adults in urban and rural areas.

METHODS

Data were obtained from the China Longitudinal Ageing Social Survey conducted in 2014, and bivariate linear regression and multivariable linear regression analyses were conducted.

RESULTS

The prevalence of depressive symptoms was significantly higher among older adults residing in rural areas than among older adults in urban areas. Participation in paid work activities was significantly associated with fewer depressive symptoms among older adults in urban and rural areas, whereas participation in political or voluntary activities was negatively associated with depressive symptoms only among older adults in urban areas. Older adults who participated in two or three types of activities (paid work, political, and voluntary activities) tended to have fewer depressive symptoms both in urban and rural areas.

LIMITATIONS

Because this study comprised a cross-sectional design, causality could not be established between social participation and depressive symptoms.

CONCLUSIONS

Social participation plays a protective role against depressive symptoms among Chinese older adults, especially among those in urban areas. Urban-rural differences exist between participation in different types of social activities and depression symptoms.

Aging in Lebanon: Challenges and Opportunities

This spotlight offers a unique window into factors affecting aging in Lebanon. As a bridge between east and west, both geographically and culturally, Lebanon has the fastest growing older adult population in the Arab region, but few societal resources to address its needs. In a country with a history of political instability and war, but also a culture with strong family values, aging adults in Lebanon are vulnerable in some ways and advantaged in others. Outmigration of youth is an important determinant of the wellbeing of the elderly. While often advantaged by remittances sent by their children, older Lebanese adults have less access to instrumental social and personal support previously provided by young adults in the family. How Lebanon manages these challenges is likely to foreshadow the future aging experience for much of the Arab region.

Nutritional and health status among nursing home residents in Lebanon: comparison across gender in a national cross sectional study

Background

This study described the differences between elderly men and women living in Lebanese long-term care nursing homes on socio-economic, health and nutritional status.

Methods

This study used a cross-sectional design. Field researchers obtained data from 221 residents; 148 (67%) women and 73 (33%) men, living in 36 nursing homes. Data on health conditions; nutritional, psychological, and functional status; socio-demographic characteristics, as well as social relations were collected. The analysis used both chi-square and t-test tests.

Results

The majority of elderly had low socio-economic and poor health status. In comparison to men, women were significantly less educated, had lower occupational status, had no partner, relied financially on their children and relatives, and enjoyed better social relations and health behaviours. Furthermore, the prevalence of both; malnutrition, and at risk of malnutrition, were at 3.2% and 27.6% respectively. There was no statistically significant difference between women and men on Mini Nutritional Assessment, Activities of Daily Living, Geriatric Depression Scale, Body Mass Index, and chronic diseases. While women reported “good” health status compared to men, they continued to have higher prevalence of diseases and chronic pain.

Conclusions

This study explored the socio-demographic, health, and nutritional status of elderly residing in Lebanese nursing homes and compared these characteristics across gender. The results indicated the need of health support and institutional interventions for elderly women residents.

Coping and disability: evidence from a developing country

AIM

In view of the increasing burden of musculoskeletal-related disability, the growing number of older persons and the scarcity of research on musculoskeletal conditions in the Eastern Mediterranean region, coping with musculoskeletal problems deserves special attention. This paper examines how good coping links to musculoskeletal-related disability among Lebanese citizens aged 15 years and older.

METHODS

The sample included 200 people living in southern Lebanon and who participated in the Community Oriented Program for Control of Rheumatic Diseases (COPCORD) survey. Disability and coping were assessed using self-reported questions. Covariates included demographics, musculoskeletal pain variables, and body mass index (BMI).

RESULTS

Around one-third of the sample had lifetime functional disability due to musculoskeletal problems and 62% were coping well with their problems. Adjusted data showed that the odds of musculoskeletal-related disability among individuals who were not coping well was 2.35 times the odds of disability among individuals who were coping well with 95% CI = 1.10-5.02.

CONCLUSION

This study provides evidence of the importance of complementing pharmacological treatment with a cognitive-behavioral approach for management of musculoskeletal problems.

Socioeconomic resources and living arrangements of older adults in Lebanon: who chooses to live alone?

During recent decades, Lebanon has experienced demographic and social changes which, coupled with political instability, have led to waves of youth migration and a higher proportion of older adults living alone. This paper uses the 2004 data of the ‘Pan Arab Project for Family Health’ to assess the levels of various living arrangements and to examine the correlates of living alone, with a focus on economic resources. The findings reveal that 12 per cent of older adults in Lebanon lived alone (17.3 per cent of women and 6.2 per cent of men). Financially better-off older adults and those who reported being satisfied with their income were, respectively, 4.4 and 1.7 times significantly more likely to live alone than their counterparts. The incomes of Lebanese older adults were mainly provided by their children (74.8%) and a relatively small share derived from pension schemes. Contrary to findings from other Arab countries, variations in living arrangements among Lebanese older adults seem to follow the western model whereby wealthier older individuals are more likely to live alone and to be residentially independent. Further studies are warranted to examine to what extent this trend is the result of past migration of adult children who are now established elsewhere and sending remittances home.