Investigating the associations between productive housework activities, sleep hours and self-reported health among elderly men and women in western industrialised countries

Sleep Experiences of Older Indian Women: An Exploratory Study

As adequate sleep is an indicator of healthy aging, it is of concern that in India, the prevalence of sleep disorders is significant among older women. Using a qualitative approach, we aimed to understand how older Indian women perceive, engage in, and experience sleep and the factors influencing their sleep. Eight urban-residing older women from a southern Indian district were interviewed. Three main themes emerged: perceptions about sleep and sleep disturbances, causes and consequences of disturbed sleep, and sleep practices. Results may guide contextually relevant occupational assessments and interventions to support good sleep and healthy aging of this vulnerable population.

The relationship between educational attainment, lifestyle, self-rated health, and depressive symptoms among Chinese adults: a longitudinal survey from 2012 to 2020

Education holds significant implications for individual health. This work aims to examine the relationship between educational attainment, lifestyle, self-rated health, and depressive symptoms among Chinese adults. We used China Family Panel Studies data from 2012 to 2020. Multiple linear regression models were used to explore the relationship between educational attainment and self-rated health and depressive symptoms, where multidimensional lifestyle (sleep time, exercise time, overtime time, leisure time, housework time, and protein intake) was the mediator variable of the above relationship, and the causal step method was used to test the mediating effect. Our findings show that educational attainment is associated with higher levels of self-rated health and lower levels of depressive symptoms. More importantly, educational attainment also indirectly affects individuals' self-rated health and depressive symptoms through lifestyle. These findings reveal health interventions to develop education further and improve its quality.

Sex-specific poor physical performance in Korean community-dwelling older adults

BACKGROUND

Poor physical performance appears to be different across age and sex. The aim of this study was to examine changes in physical performance across age groups by sex.

METHODS

A cross-sectional study was conducted with 292 community-dwelling older adults (144 males, 148 females; age: 74.7 ± 5.2 years, body mass index: 23.8 ± 2.7 kg/m2). Physical performance tests included (i) strength (handgrip, knee extension, ankle dorsiflexion, ankle plantarflexion, and toe grip), (ii) functional mobility (5 sit-to-stand, 4-m gait speed, and 4-m fast gait speed), and (iii) postural control (timed single-leg stance). Physical performance was compared across four different age groups by sex using ANOVA tests, T-score, and linear regression analysis. All statistical analysis was set at 0.05.

RESULTS

ANOVA showed a significant age effect (p < 0.05) on physical performance measures with only exception for ankle muscle strength. T-score and linear regression analyses revealed sex-specific trends. In males, postural control showed the most significant poor performance, followed by strength. In females, the most notable poor performance was also observed in postural control, followed by functional mobility.

CONCLUSIONS

Most main outcome measures in physical performance worsened over time across age groups while poor performance pattern was different between older males (strength) and females (functional mobility). We highlighted the importance of assessing strength, functional mobility, and postural control in older adults. Based on observed poor performance patterns across age groups by sex, sex-specific interventions should be implemented.

The Night Divide: Gender-Specific Trajectories of Sleep Disturbances Among Multiple Cohorts of Aging Populations

OBJECTIVES

Sleep disturbances in later life are prevalent and can profoundly impact health and well-being. However, whether and how trajectories of sleep disturbances vary as people age by gender and across age cohorts remains unexplored. This study applies an integrated theoretical framework to understand gender-specific trajectories of sleep disturbances over time and how they vary by cohort.

METHODS

Accelerated longitudinal data from the Health and Retirement Study (N = 20,947; M = 8,562, F = 12,385) was analyzed to investigate gender-specific trajectories of sleep disturbances and potential cohort variations. Weighted growth curve model was applied with sociodemographic and health-related variables. Men and women were analyzed separately.

RESULTS

Results showed that sleep disturbances increased with age in men, but not in women. Also, younger cohorts of men increased sleep disturbances over time at a slower rate than older cohorts. Among men, health profiles accounted for the association between age and sleep disturbances. Among men and women, younger cohorts started with higher levels of sleep disturbances around midlife. When examining specific types of sleep disturbance separately, having trouble falling asleep was the type that drove the observed patterns in men. For women, there was no association between age and any individual type of sleep disturbance.

DISCUSSION

This study shows that men, rather than women, tend to experience increasing sleep disturbances with age, with some variations across cohorts. These findings imply that different strategies for men and women and targeted timing over the life course would be most effective at promoting sleep health in American men and women.

Gender difference in "second-shift" physical activity: New insights from analyzing accelerometry data in a nationally representative sample

The gendered organization of daily activities results in differential contexts of physical activity (PA) for the working population, especially during the "second shift" - a time window dominated by household-based activities. Existing research predominantly relies on self-reported leisure-time activities, yielding a partial understanding of gender difference in the source, timing, and accumulation pattern of PA. To address these limitations, this study draws on the interplay between work and family to understand how they shape gender difference in household-based PA across occupational groups. It combines work schedule and accelerometry PA data from the 2005-2006 National Health and Nutrition Examination Survey (NHANES), which permits our study of second-shift PA on workdays among full-time workers, aged 20 to 49, with a regular daytime schedule. To capture different aspects of second-shift PA, the PA outcomes are measured as both volume and accumulation patterns during time windows following (i.e., 6pm-9pm) and prior to typical working hours (7:30am-8:30am). Using generalized estimating equations, we estimate gender differences in the volume and fragmentation of second-shift PA. Overall, women with a full-time job exhibit both higher volume and higher fragmentation of second-shift PA than their male counterparts. The occupational group moderates such gender difference in PA. The gender gaps in PA volume and fragmentation are only evident for professional workers, whereas the second shift represents a gender-neutral context for PA accumulation for non-professional groups. These findings are supported by a secondary analysis when analyzing the whole-day PA data using functional data analysis. Such social patterning of second-shift PA calls for further research on gendered PA under the interplay of work and family beyond the usual focus on leisure activities.

Exploring Perceived Barriers to Physical Activity among Older Adults Living in Low-Population Density Regions: Gender Differences and Associations with Activity Dimensions

Older people in low-population density regions tend to have fewer resources to engage in regular physical activity (PA) compared to their counterparts in urban areas. Moreover, PA assumes different dimensions, and the amount of PA related to each dimension may differ between women and men, predisposing them to different PA practices. Therefore, this cross-sectional study aims to describe the prevalence of barriers to PA, gender differences, and their associations with different PA dimensions. A total of 259 older adults (153 women and 106 men; age, 75.17 ± 8.05 years old) living in the community in the region of Guarda (Portugal) were interviewed face to face to record their sociodemographic characteristics, general health status (comorbidity index and self-reported health), PA behaviour, and barriers to PA. Women were more likely to report "low" income and living alone (p ≤ 0.05), while men reported a higher negative health status than women (p < 0.05). Two intrinsic ("Fear of injury" (40.1%) and "Need for rest" (26.3%)) and two extrinsic barriers ("Lack of nearby facilities" (30.5%) and "I don't have transport" (25.6%)) were the most prevalent. For women, age, self-reported health, comorbidity index, and intrinsic and extrinsic barriers were similarly associated with the different PA dimensions. However, only self-reported health and extrinsic barriers were the variables associated with the different PA dimensions in men. Therefore, strategies to promote active ageing in low-population density regions should be focused on reducing intrinsic and extrinsic barriers based on gender and the PA dimension to be achieved.

Evaluation of the correlation between depression and physical activity among older persons with osteoporosis: a cross-sectional study

BACKGROUND

Osteoporosis is a common chronic disease in older persons. Physical activity can prevent chronic diseases as well as many diseases associated with aging. Older persons often suffer from depression and other psychological problems. However, there are few studies on the correlation between depression and physical activity in older persons with osteoporosis in China.

METHODS

This cross-sectional study was conducted from June 1 to December 28, 2021. A total of 207 subjects who met the inclusion and were exclusion criteria were selected from the outpatient department of West China Hospital and evaluated using a self-designed demographic data questionnaire, the Self-rating Depression Scale (SDS), and the Physical Activity Scale for the Elderly (PASE). Multivariate linear regression was performed to analyze the factors affecting physical activity, and multivariate logistic regression analysis was performed to analyze the factors affecting depression. Spearman's correlation coefficients were calculated to analyze the correlation between depression and physical activity in older persons with osteoporosis.

RESULTS

A total of 173 valid questionnaires were statistically analyzed. A total of 122 (70.5%) participants were identified as having depression (SDS ≥ 50 points). The median depression score was 62.5 (24.38), and the median PASE score was 69.29 (116.64). Multivariate logistic regression model results showed that physical activity and pain were the main risk factors for depression in older persons with osteoporosis (p < 0.05). Multivariate linear regression model results showed that gender, participation in social activities, activities of daily living status (ADLs), and depression status were the main risk factors associated with physical activity in older persons with osteoporosis (p < 0.05). The results of the correlation analysis showed that physical activity was negatively correlated with depression (R = -0.510, p = 0.000).

CONCLUSION

We found that depression was negatively correlated with physical activity in older persons with osteoporosis in China. This means that the less physical activity there is, the more serious the depression status and having depression may result in reduced physical activity in older persons with osteoporosis. To better help older persons with osteoporosis, medical staff should give more attention to influencing factors of depression and physical activity.

The perks of doing housework: Longitudinal associations with survival and underlying mechanisms

BACKGROUND

Although the majority of existing literature has suggested positive effects of housework on older adults' health and survival rate, the underlying mechanisms of such effects remain unclear. To address potential mechanisms, the present study examined the association between older adults' housework engagement and days of survival across 14 years and tested three potential mediation pathways in this association.

METHODS

Four thousand Hong Kong older adults (50% female; aged between 65 and 98 years) participated in a longitudinal study in which they reported initial housework engagement and health status across three domains (cognitive functioning, physical health, and mental health) at the baseline, and the numbers of days they survived over the subsequent 14-year period were recorded. Linear regression, Cox proportional hazard, and parallel mediation analyses were performed to examine the relationship between housework engagement and days survived, and the mediating effects of these three health factors.

RESULTS

The results showed a positive association between housework engagement and days survived after controlling for demographic variables (age, sex, education, marital status, subjective social status, and living alone). Physical health and mental health, but not cognitive functioning, partially mediated the relationship between housework engagement and days survived. The findings suggest that doing housework may contribute to longer survival by improving older adults' physical and mental health.

CONCLUSION

The current study confirms positive relations of housework with health and mortality among Hong Kong older adults. As the first study examining the relationships and mediation pathways between doing housework and survival in later life, the findings advance our understanding of the mechanisms underlying the positive association between housework and mortality and provide insights for future daily-life health-promotion interventions for older adults.

Associação entre Atividade Física e Aspectos Emocionais de Idosos durante a Pandemia da Covid-19

Para conhecer repercussões da pandemia da covid-19, investigamos a associação entre atividade física e aspectos emocionais de idosos. Para isso, 101 pessoas com 60 anos ou mais responderam a um questionário on-line, via Google Forms. Identificamos que 45,5% dos entrevistados pioraram o desempenho físico, enquanto 11% relataram melhora da aptidão física durante a pandemia. Os exercícios físicos mais praticados foram caminhada (54,5%) e musculação (21,8%). Sobre a mobilidade, as atividades mais frequentes foram ir ao mercado (76,2%), caminhar na vizinhança (64,4%) e sair para tomar sol (61,4%). O Modelo Linear Generalizado mostrou que a piora do desempenho físico foi associada aos níveis mais altos de sofrimento emocional (b=4,35; IC 95%: 1,31-7,11; p=0,003). Os nossos resultados indicam que a melhora do desempenho físico gera repercussões positivas sobre aspectos emocionais de idosos, reforçando a importância da prática regular de exercícios físicos, mesmo em um período de pandemia.

Anxiety prevalence and its association with physical activity in patients with non-communicable diseases during COVID-19 lockdown: a cross-sectional study in Shanghai, China

BACKGROUND

Quarantine due to the COVID-19 pandemic may have created great psychological stress among vulnerable populations. We aimed to investigate the prevalence of anxiety and explore the association between physical activities (PA) and anxiety risk in people with non-communicable diseases during the period of COVID-19 lockdown.

METHODS

We conducted a cross-sectional telephone survey from February 25 to April 20, 2020, the period of COVID-19 lockdown in Shanghai. Up to 8000 patients with type 2 diabetes and/or hypertension were selected using multi-stage cluster random sampling. PA level was measured based on the International Physical Activity Questionnaire using Metabolic Equivalent for Task scores, while symptoms of anxiety were assessed by the 7-item Generalized Anxiety Disorder scale. Multiple logistic regression analyses were performed to evaluate the associations of type and level of PA with the risk of anxiety.

RESULTS

Of a total 4877 eligible patients, 2602 (53.4%) reported with anxiety, and 2463 (50.5%), 123 (2.5%) and 16 (0.3%) reported with mild, moderate, and severe anxiety. The prevalence of anxiety was higher in the females, the elders, non-smokers, non-drinkers, and patients with diabetes, and the associations of anxiety with sex, age, smoking, drinking and diagnosis of diabetes were significant. A significant negative association was observed for housework activities (OR 0.53, 95%CI: [0.45, 0.63], p < 0.001) and trip activities (OR 0.55, 95%CI: [0.48, 0.63], p < 0.001) with anxiety, but no significant was found for exercise activities (OR 1.06, 95%CI: [0.94, 1.20], p = 0.321). Compared with patients with a low PA level, those with a moderate (OR 0.53, 95%CI: [0.44, 0.64], p < 0.001) or a high PA level (OR 0.51, 95%CI: [0.43, 0.51], p < 0.001) had a lower prevalence of anxiety.

CONCLUSION

This study demonstrates a higher prevalence of anxiety in patients with hypertension, diabetes, or both during the COVID-19 lockdown. The negative associations of housework and trip activities with anxiety highlight the potential benefit of PA among patients with non-communicable diseases.

Is Wrist Accelerometry Suitable for Threshold Scoring? A Comparison of Hip-Worn and Wrist-Worn ActiGraph Data in Low-Active Older Adults With Obesity

BACKGROUND

Hip- and wrist-worn ActiGraph accelerometers are widely used in research on physical activity as they offer an objective assessment of movement intensity across the day. Herein we characterize and contrast key structured physical activities and common activities of daily living via accelerometry data collected at the hip and wrist from a sample of community-dwelling older adults.

METHODS

Low-active, older adults with obesity (age 60+ years) were fit with an ActiGraph GT3X+ accelerometer on their nondominant wrist and hip before completing a series of tasks in a randomized order, including sitting/standing, sweeping, folding laundry, stair climbing, ambulation at different intensities, and cycling at different intensities. Participants returned a week later and completed the tasks once again. Vector magnitude counts/second were time-matched during each task and then summarized into counts/minute (CPM).

RESULTS

Monitors at both wear locations similarly characterized standing, sitting, and ambulatory tasks. A key finding was that light home chores (sweeping, folding laundry) produced higher and more variable CPM values than fast walking via wrist ActiGraph. Regression analyses revealed wrist CPM values were poor predictors of hip CPM values, with devices aligning best during fast walking (R2 = 0.25) and stair climbing (R2 = 0.35).

CONCLUSIONS

As older adults spend a considerable portion of their day in nonexercise activities of daily living, researchers should be cautious in the use of simply acceleration thresholds for scoring wrist-worn accelerometer data. Methods for better classifying wrist-worn activity monitor data in older adults are needed.

Implications of providing social support to close network members on the social well-being of older people in Kitui County, Kenya

Social support is a strong predictor of social well-being. Older people are key providers of social support to others, but an overemphasis on received social support in gerontological literature portrays them as mere recipients. We examined the association between social support provided by older people and its influence on their social well-being. Data were collected from 369 respondents residing in rural dwellings in Kitui County using mixed methods and were analyzed for association using chi-square statistics. Instrumental, emotional, and information support provision was determined by asking four questions in each category about whether the respondents provided social support to close network members. The subjective experience of support provision using a satisfaction question for each domain of social support was used to determine the influence of providing social support on the social well-being of older people. Provision of social support across the three domains was found to be significantly associated with social well-being. The level of statistical significance was highest for emotional and information support compared to instrumental support. Older people are important providers of social support. The majority of those who provided social support reported being satisfied. Therefore, offering social support, especially emotional and information support, is an important contributor to satisfaction with these aspects of social well-being.

Classifying and characterizing the development of self-reported overall quality of life among the Chinese elderly: a twelve-year longitudinal study

Background

To promote healthy aging, the information about the development of quality of life (QoL) is of great importance. However, the explorations of the heterogeneity in the change of QoL under the Chinese context were limited. This study aimed to identify potential different development patterns of QoL and the influential factors using a longitudinal, nationally representative sample of the Chinese elderly.

Methods

We adopted a five-wave longitudinal dataset from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), and a total of 1645 elderly were obtained. The sample had a mean age of 72.7 years (SD = 6.64) and was 47.2% male. Overall QoL was measured through self-report during the longitudinal process. We utilized the conditional growth mixture model (GMM) with time-invariant covariates (TICs) to explore various development patterns and associated factors.

Results

Three distinct trajectories of self-reported overall QoL were identified: the High-level Steady Group (17.08%), the Mid-level Steady Group (63.10%), and the Low-level Growth Group (19.82%). Results also indicated that several factors predicted distinct trajectories of self-reported overall QoL. Those elderly who received enough financial resources, had adequate nutrition, did not exhibit any disability, engaged in leisure activities, and did less physical labor or housework at the baseline were more likely to report a higher level of overall QoL over time.

Conclusions

There existed three development patterns of self-reported overall QoL in elders, and the findings provided valuable implications for the maintenance and improvement of QoL among the Chinese elderly. Future studies could examine the influence of other confounding factors.

Familial factors, depression and cognitive decline: A longitudinal mediation analysis based on latent growth modeling (LGM)

BACKGROUND

Cognitive decline of ageing population has become one of the major public health challenges worldwide, and familial factors (such as household income, marital status, etc.) have been identified as risk factors. Currently, we mainly focused on two familial factors: living with spouse/child and intergenerational rearing (taking care of grandchildren), exploring their relations with cognitive ageing. We also tested the possible mediating role of depression between the two family factors and cognitive decline.

METHODS

Data was derived from China Health and Retirement Longitudinal Study (CHARLS) database, and a total of 8474 participants (3602 females, mean age = 69.64) were included in the current research. Latent growth model (LGM) has been constructed for cognitive functions, with initial level and declining rate being estimated respectively. We further examined: (1) whether living with spouse/child and intergenerational rearing could influence the declining trajectory (initial level and declining rate) of elders' cognitive functioning; (2) and if so, whether depression could mediate the effects of living with spouse/child and intergenerational rearing on cognitive functioning.

RESULTS

First, while living with spouse/child was related to higher initial level of cognitive functions and slower declining rate, intergenerational rearing was associated with neither of them. Second, growth trajectory of depression partly mediated the effects of living with spouse/child on cognitive functioning (Indirect effect = 0.14; p < 0.01).

CONCLUSIONS

Familial factors (living with spouse/child and intergenerational rearing) may be influential on declining trajectories of elders' cognitive functions, and depression may mediate such effects. More research efforts are needed to investigate the mechanisms underlying the relations between familial factors and cognitive ageing.

Relationship Between Old-Aged Preferences Regarding Various Types of Physical Activity and Chronic Disease Status: A Cross-Sectional Study in Shanghai, China

Background

A lack of physical activity (PA) is a threat to public health. However, for the elderly, most PA abilities are limited. By focusing on the types and intensity of PA that the elderly can bear, this study aimed to reveal whether preferences regarding types of PA (including housework, transportation, and recreational activities) and their intensity were associated with health status. The main forms of PA include shopping, cooking, cleaning, walking, cycling, various fitness activities and other activities with a certain intensity.

Methods

Surveillance data on chronic diseases and their risk factors were collected from one district of Shanghai in 2017-2018. A Kish table was used for sampling 500 older adults, including the diagnosed group (chronic diseases diagnosed by physicians, n = 119), the abnormal group (not diagnosed but abnormal indicators detected in this investigation, n = 287) and the healthy group (n = 94). Multiple regressions were used to test the relationship between the various types, durations and intensities of PA the elderly individuals participated in and their health status.

Results

All three groups included a large proportion of older adults who participated in housework- and transport-related PA. The diagnosed group had the largest proportion (63.06% for housework-related PA; 87.39% for transport-related PA) and median minutes (17.14 min of housework-related PA per day; 30.00 min of transport-related PA per day). The diagnosed group had more metabolic equivalents (METs) of moderate-intensity PA than the two other groups (H = 33.01, P < 0.01), and more people met the WHO recommendation (χ² = 34.71, P < 0.01). Diagnosis was associated with performing housework- and transport-related PA and moderate-intensity PA and with meeting the WHO's recommendation. Higher education levels were a positive factor for elderly individuals to participate in PA.

Conclusions

Transportation and housework activities are good targets for increasing PA in older adults. Diagnosis is associated with older adults' more PA.

Gender differences in the relationships between housework and metabolic markers: a longitudinal cohort study in China

Background

Metabolic syndrome has become a major health threat throughout the world, but there are few studies that focus on the effects of housework on human metabolism. This study explores the association between housework and metabolic markers and examines whether there are gender differences in the relationship of housework intensity on these markers.

Methods

We obtained data for 2,624 participants from the China Health and Nutrition Survey and used binary logistic regression to analyze the association between housework and metabolic markers (triglycerides, high- and low-density lipoprotein cholesterol, hemoglobin, blood glucose, cholesterol, and blood pressure).

Results

We observed no association between housework and metabolic markers for men. However, we find that women who engaged in housework had a higher risk of triglycerides than those who did not (OR=1.16, 95% CI: 1.16, 4.25). Compared with low-intensity, we also find that women who performed moderate- and high-housework intensity had a higher risk of triglycerides (moderate-intensity: OR=1.78, 95% CI: 1.14, 2.78; high-intensity: OR=1.91, 95% CI: 1.22, 2.98), MetS (OR=1.54, 95% CI: 0.98, 2.43; OR=1.68, 95% CI: 1.07, 2.66), pre-hypertension (OR=1.68, 95% CI: 1.08, 2.62; OR=1.63, 95% CI: 1.04, 2.55), and obesity (OR=1.65, 95% CI: 1.01, 2.70; OR=1.66, 95% CI: 1.01, 2.72).

Conclusion

In women, we find that housework is positively associated with the metabolic markers, triglycerides, MetS, and pre-hypertension. However, we did not find evidence that this relationship exists in men, f or any biomarkers we considered. One possible explanation is that people who engage in high-intensity housework are more stressed and sleep less, which could be a mechanism by which housework becomes associated with metabolic disease.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-12566-6.

Physical Activity, Obesity, and Hypertension among Adults in a Rapidly Urbanised City

Background

Few studies have explored the relationship between the level of physical activity and the occurrence or prevalence of obesity and hypertension among people residing in urbanised areas.

Method

A cross-sectional study involving a sample of 1,001 adults was conducted. Descriptive statistics were used to describe sociodemographic variables, physical activity levels, body mass index (BMI), and prevalence of hypertension. Logistic regression models were adopted to investigate the relationship between these factors.

Results

A total of 939 respondents who provided valid responses were included. Among them, 56.5% of the participants reported engaging in high levels of physical activity. However, 40.4% of the respondents were classified as overweight or obese, and 31.9% had diagnosed hypertension. After adjusting for sociodemographic factors, logistic regression analysis revealed that physical activity levels were negatively correlated with the prevalence of BMI (OR = 0.564, 95% CI: 0.352-0.905; OR = 0.583, 95% CI: 0.375-0.907) and hypertension (OR = 0.556, 95% CI: 0.348-0.888).

Conclusions

Our study confirms recent evidence regarding the amount of physical activity that is associated with lower prevalence of obesity and hypertension in Pingshan District. Furthermore, different physical activities of various intensity levels had different effects on hypertension. Residents should be encouraged to engage in physical activities and maintain a healthy weight to improve their quality of life.

How do Older Adults Spend Their Time? Gender Gaps and Educational Gradients in Time Use in East Asian and Western Countries

This study is the first to document how older adults in East Asian and Western societies spend their time, across four key dimensions of daily life, by respondent’s gender and education level. To do this, we undertook a pioneering effort and harmonized cross-sectional time-use data from East Asian countries (China, Japan, South Korea, Taiwan) with data from the Multinational Time Use Study (Canada, Denmark, Finland, France, Italy, The Netherlands, Norway, Spain, United Kingdom, United States; to which we refer as Western countries), collected between 2000 and 2015. Findings from bivariate and multivariate models suggest that daily time budgets of East Asian older adults are different from their counterparts in most Western countries. Specifically, gender gaps in domestic work, leisure, and sleep time were larger in East Asian contexts, than in Western countries. Gender gaps in paid work were larger in China compared to all other regions. Higher levels of educational attainment were associated with less paid work, more leisure, and less sleep time in East Asian countries, while in Western countries they were associated with more paid work, less domestic work, and less sleep. Interestingly, Italy and Spain, two Southern European welfare regimes, shared more similarities with East Asian countries than with other Western countries. We interpret and discuss the implications of these findings for population aging research, and welfare policies.

Mixed methods exploration of Ghanaian women's domestic work, childcare and effects on their mental health

This research paper aims to understand the effects of time spent in domestic work, including childcare, on women’s mental health in Ghana. The paper adopted a triangulation convergence mixed methods approach. The quantitative information was sourced from two waves (2009/ 2014) of the Ghana Socioeconomic Panel Survey (GSEPS) while qualitative information was obtained from in-depth interviews with couples and key informants from five (5) regions, representing diverse ethnic backgrounds, in Ghana. Employing fixed effects regressions and a multinomial logistic regression model with fixed effects, we find that domestic work contributes to poorer mental health outcomes among women. These results are consistent, even when we correct for potential self-selectivity of women into domestic work. We also examine whether the relationship is differentiated between women of higher and lower socioeconomic status. We find that women from wealthier households who spend increasing time in domestic work have higher odds of mental distress. These results are supported by the qualitative data- women indicate increasing stress levels from domestic work and while some husbands acknowledge the situation of their overburdened wives and make attempts, however minor, to help, others cite social norms and cultural expectations that act as a deterrent to men’s assistance with domestic work. Efforts should be made to lessen the effects of social and cultural norms which continue to encourage gendered distributions of domestic work. This may be done through increased education, sensitization and general re-socialization of both men and women about the need for more egalitarian divisions of household work.

Associations between Intensity, Frequency, Duration, and Volume of Physical Activity and the Risk of Stroke in Middle- and Older-Aged Chinese People: A Cross-Sectional Study

Context: Persuasive evidence has shown the inverse associations between physical activity (PA) and the risk of stroke. However, few studies have investigated the associations between different dimensions (intensity, frequency, duration, volume) of PA and the risk of stroke. Objective: To investigate the associations between different dimensions of PA and the risk of stroke in total participants and subgroups. Method: This study included 6250 individuals aged 45 years old and above from the China Health and Retirement Longitudinal Study (CHARLS). PA was divided into vigorous PA (VPA), moderate PA (MPA), and light PA (LPA), and described in different dimensions (intensity, frequency, duration, volume). Stroke was defined on the basis of self-reported diagnosis and related treatments. Binary logistic regression models were established to assess the associations between different dimensions of PA and the risk of stroke in total participants and subgroups stratified by sex. Results: Individuals taking VPA with a frequency of 3–5 d/w, duration of ≥240 min/d, volume of ≥300 min/w had lower risks of strokes in total participants (Odds ratio (OR) = 0.32, 95% confidence interval (CI): 0.13, 0.75; OR = 0.60, 95% CI: 0.38, 0.94; OR = 0.68, 95% CI: 0.46, 0.99, respectively). However, significant associations of VPA with the risk of stroke in men were only observed in the duration of ≥240 min/d and volume of ≥300 min/w (OR = 0.53, 95% CI: 0.30, 0.93; OR = 0.61, 95% CI: 0.38, 0.99, respectively) whereas no significance in women. Compared with individuals taking no MPA, inverse significant associations between the risk of stroke and any level of frequency, duration and volume in MPA were observed in total sample (OR ranging from 0.16–0.40, all p < 0.05), whereas significant associations between the risk of stroke and MPA were found in men except the duration of 10–29 min/d and volume of 150–299 min/w (OR ranging from 0.26–0.35, all p < 0.05), and in women except the frequency of 1–2 d/w and duration of ≥240 min/d (OR ranging from 0.14–0.49, all p < 0.05). No significant associations could be observed in total participants and subgroups between LPA and the risk of stroke. Conclusion: This study revealed some significant associations between different dimensions of PA, especially MPA, and the risk of stroke. Furthermore, the difference of association was observed in the groups with different sex. Further prospective study is needed to determine deeper associations between PA and the risk of stroke.

Sleep characteristics across the lifespan in 1.1 million people from the Netherlands, United Kingdom and United States: a systematic review and meta-analysis

We aimed to obtain reliable reference charts for sleep duration, estimate the prevalence of sleep complaints across the lifespan and identify risk indicators of poor sleep. Studies were identified through systematic literature search in Embase, Medline and Web of Science (9 August 2019) and through personal contacts. Eligible studies had to be published between 2000 and 2017 with data on sleep assessed with questionnaires including ≥100 participants from the general population. We assembled individual participant data from 200,358 people (aged 1-100 years, 55% female) from 36 studies from the Netherlands, 471,759 people (40-69 years, 55.5% female) from the United Kingdom and 409,617 people (≥18 years, 55.8% female) from the United States. One in four people slept less than age-specific recommendations, but only 5.8% slept outside of the 'acceptable' sleep duration. Among teenagers, 51.5% reported total sleep times (TST) of less than the recommended 8-10 h and 18% report daytime sleepiness. In adults (≥18 years), poor sleep quality (13.3%) and insomnia symptoms (9.6-19.4%) were more prevalent than short sleep duration (6.5% with TST < 6 h). Insomnia symptoms were most frequent in people spending ≥9 h in bed, whereas poor sleep quality was more frequent in those spending <6 h in bed. TST was similar across countries, but insomnia symptoms were 1.5-2.9 times higher in the United States. Women (≥41 years) reported sleeping shorter times or slightly less efficiently than men, whereas with actigraphy they were estimated to sleep longer and more efficiently than man. This study provides age- and sex-specific population reference charts for sleep duration and efficiency which can help guide personalized advice on sleep length and preventive practices.

Time allocation to active domains, physical activity, and health indicators in older adults: cross-sectional results from the OUTDOOR ACTIVE study

BACKGROUND

Physical activity (PA) is one of the key determinants of healthy ageing. Research showed that time allocation plays an important role in PA. Therefore, an understanding of the time use of older adults is crucial for developing PA programs. The aim of this study was to examine the associations of time allocation and objectively measured PA, and several health indicators in older adults.

METHODS

In this cross-sectional study all 915 participants of the OUTDOOR ACTIVE study were included. The participants were 65 to 75 years old and resided in a subdistrict of Bremen, Germany (50.9% female). The active domains were derived from the SLOTH model (leisure activities, occupation, active transport, home-based activities). PA was objectively measured with accelerometers over seven consecutive days. Binary logistic regressions were used to test the associations of total PA and time spent in the domains with several health indicators (self-rated health, overweight, obesity, activities of daily living (ADL)).

RESULTS

Participants over the age of 70 years were significantly less physically active than those under 70 years and women were significantly more physically active than men. Regardless of age and sex, most time was spent on home-based activities (women: 118.5 ± 87.8 min/day; men: 80.2 ± 69.4 min/day). Both PA and time spent on leisure activities were associated with a lower risk of bad self-rated health (0.36; 95%-CL: 0.20, 0.65 for PA; 0.93; 95%-CL: 0.87, 0.99 for leisure activities) and less limitations in ADL. PA and active transport seemed to lower the risk of overweight (0.39; 95%-CL: 0.25, 0.62 for PA; 0.80; 95%-CL: 0.69, 0.93 for active transport) and obesity (0.36; 95%-CL: 0.21, 0.60 for PA; 0.77; 95%-CL: 0.64, 0.92 for active transport). Having an occupation was associated with a lower risk of bad self-rated health (0.60; 95%-CL: 0.40, 0.92).

CONCLUSIONS

The results of this study provide insights in the time allocation to active domains and total PA of older adults, as well as the associations with health indicators. These findings have important implications for the development of PA programs and guidelines. Future research should examine the associations further in longitudinal studies.

Sleep Quality and Daytime Functioning in Older European Adults

Abstract. The aim of this article was to review research studies related to the issues of sleep in older adults, examining the relationship between sleep quality and a set of psychological variables of daytime functioning in healthy older adults: quality of life, subjective health, functional ability, cognitive function, and emotional state, in Europe. Combined scoping review search strategies resulted in a total of 84 articles selected for review. We conclude there is a considerable amount of European research on sleep quality and its correlates in older adults’ population. Studying these relationships may be the basis for the targeted planning of psychological interventions aiming at raising the quality of life in older adults. The selected domains of older adults’ everyday functioning were all well represented in the retrieved research studies.

Impact of visual impairment on physical activity in early and late age-related macular degeneration

BACKGROUND

Modifiable risk factors for age-related macular degeneration (AMD) include smoking, nutrition and likely physical activity (PA). Levels of PA, however, are impacted by any visual impairment which makes the assessment of any association with AMD difficult.

PURPOSE

To assess the impact of visual impairment under both high and low luminance conditions on levels of PA in early and late AMD.

METHODS

Ninety participants with early to late AMD underwent a clinical assessment including conventional best-corrected visual acuity, low luminance visual acuity, contrast sensitivity and the Moorfields acuity test. PA was recorded using a wrist-worn accelerometer (GENEActiv, Activeinsights) on seven consecutive days. Patient characteristics were compared with the Wilcoxon rank-sum test and determinants of moderate-to-vigorous-PA (MVPA) were assessed using linear regression models.

RESULTS

Mean age was 73.9 ± 8.5 years (range 50-89) and 47 subjects (52.2%) were women. Average MVPA time was longer in the early (355.1 ± 252.0 minutes/week) compared to the late AMD group (162.2 ± 134.6 minutes/week; p<0.001). Using linear regression, age [β = -0.25; 95% confidence interval (CI): -12.9; -0.8, p = 0.028] and AMD stage (β = -0.28; 95% CI: -230.9, -25.0; p = 0.015) but not visual impairment on any of the employed tests were associated with MVPA (minutes/week).

CONCLUSIONS

We found late AMD to be associated with reduced PA. As performance on any of the visual tests was not associated with PA, this association cannot entirely be explained by functional impairment. More research is needed to further explore the association of PA and AMD as PA may be a potentially modifiable risk factor.

A Cluster of Failures of Midline Catheters in a Hospital in the Home Program: A Retrospective Analysis

A cluster of 11 midline catheter failures occurred during a 2-week period in a Hospital in the Home program in an urban tertiary hospital in Australia. These failures prompted a 4-month retrospective audit of patients receiving outpatient antimicrobial therapy between December 1, 2016 and March 1, 2017. Primary outcomes were dwell time and catheter failure. Peripherally inserted central catheters had significantly fewer failures and significantly longer dwell times compared with midline catheters. Women experienced higher rates of midline catheter failure than men. The proportion of patients with midline catheters receiving continuous infusions who experienced a failure was markedly higher than those receiving bolus doses. Suggestions for further related research are discussed.

Time spent on work-related activities, social activities and time pressure as intermediary determinants of health disparities among elderly women and men in 5 European countries: a structural equation model

BACKGROUND

Psychosocial factors shape the health of older adults through complex inter-relating pathways. Besides socioeconomic factors, time use activities may explain gender inequality in self-reported health. This study investigated the role of work-related and social time use activities as determinants of health in old age. Specifically, we analysed whether the impact of stress in terms of time pressure on health mediated the relationship between work-related time use activities (i.e. housework and paid work) on self-reported health.

METHODS

We applied structural equation models and a maximum-likelihood function to estimate the direct and indirect effects of psychosocial factors on health using pooled data from the Multinational Time Use Study on 11,168 men and 14,295 women aged 65+ from Italy, Spain, UK, France and the Netherlands.

RESULTS

The fit indices for the conceptual model indicated an acceptable fit for both men and women. The results showed that socioeconomic status (SES), demographic factors, stress and work-related time use activities after retirement had a significant direct influence on self-reported health among the elderly, but the magnitude of the effects varied by gender. Social activities had a positive impact on self-reported health but had no significant impact on stress among older men and women. The indirect standardized effects of work-related activities on self-reported health was statistically significant for housework (β = - 0.006; P < 0.001 among men and β = - 0.008; P < 0.001 among women) and paid work (β = 0.012; P < 0.01 among men and β = 0.000; P > 0.05 among women), which implied that the paths from paid work and housework on self-reported health via stress (mediator) was very weak because their indirect effects were close to zero.

CONCLUSIONS

Our findings suggest that although stress in terms of time pressure has a direct negative effect on health, it does not indirectly influence the positive effects of work-related time use activities on self-reported health among elderly men and women. The results support the time availability hypothesis that the elderly may not have the same time pressure as younger adults after retirement.