The development of the social health scale for the elderly

Can Post-Retirement Work Always Prevent Depression?

Given the rising popularity of post-retirement work and its potential benefits for older adults' mental health, this study examined older adults' adaptation ability as a conditional factor for the impact of post-retirement work on depression. Quantitative data from 1433 working older adults and 1433 non-working older adults were analyzed using the PROCESS macro in SPSS to test a moderated regression model with adaptation ability as the moderator. Results showed that older adults with lower adaptation ability demonstrated significantly lower depression if they worked (vs. did not work). Older adults with higher adaptation ability exhibited significantly higher depression if they worked (vs. did not work). These findings were subsequently verified with a robustness check. Overall, post-retirement work did not prevent depression for the entire sample; working only alleviated depression among older adults with limited adaptation ability. Older adults with stronger adaptation ability could better maintain their mental health by staying retired. This study fills a knowledge gap regarding the relationship between post-retirement work and mental health. Implications for aging societies are also discussed.

Development and Initial Validity of the Patients' Literacy Scale Among Outpatients in Hangzhou City, China

Purpose

There are few studies on the intervention of the doctor-patient relationship (DPR) from patients' perspective, because of lacking appropriate measurement instruments for the effect of the patient interveqntion. Understanding the status of patients' literacy (the ability to initiatively obtain, read, and analyze health-related materials, make appropriate decisions, reduce risks of health-related problems) and developing the patients' literacy scale (PLS) align with the interests of patients, doctors, and researchers.

Patients and Methods

This study was conducted in two stages: item building and item refinement. A total of 303 subjects were recruited from the outpatient hall in three hospitals with different levels in Hangzhou city, China. Twenty patients and seven experts determined the face and content validity, respectively. The construct validity, convergent, discriminant validity, and known-group validity of the scale were examined by exploratory and confirmatory factor analysis (EFA and CFA). Internal consistency, including Cronbach's alpha, McDonald's ω, split-half reliability, and composite reliability (CR), was also tested.

Results

The EFA of PLS showed that Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy was 0.787, and Bartlett's Test of Sphericity showed a significance of p < 0.001. The extracted four-factor (patient activation, knowledge, attitudes, practice) model explained 61.266% of the total variance. For the overall PLS, the Cronbach's alpha, McDonald's ω and split-half reliability coefficient were 0.815, 0.838 and 0.720, respectively. The CFA showed the goodness of fit (RMSEA = 0.065, CMIN/DF = 1.635, GFI = 0.900, CFI = 0.905, TLI = 0.909). The CR of each factor in this scale was 0.740, 0.732, 0.630, and 0.749, respectively.

Conclusion

This study showed that the PLS was valid and reliable to measure the patients' literacy (PL). The 15-item PLS can help not only measure PL but also be used as a standard and advocacy target for patients' behavioral model which can further improve the DPR.

Sport, physical activity and social health in older adults. Caring with technology in the COVID-19 pandemic

The aim of this paper was to photograph this precise moment in history, focusing on the situation of older adults during the COVID-19 health emergency in Northern Italy. In particular, we analysed the relationship between social networks and social support, sport and recreational activity, and the use of communications technologies in December 2020. We investigated and discussed such use of technologies, wondering if and how it helped to compensate for the diminishment in social health, usually gained trough social interactions and the practice of sport and physical activity. We examined how reduction of mobility, social distancing and isolation measures imposed by the government to reduce the spread of COVID-19, affected the living conditions of the older adults, in particular their social health, and the level of sport and physical activity they were engaged in. We collected data through interviews with the subjects, assessing their social networks, the perceived social support provided by their family members, friends and caregivers, and the level of sport and physical activity they were engaged in. Moreover, we analysed the impact of technological communications devices, which were employed to help older adults to maintain their relationships with the outside world and to preserve their active life. The interview questions were formulated based on the Lubben Social Network Scale-Revised (LSNS-R), the short version of the Social Support List (SSL12-I) for the elderly and the Physical Activity Scale for the Elderly (PASE). A relationship was found between the social health related to physical activity of the older adults subjects during the COVID-19 emergency and the use of communications technologies, which played a role in mitigating the impact of the crisis on their social health by helping them to keep physically and socially active.

The Development of Social Function Questionnaire for Chinese Older Adults

Objectives

Social function is an important indicator for physical and psychological health of older adults. However, there is a lack of a standardized questionnaire for measuring social function of older adults. This study developed a questionnaire to assess Chinese older adults' social function.

Methods

We used three samples (N = 2,257 aged ≥60 years) to test the reliability and validity of the questionnaire.

Results

Based on exploratory and confirmatory factor analyses with two samples, the final version of Social Function Questionnaire for Chinese Older Adults (SFQCOA) contained three dimensions with 12 items: social support, social adaptation, and social engagement. Criterion validity test with the third sample showed that SFQCOA was positively related to the healthy indices and negatively related to the unhealthy indices.

Conclusion

The validity and reliability of the questionnaire reach the requirements of psychometric standards, suggesting it is an effective tool for measuring social function of older adults.

The ICECAP-A instrument for capabilities: assessment of construct validity and test-retest reliability in a general Dutch population

PURPOSE

The ICEpop CAPability measure for Adults (ICECAP-A) assesses five capabilities that are important to one's well-being. The instrument might be an important addition to generic health questionnaires when evaluating quality of life extending beyond health. This study aimed to conduct a psychometric assessment of the Dutch translation of the ICECAP-A.

METHODS

Construct validity of the instrument was assessed in two ways. First, by measuring correlations with the EQ-5D-5L questionnaire and a measure of self-efficacy and, second, by investigating the ability to distinguish between groups known to differ on the construct the ICECAP-A means to capture. Additionally, test-retest reliability was evaluated.

RESULTS

In total, 1002 participants representative of the general Dutch population completed an online survey. For test-retest reliability, 252 participants completed the same questionnaire 2 weeks later. The ICECAP-A indicated moderate to strong correlations with the EQ-5D-5L and a strong correlation with self-efficacy. Furthermore, it was capable of differentiating known groups. Moreover, results indicated adequate test-retest reliability with an intraclass correlation coefficient of 0.79.

CONCLUSION

In summary, results suggest adequate test-retest reliability and construct validity and indicate that the ICECAP-A might be of added value, especially when considering areas outside of the traditional health intervention model.

Aerobic exercise training decreases cognitive impairment caused by demyelination by regulating ROCK signaling pathway in aging mice

Recent studies have discovered a strong link between physical exercise and the prevention of neuro-degenerative symptoms, especially in elderly subjects, nonetheless, the exact underlying mechanism remains unclear. In this study, we hypothesized that aerobic exercise training may have a protective effect on myelin sheath in aged mice by regulating the ROCK signal pathway, which is considered as a crucial mechanism for decreasing apoptosis and promoting regeneration. Briefly, C57/BL aged mice underwent an exercise training (5 days/week, lasting 6 weeks). Memory and cognitive impairment were examined using Novel object recognition (NOR) test and Morris water maze test (MWM). Demyelination was explored using Luxol fast blue staining and transmission electron microscopy in the corpus callosum (CC), and the expression of ROCK and apoptotic protein were analyzed via western blot. We demonstrated the impairment of memory and cognitive and the decrease of myelin sheath thickness in aged mice. In addition, severe demyelination was observed in aged mice, accompanied with increased expression of RhoA, ROCK, ATF3, and Caspase 3, and reduced expression of MBP, Olig2, and NG2. Aerobic exercise training improved behavioral functions, increased the expression of MBP and myelin sheath thickness, reduced apoptosis and promoted myelination. To sum up, our data indicate that aerobic exercise training protects demyelination from aging-related white matter injury, which is associated with the up-regulation of ROCK signal pathway.

Regression-based normative data for social health scale for the elderly (short version) in eastern China

Backgrounds

Social Health Scale for the Elderly short version (SHSE-S) is a psychometrically sound instrument that comprehensively assesses the social health status of older adults in China. The aim of the present study was to establish continuous normative data of SHSE-S.

Methods

We conducted a multicenter cross-sectional study among 31 communities in eastern China. Older adults aged 60 years and above were invited to participate in the study. Each participant was interviewed in-person to finish a structured questionnaire. The SHES-S score was calculated and standardized for each participant. We split the sample into generation and validation datasets and compared the distribution of SHSE-S score between two datasets. Multivariable linear regression was used to assess the SHSE-S score and demographic variables. Regression-based norms were built using a four-step process.

Results

A total of 6089 participants (51.2% females) aged 60 years old and above (mean age = 71.3, SD = 8.0) were enrolled as the normative sample. No significant difference was found between the distribution of SHSE-S standardized score in the generation (N = 2392) and validation (N = 3697) datasets. Multivariable linear regression showed that females, higher education levels were positive indicators while aging, living alone, divorced or never married, multimorbidity were negative factors. The regression-based norm which taking demographic factors into account was established and a user-friendly worksheet was also provided to facilitate the scoring and norming of the SHSE-S.

Conclusions

The population-based regression norm of SHSE-S can be a useful tool for assessing the social health status of the Chinese elderly population.

Capability instruments in economic evaluations of health-related interventions: a comparative review of the literature

PURPOSE

Given increasing interest in using the capability approach for health economic evaluations and a growing literature, this paper aims to synthesise current information about the characteristics of capability instruments and their application in health economic evaluations.

METHODS

A systematic literature review was conducted to assess studies that contained information on the development, psychometric properties and valuation of capability instruments, or their application in economic evaluations.

RESULTS

The review identified 98 studies and 14 instruments for inclusion. There is some evidence on the psychometric properties of most instruments. Most papers found moderate-to-high correlation between health and capability measures, ranging between 0.41 and 0.64. ASCOT, ICECAP-A, -O and -SCM instruments have published valuation sets, most frequently developed using best-worst scaling. Thirteen instruments were originally developed in English and one in Portuguese; however, some translations to other languages are available. Ten economic evaluations using capability instruments were identified. The presentation of results show a lack of consensus regarding the most appropriate way to use capability instruments in economic evaluations with discussion about capability-adjusted life years (CALYs), years of capability equivalence and the trade-off between maximisation of capability versus sufficient capability.

CONCLUSION

There has been increasing interest in applying the capability-based approach in health economic evaluations, but methodological and conceptual issues remain. There is still a need for direct comparison of the different capability instruments and for clear guidance on when and how they should be used in economic evaluations.

Association between social health status and health-related quality of life among community-dwelling elderly in Zhejiang

Background

Population aging is an inevitable trend and previous studies have showed the relationship between social health related factors and health-related quality of life (HR-QOL) in the elderly. The objective of this study is to investigate the association of social health status with HR-QOL among community-dwelling elderly in Zhejiang.

Methods

This cross-sectional study was based on community-dwelling elderly individuals from July 2018 to September 2018 in Zhejiang, China. HR-QOL was measured by the 12-item Short-Form Health Survey (SF-12). Social health status was estimated by the long-form of the Social Health Scale for the Elderly (SHSE-L) and classified into three categories (poor, moderate and good). Multivariable linear regression models were conducted to evaluate the association between social health status and HR-QOL (PCS, MCS and SF-12 total score).

Results

A total of 2952 elderly participants were included in this study. The mean age was 70.68 ± 7.75 years (mean ± SD); of the eligible participants, more than half (50.4%) were females; the mean scores were 48.10 ± 8.49, 47.70 ± 7.09 and 47.90 ± 5.86 for PCS, MCS and SF-12 total score, separately. Results from the multivariable models showed that social health status was positively related to HR-QOL after adjusting for covariates. Compared with individuals with a poor social health status, those who had a moderate or good social health status were more likely to report better HR-QOL (for moderate social health status: β = 1.90(95%CI: 1.09, 2.71) for PCS, β = 1.78(1.08, 2.48) for MCS, β = 1.84(1.29, 2.39) for SF-12 total score; for good social health status: β = 3.29(2.24, 4.34) for PCS, β = 3.10(2.12, 4.01) for MCS, β = 3.20(2.48, 3.91) for SF-12 total score).

Conclusion

In our study, we found that social health status was positively associated with HR-QOL among the elderly in Zhejiang. Our findings could provide valuable information for decision-makers to develop interventions to improve the HR-QOL of the elderly.

Association between social health status and depressive symptoms among community-dwelling elderly adults in Zhejiang Province, China

OBJECTIVE

Mental disorders of the elderly population in China deserve attention. Social health is significantly associated with depression. This study aimed to evaluate the rate of depressive symptoms and to test the relationships between social health and depressive symptoms among a large sample of community-dwelling elderly adults.

METHODS

We conducted a cross-sectional study among community-dwelling adults aged 60 years or above in Zhejiang Province, China. Face-to-face interviews were used to complete a structured questionnaire for all participants. We used the Social Health Scale for the Elderly (SHSE) to evaluate social health status and used the short form of the Geriatric Depression Scale to evaluate depressive symptoms. Multivariate logistic regression was used to evaluate the association between social health status and depressive symptoms.

RESULTS

Of the total of 3757 participants included, 1887 (50.23%) were female, and the mean±standard deviation (SD) age was (70.0±8.3) years. The rate of depressive symptoms was 25.92%. The social health score was higher in non-depressed participants than in depressed participants (raw score 50.7 vs. 48.3, P<0.001). Participants with "moderate" or "good" social health had a significantly lower risk of depressive symptoms than those with "poor" social health (odds ratio (OR)=0.55, 95% confidence interval (CI): 0.46-0.66 for moderate social health; OR=0.45, 95% CI: 0.35-0.60 for good social health). The association between social health and depressive symptoms was consistent across several subgroups.

CONCLUSIONS

Social health is significantly inversely associated with depressive symptoms. The SHSE may serve as an efficient screener to identify those elderly adults with social health deficits, but systematic assessment to guide intervention merits further investigation.

Association Between Multimorbidity and Depressive Symptom Among Community-Dwelling Elders in Eastern China

Purpose

This study aimed to investigate the prevalence of depressive symptoms and the association between multimorbidity and depressive symptoms among the elderly in eastern China.

Patients and methods

A multicenter cross-sectional study was conducted in four cities (Jianggan, Yiwu and Anji in Zhejiang Province and Taixing in Jiangsu Province) in eastern China. We collected the information on 27 chronic conditions through the self-reported medical history and used the Geriatric Depression Scale (GDS) short form to evaluate depressive symptoms. Multivariate Logistic regression was used to evaluate the relationship between multimorbidity and depressive symptoms.

Results

Five thousand two hundred and ninety-six participants were included into the current study, among which 2687 (50.74%) were female, with the mean ± SD age 72.0 ± 8.1 years old. The overall prevalence of depressive symptoms in eastern China was 23.5%. And the percentage of multimorbidity in depressed participants was higher compared with non-depressed participants (50.8% vs 38.8%, P<0.001). The univariate model and adjusted model suggested that participants with multiple chronic diseases were more likely to have a depressive symptom (adjusted OR=1.42; 95% CIs 1.19–1.70).

Conclusion

Depressive symptom was significantly associated with multimorbidity among the community-dwelling elderly population in eastern China.