Standard indicators of deprivation: do they disadvantage older people?

BACKGROUND: ecological studies using standard generic indicators of material deprivation have suggested that there is little social inequality at older ages. This may be because the indicators used were designed for studying younger populations and may be biased against older people. OBJECTIVE: to examine the association, at different ages, between mortality ratios, indicators of deprivation and an indicator of poverty, which can be easily tailored to different age groups. METHODS: an ecological study comparing mortality ratios and indicators of deprivation and poverty. We calculated standardised mortality ratios for those under and over 75 years, using all deaths for Northern Ireland between 1990 and 1998. We calculated levels of income support uptake (a social security benefit) for similar age groups. We derived three commonly used indicators of deprivation (Townsend, Carstairs and Jarman) from census data. We assessed the strength of association between the mortality ratios and the indicators of poverty and deprivation using Pearson correlation coefficients. RESULTS: 11.1% of people under 75 and 24.3% of those over 75 were on income support. Income support uptake for those over 75 was strongly correlated with deprivation indicators. There was a much weaker relationship between disadvantage and mortality at older ages, especially in women. Poverty, as measured by income support ratios, was more highly correlated with mortality than any other deprivation indicator-especially at older ages and in women, where income support uptake produced the highest correlations. CONCLUSIONS: many of the commonly used indicators of deprivation are poorly suited to studying inequalities in health in older people. Uptake of income support offers many advantages over conventional indicators.     

Health-related quality of life in older age and a risk of being a victim of domestic violence

Violence against older people remains a taboo topic in Poland, and is still an under-recognized phenomenon. The aim of this study was to examine the risk of different types of domestic violence in older people in relation to their health-related quality of life as measured by chronic conditions, functional limitations, psychological well-being, depressive symptoms and feelings of social isolation. A cross-sectional study using a standardized questionnaire in a simple random sample of 518 older citizens of Krakow was carried out. A multidimensional logistic regression of data showed that such factors as poor assessment of psychological health, number of chronic conditions, suffering from emotional and social loneliness and lack of social support in everyday life significantly increased the risk of being a victim of domestic violence in older citizens of Krakow.     

Auswirkungen erhöhter sozialer Unterstützung auf das Wohlbefinden kognitiv beeinträchtigter älterer Menschen

Social relationships are an important factor for maintaining life satisfaction in elderly people. Little is known, however, about the influence of increased social support towards the well-being of cognitively impaired people. This is why two comparative studies in Switzerland and Austria, with 84 cognitively impaired individuals (aged between 65 and 98) with in-patient treatment, used a control group design to examine whether increased social support would have a positive effect on the well-being of these individuals. To this end, interventions in the form of emotional social support through volunteer visitors for dementia patients were carried out. In both studies, a positive association between increased social support by volunteer assistants and well-being emerged. The investigations show that social support and attention are generally registered and perceived as creating a pleasantly soothing feeling in cognitively impaired people.     

The experiences and needs of Asian older adults who are socially isolated and lonely: A qualitative systematic review

PurposeTo examine the experiences and needs of Asian older adults who are socially isolated and lonely living in Asian and western countries.Materials and methodsSix databases were searched for qualitative studies from each database’s inception to December 2019. Qualitative data were meta-summarized and then meta-synthesized.ResultsFourteen studies were included in this review. Five themes emerged: (1) association with older adults’ well-being, (2) loss of social support, (3) dealing with social isolation and loneliness (4) unique experiences of Asian older adults in western countries, and (5) wish list of older adults. The older adults felt psychologically down and experienced a lack of social support from their family members. They coped using strategies such as religious reliance and social engagement with peers. Asian older adults in western countries faced cultural barriers and tried to form ethnic communities. The older adults wished for more community resources and care.ConclusionThere were multiple associations of social isolation and loneliness on the Asian older adults’ well-being and social support. Coping mechanisms such as acceptance and social engagement were adopted. They expressed support needs such as social programs and healthcare services. More geographically distributed studies are needed to gather a more comprehensive and causality-related perspectives of socially isolated and lonely older adults. Lay-led programs, technology, and active coping strategies are proposed and can be incorporated in healthcare services and social programs to assist these older adults.     

Social support and mortality among older persons with diabetes

PURPOSE: The purpose of this study was to examine the relationship between social support and mortality among older persons with diabetes and the pathways by which social support affects diabetes survival. METHODS: Using data from the Longitudinal Study of Aging cohort 2 baseline (1994) and follow-up (1997-1998 and 1999-2000 surveys), the authors identified 1431 persons aged >or=70 years with diabetes, among whom 387 deaths occurred. Social support was measured by an index with regard to participants' connection with relatives, friends, neighbors, social events, church, and senior centers. Regression analysis was used to find the pathway, and survival analysis was used to find the relationship between social support and mortality. RESULTS: Compared to people with a low level of social support, the risk of death is 41% lower among people with medium levels of support (hazards ratio = 0.59, 0.39-0.91) and 55% lower among those with the highest levels of support (hazards ratio = 0.45, 0.21-0.98). Eight of the 11 regression models demonstrated that the effect of social support on mortality was mediated by both physical and mental health status. CONCLUSIONS: Social support is strongly associated with mortality. Based on findings from this study, social support should be considered an important target for intervention to reduce mortality risk among older adults with diabetes.     

Predictors of depressive symptoms in older people--a survey of two general practice populations

BACKGROUND: Studies have shown strong associations between disability, social support and depressive symptoms in older people; but socio-economic effects are less clear and little is known about the role of health locus of control. OBJECTIVE: To examine the roles of physical health, disability, social support, socio-economic factors and health locus of control as predictors of depressive symptoms in older people. METHOD: A postal survey of patients aged >/= 65 years from two London practices. Outcome measure was a score of > 5 on the 15-item Geriatric Depression Scale. Associations with other factors were examined using logistic regression and expressed as odds ratios. RESULTS: 70.4% (1602/2276) responded and provided Geriatric Depression Score 15 data, with 23.8% (381/1602) scoring > 5. After adjusting for age, sex and practice, high depression scores were associated with: (i) physical health and disability [e.g. severe versus no disability odds ratio 26.9 (15.7-46.2)]; (ii) social support [e.g. dissatisfaction with support odds ratio 4.2 (3.2-5.6)]; (iii) socio-economic [e.g. no occupational pension odds ratio 1.9 (1.5-2.4)]; (iv) health locus of control [e.g. internality 0.6 (0.6-0.7)]. After adjusting for disability, associations with general measures of physical health were reduced but still significant, while associations with social support, socio-economic factors, and health locus of control were unaffected. All four groups of factors were included in a final model for predicting depressive symptoms. CONCLUSIONS: Disability, physical health, social support, socio-economic factors, and health locus of control were all independent depression score predictors in this study. This has implications for measures to reduce depressive symptoms in older people.     

Exploring the stress-buffering effects of church-based and secular social support on self-rated health in late life

OBJECTIVES: The purpose of this study is to see if emotional support received from fellow church members and emotional support from secular social networks reduce the effects of financial strain on self-rated health. A second goal is to determine if church-based social support is a more important coping resource for older Blacks than for older Whites. METHODS: The data come from the second wave of interviews with a nationwide sample of older people. Two groups of older adults are included in the analyses: Older Christians who go to church more than twice a year (N=548) and older people who do not go to church as frequently (N=238). RESULTS: The data suggest that support from fellow church members tends to reduce the impact of financial strain on self-rated health, but support from secular network members fails to exert a similar effect. The findings also reveal that the stress-buffering effects of church-based support emerge among older Blacks, but not older Whites. DISCUSSION: The findings from this study suggest that there may be something relatively unique about support that is provided by fellow church members.     

Health and social needs of older Australians from culturally and linguistically diverse backgrounds: issues and implications

Australia has one of the most diverse migrant populations in the world. This pattern of cultural diversity is also reflected in the older population, with increasing numbers of older people from culturally and linguistically diverse (CALD) backgrounds. The aim of the present review is to examine the evidence base related to the health and social needs and existing support systems for older Australians from CALD backgrounds. It is difficult to generalise the issues and challenges associated with these groups because of their heterogeneity, both between and within groups. However, their health and social needs may be particularly acute as a result of cultural and language barriers; their geographical location and the circumstances of migration, which impact on their financial circumstances as well as psycho‐social health. Whilst there is a range of community and government stakeholders involved in addressing these issues, the evidence base for policy and practice is not well understood.     

Measuring social support among older adults

The purpose of this study is to introduce a measure of natural supportive behaviors for use in studies that examine the relationship between stress, social support, and health among older adults. The index improves on existing measures in three ways: it avoids problems arising from confounding potentially supportive relationships with support that is actually received; the scale also assesses variations in individual support needs; and it measures four distinct dimensions of social support (informational support, tangible help, emotional support, and integration). Based on data from a random community survey of 351 older adults, the basic psychometric properties and the factor structure of the scale are explored. The predictive validity of the scale is demonstrated by showing that the dimensions of support buffer the stressful effects of bereavement on depressive symptoms.     

Improving older people's life satisfaction via social networking site use: Evidence from China

Objective

This study aimed to examine the pathways by which social networking sites (SNSs) can improve older people's life satisfaction.

Methods

We conducted an online survey in China that lasted eight weeks. Respondents were required to report their demographic characteristics and feelings regarding SNS use. Data were analysed using SPSS 20 and Amos 21.

Results

We collected 596 valid samples. The empirical results show that SNS use improves older people's life satisfaction by reducing their loneliness and improving their self‐efficacy. Social support alleviates the negative effect of loneliness and enhances the positive effect of self‐efficacy on life satisfaction. Sex differences and education differences were significant. Men and less educated people had higher levels of life satisfaction.

Conclusion

Policymakers should offer support to SNSs targeting older people and encourage them to provide more useful services. SNS operators should encourage social support among older users and pay attention to sex differences and education differences.     

The link between falls,social isolation and loneliness: A systematic review

BackgroundThe chances of experiencing a fall among those aged 60 years and older increase as risk factors accumulate. In the last few decades, several studies have identified different risk factors for falls in older people, including the role of social isolation and loneliness. This systematic review provides an overview of published literature that analyzes the bidirectional relation between falls and social isolation or loneliness.Material and methodsTwo databases (PubMed and Europe PMC) were used to search for publications investigating the relationship between falls, social isolation and/or loneliness in older people. Similar articles and references were screened against the inclusion criteria.Results17 studies met the inclusion criteria and were included. Only a few studies assessed the association between falls and social isolation/loneliness among older people. Therefore, articles examining the association between falls and living alone status among people aged 60 and older were included as well. In all studies loneliness, social isolation, and living alone were significantly associated with falls in older people.ConclusionsThe findings emphasize the importance of the relationship between falls and social isolation, loneliness and living alone among older people. As there are only a few studies assessing the relationship between falls and loneliness or social isolation, further research in this field should be conducted. In particular, longitudinal studies that utilize standardized measurement instruments should be carried out.     

Characteristics of social support in a community‐living sample of older people: The Sydney Older Persons Study

Objectives : Lower levels of social support have been associated with higher mortality, poor health and lower levels of well‐being. The aim of this study is to describe the characteristics of social support in a sample of community‐living people over the age of 75 years and secondly to identify sociodemographic variables associated with social support. Method : A sample of 647 community‐dwelling elderly (75 or older) were interviewed using a structured instrument assessing social support. Social support was defined as: instrumental support; emotional support including the presence of a confidant; perceived support (perceived availability and perceived adequacy of support) and finally, social involvement or participation. Chi‐squared tests were used to compare levels of social support between males and females. Univariate and multivariate linear regression analyses were conducted in order to examine the relationship between social support and sociodemographic variables.     

Change of depressive symptoms in a French nine-year longitudinal study of aging: Gender differences and relationships between social support,health status and depressive symptoms

ObjectivesThe aims of this study were to examine the trajectory of depressive symptoms among older French people, to investigate the role of gender in the developmental trajectory of depressive symptoms and to explore whether the linear increase in depressive symptoms might be accentuated or attenuated at time points during which the older adults’ scores on social support and health satisfaction scales were higher than their individual averages.Methods/materialsData were used from a subsample of older adults living at home who participated in a longitudinal study initiated by researchers from the University of Tours. They were collected at five time points over a 9-year period (T1: 2003; T2: 2005; T3: 2007; T4: 2009; T5: 2011). This study included 707 participants, and multilevel growth curve analysis was used on measures of depressive symptoms, gender differences, social support and health satisfaction.ResultsResults indicated (1) a significant positive linear effect of age on depressive symptoms; (2) that women reported significantly higher scores of depressive symptoms than men at 63 years old (i.e., intercept) and that this gender difference remained constant across age; (3) that the slope of depressive symptoms appeared to increase at time points during which participants had higher levels of social support and to decrease when they had greater health satisfaction.ConclusionThis study provides pertinent information about the change of depressive symptoms in older people living at home and particularly highlights the interest in studying gender, social support and health satisfaction.     

Church-based social support and health in old age: exploring variations by race

OBJECTIVES: A conceptual model is evaluated that explores the relationship between church-based support and health. In the process, an effort is made to see if the relationships in this model differ for older White and African American people. METHODS: Interviews were conducted with a national sample of 748 older White and 752 older Black people. The responses of 1,126 of these study participants are used in the analyses presented herein. Survey measures were administered to assess church-based social ties and health. RESULTS: Empirical support was provided for the following theoretical linkages: Older people who attend church often feel their congregations are more cohesive; older people in highly cohesive congregations receive more spiritual and emotional support from their fellow parishioners; older respondents who receive more church-based support have a more personal relationship with God; older people who feel more closely connected with God are more optimistic; and older people who are more optimistic enjoy better health. Data further reveal that older Black people are more likely than older White people to reap the health-related benefits of religion. DISCUSSION: The findings contribute to research on religion and health by specifying how the salubrious effects of religion may arise.     

Effects of Pet Ownership on the Health and Well‐being of Older People

Objective : To examine the view that having a pet is good for the health and well‐being of older people, particularly those who are socially isolated. Method : Benefits and disadvantages of owning a pet were explored in two studies. Data from the Health Status of Older People project were used to compare the health, health behaviours and well‐being of those who owned and did not own pets. In addition, twenty older people were interviewed in‐depth about pet ownership and its impact on their lives. Results : Few health or well‐being outcomes were predicted by pet ownership. Having a pet did not compensate for social isolation. The qualitative data largely substantiate and provide possible explanations for the survey findings. Conclusion : Pets may have some limited value in promoting health and well‐being in older people.     

Intergenerational support and subjective health of older people in rural China: A gender‐based longitudinal study

Aim: To examine gender differences in the effect of intergenerational exchanges on subjective health of Chinese rural elderly. Methods: Using the data from three waves of the survey ‘Well‐being of Elderly in Anhui Province, China’ conducted in 2001, 2003 and 2006, respectively, this study uses random effect logit models for men and women separately. Results: While an increase in instrumental support from children to older people is associated with deterioration in the subjective health of older men, financial support from older people to children is associated with improvement in the formers' subjective health. Although an increase in instrumental support from older people to children, and mutual emotional support is associated with improved subjective health of older women, financial support from children to older women has a negative effect on the latter's subjective health. Conclusions: Reciprocal intergenerational transfers contribute to improvement in subjective health of older people, while increased support through demand‐based transfers appears to result in deterioration of their health.     

Effects of Social Exclusion on Depressive Symptoms: Elderly Chinese Living Alone in Shanghai,China

Research has identified social exclusion as one of the social determinants of health. There are risks of social exclusion in later life in recent years. However, despite the fact that China has the largest aging population in the world and reports a rapid growth in the proportion of older people living alone, research on the role of social exclusion on depression is limited. This study examined the effects of social exclusion on depressive symptoms in older Chinese who are living alone in China, based on the data from one Shanghai neighbourhood. The data used were obtained between August and October 2008 through face-to-face interviews, using a structured survey questionnaire, from a simple random sample of 228 Chinese 60 and older living alone in a Shanghai community. Depressive symptoms were measured by a 15-item Chinese version Geriatric Depression Scale. Social exclusion was represented by income adequacy, social relations, civic participation, and housing condition. Over 30% of participants reported symptoms of a mild or above mild level of depression. When controlled for the demographics and health variables in hierarchical multiple regression, social exclusion variables, represented by a lower level income adequacy, a less favourable housing condition, and feeling more lonely correlated significantly with more depressive symptoms. Contrary to previous studies on depression in the older adults in China, this study has obtained findings indicating that social exclusion variables are more important than other socio-demographic factors in the context of contemporary China. While two significant social exclusion variables (i.e. income and housing) are related to structural changes in the economic context in China, the intra-personal role of feeling lonely that ties strongly living alone and role of older adults in an increasingly competitive market economy should not be underestimated. To address depression and mental health of older Chinese who live alone, social policies and programs to reduce various forms of social exclusion should be developed. In additional to providing assistance in financial support and housing improvement, services to strengthen the social networks and social relations of these older people are essential.     

The effects of intergenerational experiences on adolescents and older adults

We evaluated an intergenerational program bringing together older people and adolescents to examine assumptions underlying intergenerational programming and determine if either generation changed its attitudes toward the other. Program components allowed older people and adolescents to act as either intergenerational helpers or recipients of help. The amount of intergenerational contact prior to participating in the program was examined. Only one group's attitudes changed following participation in the program: adolescents who helped older people showed more enjoyment in being with older people, decreased social distance, and a more positive perception of older people's attitudes toward the young.     

Volunteering and health among older people: a review

This paper presents a review of the available literature on the relationship between volunteering and health among older people. There is consistent evidence that morbidity rates, functional health indices, self reported health and life satisfaction are affected by formal and informal volunteering. Some studies suggest that the benefits of volunteering are reciprocal, in that both those who give and those who receive assistance benefit. The evidence is consistent with the proposal that social capital is generated through volunteering. It is likely that the presence of high levels of social capital supports and maintains the health of older persons, provides informal support in times of sickness and stress and thus enhances quality of life as well as reducing or delaying the onset of illness and death.     

Psychological Distress of Older Chinese: Exploring the Roles of Activities,Social Support,and Subjective Social Status

The goal of this research is to examine if the long neglected correlates such as social and leisure activities, social support, and subjective social status contribute to variations in psychological distress among older Chinese. Using data collected in one of the most developed areas in China—Suzhou city, Jiangsu province, the authors find that engaging in various exercises, living with both spouse and adult children, perceived availability of social support from others as well as believing in the importance of caring for other family members are particularly beneficial for mental health whereas the perception of relative deprivation and low life quality is detrimental to mental health for older Chinese. This work is among the first studies that comprehensively examined various important correlates of psychological distress and indicate the unique patterns of distress among the elderly in the most developed area in the contemporary China.