Retirement transitions and spouse disability: effects on depressive symptoms

OBJECTIVES: The purpose of this study was to investigate the effects of type of retirement (forced, early, abrupt) and spouse's disability on longitudinal change in depressive symptoms. METHODS: The analyses rely on Waves 1-4 of the Health and Retirement Survey (N = 2,649). Generalized estimating equations models with bootstrapped standard errors and adjustment for survey design and non-independence of dyad members estimate effects of retirement, type of retirement, and spouse's disability on depressive symptoms, controlling for relevant covariates. RESULTS: The results suggest that depressive symptoms increase when retirement is abrupt and perceived as too early or forced. Women retirees who stopped employment and were either forced into retirement or perceived their retirement as too early report significantly more depressive symptoms with increasing spouse activities of daily living (ADLs) limitations. There is no similar effect for men. In contrast, for working retirees who retired on time, depressive symptoms decrease with increasing spouse ADLs. DISCUSSION: These results highlight the importance of retirement context on postretirement well-being. They suggest that both type of retirement transition and marital contexts such as spouse's disability influence postretirement well-being, and these effects differ by gender.     

Supplemental private health insurance and depressive symptoms in older married couples

Stress process theory is applied to examine lack of supplemental private health insurance as a risk factor for depressive symptomatology among older married couples covered by Medicare. Dyadic data from 130 African-American couples and 1,429 White couples in the 1993 Asset and Health Dynamics Among the Oldest-Old Survey were analyzed using hierarchical generalized linear modeling. Lack of supplemental insurance is operationalized at the household level in terms of neither spouse covered, one spouse covered, or both spouses covered. Controlling for covariates at both individual and couple levels, supplemental insurance has significant impact on depression, but the pattern differs by race. White couples report the highest depression when neither spouse is covered by private health insurance; African-American couples report the highest depression when only one spouse is covered. Results suggest lack of supplemental private health insurance coverage is a stressor that significantly affects depressive symptoms.     

A comparison of correlates of self-rated health and functional disability of older persons in the Far East: Japan and Korea

Self-rated health and physical functioning are recognized as important indicators of health in older persons. Rarely, however, there have been studies done which examine cross-cultural differences in the health of older people using these measures, especially among non-Western countries. The objective of this study was to examine patterns of association of self-rated health and functional disability of Japanese and Korean elderly people living in the community, using nationwide surveys of persons aged 60 years or over. There were striking similarities in the general pattern of associations with covariates. In the multivariate analysis, age, work status, comorbidity, depressive symptoms, life satisfaction, hospitalization, and functional disability were strongly associated with self-rated health in both populations. For functional disability, older age, female, low social contact, depressive symptoms, poor life satisfaction, and poor self-rated health were found to be significantly associated. Some differences in the structure of associations with self-rated health, however, were noted. Women tended to assess their health more favorably than men in Korea, but in the Japanese elderly gender differences disappeared when other variables were taken into account. Health-related variables tended to be more closely associated with functional disability in the Japanese sample. An overall similarity, however, in the pattern of associations of these measures supports their utility in assessing and comparing the health of older populations in this region.     

Predicates of personal control among middle-aged and young-old men and women in middle America

These analyses explore relationships between the conscious general sense of control and :1) personal evaluations of major life domains (health, spouse's health, marriage, parenting, work, leisure): and 2) spouse's evaluations of life domains, within groups defined by gender and age. Respondents include 101 men and 127 women; all are Caucasian; they reside in a middle-class community in the midwestern United States; they are aged forty-three to seventy-six (M = 56); they are all in long-term marriages, with an average of 4.4 children; and 73 percent had at least one child living at home. Evaluations of life domains included self-report satisfaction and investment scales completed after personal interview questions about the domain. There were no gender differences and minimal age differences in levels of sense of control or evaluations of the life domains. However, as expected, multiple regression analyses indicated that the evaluations that contribute to a sense of control vary by gender and be age group within gender group. For men, the sense of control is linked to experiences in work; for younger middle-aged men, satisfaction with health is important; and for older men, investment in marriage is also important. Younger middle-aged women's sense of mastery is tied to satisfaction with mothering and investment in their own health; older women's sense of control is linked to satisfaction with marriage, health, and leisure. Age group patterns may reflect both developmental and cohort effects.     

Impact of self-assessed hearing loss on a spouse: a longitudinal analysis of couples

OBJECTIVES: Hearing loss is increasingly common among older persons and is negatively associated with health and well-being. Its impact on spouses, however, is poorly researched. This study analyzed the relationship between a spouse's self-assessed hearing loss and his or her partner's physical, psychological, and social well-being 5 years later. METHODS: Subjects were 418 older married couples from the Alameda County Study. Hearing loss and adjustment variables were assessed in 1994 and outcomes in 1999. Longitudinal analyses included multivariate statistical models using generalized estimating equations to adjust for paired data and partners' hearing loss, age, gender, chronic conditions, and financial problems. RESULTS: Spouse hearing loss increased the likelihood of subsequent poorer physical, psychological, and social well-being in partners. The negative impact of husbands' hearing loss on wives' well-being appears stronger than the reverse. DISCUSSION: Findings suggest that early diagnosis and treatment of hearing loss constitute important clinical strategies to enhance the well-being of both hearing-impaired individuals and their spouses and support policy change to cover hearing devices by insurance. Further research incorporating theoretical perspectives from communication theory and qualitative methodology would enhance understanding of how hearing loss impacts older couples and support refinement of interventions to promote quality of life.     

Residency in the United States, subjective well-being, and depression in an older Mexican-origin sample

OBJECTIVE: To compare the mental health and well-being of Mexican immigrants with native-born Mexican Americans living in the Lower Rio Grande Valley of Texas. METHODS: A randomly stratified sample of 353 Hispanics aged 45 and older were interviewed. The immigrant group (n = 148) was compared with native-born Mexican Americans (n = 205). RESULTS: The findings showed that the native-born group was not significantly different from the immigrant group on measures of depression, health status, life satisfaction, or self-esteem. The immigrant group was found to report significantly more stress than the Mexican American group. Income, age, gender, and acculturation were significant predictors of well-being, whereas immigration status and years of residency were not. DISCUSSION: The well-being of Mexican immigrants in the United States is confounded by such variables as income, age, gender, and acculturation, along with various other contextual factors that characterize their life experiences in the United States.     

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.     

Depressive symptoms and self-rated health in community-dwelling older adults: a longitudinal study

OBJECTIVES: To test whether baseline depressive symptoms in older adults increase the risk of subsequent decline in self-rated health and decrease the likelihood of subsequent improvement in self-rated health. DESIGN: A 2-year prospective cohort study. SETTING: Six thousand seven hundred fourteen community-dwelling older persons who completed the first and second wave of the Asset and Health Dynamics among the Oldest-Old Survey in the United States. PARTICIPANTS: Community-dwelling older people in the United States. MEASUREMENTS: Baseline depressive symptoms were measured using a short-form of the Center for Epidemiological Studies Depression Scale. Self-rated health was measured using a single item of global health rating. RESULTS: After adjustment for covariates, a high burden of depressive symptoms at baseline was predictive of greater decline in self-rated health (odds ratio (OR) for decline in those with high burden of depressive symptoms vs those without = 1.47, 95% confidence interval (CI) = 1.26-1.70). Likewise, high burden of depressive symptoms at baseline predicted less improvement in self-rated health (OR for improvement in those with high burden of depressive symptoms vs those without = 0.57, 95% CI = 0.50-0.65). CONCLUSIONS: Depressive symptomatology is an independent risk factor for subsequent changes in self-rated health in older adults. Thus, early prevention and intervention of depressive symptoms in community-dwelling older adults might be critical to promote and maintain their self-rated health.     

The effect of spousal mental and physical health on husbands' and wives' depressive symptoms, among older adults: longitudinal evidence from the Health and Retirement Survey

OBJECTIVE: To estimate the effect of spousal depressive symptoms and physical health on respondents' depressive symptoms in a national sample of older married couples. METHOD: We used data on 5,035 respondent husbands and wives from the 1992 and 1994 waves of the Health and Retirement Survey. Multivariate regression models were estimated to examine the impact of spousal depressive symptoms and physical health on respondents' depressive symptoms. RESULTS: Adjusting for respondent mental and physical health and sociodemographic traits, having a spouse with more depressive symptoms was associated with significantly higher follow-up depressive symptoms in the respondent (p < .001). Controlling for spousal depressive symptoms, a decline in the spouses' physical health was associated with a significant reduction in respondent depressive symptoms (p < .05). DISCUSSION: Our findings suggest that health care providers treating older adults should be sensitive to the possibility that spouses may be affected when clients suffer poor mental or physical health.     

Inflammatory bowel disease in married couples: 10 cases in Nord Pas de Calais region of France and Liège county of Belgium.

Ten pairs of husband-wife couples are reported with inflammatory bowel disease who were seen in the same geographical area in Nord Pas de Calais region of France and in Liège county (Belgium). Among these 10 couples, four were concordant for Crohn's disease, two for ulcerative colitis, and four were discordant. In nine of 10 couples neither spouse had symptoms before marriage but inflammatory bowel disease subsequently developed in both. In one couple, one spouse had Crohn's disease before marriage and the other partner experienced symptoms afterwards. Eighteen children were born to eight of 10 couples. Five of them developed Crohn's disease but four belong to the same family. In all cases the affected children were born to parents who both developed Crohn's disease after they had married and were conceived at a time when parents did not yet have symptoms. It is proposed that this pattern of emergence of inflammatory bowel disease suggests a role for an infectious agent yet to be identified.     

Association of comorbidity with depressive symptoms in community-dwelling older persons

BACKGROUND: Depression in later life poses a serious threat to mental health and well-being of older persons burdened with medical illnesses. Comorbid medical conditions independently, as well as through interactions, may influence the degree of depressive symptoms manifested by the elderly. Insight into the role medical comorbidity plays in the manifestation of depression may help to better address both physical and mental health care needs of the depressed elderly. OBJECTIVE: To examine independent and synergistic effects of comorbid medical conditions in the presentation of depressive symptoms among older adults living in the community. METHODS: Data from a national survey of community-dwelling older persons aged 60 years and over (n = 2,058) in Korea were used. The levels of depression were assessed using an eleven-item Center for Epidemiological Studies Depression Scale. Comorbidity was defined as the number of chronic medical conditions and the combination of disease pairs. Sociodemographic characteristics, self-rated health, physical functioning, history of hospital admission in the past year, frequency of contact with friends or neighbors, and emotional support were used as covariates. RESULTS: Overall, persons with a medical condition compared to those without tended to show a higher depressive symptom score. Comorbidity, in terms of the number of medical conditions, tended to show a significant linear association with depression, controlling for confounders. More important, independent effects of medical conditions as well as a tendency to synergy among specific medical conditions were found, with notable gender differences. CONCLUSION: Given the significant but complex association of comorbid medical conditions with depressive symptoms in aged persons, clinicians should exercise care to address their physical and mental health needs within a common therapeutic context.     

Effects of surrogate parenting on grandparents' well-being

OBJECTIVES: This study assesses whether grandchildren's moving into or out of grandparents' households affects grandparents' depressive symptoms and life satisfaction, and whether such effects vary by gender or race. It further examines whether effects of surrogate parenting on grandparents' subjective well-being are direct or mediated through the impact of surrogate parenting on other life changes, namely, health, work hours, income, socializing, and social supports. METHODS: The analyses rely on panel data from the National Survey of Families and Households, Waves 1 and 2. The sub-sample consists of Black and White grandparents with grandchildren younger than age 18 (N = 1,789). Ordinary least squares (OLS) regressions and path analyses are used to identify direct and indirect effects of grandchildren's move into and out of grandparents' household on change in depressive symptoms and life satisfaction (residualized gain scores). RESULTS: The data indicate that grandchildren's move into the household increases depressive symptoms among grandmothers. On the other hand, grandchildren's leaving the household leads to reduced well-being among grandfathers. Grandmothers report less participation in church activities and more supports from friends and relatives after the grandchildren move in, whereas grandfathers frequent bars/taverns more when grandchildren move in and reduce time spent with church activities and paid work when grandchildren remain in the household. DISCUSSION: The findings suggest that effects of surrogate parenting differ by gender, and that they are partially contingent on grandparents' vulnerabilities (marital status, education, and presence of childless dependent children in the household) before grandchildren join the household. Mediating effects of other life changes are relatively small.     

The relationship between a couple's marital adjustment and beliefs about diabetes mellitus

Twenty married couples with one partner diagnosed as having diabetes at age 40 or older within the past 5 years participated in this study. Participants completed the diabetes or family version of Beliefs About Diabetes (BAD) and the Dyadic Adjustment Scale (DAS). Results showed that perceived barriers to diet and to medication by the person with diabetes were associated with higher marital satisfaction and quality of marriage. In contrast, for the nondiabetic spouse, the perceived benefits of diet were negatively associated with the ability to work with the diabetic spouse. Additional research is needed to better understand the effect of diabetes on the marital relationship.     

Familism,Social Network Characteristics,and Well-being among Older Adults in Mexico

Familism, is a cultural value considered to be central to Mexican culture. Older generations are thought to more strongly adhere to familistic values; however, little is known about the implications of familism in late-life. The goal of the current study was to examine links between familism, social network characteristics, and well-being among Mexican older adults. A sample of 556 older adults (50–99 years old) was drawn from the Study of Social Relations and Well-being in Mexico. Various aspects of social network characteristics and familism varied by age, gender, and education status. Familism was correlated with contact frequency and geographic proximity, but not proportion of family in network. Regression analyses indicated higher familism was associated with better psychological and physical well-being, yet familism interacted with proportion of family to predict both self-rated health and chronic conditions indicating that a discrepancy between familistic values and actual family support may be detrimental for older Mexicans’ physical health. The discussion highlights the complex interrelationships and potential protective effects of familism. Future research should continue to examine the implications of familism and family relationships in the Mexican context; in particular, how generational shifts in familism influence intergenerational relations and well-being.     

Depressive symptomatology in middle-aged and older married couples: a dyadic analysis.

OBJECTIVES: Depressive symptomatology has been frequently conceptualized as an individual matter, but social contextual models argue that symptom levels are likely to covary in close relationships. The present study investigated correlation between spouses' depressive symptomatology in middle-aged and older married couples, the influence of gender and race/ethnicity in predicting variability in symptom level, and the importance of individual-level covariates (education, health, and age) and couple-level covariates (household income and net worth). METHODS: Results were based on secondary analysis of Wave 1 interviews with White, Black, and Mexican American married couples (N = 5,423) from the Health and Retirement Study (HRS) and the Study of Asset and Health Dynamics Among the Oldest Old (AHEAD). Dyadic data from husbands and wives were analyzed with multilevel modeling. RESULTS: Husbands' and wives' depressive symptoms were moderately correlated, gender and race/ethnicity (and their interaction) predicted depressive symptoms, and both individual-level and couple-level characteristics were significant covariates. Similarities as well as differences are noted between the HRS and AHEAD results. DISCUSSION: Results highlight the importance of dyadic data and multilevel models for understanding depressive symptomatology in married couples. The influence of race/ethnicity merits greater attention in future research. Differences in findings between HRS and AHEAD suggest life-course, cohort, or methodological influences.     

Determinants of depressive symptoms in Filipino senior citizens of the community-based ENGAGE study

ObjectiveThis study investigated the factors associated with depressive symptoms among community-dwelling Filipino senior citizens.MethodsWe conducted a cross-sectional study among 1021 Filipino senior citizens aged 60–91 years. We used multiple linear regression analysis to identify the factors independently associated with levels of depressive symptoms. We predicted the model using hierarchical regression analysis.ResultsBoth men and women who had higher subjective psychological well-being showed a lower level of depressive symptoms while those who had negative self-rated health and reported to be lonely showed a contrasting result. Among women, those who reported positive self-rated health, and had higher psychological resilience and social interaction, showed a lower level of depressive symptoms. Moreover, among women, those who had chronic diseases showed a higher level of depressive symptoms. Hierarchical regression analysis revealed that loneliness was the most powerful predictor of depressive symptoms among Filipino senior citizens.DiscussionLoneliness and chronic diseases are the major risk factors for depressive symptoms while a higher level of subjective psychological well-being is the primary protective factor against it among Filipino senior citizens. To be free from depression, their psychological well-being should be strengthened through active social engagement and healthcare service improvement.     

Frequency of inflammatory bowel disease in offspring of couples both presenting with inflammatory bowel disease

A private practice was surveyed for prevalence of inflammatory bowel disease (IBD) in husband-wife partners and in their children. Among approximately 2500 patients with IBD in our files, 19 couples were identified. They were subdivided into group A (n = 5) in which both partners had symptoms of IBD before marriage; group B (n = 7) in which only one spouse had IBD before marriage and the other partner experienced symptoms afterwards; and group C (n = 7) in which neither spouse had symptoms before marriage but IBD subsequently developed in both. In group B, the disease developed in the second spouse 2-16 years after marriage (mean, 6.4 years). In group C, IBD developed in the first spouse 0.3-41 years after marriage and in the second spouse 1-14 years after the first spouse (mean, 6.8 years). Thirty-five children have been born to 16 of the couples. Two children died before age 20. Of the surviving 33 children, IBD has already developed in 12 (36%). Among the other 21 unaffected children, 1 had uveitis at age 9 and 10 are still under the age of 21, perhaps too young to have yet developed IBD. The frequency of IBD in children was slightly higher if both parents had already developed IBD at the time of conception (67%) compared with when only 1 parent (50%) or neither parent (50%) had developed IBD when conception occurred. Although these data do not distinguish genetic from environmental factors, they show a higher risk of IBD in children when both parents have this illness.     

Helicobacter pylori: Evidence for spouse-to-spouse transmission

BACKGROUND: Spouse-to-spouse transmission of Helicobacter pylori infection still remains controversial. METHODS: We studied the prevalence of H. pylori infection among spouses of H. pylori-positive or -negative individuals and looked for intraspousal transmission. Twenty-five couples were studied. Initially, one individual per couple was selected as the index subject. Spouses of these H. pylori-positive or -negative index individuals underwent screening for H. pylori by serology, the rapid urease test and histology. Those couples in whom only one spouse was positive were followed up and H. pylori status was re-evaluated using the above tests after approximately 1 year in the H. pylori-negative spouse. RESULTS: Of 25 randomly selected index subjects, 18 were H. pylori positive and seven were negative. There was no significant difference in age, sex, socioeconomic status, presence of dyspeptic symptoms, duration of marriage and number of children in these index subjects. Spouses of H. pylori-infected index subjects had a significantly higher prevalence of H. pylori infection than the spouses of H. pylori-negative index subjects (83.3 vs 28.5%; P < 0.01). Age, sex, socioeconomic status, dyspeptic symptoms, duration of marriage and number of children were not different in H. pylori-positive or -negative spouses of H. pylori-positive index subjects. There were five such couples in whom only one spouse was H. pylori positive initially. At follow up, three of these H. pylori-negative spouses became positive. These findings suggest person-to-person transmission or common source exposure within couples.     

The long-term marriage: perceptions of stability and satisfaction

Marriage has been shown to be conducive to the well-being of both men and women. An increasing proportion of older people, however, are likely to live alone because of the high divorce rate. This research raises the question of what factors might be involved in a stable and satisfying marriage. Data were gathered from 100 couples who have been married forty-five years or more. The variables identified by couples as important to their marriages were: being married to someone they liked as a person and enjoyed being with; commitment to the spouse and to marriage; a sense of humor; and consensus on various matters such as aims and goals in life, friends, and decision making. Husbands and wives were strikingly similar in their responses; thus, men and women perceive the same variables to be critical in the success of long-term marriages.