Life Events and Stress: Do Older Men and Women in Malaysia Cope Differently as Consumers?

The study of major life events and their effects on well-being has considerable relevance for scientific disciplines and policy making in understanding the consumer behaviour of older people. There is evidence of differences in reactions to and coping with stress between males and females but relatively little knowledge about such gender differences amongst older people, especially in middle-income countries. This study of older Malaysians looked at both coping strategies and gender differences in reactions to stress when people are confronted with certain life events. Seventeen major life events were used in interviews with 645 respondents aged 50 years or older in five major urban areas in Peninsular Malaysia. The analysis showed older women tended to experience higher levels of chronic stress than older men. They also had more health problems, had lower levels of self-esteem and were less satisfied with life. Whilst the results showed little support for gender differences in coping behaviours, stress had a significant influence on the way older men and women change store preferences. A hypothesis that older women would use more emotion-focused coping strategies was not supported. Knowledge of how older Malaysians cope with life events and stress and especially in this instance with regard to consumption behaviour, is likely to be of considerable academic and policy related interest.     

Perceptions of Aging in Two Cultures: Korean and American Views on Old Age

The current study investigated whether beliefs about aging vary by culture, age, and gender. The Lasher and Faulkender (Int. J. Aging Hum. Dev., 37:247–259, 1993) Anxiety about Aging scale was administered to 153 American and 167 South Korean men and women divided into three age groups: young (18–39), middle-aged (40–59), and older (60–91) adults. Significant cultural differences were found for the total anxiety scale and three of the four subscales. Compared to Americans, Koreans portrayed higher overall levels of anxiety about aging, and greater fear of old people, psychological concerns, and concerns over physical appearance. For Koreans, younger adults had greater fear of old people, whereas among Americans, older adults had greater fear of old people. In both cultures, the older adults had greater psychological concerns and fear of losses than did the younger groups, and American women showed more anxiety about aging and concerns over physical appearance than their male counterparts. Results are discussed in relation to aging in different cultural contexts.     

The impact of obesity on active life expectancy in older American men and women

PURPOSE: The purpose of this article is to estimate the effect of obesity on both the length of life and length of nondisabled life for older Americans. DESIGN AND METHODS: Using data from the first 3 waves of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey, this article develops estimates of total, active, and disabled life expectancy for obese and nonobese older men and women. We used the Interpolation of Markov Chains (IMaCh) method to estimate the average number of years obese and nonobese older persons can expect to live with and without activity of daily living (ADL) disability. RESULTS: Our findings indicate that obesity has little effect on life expectancy in adults aged 70 years and older. However, the obese are more likely to become disabled. This means that obese older adults live both more years and a higher proportion of their remaining lives disabled. IMPLICATIONS: The lack of significant differences in life expectancy by obesity status among the old suggests that obesity-related death is less of a concern than disability in this age range. Given steady increases in obesity among Americans at all ages, future disability rates may be higher than anticipated among older U.S. adults. In order to reduce disability among future cohorts of older adults, more research is needed on the causes and treatment of obesity and evaluations done on interventions to accomplish and maintain weight loss.     

The Effects of Religious Participation and Familial Assistance on Mental Health among Older Chinese and Korean Immigrants: Multiple Mediator Analyses

Older Asian immigrants are one of the fastest growing segments of the U.S. population and a growing number of them reside in non-traditional destination cities. However, there is a paucity of research on older Asian immigrants living in these non-traditional destination cities, and how this residential choice impacts their stress and mental health. In the current study, we examined how stressors and social support contribute to the overall mental health of older Asian immigrants who lack access to culturally responsive formal social support services. Using a convenience sample of older Chinese (n?=?120) and Korean (n?=?118) immigrants living in Arizona, we conducted multiple mediator analyses, focusing specifically on how ethnicity would differentially influence mediating effects of religious participation and familial assistance in the relationships between physical/acculturative stressors and mental health outcomes. The results showed that among older Chinese immigrants, religious participation significantly mediated the relationships between both physical/acculturative stressors and mental health, while there was no significant mediation effect detected among older Korean immigrants. Although Asian Americans are often perceived as a monolithic homogeneous group, the multiple mediator models suggest significant differences in the use of cultural/information resources in coping with life stressors and their impact on mental health outcomes between the older Chinese and Korean immigrants in our study. The study findings suggest a need for developing and strengthening formal social services in non-traditional destination cities that are culturally and linguistically responsive to those older Asian immigrants.     

Coping: Impact of Gender and Stressful Life Events in Middle and in Old Age

ABSTRACT

Objectives: This study seeks to identify different life events that participants considered stressful and to study the joint effect of gender, age group, and main stressful life events on the use of different coping strategies.Methods: The sample comprised 243 men and women, 55 to 99 years old, who attended senior activity centers. Analyses were conducted using multivariate analysis of variance (MANOVA).Results: Three main categories of stressful life events were identified: health problems, family problems, and other problems. Significant main effects of gender and stressful life events, and marginal effects of age group on coping strategies were found. Furthermore, an interaction between gender and age group, and also between gender and stressful life events emerged in some of the coping strategies analyzed.Conclusions: Age, gender or type of stressful situation impact on the coping strategies used by older people. Older men and women were found to use different strategies depending upon the situation they are facing and upon their age group. The results may prove useful to practitioners and clinicians who directly work with older people and may help clinicians provide effective coping strategies to address the specific life events that older adults find stressful.     

Late Life Attachment in Context: Patterns of Relating Among Men and Women from Seven Ethnic Groups

The purpose of the present study was to develop the later life attachment literature by providing data contrasting patterns of attachment among 616 older men and women (aged 50 to 70) from seven ethnic groups in the United States: African Americans, English-speaking Caribbeans, Haitians, Dominicans, Puerto Ricans, Eastern Europeans, and European Americans. A multivariate analysis of the variance with ethnicity, gender, and income as factors predicting four dimensional styles of attachment (secure, dismissive, preoccupied, and fearful avoidant) revealed numerous ethnic differences in attachment styles. Most notably, Haitians reported greater dismissiveness than all other groups, with Eastern Europeans reporting more than Dominicans, Puerto Ricans, European Americans and African Americans. Haitians also reported lower fearful avoidance than all other groups. Dominicans and Puerto Ricans reported greater preoccupation than Haitians, African Americans, and English-speaking Caribbeans. The most notable interactions with gender and income revealed that although preoccupation was lower among African American, English-speaking Caribbean, Haitian, and European American women versus men, it was greater among Dominican, Puerto Rican, and Eastern European women, and that whereas security was generally high among European Americans notwithstanding income, income strongly impacted attachment security in other groups. These differences are interpreted in light of ethnic differences in historical, familial, and religious contexts. This study provides a glimpse into the ethnic and cultural diversity in the ways in which older adults relate to significant others.     

Correlates of Depression Among Chinese and Korean Immigrant Elders in the United States

This study examines the effects of life stresses, religiosity and family coping resources on depression in a regional probability sample of older Chinese (n?=?105) and older Korean (n?=?100) immigrants. A major focus is placed on assessing the ethnic differences found in the relationship between religiosity and depressive symptoms, as experienced by the two Asian ethnic groups. The data for this secondary analysis was derived from a landmark study, Asian American Elders in New York City Survey. Findings suggest that about 46 % of the Chinese sample and 24 % of the Korean sample were depressed, indicating higher depression rates than those found among older Americans of other ethnicities in the literature. Data also show that Korean immigrant elders reported higher levels of religiosity (attended religious services at least once a week and felt that religion was very important in their lives) than their Chinese counterparts. Multivariate analyses confirm ethnic differences in depressive symptoms. Other things being equal, factors of religiosity have an overall significant positive impact on depression among the Korean group, but appear to have no effect on the Chinese group. This data shows that the impact of religiosity on psychological well-being is crucial for mental health professionals in maintaining cultural competency when working with clients from different Asian immigrant subgroups.     

Awareness and Completion of Advance Directives in Older Korean‐American Adults

There has been growing concern about racial and ethnic disparities in completion rates of advance directives (ADs) in community‐dwelling older populations. Although differences in AD completion rates between non‐Hispanic whites and African Americans have been reported, not much is known about the awareness and completion of ADs in other groups of ethnic minorities. Using a sample of community‐dwelling Korean‐American older adults (n = 675) as a target, factors associated with their awareness and completion of ADs were explored. Guided by Andersen's behavioral health model, predisposing (age, sex, marital status, education), need (chronic conditions, functional disability), and enabling (health insurance, acculturation) variables were included in the separate logistic regression models of AD awareness and AD completion. In both models, acculturation was found to be a significant predictor; those who were more acculturated were more likely to be aware of ADs and to have completed ADs. This study contributes to the knowledge about the role of acculturation in explaining AD awareness and completion in Korean‐American older adults and provides recommendations for possible AD educational interventions for this older adult minority population.     

Place of death and associated gender difference in Korea 2006–2014: Evidence from exit interviews of the Korean Longitudinal Study of Ageing

Previous research has revealed that many people wish to die at home; however, most die in healthcare institutions. This study explored factors related to the place of death and gender differences in this regard among older adults in South Korea. Participants included older adults from the Korean Longitudinal Study of Ageing. Multinomial logistic regression was used to examine relationships between place of death and relevant factors. Most older adults died in hospitals, followed by at home and in assisted living residences. Hospital and assisted living residence deaths increased while home deaths decreased. In both men and women, higher daily living dependency increased the probability of dying in an assisted living residence. Women were more likely to die in assisted living residences than men, and for persons living in urban areas, there was a decreased likelihood of home death only in women. Findings support that end-of-life care is performed mostly by institutions in Korea and there are gendered patterns. To achieve aging in place, the place of death and community-based terminal care should be more considered when implementing long-term care policies.     

Ethnic differences in the frequency and circumstances of falling in older community-dwelling women

OBJECTIVES: To examine ethnic differences in fall rates and fall circumstances in older community-dwelling Caucasian and African-American women. DESIGN: Prospective analysis of incident falls and a nested retrospective analysis of fall circumstances over 5.7 years. SETTING: Monongahela Valley, Pennsylvania. PARTICIPANTS: A total of 1,821 Caucasian and African-American women (mean age+/-standard deviation 76+/-5) enrolled in the Study of Osteoporotic Fractures and participating in 1993/94. Circumstances of 338 falls were collected on a subsample of 197 women who fell. MEASUREMENTS: Fall rates and fall circumstances. RESULTS: Women reported 4,547 falls in 9,508 person-years, averaging 0.48 falls per woman annually (95% confidence interval (CI)=0.43-0.53). Age-adjusted fall rates were nonsignificantly higher in Caucasians than African Americans (relative risk (RR)=1.30, 95% CI=0.93-1.83%). In women younger than 75, fall rates were similar in Caucasians and African Americans (RR=1.17, P=.46). In women aged 75 and older, fall rates were 50% higher in Caucasians than in African Americans (RR=1.50, 95% CI=0.90-2.49), although this difference was not significant (P=.12). Fall circumstances differed by ethnicity. Caucasian women were significantly more likely than African Americans to fall outdoors versus indoors (odds ratio (OR)=1.6, 95% CI =1.0-2.7) and laterally versus forward (OR=2.0, 95% CI =1.1-3.4) but less likely to fall on the hand/wrist (OR=0.6, 95% CI =0.3-1.0). Ninety-eight percent of individuals falling on their hand/wrist reported that they extended their hand to attempt to break their fall. CONCLUSION: Although the circumstances of falling differed for older Caucasian and African-American women, there were no differences in the frequencies of falling. These findings suggest that ethnic differences in fracture risk in older women may be due in part to the different ways in which older Caucasian and African-American women fall, rather than how often they fall. More information will be needed on fall circumstances to determine whether interventions need to be tailored by ethnic group.     

Protective neighborhoods: neighborhood proportion of Mexican Americans and depressive symptoms in very old Mexican Americans

Research indicates that neighborhood context can have a significant effect on the health of older adults. The evidence suggests that there may be physical health benefits afforded to Mexican Americans living in ethnically homogenous neighborhoods, despite the relatively high economic risk in such neighborhoods, but few studies have considered the effect of neighborhood ethnic density on mental health outcomes in older adults. This study evaluated the association between neighborhoods with a high proportion of Mexican Americans and depressive symptoms in very old Mexican Americans. Hierarchical linear modeling was used to examine data from Wave 5 (2004/05) of the Hispanic Established Populations for the Epidemiologic Study of the Elderly. Subjects included 1,875 community-dwelling Mexican Americans aged 75 and older living in 386 neighborhoods in five states in the southwestern United States (Arizona, California, Colorado, New Mexico, Texas). Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (α=0.88). Results showed that, in very old men, there was a significant negative association between percentage of Mexican Americans in the neighborhood and depressive symptoms (P=.01). In women, the direction of the association was the same, but the effect was not significant. These findings suggest that the proportion of Mexican Americans in the neighborhood matter more for very old Mexican American men than women. Further research may inform screening and treatment for depressive symptoms based on differences in neighborhood composition. Recommendations include culturally customized programs that offer older Mexican Americans greater mobility and access to programs and opportunities in culturally identifiable neighborhoods.     

The relationships of cognitive coping and pain control beliefs to pain and adjustment among African-American and Caucasian women with rheumatoid arthritis

Objective. Ethnic groups may experience or report pain differently; thus, we compared ethnic differences on pain coping strategies and control beliefs, and the relationships of these variables to health status, among women with rheumatoid arthritis (RA). Methods. Using a sample of 100 women (48 African-American, 52 Caucasian), we related pain coping strategies and control beliefs to pain severity, activity levels, and affective state, controlling for socioeconomics, behavioral impairment, and disease activity. Results. Ethnic groups did not differ in pain severity or negative affect, but African-Americans were less physically active. African-Americans used more coping techniques involving diverting attention and praying/hoping; Caucasians used more coping techniques involving ignoring pain. The relationships of praying/hoping and reinterpreting pain to RA adjustment differed by ethnic group. In contrast, ignoring pain, coping statements, and stronger control beliefs predicted better health status, and diverting attention predicted more pain for all patients. Conclusion. There are ethnic differences in the use of coping strategies that should be acknowledged when helping RA patients cope with their disease, but control beliefs and several coping strategies predict pain and adjustment, regardless of ethnicity.     

Gender differentials on the health consequences of care-giving to people with AIDS-related illness among older informal carers in two slums in Nairobi, Kenya

Informal caregivers, most often older people, provide valuable care and support for people ill due to AIDS, especially in poor-resource settings with inadequate health care systems and limited access to antiretroviral therapy. The negative health consequences associated with care-giving may vary depending on various factors that act to mediate the extent of the effects on the caregiver. This paper investigates the association between care-giving and poor health among older carers to people living with AIDS, and examines potential within-gender differences in reporting poor health. Data from 1429 men and women aged 50 years or older living in two slum areas of Nairobi are used to compare AIDS-caregivers with other caregivers and non-caregivers based on self-reported health using the World Health Organization disability assessment (WHODAS) score and the presence of a severe health problem. Women AIDS-caregivers reported higher disability scores for mobility and the lowest scores in self-care and life activities domains while men AIDS-caregivers reported higher scores in all domains (except interpersonal interaction) compared with other caregivers and non-caregivers. Multiple regression analysis is used to examine the association of providing care with health outcomes while controlling for other confounders. Consistently across all the health measures, no significant differences were observed between female AIDS-caregivers and female non-caregivers. Male AIDS-caregivers were however significantly more likely to report disability and having a severe health problem compared with male non-caregivers. This finding highlights a gendered variation in outcome and is possibly an indication of the differences in care-giving gender-role expectations and coping strategies. This study highlights the relatively neglected role of older men as caregivers and recommends comprehensive interventions to mitigate the impact of HIV and AIDS on caregivers that embrace men as well as women.     

Comparison of coping strategies and supports between aboriginal and non-aboriginal people living with HIV in Ontario

Complex historical and cultural factors have contributed to the HIV epidemic among Aboriginal populations in Canada. This study assesses social supports, adaptive and maladaptive coping mechanisms, stress, and mastery of Canadian-born Aboriginal and Canadian-born Caucasian people living with HIV in Ontario and posits that coping and social support are important micro- and meso-level factors associated with the epidemic. This cross-sectional analysis included questionnaire data collected from 2007 to 2011 at HIV clinics in Toronto. Categorical and continuous variables were compared using chi-square and Wilcoxon rank sum tests, respectively. Correlates of social support and coping were determined using univariate and multivariable linear regression. The analysis included 70 Aboriginal and 665 Caucasian participants. Aboriginal participants had lower levels of employment, education, and annual household income. Aboriginal participants reported more overall (7 vs. 4, p?=?0.0003), ongoing (4 vs. 2, p?=?0.0004), and early childhood (2 vs. 1, p?=?0.02) stressors. Maladaptive coping, adaptive coping, and mastery scores were similar between Aboriginal and Caucasian participants. In multivariable analysis, injection drug use and lower education levels were significant correlates of higher maladaptive coping and lower overall support scores. Despite numerous socioeconomic challenges and personal stressors, Aboriginal people living with HIV who are accessing care exhibited comparable coping and mastery scores to Canadian-born Caucasian people living with HIV, suggesting remarkable strengths within Aboriginal people living with HIV and their communities.     

Living Well with Living Wills: Application of Protection Motivation Theory to Living Wills Among Older Caucasian and African American Adults

Using protection motivation theory, we examined racial differences in intent to complete a living will, rational problem solving (e.g., information seeking), and maladaptive coping responses (i.e., wishful thinking) to a health crisis. Sixty healthy, older adults without living wills responded to written vignettes, including information about living wills as an effective coping mechanism to avoid a health crisis. Use of adaptive coping responses predicted intent to execute a living will. A significant race-by-threat interaction predicted use of rational problem solving, with Caucasians more likely to seek information in response to perceived threat in comparison with African Americans. A significant race-by-adaptive-coping interaction predicted maladaptive coping, indicating that Caucasians were more variable in their maladaptive responses. The effectiveness of health care messages regarding living wills for older adults may be enhanced by focusing on racial differences in response to perceived health threat and perceived adaptive coping information.     

Correlates of sexually transmitted disease infection among adults living with HIV

This study examined the prevalence of sexually transmitted diseases (STDs) as well as the relationships between STDs and coping strategies used to deal with the stress of living with HIV among adults. The sample comprised 179 men and women, 58% were Caucasian, 54% were male, more than half (61%) were diagnosed with AIDS, 43% were heterosexual, and 39% reported an STD post-HIV diagnosis. Logistic regression analysis indicated that individuals reporting longer time elapsed since HIV diagnosis and greater use of emotion-focused coping were more likely to report STDs. There was an interaction effect between time and coping such that the less time that elapsed since HIV diagnosis and the more an individual used emotion-focused coping, the more likely they were to report an STD. Tailoring interventions to address specific stressors associated with length of time living with HIV, may be a particularly effective prevention strategy.     

Common facets of religion, unique facets of religion, and life satisfaction among older African Americans

OBJECTIVES: Common facets of religion are those aspects of religion that can be shared by people from any racial group. In contrast, unique facets of religion are available only to people in specific racial groups. The purpose of this study is to evaluate the interface among common facets of religion, unique facets of religion, and life satisfaction in a nationwide sample of older Black people. METHODS: Interviews were conducted with a nationally representative sample of older African Americans. Survey items were administered to assess common religious factors (e.g., the frequency of church attendance) and unique religious factors (i.e., the belief that religion sustains Black people in the face of racial adversity). Subjective well-being was measured with a life satisfaction index. RESULTS: The findings reveal that both the common and the unique aspects of religion contribute to life satisfaction among older African Americans. DISCUSSION: Most studies on race differences in religion focus solely on common religious factors that may enhance the subjective well-being of older Whites as well as older Blacks. The findings from this study are important because they call attention to the insight that can be obtained by also taking the unique facets of religion for older Black people into consideration.     

Coping Strategies of Older American Korean War Veterans: A Mixed Research Study

For American Korean War veterans, military service during wartime is a major life-changing experience across their lifespan. Research on them, while they are still living, is critical to understanding how older veterans have dealt with social adjustment after the war and in their later lives. This study examined the impact of military experience and social support upon coping strategies of older veterans. Both surveys and focus groups were conducted to collect data from 20 American Korean War veterans and 22 older non-veterans. Our findings indicate that the American Korean War Veterans Association has been a critical source of social support for veteran participants, leading them into more adaptive coping strategies. Focusing upon positive adaptation after traumatic events is a recommended shift of practice for helping professionals. More implications of the activity professionals were discussed.     

Older adults' coping with negative life events: common processes of managing health, interpersonal, and financial/work stressors

This study examined how older adults cope with negative life events in health, interpersonal, and financial/work domains and whether common stress and coping processes hold across these three domains. On three occasions, older adults identified the most severe negative event they faced in the last year and described how they appraised and coped with that event, their ambient chronic stressors, and event and functioning outcomes. The stress and coping process was largely consistent across the three life domains. Individuals who appraised events as challenging and relied more on approach coping were more likely to report some benefit from those events. Individuals who experienced more chronic stressors and favored avoidance coping were more likely to be depressed and to have late-life drinking problems. Chronic stressors, as well as approach and avoidance coping, were predictably associated with overall outcomes in all three event domains. These findings provide a basis for preventive interventions that may help older adults' address the most prevalent stressors of aging more effectively.     

Religious meaning and subjective well-being in late life

OBJECTIVES: The purpose of this study is to examine the relationship between religious meaning and subjective well-being. A major emphasis is placed on assessing race differences in the relationship between these constructs. METHODS: Interviews were conducted with a nationwide sample of older White and older Black adults. Survey items were administered to assess a sense of meaning in life that is derived specifically from religion. Subjective well-being was measured with indices of life satisfaction, self-esteem, and optimism. RESULTS: The findings suggest that older adults who derive a sense of meaning in life from religion tend to have higher levels of life satisfaction, self-esteem, and optimism. The data further reveal that older Black adults are more likely to find meaning in religion than older White adults. In addition, the relationships among religious meaning, life satisfaction, self-esteem, and optimism tend to be stronger for older African Americans persons than older White persons. DISCUSSION: Researchers have argued for some time that religion may be an important source of resilience for older Black adults, but it is not clear how these beneficial effects arise. The data from this study suggest that religious meaning may be an important factor.