Gender disparity in authorships of manuscripts on the COVID-19 outbreak

Journal of Public Health -     

Constructing area-level indicators of successful ageing in Taiwan

We constructed area-level indicators of successful ageing in Taiwan. Area-level successful ageing was defined as follows: the living environment in a community/city is beneficial for physical, psychological and social health, and the people living in the area are well informed about the issues that pertain to maintaining health and behave in ways that promote their health. A modified Delphi method and analytical hierarchy process were used, with eight experts completing three successive rounds of questionnaires to determine the appropriate dimensions and indicators. In total, 65 indicators of area-level successful ageing were suggested. The weights of the six dimensions of the area indicators were determined as follows: health status (0.273), health lifestyle (0.182), social participation (0.166), health-care resources and utilisation (0.164), social environment (0.113) and natural environment (0.102). Nationwide survey data and government statistics were used to describe the profiles of 23 cities and counties in Taiwan with respect to successful ageing. Degree of ageing and geographic location were not related significantly to the total successful ageing scores of the cities/counties. However, urbanisation was correlated negatively to the total score (Spearman's ρ  = −0.43), the dimensions health status ( ρ  = −0.54), health lifestyle ( ρ  = −0.52), and natural environment ( ρ  = −0.43), and degree of ageing was related moderately and negatively to health lifestyle ( ρ  = −0.39). There were significant differences in health lifestyle and natural environment according to geographic location. These area indicators will be helpful to local governments for monitoring and improving successful ageing within their communities.     

社会隔离在社区老年人自我感知老化和成功老龄化之间的中介效应

目的探讨社会隔离在社区老年人自我感知老化与成功老龄化之间的中介效应。方法采取简版自我感知老化量表(B-APQ)、社会网络量表(LSNS-6)、成功老龄量表(SAI)对628名社区老年人进行问卷调查。结果社会隔离在自我感知老化和成功老龄化之间起部分中介作用,自我感知老化对成功老龄化的直接效应为-0.421,95%CI (-0.166,-0.468);通过社会隔离对其的间接效应为-0.281,95%CI(-0.301,-0.102),中介效应占总效应的40.03%。结论老年人对自身积极的老化态度能直接促进成功老龄化,又可通过提高老年人的社会参与,减少社会隔离间接促进其成功老龄化。因此,社区工作者需给予老年人老化态度与社会隔离足够的重视,以期提高老年人晚年的生活质量,最终实现成功老龄化。     

What attributes of successful aging are important to older adults? The development of a multidimensional definition of successful aging

ABSTRACT

Older adults’ experiences and perspectives have been missing in the quest to develop a unified definition of successful aging. Through an online survey using convenience sampling, respondents (N = 477) were asked to report how important 25 specific attributes of successful aging, originating from published literature that examined successful aging from the perspective of older adults, were to them as they age. Over 90% of respondents reported 11 attributes as important or very important to them as they age, which included “remaining free of chronic diseases” and “feeling good about myself.” A factor analysis (N = 462) resulted in four dimensions explaining 57.06% of the variance: Adaptation and Coping; Being Healthy; Self-Determination; and Social Relationships and Interactions. The findings revealed older adults’ definition of what is important to them as they age is multidimensional, with having access to affordable health care and remaining alert and mentally active as critical elements followed by elements of self-determination, coping, and physical and social health. Future research should replicate the study with diverse populations to continue to refine a definition of successful aging that could influence program development and intervention approaches in health and social services.     

Impact of morbidity and life events on successful aging

The purpose of this study was to examine the risks of the incidence of chronic conditions and life events on successful aging. Longitudinal data from a 10-year follow-up health survey were used. Successful aging indicators included basic and advanced physical function, depressive symptoms, cognitive function, emotional support, participation in productive activities, and life satisfaction. The stressors included life events and morbidity years of 10 chronic conditions. Loss of offspring increased the risk to physical health, psychological health, and life satisfaction. Being newly widowed was related to depressive symptoms, whereas being newly divorced increased the risk of poor social support. Morbidity years increased the risk of failure in successful aging, especially for stroke, respiratory system disease, diabetes, and cancer. Emotional health of the elderly should be carefully monitored after onset of life events and incidences of chronic conditions.     

Social-strata-related cardiovascular health disparity and comorbidity in an aging society: implications for professional care

Cardiovascular disease (CVD) is on the rise in the aging population of the United States. Heart disease is the leading cause of death, hospital bed use, and social security disability. Enhancing knowledge about CVD may improve social work's professional role in the health care system. This article focuses on a pressing CVD-related issue that needs professional attention-CVD health disparity and the associated mental health comorbidity (depression and anxiety) that predicts poor CVD outcome. Findings from a large-sample clinical trial by the National Institutes of Health call for innovative psychosocial intervention. Implications for professional practice, research, and education are outlined.     

Disability and aging: From successful aging to wellbeing through the capability and human development lens

This commentary explores the use of the capability approach and one of its recent applications, the human development model of disability, health and wellbeing, as a lens that can guide aging-related research as well as policy and practice in ways that are inclusive of older persons who have health conditions and impairments. As an alternative to biomedical theories of aging, the capability and human development lens includes human diversity and agency at its core while also reconsidering success to be the practical opportunities that older people value. The practical opportunities that older people value, including older people with disabilities, are what research, policy and practice should aim to expand.     

Predictors of successful aging: a twelve-year study of Manitoba elderly.

In Manitoba, Canada, a representative cohort of elderly individuals ages 65 to 84 (n = 3,573) were interviewed in 1971 and the survivors of this cohort were reinterviewed in 1983. This analysis assesses the determinants of successful aging--whether or not an individual will live to an advanced age, continue to function well at home, and remain mentally alert. Over 100 separate indicators of demographic and socio-economic status, social supports, health and mental status in 1971 were available as potential predictors of successful aging. Indicators of access to health care over the period 1970-82 and indicators of diseases over this period were also available as predictors. Those who aged successfully were shown to have greater satisfaction with life in 1983 and to have made fewer demands on the health care system than those who aged less well. Despite the large number of potential predictors of successful aging which were examined, only age, four measures of health status, two measures of mental status, and not having one's spouse die or enter a nursing home were shown to be predictive of successful aging.     

成功老龄化影响因素及其不同理论模型预测效用研究

目的 探讨不同理论模型中成功老龄化（SA）的影响因素。方法 随机抽取某疗养院230名老年人,通过问卷调查和量表评估收集相关数据,并采用二元逻辑回归对不同理论模型的影响因素进行分析比较。结果 86名老年人满足 SA 三维（患病状况-身心功能-社会功能）模型标准,占37.39％;51名老年人满足 SA 四维模型标准（患病状况-身心功能-社会功能-主观幸福）,占22.17％。年龄和受教育程度2个因素在 SA 三维模型下预测效用达到显著性水平,可解释总变异的69.10％。年龄、心理韧性和主观支持3个因素在 SA 四维模型下预测效用达到显著性水平,可解释总变异的79.12％。结论 SA 影响因素分析受理论模型影响较大。     

我国不同性别老年人成功老龄化与死亡的关系研究

目的 了解我国老年人成功老龄化的现状,并探究不同性别老年人成功老龄化及其组成部分与死亡的关系.方法 数据来源为2010-2016年中国健康与养老全国追踪调查(China Health and Retirement Longitudinal Study,CHARLS)数据.采用x2检验比较不同性别老年人成功老龄化之间的差...     

Cumulative biological risk and socio-economic differences in mortality: MacArthur studies of successful aging

Previous research has suggested that socio-economic status (SES) differences in mortality are only partially explained by differences in life-style, psychological and social factors. Seven year mortality data (1988-1995) from the MacArthur Study of Successful Aging, a longitudinal study of adults, aged 70-79, from New Haven, CT; East Boston, MA; and Durham, NC; were used to test the hypothesis that a cumulative measure of biological dysregulation ("allostatic load"), reflecting multiple regulatory systems, would serve as a further mediator of SES differences in mortality. Logistic regression analyses revealed that a cumulative index of biological risk explained 35.4% of the difference in mortality risk between those with higher versus lower SES (as measured by less than high school education versus high school or greater educational attainment). Importantly, the cumulative index provided independent explanatory power, over and above a measure of doctor-diagnosed disease, though the latter also contributed to education-related variation in mortality risks. The summary measure of biological risk also accounted for more variance than individual biological parameters, suggesting the potential value of a multi-systems view of biological pathways through which SES ultimately affects morbidity and mortality.     

我国老年人成功老龄化现状与死亡风险关系研究

目的 调查我国老年人成功老龄化的现状,并检验不同性别老年人成功老龄化及其各组成部分对死亡率的影响。方法 数据来源为2014—2018年中国老年健康影响因素跟踪调查(Chinese Longitudinal Healthy Longevity Survey, CLHLS)数据,利用卡方检验对6539例老年人进行组间分析,进一步采取Cox比例风险回归模型探讨不同性别老年人成功老龄化与死亡的关系及其差异。结果 本次研究发现我国老年人成功老龄化率为10.55% ,男性(15.12%)高于女性( 6.43%); 无论男女,未成功老龄化组的老年人的死亡风险均高于成功老龄化组（男性HR=2.154,95%CI:1.595~2.908;女性HR=3.099,95%CI:1.746~5.501）。多因素分析显示未成功老龄化、低认知能力、有功能损失、低身体功能和抑郁是导致老年人不良生存结局的独立危险因素,不积极参与社会的男性死亡风险更高。 结论 我国老年人成功老龄化率较低且存在性别差异,成功老龄化组的死亡率显著低于未成功老龄化组;相比男性,女性成功老龄化与死亡的关系更加显著,尤其要针对不同性别老年人在成功老龄化各维度之间存在的差异进行个性化的干预。     

Recalled Parental Gender Preference in Chinese Culture: A Taiwan Birth Cohort Study

Archives of Sexual Behavior - Chinese culture has long favored sons over daughters. With the development of reproductive technology, the methods can be used not only in facilitation of conception,...     

Gender difference on the development of metabolic syndrome: a population-based study in Taiwan

Little is known regarding the development of metabolic syndrome. This study examining gender difference in the characteristics of metabolic components aimed to estimate the development of metabolic syndrome in both genders. This nation-wide, population-based survey included 5,880 men and women aged 20–79 years in Taiwan. Metabolic syndrome was defined by the revised National Cholesterol Education Program Adult Treatment Panel III, with adoption of the Asian criteria for abdominal obesity. The results indicate that metabolic syndrome was prevalent in 20.4% of the men and 15.3% of the women. Lipid components occurred the earliest in both genders. The appearance of the first isolated component was earlier in women than in men (mean age 43.4 vs. 45.6 years, P < 0.05). In contrast, the mean prevalent age of metabolic syndrome appeared earlier in men than in women by 4.9 years (mean age 51.3 vs. 56.2 years, P < 0.05). The differences in prevalent age from the appearance of any isolated component to metabolic syndrome were 12.8 years in women and 5.7 years in men, respectively. If men had a body mass index less than 23 kg/m² and exercise habits, the difference in the prevalent age from the isolated component to metabolic syndrome was 15.4 years, longer than for all women subjects. We conclude lipid components appeared the earliest. Women had the first isolated component earlier, presenting as metabolic syndrome later than men. The development of metabolic syndrome was slower in subjects without overweight characteristics and with exercise habits.     

Allostatic load as a predictor of functional decline. MacArthur studies of successful aging

Allostatic load has been proposed as a cumulative measure of dysregulation across multiple physiological systems, and has been postulated to impact health risks. In the allostatic load model, increased risk is hypothesized to result not only from large and clinically significant dysregulation in individual systems, but also from more modest dysregulation, if present in multiple systems. Our objective was to construct an allostatic load score by optimally combining several physiologic measurements, and to examine its association with future functional decline. We analyzed data from a 7-year longitudinal study of a community-based cohort, whose age at baseline was between 70 and 79 years. Canonical correlation analysis was used to study the association of 10 biological measurements representing allostatic load with declines in scores on five tests each of physical and cognitive function over two follow-up periods: 1998-1991 and 1991-1995. We used bootstrapping to evaluate the stability of the canonical correlation and canonical weights. The canonical correlation between allostatic load and the 20 decline scores was 0.43 (P =.03) and the [25th, 75th] percentile interval of its distribution over 200 bootstrapped subsamples of the cohort was [0.48, 0.53]. These findings were not substantially affected by adjusting for covariates and cardiovascular disease. We conclude that a summary measure of physiologic dysregulation, such as allostatic load, is an independent predictor of functional decline in elderly men and women.     

Gender differences in relationships between social capital and individual smoking and drinking behavior in Taiwan

Despite the concept of social capital receiving great attention in the area of health research, few studies have analyzed the differential effects of social capital between genders. This article assesses gender differences in the relationships between social capital and smoking and drinking behavior in Taiwan. Data on individual sociodemographic characteristics, smoking, drinking, and social capital were obtained from the Taiwan Social Change Survey conducted in 1995 and in 2000. The overall response rate was 67%. In total, 3713 women and men aged over 20 years living in 204 neighborhoods were interviewed. Social capital indicators were aggregated at the neighborhood level, and included neighborhood closeness, political influence, social contact, social trust, and social participation. The data were analyzed with multilevel binomial regression models. Gender differences were found in some aspects of social capital. Stronger effects of social trust on smoking were found for women than for men, whereas stronger effects of neighborhood closeness on drinking were found for women than for men. Social participation was positively associated with drinking in both genders. The findings of this study provide new evidence for the differential effects of social capital by gender in Taiwan, suggesting that more studies are needed to understand social capital's effects in Asian societies and the mechanisms by which the effects may vary with gender.     

我国不同地区老年人成功老龄化现状及影响因素分析-基于CHARLS数据的实证研究

目的 了解我国不同地区老年人成功老龄化的现状及其影响因素的差异,为促进我国老年人健康老龄化和探讨预防措施提供依据。方法 数据来源为2015年中国健康与养老全国追踪调查（China Health and Retirement Longitudinal Study,CHARLS）数据,利用二分类logistic回归模型进行危险因素的分析。结果 本次研究发现我国老年人成功老龄化率为14.41%,城市(31.35%)高于农村(10.70%);城市老年人群慢性病患病率、抑郁率、功能损失率、低认知功能占比和低社会参与率均低于农村老年人;年龄、婚姻状况、受教育程度、饮酒情况、中心性肥胖是成功老龄化的影响因素(P均<0.05)。结论 我国老年人成功老龄化率较低,城乡健康不公平显著,老年人心理和生理健康相关问题可能增多,应积极采取预防控制措施,促进我国健康老龄化的发展。