Longitudinal Relationship Between Living Alone and Activity Engagement of Chinese Older Adults

Abstract The living arrangement of older adults plays a key role in their health status and psychological well-being. Yet the relationship between living arrangement and activity engagement remains unclear. Using data from three waves of the nationally representative China Health and Retirement Longitudinal Study (CHARLS) with a study sample of 7,479 respondents aged 60 or older, this study examined the effect of living alone on the frequency of activity engagement among Chinese older adults. Two types of activity engagement were examined in this study, including social interaction with friends and leisure activity (i.e., play chess, go to a sport or club). The multinomial logistic regression analyses were performed using generalized structural equation modeling (GSEM). Compared with those living with others, older adults living alone were older, more likely to be female and living in urban areas, and with fewer years of education and more functional limitations. The results also indicated that after controlling for a set of covariates, living alone status was significantly associated with the increased likelihood of high and medium frequency of both social interaction and leisure activity in reference to no engagement. This study not only improves the understanding of activity engagement preference of Chinese older adults who are living alone but also indicates the importance of improving community facilities and outdoor spaces to promote activity engagement among older adults.

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Loneliness, isolation and living alone associate with psychological well-being among the older adults in Taipei

Innovation in Aging ◽

10.1093/geroni/igaa057.3397 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 926-926

Author(s):

Hui-chuan Hsu

Keyword(s):

Older Adults ◽

Psychological Health ◽

Multinomial Logistic Regression ◽

Living Arrangement ◽

Senior Citizen ◽

Well Being ◽

Living Alone ◽

Related Factors ◽

Self Rated Health ◽

Economic Satisfaction

Abstract Purpose: The purpose of this study was to examine the clustering of loneliness, isolation, and living alone, the risk factors and the associations with psychological wellbeing. Methods: The data were from the 2019 Taipei City Senior Citizen Condition Survey collected by face-to-face interviews, which included aged 60 and above community-based and institution-based samples. The completed sample was 3,853 persons. Loneliness, isolation, and living arrangement were analysed by cluster analysis to define the Loneliness-Isolation-Living Alone clusters. Multinomial logistic regression was used to examine the related factors to LIL clusters. Results: Four clusters of the older adults were identified and named as following: Connected (44.1%), Alone /Institutionalized (9.2%); Lonely (10.7%); and Isolated (22.0%). Compared with the Connected cluster, the Alone/Institutionalized cluster was more likely to have higher education, more IADL difficulties, more diseases , lower economic satisfaction, more likely to be males, having no spouse, and no children; the Lonely cluster was more likely to poor self-rated health, lower financial satisfaction, feeling less age-friendliness, more likely to be older, female, and no spouse; the Isolated cluster was more likely to have lower education, reported poorer self-rated health, lower economic satisfaction, and being older. The Alone/Institutionalized cluster and the Lonely cluster had higher depressive symptoms; the Alone/Institutionalized, Lonely, and Isolated clusters reported lower life satisfaction and had higher risks of cognitive impairment. Discussion: Loneliness, isolation, and living alone jointly associate with psychological health and well-being. High risk older populations may need social care and encourage social participation to promote health and wellbeing.

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Typologies of Loneliness, Isolation and Living Alone Are Associated with Psychological Well-Being among Older Adults in Taipei: A Cross-Sectional Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17249181 ◽

2020 ◽

Vol 17 (24) ◽

pp. 9181

Author(s):

Hui-Chuan Hsu

Keyword(s):

Older Adults ◽

Life Satisfaction ◽

Multinomial Logistic Regression ◽

Living Arrangement ◽

Well Being ◽

Living Alone ◽

Cross Sectional ◽

Psychological Well Being ◽

The Government ◽

Lower Life Satisfaction

Background: Loneliness, isolation, and living alone are emerging as critical issues in older people’s health and well-being, but the effects are not consistent. The purpose of this study was to examine the clustering of loneliness, isolation, and living alone, the risk factors and the associations with psychological well-being. Methods: The data were collected from the 2019 Taipei City Senior Citizen Condition Survey by face-to-face interviews and included a community-based sample (n = 3553). Loneliness, isolation, and living arrangement were analyzed by cluster analysis to define Loneliness-Isolation-Living-Alone clusters. Multinomial logistic regression was used to examine the factors related to Loneliness-Isolation-Living-Alone clusters, and linear regression was used to examine association of clusters with psychological well-being. Results: Five clusters of older adults were identified and named as follows: Not Lonely-Connected-Others (53.4%), Not Lonely-Isolated-Others (26.6%), Not Lonely-Alone (5.0%), Lonely-Connected (8.1%), and Lonely-Isolated-Others (6.9%). Demographics, financial satisfaction, physical function, family relationship, and social participation were related to the Loneliness-Isolation-Living-Alone clusters. Compared with the Not Lonely-Connected-Others cluster, the Lonely-Connected cluster and Lonely-Isolated-Others cluster had higher depressive symptoms and lower life satisfaction, and the Not Lonely-Isolated-Others cluster reported lower life satisfaction; the Not Lonely-Alone cluster was not different. Discussion: Loneliness and isolation are negatively associated with psychological well-being, and living arrangement is not the determinant to loneliness or isolation. Older adults are suggested to strengthen their informal social support, and the government may encourage social care and create an age friendly environment to reduce loneliness and isolation.

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PSYCHOLOGICAL WELL-BEING AND THE ONSET OF COGNITIVE IMPAIRMENT AMONG CHINESE OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igz038.423 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S114-S115

Author(s):

Jiaan Zhang

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Multinomial Logistic Regression ◽

Well Being ◽

Functional Health ◽

Survey Study ◽

Psychological Well Being ◽

Chinese Older Adults ◽

Study Results ◽

Over Time

Abstract Previous research has shown the beneficial effects of positive psychological assets on health, but more research is needed to confirm the prospective effects on cognitive function. The purpose of this study is to examine the relationship between psychological well-being and the earliest onset of cognitive impairment among Chinese older adults. Data came from 2000 to 2014 waves of the Chinese Longitudinal Healthy Longevity Survey. Study sample consisted of 6,225 older adults who were free from cognitive impairment in 2000. Psychological well-being was measured based on seven items that assessed optimism, conscientiousness, self-determination, happiness, self-esteem, pessimism, and loneliness, with responses ranging from “always (1)” to never (5)”. Negative feelings items were reverse coded. Higher score indicated more positive psychological well-being. Cognitive impairment was measured by a Chinese version of the Mini-Mental State Examination. Respondents scored at or above 24 were regarded as having no cognitive impairment. A multi-category time-varying variable was used to capture four potential outcomes: (1) persistently free of cognitive impairment between waves, (2) onset of cognitive impairment, (3) death between waves, and (4) attrition. Socio-demographics, chronical diseases conditions, functional health status were served as controls. Multilevel multinomial logistic regression models that account for clustering of observations within a subject over time were employed for the study. Results show that more positive psychological well-being is significantly associated with reduced risk of cognitive impairment onset and death over time. Results suggest that developing more psychological resilience-based intervention programs among older adults may help them delay the onset of cognitive impairment.

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The association of widowhood and living alone with depression among older adults in India

Scientific Reports ◽

10.1038/s41598-021-01238-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Shobhit Srivastava ◽

Paramita Debnath ◽

Neha Shri ◽

T. Muhammad

Keyword(s):

Older Adults ◽

Marital Status ◽

Living Arrangement ◽

Binary Logistic Regression ◽

Well Being ◽

Living Alone ◽

Bivariate Analysis ◽

Binary Logistic Regression Analysis ◽

Effective Sample Size ◽

Nationally Representative

AbstractWidowhood is a catastrophic event at any stage of life for the surviving partner particularly in old age, with serious repercussions on their physical, economic, and emotional well-being. This study investigates the association of marital status and living arrangement with depression among older adults. Additionally, the study aims to evaluate the effects of factors such as socio-economic conditions and other health problems contributing to the risk of depression among older adults in India. This study utilizes data from the nationally representative Longitudinal Ageing Study in India (LASI-2017–18). The effective sample size was 30,639 older adults aged 60 years and above. Descriptive statistics and bivariate analysis have been performed to determine the prevalence of depression. Further, binary logistic regression analysis was conducted to study the association between marital status and living arrangement on depression among older adults in India. Overall, around nine percent of the older adults suffered from depression. 10.3% of the widowed (currently married: 7.8%) and 13.6% of the older adults who were living alone suffered from depression. Further, 8.4% of the respondents who were co-residing with someone were suffering from depression. Widowed older adults were 34% more likely to be depressed than currently married counterparts [AOR: 1.34, CI 1.2–1.49]. Similarly, respondents who lived alone were 16% more likely to be depressed compared to their counterparts [AOR: 1.16; CI 1.02, 1.40]. Older adults who were widowed and living alone were 56% more likely to suffer from depression [AOR: 1.56; CI 1.28, 1.91] in reference to older adults who were currently married and co-residing. The study shows vulnerability of widowed older adults who are living alone and among those who had lack of socio-economic resources and face poor health status. The study can be used to target outreach programs and service delivery for the older adults who are living alone or widowed and suffering from depression.

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A Longitudinal Analysis of the Association Between Living Arrangements and Health Among Older Adults in China

Research on Aging ◽

10.1177/0164027516680854 ◽

2016 ◽

Vol 40 (1) ◽

pp. 72-97 ◽

Cited By ~ 14

Author(s):

Zi Zhou ◽

Fanzhen Mao ◽

Jiaping Ma ◽

Shichao Hao ◽

Zhengmin (Min) Qian ◽

...

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Living Arrangements ◽

Living Arrangement ◽

Well Being ◽

Living Alone ◽

Psychological Well Being ◽

Self Rated Health ◽

Health Differences ◽

Adl Disability

This article used the nationally representative Chinese Longitudinal Healthy Longevity Survey to explore the associations between living arrangements and health among older adults. Living arrangements were stratified into six categories. Health was measured by self-rated health, activities of daily living (ADL) disability, and cognitive impairment. Random-effects ordered probit regressions were applied. The results indicated that coresidence had a positive effect on self-rated health compared with living alone. After introducing psychological well-being, the health differences observed in living with a spouse and living with both spouse and children were not significant. Participants with each of the living arrangement were more likely to have a higher rate of cognitive impairment and ADL disability than those living alone. Living arrangements were associated with older adults’ health. Psychological well-being was a key factor in this association, which may result from living with a spouse, and could contribute to the self-rated health of older adults.

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Loneliness as a mediator of the impact of social isolation on cognitive functioning of Chinese older adults

Age and Ageing ◽

10.1093/ageing/afaa020 ◽

2020 ◽

Vol 49 (4) ◽

pp. 599-604 ◽

Cited By ~ 4

Author(s):

Rumei Yang ◽

Haocen Wang ◽

Linda S Edelman ◽

Eunjin L Tracy ◽

George Demiris ◽

...

Keyword(s):

Older Adults ◽

Cognitive Functioning ◽

Social Isolation ◽

Adult Children ◽

Social Activity ◽

Community Dwelling ◽

Living Alone ◽

Activity Engagement ◽

Chinese Older Adults ◽

The Impact

Abstract Background and Objective older adults have increased risk of social isolation, loneliness and cognitive functioning impairment, but the relationships among these factors are not conclusive. We investigated the potential mediation mechanism of loneliness on the association between social isolation and cognitive functioning among Chinese older adults within their cultural context. Design secondary analysis of the baseline wave (2011–12) of the harmonised China Health and Retirement Longitudinal Study. Setting and Subjects community-dwelling older adults in China (N = 7,410 participants aged 60–101 years). Methods we applied a multiple indicator multiple cause approach to determine whether the construct of social isolation is well defined by four indicators (social activity engagement, weekly adult children contact, caregiving for grandchildren and living alone) and used structural equation modelling to examine the direct and indirect effects among variables of interest. Results the results demonstrated that social activity engagement, weekly adult children contact and caregiving for grandchildren were significantly related to social isolation (β = −0.26 to −0.28) (Living alone was fixed to 1 for model identification.) The indirect effect of social isolation on cognitive functioning through loneliness was significant (β = −0.15), indicating loneliness was an important mediator. However, the direct effect of social isolation on cognitive functioning also remained significant (β = −0.83), suggesting a partial mediation effect. Conclusions our study highlights the mediation role of loneliness in the relationship between social isolation and cognitive functioning among Chinese older adults. The findings support the beneficial effects of maintaining social relations and coping with feelings of loneliness on older adults’ cognitive functioning.

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Transition of Living Arrangement and Cognitive Impairment Status among Chinese Older Adults: Are They Associated?

Medicina ◽

10.3390/medicina57090961 ◽

2021 ◽

Vol 57 (9) ◽

pp. 961

Author(s):

Yen-Han Lee ◽

Chia-Hung Lin ◽

Jia-Ren Chang ◽

Ching-Ti Liu ◽

Mack Shelley ◽

...

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Cognitive Function ◽

Filial Piety ◽

Cox Regression ◽

Living Arrangement ◽

Living Alone ◽

Chinese Older Adults ◽

Healthy Longevity ◽

Household Members

Background and Objectives: Living arrangement is a crucial factor for older adults’ health. It is even more critical for Chinese older adults due to the tradition of filial piety. With the aging of China’s population, the prevalence of cognitive impairment among older adults has increased. This study examines the association between living arrangement transition and cognitive function among Chinese older adults. Materials and Methods: Using three waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS; 2008–2009, 2011–2012, and 2014), we analyzed data for older adults (age ≥ 65) who lived with other household members and reported good cognitive function or mild cognitive impairment when they participated in the survey. Multistate Cox regression was employed to study changes in cognitive function. Results: Older adults who transitioned to living alone had lower risk of cognitive impairment (hazard ratio (HR) = 0.66, 95% CI: 0.52, 0.83; p < 0.01), compared with those who continued to live with other household members. Moving into an institution was also not associated with cognitive impairment. Conclusions: With older adults’ transition to living alone, public health practitioners or social workers might educate them on the benefits of such a living arrangement for cognitive function.

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Social Engagement and Well-Being Among Chinese Older Adults

Innovation in Aging ◽

10.1093/geroni/igab046.1132 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 293-293

Author(s):

Wei Zhang ◽

Bei Wu ◽

Yan Yan Wu

Keyword(s):

Older Adults ◽

Social Isolation ◽

Social Participation ◽

Social Engagement ◽

Protective Factor ◽

Leisure Activity ◽

Well Being ◽

Psychological Well Being ◽

Chinese Older Adults ◽

New Findings

Abstract Social engagement is increasingly recognized as a protective factor to promote healthy aging. This symposium provides new findings on social participation and social isolation in relation to individuals’ health and well-being among the Chinese populations. Using the 2002–2018 Chinese Longitudinal Healthy Longevity Survey, the first study examined the trends of leisure activity engagement among young-old adults aged 65–74 in China over a 16-year period. Findings revealed a general downward trend of engaging in any form of social leisure activity and upward trends for engaging in home-bound and solitary leisure activities. Similarly, the second study examined social participation patterns and individual factors associated with these patterns using three nationally representative data in China, UK, and US. Their findings highlighted several underlying participation patterns across these nations as well as differences in how socio-demographics were associated with these patterns. Using data collected among Chinese older adults in Hawaii, the third study examined the associations of social isolation with psychological well-being. Results showed that social isolation was positively related to psychological distress, and negatively related to life satisfaction and happiness. These associations were partially mediated by resilience. Their findings revealed the detrimental health effects of social isolation. Using the same dataset in Hawaii, the last study examined the associations between neighbourhood conditions and psychological well-being for Chinese older adults. Their findings revealed that both physical and social neighbourhood conditions were associated with psychological well-being, particularly for foreign-born older adults, and psychological resources such as self-management abilities could mediate the associations.

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Effects of a Movement-Based Mind-Body Intervention in Managing Osteoarthritis Symptoms in Older Adults

Innovation in Aging ◽

10.1093/geroni/igab046.1767 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 458-458

Author(s):

Juyoung Park ◽

Carson Herron

Keyword(s):

Older Adults ◽

Older Women ◽

Living Arrangement ◽

Intervention Group ◽

Secondary Analysis ◽

Well Being ◽

Living Alone ◽

Pain Interference ◽

Randomized Control ◽

Mental Well Being

Abstract In a secondary analysis, this study examined differences in age (younger vs. older geriatric groups), gender, and living arrangement (living alone vs. living with others) in elderly patients with osteoarthritis (OA) who utilized chair yoga (CY) as an type of movement-based mind-body intervention (MMBI) for symptom management. A two-arm, assessor-blinded, randomized control trial was used to examine effects of CY (twice-weekly 45-minute sessions for 8 weeks) on pain interference, physical function, and psychosocial outcomes by gender, age, and living arrangement in older adults with OA who could not participate in traditional exercise. A total of 112 older adults completed CY or a health education program (HEP) and participated in five data collection points. Older women in the CY group showed greater reduction in pain interference during the CY intervention than those in HEP, F(4, 86) = 3.255, p = .016, η2 = .131. The younger group (ages 61 to 74) had decreased depression scores during the intervention, F(4, 87) = 2.598, p = .042, η2 = .107. Regardless of the intervention (CY or HEP), depression scores in older adults who were living alone decreased substantially during the intervention. Group-based and supervised CY interventions are recommended for older adults with OA to reduce pain interference, reduce depressive symptoms, and develop social networks. Online-based synchronous CY sessions may address physical activity needs and improve mental well-being in this population in light of physical distancing practices due to COVID-19.

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Leisure Activities and the Subjective Well-Being of Older Adults in Croatia

GeroPsych ◽

10.1024/1662-9647/a000179 ◽

2018 ◽

Vol 31 (1) ◽

pp. 31-39 ◽

Cited By ~ 1

Author(s):

Ljiljana Kaliterna Lipovčan ◽

Tihana Brkljačić ◽

Zvjezdana Prizmić Larsen ◽

Andreja Brajša-Žganec ◽

Renata Franc

Keyword(s):

Older Adults ◽

Leisure Activities ◽

Leisure Activity ◽

Later Life ◽

Perceived Health ◽

Well Being ◽

Hierarchical Regression ◽

Subjective Well Being ◽

Convenience Sample ◽

Financial Status

Abstract. Research shows that engagement in leisure activities promotes well-being among older adults. The objective of the current study was to examine the relationship between subjective well-being (flourishing) and leisure activities (total number of different activities in the previous year) in a sample of older adults in Croatia, thereby considering the variables of sex, marital status, financial status, and self-perceived health. The differences in the examined variables between the groups of older adults who reported to be engaged in new activities with those who did not were also examined. The sample of N = 169 older adults aged 60 years and above was drawn from a convenience sample of adult internet users in Croatia. Participants reported their self-perceived health and the number of leisure activities they engaged in over the previous year as well as completing the Flourishing Scale. Hierarchical regression analyses indicated that older adults who were engaged in more various leisure activities, who perceived better financial status, and who were married reported higher levels of flourishing. A comparison of the two groups of older adults with and without engagement in leisure activities showed that those engaged in at least one leisure activity were more likely to be women, reported higher levels of flourishing, and perceived their own financial status as better. This study indicated that engaging in leisure activities in later life might provide beneficial effects for the well-being of older adults.

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