Risks of malnutrition and depression in older adults living alone or with a spouse in Hong Kong

With an ageing world population, preservation of older adults’ health and quality of life (QoL) is paramount. Due to lower levels of physical functionality, older adults are particularly susceptible to local environment influences, especially those living alone and lacking family support. Using generalised additive mixed models, we examined associations and confounder-adjusted associations between objectively-measured neighbourhood attributes and QoL domains in 909 Hong Kong Chinese elderly community dwellers. Most examined neighbourhood attributes were not associated with QoL in the whole sample. Neighbourhood residential and entertainment density was curvilinearly and/or linearly related to specific QoL domains. Number of parks was negatively associated with social QoL and having well-treed parks with higher levels of social QoL. Older adults living alone in neighbourhoods with poor access to destinations and few activities in parks showed lower environmental and/or social QoL than their counterparts. Neighbourhood built environment characteristics do not seem to impact Hong Kong older adults’ physical and psychological QoL. Medium-to-high density, well-ordered neighbourhoods with optimal mixes of well-treed public open spaces and services meeting their daily needs may significantly contribute to social and environmental QoL in this population and appear particularly important to those living alone.

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Poverty in old age: evidence from Hong Kong

Ageing and Society ◽

10.1017/s0144686x16000817 ◽

2016 ◽

Vol 38 (1) ◽

pp. 37-55 ◽

Cited By ~ 6

Author(s):

LIH-SHING CHAN ◽

KEE-LEE CHOU

Keyword(s):

Older Adults ◽

Hong Kong ◽

Old Age ◽

Response Rate ◽

Living Alone ◽

School Level ◽

Stratified Sample ◽

Old Age Poverty ◽

The Government ◽

Distribution Of Income

ABSTRACTThe Hong Kong population will age rapidly over the next three decades and the entailing problem of old-age poverty will put the Hong Kong government to test. While the government has been using a solely income-based measurement, the main purpose of this study is to assess poverty rates among Hong Kong's older population in terms of both income and consumption-based measurements by using both relative and absolute concepts of poverty. It also examines the association of socio-economic and household characteristics with elder poverty rates. A two-stage stratified sample design was adopted. A total of 4,306 older adults were personally interviewed in their homes, yielding a response rate of 66.2 per cent. This study contributes to the larger study on poverty in Hong Kong by revealing how income and consumption poverty rates may differ among older adults. Older adults who were both income and consumption poor were more likely to be female, widowed, living alone and to have received less than an elementary school-level education. They possessed very few assets and were most likely financially dependent on family support and welfare payments. To understand fully the economic wellbeing of older adults in Hong Kong, this study proposes that joint distribution of income and consumption poverty can better identify and explain the demographic characteristics of the poor older adults. Implications of the study are discussed based on the neo-liberalist approach that the Hong Kong government has taken in welfare provisions.

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Cross-sectional associations of objectively assessed neighbourhood attributes with depressive symptoms in older adults of an ultra-dense urban environment: the Hong Kong ALECS study

BMJ Open ◽

10.1136/bmjopen-2017-020480 ◽

2018 ◽

Vol 8 (3) ◽

pp. e020480 ◽

Cited By ~ 5

Author(s):

Casper J P Zhang ◽

Anthony Barnett ◽

Cindy H P Sit ◽

Poh-chin Lai ◽

Janice M Johnston ◽

...

Keyword(s):

Older Adults ◽

Hong Kong ◽

Depressive Symptoms ◽

Public Transport ◽

Living Arrangements ◽

Depression Scale ◽

Living Alone ◽

Hong Kong Chinese ◽

Cross Sectional ◽

Environmental Attributes

ObjectivesThis study aimed to examine the associations between objectively assessed neighbourhood environmental attributes and depressive symptoms in Hong Kong Chinese older adults and the moderating effects of neighbourhood environmental attributes on the associations between living arrangements and depressive symptoms.DesignCross-sectional observational study.SettingHong Kong.Participants909 Hong Kong Chinese community dwellers aged 65+ years residing in preselected areas stratified by walkability and socioeconomic status.Exposure and outcome measuresAttributes of participants’ neighbourhood environment were objectively assessed using geographic information systems and environmental audits. Depressive symptoms were measured using the Geriatric Depression Scale.ResultsOverall, pedestrian infrastructure (OR=1.025; P=0.008), connectivity (OR=1.039; P=0.002) and prevalence of public transport stops (OR=1.056; P=0.012) were positively associated with the odds of reporting depressive symptoms. Older adults living alone were at higher risk of reporting any depressive symptoms than those living with others (OR=1.497; P=0.039). This association was moderated by neighbourhood crowdedness, perceptible pollution, access to destinations and presence of people. Residing in neighbourhoods with lower levels of these attributes was associated with increased deleterious effects of living alone. Living in neighbourhoods with lower public transport density also increased the deleterious effects of living alone on the number of depressive symptoms. Those living alone and residing in neighbourhoods with higher levels of connectivity tended to report more depressive symptoms than their counterparts.ConclusionsThe level of access to destinations and social networks across Hong Kong may be sufficiently high to reduce the risk of depressive symptoms in older adults. Yet, exposure to extreme levels of public transport density and associated traffic volumes may increase the risk of depressive symptoms. The provision of good access to a variety of destinations, public transport and public open spaces for socialising in the neighbourhood may help reduce the risk of depressive symptoms in older adults who live alone.

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Typology of Social Exclusion of Older Adults Living Alone: Policy Analysis of Local Government A

The Korean Association of Governance Studies ◽

10.26847/mspa.2020.30.2.89 ◽

2020 ◽

Vol 30 (2) ◽

pp. 89-111

Author(s):

Seung-Eun Oh ◽

Bon Kim ◽

Joohong Min

Keyword(s):

Older Adults ◽

Local Government ◽

Policy Analysis ◽

Social Exclusion ◽

Living Alone

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An Association between Social Networks of Closed Triads and Physical Health among Korea‘s Living-Alone Older Adults

Korean Journal of Sociology ◽

10.21562/kjs.2018.05.52.2.1 ◽

2018 ◽

Vol 52 (2) ◽

pp. 1-35

Author(s):

Minseong Kim ◽

Dasol Park ◽

Jihyeong Yoo ◽

Yoosik Youm

Keyword(s):

Older Adults ◽

Social Networks ◽

Physical Health ◽

Living Alone

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Comparison of adaptive versions of the Hong Kong-specific criteria and 2015 Beers criteria for assessing potentially inappropriate medication use in Hong Kong older patients

BMC Geriatrics ◽

10.1186/s12877-021-02324-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Huanyu ZHANG ◽

Eliza L. Y. WONG ◽

Samuel Y. S. WONG ◽

Patsy Y. K. CHAU ◽

Benjamin H. K. YIP ◽

...

Keyword(s):

Older Adults ◽

Hong Kong ◽

Older Patients ◽

Inappropriate Medication ◽

Female Gender ◽

Potentially Inappropriate Medication ◽

Multivariable Logistic Regression Analysis ◽

Beers Criteria ◽

Medical Conditions ◽

Cross Sectional

Abstract Background The Hong Kong-specific criteria have been established in 2019 to assess potentially inappropriate medication (PIM) use in older adults and improve the local prescribing quality. The aim of this study was to compare the adaptive versions of the Hong Kong-specific criteria and 2015 Beers criteria for assessing the prevalence and correlates of PIM use in Hong Kong older patients. Methods A cross-sectional study was performed from January 1, 2014 to December 31, 2014 using the Hospital Authority (HA) database. A total of 489,301 older patients aged 65 years and older visiting general outpatient clinics (GOPCs) during the study period were included in the study. Two categories of PIM use included in the Hong Kong-specific criteria and 2015 Beers criteria, i.e. PIMs independent of diagnoses and PIMs considering specific medical conditions, were adapted to assess the prevalence of PIM use among the study sample. Characteristics of PIM users and the most frequently prescribed PIMs were investigated for each set of the criteria. Factors associated with PIM use were identified using the stepwise multivariable logistic regression analysis. Results The adaptive Hong Kong-specific criteria could detect a higher prevalence of patients exposed to at least one PIM than that assessed by the adaptive Beers criteria (49.5% vs 47.5%). Meanwhile, the adaptive Hong Kong-specific criteria could identify a higher rate of patients exposed to PIMs independent of diagnoses (48.1% vs 46.8%) and PIMs considering specific medical conditions (7.3% vs 4.9%) compared with that of the adaptive Beers criteria. The most frequently prescribed PIMs detected by the adaptive Beers criteria were all included in the adaptive Hong Kong-specific criteria. The strongest factor associated with PIM use was number of different medications prescribed. Patients with female gender, aged 65 ~ 74 years, a larger number of GOPC visits, and more than six diagnoses were associated with greater risk of PIM use, whereas advancing age was associated with lower risk of PIM use. Conclusions The adaptive Hong Kong-specific criteria could detect a higher prevalence of PIM use than the adaptive Beers criteria in older adults visiting GOPCs in Hong Kong. It is necessary to update the prevalence and correlates of PIM use regularly in older adults to monitor the burden of PIM use and identify vulnerable patients who need further interventions.

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