scholarly journals Social Disconnection and Living Arrangements among Older Adults: The Singapore Chinese Health Study

Gerontology ◽  
2021 ◽  
pp. 1-9
Author(s):  
Jon Barrenetxea ◽  
Yi Yang ◽  
An Pan ◽  
Qiushi Feng ◽  
Woon-Puay Koh
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Living Arrangement ◽  
Community Dwelling ◽  
Living Alone ◽  
Health Study ◽  
Factors Associated ◽  
Self Rated Health ◽  
Singapore Chinese ◽  
Social Disconnection

<b><i>Introduction:</i></b> Although living alone is associated with social disconnection, older adults could be socially disconnected despite living with others. Understanding the factors associated with social disconnection by living arrangement could help identify vulnerable older adults in the community. We examined the sociodemographic and health factors associated with social disconnection among two groups of older adults: those living alone and those living with others. <b><i>Methods:</i></b> We used data from 16,943 community-dwelling older adults from the third follow-up of the Singapore Chinese Health Study (mean age: 73 years, range: 61–96 years). We defined social disconnection as having no social participation and scoring in the lowest decile on the Duke Social Support Scale of perceived social support. We ran logistic regression models to study the sociodemographic (age, gender, and education) and health (self-rated health, instrumental limitations, cognitive function, and depression) factors associated with social disconnection, stratified by living arrangement. <b><i>Results:</i></b> About 6% of our participants were socially disconnected. Although living alone was significantly associated with social disconnection (OR 1.93, 95% CI: 1.58–2.35), 85.6% of socially disconnected older adults lived with others, most of them (92%) with family. Lower education level, cognitive impairment, fair/poor self-rated health, instrumental limitations, and depression were independently associated with social disconnection. Among those living alone, men were more likely to experience social disconnection than women (OR 2.18, 95% CI: 1.43–3.32). <b><i>Discussion/Conclusion:</i></b> Though living alone is associated with social disconnection, most socially disconnected individuals lived with family. Community interventions could focus on those in poor health despite living with family and older men living alone.

scholarly journals Factors Associated With Social Isolation Among Older Adults: The Singapore Chinese Health Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 168-168
Author(s):  
Jon Barrenetxea ◽  
Yang Yi ◽  
Woon Puay Koh ◽  
Feng Qiushi
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Social Isolation ◽  
Well Being ◽  
Population Based ◽  
Living Alone ◽  
Health Study ◽  
Factors Associated ◽  
Singapore Chinese

Abstract Social isolation is a determinant of mortality and well-being among older people. Factors associated with isolation could be different in societies where older adults live mainly with family, as individuals might feel isolated despite living with others. We studied the factors associated with isolation among 16,948 older adults from follow-up 3 of the Singapore Chinese Health Study, a population-based cohort of older Singapore Chinese (mean age of 73, range: 61-96 years). We defined social isolation as having “zero hour per week” of participation in social activities involving 3 or more people and scoring the lowest decile on the Duke Social Support Scale of perceived social support. We used multivariable logistic regressions to compute odds ratio (OR) and 95% confidence interval (CI) for factors associated with likelihood of social isolation. Although only 14.4% of isolated participants lived alone, living alone remained a significant factor associated with isolation (OR 1.93, 95% CI 1.58-2.35), together with cognitive impairment (OR 1.73, 95% CI 1.46-2.04) and depression (OR 2.44, 95% CI 2.12-2.80). Higher education level was inversely associated with isolation (p for trend&lt;0.001). In stratified analysis, among those living alone, compared to women, men had higher odds of social isolation (OR 2.18, 95% CI 1.43-3.32) than among those not living alone (OR 0.99, 95% CI 0.84-1.17) (p for interaction&lt;0.001). Our results showed that living alone, cognitive impairment and depression were indicators of isolation among older Singaporeans. In addition, among those living alone, men were more likely to experience social isolation than women.

Social support and health among older adults – the Singapore Chinese Health Study

2021 ◽  
pp. 1-17
Author(s):  
Jon Barrenetxea ◽  
Yi Yang ◽  
Kyriakos S. Markides ◽  
An Pan ◽  
Woon-Puay Koh ◽  
...  
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Poor Health ◽  
Health Study ◽  
Factors Associated ◽  
Self Rated Health ◽  
Health Factors ◽  
Lower Social Support ◽  
Singapore Chinese ◽  
To Receive

Abstract While having social support can contribute to better health, those in poor health may be limited in their capacity to receive social support. We studied the health factors associated with social support among community-dwelling older adults in Singapore. We used data from the third follow-up interviews (2014–2016) of 16,943 participants of the Singapore Chinese Health Study, a population-based cohort of older Singapore Chinese. Participants were interviewed at a mean age of 73 years (range 61–96 years) using the Duke Social Support Scale (DUSOCS). We first applied ordinary least squares regression to DUSOCS scores and found that those with instrumental limitations, poor self-rated health, cognitive impairment and depression had lower social support scores. We then applied latent class analysis to DUSOCS answer patterns and revealed four groups of older adults based on the source and amount of social support. Among them, compared to the ‘overall supported’ group (17%) with the highest social support scores and broad support from family members and non-family individuals, the ‘family restricted’ (50%) group had the lowest social support scores and only received support from children. Health factors associated with being ‘family restricted’ were instrumental limitations (odds ratio (OR) = 1.33, 95% confidence interval (CI) = 1.19–1.49), poor self-rated health (OR = 1.40, 95% CI = 1.28–1.53), cognitive impairment (OR = 1.19, 95% CI = 1.04–1.37) and depression (OR = 2.50, 95% CI = 2.22–2.82). We found that while older adults in poor health have lower social support scores, they were more likely to receive a lot of support from children. Our results showed that lower social support scores among Singaporean older adults in poor health may not indicate lack of social support, but rather that social support is restricted in scope and intensified around children. These results may apply to other Asian societies where family plays a central role in elder-care.

scholarly journals Older Adults in Poor Health Received Social Support Mainly From Family: The Singapore Chinese Health Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 169-169
Author(s):  
Jon Barrenetxea ◽  
Yang Yi ◽  
Kyriakos S Markides ◽  
Woon Puay Koh ◽  
Feng Qiushi
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Extended Family ◽  
Poor Health ◽  
Health Study ◽  
Factors Associated ◽  
The Family ◽  
Health Factors ◽  
Received Social Support ◽  
Singapore Chinese

Abstract While having social support can contribute to the health of older adults, those in poor health may be limited in their capacity to receive social support. We studied health factors associated with social support among 16,948 participants from follow-up 3 of the Singapore Chinese Health Study, a population-based cohort of older Singapore Chinese. Participants were interviewed at mean age of 73 years (range from 61 to 96 years) using the Duke Social Support Scale. Latent Class Analysis (LCA) was applied to derive groups based on the source and intensity of social support. We ran multivariate logistic regression models to study health factors associated with group membership. LCA revealed four groups in increasing social support scores: The “family restricted”, who had the lowest social support scores and only received support from family (50%); the “loners”, who had some support from extended family and non-family (5%); the “family oriented”, who had broad family support and some non-family support (28%); and the “overall supported”, who had the highest social support scores and received broad support from family, extended family and non-family (17%). Compared to the “overall supported” group, health factors associated with being “family restricted” were: having instrumental limitations [odds ratio (OR) 1.34, 95% confidence interval (CI) 1.19-1.50], having poor self-rated health (OR 1.40, 95% CI 1.28-1.54), being depressed (OR 2.49, 95% CI 2.21-2.81) and being cognitively impaired (OR 1.19, 95% CI 1.04-1.37). Our results showed that older adults in poor health received social support mainly from family.

scholarly journals Emergency hospital admissions among older adults living alone in the community

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jon Barrenetxea ◽  
Kelvin Bryan Tan ◽  
Rachel Tong ◽  
Kevin Chua ◽  
Qiushi Feng ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Status ◽  
Living Arrangements ◽  
Hospital Admissions ◽  
Living Arrangement ◽  
Joint Effect ◽  
Living Alone ◽  
Health Study ◽  
P Value ◽  
Singapore Chinese

Abstract Background Among older adults, living alone is often associated with higher risk of Emergency Department (ED) admissions. However, older adults living alone are very heterogeneous in terms of health. As more older adults choose to live independently, it remains unclear if the association between living alone and ED admissions is moderated by health status. We studied the association between living alone and ED admission outcomes (number of admissions, inpatient days and inpatient costs) among older adults with and without multimorbidity. Methods We used data from 16,785 individuals of the third follow-up of the Singapore Chinese Health Study, a population-based cohort of older Singapore Chinese (mean age: 73(61-96) years). Participants were interviewed face-to-face from 2014 to 2016 for sociodemographic/health factors and followed-up for one year on ED admission outcomes using Singapore Ministry of Health’s Mediclaim Database. We first applied multivariable logistic regression and two-part models to test if living alone is a risk factor for ED admission outcomes. We then ran stratified and joint effect analysis to examine if the associations between living alone and ED admission outcomes were moderated by multimorbidity. Results Compared to living with others, living alone was associated with higher odds of ED admission [Odds Ratio (OR) 1.28, 95 % Confidence Interval(CI) 1.08-1.51)], longer inpatient days (+0.61, 95 %CI 0.25-0.97) and higher inpatient costs (+322 USD, 95 %CI 54-591). The interaction effects of living arrangement and multimorbidity on ED admissions and inpatient costs were not statistically different, whereas the interaction between living arrangements and multimorbidity on inpatient days was borderline significant (p-value for interaction=0.050). Compared to those living with others and without multimorbidity, the relative mean increase was 1.13 inpatient days (95 %CI 0.39-1.86) for those living alone without multimorbidity, and 0.73 inpatient days ( 95 %CI 0.29-1.17) for those living alone with multimorbidity. Conclusions Older adults living alone were at higher risk of ED admission and higher inpatient costs regardless of multimorbidity, while those living alone without multimorbidity had the longest average inpatient days. To enable aging in place while avoiding ED admissions, interventions could provide instrumental support and regular health monitoring to older adults living alone, regardless of their health status.

Educational Differences in Self-Rated Health Trends Among Middle-Aged and Older Adults Living Alone, 1972–2018

2022 ◽  
pp. 089826432110527
Author(s):  
Esther O. Lamidi
Keyword(s):  
Older Adults ◽  
Living Arrangements ◽  
Living Arrangement ◽  
Living Alone ◽  
Middle Aged ◽  
Older Americans ◽  
Health Trends ◽  
Self Rated Health ◽  
Educational Differences ◽  
Middle Aged Adults

Objectives: This study examines educational differences in living alone and in self-rated health trends among middle-aged and older adults. Methods: We used logistic regression to analyze data from the 1972–2018 National Health Interview Survey ( n = 795,239 aged 40–64; n = 357,974 aged 65–84). Results: Between 1972–1974 and 2015–2018, living alone became more prevalent, particularly among men and at lower levels of education. Self-rated health trends varied by living arrangement and education. We found self-rated health declines among middle-aged adults having no college degree and living alone, but trends in self-rated health were mostly stable or even improved among middle-aged adults living with others. Among older adults, self-rated health improved over time, but for the least-educated older Americans living alone, the probability of reporting fair or poor health increased between 1972–1974 and 2015–2018. Discussion: The findings suggest growing disparities by social class, in living arrangements and in self-rated health.

scholarly journals Factors Associated with Successful Aging among Community-Dwelling Older Adults Based on Ecological System Model

2020 ◽  
Vol 17 (9) ◽  
pp. 3220 ◽  
Author(s):  
Hye-Young Jang
Keyword(s):  
Older Adults ◽  
Successful Aging ◽  
Living Arrangement ◽  
Individual Characteristics ◽  
Community Dwelling ◽  
Ecological System ◽  
System Model ◽  
Healthcare Intervention ◽  
Factors Associated ◽  
Study Results

This study was conducted to identify the factors associated with successful aging in older adults based on the ecological system model. Data from the 2017 National Survey of the Living Conditions of Korean Elderly were used. Participants comprised 10,074 older adults. The three principal components in the successful aging model developed by Rowe and Kahn, “absence of disease and disease-related disability,” “maintenance of high mental and physical function,” and “continued engagement with life,” were used to determine successful aging. The collected data were analyzed using descriptive statistics, chi-squared test, t-test, and logistic regression. The study results showed that the correlation factors were age, sex, educational level, economic status, heavy drinking, subjective health status, and health screening in the individual system; living arrangement, satisfaction with spouse, and frequency of contacting family, siblings, and relatives in the family system; and the frequency of contacting neighbors and friends, number of close neighbors and friends, and accessibility of neighborhood facilities in the community system. This study is significant because it confirms that individual characteristics and the environmental systems surrounding older adults should be considered for successful aging; it is necessary to develop and apply healthcare intervention programs that consider both of these aspects.

scholarly journals Prevalence and factors associated with poor self-rated health among community dwelling older adults in Lomé (Togo) in 2019

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Fifonsi Adjidossi Gbeasor-Komlanvi ◽  
Martin Kouame Tchankoni ◽  
Ama Boilassi Adjonko ◽  
Wendpouire Ida Carine Zida-Compaore ◽  
Nicolas Konan Kouakou ◽  
...  
Keyword(s):  
Older Adults ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Sub Saharan Africa ◽  
Cross Sectional ◽  
Herbal Products ◽  
Factors Associated ◽  
Self Rated Health ◽  
Sub Saharan ◽  
Community Dwelling Older Adults

The number of older adults is increasing worldwide, including in sub-Saharan Africa (SSA). However, there is a paucity of data on the overall health status of older adults living in SSA. To assess the prevalence and factors associated with poor Self-Rated Health (SRH) among community-dwelling older adults in Lomé, Togo, we conducted a cross-sectional study from January to June 2019 in Lomé among community-dwelling older adults aged 50 years and older. A 30- minute questionnaire was used to collect socio-demographic characteristics, medical history, patterns of medication use and use of herbal products and dietary supplements during a face-to-face interview. SRH was assessed using a single item: Overall, you would say that your health is… (1) excellent, (2) very good, (3) good, (4) fair and (5) poor with response fair or poor defining poor SRH. A total of 344 respondents with median age 63 years, (IQR: 55-72) were enrolled in the study. Women represented 57.6% of the sample. Overall prevalence of poor SRH was 56.4% (95%CI: 51.0-61.9) and was the highest among females (62.6% vs 47.9%; P=0.007) and participants >60 years (61.5% vs 51.1%; P=0.021). Female sex, aged ≥60 years, osteoarthritis, hospitalization within the 12 months preceding the survey, polypharmacy, and the use of herbal products were factors associated with poor SRH (P<0.05). More than half of community- dwelling older adults had poor SRH in Lomé. Further studies are needed to guide policymakers in their efforts to design and implement meaningful policies to improve older adults health conditions.

scholarly journals Emergency Department Admissions Among Older Adults Living Alone With Multimorbidity

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 583-584
Author(s):  
Jon Barrenetxea ◽  
Cynthia Chen ◽  
Woon-Puay Koh ◽  
Feng Qiushi ◽  
Kelvin Bryan Tan ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Living Arrangements ◽  
Population Based ◽  
Living Alone ◽  
Health Study ◽  
Risk Of Mortality ◽  
Hospitalization Costs ◽  
Singapore Chinese ◽  
One Year

Abstract Older adults living alone are at higher risk of mortality, morbidity and healthcare utilization. As more older adults live alone, Emergency Department (ED) admissions could rapidly increase, particularly among those with multimorbidity. We studied the association of living alone on ED admissions among older adults with multimorbidity. We used data from 16,785 older adults of the population-based Singapore Chinese Health Study (mean age: 73 years, range: 61-96 years) who were interviewed in 2014-2016 for living arrangements and medical history. Participants were followed-up for one year on ED admission outcomes (number of admissions, inpatient days and hospitalization costs). We used multivariable logistic regression to study the association between living alone and ED admission, and ran two-part models (probit & generalised linear model) to estimate the association of living alone on inpatient days and hospitalization cost. We found that compared to living with others, living alone was associated with a higher odds of ED admissions [Odds Ratio (OR) 1.28, 95% Confidence Interval (CI) 1.08-1.51)], longer inpatient days (+0.61, 95% CI 0.25-0.97) and higher hospitalization costs (+322 USD, 95% CI 54-591). Compared to those living with others without multimorbidity, living alone with multimorbidity was associated with higher odds of ED admission (OR 1.64 95% CI 1.33-2.03), longer inpatient days (+0.73, 95% CI 0.29-1.17) and higher hospitalization costs (+567 USD, 95% CI 230-906). In conclusion, living alone is associated with higher odds of ED admission, longer inpatient days and higher hospitalization costs among older adults, particularly among those with multimorbidity.

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

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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