Subjective Well-Being, Depression, and Delays in Care Among Older Adults: Dual-Eligible Versus Medicare-Only Beneficiaries

2021 ◽  
pp. 073346482110009
Author(s):  
Dongjuan Xu ◽  
Vicki L. Simpson
Keyword(s):  
Older Adults ◽  
Well Being ◽  
Subjective Well Being ◽  
Medicare Beneficiaries ◽  
Dual Eligibles ◽  
Predicted Probability ◽  
Dual Eligible ◽  
Nationally Representative ◽  
Implementing Strategies

We aimed to (a) determine the role of subjective well-being and depression in care delays among Medicare beneficiaries and (b) examine whether subjective well-being and depression play a differential role among Medicare-only and dual-eligible beneficiaries. A nationally representative sample of 1,696 older adults participated in the study. Roughly, 22% of participants reported often or sometimes experiencing care delays, with more delays among dual eligibles. We found that higher levels of subjective well-being were significantly related to less frequent care delays. In contrast, higher levels of depression were significantly related to more frequent care delays. Moreover, as depression increased, the predicted probability of delays increased to a greater extent among dual eligibles than Medicare-only beneficiaries. These findings signify the importance of identifying and implementing strategies to enhance subjective well-being and reduce depression in older adults, particularly dual eligibles, to improve access to timely care.

scholarly journals Self-reported Vision Impairment and Subjective Well-being in Older Adults: A Longitudinal Mediation Analysis

2019 ◽  
Vol 75 (3) ◽  
pp. 589-595 ◽  
Author(s):  
Xiaoling Xiang ◽  
Vicki A Freedman ◽  
Khushali Shah ◽  
Rita X Hu ◽  
Brian C Stagg ◽  
...  
Keyword(s):  
Older Adults ◽  
Well Being ◽  
Vision Impairment ◽  
Activity Limitations ◽  
Subjective Well Being ◽  
Medicare Beneficiaries ◽  
Poor Vision ◽  
Longitudinal Mediation ◽  
Participation Restrictions ◽  
The Impact

Abstract Background Vision impairment (VI) in older adults is associated with declines in well-being. However, the pathways through which poor vision leads to declines in well-being have not been well-described. The purpose of this study was to determine whether activity limitations and social participation restrictions mediate the impact of self-reported VI on subjective well-being. Methods The National Health and Aging Trends Study (NHATS) is a nationally representative longitudinal study of Medicare beneficiaries 65 and older that includes detailed measures of the disablement process. A longitudinal mediation model was conceptualized linking self-reported VI and subjective well-being. Structural equation modeling was used to test the mediating effects of activity limitations and social participation restrictions while adjusting for relevant covariates. Results The final sample included 5,431 respondents. At baseline, 8.0% of Medicare beneficiaries had self-reported VI. Subjective well-being scores were significantly lower among respondents with self-reported VI (15.7; 95% confidence interval [CI]: 15.2, 16.2) compared with those without VI (17.6; 95% CI: 17.5, 17.7). Self-reported VI had a significant indirect effect on subjective well-being through limiting mobility (β = −0.04; 95% CI: −0.07, −0.03) and household activities (β = −0.05; 95% CI: −0.08, −0.03), but not self-care limitations (β = 0.0; 95% CI = 0.0, 0.0) or participation restrictions (β = 0.0; 95% CI = −0.01, 0.00). Total indirect effects from all mediation paths accounted for 42% of the effect of VI on well-being. Conclusions Mobility and household activity limitations are significant mediators that explain a considerable portion of the impact of poor vision on well-being. Interventions to promote successful accommodation may result in greater overall well-being for older adults with poor vision.

Who We Live With and How We Are Feeling: A Study of Household Living Arrangements and Subjective Well-Being Among Older Adults in China

2020 ◽  
pp. 016402752096154
Author(s):  
Wen-Jui Han ◽  
Ying Li ◽  
Cliff Whetung
Keyword(s):  
Older Adults ◽  
Life Satisfaction ◽  
Rural Areas ◽  
Living Arrangements ◽  
Well Being ◽  
Adult Health ◽  
Subjective Well Being ◽  
And Control ◽  
The Relationship

Using a sample of Chinese adults over the age of 50 from wave 1 of the WHO Study on Global Ageing and Adult Health (n = 13,367), we investigated the relationship between living arrangements and subjective well-being (SWB) in regard to life satisfaction, happiness, and control. We also looked at the moderating role of resources, proxied by income and hukou status. Multivariate regression results indicate that living only with a spouse was significantly associated with better SWB. Multigenerational living arrangements may not always promote SWB, particularly when resources are constrained. Yet, results also underscore the importance of daughters and daughters-in-law in promoting SWB among older adults. Older adults in rural areas had better SWB, including greater life satisfaction if living with grandchildren only, compared to their urban peers living with a spouse only. Findings suggest that context matters in the association between living arrangements and older adults’ SWB.

scholarly journals Driving Status and Transportation Disadvantage Among Medicare Beneficiaries

2018 ◽  
Vol 39 (9) ◽  
pp. 935-943 ◽  
Author(s):  
Miriam Ryvicker ◽  
Evan Bollens-Lund ◽  
Katherine A. Ornstein
Keyword(s):  
United States ◽  
Older Adults ◽  
Well Being ◽  
The United States ◽  
Community Dwelling ◽  
Medicare Beneficiaries ◽  
Coordination Strategies ◽  
Representative Study ◽  
Nationally Representative ◽  
Community Dwelling Older Adults

Transportation disadvantage may have important implications for the health, well-being, and quality of life of older adults. This study used the 2015 National Health Aging Trends Study, a nationally representative study of Medicare beneficiaries aged 65 and over ( N = 7,498), to generate national estimates of transportation modalities and transportation disadvantage among community-dwelling older adults in the United States. An estimated 10.8 million community-dwelling older adults in the United States rarely or never drive. Among nondrivers, 25% were classified as transportation disadvantaged, representing 2.3 million individuals. Individuals with more chronic medical conditions and those reliant on assistive devices were more likely to report having a transportation disadvantage ( p < .05). Being married resulted in a 50% decreased odds of having a transportation disadvantage ( p < .01). Some individuals may be at higher risk for transportation-related barriers to engaging in valued activities and accessing care, calling for tailored interventions such as ride-share services combined with care coordination strategies.

scholarly journals SELF-REPORTED VISION IMPAIRMENT AND SUBJECTIVE WELL-BEING IN OLDER ADULTS: A LONGITUDINAL MEDIATION ANALYSIS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S551-S552
Author(s):  
Joshua R Ehrlich ◽  
Xiaoling Xiang ◽  
Khushali Shah ◽  
Rita X Hu ◽  
Brian C Stagg ◽  
...  
Keyword(s):  
Older Adults ◽  
Well Being ◽  
Vision Impairment ◽  
Activity Limitations ◽  
Subjective Well Being ◽  
Medicare Beneficiaries ◽  
Poor Vision ◽  
Longitudinal Mediation ◽  
Participation Restrictions ◽  
The Impact

Abstract Vision impairment (VI) in older adults is associated with declines in well-being. However, the pathways through which poor vision leads to declines in well-being have not been well described. The purpose of this study was to determine whether activity limitations and social participation restrictions mediate the impact of self-reported VI on subjective well-being. This study used data from the National Health and Aging Trends Study (NHATS), a nationally-representative longitudinal study of Medicare beneficiaries 65 and older that includes detailed measures of the disablement process. We conceptualized a longitudinal mediation model linking self-reported VI and subjective well-being. Structural equation modeling was used to test the mediating effects of activity limitations and social participation restrictions while adjusting for covariates. The final sample included 5,431 respondents. At baseline, 8.0% of Medicare beneficiaries had self-reported VI. Subjective well-being scores were significantly lower among respondents with self-reported VI (15.7, 95% CI=15.2, 16.2) compared to those without VI (17.6, 95% CI=17.5, 17.7). Self-reported VI had a significant indirect effect on subjective well-being through limiting mobility (β=-.04, 95% CI=-.07, -.03) and household activities (β=-.05, 95% CI=-.08, -.03), but not self-care limitations (β=0.0, 95% CI=0.0, 0.0) or participation restrictions (β=0.0, 95% CI=-0.01, 0.00). Total indirect effects from all mediation paths accounted for 42% of the effect of VI on well-being. In conclusion, mobility and household activity limitations are significant mediators that explain a considerable portion of the impact of poor vision on well-being. Interventions to promote successful accommodation may result in greater well-being for visually impaired older adults.

scholarly journals The role of psychological well-being in obese and overweight older adults

2015 ◽  
Vol 28 (1) ◽  
pp. 171-172 ◽  
Author(s):  
Cinzia Giuli ◽  
Roberta Papa ◽  
Fiorella Marcellini ◽  
Marco Boscaro ◽  
Emanuela Faloia ◽  
...  
Keyword(s):  
Older Adults ◽  
Personal Growth ◽  
Well Being ◽  
Normal Weight ◽  
Subjective Well Being ◽  
Exclusion Criteria ◽  
Psychological Well Being ◽  
Impaired Quality

Being obese or overweight is often associated with impaired quality of life and psychological well-being (PWB) in comparison with normal-weight people (Giuli et al., 2014), both in developed and developing countries. PWB is considered a very important correlate of subjective well-being in people with excess weight. The concept of PWB is based on Ryff's multidimensional model (Ryff, 2014), which considers well-being as eudaemonic concept, and includes six dimensions: autonomy, environmental mastery, personal growth, positive relations with others, purpose in life, and self-acceptance. Few studies have analyzed the role of specific correlates of perceived well-being in the obese and overweight Italian older population. The purpose of this study was to evaluate the role of perceived well-being in obese and overweight older adults. Our study included 124 overweight and obese older participants, aged 60 years or more, selected from patients attending the Division of Endocrinology, Department of Clinical and Molecular Sciences of Polytechnic University of Marche (Italy). As previously described (Giuli et al., 2014), the participants were recruited on the basis of specific inclusion/exclusion criteria, in a period of three years (January 2010–December 2012).

scholarly journals Socioeconomic status, frailty, and subjective well-being: A moderated mediation analysis in elderly Chinese

2016 ◽  
Vol 23 (7) ◽  
pp. 961-970 ◽  
Author(s):  
Fang Yang ◽  
Joyce S Pang
Keyword(s):  
Older Adults ◽  
Socioeconomic Status ◽  
Elderly Women ◽  
Well Being ◽  
Moderated Mediation ◽  
Mediation Effect ◽  
Social Activities ◽  
Subjective Well Being ◽  
Moderated Mediation Model

The study examined the mechanisms underlying the link between socioeconomic status and subjective well-being and explored the role of social activities using a representative sample of older adults ( N = 2773) in Shanghai, China. Results show that frailty mediated the relationship between socioeconomic status and subjective well-being, and social activities moderated the model, such that the mediation effect of frailty was significant only when social activities were lower. Moreover, the moderated mediation model was significant only for women, not for men. Findings highlight the importance of addressing frailty of older adults and promoting social activities (especially for elderly women) in future interventions.

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