A Study of Predictors of Depression among Elders Living Alone: Focusing on activity daily living, social support loneliness, and geism

2021 ◽  
Vol 40 ◽  
pp. 141-159
Author(s):  
Hyun-Sung Lim ◽  
Ok-Lim Kim
2004 ◽  
Vol 32 (2) ◽  
pp. 129-138 ◽  
Author(s):  
Shu-Chuan Jennifer Yeh ◽  
Sing Kai Lo

This study aimed to describe the characteristics of the elderly population living alone, and to examine how living alone relates to feeling lonely. Interviews were conducted with a stratified random sample of 4,859 elderly individuals living in Kaohsiung, Taiwan. Variables collected included demographic information, living alone or not, activities of daily living (ADL), instrumental activities of daily living (IADL), Short Portable Mental Status Questionnaire (SPMSQ), chronic conditions, perceived social support, and a subjective measure of feeling lonely. Using logistic regression, it was found that factors associated with living alone included gender, marital status, occupation, source of income, religion, and IADL. Living alone was, in turn, related to decreased levels of both perceived social support and feeling lonely after adjustment for potential confounders. Managing retired life is important for adult elders, particularly for men. Lack of social support is common among the elderly community who live alone, which could well be a main reason for this group to feel lonely. As loneliness is linked to physical and mental health problems, increasing social support and facilitating friendship should be factored into life-style management for communities of elderly.


Author(s):  
Edward P Havranek ◽  
Kensey L Gosch ◽  
Donna M Buchanan ◽  
Kim G Smolderen ◽  
John A Spertus

Background: Lack of social support is associated with worse outcomes after myocardial infarction (MI). Social support is a complex concept that includes the quality of perceived support and the size and quality of one's social network. It is not known if having a geographically close social network affects outcomes post-MI. We hypothesized that patients with a greater number of close network contacts would have better post-MI outcomes. Methods: From contacts listed by subjects in TRIUMPH, a prospective registry of MI patients from 24 US centers, we characterized social network size (number of contacts listed) and closeness (number of nuclear family contacts and number of contacts residing in the same area code). We assessed univariate relationships between these indices and outcomes (mortality and health status by the EQ-5D Visual Analogue Scale [VAS], an overall assessment of patients' quality of life), and scores from the ENRICHD Social Support Instrument (ESSI). We created multivariable Cox proportional hazards and linear regression models with mortality and VAS as dependent variables and with demographic, clinical, treatment and social support measures as independent variables. Results: Of 4340 subjects enrolled, 472 died over a median of 28.6 months. Mean 12-month VAS score was 75.4 ± 21.1. Having no same area code contacts (19.3% vs. 15.9%) (p=0.025 for trend), no nuclear family contacts (40.9% vs. 33.8%) (p=0.010 for trend), and living alone (33.0% vs. 23.6%, p<0.001) were associated with higher mortality on univariate analysis; total number of contacts and ESSI tertile were not. Univariate relationships with VAS were similar. In a multivariable model, age, prior stroke, diabetes, kidney disease, ejection fraction <40%, and living alone were significantly associated with mortality. In the multivariable VAS model, fewer area code contacts was additionally significant (p=0.023 for trend across number of contacts). Subjects with no area code contacts had a VAS score 3.2 ± 2.0 points lower than those with 4 near contacts. Conclusions: Geographic closeness of patients' social networks is weakly associated with outcomes after MI. Further investigation is warranted before proposing interventions designed to compensate for low network-based support.


Author(s):  
Lu Niu ◽  
Cunxian Jia ◽  
Zhenyu Ma ◽  
Guojun Wang ◽  
Bin Sun ◽  
...  

Abstract Aims Loneliness is increasingly recognised as a serious public health issue worldwide. However, there is scarce research addressing the association between loneliness and suicide in older adults in rural China. We set out to examine loneliness and other psychosocial factors in elderly suicide cases and explore their interaction effects. Methods Using a 1 : 1 matched case–control design, data were collected from 242 elderly suicide cases and 242 living community controls by psychological autopsy method in rural China, including demographic characteristics, loneliness, depression, hopelessness and social support. The chi-square automatic interaction detection (CHAID) tree model and multivariable logistic regression analysis were used to explore the relationships of these factors and suicide. Results The CHAID tree model showed that loneliness, hopelessness and depressive symptoms were closely associated with completed suicide and that loneliness and hopelessness interacted with each other. The result of multivariable logistic regression showed that individuals who were unemployed [odds ratio (OR) = 2.344; 95% confidence interval (CI): 1.233–4.457], living alone (OR = 2.176; 95% CI: 1.113–4.254), had lower levels of subjective social support (OR = 2.185; 95% CI: 1.243–3.843), experienced depressive symptoms (OR = 6.700; 95% CI: 3.405–13.182), showed higher levels of hopelessness (OR = 7.253; 95% CI: 3.764–13.974) and felt higher levels of hopelessness × higher levels of loneliness (OR = 2.446; 95% CI: 1.089–5.492) were significantly associated with an elevated suicide risk in older people in rural China. Conclusions Regular evaluation of loneliness, hopelessness and depression can help detect older adults who are at risk of committing suicide. Interventions should target social support systems, particularly among people living alone, to alleviate feelings of loneliness and hopelessness. Treating depression is also key to preventing suicide among elderly people in rural China.


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