scholarly journals Factors Contributing to Older Adults Living Alone and Thereby at Risk of Poor Health and Adverse Health Outcomes

2019 ◽  
Author(s):  
Nikki Shipley
Keyword(s):  
Older Adults ◽  
At Risk ◽  
Health Status ◽  
Health Outcomes ◽  
Older Adult ◽  
Living Arrangements ◽  
Age At Onset ◽  
Poor Health ◽  
Living Child ◽  
Living Alone

Introduction: Extensive research demonstrates that older adults living alone tend to be less healthy, have poorer health outcomes and are at greater risk of dying. While many investigators have explored various aspects of aging, there has been limited work assessing factors that increase the chances of an older adult to live alone. This study examines the association between demographic characteristics; current health status; and social, cultural, and environmental factors among older adults (65 years of age and older) and the likelihood they will live alone Methods: Secondary analyses is conducted of survey data from the Americans' Changing Lives (ACL) cohort study initiated in 1986 (Wave 1) and continued through 2012, with four follow-up surveys conducted in 1989 (Wave II), 1994 (Wave III), 2001/02 (Wave IV), and 2011/12 (Wave V). All ACL participants 65 years and older at time of survey (Wave I – V) are included for this study (N=7,020). An analysis of variance (ANOVA) that included demographics, health status, and social support factors is employed to determine the relationship of these variables to an older adult reporting living alone. Additionally, the Cox proportional hazards model is used for survival analysis to predict the expected age at onset of living alone. Results: Four critical factors reduce the probability of an older adult living alone: 1) marital status (married), 2) gender (male), 3) presence of at least one living child, and 4) willingness to spend time in the garden (physical activity). An older female adult who is currently single and without a living child is most likely to report living alone (p<.001). Conclusions: Older adults living alone are at higher risk of poor health and health outcomes. The influx of baby boomers whose life expectancy is longer than the past, will cause a dramatic increase in senior adults living alone. This research suggests a guideline to public health professionals for identifying those at risk of being negatively impacted by living alone so that they can intervene and provide alternative living arrangements and support services, as necessary. Keywords: living alone, older adults, health outcomes

scholarly journals Greater Risk of Negative Health Outcomes of Older Adults Living Alone in Vietnam: A Community Survey

2021 ◽  
Vol 18 (21) ◽  
pp. 11115
Author(s):  
Man Thi Hue Vo ◽  
Keiko Nakamura ◽  
Kaoruko Seino ◽  
Thang Van Vo
Keyword(s):  
Older Adults ◽  
Health Outcomes ◽  
Rural Areas ◽  
Living Arrangements ◽  
Fear Of Falling ◽  
Living Arrangement ◽  
Community Survey ◽  
Living Alone ◽  
Cross Sectional ◽  
Solitary Living

In modern Asian societies, there has been a shift in the living arrangements of older adults away from living with others. Knowing the health characteristics of individuals living alone can help identify high-risk groups. This cross-sectional study aimed to describe characteristics of the Vietnamese older adults and to investigate the association between living alone and their reported health outcomes by utilizing survey data of individuals aged ≥60 years in Vietnam in 2018. The community survey included questions about sociodemographic factors, living arrangement, and self-reported physical functional status. Multivariate logistic regression was used to examine whether or not living alone was a predictor of health outcomes. Of 725 study participants, 8.9% lived alone. These participants were more likely to be female, aged 70–79 years, living in rural areas, and currently single or previously married. After adjusting for covariates, older adults who were living alone were more likely to have arthritis (adjusted odds ratio [AOR] = 1.95, 95% confidence interval [CI]: 1.10–3.45), a history of falling (AOR = 2.44, 95% CI: 1.02–5.82), visual difficulties (AOR = 1.89, 95% CI: 1.04–3.41), feelings of loneliness (AOR = 1.95, 95% CI: 1.10–3.47), and high fear of falling (AOR = 1.88, 95% CI: 1.02–3.46). Older adults living alone in Vietnam were at greater risk of negative health consequences than those living with others. Screening and providing adequate social support for this specific population is important in preventing the adverse effects of solitary living among these older adults.

scholarly journals Analysis of the Demand for Older Adult Care Services and Related Influencing Factors among Older Adults Living Alone in China

2020 ◽  
Author(s):  
Yanbing Zeng ◽  
Chenxi Lin ◽  
Ya Fang
Keyword(s):  
Older Adults ◽  
Influencing Factors ◽  
Older Adult ◽  
Living Arrangements ◽  
Family Members ◽  
Living Alone ◽  
Health Concern ◽  
Adult Care ◽  
Income Source ◽  
Care Services

Abstract Background: The number of older adults living alone in China is rising sharply and their care needs have become an increasing public health concern. This study aimed to explore the anticipated living arrangements and demand for home and community-based care services (HCBS) of older adults living alone and examine the related influencing factors.Methods: The data of 2217 participants living alone were extracted from the 2018 Chinese Longitudinal Health Longevity Survey (CLHLS). A chi-square test was used to examine the differences in older adult care services between respondents with different characteristics. Using the Andersen model as the analysis framework, multinomial and binary logistic regressions were used to analyze the influencing factors of anticipated living arrangements and HCBS, respectively. Results: 75.4% of the respondents hoped to maintain living alone when considering the future. Those who were older, had more children, income source was family members, always felt lonely and isolated and had limitation in activities of daily living (ADL) were inclined to choose the arrangement of “co-residence with children”. Childless and loneliness had significant impact on older adults’ willingness to live in institution. There were significant differences between urban and rural areas for provision of HCBS and the demand exceeds supply in all service types. Those who were younger, lived in urban areas, farmers, income source was family members, had poor economic status, had access to social services, with higher sense of loneliness and chronic diseases tend to show anticipated demands for various HCBS.Conclusions: The demand for older adult care services were affected by predisposing, enabling and need variables. There is a need for an overall improvement of the community care system to create a supportive environment for older adults living alone.

Relationships Between Living Arrangements and Health Status Among Older Adults in the United States, 2009-2014: Findings From the National Health Interview Survey

2016 ◽  
Vol 37 (1) ◽  
pp. 7-25 ◽  
Author(s):  
Judith D. Weissman ◽  
David Russell
Keyword(s):  
Older Adults ◽  
Psychological Distress ◽  
Health Status ◽  
National Health ◽  
Living Arrangements ◽  
National Health Interview Survey ◽  
Living Alone ◽  
Health Conditions ◽  
Serious Psychological Distress ◽  
Interview Survey

Limited research has examined how health varies across living arrangements among older adults. Adults aged 65 years and older were sampled from National Health Interview Survey 2009-2014. Four indicators of health (serious psychological distress, health status, functional limitations, and number of health conditions) were compared across older adults living alone, living with others related/unrelated, living with a spouse/partner (no children), and living with children (no spouse/partner). Regression models showed older adults living with others have the poorest health; they were less likely to report excellent or very good health, had serious psychological distress and limitations in activities of daily living (ADLs), and a greater number of health conditions compared with older adults living with a spouse/partner. However, older women living alone or with children were more likely to report two or more health conditions compared with women living with a spouse/partner, suggesting that in older age, there are gender variations in health across living arrangements.

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.

scholarly journals Analysis of The Demand for Older Adult Care Services and Related Influencing Factors Among Older Adults Living Alone in China

2020 ◽  
Author(s):  
Yanbing Zeng ◽  
Chenxi Lin ◽  
Ya Fang
Keyword(s):  
Older Adults ◽  
Influencing Factors ◽  
Older Adult ◽  
Living Arrangements ◽  
Family Members ◽  
Living Alone ◽  
Health Concern ◽  
Adult Care ◽  
Income Source ◽  
Care Services

Abstract Background: The number of older adults living alone in China is rising sharply and their care needs have become an increasing public health concern. This study aimed to explore the anticipated living arrangements and demand for home and community-based care services (HCBS) of older adults living alone and examine the related influencing factors.Methods: The data of 2217 participants living alone were extracted from the 2018 Chinese Longitudinal Health Longevity Survey (CLHLS). A chi-square test was used to examine the differences in older adult care services between respondents with different characteristics. Using the Andersen model as the analysis framework, multinomial and binary logistic regressions were used to analyze the influencing factors of anticipated living arrangements and HCBS, respectively. Results: 75.4% of the respondents hoped to maintain living alone when considering the future. Those who were older, had more children, income source was family members, always felt lonely and isolated and had limitation in activities of daily living (ADL) were inclined to choose the arrangement of “co-residence with children”. Childless and loneliness had significant impact on older adults’ willingness to live in institution. There were significant differences between urban and rural areas for provision of HCBS and the demand exceeds supply in all service types. Those who were younger, lived in urban areas, farmers, income source was family members, had poor economic status, had access to social services, with higher sense of loneliness and chronic diseases tend to show anticipated demands for various HCBS.Conclusions: The demand for older adult care services were affected by predisposing, enabling and need variables. There is a need for an overall improvement of the community care system to create a supportive environment for older adults living alone.

scholarly journals Living Arrangement Modifies the Associations of Loneliness with Adverse Health Outcomes in Older Adults: Evidence From the CLHLS

2021 ◽  
Author(s):  
Kai Wei ◽  
Yong Liu ◽  
Junjie Yang ◽  
Nannan Gu ◽  
Xinyi Cao ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Outcomes ◽  
Living Arrangements ◽  
Living Arrangement ◽  
Community Dwelling ◽  
Living Alone ◽  
Adverse Health ◽  
Adverse Health Outcomes ◽  
Physical Functions ◽  
Community Dwelling Older Adults

Abstract Background: Although it has been suggested that loneliness is a risk factor for adverse health outcomes, living arrangement may confound the association. This study aimed to investigate whether the associations of loneliness with adverse health outcomes differ in community-dwelling older adults according to different living arrangements.Methods: In the 2008/2009 wave of Chinese Longitudinal Healthy Longevity Survey, 16255 community-dwelling older adults (≥65 years) were recruited. Living arrangements and feelings of loneliness were assessed. Health outcomes including cognitive and physical functions were assessed using MMSE, ADL/IADL scales and Frailty Index in the 2008/2009 and 2011/2012 waves; mortality was assessed in the 3-year follow-up from 2008/2009 to 2011/2012. The associations of loneliness with adverse health outcomes accroding to different living arrangements were estimated using logistic regression or Cox proportional hazards regression models. Interactions between living arrangement and loneliness on adverse health outcomes were also investigated.Results: Older adults who were lonely (47.8% of those living alone and 25% of those living with others) had higher prevalence of cognitive impairment, frailty and 3-year mortality than older adults without loneliness, especially among those who lived with others (OR=1.31, 95% CI=1.15-1.51; OR=1.42, 95% CI=1.26-1.60; HR=1.16, 95% CI=1.07-1.26, respecitvely). In contrast, among the living alone older adults, loneliness was only associated with higher prevalence of frailty (OR=1.41, 95% CI=1.06-1.88). Living arrangement modified the associations of loneliness with prevalent cognitive impairment and mortality (P values for interactions=0.006 and 0.015, respectively).Conclusions: Living arrangement modifies the associations of loneliness with adverse health outcomes in community-dwelling older adults, and those who lived with others but felt lonely had worse cognitive and physical functions as well as higher mortality. Special attention should be paid to this population to reduce adverse health outcomes.

Education and skills training for care partners of hospitalised older adults: A scoping review

2021 ◽  
pp. 001789692110341
Author(s):  
Madeline Carbery ◽  
Samantha Schwartz ◽  
Nicole Werner ◽  
Beth Fields
Keyword(s):  
Older Adults ◽  
Hospital Admission ◽  
Health Outcomes ◽  
Older Adult ◽  
Scoping Review ◽  
Hospital Care ◽  
Skills Training ◽  
Individual Care ◽  
Care Partners ◽  
The Usa

Background: The care partners of hospitalised older adults often feel dissatisfied with the education and skills training provided to them, resulting in unpreparedness and poor health outcomes. Objective: This review aimed to characterise and identify gaps in the education and skills training used with the care partners of older adults in the hospital. Methods: We conducted a scoping review on the education and skills training practices used with the care partners of hospitalised older adults in the USA via sources identified in the PubMed, PsychINFO and CINAHL databases. Results: Twelve studies were included in this review. Results illustrate that nurses utilise multiple modes of delivery and frequently provide education and skills training tailored to the needs of care partners at the latter end of hospital care. The provision of education and skills training varies greatly, however, including who provides education, in what way information is conveyed, and how care partner outcomes are measured. Conclusion: This is the first scoping review to describe and synthesise the education and skills training practices used with care partners of hospitalised older adults. Findings highlight the need for education and skills training to be interprofessional, tailored to individual care partners’ needs and begin at, or even before, the hospital admission of older adult patients.

Understanding Exercise Challenges and Barriers for Older Adults with Mobility Disabilities

2020 ◽  
Vol 64 (1) ◽  
pp. 1297-1301
Author(s):  
Qiong Nie ◽  
Lyndsie M. Koon ◽  
Madina Khamzina ◽  
Wendy A. Rogers
Keyword(s):  
Older Adults ◽  
Health Status ◽  
Older People ◽  
Health Outcomes ◽  
Quantitative Evaluation ◽  
Exercise Barriers ◽  
Depth Interview ◽  
Physical Limitations ◽  
Barriers And Challenges ◽  
Depth Interviews

Interventions to address exercise challenges in older people have been the focus of recent research, given the importance of exercise for health outcomes. However, exercise challenges for older adults with mobility disabilities have received little attention. We investigated participation of exercise among older adults with mobility disabilities to understand exercise barriers and challenges experienced by this population. We conducted a needs assessment using two archival datasets: a quantitative survey with 1,137 respondents and a qualitative in-depth interview with 23 participants. The quantitative evaluation revealed low participation of walking and less engagement of vigorous activities, and significant correlates of health status and lack of energy with vigorous activities. The in-depth interviews showed exercise challenges were attributed to difficulties with physical limitations, accessibility, and environmental limitations. Individuals with mobility disabilities may face unique challenges and barriers, affordable and effective supports to promote exercise engagement for them should be adapted to such needs.

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 Frailty Indexed Classification of Bangladeshi Older Adults’ Physio-psychosocial Health and Associated Risk Factors- A Cross-sectional Survey Study

2020 ◽  
Author(s):  
Mohammad Meshbahur Rahman ◽  
Mohammad Hamiduzzaman ◽  
Saleha Akter ◽  
Zaki Farhana ◽  
Mohammad Kamal Hossain ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Health Status ◽  
Family Income ◽  
Psychosocial Health ◽  
Poor Health ◽  
Medical Conditions ◽  
Cross Sectional ◽  
Study Results ◽  
Associated Risk Factors

Abstract Background: Frailty is associated with healthy ageing, and it has been identified as a means of measuring older adults’ physio-psychosocial health. We know about the ageing trends and common diseases of older adults living in South Asia, but literature to date does not widely feature their health status based on frailty, especially in Bangladesh. This study aims to understand the prevalence of frailty in Bangladeshi older adults; classify their health status; and investigate associated risk factors.Methods: A cross-sectional study was conducted in the north-eastern region (i.e. Sylhet City Corporation) of Bangladesh. Four hundred participants aged 55 years and above were randomly selected, attended a health assessment session and completed a multi-indicator survey questionnaire. We developed a 30-indicator Frailty Index (FI30) to assess the participant’s health status and categorized: good health (no-frailty/Fit); slightly poor health (mild frailty); poor health (moderate frailty); and very poor health (severe frailty). Pearson chi-square test and binary logistic regression analysis were conducted.Results: The participants’ mean age was 63.6 years, and 61.6% of them were assessed in poor to very poor health (moderate frailty/36.3% - severe frailty/25.3%). The eldest, female and participants from lower family income were found more frailty than their counterparts. Participants aged 70 years and above were more likely (adjusted OR: 4.23, 95 % CI: 2.26–7.92, p < 0.0001) to experience frailty (medical conditions) than the pre-elderly age group (55-59 years). Female participants were more vulnerable (adjusted OR=1.487, 95% CI: 0.84-2.64, p < 0.0174) to frailty (medical conditions) than male. Also, older adults who had higher family income (Income>$473.3) found a lower risk (adjusted OR: 0.294, 95% CI: 0.11-0.76, p<0.011) of frailty (poor health).Conclusion: Our study results confirm the prevalence of frailty-related disorders in Bangladeshi older adults and highlight the importance of targeted clinical and community-led preventive care programs.

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