Examining Mental and Physical Health Status Among Sandwich Generation Caregivers

With a sample of 54,076 caregivers, the Behavioral Risk Factor Surveillance System (BRFSS, 2015-2017) provides an opportunity to assess the impact of caregiving on U.S. adults varying in age, gender, and race. We focused on sandwich generation (SG) caregivers, aged 30-59, with childcare and eldercare responsibilities (n=8,805). In multivariate regression models of mental and physical health, we evaluated the association of age, gender, race and caregiving factors controlling for marital status, education, housing status, income, employment status, and self-rated health status. SG caregivers were predominantly female (65.6%), white (69.6%), black (13%) and were caring for a parent/parent-in-law (50%) or another relative (26.4%). Age, gender, and race were associated with mental health outcomes such that SG caregivers who were younger (aged 30-39), female, and white reported poorer mental health during the past month (p<.05). Older (aged 50-59), female, and white SG caregivers reported poorer physical health during the past month (p<.05). Caregiving factors were not associated with mental health, but SG caregivers who had been providing care for a longer period of time were more likely to report poor physical health in the past month. Finally, education, income, employment, housing status, and self-rated health status were statistically significant covariates in both models (p<.05). These findings demonstrate that young caregivers are at risk for poor mental health; older caregivers for poor physical health. Being female, white, with lower socioeconomic status is associated with poor mental and physical health. Future research should address the unique needs of SG caregivers with dual caregiving responsibilities.

Perceived discrimination and health outcomes among middle-aged and older adults in India: results of a national survey in 2017–2018

Background The study aimed to estimate the associations between perceived discrimination and poor physical health, poor mental health, and health risk behaviours in middle-aged and older adults in a national population survey in India. Methods The sample included 72,262 middle-aged and older adults from a cross-sectional national community dwelling survey in India in 2017–2018. Results The prevalence of moderate (1–2 types) perceived discrimination was 10.7%, and high (3–6 types) perceived discrimination was 6.6%. In the final adjusted logistic, linear or Poisson regression analyses, moderate and/or high perceived discrimination was significantly positively associated with poor mental health (low life satisfaction, poor cognitive functioning, insomnia symptoms, and depressive symptoms), poor physical health (pain conditions count, and functional limitations), and health risk behaviours (heavy episodic drinking and physical inactivity). Conclusion Perceived discrimination is associated with poor mental health, poor physical health, and health risk behaviour, emphasising the need to consider perceived discrimination in various physical and mental health contexts.

Psychological Distress and Social Integration of Elderly People With Physical Disabilities

Background and Objectives: Poor physical health can affect the performance of everyday life activities and integration into society. The extent of disability or its influence on the life of an individual is related to his/her physical and social environment. This study aimed to examine the psychological existential orientation and social integration of elders with physical disabilities. Methods: Forty-six people with physical disabilities (with Mean±SD age of 73.7±10.6 years and age range of 53-93 years) were examined regarding psychological existential orientation, social integration, and health-related quality of life, using an extensive questionnaire set, including questionnaire on assistive technology, the Brief Symptom Inventory, and health-related quality of life. Results: The results showed that poor physical health can negatively impact the psyche and integration of the sample into society. Also, the subjects indicated a strong desire for more integration into society, however, they did not significantly participate in society in the last two weeks. Conclusion: Poor health and dependence on the environment in daily life can negatively influence the psychological and social situation and also limit social integration.

Maternal mental health during the COVID-19 lockdown in China, Italy, and the Netherlands: a cross-validation study

Background The coronavirus disease 2019 (COVID-19) pandemic had brought negative consequences and new stressors to mothers. The current study aims to compare factors predicting maternal mental health during the COVID-19 lockdown in China, Italy, and the Netherlands. Methods The sample consisted of 900 Dutch, 641 Italian, and 922 Chinese mothers (age M = 36.74, s.d. = 5.58) who completed an online questionnaire during the lockdown. Ten-fold cross-validation models were applied to explore the predictive performance of related factors for maternal mental health, and also to test similarities and differences between the countries. Results COVID-19-related stress and family conflict are risk factors and resilience is a protective factor in association with maternal mental health in each country. Despite these shared factors, unique best models were identified for each of the three countries. In Italy, maternal age and poor physical health were related to more mental health symptoms, while in the Netherlands maternal high education and unemployment were associated with mental health symptoms. In China, having more than one child, being married, and grandparental support for mothers were important protective factors lowering the risk for mental health symptoms. Moreover, high SES (mother's high education, high family income) and poor physical health were found to relate to high levels of mental health symptoms among Chinese mothers. Conclusions These findings are important for the identification of at-risk mothers and the development of mental health promotion programs during COVID-19 and future pandemics.

Trajectories of Health Changes in Older Adults with Chronic Hepatitis B Infection

Despite the increasing burden of chronic hepatitis B (CHB) in aging populations, little is known about the course of health-related quality of life (HRQoL) changes during older adulthood in CHB patients. We aimed to assess individual-level longitudinal HRQoL changes in older patients with CHB and to examine their correlates. A 5-year prospective cohort study was conducted in 503 hepatitis B surface antigen-positive community-dwelling adults aged 55 years or older. Participants underwent comprehensive assessments at baseline and serial measurement of HRQoL using the short-form (12) health survey version 2. Of these participants, 82.7% remained in good physical health throughout the study period, whereas 9.1% had declining physical health and 8.2% were in poor physical health. We likewise identified three trajectories of mental health changes (“good mental health” [86.9%], “declining mental health” [6.8%], and “poor mental health” [6.4%]). Three baseline characteristics were independently associated with a lower likelihood of remaining physically or mentally healthy during older adulthood: sarcopenic obesity (odds ratio [OR] with 95% confidence interval [95% CI] of 7.5[2.8-20.5] for poor physical health, 3.1 [1.1-8.4] for declining physical health, 4.3 [1.4-13.0] for poor mental health), higher number of metabolic abnormalities (OR [95% CI] of 3.6 [1.6-8.0] for poor physical health) and depressed mood (OR [95% CI] of 21.7 [5.8-81.0] for poor physical health, 5.3 [1.4-19.9] for declining physical health, 83.1 [19.7-350.2] for poor mental health, 13.6 [2.9-64.8] for declining mental health). In conclusion, we demonstrated the heterogeneity and nonlinearity of HRQoL changes and their associations with variations in specific extrahepatic organs/systems.

Depressed Older Patients with Death Wishes: Experimental Evidence for Psychotherapists’ Age and Health Bias

Objectives: When psychotherapists encounter an older patient with depression and death wishes, especially when burdened by physical illness, they may be subject to judgmental biases. This study investigates how this group of patients with highest suicide risk may experience discrimination both on age and health status. Methods: Using a 2x2 [chronological age x physical health status] vignette design, psychotherapists (N=147) were randomly presented one of four variants of a case describing a patient with depression and death wishes (i.e., 78 years old + poor physical health; 78 years old + normal physical health; 48 years old + poor physical health; 48 years old + normal physical health). Afterwards, participants’ attitudes towards the case were assessed. Results: In case of the hypothetical patient’s old age and poor health status, participants did not underestimate the pathological significance of his death wishes, but nevertheless showed less optimistic treatment attitudes and less confidence in psychotherapeutic treatment. Conclusions: Psychotherapists’ age bias and health bias may serve as two potentially fatal factors influencing the provision of mental health services. Clinical Implications: Psychotherapists may contribute to better mental health care provision of older adults with depression and the prevention of late-life suicide by increasing awareness of their age and health bias.