Abstract
PurposeGender-related differences in life expectancy, prevalence of chronic conditions and level of disability in the process of ageing have been broadly described. Less is known about social determinants, which may have different impacts on quality of life in men and women. The investigation aims to reveal gender-related differences in social determinants on quality of life assessed by a multi-pathway model including health, social, demographic and living place characteristics.MethodsThe study group consisted of 5099 participants aged 50+ representing general populations of three different European regions (Finland, Poland, Spain) who participated in COURAGE in EUROPE Project. Standardized tools were used to measure quality of life (WHOQOL-AGE) and social determinants (COURAGE Social Network Index, OSLO-3 Social Support Scale, UCLA Loneliness Scale, participation scale and trust). A multipath model considering exogenous predictors (demographic, economic), mediators (social) and endogenous outcome (QOL) was created to reveal the role of determinants. Gender-related differences were investigated across three age categories: 50–64; 65–79 and 80+.ResultsThe model (RMSEA = 0.058; CFI = 0.939) showed the effects of all of the investigated determinants. Gender-related differences in the association between social constructs and QOL were observed for social networks in the group of 80+, for social support in the group of 50–64 and 65–79 years, and for social participation in the group of 65–79 years. Males benefited more (in QOL) from social networks and social support, and women from social participation.ConclusionsThe research provides valuable knowledge about the role of social determinants in QOL considering complex relations between different social constructs. Additionally, the results showed gender-related differences in the associations between social networks, social support, social participation and QOL, suggesting that men might benefit more from the interventions in the first two. Although our research did not investigate the effects of interventions, the results show directions for future investigations, how to shape social interventions at the population level to improve quality of life of older adults, and thus help achieve successful ageing.
Highlights
Gender-related differences in the process of ageing have been well documented in relation to life expectancy, prevalence of chronic conditions, level of disability and functional status, supporting a well-known paradox that men are likely to die earlier than women, but older women suffer from higher level of chronic health conditions and disability [1]
Victor et al showed the role of loneliness, social isolation and living alone in relation to successful ageing and quality of life in older life, and mentioned that the concept of loneliness has been interpreted in different ways using several theoretical explanations of the cause of loneliness
Number of missing values in any of the analyzed variables (n=2895): Total number of years of education (n=60) Ratio of individual's household income to median household gross adjusted disposable income in current (2011) USD PPP (n=376) Total number of people living in the household (n=0) Social Networks Index (COURAGE -SNI) (n=2) Social Support (n=287) Social participation (n=26) Trust (n=44) Loneliness (n=104) Subjective characteristic of living place (CBE-SR-Home) (n=2320) Health and disability scale (WHODAS II) (n=3)
Summary
Gender-related differences in the process of ageing have been well documented in relation to life expectancy, prevalence of chronic conditions, level of disability and functional status, supporting a well-known paradox that men are likely to die earlier than women, but older women suffer from higher level of chronic health conditions and disability [1]. Psychosocial theories and concepts used for the explanation of gender-related differences in the older stages of life are usually based on life course approach (convoy model of social relations, psychosocial and material resources such as psychological, social, financial wellbeing and security gathering during the life-span, social inequalities) Such determinants were found to significantly influence adaptation to changes attendant upon the process of ageing related to social networks’ structure and specific social ties as well as the various coping strategies with stressful life events experienced by men and women [3, 10,11,12]. Differences among one sex (older women) in prospective study of the association between living arrangement and emotional well-being did not confirm that women living independently suffered from higher risk of social isolation and decline in functional status, because contacts with friends and relatives and the level of social engagement were significant protective factors [18]. Solidarity between people is a natural prerequisite for social trust [49]
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