Elderly People In Rural China Research Articles

How Does Internet Use Improve Mental Health among Middle-Aged and Elderly People in Rural Areas in China? A Quasi-Natural Experiment Based on the China Health and Retirement Longitudinal Study (CHARLS).

One of the most significant public health issues in rural China is how to improve the mental health of middle-aged and older individuals. Using 2013, 2015, and 2018 CHARLS panel data, this paper properly examined the effects of Internet use on the mental health of middle-aged and elderly people in rural China based on the difference-in-differences method. The findings are as follows: (1) Internet use effectively improves the mental health status of middle-aged and elderly people in rural China; (2) compared to the middle-aged group, Internet use has a more obvious effect on the mental health of the elderly; (3) further analysis showed that reading news, watching videos, and playing games online could significantly improve the mental health status of middle-aged and elderly people in rural China, while chatting online and other Internet activities cannot significantly improve mental health status; and (4) playing games, watching videos, and reading news have different effects on the mental health of middle-aged and elderly people in rural China. The results indicate that playing games have a better effect on depression levels than watching videos. In contrast, watching news had the lowest effect on depression levels among middle-aged and elderly people in rural China. The results of this study also show the latest evidence that Internet use can help China’s rural middle-aged and elderly populations to reduce social isolation, establish new social connections, gain social support, and, ultimately, achieve active ageing. Therefore, promoting multiple forms of interaction is an effective path to prevent loneliness, which has become the new policy direction of the government to create an age-friendly Internet environment using various measures in the future to eliminate the barriers to Internet access affecting the middle-aged and elderly in rural China.

Prevalence, Causes, and Factors Associated with Visual Impairment in a Chinese Elderly Population: The Rugao Longevity and Aging Study.

PurposeThis study aimed to explore the current prevalence, causes, and factors associated with visual impairment in a Chinese elderly population.MethodsA random sample of 2164 candidates aged ≥70 years was selected. Among them, 1914 participants (response rate: 88.4%) underwent comprehensive eye examinations. The prevalence and causes of visual impairment were estimated, and the associated factors were identified.ResultsThe standardized prevalence of mild visual impairment (<6/12 to ≥6/18), moderate to severe visual impairment (MSVI) (<6/18 to ≥3/60), and blindness (<3/60) in the better eye were 20.5%, 25.8%, and 3.4%, respectively. The leading cause of visual impairment was cataract (49.7%), followed by uncorrected refractive error (26.5%), myopic maculopathy (5.8%), and posterior capsular opacification (5.5%). Optical coherence tomography revealed that vitreoretinal interface abnormalities were the third most common cause of monocular mild visual impairment (2.2%) and MSVI (4.4%) in the elderly population. A large number of patients with visual impairment (81.7%) were amenable to undergo the interventions. Visual impairment was associated with advanced age (odds ratio [OR], 1.09 per year; p<0.001), female sex (OR, 1.59; p=0.003), self-reported visual impairment (OR, 1.91; p<0.001), cognitive impairment (OR, 1.40, p=0.005), and high educational level (OR, 0.75; primary, p=0.045; and OR, 0.53, secondary or higher; p<0.001).ConclusionVisual impairment was common in the Chinese elderly population and a severe health and social problem. Practicable policies are urgently needed to popularize eye health knowledge and promote treatments for visual impairment in elderly people in rural China.

The power of informal institutions: The impact of clan culture on the depression of the elderly in rural China

Exploration of ways to improve the subjective welfare of residents is an important area of current academic research. Using data from the China Family Panel Studies survey conducted in 2010, this paper investigated the impact of clan culture on the mental health of elderly people in rural China. The results demonstrated that clan culture can significantly decrease the depression score of the rural elderly. Further, there was no gender difference with respect to the impact of clan culture on the depression score of the elderly. At the same time, the positive effects of clan culture on the depression score of the elderly have gradually weakened with economic development. Exploration of the mechanisms involved indicated that in areas with stronger clan culture, older people receive more social support. This study enriches our understanding of the impact of informal institutions on the welfare of rural residents. At the same time, it can also provide a certain decision-making reference for the government to formulate relative poverty relief strategies in a new stage of poverty alleviation.

The health effect of perceived built environment on depression of elderly people in rural China: Moderation by income.

This study explored the health effect of perceived built environment on depression of the Chinese elderly people in rural areas. A multifaceted approach in examining perceived built environment was used. A sample of 670 older residents in rural area of China were interviewed, and data were collected mainly for exploratory factor analysis, confirmatory factor analysis and moderation analysis. Results showed a reliable construct of perceived built environment which was developed by this study. A significant moderating role of personal income per month in the significantly negative relationship between perceived built environment and depression was confirmed. That is, the health effect of perceived built environment on depression became weakened among people of higher income levels. This study added evidence for the health effect of perceived built environment on depression among Chinese elderly people. Additionally, individual income was identified as an important influencing factor in such effect. Discussion on the negative relationship between perceived built environment and depression, as well as the moderating effect of personal income in such relationship were presented.

Gender difference in suicidal ideation and related factors among rural elderly: a cross-sectional study in Shandong, China

BackgroundSuicide is a global public health problem which has significant negative influence on individuals, families and the society. The aim of this study is to investigate the prevalence of suicidal ideation and related factors among elderly people in rural China, and further examine the gender differences of suicidal ideation.MethodsData were collected from the 2017 Survey of the Shandong Elderly Family Health Service, which was conducted by Shandong University. A total of 5514 elderly aged 60 and above from rural Shandong were included in this study. Binary logistic regression model was performed to examine the gender difference towards suicidal ideation, and to identify the influencing factors of suicidal ideation by gender among elderly.Results7.7% rural elderly reported suicidal ideation in the past 12 months in Shandong, China. The prevalence of suicidal ideation among females was significantly higher than that among males (P < 0.001). Education level, debts, stress of daily life, loneliness and psychological distress were significantly related to suicidal ideation in both males and females. Besides, negative life events and life satisfaction were found to be significantly associated with suicidal ideation in females but not in males.ConclusionsThere was a significant gender difference towards suicidal ideation among rural elderly in Shandong, China. So, gender difference should be considered when medical practitioners and public health workers seek to prevent and manage suicidal ideation among rural elderly, which will be important to develop strategies for coping with risk factors for suicidal ideation among males and females. In other words, more attention should be paid to females who had encountered negative life event or with lower life satisfaction.

Loneliness, hopelessness and suicide in later life: a case-control psychological autopsy study in rural China.

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. 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. 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. 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.

Determinants of inappropriate admission of elderly people in county-level hospitals: a cross-sectional study in rural China

ObjectiveThe purpose of this paper is to investigate the characteristics and determinants of inappropriate admission to hospital of elderly people in rural China.DesignA cross-sectional study of a comparison between the...

A Study on the mode of home-based care for the rural areas in Guanzhong, Shaanxi, China

At the beginning of the 21st century, China has entered an aging age, and the growth rate of the elderly has become one of the fastest in the world. In fact, the number of elderly people in rural China is higher than that of urban elderly. As the area of cultivated land in rural areas decreases year by year, the rural labour force shifts to cities. Most of the rural areas in China show the status of “hollow villages” with only the elderly. Influenced by the traditional Chinese Confucianism, home-based care is the most accepted way for elderly in rural China. The rural residence is dominated by traditional dwellings and newly built dwellings. Such dwellings cannot meet the living needs of modern elderly people, and have produced different of old-age care problems in rural areas. The traditional courtyard residence form is still widely used in rural Shaanxi. Taking Shaanxi rural villages as an example, this paper summarizes and analyses the architectural characteristics, space, mode and modern living conditions of traditional dwellings and new dwellings in Shaanxi, and proposes the rural home care mode and living unit in Guanzhong, in order to relieve rural social problems brought by “empty nesters” and laid the foundation for the issue of rural pensions.

Trends in stroke incidence among elderly low-income residents of rural China: a population-based study from 1992 to 2016.

In China, >70% of stroke deaths occur in people aged ≥65 years. However, trends in the stroke incidence among elderly people are unclear. We aimed to determine trends in the stroke incidence among elderly people in rural China. This was a population-based surveillance study conducted in Tianjin, China. Stroke events and all deaths were registered annually. Trends and annual proportion of change in incidence of first-ever stroke were evaluated from 1992 to 2016. The age-standardized incidence of first-ever stroke increased annually by 3.7% overall in elderly people (2.7% for men; 5.0% for women; all P<0.05). However, from 2008 to 2016, there was no significant change in the trends of stroke incidence among elderly people, across gender and subtypes. The proportion of elderly patients with first-ever stroke decreased by 1.1% annually. In contrast to young patients, annual changes in the incidence of stroke tended to be slight in elderly patients (3.7% vs. 9.5%) with greater increase in female patients than those in male patients (2.7% vs. 10.3% for men; 5.0% vs. 8.9% for women). Thus, the control of risk factors for stroke among elderly people is crucial, especially among older women, to reduce the burden of stroke in China.

The Social Pension Scheme and the Subjective Well-being of the Elderly in Rural China

The New Rural Pension Scheme （NRPS） is an important component of the social security system in rural China. After the implementation of the NRPS, many studies have investigated the effects of the NRPS on the well-being and life quality of rural elderly and their families. However, there are still little research regarding the effect of the NRPS on the subjective well-being of the rural elderly and its mechanism. With China’s social and economic development, people not only concern about economic well-being, but also pursue higher levels of subjective well-being, which has become an important component of people’s welfare and life quality in China. Therefore, studying the relationship between the NRPS and the subjective well-being of rural elderly in China is of great significance to the improvement of the current rural social security policy and the quality of life rural residents in old age. Therefore, it has crucial significance to study the relationship and the internal mechanism between the NRPS and the well-being of the elderly for improving the life quality of the rural elderly. Based on the data of China Health and Elderly Tracing Study （CHARLS） in 2011 and 2013, this study empirically analyzes the effect of the NRPS on the subjective well-being of the rural elderly by using the lag term estimation, the instrumental variable method and the regression discontinuity design, and tests possible channels of the effect by applying the path analysis method. Our study finds that the NRPS can significantly reduce the degree of depression and improve the life satisfaction of the elderly in rural China, which has passed a number of robustness tests, especially for women, youngsters and left-behind old adults. The effects of different pension amount levels are different. Receiving the basic pension only cannot significantly improve the level of the subjective well-being of the insured old adults. The positive effect of the NRPS on the rural elders’ subjective well-being begins to appear when the pension exceeds the amount of the basic pension. In the meantime, the later the participation time is, the weaker the effect of the NRPS is. In terms of the mechanism, the positive effect on the subjective well-being of the NRPS mainly comes from three channels: the absolute income effect, the relative income effect and the time allocation effect. Specifically, the mediating effects of the absolute income and the relative income are greater than the time allocation effect. Moreover, the absolute income effect of the NRPS cannot significantly increase individual and family consumptions and the relative income exerts the strongest effect among the three channels. In other words, in the current stage, the main reason why the NRPS improves the subjective well-being of elderly people in rural China is not the economic or physical support, but the spiritual support to enhance confidence toward life in the future. Therefore, in order to strengthen the positive effect of the NRPS on the subjective well-being of rural elderly in China, it is important to increase the levels of the pension subsidy, strengthen support for the disadvantaged elderly and create a better environment for social and cultural activities.

Associations of self-neglect with quality of life in older people in rural China: a cross-sectional study.

Elder self-neglect (ESN) has become a public health issue globally. Limited studies have focused on ESN, as well as the relationship between ESN and quality of life (QoL) in developing countries. The study's objective is to explore the association between ESN and QoL among rural elderly in China. A cross-sectional study was conducted among 3,182 elder adults aged 60 years or older, using a cluster-sampling technique in one township in Dangtu, a county in Anhui province. All participants completed face-to-face interview in their household. QoL was assessed using a brief form of the World Health Organization's quality of life questionnaire (WHOQOL-BREF), and ESN was assessed using the Scale of the Elderly Self-neglect (SESN). Hierarchical linear regression models were used to analyze the associations between the ESN scores and QoL scores after adjusting for sociodemographic, social support, and physical and psychological variables. The scores of overall ESN and five domains were significantly correlated with the scores of four QoL domains (p < 0.001). After adjusting for sociodemographic characteristics, social support, and physical and psychological health characteristics, elders who reported higher overall self-neglect scores had significantly lower scores in the four QoL domains (p < 0.001). Education, economic level, physical health, ADL, depression, and cognitive function are consistent predictors across all QoL domains. ESN is an independent risk factor for poor QoL in elderly people in rural China. Understanding the role of ESN and its influence on QoL is important for the management of and intervention in ESN.

Mediating effect of social support on the association between functional disability and psychological distress in older adults in rural China: does age make a difference?

This study aimed to determine the prevalence of psychological distress among elderly people in rural China. Moreover, the mediating effect of social support on the association between functional disability and psychological distress and whether this effect varies with age would be examined. A total of 741 elderly people aged 60–89 years from a rural area of Shandong Province, China participated in a cross-sectional survey. Their psychological distress, perceived social support, enacted social support, and functional disability were assessed through questionnaires. A total of 217 (29.3%) rural elderly people had psychological distress. The functional disability of people ≥75 years old had smaller total effects (0.18) on their psychological distress than in people <75 years old (0.30). Moreover, most of the effects of functional disability on psychological distress among the people ≥75 years old were indirect (0.12; 66.67% of total effects) through the mediating effect of social support especially perceived support, while the direct effect of functional disability was insignificant. In contrast, most of the effects of functional disability on psychological distress among the people <75 years old were direct (0.29; 96.67% of total effects), while the mediating effect of social support was insignificant. In conclusion, the total effect of functional disability, especially the direct effect, on psychological distress decreases sharply with age. The mediating effect of social support on the association between functional disability and psychological distress varies with age and is only found in people ≥75 years.

Social Support and the ‘Left Behind’ Elderly in Rural China: A Case Study from Jiangxi Province

This study examines the living situation of elderly people in rural China whose children have left to work in other areas [the 'left behind' elderly (LBE)] and explores policy implications associated with their care. Based on survey data and interviews conducted in three villages in Jiangxi Province, China, we compare the living situation of the LBE and the 'non-left behind' elderly (NLBE). The data reveal that the LBE are relatively more isolated and that they spend less time interacting with neighbors and more time watching television. The study shows that the LBE have a much greater need for care services than income maintenance. Also, the LBE group has less social capital than the NLBE group. Based on our findings, it is clear that the proposal to use social capital and informal care cannot effectively meet all the needs of the LBE group. Instead, it is recommended that a comprehensive system of social support is developed.

Metabolic Syndrome and Cardiovascular Disease in Elderly People in Rural China: A Population‐Based Study

Metabolic syndrome and cardiovascular disease in elderly people in rural China: a population-based study

Highly prevalent and poorly controlled cardiovascular risk factors among Chinese elderly people living in the rural community

The epidemiological scenario of cardiovascular risk factors (CRFs) among elderly people in rural China is unclear. We seek to describe the distribution, burden and management of major CRFs among older Chinese people living in the rural community. This cross-sectional study included 1538 participants in the Confucius Hometown Aging Project (2010-2011) of people ≥60 years of age (mean age 68.6 years; 59.1% women) who lived in a rural community nearby Qufu, Shandong, China. Data were collected through a face-to-face interview, a clinical examination and laboratory tests. We carried out descriptive analysis on the prevalence and management of major CRFs. The overall prevalence of current smoking, physical inactivity, hypertension, diabetes, high cholesterol and obesity were 13.8%, 83.7%, 76.0%, 26.6%, 42.4% and 13.1%, respectively: 82.8% and 50.4% of participants had ≥ 2 and ≥ 3, respectively, of the six CRFs. Prevalence of alcohol consumption was 18.7%. Men were more likely to smoke and consume alcohol than women, whereas women were more likely to be obese and physically inactive than men (p < 0.001). Prevalence of physical inactivity and hypertension increased with age, prevalence of alcohol intake and obesity decreased with age, and prevalence of smoking and diabetes was stable. Hypertension, diabetes and high cholesterol were treated in 60.6%, 68.1% and 41.1% of those with the disease, respectively, but only 11.3%, 13.7% and 31.7% achieved good control. CRFs are highly prevalent and poorly controlled among elderly people in rural China, where men and women have different CRF profiles. Intervention programs targeting major CRFs may improve the health of older people in China.

The Quality of Life and Mortality Risk of Elderly People in Rural China

The number of elderly in China's population is projected to grow well beyond the capacity of the nation's social security system. Meanwhile, family care is being challenged by a decline in fertility and an increase in migration from rural to urban areas. This article examines the short-term, mid-term, and long-term effects of family support on elderly well-being in rural China, using 4-wave panel data on 1456 persons aged 60 and older in the Chaohu region of China. Findings showed that compared with living alone, being coresident with others lowered the mortality risk of several chronic diseases, but being coresident with adult children increased the mortality risk of cardiovascular diseases, though it was associated with a higher quality of life in the short and middle terms. Children's educational attainment and financial support increased the quality of life except for an increased risk of new incidence of cardiovascular disease in the middle term.

The Quality of Life and Mortality Risk of Elderly People in Rural China: The Role of Family Support

The elderly share of China’s population is projected to grow well beyond the capacity of the nation’s social security system. Meanwhile, family care is being challenged by a decline in fertility and an increase in migration from rural to urban areas. This paper examines the short-, mid-, and long-term effects of family support on elderly well-being in rural China, using four-wave panel data on 1,456 persons aged 60 and above in the Chaohu region of China. Findings showed that compared with living alone, being coresident with others lowered the mortality risk of several chronic diseases; but being coresident with adult children increased the mortality risk of cardiovascular diseases, though it was associated with a higher quality of life in the short and middle term. Children’s educational attainment and financial support increased the quality of life except for an increased risk of new incidence of cardiovascular disease in the middle term.