Older People In Rural Areas Research Articles

Estimates of multidimensional poverty and its determinants among older people in rural China: evidence from a multicenter cross-sectional survey

BackgroundIn 2020, China declared that the absolute poverty in the country had been eradicated, but older people in rural areas are deprived in multiple domains. Poverty is multidimensional and involves deprivations in health, social welfare, living standards, and income. This study focused on assessing the poverty status of rural older persons and providing a basis for decision-making at all levels of government in China.MethodsA multicenter cross-sectional survey was conducted in four rural areas of China. Individuals aged 60 years and older were selected through stratified sampling. People with aphasia and severe cognitive impairment were excluded. An electronic questionnaire was used to collect older people’s information, including basic demographics, major illnesses, disabilities, chronic diseases, functional disorders, and ability to perform activities of daily living. It also asked about the medical, financial, and social security assistance that respondents received, food and clothing standards, safe housing, clean energy, safe drinking water, and reliable electricity. Specific questions were asked regarding income sufficiency, financial support from children, and pension income. Multidimensional poverty measurements were used to compare regional disparities and indicators differences. Logistic regression was used to identify the risk factors influencing poverty.ResultsA total of 1272 older people were analyzed. Of them, 704 (55.35%) were women and 652 (51.26%) were aged between 60 and 69 years. The most frequently mentioned causes of poverty were illness, a lack of employment, inadequate technology, and poor transportation. We found that as multidimensional poverty indicators increased (from 6 to 10), the number of poor older people decreased (from 1218 to 437), as did the poverty incidence (from 95.75 to 34.36%) and multifaceted poverty index (from 53.41 to 25.06%). Xuanwei had the highest incidence of poverty (66.61%) and multidimensional poverty index (0.66) among the four provinces studied. Regarding the contribution of indicators, financial alleviation made the greatest contribution to multidimensional poverty among rural older adults (up to 70.51%). Age, marital status, education level, awareness of poverty alleviation policies, and region were significant predictors of multidimensional poverty among older rural residents(P < 0.05).ConclusionsChina’s subsidy system and financial support must be enhanced. Particular attention should be given to the re-education of rural older individuals, basic vocational education should be strengthened in rural areas, and social participation should be encouraged.

"Kuteteza": A community-engaged COVID-19 Prevention and Protection Initiative in Southern Malawi.

The COVID-19 epidemic in Malawi involved almost 90,000 recorded cases and 2,638 deaths. In response to early concerns about vulnerable older people in rural areas, we developed 'Kuteteza': a COVID-19 mitigation response project. Clinicians, public health professionals, and researchers collaborated with government and district-level staff in two Southern Malawi districts. Interventions included supported 'shielding' of older people - minimising social mixing whilst having their daily needs supported. Additional mitigation strategies included provision of masks, handwashing stations, and soap. Government partnerships allowed additional support for vulnerable groups. We present the findings of a realist project evaluation, assessing the feasibility of this approach. We collated anonymised descriptive data on Kuteteza procedures and conducted qualitative structured observations in villages involved in the initiative. We carried out three focus groups involving community members, frontline health staff, and volunteers in each setting. These provided deeper insights into experiences of the pandemic and impacts of the intervention, including suggested opportunities during future outbreaks. The project involved 25 villages across two districts, with 1,087 people over the age of 60 voluntarily participating in 'shielding'. Supplies of food, water, and cooking fuel were mostly arranged within the family. In Kuteteza villages, the handwashing stations and soap were widely used, and there was awareness and some observance of COVID-19 prevention measures. The project, including the provision of supplies, was greatly appreciated by communities, but wider contextual constraints - namely widespread economic insecurity - presented persisting challenges. Suggestions for improvement largely concerned project enhancements and extensions. Through effective stakeholder engagement and contribution to national response strategy, the Kuteteza project helped raise COVID-19 awareness and supported populations at a critical time in the pandemic. Kuteteza approaches were welcomed locally and may be incorporated in future epidemic responses. Supported 'shielding' should be paired with government-led measures to mitigate economic hardship.

Barriers and facilitators for accepting health education of Chinese rural older adults in Henan Province: a qualitative study

BackgroundAs global aging continues to intensify, the health status of the older people requires urgent attention, and health education provides a pathway for active aging. However, the current outlook on health education for older people in rural areas of China is not optimistic. This study used Social Ecosystems Theory and explored the deep-rooted influencing factors on the acceptance of health education from the perspective of the rural older people.MethodsIn this study, a purposive sampling method was adopted, and eligible rural older individuals were selected from Hebi city, Henan Province, China, from March to May 2023 as the research participants. A semistructured interview method was used to explore the factors affecting the acceptance of health education by older people. The interview data were analyzed using the qualitative content analysis method to obtain relevant themes and subthemes.ResultsA total of 14 participants were recruited for the interviews; 8 were male, 6 were female, most had an elementary school education, and most were farmers. The results of the thematic analysis revealed a total of nine facilitators and nine barriers in micro, meso and macro levels. Among the findings, our important and unique finding is that inadequate intergenerational support somewhat hinders older adults’ exposure to health education.ConclusionThere are numerous and complex facilitators of and barriers to accessing health education for rural older adults; of these, a lack of intergenerational support is particularly important. In the future, health education needs to be centered on the families of older people with the assistance of village committees so that older people and their children can learn and communicate together.

Forecasting Informal care needs of the urban-rural older adults in China based on microsimulation model

BackgroundForecasting the intensity, source, and cost of informal care for older adults in China is essential to establish and enhance policy support systems for informal care within the context of East Asian traditional culture that emphasizes filial piety. This study aims to analyze the current situation and influencing factors for the informal care needs and predict the trends of informal care needs for older adults in China from 2020 to 2040.MethodsUsing the CHARLS database from 2015 to 2018, this study first combined a two-part model and a multinomial logit to analyze the influencing factors for the informal care needs of urban-rural older adults in China. Secondly, a multi-state Markov model was constructed to forecast the number of urban-rural older populations in each health state from 2020 to 2040. Finally, based on a microsimulation model, this study predicted the trends of informal care intensity, source, and cost for older adults in urban and rural areas from 2020 to 2040.ResultsIn 2040, the size of the disabled older population in China will expand further. In rural areas, the total number of disabled people in 2040 (39.77 million) is 1.50 times higher than that in 2020; In urban areas, the total number of disabled people in 2040 (56.01 million) is 2.51 times higher than that in 2020. Compared with 2020, older adults population with mild, moderate and severe disability in 2040 would increase by 87.60%, 101.70%, and 115.08%, respectively. In 2040, the number of older adults receiving low-, medium-, and high-intensity care in China will be 38.60 million, 22.89 million, and 41.69 million, respectively, and older people will still rely on informal care provided by spouses and children (from spouses only: 39.26 million, from children only: 36.74 million, from spouses and children only: 16.79 million, other: 10.39 million). The total cost of informal care in 2040 will be 1,086.65 billion yuan, 2.22 times that of 2020 (490.31 billion yuan), which grows faster than the economic growth rate.ConclusionFrom 2020 to 2040, the informal care needs of older people in rural areas will increase first and then decrease due to the demographic structure and rapid urbanization. In contrast, the informal care needs of older people in urban areas will continuously increase from 2020 to 2040, with the growth rate gradually slowing down. This study provides an evidence-based rationale for scientifically measuring the economic value of informal care and reasonably allocating care resources.

Barriers, Benefits, and Enablers of Acute Home-Based Care (Hospital In The Home) in Australia for Older People: A Systematic Review

To determine the barriers, benefits, and enablers of acute home-based care in Australia for older people (aged 65 and over). A systematic review for people aged 65 and over receiving acute home-based care in Australia was conducted using various databases (CINAHL, Medline, PsycINFO, SCOPUS, Web of Science, PubMed, Informit) and citation searching in September 2023. The Critical Appraisal Skills Program (CASP) was used to assess the quality of the evidence and a thematic analysis approach was utilized to narratively synthesize results. Ten studies were included, consisting mostly of cohort studies in metropolitan areas. Barriers included inefficacy, patient demographics, and carers. Benefits included efficacy, high satisfaction, and medical management. Enablers included education, holistic assessments, and support interventions. Within the literature there was a significant research gap regarding HITH for older people in rural areas of Australia. Patient outcomes were closely aligned with admission pathways.

The effect of social pension on health-related quality of life of the rural older people: a panel study from China

BackgroundSocial pensions, social assistance systems for older people in rural areas, have been put into place in many nations and have positively impacted health. The long-term health consequences of social pension programs in China are uncertain. The aim of this study is to evaluate the long-term health consequences of the new rural social pension (NRSP) for the rural older people in China.MethodsBased on the 2011 and 2018 China Health and Retirement Longitudinal Study, we compared the scores on eight Health-Related Quality of Life (HRQoL) subscales of the rural older people before and after participation in the NRSP. The propensity score matching and difference-in-difference methods were used in data analysis. We also conducted a heterogeneity analysis for subgroups with different characteristics and pension enrolment times.ResultsThe NRSP significantly enhanced scores on physical functioning, role-physical, and self-rated mental health of old rural participants by 1.90 (p < 0.01), 2.05 (p < 0.01), and 2.93 (p < 0.05), respectively. After excluding newly enrolled individuals, the beneficial health effects of the NRSP remained significant. There were no significant changes due to NRSP in the other five scores on the HRQoL subscale of the rural older people. The NRSP had more health benefits for older people in underdeveloped areas without formal schooling.ConclusionsThe NRSP reduced health disparities and had long-term benefits on the physical and mental health of the rural older people. We suggest continuously expanding the NRSP throughout rural China and further improving the social support system to enhance the overall quality of life of the rural older people. Comparable social pension programs aimed at underprivileged groups could also be conducted in other low- or middle-income nations.

The impact of income level on skeletal muscle health in rural Chinese older residents: a study of mediating effects based on dietary knowledge.

China's rural residents have basically solved the problem of subsistence, but due to aging, the prevalence of sarcopenia (abbreviated as sarcopenia) has been increasing year by year, especially the skeletal muscle health of the rural older residents has not been sufficiently paid attention to, so analyses of the impact of income level on the skeletal muscle health of the older people in rural areas of China are of great practical significance. Based on the annual data of the China Health and Nutrition Survey (CHNS) in 2006, 2009, and 2011, we introduced the mediator variable of dietary knowledge and used the Probit model regression, mediation effect model, and instrumental variable regression to assess the skeletal muscle health status of the rural older people in China and explore the mechanism of the influence of the income level on the skeletal muscle health of the rural older residents in China. The primary objectives of this study were to evaluate the impact of income level on the skeletal muscle health status of older adults living in rural areas of China and to investigate the underlying mechanisms. By analyzing the findings of this study, our aim is to establish a correlation between the economic status and skeletal muscle health of older adults in rural communities, as well as elucidate the influence of income level and dietary knowledge on their skeletal muscle health. Through the attainment of these objectives, we hope to provide valuable insights and recommendations for enhancing skeletal muscle health among the rural older population in China. Based on our research findings, it can be inferred that there was a significant association between the financial status of rural older adults and their skeletal muscle health. Additionally, the prevalence of sarcopenia was lower among individuals with higher income levels, and there was a negative correlation between the prevalence of sarcopenia and the level of dietary knowledge among rural older individuals. The knowledge of dietary knowledge level of rural older people plays a mediating role in the income level and the prevalence of sarcopenia. Moreover, with the change in income level and the increase in age, the change in skeletal muscle health status showed obvious heterogeneity, in which the effect on the relatively younger (65-70 years old) samples was greater. Therefore, sustained income growth remains an effective way to improve the skeletal muscle health of older rural residents. At the same time, improving dietary knowledge and dietary quality among the older people is important in preventing a decline in muscle strength and physical function and in preventing the onset of sarcopenia.

Effects of the Implementation of Transport-Driven Poverty Alleviation Policy on Health Care-Seeking Behavior and Medical Expenditure Among Older People in Rural Areas: Quasi-Experimental Study.

Improving the rural residents' accessibility to and affordability of health care is recognized as a common target globally. The Health in All Policies approach, from the Declaration of Helsinki to the United Nations' Decade Of Healthy Ageing, strengthened the far-reaching effect of large-scale public policies on health care-seeking behavior; however, the effects of national transport policy on health care-seeking behavior is unclear. This quasi-experimental study aimed to examine the effects of the implementation of transport-driven poverty alleviation (TPA) policy on health care-seeking behavior and medical expenditure among older adults in rural areas and the mechanism underlying these effects. We designed a quasi-experiment to estimate the effects of TPA policy implementation on health care-seeking behavior and medical expenditure among older adults in rural areas through a difference-in-differences (DID) analysis based on data from the China Health and Retirement Longitudinal Study in 2011, 2013, 2015, and 2018. The underlying mechanism was analyzed and effect modification patterns were further investigated by poor households, health status, and age. Our findings validated a positive contribution of TPA policy on health care-seeking behavior among older adults in rural areas. After the implementation of TPA policy, the number of inpatient visits increased by annually 0.35 times per person, outpatient medical expenditure increased by 192% per month, and inpatient medical expenditure increased by 57% annually compared with those of older adults in rural areas without the implementation of TPA policy. Further, there was a significant modification effect, with a positive effect among poor households, healthier older adults, and those aged 60-80 years. Additionally, the policy improved the patients' capabilities to seek long-distance care (β=23.16, 95% CI -0.99 to 45.31) and high-level hospitals (β=.08, 95% CI -0.02 to 0.13), and increased individual income to acquire more medical services (β=4.57, 95% CI -4.46 to 4.68). These findings validate the positive contribution of TPA policy on health care-seeking behavior among older adults in rural areas; however, the medical expenditure incurred was also high. Concerted efforts are needed to address health care-seeking dilemmas in rural areas, and attention must be paid to curbing medical expenditure growth for older adults in rural areas during TPA policy implementation.

Digitalising analogue policy targets! ‘Digital capabilities’ of older persons and policy digitalisation of social safety net programs in a developing country context

The optimization of the human-centeredness of technological innovations – policy digitalization - has exceedingly proliferated in most policy sectors. Yet, a few studies exist on the implications of digital policy tools in realizing social protection policies for older people, particularly in Africa. This paper discusses this issue. It examines data on the ‘digital capabilities’ of older persons and how digital technologies impact their usage and access to social safety net programs in Kenya, where digital policy tools like mHealth and e-Payment platforms are used to realize them. The data collection involved interviews with 81 respondents between 65-90 years of age (individuals targeted by social safety net programs and Social Protection officers). Findings show a need for more robust and policy target-sensitive efforts and budget allocation to overcome policy digitalization challenges, especially those arising from structural governance inequalities or older people’s capability deficits that underpin digital transformation pathways for different policy targets. Most older people in rural areas have negative attitudes and low user digital capabilities toward digital services. This is partly due to a range of challenges from infrastructural deficiencies, low access to internet resources to inadequate policy communication around digital tools. However, higher digital capabilities of policy targets and positive societal attitudes toward digital platforms could improve effective ‘public policy digitalization’ with more targeted investments and user-sensitive designs in place.

Mental Health Status and its Determinants Among Older People in Rural Area in the District of Banyumas Central java

Elderly people experience several health problems due to their vulnerability to many diseases, which may affect their mental health. This study aims to assess mental health status among older people and its determinants in rural areas. It is a cross-sectional study design and involves 412 respondents from 9 villages in the district of Banyumas, Central Java, Indonesia. The data was analyzed by using a logistic regression model. The findings showed that older people with a large number of family members were four times more likely to have a mental health problem than those with a small number. Older people with a history of chronic disease had a threefold greater risk of experiencing mental health problems than older people without chronic disease. Three times as many elderly people with middle economic status reported having mental health issues. Older people with lower education have fewer mental health problems compared to older people who graduated from higher education levels. Health check-up was discovered to influence mental health problems, with older people who did checkups even if irregularly having fewer mental health problems than older people who never did. The study concludes that family size, chronic disease history, economic condition, education, and health check-up are determinants of mental health problems in rural Indonesia.

Keeping older people mobile: Autonomous transport services in rural areas

Rural areas are characterized by limited access to public transportation. In the absence of alternatives, many older people continue to drive private cars. This imposes risks on society and older people, as traffic risks increase with declining mental and physical health. As opportunities to remain mobile have key relevance for quality of life, this paper investigates attitudes of older people to autonomous transport services (ATS), based on a sample of n = 2,349 respondents living in rural and urban areas in Freiburg, Germany. ATS are not currently available, though they are expected to follow the introduction of automated driving, thus representing a future to alternative to public transport and private car travel. Results show an openness to the use of autonomous transport services for a majority of >65 year olds, though interest declines with age. Neither willingness-to-pay nor waiting times to ATS arrival are likely barriers to adoption. The study concludes that an introduction of ATS that targets older people in rural areas is promising, and will generate social and economic benefits for individuals and society. The transition from private cars to ATS can be supported by mandatory license renewal (fitness) tests. These are welcomed by a large majority of respondents, but not currently required in Germany.

Loneliness and Psychosocial Resources among Indigenous and Afro-Descendant Older People in Rural Areas of Chile.

(1) Background: loneliness is a problem that becomes increasingly acute in old age, with greater repercussions among socially disadvantaged groups such as indigenous and Afro-descendant older adults. The aim of this research is to analyze the psychosocial variables related to loneliness in old age. (2) Methods: a multi-ethnic sample was involved, with the participation of eight indigenous peoples and Afro-descendant tribal people (n = 1.348). Various gerontological scales previously validated among the Chilean population (De Jong Gierveld Loneliness Scale, Brief Resilient Coping Scale, Health Problems Questionnaire, and Family APGAR questionnaire) and a model are contrasted, establishing the relationship between psychosocial variables and loneliness. (3) Results: Structural equation modeling (SEM) showed the existence of indirect relationships between health problems, via family functioning and resilience, and loneliness. Resilience and family functioning were directly related to loneliness (WLSMV-χ2 (df = 345) = 875.106, p < 0.001; CFI = 0.992; TLI = 0.991; RMSEA = 0.034 [C.I. 90% = 0.031-0.037]). (4) Conclusions: loneliness has cross-culturally affected older Chilean people living in rural areas and it appears that the COVID-19 pandemic has had a negative effect on well-being. This study proves that loneliness is related to several psychosocial variables that can be intervened.

SPECIFIC FEATURES OF INTERACTION BETWEEN DOCTORS AND ELDERLY PATIENTS IN RURAL AREAS(A CASE STUDY OF THE LENINGRAD REGION)

The article deals with care for older people in rural areas as part of communication between doctors and pa-tients, including during appointments. Care is analyzed from two positions (from the position of rural doc-tors and the elderly themselves), their differences are analyzed. Basing on interviews conducted in the Lu-zhsky district of the Leningrad region, the paper makes an attempt to contextualize views on professional care from both sides. The article examines how, in the context of the «dense texture»and importance of ru-ral communities, doctoral care for older people becomes more personalized and what features of such care affect the professional autonomy of doctors, the communication of older rural residents with medical profes-sionals. The separation of care and autonomy raises the question of the role of rural doctors in the rural community as well as the specific features of care, which is more personalized and shown by paramedics at rural outpatient clinics or first aid stations. The paper concludes that within the framework of doctor –pa-tient communication, when doctors and patients interact, doctors consider care as an instrumental opportuni-ty to establish more trusting communication, interaction with the elderly. However, the elderly themselves remain dissatisfied with this form of care. More personalized care is provided by rural paramedics and doc-tors, who are most integrated into the rural community and are an important part of it, which determines the specific features of care for older people provided by different professionals.

Dehydration risk factors and outcomes in older people in rural areas

Abstract Objective: To determine the risk factors for dehydration in elderly people in one of Elbehira Governorate’s villages. Methods: A descriptive correlational design was utilized in this study. The study was conducted at Elnemaria village, Markaz Abo Elmatamir, Elbehira Governorate, Egypt. Data were collected using 3 tools: a structured interviewing questionnaire, a dehydration knowledge questionnaire, and a dehydration risk appraisal checklist. Results: The study found that 29.5% of the participants were aged between 65 and 70. Males constituted 51% of the study participants. The majority of the study participants regularly took anti-acids, anti-inflammatory drugs, and diuretics. Among the elderlies comprising the respondents, 40% had a low level of knowledge regarding dehydration. More than half of the study subjects were at moderate risk for dehydration. Conclusions: The study showed that half of the participants had diabetes and a medium level of information about dehydration. The study also showed in general that the elderly in the village are exposed to a moderate dehydration rate, and there is also a strong relationship between taking different types of medication and the occurrence of dehydration.

Rural-urban disparities in healthy ageing: Evidence from a national study in China

BackgroundThe Chinese government has adopted the WHO healthy ageing framework to guide the development of services and initiatives to promote older people's health. AimTo examine the rural-urban disparities within the WHO healthy ageing domains of functional ability. MethodsA secondary data analysis was conducted using a nationally representative survey from China Health and Retirement Longitudinal Study (CHARLS). ResultsA total number of 10,746 older people were included, with the mean age of 69.10 years (SD = 7.15). More than 70% of older people lived in rural areas. Significant differences existed in all five domains of functional ability between rural and urban-dwelling older people, particularly in their ability to meet basic needs and in achieving psychosocial wellbeing. Urban respondents reported better self-perceived health status (2.95 ± 0.97) and had less functional difficulties. Rural respondents were more likely to have difficulties in making decisions for grocery shopping, taking medications and in managing finances (p < 0.001). Older people in urban areas were more supported with health insurance (97.4%) and retirement pension (57.3%) than rural residents, where only 554 (7.1%) received retirement pension (p < 0.001). In terms of contributing to society, urban respondents were more likely to participate in voluntary work, providing assistance to others, and were caregivers of individuals with disabilities than rural respondents (all p < 0.001). ConclusionsThe rural-urban disparities in healthy ageing were prevalent in China. Further research and consideration toward health resource reallocation are needed to improve functional abilities of older people in rural areas.

Social cohesion and an age-friendly environment determine the life satisfaction of elderly people in rural areas: an integrative review of the literature

Abstract Introduction. As the global population is ageing and life expectancy is gradually increasing, we wanted to use a literature review to study what determines the life satisfaction of older people in rural areas. In doing so, we focused on age-friendly communities that enable older people to live as actively and independently as possible and allow quality ageing. Methods. The integrative literature review method in accordance with PRISMA guidelines was used. The selection of articles in English was made according to the following inclusion criteria: scientificity, content relevance and topicality. The literature search covered the bibliographic-catalogue databases Web of Science and PubMed, from 2010 to 2020. After selection, a qualitative content analysis was applied to the data. Results. From the initial twenty-one articles, we gained an insight into the life satisfaction of the elderly in rural areas through a substantive analysis of nine scientific articles. Two content categories were identified: social cohesion of the elderly and age-friendly environment. Discussion and conclusion. Social cohesion and an age-friendly environment are important for ensuring the life satisfaction of elderly people in rural areas. Based on a review of the literature, we found out that literature focusing on ageing in urban areas predominates. In the future, it will be necessary to study the factors that affect the life satisfaction in geographical locations that are similar in size and cultural and social characteristics.

Measuring demand and supply of community care services for older people healthy ageing in rural Zhejiang Province

BackgroundA consequence of demographic trends and economic prosperous is the increasing diversity in needs for care services. However, the traditional family support for older people has been largely supplanted by the wider provision of community care services. This study aims to investigate the current status of demand and supply in community care services across different villages of Zhejiang province and assess service effectiveness for healthy ageing.MethodsA questionnaire survey was carried out towards 207 rural villages across 9 cities in Zhejiang province. One hundred eighty-six valid responses were received, representing a response rate of around 89.9%. Descriptive statistics were employed to identify older villagers’ care needs and available community services. Comparative analysis examined the balance between the demand and supply of community care services. Correlation analysis were applied to determine key factors that impacted the supply of social services in rural communities.ResultsThe research found that rural older residents normally lived with their children or spouse with limited literacy and income. On average the categories of community care services is substantially small in comparison with the increasingly diverse demands of older people in rural areas. There was an obvious mismatch between service demand and service supply in rural communities, which often caused the waste of public resources. Moving forward, the uppermost priority is given to infrastructure construction service and daily life service, while little attention is paid to mental health service and specialized nursing service.ConclusionThere needs to be an improvement in the socio-economic capacity of rural communities and in the diversity of social care services. Policies and strategies are also needed to encourage private sectors’ involvement in providing care services for rural older people. Local government should have a clear vision of the potential demands for community care services, practical guidelines will be useful in guaranteeing better service quality.

ОСОБЕННОСТИ ПОВСЕДНЕВНОСТИ ПОЖИЛЫХ ЛЮДЕЙ В СЕЛАХ КАРЕЛИИ ВО ВРЕМЯ КОРОНАВИРУСНЫХ ОГРАНИЧЕНИЙ

The article presents research into the peculiarities of life of older people in rural areas during the COVID-19 pandemic. In total, there were conducted 20 interviews and collected 15 observation diaries of older people living in rural areas in peripheral settlements of the Republic of Karelia. The study examines the isolation of older people and the peculiarities of isolation of older people who live in rural areas; the effects that social exclusion of older people living in rural areas creates; the possible ways of adaptation that could minimize this social exclusion. The article contributes to the emerging research into the peculiarities of understanding aging in the context of forced social exclusion caused by the COVID-19 pandemic. A thematic method was used in the analysis of interviews and observation diaries of older people. The paper identifies various fears and peculiarities of the perception of the lonely state associated with changes in habitual everyday life due to isolation, as well as sensations related to the informants’ perception of their body as excluded from previous life and as an invisible body confined in the space where self-isolation occurs. The research also analyzes the role of bodies and the features of restrictions that the COVID-19 pandemic creates for the elderly in the context of bodily restrictions and studies how self-isolation and various fears are associated with the bodily restrictions of older people.

The Impact of Living Arrangements and Intergenerational Support on the Health Status of Older People in China

Research to-date has examined the impact of intergenerational support in terms of isolated types of support, or at one point in time, failing to provide strong evidence of the complex effect of support on older persons’ wellbeing. Using the Harmonised China Health and Retirement Longitudinal Study (2011, 2013 and 2015), this paper investigates the impact of older people’s living arrangements and intergenerational support provision/ receipt on their physical and psychological wellbeing, focusing on rural/ urban differences. The results show that receiving economic support from one’s adult children was a stronger predictor for higher life satisfaction among older rural residents compared to those in urban areas, while grandchild care provision was an important determinant for poor life satisfaction only for older urban residents. Receiving informal care from one’s adult children was associated with a poor (I)ADL functional status and with depressive symptoms among older rural people. Meanwhile, having weekly in-person and distant contact reduced the risk of depression among older people in both rural and urban areas. The paper shows that it is important to improve the level of public economic transfers and public social care towards vulnerable older people in rural areas, and more emphasis should be placed on improving the psychological well-being of urban older residents, such as with the early diagnosis of depression.

Sex Differences in the Association between Different Obesity Parameters and Cognitive Function in Older Adults: A Cross-Sectional Study in Rural China

Background: Early identification of risk factors for cognition decline may contribute to the interventions for Alzheimer’s disease. Obesity is a common modifiable risk factor for chronic diseases. The association between obesity and cognition in older adults is limited, and sex differences in this area have not been well recognized. Objective: The aim of the study was to observe the sex differences in the relationship between obesity and cognition in a rural community-dwelling older population of Guizhou, China. Methods: Data were gathered from the baseline survey of a cohort study of older people in rural areas of Guizhou, China. Demographic and behavioral data (sex, age, education, household income, smoking history, drinking history, history of head injury, diet, and level of physical exercise time) were collected. The Mini-Mental State Examination (MMSE) was used to assess cognitive function. Body mass index (BMI), waist circumference (WC), hip circumference (HC), and waist-to-hip ratio (WHR) were used as different measures of obesity. Comparisons between the groups were made by the Wilcoxon rank-sum test or Kruskal-Wallis H test. Restricted cubic spline regression was used to examine a dose-response relationship between obesity indicators and cognitive function. Linear relationships were performed by the multivariable linear regression model. Results: A total of 1,654 participants including 964 women and 690 men were enrolled in this study. After adjustment, BMI showed a nonlinear relationship with MMSE scores in women. There was a significant trend toward increasing MMSE scores at the low end of BMI (13.52–20.10 kg/m², p = 0.014). The multivariable linear regression model showed that MMSE increased by 0.631 (p < 0.001) for every one standard deviation increase in HC in women. No association was found between obesity parameters and cognitive function in men. Conclusion: Our results suggest that there are significant sex differences in some obesity parameters and cognition in an older Chinese population. BMI and HC are positively associated with cognitive function in women. No association was found between obesity measures and cognitive function in men.