Urban Older People Research Articles

Association Between Ego-Resilience and Social Isolation Among Urban Older People.

Social isolation among older adults affects their physical and mental health. Ego-resilience is associated with flexible adaptation to various environments and acceptable behaviors. However, its association with social isolation among older people is unclear. Therefore, a health survey was conducted with 510 adults aged 65 years or older to assess social isolation, its associated factors, and ego resilience. The results showed that the social isolation group had a lower median ego-resiliency scale score (42.0) compared to the non-social isolation group (38.0). The social isolation group were mostly males without spouses, took time to move, had more depressive moods, and poorer subjective health status. The non-social isolated group had faster maximum walking speed. Low ego-resilience was newly identified as a factor associated with social isolation among older people, as were being male, having no spouse, and depressive symptoms. Mediation analysis revealed that ego-resilience affected social isolation and was partially mediated by depressive symptoms.

Influencing factors of psychological pain among older people in China: A cross-sectional study

Limited research has focused on the psychological pain among older people and factors associated with psychological distress in older adults also remain to be evaluated. This study aims to examine the status and correlates of psychological pain among older people from urban and rural areas in China. This cross-sectional study analyzed data from 4312 samples which extracted from the dataset of China's Health-Related Quality of Life Survey for Older Adults 2018. Psychological pain was assessed by the Chinese version of the Psychache Scale (PAS). Multiple linear regression models were established to examine the associations between demographic characteristics and psychological pain. The average score of PAS among older people was 41.79 ± 14.52, and the average score of PAS among urban older people was higher than rural ones in this study. For rural older people, age (B ≥ 80 = 2.55), gender (B Female = 1.27), educational level (B Primary school = 1.63; B ≥ Middle school = 0.27), smoking (B yes = 0.83), number of chronic diseases (B ≥ 2 = 3.19) and personal social capital (B BRC = 0.27) were positively related to psychological pain, while family per-capita annual income (B15,000-30,000 = −2.52; B > 30,000 = −3.44), living arrangement (B With spouse = -3.40; B With children = -2.89; B Others = -3.82) and personal social capital (B BOC = −0.36) were negatively associated with psychological pain (p < 0.05). Moreover, for urban older people, gender (B Female = 0.98), current occupation (B With occupation = 1.13) and smoking (B yes = 2.14) were positively related to psychological pain, whereas age (B ≥ 80 = −1.45), family per-capita annual income (B > 30,000 = −3.63), living arrangement (B With spouse = -1.31), BMI (Bnormal = −2.62) and personal social capital (B BOC = −0.16) were negatively associated with psychological pain (p < 0.05). The present study sheds light on the worrying state of psychological pain experienced by Chinese older people. The results suggest that targeted interventions and social support, should be taken to alleviate the psychological pain among older people, especially urban older people.

Comparing well-being among rural and urban Indonesian older people: a quantitative analysis of the related factors

&lt;p&gt;Residential area has been identified as a factor that influences the well-being of older people. This study aimed to compare the well-being of older people living in urban and rural areas in Yogyakarta province, Indonesia, and analyze the predictors of well-being. A total of 141 (79 rural and 62 urban) older people participated in this study. Well-being was assessed using the world health organization-five (WHO-5) well-being index. The factors measured included sociodemographic data (age, sex, educational level, living arrangements, and current employment status), physical function, cognitive function, depression, independence, and attitude towards aging. Data of the two groups were compared using t-tests and Chi-square analysis. Correlations with well-being were analyzed using univariate correlation and multivariate hierarchical regression. The urban group had slightly older age, higher education, lower mobility and balance, higher attitude scores, and higher well-being. Depression was a significant variable in well-being for both communities. Physical capacity was an important factor in urban populations, while well-being in rural areas was better predicted by independence and cognitive function. The results suggest that there are similar and different correlates of the well-being of rural and urban older people, recommending different programs to enhance the well-being of older people living in different areas.&lt;/p&gt;

Does social capital interact with economic hardships in influencing older adults\u2019 health? A study from China

BackgroundThe importance of social and economic capital as predictors of health is widely documented, yet the complexity of interactions between them and effects on older people’s health is still unclear. Combining the material and psychosocial explanations of health, this study explores the potential interactions between social and economic capital in influencing older adults’ health in urban and rural China.MethodsUsing data from the China Family Panel Survey, physical and mental health in 2018 were regressed on social and economic capital indicators in 2016, controlling for sociodemographic characteristics of 3535 respondents aged 65 and older. Rothman’s synergy index was calculated to investigate potential interaction effects.ResultsEconomic hardships were significantly related to both self-reported health and mental health. Neighborhood cohesion and social participation were significantly associated with mental health for all, bonding trust was significantly associated with mental health for urban older people. We found no significant associations between social capital components and self-reported health. There was an interaction effect between low neighborhood cohesion and economic hardships, and between low social participation and economic hardships, creating an increased burden of poor mental health. The interaction effect between low bonding trust and economic hardships on mental health was apparent only among urban older people.ConclusionsGeographical settings are important factors in the complexity between social and economic capital in affecting older health. Intervention efforts directed towards reducing simultaneously multiple dimensions of deprivation, such as poverty, social exclusion, social isolation, could be helpful in improving older people’s health. In materially deprived places, policies to promote health equity by improving social capital but without eliminating poverty may be less effective.

Association between structural social support and quality of life among urban older Malaysians.

The aim of this study was to examine the association between structural social support and quality of life (QoL) among urban older people in Malaysia. Cross-sectional data of 1484 participants from the first wave of the Malaysian Elders Longitudinal Research (MELoR) were analysed. QoL was measured with the Control, Autonomy, Self-realization, and Pleasure 12-item scale (CASP-12). Multivariate analyses were run using the generalised linear interactive model (GLIM) to determine the association between structural social support measures and QoL. The mean age of the sample was 70.1 (SD=7.4) years. Being married (B=0.05, 95%CI 0.02, 0.08), larger social networks (B=0.01, 95%CI 0.01, 0.02) and social participation (B=0.02, 95%CI 0.02, 0.09) were associated with higher QoL, while living alone (B= -0.04, 95%CI -0.06, -0.02) was associated with lower QoL. Structural social support plays an important role in the QoL of older people in Malaysia.

Hypertension and Comorbidities in Rural and Urban Chinese Older People: An Epidemiological Subanalysis From the SAGE Study.

There is a lack of studies comparing hypertension and comorbidities in rural and urban older people in China. This study aimed to investigate the prevalence of hypertension and comorbidities in older people and to describe differences between patients from rural and urban areas in China. A cross-sectional study on global AGEing and adult health (SAGE) was conducted from 2007 to 2010 across 8 provinces in China. The current study included a nationally representative subsample of 7,403 respondents aged 60 years and above. Hypertension was either self-reported diagnosed hypertension or 1 elevated measured blood pressure measurement (≥140/90 mm Hg). Comorbidities were self-reported and included angina, arthritis, asthma, stroke, diabetes, depression, and chronic lung disease. The prevalence of hypertension was 66.1%. Hypertension associated with 1 comorbidity was recorded in 35.9% of all participants. A large majority (73.6%) of participants with hypertension reported "good" or "very good" general health status. The prevalence of hypertension and the number of comorbidities increased with age. The prevalence rates of multiple comorbidities were higher for urban participants than their rural counterparts (27.8 vs. 42.4% for 1 morbidity; 7.7 vs. 16.4% for 2 comorbidities; 1.4 vs. 4.7% for 3 comorbidities; 0.4 vs. 1.2% for ≥4 comorbidities) after adjustment for sociodemographic factors. However, urban participants reported better general health status, irrespective of the number of comorbidities. Our study implies that health promotion policies targeting older people should be developed. Rural areas should be a priority, and investment in the quality of health care in rural areas is urgently needed.

Social Participation and Functional Decline: A Comparative Study of Rural and Urban Older People, Using Japan Gerontological Evaluation Study Longitudinal Data

This study compared the relationship between social participation, including work, and incidence of functional decline in rural and urban older people in Japan, by focusing on the number and types of organizations older people participated in. The longitudinal data of the Japan Gerontological Evaluation Study (JAGES) that followed 55,243 individuals aged 65 years or older for six years were used. The Cox proportional hazards model was employed to calculate the hazard ratio (HR) of the incidence of functional decline over six years and the stratification of rural and urban settings. In this model, we adjusted 13 variables as behavioral, psychosocial, and functional confounders. The more rural and urban older people participated in various organizations, the more they were protected from functional decline. Participation in sports (HR: rural = 0.79; urban = 0.83), hobby groups (HR: rural = 0.76; urban = 0.90), and work (HR: rural = 0.83; urban = 0.80) significantly protected against the incidence of decline in both rural and urban areas. For both rural and urban older people, promoting social participation, such as sports and hobby groups and employment support, seemed to be an important aspect of public health policies that would prevent functional decline.

Falls and risk factors of falls for urban and rural community-dwelling older adults in China

BackgroundFalls among older people have become a public health concern due to serious health consequences. Despite abundant literature on falls in older people, little is known about the rural-urban differentials in falls among older people in China. This research fills the voids of prior literature by investigating falls and the associated risk factors among Chinese seniors, with a particular focus on the rural-urban differences.MethodsData are from the 2010 wave of Chinese Longitudinal Survey on Urban and Rural Elderly. The analysis includes 16,393 respondents aged 65 and over, with 8440 and 7953 of them living in urban and rural areas, respectively. Descriptive analyses are performed to examine incidence, locations, circumstances and consequences of falls in older people. Regression analysis is used to investigate the effects of risk factors on falls among older people in urban and rural China.ResultsThe incidence of falls is higher among rural than urban older people. In both settings, older people are more likely to fell outside of home. But common outdoor falls among rural and urban older people differ in terms of locations and circumstances. Urban older people are more likely to report falling on the road whereas their rural counterparts have experienced more falls in the yard. Falls occurring within homes or immediate home surroundings are also common; but few falls occurred in public areas. The rate of hospitalization of urban seniors after falling is higher than that of rural ones. Most risk factors of falls show similar than different effects on rural and urban elders’ risks of falling.ConclusionsIncidence, locations, circumstances and consequences of falls vary among Chinese rural and urban older people. But most risk factors for falls show similar effects on rural and urban elders’ odds of falling. Implications drawn from this research provide suggestions for the government and local agencies to develop suitable fall prevention strategies which may well be applicable to other countries.

Productive activities of the older people in Vietnam

Productive activities are crucial factors leading to an “active aging” population. With the case of Vietnam, this paper aimed to explore the productive activities among Vietnamese older people by using data from the Vietnam Aging Survey (VNAS), which was conducted in 2011 as the first-ever nationally representative survey on persons aged 50 and over in Vietnam and contained 2789 older people (those aged 60 and over) representing all older people living in 6 ecological regions and urban and rural areas in Vietnam. Productive activities included working and/or taking care of any (great)grandchild(ren) in the past 12 months prior to the survey. Using paired t-tests and probit models, we compared the differences in these productive activities among older people in terms of sex and living area. The results from various t-tests showed that educational attainment, health status and poverty status were key factors differentiating older men and women and rural and urban older people in these productive activities. For the probit estimations in terms of both gender and living location, the results indicated that age, education, health status and supportive children were determinants of working decision, while age, marital status and size of household were consistently important factors of taking care of (great)grandchildren. The paper also discussed policy implications for socio-economic and health protection in promoting older people's productive activities as well as protecting them from a variety of risks and vulnerabilities.

Unmet long-term care needs and depression: The double disadvantage of community-dwelling older people in rural China.

This study investigates the relationship between unmet long-term care needs and depressive symptoms among community-dwelling older people in China. The data come from a nationally representative sample of 1,324 disabled older people from the China Health and Retirement Longitudinal Survey (CHARLS) collected between 2013 and 2014. Regression analyses were conducted to examine the factors associated with unmet needs and the impacts of unmet needs on people's depressive symptoms. We found that disabled older people living in rural communities have a higher level of unmet needs than those in urban communities. Unmet needs cause more severe depressive symptoms among rural older people, but they do not have a significant impact among urban older people. Depressive symptoms are also affected by people's health conditions in rural China and by household income in urban China. We argue that older people living in rural communities face a double disadvantage. The first disadvantage relating to unmet needs reinforces the second one relating to mental health. These findings highlight the urgent need for more investment by the Chinese central government in formal social care services and support for carers in rural areas.

Improving Quality of Care for Urban Older People with Diabetes Mellitus and Cardiovascular Disease

The management of older patients with chronic medical conditions dominates medical practice. Cardiovascular disease (CVD) and diabetes mellitus type 2 (DM) in patients aged 65 and older have reached epidemic proportions. Using elements of the Chronic Care Model (CCM), a quality improvement project was undertaken to restructure the Geriatric Ambulatory Practice at Boston Medical Center, Boston's safety net hospital, to improve the quality of care for CVD and diabetes mellitus. Two hundred eighty-three eligible patients who had CVD, DM, or both were identified. The 39-month project period was divided into a 12-month baseline period and three follow-up periods. The multifaceted intervention consisted of development of a disease registry that centralized clinical information, implementation of an electronic medical record, patient education, physician education regarding evidence-based guidelines, feedback of provider-specific and practice data to physicians, and implementation of a foot examination protocol. Clinical measures included glycosylated hemoglobin, a diabetic foot examination, lipid profile, and blood pressure measurement. These were collected at baseline and at each patient visit for the entire project period. The average age of all patients was 76; 64% were female, 64% were African American, 72% had Medicare, and 22% had state subsidized medical insurance. Patients in all disease groups showed significant improvement in all clinical measures over time, independent of the frequency of visits. Using the CCM as a quality improvement framework can improve clinical measures for older urban minority populations with CVD and DM.

Functional Disability at Nursing Home Admission: A Comparison of Urban and Rural Admission Cohorts

This study's objective was to examine the relationships between rural residence and availability of nursing home and home health care to functional disability at the time of nursing home admission. Secondary data were obtained from the Minimum Data Set (MDS) 2.0 for Nebraska for 3,443 rural and 1,296 urban older people admitted to nursing facilities. Data from the MDS were merged with county-level data on home health agencies and nursing homes in Nebraska. The relationship of rurality of nursing home residents' prior residence and availability of nursing home and home health care to functional status at admission, controlling for demographic and health characteristics of older people, was estimated using multiple linear regression with robust variance estimates. After taking account of demographic and health status characteristics, rural residence and availability of home health and nursing home care had nonsignificant effects on functional status at admission. The findings indicate that functional disability at admission is associated with specific diseases and medical conditions, cognitive status, gender, living arrangements and marital arrangements. Rural older people are not at higher risk of admission at lower levels of functional disability compared to their urban counterparts.

Rural and Urban Elderly: Differences in the Quality of the Parent-Child Relationship

The purpose of this study was to examine any differences in the quality of the relationship between rural and urban older people and their children. Data were gathered from a stratified random sample of 111 rural and 112 urban parents. For rural parents, living close to the child was the most important contributor to a high quality of relationship, followed by having an internal locus of control and low filial expectations. The internalized locus of control was the most important factor of high quality relationships with their children for urban parents. Implications for practice and education are discussed.

The Rural Aged

Available data suggest that the rural aged, com pared with urban older people, have substantially smaller incomes, are restricted in mobility because of inadequate transportation facilities, report poorer physical health, and reveal a more negative outlook on life. Evidence suggests that the industrialization of rural communities may have a negative impact upon the rural elderly. Periodic longitudinal studies of rural older persons in strategic locations of the nation are needed to provide guidance for programs and services.