Relationship of living arrangement with the decline in functional capacity in elderly people by gender: a longitudinal observational study

BACKGROUND@#The living arrangement has been suggested as an important factor affecting health. Recent studies have also suggested that there was a risk among elderly persons who were not alone. This study examined whether the detailed living arrangement was associated with a future decline in functional capacity in the elderly, by gender, in a Japanese suburban city.@*METHODS@#A 3-year longitudinal questionnaire survey (baseline: 2011; follow-up: 2014) for aged 65 years or older was conducted in Kurihara city, Japan. Of the respondents in the baseline survey, we analyzed those who scored 13 points (a perfect score which indicates the highest functional capacity; n = 2627) on the Tokyo Metropolitan Institute of Gerontology Index of Competence at the baseline. The exposure was living arrangement at baseline, divided into five categories: "with spouse only," "living alone," "with child and his/her spouse," "with child without his/her spouse," and "with other family/person." The outcome was the decline in functional capacity at the follow-up survey (score decreased to 10 points or less from 13 points).@*RESULTS@#Of the 2627 analyzed population, 1199 (45.6%) were men. The incidence of the decline was 5.8% in men and 5.9% in women. Multivariable logistic regression analyses adjusted for age, educational attainment, and health behavior and condition revealed that in women, the odds ratio of the decline was higher in living with child and his/her spouse (2.41, 95% confidence interval; 1.10-5.28) referring to living with spouse only. When adjusting activities inside and outside the home such as housework additionally, the association was attenuated to marginal significance (2.25, 0.98-5.18). No statistical significance was observed in men.@*CONCLUSIONS@#These results suggested that living with child and spouse of a child was associated with the future decline in women's functional capacity.

The impact of a discrepancy between actual and preferred living arrangements on life satisfaction among the elderly in China

OBJECTIVES:To explore the effects of a discrepancy between actual and preferred living arrangements on the relationship between living arrangements and life satisfaction among the elderly in China.METHODS:Secondary analysis of the 2005 dataset of the Chinese Longitudinal Healthy Longevity Survey was performed. A binary logistic regression model was used to analyze the relationship between life satisfaction and living arrangements.RESULTS:Among those with concordant actual and preferred living arrangements, living in a nursing home increased the likelihood of life satisfaction, whereas living alone and living with a spouse decreased the likelihood of life satisfaction compared to living with the next generation and a spouse. Among those with discordant living arrangements, there were no differences in life satisfaction between the various living arrangements, except that living with a spouse increased life satisfaction compared to living with the next generation and a spouse.CONCLUSIONS:A discrepancy between actual and preferred living arrangements modifies the relationship between life satisfaction and actual living arrangement. Living in a nursing home is a good option for Chinese elder care only if the older individual emotionally accepts it. Living alone or with a spouse is not a good arrangement for elder care, even though it is often preferred by the elderly. Those with discordant living arrangements are more satisfied living with their spouses.

Depressive Symptomatology among the Living-Alone Elderly : Hopelessness and Boredom

OBJECTIVES: The aim of this study is to examine the symptom characteristics of depression in the elderly who live alone. METHODS: This study is a community-based, cross-sectional study that included 915 elderly subjects aged 65 years and over without cognitive impairment. The Korean version of the Geriatric Depression Scale Short Form (SGDS-K) was used for the evaluation of depressive symptoms. Participants were classified into three groups ; 1) living with their spouse and other family members, 2) living without their spouse (separated, divorced, or widowed) but with other family members, 3) living alone. The odds ratios of each item of SGDS-K were evaluated by logistic regression using the first group as the reference group. Adjustments were done for age, sex, education years, insurance, presence of illness, drinking, smoking and exercise. RESULTS: The living-alone elderly were at increased risk of reporting 'hopelessness' (AOR 1.50, 95% CI 1.03-2.18, p=0.033) and 'boredom' (AOR 1.57, 95% CI 1.08-2.23, p=0.018). The depressive symptoms of the elderly who were living with family members other than spouse were not significantly different from those of the reference group. CONCLUSION: Living alone is related to depression in the elderly, especially to the symptoms of hopelessness and boredom.

Impact of Body Mass Index and Perceived Health Status on Depression in Elderly Women Living Alone in the Community / 정신간호학회지

PURPOSE: This study was done to identify the prevalence of depression and determine the relationship of body mass index and perceived health status to depression for elderly women who live alone in the community. METHODS: A total of 175 adults aged over 60 participated in this cross-sectional descriptive study. Perceived heath status was measured using a self-report one-item questionnaire. Body mass index was calculated as weight in kilograms divided by the square of height in meters. Depression was assessed using the Korean short version of the geriatric depression scale. Hierarchical linear regression was used to identify associations between variables. RESULTS: Approximately 61.7% of elderly women who lived alone were depressed. The mean score for depression was 7.4 (SD 3.39). Hierarchical linear regression showed body mass index (beta=.25, p<.001) and perceived health status (beta=-.26, p<.001) were independently associated with depression adjusting for general characteristics. These two predictors accounted for 12% of the variance in depression. CONCLUSION: These results suggest that obesity and perceived health status are risk factors for depression in elderly women living alone. Therefore, these factors should be considered when developing intervention program for elderly women with depression.

Comparison of Health Habits, Perceived Stress, Depression, and Suicidal Thinking by Gender between Elders Living Alone and Those Living with Others / 기본간호학회지

PURPOSE: This study was done to identify differences in health habits, perceived stress, depression, and suicidal thinking by gender for elderly people who are living alone and elderly people who are living with others. METHOD: The study participants were 4,051 people aged 65 years and over who were surveyed in the Third Korea National Health and Nutrition Examination Survey in 2005. The relationship among outcomes and living arrangement by gender in elders was assessed using multiple logistic regression while controlling for sociodemographic characteristics. RESULTS: Older men living alone were less likely to have breakfast and more likely to perceive stress and think of suicide than older men living with family or others. On the other hand, older women who live alone were less likely to perceive stress than older women who live with others. Age, educational level, income, and number of diseases were significantly associated with each individual outcome. CONCLUSION: This study showed that living alone has a significant impact on physical health habits and psychological health of elderly people, especially for older men. Therefore, living arrangement should be considered in developing a health promotion program for elders as well as age, gender, education, and income.

The Effect of the Traditional Living Arrangement, Anpakkori, on Depressive Symptoms in Elderly People Residing on Jeju Island

OBJECTIVE: We examined the effect of anpakkori, a traditional living arrangement, on depression among elderly people on Jeju Island in Korea. METHODS: A total of 593 subjects were assessed using a sociodemographic questionnaire developed by the authors, the Korean version of Geriatric Depression Scale (KGDS), the Social Support Scale, and the Activities of Daily Living/Instrumental Activities of Daily Living scales (ADL/IADL). Subjects were classified into three groups: those residing with their adult children, those living individually, and those living in the traditional Jeju anpakkori living arrangement. RESULTS: The prevalence of depression in this study was 53.1%, and the traditional Jeju living arrangement, anpakkori, was significantly correlated with the presence of depressive symptoms (p=0.005)[odds ratio (OR)=1.88, 95% confidence interval (CI)=1.16-3.06]. CONCLUSION: Living in the traditional Jeju way may not be as good for establishing family solidarity as is living with adult children. Moreover, elderly individuals prone to depression tended to live in this anpakkori living arrangement. Careful psychological and social support systems that might prevent the development of depressive symptoms should be provided for those who live in anpakkori living arrangements.

Comparison of Attitude Toward Elders, Cognitive Level, and Mood State According to Living Arrangement of the Elderly / 성인간호학회지

PURPOSE: The purpose of this study was to compare the degree of attitude toward elders, cognitive level, and mood state by living arrangements of the elderly. METHOD: The subjects consisted of 238 elderly who divided by living arrangements(living alone, living with spouse, living with children). The data were collected by structured questionnaire that included general characteristics, attitude toward elders, MMSE-K and mood state scale, from March to December, 2005. The collected data were analyzed by Windows SPSS program including descriptive statistics, chi-square-test, Fisher's exact test, ANCOVA, Scheffe test and Pearson Correlation Coefficient. RESULTS: In MMSE-K and mood state, there were statistically significant differences among the three groups. In depression and anxiety factor of mood state, the living alone group showed higher scores than the other two groups. There was a positive correlation between attitude toward elders and MMSE-K in the elderly living with a spouse group and a negative correlation between MMSE-K and mood state in all three groups. CONCLUSION: It is necessary to develop a supportive program for decreasing the risk of health in the elderly and perform a differential approach according to their living arrangementa. Especially, more concern and intervention are needed to be performed for the elderly living in solitude.

Comparison of Attitude Toward Elders, Cognitive Level, and Mood State According to Living Arrangement of the Elderly / 성인간호학회지

PURPOSE: The purpose of this study was to compare the degree of attitude toward elders, cognitive level, and mood state by living arrangements of the elderly. METHOD: The subjects consisted of 238 elderly who divided by living arrangements(living alone, living with spouse, living with children). The data were collected by structured questionnaire that included general characteristics, attitude toward elders, MMSE-K and mood state scale, from March to December, 2005. The collected data were analyzed by Windows SPSS program including descriptive statistics, chi-square-test, Fisher's exact test, ANCOVA, Scheffe test and Pearson Correlation Coefficient. RESULTS: In MMSE-K and mood state, there were statistically significant differences among the three groups. In depression and anxiety factor of mood state, the living alone group showed higher scores than the other two groups. There was a positive correlation between attitude toward elders and MMSE-K in the elderly living with a spouse group and a negative correlation between MMSE-K and mood state in all three groups. CONCLUSION: It is necessary to develop a supportive program for decreasing the risk of health in the elderly and perform a differential approach according to their living arrangementa. Especially, more concern and intervention are needed to be performed for the elderly living in solitude.

Life Satisfaction and Depression according to Living Arrangement in Elderly / 성인간호학회지

PURPOSE: The purpose of this study is to examine the relationship between the living arrangement, life satisfaction and depression in the elderly. METHOD: The subjects consisted of 371 elderly who has at least one adult child classifying two groups(living with children and not living with children). The data were collected by a structured questionnaire that included general characteristics, Geriatric Leisure Activity Scale, Geriatric Life Satisfaction Scale, Geriatric Depression Scale, from March to December, 2004. The collected data were analyzed by SPSS program including descriptive statistics, chi2-test, t-test, Pearson Correlation Coefficient and Hierarchical Regression. RESULT: In hierarchical regression, the elders who live with their children showed more life satisfaction than elders who lived by themselves. However, living arrangement showed no effect on the level of depression of the elderly parents. Significant leisure activity interaction effect was found on the depression among the elderly: The elderly with no leisure activity reported lower levels of depression when they lived with their adult child. CONCLUSION: It is necessary to explore further the various relationship among living arrangement and life satisfaction of the elderly, their preferences and expectations regarding inter-generational obligations and living arrangements.

Psycho-Social, Nutritional Status and Meal Service Utility Patterns by Living Arrangements of the Elderly Participated in Meal Service / 대한지역사회영양학회지

This study is designed to examine influences of living arrangements on psycho-social factors, health and nutritional status, dietary adequacy and meal service utility patterns of the elderly. Nutritional status was evaluated by Mini Nutritional Assessment (MNA). Three hundred and nine elderly (110 men and 199 women) who participated in meal service in the Chung-buk province were investigated. Proportion of the elderly living alone, couples only, living with spouse and family, living with family without spouse, and living with other than family were 30.7%, 25.9%, 14.2%, 24.3% and 4.9% respectively. The mean age of the elderly was 74.1 years and the elderly who are living couples only and living with spouse and family were younger than those with other living status. Living arrangements seem to be related to psycho-social factors, health and nutritional status, and dietary quality. Those who live alone and live with other than family were mostly women and they have lower socio-economic status, psycho-social, health and nutritional status and dietary patterns compared with those of the elderly who are living with spouse or family. It was found that the elderly who live a couple only and live with spouse and family had better emotional, health and nutritional index than those of the elderly who live with family without spouse, especially in case of females. Most of elderly perceived that participation of meal service programs had a positive effect on their daily life and satisfied with meals. The elderly living alone and living with other than family were more frequently using meal service but had a negative attitude about the charged meal service for better quality than the elderly with other living status. The most important reason for all the elderly to participate in meal service was to meet their friends and then to get other services. Particularly those who are living alone and living with other than family showed lack of moivation to prepare and set the meal, and for them the economic reason is also important. They also replied that the poor health and lack of other help were the most difficult problems for them to prepare meals. It would be effective to provide nutritional services that meet specific needs of the elderly according to their characteristics and living environment.