Socioeconomic status and health among older adults in Thailand: an examination using multiple indicators.

A survey of 14,000 Thais, 50 and older, is utilized to test hypotheses about the association between socioeconomic status (SES) and health previously derived through observation of Western populations. Central among hypotheses is the notion that an inverse association can be uniformly detected across a matrix of SES indicators and health outcomes. Indicators of SES in this study include the traditional education, occupation and income measures, and a measure of household possessions. This later indicator may be particularly useful in a non-Western setting such as Thailand. Health outcomes were derived in order to represent a subjective, a social, and a medical conceptualization of health and included measures for self-assessed health, functional disorders and chronic health conditions. All health indicators were dichotomously coded as existence or non-existence. Also tested are associations throughout ordered categories of SES. Results generally support hypotheses. Unadjusted for other SES covariates, all four indicators of status strongly related to two of the three health measures, when controlling for other important covariates. When adjusted for each other, a number of the associations remained strong. There were also several notable exceptions. Little association existed between SES and chronic health disorders. The results may serve to highlight the distinct social environment acting upon the association.

Living arrangements and socio-demographic conditions of older adults in Cambodia.

Since the takeover of Cambodia by the Khmer Rouge in 1975, the social conditions within the country have been understudied. Only recently has dependable socio-demographic data become available. We use some these data to examine living arrangements and other socio-demographic conditions among Cambodia's older population. We compare results to those recently found in Thailand and Vietnam, two neighboring countries, in order to place Cambodia within a regional context. On balance, living arrangements in Cambodia are similar to those in neighboring countries. Older adults are likely to be living with a child and in a variety of diverse arrangements involving different family members. We attempt to get at gender preference for coresident children indirectly by adjusting living arrangement patterns for Cambodia's unique sex and marital status structure. We find a predominance of elders living with never married children of either sex and a slight daughter preference. Older adults in Cambodia may face particular challenges due to the influences of the past decades of instability and violence. We conclude our paper with a discussion of how future research might assist in developing a national policy for older adults.

A cross-national examination of the determinants of self-assessed health.

Self-assessed health measures are often utilized in surveys of older adults, and these have been found to be powerful predictors of other health indicators and future health. However, there is still much that is puzzling about the measure. Few studies use comparative techniques to ascertain the determinants of self-assessed health across diverse settings. Using recent data from the Philippines, Taiwan, and Thailand, the current study tests whether determinants of self-assessed health are similar across samples and whether there are distinct country effects acting upon the association. Ordered probit models reveal that, on the one hand, the determinants of self-assessed health are relatively similar across the three countries, while, on the other, the overall probabilities of reporting favorable self-assessed health remain differentiated even when controlling for a broad series of determinants. The results suggest that cultural variation in the interpretation of health may be a factor and that more subtle measures should be included in future studies of this nature.

A comparison of correlates of cognitive functioning in older persons in Taiwan and the United States.

OBJECTIVES: This article compares patterns of association between cognitive functioning and a number of sociodemographic and health correlates among older persons in Taiwan and the United States. METHODS: The study uses data from the 1993 Survey of Health and Living Status of the Elderly in Taiwan and the 1993 Study of Asset and Health Dynamics Among the Oldest Old in the United States. Separate multivariate regression models are employed for each country to examine the effects of sociodemographic and health factors on cognitive functioning, and to examine the marginal impact of cognitive functioning on activities of daily living (ADL) and instrumental ADL (IADL) functioning. RESULTS: Results of the multivariate analyses show similar patterns of association across the two countries and replicate findings from previous studies. Increasing age, female gender, lower education, depression, and selected health conditions are associated with lower cognitive functioning. In addition, although a significant predictor of both ADL and IADL impairments, cognitive functioning is more powerful with respect to explaining IADL impairments. DISCUSSION: Study findings suggest that the cognitive measures are capturing similar dimensions in Taiwan and the United States, and that factors associated with cognitive functioning and its consequences with respect to physical functioning are similar in the two countries.

Receptivity to new technology among older adults.

PURPOSE: Both absolute and relative increases in the older adult population are occurring concurrently with the growth of high technology. Technological devices offer sophisticated solutions to some of the problems associated with ageing. This study borrows from the health utilization literature in order to develop and test a model for understanding receptivity to specific technological products by older adults. RESULTS: Receptivity is directly influenced by predispositional, need and social support factors, as well as by one's level of concern for problems that could be alleviated through the use of technology. Hierarchical regression equations reveal that this latter variable, concern, has the strongest influence on receptivity, while need factors display strong indirect effects. Those with unsatisfactory contact with others are also more receptive, suggesting that the lack of social support acts as a need factor. Contrary to past research, women are more receptive to technology than men. CONCLUSIONS: The results indicate that new technology geared toward enhancing the quality of life of seniors in their homes would be welcomed by many.

Educational attainment and transitions in functional status among older Taiwanese.

Despite considerable research examining the influence of socioeconomic status on health, few studies have considered this relationship as it pertains to older adults in non-Western societies. We attempt to ascertain the influence of education on changes in physical functioning in a rapidly developing country. Data come from the 1989 Survey of Health and Living Status of the Elderly in Taiwan and a follow-up interview in 1993 (N = 4,049, age = 60+). Individuals are conceptualized to be in a state of functional independence or functional limitation at the time of origin, based on their ability to perform three physical functioning tasks. The outcome at the follow-up interview is categorized as functionally independent, limited, or dead, allowing for six probabilities, one from each state of origin to each outcome. These are calculated using a multinomial logit model, controlling for other factors often thought to be associated with health transitions. High levels of educational attainment result in a decreased incidence of functional limitation for those originating in a state of independence. Contrary to expectations, however, education has little influence on those who originate functionally limited. Thus, higher education plays a substantial role in primary prevention of morbidity, delaying the onset of disability, but other factors are more important once limitations begin. We speculate on the reasons behind these findings, including that the results may be culturally dependent.

Receptivity to protective garments among the elderly.

Hip fractures among elders resulting from falls are a growing concern as the proportion of elders increases and health care costs mount. A recent innovation is the development of an undergarment worn to protect against hip injuries. This study attempted to determine whether a community population of elders would be receptive to wearing such a garment and the characteristics of those who would and would not be receptive. It was assumed that receptivity can be predicted by variables that have been shown to relate to risks of falling. Predictor characteristics represent three domains: demographic/predisposition, health/mobility, and social support. A logistic regression procedure was employed to determine the probability and odds of receptivity among elders given a profile of specific characteristics. Results were interpreted with reference to past research on risks of falling.

The pattern of change in leisure activity behavior among older adults with arthritis.

This study employed a "ceasing participation" framework to examine changing leisure activity patterns. Respondents of the Living With Arthritis project were classified into four participation pattern categories. Results confirmed that older adults with arthritis are more likely to experience changes to their activity regimen than older adults without arthritis. A multi-group discriminant function analysis showed that arthritis severity distinguished those who tend to cease activity. Social network and age best distinguished those who quit activities without replacement. Results are placed in the context of coping strategies. Those who do not replace forfeited activities with other activities are least flexible in their response to their chronic condition and face challenges to their well-being.

Leisure activity and well-being among the elderly in Taiwan: Testing hypotheses in an Asian setting.

Studies conducted in Western nations suggest hypotheses regarding the relationship between leisure activity and well-being among older adults. For instance, leisure activity is found to increase feelings of emotional well-being, and there are gender differences in both the types of activities in which elders tend to engage and their subsequent influences. This study attempts to verify these relationships among a sample of 4,049 Taiwanese elders (age 60+). Analyses show that men participate in most leisure activities with greater frequency than women; physical activity has the strongest positive influence on emotional well-being; contemplative activity, the only pursuit in which women out-participate men, displays a negative effect for women, and; the impact of different activity types vary by gender. These results both substantiate and refute hypotheses developed in the West, suggesting cultural variation in the impact of activity. Gender differences are explained in the context of role expectations and self-concept development. jg]Key words gw]Life satisfaction gw]Well-being gw]Activity participation gw]Leisure activity gw]Taiwan gw]Elderly.

Activity participation and well-being among older people with arthritis.

This study tests the hypotheses that (a) severity of arthritis is inversely associated with frequency of activity participation, and (b) arthritis sufferers who maintain higher levels of participation, particularly in activities which are social in nature, are less likely to experience a decline in well-being. Three activity types are considered: social, physical, and solitary. Results indicate that well-being is influenced by social activity, whereas solitary and physical activity have minimal impact. This suggests that elders with arthritis need not remove themselves from the pursuit of activity and should be encouraged to develop new interests when physical functioning fails. The study also demonstrates the utility of considering activity as multidimensional.

Isolation and characterization of a ColE1 plasmid containing the entire bio gene cluster of Escherichia coli K12.

ColE1amp plasmids carrying the entire bio gene cluster were constructed in vitro using ColE1amp as the cloning vehicle and a lambda transducing phage, lambdaatt2, as the source of bio DNA. Restriction endonuclease EcoRI digests of ColE1amp and lambdaatt2 DNA were joined by polynucleotide ligase and plasmids bearing the entire bio gene cluster were selected, after transformation, in bio deletion strains of E. coli. Recombinant DNA molecules contained one ColE1amp fragment (7.4 X 10(6) daltons) and one lambdaatt2 DNA fragment (5.4 X 10(6) daltons). Clones carrying ColE1 amp-bio plasmids produce elevated levels of biotin and biotin synthetase activity.