Volunteering and self-reported health outcomes among older people living in the community: the Yilan study, Taiwan.

PURPOSE: This study aimed to explore associations between volunteering and various self-reported health outcomes among older people, including subjective physical and mental health, self-rated health, and self-rated happiness. METHODS: This questionnaire survey was conducted in Yilan, Taiwan. By convenient sampling, a total of 3692 older people living in the community were recruited from 2012 to 2016. Participants' engagement in community volunteer activities in the past month was recorded. Subjective physical and mental health were evaluated using the Short Form-12 version2 Health Survey physical and mental component summary scores. Self-rated health and happiness were each evaluated by a single question. Participants' demographic information and comorbidities were also recorded. We conducted multiple linear regression analyses adjusted for age, sex, marital status, body mass index, educational level, living status, comorbidities, smoking status, and status of alcohol drinking. RESULTSS: After adjusting for covariates, volunteering was significantly associated with better subjective physical health, self-rated health, and self-rated happiness scores (B = 2.41, 95% confidence interval [CI] (1.56, 3.26); B = 3.46, 95% CI (2.66, 4.66), and B = 4.62, 95% CI (3.18, 6.05), respectively). The strength of the relationships between volunteering and various self-reported health outcomes differed. CONCLUSIONS: Volunteering has positive associations on subjective physical health, self-rated health, and happiness for older people living in the community in Yilan, Taiwan. Further follow-up studies are needed to examine the mechanisms of associations between volunteering and various self-reported health outcomes, and clarify the differences in the strength of their associations.

The paradox of aging and health-related quality of life in Asian Chinese: results from the Healthy Aging Longitudinal Study in Taiwan.

BACKGROUND: Declines in health, physical, cognitive, and mental function with age suggest a lower level of health-related quality of life (HRQoL) in late life; however, previous studies found that the associations were weak and varied, depending on the study designs and cohort characteristics. METHODS: The present study examined the paradox of aging in an East Asian context by regressing the age patterns of objective health indicators (physical, cognitive, and mental function), and subjective HRQoL (12-item Short Form, SF-12), on the independent and interactive effects of age and physical function in a cohort study of 5022 community-dwelling adults aged 55 and older in Taiwan. RESULTS: Age patterns differed across measures. The SF-12 mental health score (MCS) showed a slight positive association with age and this effect remained stable after controlling for various age-related covariates. The SF-12 physical health score (PCS), in turn, was negatively associated with age. Age differences in PCS were fully explained by age decrements in objective physical health. However, consistent with the so-called paradox of aging, the association between objective and subjective physical health weakened with age. CONCLUSION: These findings add to prior evidence indicating that - in spite of objective health decrements - subjective HRQoL is maintained in later life among Asian Chinese. Also, these paradoxical patterns appear to vary for mental and physical components of HRQoL, and future research is needed to explore the underlying mechanism. TRIAL REGISTRATION: Healthy Aging Longitudinal Study in Taiwan (HALST) is retrospectively registered at ClinicalTrials.gov on January 24, 2016 with trial registration number NCT02677831.

Latent profiles of physical and psychological outcomes of bereaved parents in China who lost their only child.

Background: Along with the implementation of the one-child policy in China, a special group of bereaved parents called 'shiduer' (), meaning parents bereaved by the loss of their only child, emerged. Although previous research has examined the physical and psychological health of this population, individual differences in physical and psychological outcomes are still not well understood. Objective: This study aimed to identify heterogenous subgroups of Chinese bereaved parents who lost their only child based on the physical and psychological health of this population as well as the predictive factors of each subgroup. Method: Latent profile analysis was used to explore underlying patterns of physical and psychological indicators including subjective physical health, negative psychological outcomes (i.e. depression, post-traumatic stress disorder and prolonged grief disorder) and positive psychological outcomes (i.e. post-traumatic growth) among a sample of Chinese bereaved parents who lost their only child (N = 536). A three-step approach was used to examine the effects of covariates including quality of spousal relationship and recruitment channels on psychological and physical outcomes. Results: A three-profile model identified severity-based groupings of a 'resilient' subgroup (n = 153), a 'coping' subgroup (n = 338) and a 'dysfunctional' subgroup (n = 45). Less satisfaction with spousal relationship and recruitment from institutions in the community and online self-help groups (vs. offline support groups) are associated with the membership of the 'coping' or 'dysfunctional' subgroup compared to the 'resilient' subgroup. Conclusions: There is heterogeneity regarding the physical and psychological health of Chinese parents after losing their only child. The predictive effects of the quality of spousal relationship and the recruitment channels could provide directions for professional intervention.

Resumen del Artículo: Antecedentes: Junto a la implementación de la política de un solo hijo en China, surgió un grupo especial de padres afligidos llamado 'shiduer' (失 独 者), que significa padres despojados (en duelo) por la pérdida de su único hijo. Aunque investigaciones previas han examinado la salud física y psicológica de esta población, las diferencias individuales en los resultados físicos y psicológicos aún no son bien comprendidos.Método: Se usó el análisis de perfil latente para explorar patrones subyacentes de indicadores físicos y psicológicos que incluían salud física subjetiva, resultados psicológicos negativos (es decir, depresión, trastorno de estrés postraumático y trastorno de duelo prolongado) y resultados psicológicos positivos (es decir, crecimiento postraumático) en una muestra de padres chinos en duelo que perdieron a su único hijo (N = 536). Se utilizó un enfoque de tres pasos para examinar los efectos de las covariables, incluida la calidad de la relación conyugal y las vías de reclutamiento, en los resultados psicológicos y físicos.Resultados: Un modelo de tres perfiles identificó agrupaciones basadas en la gravedad mostrando un subgrupo 'resilente' (n = 153), un subgrupo 'de afrontamiento' (n = 338) y un subgrupo 'disfuncional' (n = 45). La menor satisfacción con la relación conyugal y el reclutamiento de instituciones en la comunidad y grupos de autoayuda en línea (en comparación con grupos de apoyo presenciales) se asociaron con la pertenencia al subgrupo 'afrontamiento' o 'disfuncional' en comparación con el subgrupo 'resilente'.Conclusiones: Existe heterogeneidad con respecto a la salud física y psicológica de los padres chinos después de perder a su único hijo. Los efectos predictivos de la calidad de la relación conyugal y las vías de reclutamiento podrían proporcionar instrucciones para la intervención profesional.

The effect of employment transitions on physical health among the elderly in South Korea: A longitudinal analysis of the Korean Retirement and Income Study.

This study aims to answer three research questions: First, is the positive effect of retirement on physical health replicated in Korea? Second, is there any difference in health effects of employment transition according to employment status? Third, to what extent do monetary, non-monetary and work-related factors explain the effects of employment transitions on changes in physical health? The longitudinal panel data from five waves of the Korea Retirement and Income Study was used. We conducted (a) the pooled cross-sectional analysis, which used five-wave pooled data; and (b) the fixed-effects analyses to investigate how within-individual changes in employment status correspond to changes in subjective physical health among older adults aged 55 to 84. Results show that transition into retirement leads to poor physical health in Korea, and such effect was moderately mediated by both monetary and non-monetary factors. Compared to respondents who moved to non-precarious employment, those who became employers, self-employers, precarious workers, and unpaid family workers experienced significantly greater odds of reporting subjective poor physical health. Job dissatisfaction seems to be the most important mechanism through which employment transitions were translated into increasing likelihood of poor physical health. In conclusion, the social cost of retirement should consider the negative effects of retirement on the well-being and psychological health of retired individuals and their relationships with family, friends and neighbors, as well as income loss and economic uncertainty. Improving employment quality and working conditions for older working adults may be crucial in accomplishing longer and healthier working lives.

The Effect of Subjective Physical and Mental Health on Cognitive Decline in the Elderly

OBJECTIVES: The aim of this study was to describe subjective physical and mental health assessed by the single item self-rated physical health (SRPH), and self-rated mental health (SRMH) had influence on the cognitive decline in community-dwelling elderly. METHODS: This study was based on the Suwon Project, a cohort comprising of non-random convenience samples of ethnic Koreans aged 60 years and above. 1,356 individuals were assessed at 2 time points 2 years apart for questionnaire which included demographic characteristics, medical history, Korean Mini-Mental State Examination (K-MMSE), Korean version of Geriatric Depression Scale (SGDS-K), SRPH, and SRMH. Multiple logistic regression was used to assess K-MMSE score change from the SRPH, and SRMH. RESULTS: At baseline, both SRPH (beta=0.18, p<0.01) and SRMH (beta=0.19, p<0.01) score positively associated with the K-MMSE score. At follow-up, subjects with baseline lower SRMH score had significantly greater decline in K-MMSE score (beta=0.09, p=0.007). However, baseline SRPH score showed no effect to follow up K-MMSE score before and after adjusting age, sex, education, number of chronic disease, SGDS-K, and baseline K-MMSE score (p=0.89). CONCLUSION: Brief and easily collected subjective mental health may predict the risk of cognitive decline, but subjective physical health may not.