Health and Other Aspects of the Quality of Life of Older People

Celebrating the United Nations' International Year of Older Persons, in September 1999 a survey research project was undertaken throughout the Northern Interior Health Region (NIHR) of British Columbia. A total of 875 people completed 23-page questionnaires, the average age of the respondents was 69 and the range ran from 55 to 95 years. Responses to the SF-36 questionnaire indicated that for male respondents aged 55–64, the mean score for the 8 dimensions was 74.4. This mean was practically identical to that of the United States norm for such people (74.5) and lower than that for the United Kingdom (77.4). For male respondents aged 65 and older, the mean was 68.3. This was numerically higher but again practically the same as that of the norm for the United States (68.1). For females aged 55–64, the mean score for 8 dimensions was 73. This was superior to that of the United States norm of (70.6) for such people and lower than that for the United Kingdom (74.6). For female respondents aged 65 and older, the mean score was 65.4. This was practically identical to that of the United States (65.5).Comparing 18 average figures for our respondents on satisfaction with specific domains of life (e.g., financial security, health, friendships) and life as a whole with those of average adults in Prince George in November 1999, we found that in all but two cases the older people's scores were higher. Only in the cases of satisfaction with health and overall happiness were older people's scores lower, and the differences were not statistically significant.Eleven percent of our respondents reported that they had been a victim of a crime in the last year, compared to 38% in our 1997 adult victimization survey. Older people had a more benign view than ordinary adults of the growth of crime in their neighbourhood and city, although exactly 64% of both groups thought that crime had increased in Canada. Although older people had a more optimistic view than other adults of the increase in crime in their neighbourhoods, fewer of the former than the latter felt safe out at night. Nevertheless, compared to adults surveyed in 1997, the behaviour of respondents in our survey of older people was not as constrained by concerns of criminal victimization.Two or three of the 8 SF-36 health dimensions explained 37% of the variation in life satisfaction scores, 34% of variation in happiness scores, 34% in satisfaction with the overall quality of life scores and 22% in satisfaction with one's overall standard of living. In every case, Mental Health was the dimension that had the greatest impact on our four dependent variables.When all of our potential predictors were entered into a regression equation simultaneously, we found that they could explain 60% of the variance in life satisfaction scores, 44% in happiness scores, 58% in satisfaction with the overall quality of life scores and 59% in satisfaction with one's overall standard of living scores.     

An Exploratory Study on the Quality of Life of older Chinese People Living alone in Hong Kong

This study successfully interviewed 109 randomly selected Chinese people aged 60 and over living alone in two public housing estates in an urban area of Hong Kong. The results show that mental health status, number of days staying in hospital, life satisfaction, age, and self-esteem are significant factors in predicting the life quality of older Chinese respondents living alone. The explanatory power of this model is 56.4. The results of this study are consistent with previous findings reported in the west and in Hong Kong. A subgroup analysis of those older Chinese respondents living alone who have offspring also living in Hong Kong shows that belief in childrens’ support in old age, good walking ability, and better self-reported health status via life satisfaction as the mediating variable, better self-reported health status and satisfactory self-reported financial status via self-esteem as the mediating variable, are crucial predictors of quality of life. This model explains 64.2% of the variance in quality of life from a subset of the predictor variables.     

An Exploratory Study on the Quality of Life of older Chinese People Living alone in Hong Kong

This study successfully interviewed 109 randomly selected Chinese people aged 60 and over living alone in two public housing estates in an urban area of Hong Kong. The results show that mental health status, number of days staying in hospital, life satisfaction, age, and self-esteem are significant factors in predicting the life quality of older Chinese respondents living alone. The explanatory power of this model is 56.4. The results of this study are consistent with previous findings reported in the west and in Hong Kong. A subgroup analysis of those older Chinese respondents living alone who have offspring also living in Hong Kong shows that belief in childrens support in old age, good walking ability, and better self-reported health status via life satisfaction as the mediating variable, better self-reported health status and satisfactory self-reported financial status via self-esteem as the mediating variable, are crucial predictors of quality of life. This model explains 64.2% of the variance in quality of life from a subset of the predictor variables.     

The marriage of mentally handicapped people and family planning services for them in Shanghai

This brief article discusses findings from a study by the Shanghai Population Information Center on marriage, fertility, and family planning among mentally handicapped adults in Shanghai, China, and population dynamics. The sample included 184 mentally handicapped persons aged 20-49 years (79 men and 116 women). 47 people had mild, 92 had moderate, and 45 had severe mental deficiencies. The mean age was 33 years. About 29% were married or ever married. 49 were married or ever married women. 6 spouses were mentally deficient. About 70% of the married or ever married had children. 43 had ever used contraception. The most commonly used method was the IUD. Several people had the approval of family members and were sterilized. Only 3 women were prevented from use of contraceptive services by family. 38% of the unmarried women's parents or relatives wanted their mentally deficient family members to be married before old age. 48% discouraged marriage because of the mental deficiency.     

中国老年人的主观年龄及影响因素分析

随着中国老龄化进程的加快,越来越多的研究开始探讨老年的定义和标准,但很少有研究直观地描述和分析老年人对自身进入老年的年龄标准的看法以及其主观年龄的差异。本研究使用2014年至2018年中国老年社会追踪调查的三期数据,比较分析不同队列在不同实际年龄(日历年龄)下认定的自身进入老年的年龄标准的变化以及不同实际年龄老年人的主观年龄的差异。数据分析结果显示受访者自我认定的老年的年龄标准平均为70岁,远高于社会上通常认定的60岁或65岁的标准;主观年龄和主观外表年龄平均在68岁左右,低于受访者的平均实际年龄(71岁),超过六成的受访者的主观年龄与主观外表年龄比实际年龄“更年轻”。进一步的统计模型分析结果显示健康状况越好、与子女同住、有广泛的朋友支持网络以及更愿意参与村居委会投票的老年人所认定的自己进入老年的年龄标准也更高。更多的社区娱乐场所或设施和室外活动场地也能显著地提高受访者认定的进入老年的年龄标准。更高的受教育程度以及更好的健康状况是促使老年人的主观年龄和主观外表年龄小于实际年龄的重要因素。本文直观地描述了不同实际年龄的老年人所认定的自身进入老年的年龄标准以及其主观年龄与实际年龄的差异,为与年龄相关的老龄政策的制定提供了参考。     

Living Arrangements and Quality of Life Among Chinese Canadian Elders

This paper examines the role of living arrangements in thequality of life of community-dwelling Chinese elders (aged 65 andover) currently residing in Vancouver and Victoria, BritishColumbia. Data are based on a random sample of 830 persons[response rate = 71.5%], who were interviewed in their homes inthe language of their choice in 1995–96. Three dimensions ofquality of life – satisfaction, well-being and social support –are examined for married men and women [living with spouse alonevs. living intergenerationally] and widowed women [living alonevs. living intergenerationally]. Few differences are found formarried persons, especially women; for widows, living alonesignificantly reduces quality of life in a number of areas.Regression analyses indicate that living arrangements are not asignificant predictor of life satisfaction or well-being formarried men and women. For widows, living arrangements determinewell-being but not life satisfaction.Overall, age, health status, and social support (havingfriends/confidante) are better predictors of quality of life forelderly Chinese Canadians than are living arrangements. Findingshighlight the importance of: empirically distinguishing maritalstatus and living arrangements in studying the quality of life ofelders; not homogenizing Chinese Canadian seniors with regard toliving arrangements; and focussing on Chinese elderly widows wholive alone as a group at risk of low well-being.     

Planned retirement housing preferences of older homosexuals

This preliminary study investigated interest in planned retirement housing among older homosexuals and their preferences for certain facility characteristics. A nonrandom, volunteer sample of 57 lesbians and 399 gay men with a mean age of 63.3 years completed an anonymous survey. There was no difference with regard to living arrangement, home ownership, relationship status, or annual income between those respondents 55 to 64 years old and those 65 and older within each sex. The respondents were more likely to live alone, to be still working, and to have a higher socioeconomic status than the general older population. A large majority indicated an interest in planned retirement housing specifically sensitive to the needs of gay men and lesbians, with support for a continuum of services. Many respondents expressed a willingness to relocate significant distances in order to live in such a community. Security and health services were the most preferred, while mandatory services were rejected.     

Variations in interstate migration of men across the early stages of the life cycle

The results reported here show that the stage of an individual's life cycle not only has direct effects on the likelihood of migration, but also establishes a context within which the motives to migrate are evaluated and acted upon. One contextual impact of the life cycle concerns the effects of length of residence on migration. The results show that the probability of migrating declines more rapidly over time for married males with children than for singles males--i.e., the difference between the likelihood of migration for single males and married males with children widens with increasing length of residence. Much of this difference may be due to the greater number and strength of community ties for individuals who are married with children. These ties are not well developed at the beginning of a residence but continue to strengthen over the course of a residence. In addition, there are variations in the levels of job rewards and location-specific resources across the life cycle and there are two variations across the early life cycle in the effects of independent variables on the initial rate of migration. One resource (self-employment) and one job reward (prestige) have different effects for single individuals than for either group of married males. If the span of the life cycle considered in this analysis were broadened to include older men, additional differences in the effects of independent variables might be uncovered. In research with cross-sectional data containing a wider range of ages than the data used here, Heaton et al. (1981) found that economic variables were more important in determining the migration of younger individuals than that of older individuals, whereas noneconomic factors were more important determinants of the migration of older than of younger individuals. The results of this paper and Heaton's results suggest that at different stages of life people use a somewhat different "subjective cost-benefit calculus" in making migration decisions. The importance of certain migration determinants may vary significantly depending on whether an individual is married, whether he or she has children, and/or whether he or she is in the labor force or retired. Additional research on these issues could greatly contribute to our understanding of migration.     

Health and quality of life of older people,a replication after six years

Replicating a survey of 875 people 55 years old or more undertaken in September 1999 throughout the former Northern Interior Health Region (NIHR) of British Columbia, in September 2005 a sample of 656 people completed a 22-page questionnaire. The average age of the respondents was 68, with a range running from 55 to 96 years, and 64% were women. Responses to the SF-36 questionnaire indicated that for male respondents aged 55–64, the mean score for the 8 dimensions was 76.1. This mean was a bit higher than the 74.4 mean of 1999. For male respondents aged 65 and older the mean was 69.0, which was also higher than the 68.3 mean of 1999. For females aged 55–64, the mean score for 8 dimensions was 73.1, versus 73.0 in 1999. For female respondents aged 65 and older, the mean score was 67.0, versus 65.4 in 1999. Based on these mean scores for the 8 dimensions, then, it is fair to say that the overall health status of males and females aged 55 years and older in the region in 2005 was at least as good as (i.e., the same as or better than) that in 1999. Comparing 28 average figures for the 2005 respondents on satisfaction with specific domains of life (e.g., financial security, health, sense of meaning) and three global indicators (satisfaction with life as a whole and with the overall quality of life, and happiness) with those of the 1999 respondents, we found that the scores for the 2005 sample were at least as high as those of the other sample. Thus, it seems fair to say that the perceived quality of life of older people in the former NIHR so far as it is revealed in domain and global satisfaction and happiness scores, is at least as good as the perceived quality of life of a similar sample in 1999. Although a large majority perceived increases in crime in the 2 year periods prior to both surveys, smaller percentages of the 2005 sample than of the 1999 sample thought that crime had increased over the past two years, avoided going out at night, feared for their safety, had crime-related worries, engaged in crime-related defensive behaviours and were actually the victims of any crimes. Therefore, it seems fair to say that, so far as crime-related issues are concerned for the two samples of seniors responding to our surveys, there is more evidence of improvement than of deterioration. Applying stepwise multiple regression, each of the eight dependent variables was explained on the basis of four clusters of predictors separately and then a final regression was run using only the statistically significant predictors from the four clusters. Broadly speaking, 7 SF-36 health status scales explained from 28% to 45% of the variance in the 8 dependent variables, running from satisfaction with the overall quality of life (28%) to the single item measure of general health (45%). The seven predictors in the Social Relations cluster explained from 7% of the variance in the SF-36 General Health scale scores to 57% of the variance in the Life Satisfaction scores. The four predictors in the Problems cluster explained from 10% of the variance in the SF-36 General Health scale scores to 24% of the variance in the SWLS scores. The 11 predictors in the Domain Satisfaction cluster explained from 14% of the variance in the SF-36 General Health scale scores to 64% of the variance in the SWB scores. Putting all the significant predictors together for each dependent variable, in the weakest case, 4 of 11 potential predictors explained 33% of the variance in the SF-36 General Health scale scores and in the strongest case, 9 of 15 potential predictors explained 70% of the variance in Life Satisfaction scores. Among other things, these results clearly show that respondents’ ideas about a generally healthy life are different from, but not independent of, their ideas about a happy, satisfying or contented life, or about the perceived quality of their lives or their subjective wellbeing. Finally, the 7 core discrepancy predictors of MDT plus incomes were used to explain the eight dependent variables. From 13% of the variance in the SF-36 General Health scale scores to 57% of the variance in SWLS scores was explained using those predictors. Based on an examination of the Total Effects scores for the predictors of the 8 dependent variables, the most influential predictors were Self-Wants, followed by Self-Others and then Self-Best. In other words, the most influential discrepancy predictors of respondents’ overall life assessments were those between what respondents have versus what they want, followed by what they have versus what others of the same age and sex have, and then by what they have versus the best they ever had in the past. We would like to thank the Social Sciences and Humanities Research Council of Canada for support of this research with funds granted to Alex C. Michalos through the Gold Medal Award in 2004.     

Mental health differences between men and women caregivers,BRFSS 2009

This study uses data from the 2009 Behavioral Risk Factors Surveillance System (BRFSS) to examine differences between male and female caregivers by demographics, health-related quality of life (HRQOL), and the effect of social support on HRQOL. Roughly two-thirds of caregivers were women, and demographic characteristics differed among men and women caregivers. Women caregivers reported significantly more mentally and physically unhealthy days than men, but there were no differences between men and women in general health or life satisfaction. Men were significantly more likely to report that they rarely or never received social support. Despite this, the effect of social support on HRQOL was stronger in men than in women. Implications of these findings for caregiver support programs are discussed.     

Aftereffects of Alzheimer's Caregiving on Widows' Health and Financial Well-Being

This stud examined interview data from 309 widows 18 months after the hus g and's death. The present health and financia1 well-being of former caregivers of Alzheimer's disease individuals were compared to a group of other caregivers and a group on non-caregivers. There were no significant differences among the groups in either self-rated health or functional health at 18 months after husband's death. Couples in the Alzheimer's groups were more likely to have seriously depleted financial resources by paying a higher proportion of the husband's healthcare costs.     

Age,Health and Life Satisfaction Among Older Europeans

In this paper we investigate how age affects the self-reported level of life satisfaction among the elderly in Europe. By using a vignette approach, we find evidence that age influences life satisfaction through two counterbalancing channels. On the one hand, controlling for the effects of all other variables, the own perceived level of life satisfaction increases with age. On the other hand, given the same true level of life satisfaction, older respondents are more likely to rank themselves as “dissatisfied” with their life than younger individuals. Detrimental health conditions and physical limitations play a crucial role in explaining scale biases in the reporting style of older individuals.     

Changes in the Living Arrangements of Elderly People in Greece: 1974–1999

During the period 1974–1999 two contrasting trends were observed with respect to the living arrangements of older people in Greece. On the one hand the proportion of older people living with their unmarried children had been slightly rising while on the other hand the proportion of older people living with their married children declined substantially. As a result of the declining trend in the incidence of co-residence with married children the percentage of older people living with their children or other members of their extended family fell by 25% points (from a 58% in 1974 to about 33% in 1999). Our analysis suggests that the main driving force behind the decrease in co-residence between older people and their married children was the rise in the incomes of older people (which resulted from some important exogenous policy changes which increased substantially pension incomes). On the other hand, the main driving force behind the slight increase in the co-residence with unmarried children was the increase in the percentage of unmarried younger people (which is associated with the postponement in the age of marriage) and the high and in some cases increasing needs of children’s generation.     

Living arrangements of older malaysians: Who coresides with their adult children?

More than two-thirds of Malaysians age 60 or older coreside with an adult child. Data from the Senior sample of the Second Malaysian Family Life Survey (MFLS-2) are used to investigate which “seniors” (persons age 60 or older) live in this way. The analysis generally supports the notion that coresidence is influenced by the benefits, costs, opportunities, and preferences for coresidence versus separate living arrangements. For example, married seniors are more likely to coreside with adult children when housing costs are greater in their area or when the husband or wife is in poor health. This finding suggests that married parents and children live together to economize on living costs or to receive help with household services. Unmarried seniors who are better off economically are less likely to live with adult children, presumably because they use their higher incomes to “purchase privacy.”     

Gender differences in retirement decisions in Hong Kong

The study of labor force participation at older ages and the process of retirement do not have a long tradition in Asia's newly developed societies. This study, based on telephone survey of 950 respondents, examines various socio-economic factors that would influence retirement decision among older workers in Hong Kong. The findings show that older men were more likely to participate in the labor force than older women. Interestingly, older workers, in particular older women, with pension were less likely to retire. Having a working spouse decreased the likelihood of retirement and older workers, in particular older women, living with married children were more likely to retire. Poor health also discourages the propensity to continue working at old age. These findings confirm that retirement entails much more than just a decision to stop work, and that there were gender differences in retirement decision. Finally, several policy challenges, with reference to elderly women, concerning older workers' labor force participation were discussed.     

The Association Between Individual Income and Remaining Life Expectancy at the Age of 65 in the Netherlands

This article quantifies the association between individual income and remaining life expectancy at the statutory retirement age (65) in the Netherlands. For this purpose, we estimate a mortality risk model using a large administrative data set that covers the 1996–2007 period. Besides age and marital status, the model includes as covariates individual and spouse’s income as well as a random individual specific effect. It thus allows for dynamic selection based on both observed and unobserved characteristics. We find that conditional on marital status, individual income is about equally strong and negatively associated with mortality risk for men and women and that spouse’s income is only weakly associated with mortality risk for women. For both men and women, we quantify remaining life expectancy at age 65 for low-income individuals as approximately 2.5 years less than that for high-income individuals.     

Differences between previously married and never married 'gay' men: family background, childhood experiences and current attitudes

Despite a large body of literature on the development of sexual orientation, little is known about why some gay men have been (or remain) married to a woman. In the current study, a self-selected sample of 43 never married gay men ('never married') and 26 gay men who were married to a woman ('previously married') completed a self-report questionnaire. Hypotheses were based on five possible explanations for gay men's marriages: (a) differences in sexual orientation (i.e., bisexuality); (b) internalized homophobia; (c) religious intolerance; (d) confusion created because of childhood/adolescent sexual experiences; and/or (e) poor psychological adjustment. Previously married described their families' religious beliefs as more fundamentalist than never married. No differences were found between married' and never married' ratings of their sexual orientation and identity, and levels of homophobia and self-depreciation. Family adaptability and family cohesion and the degree to which respondents reported having experienced child maltreatment did not distinguish between previously married and never married. The results highlight how little is understood of the reasons why gay men marry, and the need to develop an adequate theoretical model.     

Coffee intake,health-related quality of life,and associated factors of overactive bladder in older Korean women living in rural South Korea

ABSTRACT

Overactive bladder (OAB) is a common health problem in older women. The aim of the study was to investigate coffee consumption, health-related quality of life (HRQOL), and associated factors of OAB in older Korean women living in rural South Korea. A total of 248 women aged 65 years and older participated in this study. Chi-square tests, t-tests, and multivariable logistic regressions were performed. The means of coffee consumption between OAB and non-OAB groups were not significantly different. Women with OAB showed significantly lower HRQOL than women with stress urinary incontinence only. OAB was associated with high body mass index and poor health status.     

Perception of health,well-being,and quality of life in female caregivers: Comparative study of a sample of adult and older women in Spain

In a study on informal or unpaid care, it is difficult to identify the consequences and effects of care provision on the caregiver’s daily life. Thus, it is important to analyze the perceptions of the individual caregiver. This study describes the perceptions of health, well-being, support networks, and quality of life of 13 women aged between 45 and 70 years after completing an intervention program. The data indicate that caregivers’ health and quality of life worsen with the intervention, and their well-being and social relations (through new technologies) improve.     

Diverging Trends in Female Old‐Age Mortality: The United States and the Netherlands versus France and Japan

In the most advanced countries, child mortality and adult mortality under age 65 years have fallen so low that further improvement in life expectancy relies almost completely on the decline of mortality at older ages. This phenomenon is particularly pronounced among women, who are far ahead of men in survival rates. Thus, to project the future of life expectancy, this study focuses on trends in female life expectancy at ages 65 and older. Four countries are selected for this analysis: the United States, Netherlands, France, and Japan. It is particularly interesting to understand why American and Dutch trends in female old‐age mortality have been diverging from those in France and Japan for two decades. It is shown here that most of the divergence derives from the fact that decline in cardiovascular mortality is more and more offset by increases in other causes of death in the United States and the Netherlands, while the other two countries are more successful in reducing mortality from all causes at increasingly older ages. This latter phenomenon could represent a new stage of the health transition.