Gender differences in the associations of self esteem, stress and social support with functional health status among older adults with heart disease

This study explored and compared the role of self esteem, stress and social support in maintenance or improvement in physical and psychosocial functioning over 12 months in older men and women with cardiovascular disease. Data from 502 adults over 60 years of age showed that self esteem and stress were both significantly associated with functioning when demographic and clinical factors were controlled. Men were significantly more likely than women to maintain or improve in functioning. Self esteem, stress, compliance with medication regimens, and marital status were significantly associated with maintenance or improvement of functioning among women. Only age and stress were significantly associated with maintenance or improvement in functioning among men. Findings indicated that: (1) stress and self esteem were stronger predictors of functioning, especially among women, than demographic and clinical factors; and (2) women in the highest quartile of the self esteem distribution were approximately five times as likely to maintain or improve their functioning as women in the lowest quartile.     

Posttraumatic stress disorder and older women

This article examines the literature related to the identification and treatment of post traumatic stress disorder in older women. From this review, several key findings emerge. Consistent in the research literature is the fact that American women are more at risk for PTSD than are men as a result of the high frequency of sexual and domestic physical abuse that women experience. Studies on older women and PTSD indicate that older women are underdiagnosed and are more typically perceived as suffering from depression, anxiety or poor physical health. It was found consistently that older women who present with age-related stressors may not be asked about earlier trauma history or it may not be understood within the context of trauma related variables. In several research studies, trauma history was often not identified either as a result of current assessment practice or because women from certain age cohorts did not disclose trauma-related data to health professionals. Key researchers emphasize the necessity of clinicians, staff and medical personnel to attend to the historical variables present in trauma histories of older women. Researchers underscore the importance of understanding the impact of early and repeated trauma, especially interpersonal trauma, on the physical health and social functioning of older women- even though a significant amount of time may have elapsed since exposure. These findings indicate that further study of PTSD in older women is warranted. The paper concludes with a discussion of assessment and treatment options.     

Posttraumatic Stress Disorder and Older Women

SUMMARY

This article examines the literature related to the identification and treatment of posttraumatic stress disorder in older women. From this review, several key findings emerge. Consistent in the research literature is the fact that American women are more at risk for PTSD than are men as a result of the high frequency of sexual and domestic physical abuse that women experience. Studies on older women and PTSD indicate that older women are under-diagnosed and are more typically perceived as suffering from depression, anxiety or poor physical health. It was found consistently that older women who present with age-related stressors may not be asked about earlier trauma history or it may not be understood within the context of trauma-related variables. In several research studies, trauma history was often not identified either as a result of current assessment practice or because women from certain age cohorts did not disclose trauma-related data to health professionals. Key researchers emphasize the necessity of clinicians, staff and medical personnel to attend to the historical variables present in trauma histories of older women. Researchers underscore the importance of understanding the impact of early and repeated trauma, especially interpersonal trauma, on the physical health and social functioning of older women–even though a significant amount of time may have elapsed since exposure. These findings indicate that further study of PTSD in older women is warranted. The paper concludes with a discussion of assessment and treatment options.     

The Relationship of Social Support to Functional Limitations,Pain, and Well Being Among Men and Women

The purposes of this study were to assess the relationships of functional limitations, pain and well being to social support (emotional, tangible, informational and integrative) and to assess gender differences in these relationships. Except for integrative support, significant positive relationships were found between types of functional limitations and specific types of social supports among 15 men and 15 women (M = 67 years) with end stage joint disease. Pain was not significantly associated with any social support, but well being was related to informational and emotional supports. As compared to men, the relationships of tangible and integrative supports to well being, pain and functional impairment were signficantly greater for women as was the association of emotional support to limitations in mobility and physical activity. In contrast, women had signif~cantlys maller relationships of emotional support to limitations in ADL and household activities.     

Serious psychological distress,sex, and falls among the elderly

Serious psychological distress and falls are two major public health problems among the elderly. This study aims to test the hypothesis that although serious psychological distress can increase the risks of falls among the elderly, it tends to affect elderly women more than elderly men. Data of this study are from the 2011 California Health Survey Interviews (CHIS). We extracted a sample of 13,153 respondents aged 65 and older for this study, including 8,087 females and 5,066 males. We tested both unadjusted and adjusted interaction effects using bivariate and multivariate logistic regression analysis. Elderly women with serious psychological distress had the greatest likelihood of falls as compared to men with serious psychological distress and men and women without serious psychological distress. With respect to the covariates, limitations of physical activity and poor self-rated health status, Asian race, and older age were more likely to be associated with falls. This study provides further information on sex disparities of falls among the elderly such that serious psychological distress has a greater impact on falls for elderly women than elderly men. Thus, the findings of our studies suggest that mental health services and intervention can be useful to prevent falls for elderly women.     

An Examination of Coping Resources of Very Old Men and Women:

This paper explores the stressors, hassles and coping processes of very old men and women in relation to their physical and instrumental functioning. Sex differences exist in relation to hassles, coping processes and instrumental functioning. Results of regression analyses show that the relationships between stresses and hassles and two types of function, instrumental and physical, are mediated by the elder's personal resources and coping strategies. Although when sex is considered as an independent measure, it has no significant relationship to either type of function.     

Gender, resources across the life course, and cognitive functioning in Egypt

In this article, I evaluate the life-course determinants of cognitive functioning among 1,003 women and men aged 50 and older in Ismailia, Egypt. Three questions motivate this analysis: (1) Do older women have poorer cognitive functioning than do older men?; (2) Do cognitive resources accrued in childhood and adulthood have net positive associations with later-life cognitive functioning for women and men?; and (3) To what extent do differences in the amounts and effects of women’s and men’s cognitive resources account for gaps in their cognitive functioning? Compared with men, women have lower Modified-Mini Mental Status Exam (M-MMSE) scores for overall cognitive functioning. Cognitive resources in childhood and adulthood are jointly associated with the M-MMSE score. About 83% of the gender gap in mean M-MMSE scores is attributable to gaps in men’s and women’s attributes across the life course. Gender gaps in childhood cognitive resources—and especially schooling attainment—account for the largest share (18%) of the residual gender gap in cognitive functioning.Preferential investments in the human resources of boys have been common to many resource-poor settings (King and Mason 2001; Lloyd 2005), and the effects of such investments on gender gaps in child health are known (e.g., Hill and Upchurch 1995). Less well known is the extent to which gender gaps in resources that are accrued across the life course account for gender gaps in later-life health, despite known gender differences in the risks of illness, disability, and death. Demographic research on later-life health also has focused on physical conditions, even though dementia and neuropsychiatric disorders account for a large (~3%) and growing share of the disease burden worldwide (World Health Organization [WHO] 2007).This article assesses the determinants of cognitive functioning among older women and men (e.g., those aged 50 and older) in Ismailia, Egypt. It explores whether and to what extent (1) women have poorer cognitive functioning than men, (2) cognitive resources in childhood and adulthood have net positive associations with cognitive functioning for women and men, and (3) differences in the amounts and effects of women’s and men’s cognitive resources account for differences in their cognitive functioning. Egypt is a superb setting in which to conduct this work because of long-standing gender gaps in opportunities across the life course (e.g., Yount 2001; Yount and Sibai forthcoming) and poor knowledge about their potential effects on later-life cognitive functioning.     

Osteoporosis and Older Women:

Osteoporosis, a metabolic bone disorder, affects four times as many women as men. Each year 1.3 million fractures, primarily of the vertebra, hip, and wrist can be attributed to osteoporosis. Risk factors for the development of this disease include age, sex, body build, family history, race, loss of estrogen, calcium deficiency, sedentary lifestyle, smoking, and the excessive use of alcohol. Three common approaches used in the treatment and prevention of osteoporosis are hormone replacement therapies, nutrition interventions. and exercise programs. These strategies are aimed at maintaining or stabilizing bone mass and preventing further loss. Living with osteoporosis presents older women with a variety of physical, psychological, and social challenges. To maintain a productive and healthy lifestyle, older women must recognize their physical limitations and make adjustments in their daily lives to cope successfully with these changes.     

Education and Male-Female Differences in Later-Life Cognition: International Evidence From Latin America and the Caribbean

This study explores the role of early-life education for differences in cognitive functioning between men and women aged 60 and older from seven major urban areas in Latin America and the Caribbean. After documenting statistically significant differences in cognitive functioning between men and women for six of the seven study sites, I assess the extent to which these differences can be explained by prevailing male-female differences in education. I decompose predicted male-female differences in cognitive functioning based on various statistical models for later-life cognition and find robust evidence that male-female differences in education are a major driving force behind cognitive functioning differences between older men and women. This study therefore suggests that early-life differences in educational attainment between boys and girls during childhood have a lasting impact on gender inequity in cognitive functioning at older ages. Increases in educational attainment and the closing of the gender gap in education in many countries in Latin America and the Caribbean may thus result in both higher levels and a more gender-equitable distribution of later-life cognition among the future elderly in those countries.     

Understanding and reducing stress and psychological distress in older women with heart disease

Stress and psychological distress were assessed in 457 older women who were subsequently randomized to a six-week heart disease management program ("Women take PRIDE") or to a "usual care" control group. Baseline distress was significantly associated with age, symptoms, physical functioning, social support, optimism, and self-esteem (p < .05). Only 20% of women reported their physician had recommended reducing stress. At four months follow-up, intervention women compared to controls were significantly more likely to report reductions in stress levels (p = 0.02) and also showed improvement in emotional behavior (p = 0.09).     

Perceptions of aging among rural, midwestern senior citizens: signs of women's resiliency

This study utilized both quantitative and qualitative approaches to examine perceptions of aging among rural-dwelling senior citizens (203 women and 112 men), ages 65 and older. Quantitative results revealed that, despite no significant gender differences in the total number of medical conditions reported, women were less likely than men to report that health problems interfered with their daily functioning. Qualitative analyses revealed that women were particularly like to identify relationships, frame of mind, participating in activities, and religion/spirituality as important contributors to successful aging.     

Battered gay men: an exploration of abuse, help seeking, and why they stay

In comparison to a large body of literature about battered heterosexual women and a growing body about battered lesbians, this is one of the first published studies that investigates the experiences of battered gay and bisexual men. Results indicated that these men suffered patterns, forms, and frequencies of physical, emotional, and sexual abuse similar to what has been documented by research on battered heterosexual and lesbian women. Likewise, the most commonly reported reasons for staying--namely, hope for change and love for partner--appear to be universal to the experience of being battered. Unlike battered heterosexual women, respondents in this study were not likely to report that being financially trapped was a major reason why they had remained. HIV-status, however, appears to significantly influence their decision to remain. Moreover, lack of knowledge about domestic violence and the lack of availability of appropriate resources play a significant role in same-gender domestic violence victims' decisions to remain. Like battered lesbians, battered gay men infrequently sought assistance from battered women's services and perceived these services as not helpful. By contrast, individual counselors and agencies who provided individual counselors were rated as quite helpful.     

Blurring Boundaries? Immigration and Exogamous Marriages in Hong Kong

This article uses micro‐data from the Hong Kong census since 1991 to report trends in the integration of Chinese residents who were born either in Colonial Hong Kong or in Mainland China. We focus on marital exogamy by nativity for women aged 25–34. From 1991 to 2011, we found an increasing likelihood for Hong Kong native men and Mainland women to be married to one another. This increase reflects cross‐border marriages. Such exogamous marriages were associated with a lower degree of educational homogamy, since Hong Kong‐born men tend to be more educated than their Mainland spouses. They are also older than their immigrant wives. Implications for social distance between natives and immigrants in this context of exogamous marriages are discussed.     

Perceptions of Aging Among Rural,Midwestern Senior Citizens: Signs of Women's Resiliency

ABSTRACT

This study utilized both quantitative and qualitative approaches to examine perceptions of aging among rural-dwelling senior citizens (203 women and 112 men), ages 65 and older. Quantitative results revealed that, despite no significant gender differences in the total number of medical conditions reported, women were less likely than men to report that health problems interfered with their daily functioning. Qualitative analyses revealed that women were particularly like to identify relationships, frame of mind, participating in activities, and religion/spirituality as important contributors to successful aging.     

Understanding and Reducing Stress and Psychological Distress in Older Women with Heart Disease

ABSTRACT

Stress and psychological distress were assessed in 457 older women who were subsequently randomized to a six-week heart disease management program (“Women take PRIDE”) or to a “usual care” control group. Baseline distress was significantly associated with age, symptoms, physical functioning, social support, optimism, and self-esteem (p < .05). Only 20% of women reported their physician had recommended reducing stress. At four months follow-up, intervention women compared to controls were significantly more likely to report reductions in stress levels (p = 0.02) and also showed improvement in emotional behavior (p = 0.09).     

Social Networks and Support,Gender, and Racial/Ethnic Disparities in Hypertension Among Older Adults

Using data from the 2001 NHIS and the 2005–2006 and 2007–2008 NHANES, we examine how self-reporting a previous diagnosis of hypertension among adults aged 65+ differs by race/ethnicity for men and women; we explore the extent to which disparities are driven by group differences in social risk factors, particularly social support and integration; and last, whether these relationships mimic patterns seen for measured hypertension at interview. Findings indicate that rates of ever-diagnosed hypertension in both samples are highest among black seniors and older women and lowest among Mexican-American men, with the gender gap lowest among whites and substantially higher among blacks and Mexican-Americans. However, replication analyses of NHANES models using measured hypertension, instead of a self-report of having ever been diagnosed with hypertension, suggests that reporting bias and measurement error contribute to observed disparities, as racial/ethnic differences in hypertension rates are smaller when measured hypertension is examined, especially among women. Logistic regression models also show that while adjusting for group differences in measures of support and integration mediates some of the disparity in measured hypertension between Mexican-American and white seniors, adjusting for support and integration amplifies black-white disparities in both ever diagnosed and measured hypertension—driven primarily by adjustment for attendance at religious services, which reduces hypertension risk for all older adults but is more commonly reported among black seniors, especially women.     

Gender Difference in Sleep Problems: Focused on Time Use in Daily Life of Korea

Korea is well-known as one of the most sleepless country on the globe. Given the fact that sleep is closely connected with various health outcomes, we examined which group is more likely to experience sleep disorder problems within the context of time use. This study sets out to describe the differences in sleep disorder patterns between Korean men and women. In this study, we also tried to identify important socio-demoraphic factors and wake activity time use factors that might account for the sleep problem (short sleep/oversleep) and gender differences in sleep. Data from the original 2004 Korean Time Use Survey were used for this study (n = 16,958). Fifty-two percent of the respondents were women; the age range of the sample was 25–59 years. Results showed us that there was no gender differences found in dimension of short sleep. Still, women were less likely to be over sleeper rather than men, implying the existence of gender inequality in rest/free time. Results from the multinomial regression model showed that, although there were similarities in the impact of relevant factors, men’s sleep was more likely to be disturbed by their work role, while women’s sleep was affected by their work and family role. In this study, it was found that the gender difference in sleep problems was associated with time use, and especially the social roles that men and women occupied.     

Living Productively with Arthritis

Anhritis is the most commonly experienced chronic disease among older women. As such, it is essential for professionals to understand the disease process, treatment options, physiological and psychosocial implications as well as how to assist older arthrictic women in developing and implementing strategies for productive living. The disease process, treatment options, physiological and psychosocial implications are presented. The importance of patient education is stressed in addition to mechanisms for assisting older women in coping with pain, preventing or combating learned helplessness, minimizing functional limitations, addressing issues of sexual functioning, complying with medical regimen, and enhancing social supports. Managing stress and dealing with feelings are also discussed.     

Fertility trajectories and later-life depression among parents in England

We examine pathways between indicators of fertility tempo/quantum and depressive symptoms among parents aged 55+ with at least two children, using three waves of the English Longitudinal Study of Ageing. Using standard regression approaches and path analysis within the structural equation framework, we also investigate whether fertility trajectories mediated the association between childhood disadvantage and later-life depression. Results provide limited support for direct influences of fertility trajectories on depression, but indicate indirect linkages for both women and men. Associations are mediated by partnership history, social support, wealth, later-life smoking, and functional limitation. Associations between childhood disadvantage and later-life depression are partially mediated by fertility stressors. Results confirm the influence of life course experiences on depression at older ages and demonstrate the interlinked role of family and other life course pathways on later-life well-being.     

The Relationships between Activity and Quality of Life for Older Men and Women at Different Ages in Taiwan

This study investigated the relationships between types of activity and quality of life (QOL) for older men and women at different ages. Based on cross-sectional data that included 220 community-dwelling elderly persons aged 65 and older in southern Taiwan, the results showed that the participation rates in many activities declined with age for both genders. Social activity and solitary leisure activity were significantly associated with QOL for old-old men, but not for young-old men. Only social activity was significantly associated with QOL for young-old women, but there was no significant association between any activity and QOL for old-old women.