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13 pages, 779 KiB

Open AccessArticle

For Children or Grandchildren?—The Motivation of Intergenerational Care for the Elderly in China

by Juan Luo and Mengmeng Cui

Int. J. Environ. Res. Public Health 2023, 20(2), 1441; https://doi.org/10.3390/ijerph20021441 - 12 Jan 2023

Cited by 1 | Viewed by 1545

Abstract

Considering our aging society and declining birthrate, we studied the motivations for intergenerational care for the elderly in China and analyze it through different generations of children and grandchildren. This paper mainly uses logistic regression analysis, descriptive statistics, heterogeneity analysis, robustness analysis, and [...] Read more.

Considering our aging society and declining birthrate, we studied the motivations for intergenerational care for the elderly in China and analyze it through different generations of children and grandchildren. This paper mainly uses logistic regression analysis, descriptive statistics, heterogeneity analysis, robustness analysis, and other quantitative methods to analyze the data of the China Household Tracking Survey (CFPS) in 2018. According to the relevant research results, we believe that both children or grandchildren may be motivations. However, the proportion of factors is higher because the proportion of parents choosing alternate-generation care has increased based on the financial support provided by their children, and underdeveloped children are more likely to be favored by their parents to provide alternate-generation care. This paper is more inclined to consider children to be the main motivator for intergenerational care under the dual motives of “feedback” exchange and altruism through “helping the weak”. Next, the influence factors of a series of control variables are analyzed for the groups that take care of the next generation, and it is found that the intimacy between the elderly and their spouses, the number of meals with their families per week, and the use of electronic products will all affect the degree of care provided by their fathers. Based on this, this paper proposes that the three forces of government, society, and family are needed for joint support of the elderly when they are taking care of each other. We will make generational care less responsible, free and burdensome, and at the same time respect the right of the elderly to say “no” to providing care. Full article

(This article belongs to the Special Issue Healthy Aging)

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12 pages, 354 KiB

Open AccessArticle

Nutritional Status and Sarcopenia in Nursing Home Residents: A Cross-Sectional Study

by Nan Hua, Yifan Zhang, Xiangmin Tan, Li Liu, Yihan Mo, Xuemei Yao, Xiuhua Wang, James Wiley and Xiaoqing Wang

Int. J. Environ. Res. Public Health 2022, 19(24), 17013; https://doi.org/10.3390/ijerph192417013 - 18 Dec 2022

Cited by 3 | Viewed by 2093

Abstract

Objective: This study aimed to assess the nutritional status and sarcopenia in older people living in nursing homes. Methods: This cross-sectional study enrolled 386 older adults in nursing homes in Hunan Province, China. Assessments included the Mini Nutritional Assessment Short Form for nutrition [...] Read more.

Objective: This study aimed to assess the nutritional status and sarcopenia in older people living in nursing homes. Methods: This cross-sectional study enrolled 386 older adults in nursing homes in Hunan Province, China. Assessments included the Mini Nutritional Assessment Short Form for nutrition risk, Dietary Diversity Score for dietary diversity and Mini Mental State Examination for cognitive status. Sociodemographic (e.g., age, sex and educational level), health-related characteristics (e.g., food intake, self-care status and medication), body composition (e.g., body mass index [BMI], protein, body fat mass [BFM], percent body fat [PBF], skeletal muscle index [SMI] and total body water [TBW]) and anthropometric parameters data (e.g., calf circumference [CC], upper arm circumference [UAC], handgrip and gait speed) were also collected. Malnutrition and their associated risk were analyzed by multivariable Poisson regression analysis. Results: In total, 32.4% of participants (n = 125) were at risk of malnutrition and 49.7% (n = 192) suffered from sarcopenia. Nutritional status was positively associated with age (risk ratio [RR] = 1.03), sarcopenia (RR = 1.88), tooth loss affecting food intake (RR = 1.45), low self-care status (RR = 1.82) and moderate/inadequate dietary diversity (RR = 2.04) and negatively associated with one child (RR = 0.27), BMI (RR = 0.82), protein (RR = 0.76), BFM (RR = 0.91), PBF (RR = 0.94), SMI (RR = 0.65), TBW (RR = 0.94), CC (RR = 0.89) and UAC (RR = 0.86). Conclusions: Age, number of children, sarcopenia, food intake, self-care status, dietary diversity and body composition were associated with malnutrition among nursing home residents. For vulnerable groups, researchers should focus on raising the body composition indicators, such as BMI, protein, BFM, SMI and TBW and measuring CC and UAC for initial screening. Full article

(This article belongs to the Special Issue Healthy Aging)

13 pages, 820 KiB

Open AccessArticle

Self-Rated Health and Life Satisfaction among Elderly Migrants in China: A Moderated Mediation Model of Resilience and Upward Intergenerational Support

by Li Zhang, Yanjie Hou, Hao Wang and Jun Yao

Int. J. Environ. Res. Public Health 2022, 19(24), 17009; https://doi.org/10.3390/ijerph192417009 - 18 Dec 2022

Cited by 1 | Viewed by 1556

Abstract

Objective: This study aimed to test whether resilience mediates the association between self-rated health and life satisfaction and the moderated effect of upward intergenerational support among elderly migrants in China. Method: We used self-reported data collected from 654 elderly migrants in Nanjing. The [...] Read more.

Objective: This study aimed to test whether resilience mediates the association between self-rated health and life satisfaction and the moderated effect of upward intergenerational support among elderly migrants in China. Method: We used self-reported data collected from 654 elderly migrants in Nanjing. The regression analysis using bootstrapping methods was conducted to explore the mediating and moderating effects. Results: Resilience mediated the relationship between self-rated health and life satisfaction among elderly migrants in China. The moderated mediation analysis indicated that the upward intergenerational support moderated the path between self-rated health and resilience. Specifically, compared with those with a low level of emotional support, the self-rated health of elderly migrants with a high level of emotional support has a stronger effect on resilience. Moreover, the self-rated health of elderly migrants with a low level of financial support has a stronger effect on resilience than those with a higher level of financial support. Conclusion: Resilience could partially mediate the effect of self-rated health on life satisfaction among elderly migrants in China, and upward intergenerational support moderated the indirect relationship between self-rated health and life satisfaction via resilience. Full article

(This article belongs to the Special Issue Healthy Aging)

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18 pages, 2179 KiB

Open AccessArticle

Promoting the Integration of Elderly Healthcare and Elderly Nursing: Evidence from the Chinese Government

by Mo Hu, Zhiyuan Hao and Yinrui Yin

Int. J. Environ. Res. Public Health 2022, 19(24), 16379; https://doi.org/10.3390/ijerph192416379 - 07 Dec 2022

Cited by 1 | Viewed by 1434

Abstract

The increase of the aging population in China and the rise of the concept of healthy aging have accelerated the transformation and upgrading of the traditional elderly nursing pattern. Nevertheless, there is a critical limitation existing in the current situation of China’s elderly [...] Read more.

The increase of the aging population in China and the rise of the concept of healthy aging have accelerated the transformation and upgrading of the traditional elderly nursing pattern. Nevertheless, there is a critical limitation existing in the current situation of China’s elderly care, i.e., the medical institutions do not support elderly nursing and the elderly nursing institutions do not facilitate access to medical care. To eliminate the adverse impact of this issue, twelve ministries and commissions of the Chinese government have jointly issued a document, i.e., the Several Opinions on Further Promoting the Development of Combining the Healthcare with the Elderly care (SOFPDCHE), to provide guidance from the government level for further promoting the integration of elderly healthcare and elderly nursing. Under this background, this paper constructs a healthcare–nursing information collaboration network (HnICN) based on the SOFPDCHE, proposing three novel strategies to explore the different roles and collaboration relationships of relevant government departments and public organizations in this integration process, i.e., the node identification strategy (NIS), the local adjacency subgroup strategy (LASS), and the information collaboration effect measurement strategy (ICEMS). Furthermore, this paper retrieves 484 valid policy documents related to “the integration of elderly healthcare and elderly nursing” as data samples on the official websites of 12 sponsored ministries and commissions, and finally confirms 22 government departments and public organizations as the network nodes based on these obtained documents, such as the National Health Commission of the People’s Republic of China (NHC), the Ministry of Industry and Information Technology of the People’s Republic of China (MIIT), and the National Working Commission on Aging (NWCA). In terms of the collaboration effect, the results of all node-pairs in the HnICN are significantly different, where the collaboration effect between the NHC and MIIT is best and that between the NATCM and MIIT is second best, which are 84.572% and 20.275%, respectively. This study provides the quantifiable results of the information collaboration degree between different government agencies and forms the optimization scheme for the current collaboration status based on these results, which play a positive role in integrating elderly healthcare and elderly nursing and eventually achieving healthy aging. Full article

(This article belongs to the Special Issue Healthy Aging)

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12 pages, 422 KiB

Open AccessArticle

by Michael Annear, Yasuo Shimizu and Tetsuhiro Kidokoro

Int. J. Environ. Res. Public Health 2022, 19(20), 13509; https://doi.org/10.3390/ijerph192013509 - 19 Oct 2022

Cited by 2 | Viewed by 1576

Abstract

Background and objectives: Health-related expectations regarding aging is a gerontological construct that is potentially predictive of morbidity and mortality in later life. The Expectations Regarding Ageing scale (ERA-12) is a widely used measure of health-related expectations, although it has not previously been administered [...] Read more.

Background and objectives: Health-related expectations regarding aging is a gerontological construct that is potentially predictive of morbidity and mortality in later life. The Expectations Regarding Ageing scale (ERA-12) is a widely used measure of health-related expectations, although it has not previously been administered in Japanese. The present research aimed to elucidate the psychometric properties of the first Japanese translation of the ERA-12 and evaluate health-related expectations among middle-aged and older Japanese. Research design and methods: Repeated online surveys were conducted with representative quota samples of middle-aged and older adults in Tokyo during 2021 (N = 1600). Primary outcome measures included total and subscale scores on a Japanese translation of the ERA-12 (ERA-12-J) addressing perceptions of physical, mental, and cognitive health. Standard measures were also used to gather information regarding respondent demographic details, general health, and health-related behavior. Results: The ERA-12-J and associated subscales showed acceptable test-retest reliability (t(1598) = 0.60, p = 0.63), internal consistency (α > 0.80), inter-item correlation (r = 0.21–0.78) and item-total correlation (r = 0.53–0.73). Confirmatory Factor Analysis verified the hypothesized three-factor structure and construct validity on four common indices of fit (GFI = 0.968; CFI = 0.978; AGFI = 0.950; RMSEA = 0.059). ERA-12-J scores among Japanese respondents revealed prevailing negative sentiments concerning physical and cognitive health, with less negative sentiment regarding mental health. Significant and independent differences emerged concerning gender and age cohort, with middle-aged adults and females holding more negative expectations about their future health. Discussion and implications: The ERA-12-J provides a sound basis for the elucidation of health-related expectations about aging in Japan and a useful tool for international comparative studies. Education and workplace intervention may be required in Japan to address age and gender disparities in health-related expectations. Full article

(This article belongs to the Special Issue Healthy Aging)

16 pages, 608 KiB

Open AccessArticle

Long-Term Influence of Locus of Control and Quality of Life on Metabolic Profile in Elderly Subjects with Type 2 Diabetes

by Annalisa Giandalia, Marta Ragonese, Eugenio Alessi, Maria C. Ruffo, Alberto Sardella, Alessandro Cuttone, Maria A. Aragona, Antonio G. Versace, Giorgio Basile, Domenico Cucinotta, Giovanni Squadrito and Giuseppina T. Russo

Int. J. Environ. Res. Public Health 2022, 19(20), 13381; https://doi.org/10.3390/ijerph192013381 - 17 Oct 2022

Cited by 2 | Viewed by 1309

Abstract

Background: The Locus of Control (LOC) is a mental disposition indicating the individuals’ belief that disease-related outcomes are under their own control (Internal), dependent on others (External), or dependent on chance (Chance). Quality of Life (QoL) and LOC may have complex effects on [...] Read more.

Background: The Locus of Control (LOC) is a mental disposition indicating the individuals’ belief that disease-related outcomes are under their own control (Internal), dependent on others (External), or dependent on chance (Chance). Quality of Life (QoL) and LOC may have complex effects on self-care activities and diabetes management in subjects with type 2 diabetes (T2D). The aim of the present study was to evaluate the predictive role of LOC and QoL scores on metabolic control in elderly T2D outpatients, secondly evaluating potential gender differences. Methods: An extensive set of questionnaires was administered to a group of consecutive elderly T2D outpatients on oral glucose-lowering drugs attending a single diabetes center. Personal and clinical variables were analyzed at baseline (between 1 February and 31 March 2015) and after 6 years of follow-up. Results: At baseline, study participants showed an overall good metabolic control. Diabetes Specific Quality of Life (DSQoL) scores indicated an overall good QoL in both genders, with a higher DSQoL satisfaction score in women. Both genders presented higher scores in the LOC-Internal domain, with men reaching higher scores in the LOC-External domain than women. At the 6-years follow-up, subjects with baseline higher LOC-External score presented better metabolic outcome. In the regression analysis, LOC-External score was an independent predictor of good metabolic control maintenance, but this result was only statistically significant in men. Conclusions: LOC scores may influence long-term glycemic control in elderly T2D patients on oral glucose-lowering drugs. Full article

(This article belongs to the Special Issue Healthy Aging)

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12 pages, 469 KiB

Open AccessArticle

Multidimensional Factors Affecting Successful Aging among Empty-Nesters in China Based on Social-Ecological System Theory

by Hui Chang, Jia Zhou and Zhiwen Wang

Int. J. Environ. Res. Public Health 2022, 19(19), 11885; https://doi.org/10.3390/ijerph191911885 - 20 Sep 2022

Cited by 11 | Viewed by 2184

Abstract

Background: This study aims to identify the status of successful aging and the factors influencing empty-nest elderly in China based on the social-ecological system theory. Methods: The data came from the follow-up survey (2018) of the China Health and Retirement Longitudinal Study and [...] Read more.

Background: This study aims to identify the status of successful aging and the factors influencing empty-nest elderly in China based on the social-ecological system theory. Methods: The data came from the follow-up survey (2018) of the China Health and Retirement Longitudinal Study and 3074 empty-nesters aged 60 and over are included. Chi-squared tests and logistic regressions were used to identify factors associated with successful aging. Results: The successful aging rate of empty-nesters in China was 5.9%. The results of the multifactor analysis showed that younger age, higher education level, good self-rated health, good hearing, high life satisfaction, availability of financial resources at the microsystem level, higher frequency of contact with children at the mesosystem level, and medical insurance at the macrosystem level were the contributing influencing factors for successful aging of empty-nesters in China. Conclusion: This study is an important attempt to explore the successful aging of empty-nesters in China. Because this study is based on social-ecological system theory, it confirms the important role of individual characteristics of older adults and their surrounding environment in achieving successful aging. Therefore, we should pay attention not only to the individual characteristics of the elderly, but also to the role of the surrounding environment on the health of the elderly, so that we can develop intervention measures to promote their successful aging. Full article

(This article belongs to the Special Issue Healthy Aging)

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16 pages, 885 KiB

Open AccessProtocol

The Impact of a Yoga-Based Mindfulness Intervention versus Psycho-Educational Session for Older Adults with Mild Cognitive Impairment: The Protocol of a Randomized Controlled Trial

by Maryam Farhang, Graciela Rojas, Pablo Martínez, Maria Isabel Behrens, Álvaro I. Langer, Marcela Diaz and Claudia Miranda-Castillo

Int. J. Environ. Res. Public Health 2022, 19(22), 15374; https://doi.org/10.3390/ijerph192215374 - 21 Nov 2022

Cited by 2 | Viewed by 2561

Abstract

Background: There is a global agreement in the medical community that a significant proportion of dementia cases could be prevented or postponed. One of the factors behind this agreement comes from scientific evidence showing that mind-body interventions such as mindfulness and yoga for [...] Read more.

Background: There is a global agreement in the medical community that a significant proportion of dementia cases could be prevented or postponed. One of the factors behind this agreement comes from scientific evidence showing that mind-body interventions such as mindfulness and yoga for the elderly have been related to a range of positive outcomes, including improved cognition performance in seniors with mild cognitive impairment (MCI). Objective: This study aims to evaluate the effectiveness of a yoga-based mindfulness intervention (YBM) versus psychoeducational sessions for older adults with MCI attending Hospital Clinic Universidad de Chile in Santiago. Method: Two-arm, individually randomized controlled trial (RCT) will be carried out at Clinical Hospital Universidad de Chile in Santiago. Older people over 60 years with any type of MCI using a score < 21 in the Montreal Cognitive Assessment (MoCA) test and a score of 0.05 in the Clinical Dementia Rating (CDR) Scale; and with preserved activities of daily living will be randomly assigned with an allocation ratio of 1:1 in either the yoga-based mindfulness intervention or the active control group based on the psycho-educational program. People who have performed yoga and/or mindfulness in the last 6 months or/and people with a psychiatric clinical diagnosis will be excluded from the study. Montreal Cognitive Assessment, the Lawton Instrumental Activities of Daily Living Scale (IADL), the Barthel Index (BI), the Pemberton happiness index, the Geriatric Anxiety Inventory (GAI) as well as the Geriatric Depression Scale (GDS-5) will be administered by blinded outcomes assessors before random assignment (Pre-test), the week following the last session of the intervention (post-test), and then after 3- and 6-months follow-up. Results: The YBM intervention protocol based on a video recording has been adapted and designed. This is the first RCT to examine the effects of a yoga-based mindfulness intervention in improving cognitive and physical functions and mental health outcomes for Chilean elderly diagnosed with MCI. It is expected to be implemented as an acceptable and effective non-pharmacological option for older people with MCI. Conclusion: Providing evidence-based programs such as preventive therapy for Alzheimer’s disease has relevant implications for public mental health services in Chile. Full article

(This article belongs to the Special Issue Healthy Aging)

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