Browsing by Subject "Older adults"

AbstractBackground: Common mental disorders (CMDs) can be defined as depression and anxiety, which have a great influence on the quality of life among older adults. CMDs are becoming a serious public health problem among the older adult population, especially depression. Effective management can improve the overall well-being of older adults. The policy significance of combining the hierarchical healthcare system (HHS) and CMDs is to promote the screening of high-risk elderly groups represented by depression, promote the prevention system of early detection, diagnosis, and treatment of elderly diseases, improve the early prevention and management mechanism of mental disorders, improve the psychological serviceability of older adults, and achieve healthy aging. This study aims to investigate the attitudes of older adults in Kunshan towards mental health services in the community and to assess the conditions and challenges of HHS for older adults’ CMDs in Kunshan. Methods: The quantitative analytical sample is restricted to older adults aged over 60 years who lived in Tinglin or Jinxi communities in Kunshan and who responded to the attitude survey (n=100). Attitudes were measured by asking older adults about their willingness or concern for community mental health services. The two-sample t-test and the chi-square test were used to compare the characteristics of the Tinglin and Jinxi communities. Logistic regression was used to determine the adjusted associations between sex, education, and attitudes related to managing common mental disorders in two communities. The qualitative data is obtained from semi-structured qualitative interviews with 7 relevant experts from 7 medical or social departments in Kunshan, including Jinxi People's Hospital, Jinxi Community Health Center (CHC), Mental Disorders Prevention and Treatment Department (MDPTD) of CHC in Jinxi, Kunshan Mental Health Center (KMHC), Kunshan First People's Hospital, Tinglin Community, and the Civil Affairs Bureau (CAB). The semi-structured interview was designed around the current situation of medical systems and mental health services in Kunshan, challenges in managing CMDs in older adults, and science communication for mental health. All interviews will be imported into Nvivo 12 for thematic analysis through grounded theory.   Results: 74% of participants from Tinglin have an education level of Grade 9 and above, but only 28% of those from Jinxi at the same educational attainment. Tinglin residents demonstrated higher levels of understanding and acceptance of mental health. 60% of participants from Tinglin understand mental health, while only 18% in Jinxi. Tinglin residents (17%) show a higher willingness to seek professional treatment compared to Jinxi (4%). Tinglin (68%) exhibited a more favorable attitude towards community-recommended treatment compared to Jinxi (36%). Residents in Tinglin (50%) expressed the necessity of professional psychiatrists in the community, while only 14% in Jinxi. However, only 30% of residents in Tinglin showed a low will to cooperate, while 66% in Jinxi. It was also found that there was a significant association between education level and attitudes towards mental health in older adults. The qualitative results first introduced Kunshan’s family physicians and HHS model, management of severe mental disorders (SMD), screening for dementia, daily care center (DCC) and psychiatric rehabilitation station (PRS), and social workers policy. These provide guidance and experience for the implementation of management of CMD in the elderly. However, the implementation of HHS for older adults’ CMDs is hampered by multiple obstacles from older adults, their families, communities, the medical system, society, and the government. The interviewees also stressed the importance of science communication. Conclusions: With the current level of social development and medical resources, implementing HHS for the CMDs in older adults in Kunshan faces many difficulties at this stage.

Introduction

Methods

Results

Conclusions

Many older adults in the developing world rely on their adult children for financial, instrumental, and emotional support. The People's Republic of China (PRC), which will experience rapid population aging in the current century, is no exception. Many scholars and policy-makers are concerned that rapid economic, social, and demographic change in China is leading to a decline in traditional support for aging parents. This study examines the impact of family ties and economic resources on the receipt of support and the health of older adults across communities in China at different levels of economic development.

I analyze data from the 2002 and 2008 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) as well as the 2000 and 2005 1% Chinese Census. Initiated in 1998, the CLHLS interviewed older adults residing in a random sample of counties and cities in 22 provinces and municipalities of China. Additionally, in 2002 a subset of adult children of CLHLS respondents were also interviewed in a separate survey. Furthermore, the 2008-2009 wave collected additional data from middle-aged and older adults residing in specially designated "longevity areas" in China. In addition to the standard questionnaire and health exam, samples of blood and urine were also collected by medical personnel.

The first empirical chapter of this dissertation examines the association between filial piety/altruism and financial transfers to aging parents from adult children using factor analysis, binary logistic regression, and linear regression. The second paper looks at the socioeconomic-status health gradient using biomarker data among older adults residing in longevity areas using binary logistic regression analysis. The third paper examines both individual-level and community-level determinants of non-normative intergenerational coresidence - living with an adult daughter instead of an adult son-- through multilevel binary logistic models analyzing both survey and census data.

I find that (1) adult children's attitudes towards filial piety and family values are associated with both presence and amount of financial transfers to older parents, net of controls for adult child's socioeconomic status, parental need, parents' earlier life transfers to children, and whether elderly parents' provide instrumental support to adult children. (2) Similar to previous research in middle-income countries, many biomarkers were not associated with socioeconomic status but those that were demonstrated a reversed gradient - higher socioeconomic status was associated with worse health. (3) Greater numbers of daughters, higher levels of individual socioeconomic status, and residing in a more developed community was associated with greater likelihood of coresidence with adult daughters versus adult sons.

Background and aim: This study aimed at building the prediction model of all-cause mortality among Chinese dwelling elderly with different methods including regression models and machine learning models and to compare the performance of machine learning models with regression models on predicting mortality. Additionally, this study also aimed at ranking the predictors of mortality within different models and comparing the predictive value of different groups of predictors using the model with the best performance.Method: I used data from the Healthy Ageing and Biomarkers Cohort Study, a sub-study of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). The baseline survey was conducted in 2008 and participants were followed every 2-3 years till 2018. The analysis sample included 2,448 participants. I used totally 117 predictors to build the prediction model, including 65 questionnaires, 39 biomarkers, and 15 genetics predictors. Four models were built (XG-Boost, random survival forest [RSF], Cox regression with all variables, and Cox-backward). I used C-index and integrated Brier score to evaluate the performance of those four models. Results: The XG-Boost model and RSF model shows slightly better predictive performance than Cox models and Cox-backward models based on the C-index and integrated Brier score. Age. The activity of daily living and Mini-Mental State Examination score were identified as the top 3 predictors in the XG-Boost and RSF models. Biomarker and questionnaire predictors have a similar predictive value, while genetic predictors have no addictive predictive value when combined with questionnaire or biomarker predictors. Conclusion: In this work, it is shown that machine learning techniques can be a useful tool for both prediction and its performance sightly outperformed the regression model in predicting survival.

Retirement is the quintessential transition from mid-life to late-life for many working Americans. However, questions about the positive and negative effects of retirement have sparked widely divergent empirical findings. Developmental theories of self-regulation may add to the understanding of the subtle differences and transitions within retirement. Retirement may be viewed as a transition in resources (e.g., psychological, social, and financial), so that individual mental health outcomes are linked to how well these resources are reallocated. According to goal disengagement perspectives, failure either in disengagement from past goals or reengagement in new goals can lead to decreased well-being and increased depression. Further, as individuals enter late-life, their focus may turn away from growth and achievement and more toward preventing losses and maintaining current resources. In the present study, it was hypothesized that when pre-retirement individuals were compared against early and late post-retirement individuals, engagement in developmentally relevant goals (e.g., self, family, and leisure) in retirees would be associated with better mental health outcomes while retirees who reported continued engagement in less developmentally accessible goals (i.e., occupational and financial) would report worse outcomes.

A total of 100 study participants (aged 50 to 84) were interviewed about their current goals and completed self-report measures of depression, well-being, social support, physical health, and regulatory focus. Interview data were coded for goal content as well as for regulatory focus. Findings did not support the hypotheses, as there were no significant differences among the 47 pre-retirement, 29 early post-retirement, and 24 late post-retirement participants in their goal content or regulatory focus. Goal content also was not associated differentially with depression or well-being among the three groups. However, the interview data did provide valuable information about the heterogeneous and fluid nature of retirement. Retirement, rather than a clear loss in certain resources (i.e., financial and occupational) and a clear gain in others (i.e., time and personal freedom), seemed to be a renegotiation of those resources. Furthermore, even pre-retirement participants named retirement goals, suggesting that, if a goal transition did occur, it may have been a more conscious, gradual process.

Objective

Methods

Impact

Background

Methods

Results

Conclusion