Health Services Utilization Among Chinese American Older Adults: Moderation of Social Support With Functional Limitation.
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ABSTRACT:
SUBMITTER: Wang J
PROVIDER: S-EPMC6312757 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Family members and friends are important for the psychological well being of older adults. The present study examined the relative contribution of these two sources of support to life satisfaction among Chinese older adults living in Hong Kong. The moderating role of familism, which represents the commitment of family members to the family, was also examined. One hundred and eight Chinese older adults participated in the study. Findings suggest that, in general, family support contributes more to the life satisfaction of older adults than does friend support. While emotional support from family members is beneficial to life satisfaction of older adults regardless of individual differences in familism, instrumental support contributes more to life satisfaction for older adults with higher familism.
| S-EPMC5546368 | biostudies-other
Project description:ObjectiveDisability and social support can impact depressive symptoms of the elderly. Yet, studies infrequently discuss the moderating role of social support when evaluating the association between disability and depressive symptoms. The purpose of this study was to explore the association between disability, social support, and depressive symptoms among the Chinese elderly, and further examine the moderating effect of social support.Materials and methodsUsing the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS) data set, we finally selected 9,231 Chinese elderly after screening. The Center for Epidemiologic Studies Depression Scale (CESD-10) was used to evaluate depressive symptoms in the elderly. Disability was measured by basic activities of daily living (B-ADL) and instrumental activities of daily living (I-ADL). Social support included contact with family and friends, sick care, and money received, measured by five self-reported questions. We used multiple linear regression and moderating model to explore the association between disability, social support, and depressive symptoms.ResultsA total of 9,231 patients were included in this study, and approximately 26.75% of the elderly had depressive symptoms. Study found that depressive symptoms were associated with social support (β B-ADL = -0.108, 95% CI: -0.168- -0.047; β I-ADL = -0.098, 95% CI: -0.156- -0.039), β B-ADL (β = 0.296, 95% CI: 0.248-0.343) and I-ADL (β = 0.174, 95% CI: 0.152-0.195). Moreover, the result also showed that social support moderated the effects of B-ADL ( βB-ADL*socialsupport = 0.034, 95% CI: 0.014-0.053, F = 11.57, p = 0.001) and I-ADL ( βI-ADL*socialsupport = 0.025, 95% CI: 0.017-0.033) on depressive symptoms.ConclusionsThe study suggests that disability and social support can affect depressive symptoms, and social support moderates the effect of disability on depressive symptoms. Therefore, taking effective measures to reduce the elderly disability rate of disability and increase their social support are necessary condition for realizing mental health.
| S-EPMC9437525 | biostudies-literature
Project description:The share of the population aged 65 years and over is increasing in every EU Member State, candidate country, and EFTA Member State. WHO/Europe has established a Subnetwork on Healthy Ageing within the European Healthy Cities Network and provides guidance to Member States in developing profiles of healthy ageing, since, given the increasing number of older adults, maintaining their health status is a crucial issue. This article, which is part of the Latvian national scientific program VPP INOSOCTEREHI, focuses on the issues related to the design, implementation, and assessment of user interfaces that can maximize usability in social telerehabilitation systems for older adult users. This is a very real challenge, since older adults don't form a homogeneous class. Investigating older adults' skills and their attitudes towards the perceived usefulness of computer applications could be helpful in identifying some sub-sets of older adult users and their typical behaviours.
| S-EPMC5536724 | biostudies-other
Project description:It is important to measure the prevalence and onset of limitations for older adults to take critical day-to-day activities in the population. However, too often, only very older people are covered, and too few activities are included in the studies. Using a nationally representative sample from 2011 to 2018 (N = 16, 381), this study characterizes the limitation pattern covering ADL and IADL activities among middle-aged and older adults in China. We use survival models to characterize the limitation transition. We find that half of the population become limited in activities including housekeeping, toileting, managing money, and cooking in their early 70s, followed by shopping, bathing, transferring and dressing in their late 70s, continence, and taking medications in their early 80s, and feeding in their early 90s. In addition, women show significantly younger age of limitation onsets for all activities except continence.
| S-EPMC10351716 | biostudies-literature
Project description:ObjectiveTo characterize comorbid chronic conditions, describe health services use, and estimate health care costs among community-dwelling older adults with prior stroke.MethodsThis is a retrospective cohort study using administrative data from Ontario, Canada. We identified all community-dwelling individuals aged 66 and over on April 1, 2008 (baseline), who had experienced a stroke at least 6 months prior. We estimated the prevalence of 14 comorbid conditions at baseline; we captured all physician visits, emergency department visits, hospital admissions, home care contacts, and associated costs over 5 years stratifying by number of comorbid conditions. Where possible, we distinguished between health services use for stroke- and non-stroke-related reasons.ResultsA total of 29,673 individuals met our criteria. Only 1% had no comorbid conditions, while 74.9% had 3 or more. The most common conditions were hypertension (89.8%) and arthritis (65.8%); 5 other conditions had a prevalence of 20% or more (ischemic heart disease, diabetes, chronic obstructive pulmonary disease, inflammatory bowel disease, and dementia). Use of all health services doubled with increasing comorbidity and was largely attributed to non-stroke-related reasons. Total and per-patient costs increased with comorbidity. Main cost drivers shifted from physician and home care visits to hospital admissions with greater comorbidity.ConclusionsOur findings demonstrate the importance of community-based patient-centered care strategies for stroke survivors that address their range of health needs and prevent more costly acute care use.
| S-EPMC5109944 | biostudies-literature
Project description:BackgroundIn older age health needs and demand for health services utilization increase. Individual's social relationships can play a decisive role regarding the utilization of outpatient health care services. This systematic review examines the associations of structural and functional dimensions of social relationships with outpatient health services use of older adults.MethodsThe databases PubMed, CINAHL, SocINDEX, PsycINFO, International Bibliography of the Social Sciences (IBSS), Sociological Abstracts, and Applied Social Sciences Index and Abstracts (ASSIA) were searched in February 2016. The methodological and reporting quality of the articles was assessed and the results were synthesized descriptively and systematically.ResultsOut of 1.392 hits, 36 articles (35 studies) were included in the systematic review. The methodological and reporting quality of the included articles was reasonable. Various structural and functional characteristics of social relationships were associated with the use (yes/no) and the frequency of using outpatient care among older adults. The majority of the associations between structural dimensions of social relationships and the use of physicians were positive and moderate in strength. The associations between functional dimensions of social relationships and the probability of using physician services were inconsistent and varied in strength. For the most part, social relationship variables assigned to the structural dimension were positively and weakly to moderately associated with the frequency of physician visits. Functional aspects of social relationships also tended to have positive associations with the frequency of physician utilization. The associations were weak to moderate in strength.ConclusionsMeasuring social relationships and their influence on health services use is a challenging methodological endeavor indicated by the inconclusive results. The results suggest that the outpatient care utilization behavior of older individuals being structurally and functionally integrated in social relationships is different to older adults being socially isolated or having no social support. All in all, the current status of quantitative data was insufficient. Future health services research should accentuate social ties in more detail, especially according to quality aspects of social relationships.
| S-EPMC5619811 | biostudies-literature
Project description:ObjectiveThis study examined the moderating effect of overall social support and the different types of social support on cognitive functioning in depressed older adults. We also investigated whether the moderating effect varied according to age.MethodsA total of 2,500 older adults (≥60 years old) from Shanghai, China were enrolled using a multistage cluster sampling method. Weighted linear regression and multiple linear regression was utilized to analyze the moderating effect of social support on the relationship between depressive symptoms and cognitive function and to explore its differences in those aged 60-69, 70-79, and 80 years and above.ResultsAfter adjusting for covariates, the results indicated that overall social support (β = 0.091, p = 0.043) and support utilization (β = 0.213, p < 0.001) moderated the relationship between depressive symptoms and cognitive function. Support utilization reduced the possibility of the cognitive decline in depressed older adults aged 60-69 years (β = 0.310, p < 0.001) and 80 years and above (β = 0.199, p < 0.001), while objective support increased the possibility of cognitive decline in depressed older people aged 70-79 years (β = -0.189, p < 0.001).ConclusionOur findings highlight the buffering effects of support utilization on cognitive decline in depressed older adults. We suggest that age-specific measures should be taken when providing social support to depressed older adults in order to reduce the deterioration of cognitive function.
| S-EPMC10213363 | biostudies-literature
Project description:BackgroundInsufficient social support is associated with increased mortality among older adults. Lung cancer is primarily a disease of older adults and is the leading cause of all cancer deaths. We assessed the association of social support with outcomes among older adults with lung cancer.Materials and methodsAdults age 65 and older with lung cancer with a completed geriatric assessment (GA) were assessed. Emotional social support (ES) and tangible (material, instrumental) support (TS) measures and patient characteristics were obtained from the GA. The electronic health record was used to extract clinical variables. Simple linear regression models evaluated the association between social support scales with patient and clinical factors.Results79 adults were assessed. White race was positively associated with ES score (p=.04), while higher BMI (p=.03), depression (p=.03) and anxiety (p=.02) were associated with worse ES. Higher BMI was associated with higher/better TS score (p=.02) while living alone was associated with lower/worse TS score (p=.03). Completion of platinum-based doublet chemotherapy with immunotherapy as planned was associated with higher ES scores (p=.02) and higher TS scores (p=.02). Disease progression was associated with lower ES scores (p=.03).ConclusionSocial support may influence clinical outcomes in older adults with lung cancer. As lung cancer often portends to poor prognosis, social support may be an important prognostic indicator.
| S-EPMC8970686 | biostudies-literature
Project description:Objectives: Using the Andersen's Behavioral Model of Health Services Use, we explored social, behavioral, and health factors that are associated with emergency department (ED) utilization among underserved African American (AA) older adults in one of the most economically disadvantaged urban areas in South Los Angeles, California. Methods: This cross-sectional study recruited a convenience sample of 609 non-institutionalized AA older adults (age ? 65 years) from South Los Angeles, California. Participants were interviewed for demographic factors, self-rated health, chronic medication conditions (CMCs), pain, depressive symptoms, access to care, and continuity of care. Outcomes included 1 or 2+ ED visits in the last 12 months. Polynomial regression was used for data analysis. Results: Almost 41% of participants were treated at an ED during the last 12 months. In all, 27% of participants attended an ED once and 14% two or more times. Half of those with 6+ chronic conditions reported being treated at an ED once; one quarter at least twice. Factors that predicted no ED visit were male gender (OR = 0.50, 95% CI = 0.29-0.85), higher continuity of medical care (OR = 1.55, 95% CI = 1.04-2.31), individuals with two CMCs or less (OR = 2.61 (1.03-6.59), second tertile of pain severity (OR = 2.80, 95% CI = 1.36-5.73). Factors that predicted only one ED visit were male gender (OR = 0.45, 95% CI = 0.25-0.82), higher continuity of medical care (OR = 1.39, 95% CI = 1.01-2.15) and second tertile of pain severity (OR = 2.42, 95% CI = 1.13-5.19). Conclusions: This study documented that a lack of continuity of care for individuals with multiple chronic conditions leads to a higher rate of ED presentations. The results are significant given that ED visits may contribute to health disparities among AA older adults. Future research should examine whether case management decreases ED utilization among underserved AA older adults with multiple chronic conditions and/or severe pain. To explore the generalizability of these findings, the study should be repeated in other settings.
| S-EPMC6479964 | biostudies-literature
Project description:Importance:Cataract-related vision impairment is an important public health issue that tends to affect older adults. Little is known about the association between older adults' social support networks and their likelihood of receiving cataract surgery. Objective:To determine if older adults with smaller social support networks are less likely to receive cataract surgery. Design, Setting, and Participants:Retrospective cohort study. The National Health and Aging Trends Study, a nationally representative US survey, administered annually from 2011 to 2015 to a cohort of Medicare beneficiaries 65 years and older with no cataract surgery prior to the start of the study. Main Outcomes and Measures:Multivariable logistic regression was performed to evaluate if the number of persons in an individual's social support network influenced whether that individual received cataract surgery during a given year of the study. Results:Overall, 3448 participants were interviewed from 2011 to 2015 for a total of 9760 observations. Of these observations, 3084 (weighted, 38.81%; 95% CI, 37.28-40.35) were aged 70 to 74 years, 5211 (weighted, 52.32%; 95% CI, 50.19-54.44) were women; 5899 (weighted, 78.53%; 95% CI, 76.29-80.61) were white, 2249 (weighted, 9.55%; 95% CI, 8.45-10.78) were black, 537 (weighted, 7.18%; 95% CI, 5.88-8.73) were Hispanic, and 303 (weighted, 4.74%; 95% CI, 3.56-62.9) reported other races. Medicare beneficiaries with smaller social support networks (0-2 individuals) were less likely to receive cataract surgery in a given year (adjusted odds ratio, 0.60; 95% CI, 0.37-0.96) than those with larger support networks (≥3 individuals). The adjusted predicted proportion of Medicare beneficiaries undergoing cataract surgery was 4.7% (95% CI, 2.7%-6.7%) and 7.5% (95% CI, 6.9%-8.1%) for those with small and large social support networks, respectively. Having fewer non-spouse/partner family members in the support network was associated with decreased odds of receiving cataract surgery (adjusted odds ratio, 0.60; 95% CI, 0.43-0.85), but having spouses/partners (adjusted odds ratio, 0.97; 95% CI, 0.77-1.22) and nonfamily members (adjusted odds ratio, 0.90; 95% CI, 0.72-1.11) did not have a significant association. Conclusions and Relevance:Medicare beneficiaries with fewer non-spouse/partner family members in their social support networks were less likely to receive cataract surgery. These findings suggest that attention should be given to patients with smaller support networks to ensure that they receive cataract surgery when it is indicated.
| S-EPMC5876831 | biostudies-other