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A National Longitudinal Study of Partnered Sex, Relationship Quality, and Mental Health Among Older Adults.

ABSTRACT: OBJECTIVES:We worked from a life course perspective to examine the relationship between partnered sex and older adults' trajectories of mental health as well as the potential mediating role of relationship quality in this association. METHOD:We analyzed nationally representative data from three waves of the National Social Life, Health, and Aging Project (2005/2006 to 2015/2016). The sample included 1,911 married and cohabiting respondents aged 57 to 85 at the baseline survey. We examined four factors related to partnered sex: being sexually active, sexual frequency, feeling okay with sexual frequency, and sexual quality. Mental health was measured by self-rated poor mental health, unhappiness, and psychological distress. The relationship quality measures considered both relationship support and relationship strain. RESULTS:Results from mixed-effects models suggest that being sexually active, having sex more frequently, feeling okay with sexual frequency, and reporting better sexual quality were all related to better mental health outcomes. Relationship quality partially explained the effects of sex on mental health. DISCUSSION:This study highlights the importance of sex for mental health and relationship quality among older adults. The findings have implications for health policy and programs that seek to promote healthy aging.

SUBMITTER: Zhang Y

PROVIDER: S-EPMC7489086 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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A National Longitudinal Study of Partnered Sex, Relationship Quality, and Mental Health Among Older Adults.

Zhang Yan Y Liu Hui H

The journals of gerontology. Series B, Psychological sciences and social sciences 20200901 8

<h4>Objectives</h4>We worked from a life course perspective to examine the relationship between partnered sex and older adults' trajectories of mental health as well as the potential mediating role of relationship quality in this association.<h4>Method</h4>We analyzed nationally representative data from three waves of the National Social Life, Health, and Aging Project (2005/2006 to 2015/2016). The sample included 1,911 married and cohabiting respondents aged 57 to 85 at the baseline survey. We ...[more]

PMID: 31132123

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Project description:This study compares the mental health of single parents relative to partnered parents and assesses the contribution of the social and demographic factors to this difference, examining the gender difference in it.We analyzed 12,024 single and partnered subjects, aged 30-59 years, living with children, aged 0-19 years, drawn from the 4th, 5th, and 6th Korea National Health and Nutrition Examination Survey (KNHANES) dataset in South Korea conducted from 2007-2013. Mental health was evaluated by self-reported questionnaires including depressive mood for recent two weeks, presence of suicidal ideation, and the Korean version of the Alcohol Use Disorder Identification Test. Covariates included age, physical illness, socioeconomic status (family income, recipient of national basic livelihood guarantees, educational level, house ownership, job, and residential area), family structure, and support (co-residence of another adult). Multiple logistic regression was carried out and the explained fractions of each covariate was calculated.Single parents had significantly poorer mental health than their partnered counterparts, with odds ratio (OR) of 2.02 (95% confidence interval (CI) 1.56-2.63) for depressive symptoms, 1.69 (95% CI 1.27-2.25) for suicidal ideation, and 1.74 (95% CI 1.38-2.20) for any of the three mental health statuses (suspicious depression, suicidal ideation, and alcohol dependence) after controlling for the covariates. The odds of depressive symptoms (OR = 3.13, 95% CI 2.50-3.93) and suicidal ideation (OR = 2.50, 95% CI 1.97-3.17) among both single fathers and mothers were higher than partnered parents. However, the odds of alcohol dependence were 3.6 times higher among single mothers than partnered mothers (OR = 3.58, 95% CI 1.81-7.08) and were 1.4 times greater among single fathers than partnered fathers (OR = 1.35, 95% CI 0.81-2.25). Socio-economic status explained more than 50% (except for substance use disorders) of the poorer mental health in single parents. These results were more remarkable for single fathers than for single mothers except for alcohol dependence. However, physical illness, family structure, and support made only minor contributions to single parents' mental health.This study demonstrates that single parents have poorer mental health than partnered parents. Although lower SES is an important factor explaining poorer mental health in single parents, there are other factors we cannot explain about their poor mental health. Therefore, we should pay proper regard to identifying other factors affecting mental health and to establishing policies to support single parents.

Project description:BackgroundMental health conditions are among the leading non-fatal diseases in middle-aged and older adults in Australia. Proximal and distal social environmental factors and physical environmental factors have been associated with mental health, but the underlying mechanisms explaining these associations remain unclear. The study objective was to examine the contribution of different types of physical activity in mediating the relationship of social and physical environmental factors with mental health-related quality of life in middle-aged and older adults.MethodsBaseline data from the Wellbeing, Eating and Exercise for a Long Life (WELL) study were used. WELL is a prospective cohort study, conducted in Victoria, Australia. Baseline data collection took place in 2010. In total, 3,965 middle-aged and older adults (55-65 years, 47.4% males) completed the SF-36 Health Survey, the International Physical Activity Questionnaire, and a questionnaire on socio-demographic, social and physical environmental attributes. Mediation analyses were conducted using the MacKinnon product-of-coefficients test.ResultsPersonal safety, the neighbourhood physical activity environment, social support for physical activity from family or friends, and neighbourhood social cohesion were positively associated with mental health-related quality of life. Active transportation and leisure-time physical activity mediated 32.9% of the association between social support for physical activity from family or friends and mental health-related quality of life. These physical activity behaviours also mediated 11.0%, 3.4% and 2.3% respectively, of the relationship between the neighbourhood physical activity environment, personal safety and neighbourhood social cohesion and mental health-related quality of life.ConclusionsIf these results are replicated in future longitudinal studies, tailored interventions to improve mental health-related quality of life in middle-aged and older adults should use a combined strategy, focusing on increasing physical activity as well as social and physical environmental attributes.

Project description:BackgroundImplementing new programs and practices is challenging, even when they are mandated. Implementation Facilitation (IF) strategies that focus on partnering with sites show promise for addressing these challenges.ObjectiveOur aim was to evaluate the effectiveness of an external/internal IF strategy within the context of a Department of Veterans Affairs (VA) mandate of Primary Care-Mental Health Integration (PC-MHI).DesignThis was a quasi-experimental, Hybrid Type III study. Generalized estimating equations assessed differences across sites.ParticipantsPatients and providers at seven VA primary care clinics receiving the IF intervention and national support and seven matched comparison clinics receiving national support only participated in the study.InterventionWe used a highly partnered IF strategy incorporating evidence-based implementation interventions.Main measuresWe evaluated the IF strategy using VA administrative data and RE-AIM framework measures for two 6-month periods.Key resultsEvaluation of RE-AIM measures from the first 6-month period indicated that PC patients at IF clinics had nine times the odds (OR=8.93, p<0.001) of also being seen in PC-MHI (Reach) compared to patients at non-IF clinics. PC providers at IF clinics had seven times the odds (OR=7.12, p=0.029) of referring patients to PC-MHI (Adoption) than providers at non-IF clinics, and a greater proportion of providers' patients at IF clinics were referred to PC-MHI (Adoption) compared to non-IF clinics (?=0.027, p<0.001). Compared to PC patients at non-IF sites, patients at IF clinics did not have lower odds (OR=1.34, p=0.232) of being referred for first-time mental health specialty clinic visits (Effectiveness), or higher odds (OR=1.90, p=0.350) of receiving same-day access (Implementation). Assessment of program sustainability (Maintenance) was conducted by repeating this analysis for a second 6-month time period. Maintenance analyses results were similar to the earlier period.ConclusionThe addition of a highly partnered IF strategy to national level support resulted in greater Reach and Adoption of the mandated PC-MHI initiative, thereby increasing patient access to VA mental health care.

Dataset Information

A National Longitudinal Study of Partnered Sex, Relationship Quality, and Mental Health Among Older Adults.

Publications

A National Longitudinal Study of Partnered Sex, Relationship Quality, and Mental Health Among Older Adults.

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