Suchergebnisse

Abstract

Objectives
Immigrants to Canada tend to have a lower incidence of diagnosed depression than nonimmigrants. One theory suggests that this "healthy immigrant effect (HIE)" is due to positive selection. Another school of thought argues that the medical underuse of immigrants may be the underlying reason. This unclear "immigrant paradox" is further confounded by the intersecting race–migration nexus.


Methods
This population-based study analyzed data of participants (n = 28,951, age ≥45) from the Canadian Community Health Survey (2015–2018). Multivariable logistic regression was employed to examine associations between race–migration nexus and mental health outcomes, including depressive symptoms (Patient Health Questionnaire [PHQ-9] score ≥10).


Results
Compared to Canadian-born (CB) Whites, immigrants, regardless of race, were less likely to receive a mood/anxiety disorder diagnosis (M/A-Dx) by health providers in their lifetime. Racialized immigrants were mentally disadvantaged with increased odds of undiagnosed depression (Adjusted odds ratio [AOR] = 1.76, 99% Confidence interval [CI]:1.30–2.37), whereas White immigrants were mentally healthier with decreased odds of PHQ depression (AOR=0.75, 99%CI: 0.58, 0.96) and poor self-rated mental health (AOR=0.56, 99% CI=0.33, 0.95). Among the subpopulation without a previous M/A-Dx (N = 25,203), racialized immigrants had increased odds of PHQ depression (AOR = 1.45, 99% CI: 1.15–1.82) and unrecognized depression (AOR = 1.47, 99% CI: 1.08–2.00) than CB Whites. Other risk factors for undiagnosed depression include the lack of regular care providers, emergency room as the usual source of care, and being home renters.


Discussion
Despite Canadian universal health coverage, the burden of undiagnosed depression disproportionately affects racialized (but not White) immigrants in mid to late life. Contingent on race–migration nexus, the HIE in mental health may be mainly driven by the healthier profile of White immigrants and partly attributable to the under-detection (by health professionals) and under-recognition of mental health conditions among racialized immigrants. A paradigm shift is needed to estimate late-life depression for medically underserved populations.

Abstract

Objectives
This research explores how the representations and meanings of living with dementia are constructed by older adults.


Methods
Focus groups (N = 19) and in-depth interviews (N = 29) were conducted with older adults aged 65+ living in the Czech Republic, representing different levels of personal familiarity with care for an individual experiencing dementia.


Results
We identified 2 different discourses: (1) Tragedy discourse with two distinctive repertoires "dementia as a thief of personality" and "dementia as a thief of humanity." Within such discourse, dementia transcends mere medical terminology, serving as a symbolic representation of existential anxieties linked to aging and the perceived loss of control. (2) The discourse of Dementia as a specific way in which people approach the world was articulated mainly by caregivers, providing them with a coping mechanism and a means to reconstruct the agency of the person experiencing dementia. In older adults' representations, references to suffering among family members emerged as a primary association with dementia. Dementia was portrayed as "contagious" in its effect on the family members who were, in a sense, depicted as the primary sufferers of the disease.


Discussion
Dementia often serves as a symbolic tool for older adults to articulate concerns about advanced old age, extending beyond its clinical definition to convey deep-seated fears associated with aging. The experience of people surrounding those diagnosed with dementia and the permeability of the impacts of this disease between bodies represented crucial frameworks for conceptualizing dementia in the narratives of older adults.

Abstract

Objectives
Childhood abuse has been extensively studied in relation to later-life health, yet relatively little attention has been given to understanding the nuanced dynamics across victim–perpetrator relationships. This study addresses this gap by identifying typologies of familial perpetrators of childhood abuse in a national sample and examining their associations with various health outcomes, including physical and mental health as well as substance abuse.


Methods
We used 2 waves of data from the Midlife in the US Study (n = 6,295, mean age = 46.9 at baseline). The analysis was completed in 3 stages. Using Latent Class Analysis (LCA), we identified subpopulations of victims with distinct familial perpetrator histories. With assigned LCA memberships and propensity score weighting, we investigated the extent to which specific victim–perpetrator relationships are associated with health outcomes measured at baseline and a 10-year follow-up adjusting for other early-life risks. We evaluated whether the observed associations differ across the waves.


Results
Parental and sibling abuse commonly co-occur, surpassing the occurrence of single perpetrators. Although minimal health disparities are evident between sibling-only abuse and no/little abuse groups at baseline, parent-only abuse is associated with compromised health outcomes. Severe abuse from both siblings and parents is linked to the most adverse health outcomes. At the follow-up survey, the associations between familiar abuse and health outcomes weakened, particularly for substance abuse.


Discussion
This study, delving into family relationships, family violence, and health disparities, provides new evidence to augment our comprehension of the enduring link between childhood abuse and health within the family context.

Abstract

Objectives
Despite the rising prevalence of individuals reaching advanced age without children, little is known about the diversity of support networks within childless populations. We examine the network profiles of childless adults aged 50+ in Singapore, which observes high childlessness rates despite societal emphasis on familism.


Methods
We employ latent class analysis to derive network typology based on a 2022 nationwide survey in Singapore. Additionally, we use logistic regression analyses to investigate the sociodemographic correlates of childless individuals' network types and the associations between these network types and subjective well-being.


Results
Childless Singaporeans form a heterogeneous group characterized by different support networks. Evidence suggests the centrality of parents in the childless' social networks and the continuity of parent–child support exchanges that extend into the child's midlife and late adulthood. When parents are absent, siblings/extended kin serve as their support sources. Age, sibship size, and socioeconomic status are key correlates of network types. Membership in diverse networks is beneficial to the subjective well-being of childless individuals. Although one-fifth of childless individuals in restricted networks demonstrate significantly poorer well-being, the remaining four-fifths show comparable, if not better, well-being than the non-childless.


Discussion
Results underscore the importance of differentiating network types among the childless, particularly when assessing their well-being. Contrary to the notion of associating later-life childlessness with social isolation and vulnerabilities, many childless Singaporeans manage to construct non-child-based networks equipped with various supportive relations that cater to their needs. Nevertheless, persistent vulnerabilities among restricted network members deserve policymakers' attention.

Abstract

Objectives
An increasing proportion of older Canadians are pursuing sports. The objective of this study was to examine the experiences of older Canadian women in curling.


Methods
Semistructured interviews were conducted with 17 participants. Interviews were transcribed and coded using thematic analysis.


Results
Participants simultaneously resisted, accepted, and ultimately redefined conceptualizations of personal aging in the context of curling. Although gender was deemed inconsequential, concepts such as the physical and cognitive demands of curling, inclusivity, social connection and support, and competition were perceived to be integral to participants' experiences.


Discussion
This study extends our understanding of the value of curling specifically, and sport in general, for older women.

Abstract

Objectives
Political participation differs across the age range, but little is known about these patterns outside of developed countries. Political context is a particularly important consideration for all political behavior in Africa, where only a few countries are fully democratic. Drawing from political opportunity structures theory, we investigate how political freedom conditions the age-based pattern of electoral and nonelectoral political engagement, as well as protesting.


Methods
This study merges the fifth, sixth, and seventh rounds of the Afrobarometer data sets, spanning 36 African countries, with country-level data on political freedom from Freedom House. Using multilevel regression models, we examine how political freedom shapes the relationship between age and 3 forms of political participation.


Results
Africans aged from 18 to 60 years and living in nonfree countries are most engaged in electoral and nonelectoral political activities, though participation begins to drop markedly past age 60. For protest participation, young Africans living in partially and non-free countries are the most engaged in protests; yet limited political freedom again means a sharp age-based decline.


Discussion
The impact of political context on the age–participation association is nuanced in ways not anticipated by mainstream research on the developed West. Repressive regimes, while spurring engagement at younger ages, appear to disproportionately deter older Africans from political engagement, especially its riskiest forms. We conclude by calling for more country-comparative gerontological research with careful attention to contextual heterogeneity, particularly in the understudied Global South.

Abstract

Objectives
Pain is a leading cause of disability and a limiting factor in individuals' assessments of their own subjective health; however, its association with subjective longevity has yet to be explored. Subjective survival probabilities (SSPs), or one's own perceived chances of living to a given age, can influence individuals' behavior as they plan for their futures. This study assesses whether pain correlates to lower SSPs.


Methods
We use a repeated cross-section of the 2000–2018 waves of the Health and Retirement Study, a longitudinal and nationally representative survey of Americans aged 51 and older (N = 31,773).


Results
Fractional logit regressions indicate that, across all age groups, respondents with severe and/or interfering pain reported significantly lower SSPs than those with no pain (Marginal Effect [ME] = −0.03 to −0.06, p < .05). Controlling for all covariates, mild or moderate noninterfering pain was only associated with a significant reduction in SSPs among the youngest group reporting their chances of living to age 75 (ME = −0.02, p < .001). Descriptively and in the model results, respondents with mild or moderate noninterfering pain appeared to more closely resemble pain-free respondents than those with severe or interfering pain.


Discussion
These findings highlight the importance of pain on SSPs, and contribute to the growing evidence that pain interference is uniquely important in predicting meaningful health outcomes.

Abstract

Objectives
This study provides one of the first national longitudinal studies of the association between caring for grandchildren (i.e., grandparenting) and the risk of dementia in the United States, with a focus on gender-specific variations.


Methods
We estimated discrete-time event history models, drawing upon data from the Health and Retirement Study (2000–2016). The analytic sample included 10,217 community-dwelling White and Black grandparents aged 52 years and older at baseline.


Results
Noncoresident grandparenting was associated with a lower risk of dementia for both women and men compared to grandparents who did not take care of grandchildren. However, the cognitive advantage showed different patterns based on gender and the combination of care intensity and family structure. Grandmothers had a lower risk of dementia than noncaregiving grandmothers when providing a light level of noncoresident grandparenting, whereas grandfathers who provided intensive noncoresident grandparenting had a reduced risk of dementia compared to their noncaregiving counterparts. Grandparenting experiences within multigenerational households and skipped-generation households were not associated with dementia risk.


Discussion
Intergenerational caregiving plays a pivotal role in shaping cognitive health during later life; however, the impact is nuanced, depending on factors such as gender, care intensity, and family structure.

Abstract

Objectives
The medical diagnosis of a disease is common in older age and can carry significant financial costs. For many older adults, equity in a home is their primary component of wealth; however, housing wealth is illiquid. We analyze the relationship between the liquidation of housing wealth through mortgage borrowing on older homeowners' ability to successfully control a disease.


Methods
We use data on homeowners aged 65 and older from the 1998–2016 waves of the Health and Retirement Study (N = 3,457). We use biomarkers and physical health indicators to measure disease control following a medical diagnosis of diabetes, heart condition, high blood pressure, lung disease, or cancer. Random effects linear probability and instrumental variable regressions estimate the associations of housing wealth, new mortgage borrowing, and disease control.


Results
Descriptively, 28% of older homeowners who borrow against home equity are not controlled on their disease, compared to 33% of non-borrowers. Panel data instrumental variable regressions show that each $10,000 borrowed from home equity after diagnosis is associated with a 17-percentage-point reduction in the probability of the disease not being controlled.


Discussion
Many older adults are not able or willing to liquidate housing wealth, and the ability to borrow also depends on changes in home values. Thus, housing wealth is not a uniform social determinant of health but is shaped by older adults' participation in financial markets.

This commentary reinforces a central commitment of life course research: to make visible how social change matters in human lives. This paper captures a moderated conversation with four senior scholars about how they came to study the intersection between social change and life experience, why this intersection is so important to life course studies, and theoretical and methodological imperatives and challenges that come with it.

Abstract

Objectives
This paper outlines the unique culturally driven cyclical migration of Alaska Native (AN) Elders, distinct from previously described migration patterns in that Elders spend extended time in more than one community. We describe this Indigenous cyclical migration of AN Elders and its influence on their identity and later life health and well-being.


Methods
Interviews with 124 AN Elders were conducted across 5 regions of Alaska: Bristol Bay, Interior, Norton Sound, Aleutian Pribilof Islands, and Southcentral. Within this sample, 87 participants engaged in cyclical migration. Thematic analysis was employed to identify themes related to Elders' cyclical migration between rural and urban communities and the impact on their identity and later life health and well-being.


Results
We identified 2 distinct patterns of Indigenous cyclical migration—Elders living primarily in rural communities migrating to urban communities and Elders living primarily in urban communities migrating to rural communities. Elders engaged in these 2 patterns of cyclical migration to maintain cultural practices, access social, and health care services to maintain their physical health and well-being, and continue their community roles contributing to their AN Elder identity.


Discussion
This study builds upon existing migration theories by introducing a cyclical pattern uniquely driven by AN identity, culture, and traditional practices. Findings illustrate how AN communities can support Elders who experience cyclical migration patterns to ensure they age successfully in both locations. Future research should explore cyclical migration patterns among other Indigenous populations with migration histories.

Abstract

Objectives
Companions (i.e., friends who spend time together) are important for the well-being of older adults. Senior centers in the United States are places for older adults to participate in group activities and form and maintain companionships. However, differences in mobility and transportation may affect the ability of older adults to leverage senior center activities into actual companionships.


Methods
This social network analysis was conducted to characterize the companionship network among members of a senior center in relation to their life-space mobility and transportation resources. An exponential random graph model was estimated to identify mobility- and transportation-related correlates of the likelihood of a companionship tie among senior center members (N = 42).


Results
Members had an average of 2 companionships with one another (M = 2.2, SD = 2.7). Companionships were more likely for members with greater life-space mobility (p = .009), who attended the senior center more frequently (p = .004), with automobile ownership in their households (p = .034), and who were not transportation cost-burdened (i.e., spent less than 15% of their income on transportation, p = .005). Demographic characteristics, limitations on instrumental activities of daily living, and being at risk for depression were not significantly associated with the likelihood of companionships.


Discussion
These findings extend previous knowledge of the role of life-space mobility and transportation in supporting general social participation for older adults to include the importance of transportation and mobility for having companions within a senior center.

Abstract

Objectives
Using the concept of relational solidarity, we examine how autonomy, equality, dignity, and personhood are practiced in the care of people living with dementia at home in urban India.


Methods
Video interviews with 19 family carers and 25 health providers conducted in English, Hindi, and Kannada in Bengaluru between March and July 2022. Data were translated into English and thematically analyzed.


Results
Family carers and providers unanimously agreed that people with dementia should be respected and cared for. Concurrently, they perceived people with dementia as being "like a kid" and used the analogy of a parent–child relationship to understand their care responsibilities. This analogy informed how ethical principles such as personhood and equality were reframed in the relationships between family carers and people with dementia, as well as how carers and providers maintained the safety but undermined the autonomy of people with dementia through restricting their movements inside and outside the home.


Discussion
There can be relational solidarity in dementia care at home in urban India but also contradictions in the interpretations and applications of the ethical principles of autonomy, equality, dignity, and personhood. As such, a more organic, grassroots model of ethical practice is needed to frame care and provide material support to families in India.