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Gepubliceerd in: Quality of Life Research 3/2011

01-04-2011

Associations between living arrangements and health-related quality of life of urban elderly people: a study from China

Auteurs: Xiaojie Sun, Henry Lucas, Qingyue Meng, Yaoguang Zhang

Gepubliceerd in: Quality of Life Research | Uitgave 3/2011

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Abstract

Purpose

This study aimed to compare health-related quality of life (HRQOL) for elderly men and women in three mutually exclusive living arrangements: living alone, living only with spouse, and non-empty-nesters. It also examined whether such living arrangements and other factors relating to social interaction have an independent influence on HRQOL after controlling for other variables.

Methods

The data were drawn from China’s 4th National Household Health Survey (NHHS) conducted in 2008. The final sample included 9,711 urban elderly people of 60 years and above. The EQ-5D inventory was used to measure health-related quality of life.

Results

The proportions of non-empty-nested men and women both changed following a ‘U’-shaped curve with the increasing age. Controlling for other variables not including social interaction indicators, “living alone” was a significant predictor of reporting problems on Mobility, Pain/Discomfort and Anxiety/Depression. After introducing social interaction indicators, urban older adults ‘having close contact with neighbors every week’ had lower odds of problems on all five EQ-5D indicators, those ‘having close contact with friends and relatives’ had lower odds of problems on Mobility, Pain/Discomfort and Anxiety/Depression, and those ‘taking part in social activities every week’ had lower odds of problems on all dimensions but Anxiety/Depression. In addition, after introducing social interaction indicators, the odds of reported problems on the three dimensions increased obviously.

Conclusions

This study suggests that the most vulnerable urban older adults are those who live entirely on their own. Frequent social interaction may buffer the negative effect of living alone on HRQOL of older adults. Policies that attempt to build harmonious neighborhoods, extend older adults’ social network and encourage them to take part in social activities should be considered by the policy-makers in the future.
Literatuur
1.
go back to reference Kinsella, K., & Wan, H. (2009). An Aging World: 2008 (International Population Reports, P95/09-1). U.S. Washington, DC: U.S. Census Bureau. Kinsella, K., & Wan, H. (2009). An Aging World: 2008 (International Population Reports, P95/09-1). U.S. Washington, DC: U.S. Census Bureau.
4.
go back to reference Center for Health Statistics and Information, Ministry of Health, China. (2009). An analysis report of National Health Service survey in China, 2008. Beijing: China Union Medical University. Center for Health Statistics and Information, Ministry of Health, China. (2009). An analysis report of National Health Service survey in China, 2008. Beijing: China Union Medical University.
6.
go back to reference Zhu, X. H., Yu, C. M., Jiang, W. L., et al. (2006). Investigation on the healthy status of the elderly in empty-nest family and community nursing need. Journal of Nursing Science, 21(8), 69–70. Zhu, X. H., Yu, C. M., Jiang, W. L., et al. (2006). Investigation on the healthy status of the elderly in empty-nest family and community nursing need. Journal of Nursing Science, 21(8), 69–70.
7.
go back to reference Davis, M. A., Moritz, D. J., Neuhaus, J. M., et al. (1997). Living arrangements, changes in living arrangements, and survival among community dwelling older adults. American Journal of Public Health, 87(3), 371–377.PubMedCrossRef Davis, M. A., Moritz, D. J., Neuhaus, J. M., et al. (1997). Living arrangements, changes in living arrangements, and survival among community dwelling older adults. American Journal of Public Health, 87(3), 371–377.PubMedCrossRef
8.
go back to reference Michael, Y., Berkman, L. F., Colditz, G. A., et al. (2001). Living arrangements, social integration, and change in functional health status. American Journal of Epidemiology, 153(2), 123–131.PubMedCrossRef Michael, Y., Berkman, L. F., Colditz, G. A., et al. (2001). Living arrangements, social integration, and change in functional health status. American Journal of Epidemiology, 153(2), 123–131.PubMedCrossRef
9.
go back to reference Sarwari, A. R., Fredman, L., Langenberg, P., et al. (1998). Prospective study on the relation between living arrangement and change in functional health status of elderly women. American Journal of Epidemiology, 147(4), 370–378.PubMed Sarwari, A. R., Fredman, L., Langenberg, P., et al. (1998). Prospective study on the relation between living arrangement and change in functional health status of elderly women. American Journal of Epidemiology, 147(4), 370–378.PubMed
10.
go back to reference Lund, R., Due, P., Modvig, J., et al. (2002). Cohabitation and marital status as predictors of mortalitydan eight year follow-up study. Social Science and Medicine, 55(4), 673–679.PubMedCrossRef Lund, R., Due, P., Modvig, J., et al. (2002). Cohabitation and marital status as predictors of mortalitydan eight year follow-up study. Social Science and Medicine, 55(4), 673–679.PubMedCrossRef
11.
go back to reference Waite, L. J., & Hughes, M. E. (1999). At risk on the cusp of old age: Living arrangements and functional status among Black, White and Hispanic adults. Journal of Gerontology: Social Sciences, 54B(3), S136–S144. Waite, L. J., & Hughes, M. E. (1999). At risk on the cusp of old age: Living arrangements and functional status among Black, White and Hispanic adults. Journal of Gerontology: Social Sciences, 54B(3), S136–S144.
12.
go back to reference Kharicha, K., Iliffe, S., Harari, D., et al. (2007). Health risk appraisal in older people: Are older people living alone an ‘at-risk’ group? British Journal of General Practice, 57(537), 271–276.PubMed Kharicha, K., Iliffe, S., Harari, D., et al. (2007). Health risk appraisal in older people: Are older people living alone an ‘at-risk’ group? British Journal of General Practice, 57(537), 271–276.PubMed
13.
go back to reference Brown, J. W., Liang, J., Krause, N., et al. (2002). Transitions in living arrangements among elders in Japan: Does health make a difference? The journals of gerontology, 57(4), S209–S220.PubMed Brown, J. W., Liang, J., Krause, N., et al. (2002). Transitions in living arrangements among elders in Japan: Does health make a difference? The journals of gerontology, 57(4), S209–S220.PubMed
14.
go back to reference Berkman, L. F. (2000). Which influences cognitive function: Living alone or being alone? Lancet, 355(9212), 1292.CrossRef Berkman, L. F. (2000). Which influences cognitive function: Living alone or being alone? Lancet, 355(9212), 1292.CrossRef
15.
go back to reference de-Belvis, A. G., Avolio, M., Spagnolo, A., et al. (2008). Factors associated with health-related quality of life: The role of social relationships among the elderly in an Italian region. Public Health, 122(8), 784–793.PubMedCrossRef de-Belvis, A. G., Avolio, M., Spagnolo, A., et al. (2008). Factors associated with health-related quality of life: The role of social relationships among the elderly in an Italian region. Public Health, 122(8), 784–793.PubMedCrossRef
16.
go back to reference Xu, X. (1995). The causes of the empty-nested households and related accommodations. Social Science Research, (5), 96. Xu, X. (1995). The causes of the empty-nested households and related accommodations. Social Science Research, (5), 96.
17.
go back to reference Xiao, H. S. (1995). The causes and development trend of the empty-nest phenomenon in China. Population Research, 19(5), 13–16. Xiao, H. S. (1995). The causes and development trend of the empty-nest phenomenon in China. Population Research, 19(5), 13–16.
18.
go back to reference Tang, L. (2002). New “Empty––Nest” family: A noteworthy social demographic phenomenon. Population Research, 26(4), 36–39. Tang, L. (2002). New “Empty––Nest” family: A noteworthy social demographic phenomenon. Population Research, 26(4), 36–39.
19.
go back to reference Chen, M. X., & Yang, L. (2003). On the empty-nest phenomenon in the process of modernization. Changbai Journal, (6), 60–63. Chen, M. X., & Yang, L. (2003). On the empty-nest phenomenon in the process of modernization. Changbai Journal, (6), 60–63.
20.
go back to reference Xiong, H. F. (1998). The empty-nested households: The elderly group who should be paid attention to. Population Research, 22(3), 51. Xiong, H. F. (1998). The empty-nested households: The elderly group who should be paid attention to. Population Research, 22(3), 51.
21.
go back to reference Zhao, F., & Xu, Y. (2003). The analysis of the elderly’s life patterns and social support system in empty nest family. Journal of Nanjing Normal University (Social Science), (3), 63–67. Zhao, F., & Xu, Y. (2003). The analysis of the elderly’s life patterns and social support system in empty nest family. Journal of Nanjing Normal University (Social Science), (3), 63–67.
22.
go back to reference Feng, T., & Chen, M. (2008). The comprehensive evaluation and analysis on life quality of empty-nest elderly in Xiamen City. South China Population, 23(2), 37–43. Feng, T., & Chen, M. (2008). The comprehensive evaluation and analysis on life quality of empty-nest elderly in Xiamen City. South China Population, 23(2), 37–43.
23.
go back to reference Li, L. W., Zhang, J., & Liang, J. (2009). Health among the oldest-old in China: Which living arrangements make a difference? Social Sciences & Medicine, 68(2), 220–227.CrossRef Li, L. W., Zhang, J., & Liang, J. (2009). Health among the oldest-old in China: Which living arrangements make a difference? Social Sciences & Medicine, 68(2), 220–227.CrossRef
24.
go back to reference Kincannon, C., He, W., & West, L. (2005). Demography of aging in china and the United States and the economic well-being of their older populations. Journal of Cross-Cultural Gerontology, 20(3), 243–255.PubMedCrossRef Kincannon, C., He, W., & West, L. (2005). Demography of aging in china and the United States and the economic well-being of their older populations. Journal of Cross-Cultural Gerontology, 20(3), 243–255.PubMedCrossRef
25.
go back to reference Li, J. J., Huang, R. G., & Feng, A. (2007). A study of urban community heterogeneity and neighborhood social capital. Fudan Journal (Social Science), 5(5), 67–73. Li, J. J., Huang, R. G., & Feng, A. (2007). A study of urban community heterogeneity and neighborhood social capital. Fudan Journal (Social Science), 5(5), 67–73.
26.
go back to reference Wang, Y. (2002). A case study on urban community in Shanghai-Community classification, spatial distributionand changing tendencies. Urban Planning Forum, (6), 33–40. Wang, Y. (2002). A case study on urban community in Shanghai-Community classification, spatial distributionand changing tendencies. Urban Planning Forum, (6), 33–40.
27.
go back to reference Apter, A. J., Reisine, S. T., Affleck, G., et al. (1999). The influence of demographic and socioeconomic factors on health-related quality of life in asthma. The Journal of Allergy and Clinical Immunology, 103(1), 72–78.PubMedCrossRef Apter, A. J., Reisine, S. T., Affleck, G., et al. (1999). The influence of demographic and socioeconomic factors on health-related quality of life in asthma. The Journal of Allergy and Clinical Immunology, 103(1), 72–78.PubMedCrossRef
28.
go back to reference Ketelaars, C. A., Schlösser, M. A., Mostert, R., et al. (1996). Determinants of health-related quality of life in patients with chronic obstructive pulmonary disease. Thorax, 51, 39–43.PubMedCrossRef Ketelaars, C. A., Schlösser, M. A., Mostert, R., et al. (1996). Determinants of health-related quality of life in patients with chronic obstructive pulmonary disease. Thorax, 51, 39–43.PubMedCrossRef
29.
go back to reference Casellas, F., López, V. J., Casado, A., et al. (2002). Factors affecting health related quality of life of patients with inflammatory bowel disease. Quality of Life Research, 11(8), 775–781.PubMedCrossRef Casellas, F., López, V. J., Casado, A., et al. (2002). Factors affecting health related quality of life of patients with inflammatory bowel disease. Quality of Life Research, 11(8), 775–781.PubMedCrossRef
30.
go back to reference Johansson, P., Dahlstrom, U., & Brostrom, A. (2006). Factors and interventions influencing health-related quality of life in patients with heart failure: A review of the literature. European Journal of Cardiovascular Nursing, 5(1), 5–15.PubMedCrossRef Johansson, P., Dahlstrom, U., & Brostrom, A. (2006). Factors and interventions influencing health-related quality of life in patients with heart failure: A review of the literature. European Journal of Cardiovascular Nursing, 5(1), 5–15.PubMedCrossRef
31.
go back to reference Chen, J. L. (2008). A commentary on the study of China’s “empty nest” families. Tianfu New Idea, (2), 105–109. Chen, J. L. (2008). A commentary on the study of China’s “empty nest” families. Tianfu New Idea, (2), 105–109.
32.
go back to reference Sapin, C. B. F., Marie-Laure, N., et al. (2004). Usefulness of EQ-5D in assessing health status in primary care patients with major depressive disorder. Health and Quality of Life Outcomes, 2, 20.PubMedCrossRef Sapin, C. B. F., Marie-Laure, N., et al. (2004). Usefulness of EQ-5D in assessing health status in primary care patients with major depressive disorder. Health and Quality of Life Outcomes, 2, 20.PubMedCrossRef
33.
go back to reference Agt, V. H., Essink-Bot, M. L., Krabbe, P., et al. (2005). Test-retest reliability of health state valuations collected with the EuroQol questionnaire. In P. Kind, R. Brooks, & R. Rabin (Eds.), EQ-5D concepts and methods: A developmental history. Dordrecht: Springer. Agt, V. H., Essink-Bot, M. L., Krabbe, P., et al. (2005). Test-retest reliability of health state valuations collected with the EuroQol questionnaire. In P. Kind, R. Brooks, & R. Rabin (Eds.), EQ-5D concepts and methods: A developmental history. Dordrecht: Springer.
34.
go back to reference Zeng, Y. C., Ching, S. S., & Loke, A. Y. (2010). Quality of life measurement in women with cervical cancer: Implications for Chinese cervical cancer survivors. Health and Quality of Life Outcomes, 8, 30.PubMedCrossRef Zeng, Y. C., Ching, S. S., & Loke, A. Y. (2010). Quality of life measurement in women with cervical cancer: Implications for Chinese cervical cancer survivors. Health and Quality of Life Outcomes, 8, 30.PubMedCrossRef
35.
go back to reference Norman, R., Cronin, P., Viney, R., et al. (2009). International comparisons in valuing EQ-5D health states: A review and analysis. Value in Health, 12(8), 1194–1200.PubMedCrossRef Norman, R., Cronin, P., Viney, R., et al. (2009). International comparisons in valuing EQ-5D health states: A review and analysis. Value in Health, 12(8), 1194–1200.PubMedCrossRef
36.
go back to reference Craig, B. M., Busschbach, J. J., & Salomon, J. A. (2009). Modeling ranking, time trade-off and visual analogue scale values for EQ-5D health states: A review and comparison of methods. Medical Care, 47(6), 634–641.PubMedCrossRef Craig, B. M., Busschbach, J. J., & Salomon, J. A. (2009). Modeling ranking, time trade-off and visual analogue scale values for EQ-5D health states: A review and comparison of methods. Medical Care, 47(6), 634–641.PubMedCrossRef
37.
go back to reference Zhao, F. L., Yue, M., Yang, H., et al. (2010). Validation and comparison of EuroQol and short form 6D in chronic prostatitis patients. Value in Health, 13(5), 649–656.PubMedCrossRef Zhao, F. L., Yue, M., Yang, H., et al. (2010). Validation and comparison of EuroQol and short form 6D in chronic prostatitis patients. Value in Health, 13(5), 649–656.PubMedCrossRef
38.
go back to reference Wang, H., Kindig, D. A., & Mullahy, J. (2005). Variation in Chinese population health related quality of life: Results from a EuroQol study in Beijing, China. Quality of Life Research, 14(1), 119–132.PubMedCrossRef Wang, H., Kindig, D. A., & Mullahy, J. (2005). Variation in Chinese population health related quality of life: Results from a EuroQol study in Beijing, China. Quality of Life Research, 14(1), 119–132.PubMedCrossRef
39.
go back to reference Luo, N., Chew, L. H., Fong, K. Y., et al. (2003). Validity and reliability of the EQ-5D self-report questionnaire in Chinese-speaking patients with rheumatic diseases in Singapore. Annals Academic Medicine Singapore, 32, 685–690. Luo, N., Chew, L. H., Fong, K. Y., et al. (2003). Validity and reliability of the EQ-5D self-report questionnaire in Chinese-speaking patients with rheumatic diseases in Singapore. Annals Academic Medicine Singapore, 32, 685–690.
40.
go back to reference Gao, F., Ng, G. Y., Cheung, Y. B., et al. (2008). The Singaporean English and Chinese versions of the EQ-5D achieved measurement equivalence in cancer patients. Journal of Clinical Epidemiology, 62, 206–213.PubMedCrossRef Gao, F., Ng, G. Y., Cheung, Y. B., et al. (2008). The Singaporean English and Chinese versions of the EQ-5D achieved measurement equivalence in cancer patients. Journal of Clinical Epidemiology, 62, 206–213.PubMedCrossRef
41.
go back to reference Ong, S. C., Lim, S. G., & Li, S. C. (2010). Reliability and validity of a Chinese version’s health-related quality of life questionnaire for hepatitis B patients. Value in Health, 13(2), 324–327.PubMedCrossRef Ong, S. C., Lim, S. G., & Li, S. C. (2010). Reliability and validity of a Chinese version’s health-related quality of life questionnaire for hepatitis B patients. Value in Health, 13(2), 324–327.PubMedCrossRef
42.
go back to reference DeVellis, R. F. (2003). Scale development: Theory and application. Thousand Oaks: Sage. DeVellis, R. F. (2003). Scale development: Theory and application. Thousand Oaks: Sage.
43.
go back to reference Bland, J. M., & Altman, D. G. (1995). Multiple significance tests: The Bonferroni method. BMJ, 310, 170.PubMed Bland, J. M., & Altman, D. G. (1995). Multiple significance tests: The Bonferroni method. BMJ, 310, 170.PubMed
44.
go back to reference Annan, K. (1999). UN press release SG/SM/6893. New York: United Nation. Annan, K. (1999). UN press release SG/SM/6893. New York: United Nation.
45.
go back to reference Sarma, S., Hawley, G., & Basu, K. (2009). Transitions in living arrangements of Canadian seniors: Findings from the NPHS longitudinal data. Social Science and Medicine, 68(6), 1106–1113.PubMedCrossRef Sarma, S., Hawley, G., & Basu, K. (2009). Transitions in living arrangements of Canadian seniors: Findings from the NPHS longitudinal data. Social Science and Medicine, 68(6), 1106–1113.PubMedCrossRef
46.
go back to reference Bowling, A., Banister, D., Sutton, S., et al. (2002). A multidimensional model of the quality of life in older age. Aging & mental health, 6(4), 355–371.CrossRef Bowling, A., Banister, D., Sutton, S., et al. (2002). A multidimensional model of the quality of life in older age. Aging & mental health, 6(4), 355–371.CrossRef
47.
go back to reference Garcia, E. L., Banegas, J. R., Perez-Regadera, A. G., et al. (2005). Social network and health-related quality of life in older adults: A population-based study in Spain. Quality of Life Research, 14(2), 511–520.PubMedCrossRef Garcia, E. L., Banegas, J. R., Perez-Regadera, A. G., et al. (2005). Social network and health-related quality of life in older adults: A population-based study in Spain. Quality of Life Research, 14(2), 511–520.PubMedCrossRef
48.
go back to reference Sun, L., & Lei, T. (2007). A study on the neighborhood ties of Beijing urban residents in old city zone. Urban Problems, (2), 56–59. Sun, L., & Lei, T. (2007). A study on the neighborhood ties of Beijing urban residents in old city zone. Urban Problems, (2), 56–59.
49.
go back to reference Hughes, M. E., & Waite, L. J. (2002). Health in household context: Living arrangements and health in late middle age. Journal of Health and Social Behavior, 43(1), 1–21.PubMedCrossRef Hughes, M. E., & Waite, L. J. (2002). Health in household context: Living arrangements and health in late middle age. Journal of Health and Social Behavior, 43(1), 1–21.PubMedCrossRef
50.
go back to reference Murphy, M., Grundy, E., & Kalogirou, S. (2007). The increase in marital status differences in mortality up to the oldest age in seven European countries, 1990–99. Population Studies, 61(3), 287–298.PubMedCrossRef Murphy, M., Grundy, E., & Kalogirou, S. (2007). The increase in marital status differences in mortality up to the oldest age in seven European countries, 1990–99. Population Studies, 61(3), 287–298.PubMedCrossRef
51.
go back to reference Pillemar, K., Moen, P., Wethington, E., et al. (2000). Social integration in the second half of life. Baltimore: Johns Hopkins University Press. Pillemar, K., Moen, P., Wethington, E., et al. (2000). Social integration in the second half of life. Baltimore: Johns Hopkins University Press.
52.
go back to reference Li, D., Chen, T., & Wu, Z. (2006). Comparison of life and psychological status of the elderly between families with children absent and families with children. Chinese Journal of Gerontology, 26(3), 294–296. Li, D., Chen, T., & Wu, Z. (2006). Comparison of life and psychological status of the elderly between families with children absent and families with children. Chinese Journal of Gerontology, 26(3), 294–296.
53.
go back to reference De Jong Gierveld, J. (2003). Social networks and social well-being of older men and women living alone. In S. Arber, K. Davidson, & J. Ginn (Eds.), Gender and ageing changing roles and relationships. Maidenhead: Open University Press. De Jong Gierveld, J. (2003). Social networks and social well-being of older men and women living alone. In S. Arber, K. Davidson, & J. Ginn (Eds.), Gender and ageing changing roles and relationships. Maidenhead: Open University Press.
54.
go back to reference Wenger, G. C. (1984). The supportive network: Coping with old age. London: Allen and Unwin. Wenger, G. C. (1984). The supportive network: Coping with old age. London: Allen and Unwin.
55.
go back to reference Burnette, D., & Mui, A. C. (1996). Psychological well-being among three successive cohorts of older American women who live alone. Journal of Women & Aging, 8(1), 63–80.CrossRef Burnette, D., & Mui, A. C. (1996). Psychological well-being among three successive cohorts of older American women who live alone. Journal of Women & Aging, 8(1), 63–80.CrossRef
56.
go back to reference Hall, M., & Havens, B. (2001). The effects of social isolation and loneliness on the health of older women. Winnipeg: Centres of Excellence for Women’s Health. Hall, M., & Havens, B. (2001). The effects of social isolation and loneliness on the health of older women. Winnipeg: Centres of Excellence for Women’s Health.
57.
go back to reference Barnes, M., Blom, A., Cox, K., et al. (2006). The social exclusion of older people: Evidence from the first wave of the English Longitudinal Study of Ageing (ELSA). London: Social Exclusion Unit, Office of the Deputy Prime Minister. Barnes, M., Blom, A., Cox, K., et al. (2006). The social exclusion of older people: Evidence from the first wave of the English Longitudinal Study of Ageing (ELSA). London: Social Exclusion Unit, Office of the Deputy Prime Minister.
58.
go back to reference Grundy, E. (1999). Changing role of the family and community in providing support for the elderly. In R. Cliquet & M. Nizamuddin (Eds.), Population ageing. Challenges for policies and programmes in developed and developing countries. New York: UNFPA. Grundy, E. (1999). Changing role of the family and community in providing support for the elderly. In R. Cliquet & M. Nizamuddin (Eds.), Population ageing. Challenges for policies and programmes in developed and developing countries. New York: UNFPA.
59.
go back to reference Hahn, B. A. (1993). Marital status and women’s health, the effect of economic and marital acquisitions. Journal of Marriage and the Family, 55, 495–504.CrossRef Hahn, B. A. (1993). Marital status and women’s health, the effect of economic and marital acquisitions. Journal of Marriage and the Family, 55, 495–504.CrossRef
Metagegevens
Titel
Associations between living arrangements and health-related quality of life of urban elderly people: a study from China
Auteurs
Xiaojie Sun
Henry Lucas
Qingyue Meng
Yaoguang Zhang
Publicatiedatum
01-04-2011
Uitgeverij
Springer Netherlands
Gepubliceerd in
Quality of Life Research / Uitgave 3/2011
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-010-9752-z

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