Co-residence with children as a mediator between widowhood and loneliness in older adults.
Causal mediation analysis
China
Living arrangements
Loneliness
Moderated mediation analysis
Widowhood
Journal
BMC geriatrics
ISSN: 1471-2318
Titre abrégé: BMC Geriatr
Pays: England
ID NLM: 100968548
Informations de publication
Date de publication:
25 Sep 2024
25 Sep 2024
Historique:
received:
01
05
2024
accepted:
06
09
2024
medline:
26
9
2024
pubmed:
26
9
2024
entrez:
25
9
2024
Statut:
epublish
Résumé
Loneliness in older adults, exacerbated by widowhood, is a significant public health concern. While widowhood can lead to changes in living arrangements, its impact on loneliness may vary across cultural contexts. In Western societies, widowhood often results in older adults living alone, which can intensify feelings of loneliness. However, in China, the cultural norm of filial piety and multigenerational households may lead to different outcomes. As few studies have explored this connection over time, this research seeks to bridge this gap using data from older Chinese adults. Using 16 years of data from the Chinese Longitudinal Healthy Longevity Survey, which covers 21,986 individuals aged 65-104 years, we conducted causal mediation analysis to test if changes in living arrangements (i.e., living alone versus with children) serve as a mediator between widowhood and loneliness. The potential variation in this mediation effect by gender and age was also evaluated. Spousal loss was associated with an increase in loneliness. However, living with adult children post-loss reduced this emotional strain compared to living alone. The mediating influence of living arrangements was notably stronger for women than men and intensified with age in long term. In the short term, the mediating impact of living arrangements is significantly greater, particularly for older adults under 80 years old. Alterations in living arrangements play a pivotal role in mediating the effects of widowhood on loneliness among China's older adults. Encouraging co-residence with adult children post-spousal loss, especially for older women and the eldest age groups, might mitigate social isolation. These insights both deepen our theoretical understanding and suggest interventions to enhance the well-being of widowed older adults.
Sections du résumé
BACKGROUND
BACKGROUND
Loneliness in older adults, exacerbated by widowhood, is a significant public health concern. While widowhood can lead to changes in living arrangements, its impact on loneliness may vary across cultural contexts. In Western societies, widowhood often results in older adults living alone, which can intensify feelings of loneliness. However, in China, the cultural norm of filial piety and multigenerational households may lead to different outcomes. As few studies have explored this connection over time, this research seeks to bridge this gap using data from older Chinese adults.
METHODS
METHODS
Using 16 years of data from the Chinese Longitudinal Healthy Longevity Survey, which covers 21,986 individuals aged 65-104 years, we conducted causal mediation analysis to test if changes in living arrangements (i.e., living alone versus with children) serve as a mediator between widowhood and loneliness. The potential variation in this mediation effect by gender and age was also evaluated.
RESULTS
RESULTS
Spousal loss was associated with an increase in loneliness. However, living with adult children post-loss reduced this emotional strain compared to living alone. The mediating influence of living arrangements was notably stronger for women than men and intensified with age in long term. In the short term, the mediating impact of living arrangements is significantly greater, particularly for older adults under 80 years old.
CONCLUSION
CONCLUSIONS
Alterations in living arrangements play a pivotal role in mediating the effects of widowhood on loneliness among China's older adults. Encouraging co-residence with adult children post-spousal loss, especially for older women and the eldest age groups, might mitigate social isolation. These insights both deepen our theoretical understanding and suggest interventions to enhance the well-being of widowed older adults.
Identifiants
pubmed: 39322948
doi: 10.1186/s12877-024-05363-w
pii: 10.1186/s12877-024-05363-w
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
787Subventions
Organisme : National Social Science Fund of China
ID : 19BRK013
Informations de copyright
© 2024. The Author(s).
Références
Zhou X, Yang F, Gao Y. A meta-analysis of the association between loneliness and all-cause mortality in older adults. Psychiatry Res. 2023;328:115430.
pubmed: 37647699
doi: 10.1016/j.psychres.2023.115430
Holt-Lunstad J, Smith TB, Baker M, Harris T, Stephenson D. Loneliness and social isolation as risk factors for mortality. Perspect Psychol Sci [Internet]. 2015;10(2):227–37. https://journals.sagepub.com/doi/full/10.1177/1745691614568352 . Availablefrom.
pubmed: 25910392
doi: 10.1177/1745691614568352
Reiland H, Giuca AM, Banerjee A, Hillard CJ, Goveas JS. The relationship of loneliness with mental health trajectories in bereaved older adults. Am J Geriatric Psychiatry. 2021;29(4):S88–9.
doi: 10.1016/j.jagp.2021.01.082
Freak-Poli R, Kung CSJ, Ryan J, Shields MA. Social isolation, Social Support, and loneliness profiles before and after Spousal Death and the Buffering Role of Financial resources. Journals Gerontology: Ser B. 2022;77(5):956–71.
doi: 10.1093/geronb/gbac039
King BM, Carr DC, Taylor MG. Loneliness Following Widowhood: The Role of the Military and Social Support. Carr D, editor. The Journals of Gerontology: Series B. 2021;76(2).
Spahni S, Bennett KM, Perrig-Chiello P. Psychological adaptation to spousal bereavement in old age: the role of trait resilience, marital history, and context of death. Death Stud. 2016;40(3):182–90.
pubmed: 26745606
doi: 10.1080/07481187.2015.1109566
Szabó Á, Kok AAL, Beekman ATF, Huisman M. Longitudinal examination of emotional functioning in older adults after spousal bereavement. Journals Gerontology: Ser B. 2020;75(8).
Yang F, Gu D. Widowhood, widowhood duration, and loneliness among older adults in China. Soc Sci Med. 2021;283:114179.
pubmed: 34225038
doi: 10.1016/j.socscimed.2021.114179
Yu J, Kahana E, Kahana B, Han C. Depressive symptoms among elderly men and women who transition to widowhood: comparisons with long term married and long term widowed over a 10-year period. J Women Aging. 2019;33(3):231–46.
pubmed: 31671028
doi: 10.1080/08952841.2019.1685855
Seiler A, Von Känel R, Slavich GM. The psychobiology of Bereavement and Health: a conceptual review from the Perspective of Social Signal Transduction Theory of Depression. Front Psychiatry. 2020;11(11):565239.
pubmed: 33343412
pmcid: 7744468
doi: 10.3389/fpsyt.2020.565239
Van Baarsen B. Theories on coping with loss: the impact of Social Support and Self-Esteem on Adjustment to Emotional and Social Loneliness following a Partner’s death in later life. Journals Gerontol Ser B: Psychol Sci Social Sci. 2002;57(1):S33–42.
doi: 10.1093/geronb/57.1.S33
Ng ACY, Phillips DR, Lee WK. Persistence and challenges to filial piety and informal support of older persons in a modern Chinese society. J Aging Stud. 2002;16(2):135–53.
doi: 10.1016/S0890-4065(02)00040-3
Silverstein M, Cong Z, Li S. Intergenerational transfers and living arrangements of older people in Rural China: consequences for Psychological Well-Being. Journals Gerontol Ser B: Psychol Sci Social Sci. 2006;61(5):S256–66.
doi: 10.1093/geronb/61.5.S256
Calhoun CD, Stone KJ, Cobb AR, Patterson MW, Danielson CK, Bendezú JJ. The role of Social Support in coping with psychological trauma: an Integrated Biopsychosocial Model for Posttraumatic stress recovery. Psychiatr Q. 2022;93(4):949–70.
pubmed: 36199000
pmcid: 9534006
doi: 10.1007/s11126-022-10003-w
Utz RL, Carr D, Nesse R, Wortman CB. The Effect of Widowhood on older adults’ social ParticipationAn evaluation of activity, disengagement, and continuity theories. Gerontologist. 2002;42(4):522–33.
pubmed: 12145380
doi: 10.1093/geront/42.4.522
Frankenberg E, Lillard L, Willis RJ. Patterns of intergenerational transfers in Southeast Asia. J Marriage Family. 2002;64(3):627–41.
doi: 10.1111/j.1741-3737.2002.00627.x
Korinek K, Zimmer Z, Gu D. Transitions in Marital Status and Functional Health and patterns of intergenerational coresidence among China’s Elderly Population. Journals Gerontol Ser B: Psychol Sci Social Sci. 2011;66B(2):260–70.
doi: 10.1093/geronb/gbq107
Zimmer Z. Health and living arrangement transitions among China’s oldest-old. In: Yi Z, Poston DL, Vlosky DA, Gu D, editors Healthy longevity in China. The Springer Series on demographic methods and Population Analysis, vol 20. Springer, Dordrecht;2008:526–55.
Antonucci TC, Ajrouch KJ, Birditt KS. The Convoy Model: explaining Social relations from a multidisciplinary perspective. Gerontologist. 2014;54(1):82–92.
pubmed: 24142914
doi: 10.1093/geront/gnt118
Koehly LM, Manalel JA. Interconnected social convoys: understanding health and well-being through linked personal networks. Adv Life Course Res. 2023;56:100541.
pubmed: 38054886
doi: 10.1016/j.alcr.2023.100541
Cornwell B, Qu T. I love you to death: Social Networks and the Widowhood Effect on Mortality. J Health Soc Behav, 2023: 00221465231175685.
De Vaus D, Qu L. Demographics of living alone (Australian Family trends No. 6). Melbourne: Australian Institute of Family Studies; 2015.
Newton NJ, Breheny M, Stephens C. Social connections and Future Horizons: socioemotional selectivity among midlife and older adults in Aotearoa/New Zealand during COVID-19. J Adult Dev, 2024,.1–13.
Carr DC, Ureña S, Taylor MG. Adjustment to Widowhood and Loneliness among older men: the influence of Military Service. Gerontologist. 2017;58(6):1085–95.
doi: 10.1093/geront/gnx110
Kafková MP. Sources of loneliness for older adults in the Czech Republic and Strategies for coping with loneliness. Social Inclusion. 2023;11(1).
Larsson K, Wallroth V, Schröder A. You never get used to loneliness – older adults’ experiences of Loneliness when applying for going on a senior summer Camp. J Gerontol Soc Work. 2019;62(8):892–911.
pubmed: 31809684
doi: 10.1080/01634372.2019.1687633
Morris A, Verdasco A. Loneliness and housing tenure: older private renters and social housing tenants in Australia. J Sociol. 2020;57(4):144078332096052.
Yuan ZQ, Zheng X, Hui ECM. Happiness under one roof? The intergenerational co-residence and subjective well-being of elders in China. J Happiness Stud, 2021, 22.
Mullins LC, Tucker R, Longino CF, Marshall V. An examination of Loneliness among Elderly Canadian Seasonal residents in Florida. J Gerontol. 1989;44(2):S80–6.
pubmed: 2921482
doi: 10.1093/geronj/44.2.S80
Ha JH, Ingersoll-Dayton B. Moderators in the relationship between social contact and psychological distress among widowed adults. Aging Ment Health. 2011;15(3):354–63.
pubmed: 21491220
pmcid: 3095214
doi: 10.1080/13607863.2010.519325
Bennett KM, Soulsby LK. Wellbeing in Bereavement and Widowhood. Illn Crisis Loss. 2012;20(4):321–37.
doi: 10.2190/IL.20.4.b
Stroebe M, Stroebe W, Schut H. Gender differences in Adjustment to Bereavement: an empirical and theoretical review. Rev Gen Psychol. 2001;5(1):62–83.
doi: 10.1037/1089-2680.5.1.62
Hansen T, Slagsvold B. Late-life loneliness in 11 European countries: results from the generations and gender survey. Soc Indic Res. 2015;129(1):445–64.
doi: 10.1007/s11205-015-1111-6
Arber S. Gender, marital status, and ageing: linking material, health, and social resources. J Aging Stud. 2004;18(1):91–108.
doi: 10.1016/j.jaging.2003.09.007
Zhou M, Qian Z. Social Support and Self-reported quality of Life China’s Oldest Old. In: Yi Z, Poston DL, Vlosky DA, Gu D, editors Healthy longevity in China. The Springer Series on demographic methods and Population Analysis, vol 20. Springer, Dordrecht;2008:357–76.
Seltzer JA, Friedman EM. Widowed mothers’ coresidence with Adult Children. Journals Gerontol Ser B: Psychol Sci Social Sci. 2013;69B(1):63–74.
doi: 10.1093/geronb/gbt072
Streeter JL. Gender differences in widowhood in the short-run and long-run: Financial, emotional, and mental wellbeing. J Econ Ageing. 2020;17:100258.
doi: 10.1016/j.jeoa.2020.100258
Wei K, Yang J, Yang B, Jiang L, Jiang J, Cao X, et al. Living preference modifies the associations of living arrangements with loneliness among Community-Dwelling older adults. Front Public Health. 2022;9:794141.
pubmed: 35127625
pmcid: 8814323
doi: 10.3389/fpubh.2021.794141
Carstensen LL. Social and emotional patterns in adulthood: support for socioemotional selectivity theory. Psychol Aging. 1992;7(3):331–8.
pubmed: 1388852
doi: 10.1037/0882-7974.7.3.331
Lei X, Strauss J, Tian M, Zhao Y. Living arrangements of the elderly in China: evidence from the CHARLS national baseline. China Economic J. 2015;8(3):191–214.
pubmed: 27182281
pmcid: 4865266
doi: 10.1080/17538963.2015.1102473
Chen F. Residential patterns of parents and their married children in contemporary China: a life course approach. Popul Res Policy Rev. 2005;24(2):125–48.
doi: 10.1007/s11113-004-6371-9
Yi Z, Wang Z. Dynamics of Family and Elderly living arrangements in China: New lessons learned from the 2000 Census. China Rev. 2003;3(2).
Zeng Y. Introduction to the Chinese Longitudinal Healthy Longevity Survey (CLHLS), in: Zeng, Yi, Poston, D.L., Vlosky, D.A., Gu, D, editors, Healthy Longevity in China: Demographic, Socioeconomic, and Psychological Dimensions, The Springer Series on Demographic Methods and Population Analysis. Springer Netherlands, Dordrecht;2008:23–38.
Victor CR, Scambler SJ, Marston L, Bond J, Bowling A. Older people’s experiences of loneliness in the UK: does gender matter? Social Policy Soc. 2006;5(1):27–38.
doi: 10.1017/S1474746405002733
De Ayala RJ, Little TD. The theory and practice of item response theory. The Guilford Press; 2022.
Imai K, Keele L, Tingley D. A general approach to causal mediation analysis. Psychol Methods. 2010;15(4):309–34.
pubmed: 20954780
doi: 10.1037/a0020761
Tingley D, Yamamoto T, Hirose K, Keele L, Imai K. Mediation: R Package for Causal Mediation Analysis. J Stat Softw. 2014;59(5):1–38.
doi: 10.18637/jss.v059.i05
Cong Z, Silverstein M. Intergenerational support and Depression among elders in Rural China: do Daughters-In-Law. Matter? J Marriage Family. 2008;70(3):599–612.
doi: 10.1111/j.1741-3737.2008.00508.x
Sugihara Y, Sugisawa H, Nakatani Y, Hougham GW. Longitudinal changes in the Well-Being of Japanese caregivers: variations across Kin relationships. Journals Gerontol Ser B: Psychol Sci Social Sci. 2004;59(4):P177–84.
doi: 10.1093/geronb/59.4.P177
Rajan SI, Kumar S. Living arrangements among Indian elderly: new evidence from national family health survey. Econ Polit Economic Political Wkly. 2003;2003381:75–80.
CHEUNG CK, KWAN AYH. The erosion of filial piety by modernisation in Chinese cities. Aging Soc. 2009;29(2):179–98.
doi: 10.1017/S0144686X08007836
Tsutsui T, Muramatsu N, Higashino S. Changes in perceived filial Obligation norms among Coresident Family caregivers in Japan. Gerontologist. 2014;54(5):797–807.
pubmed: 24009170
doi: 10.1093/geront/gnt093
Davidson K. What we want: older widows and widowers speak for themselves. Practice. 2000;12(1):45–54.
doi: 10.1080/09503150008415176
Lee GR, DeMaris A, Bavin S, Sullivan R. Gender differences in the Depressive Effect of Widowhood in later life. Journals Gerontol Ser B: Psychol Sci Social Sci. 2001;56(1):S56–61.
doi: 10.1093/geronb/56.1.S56
Chen F, Short SE. Household Context and Subjective Well-being among the Oldest Old in China. J Fam Issues. 2008;29(10):1379–403.
pubmed: 19554216
pmcid: 2701306
doi: 10.1177/0192513X07313602
Cornwell B, Laumann EO, Schumm LP. The Social Connectedness of older adults: a National Profile. Am Sociol Rev. 2008;73(2):185–203.
pubmed: 19018292
pmcid: 2583428
doi: 10.1177/000312240807300201
McPherson M, Smith-Lovin L, Brashears ME. Social isolation in America: changes in core discussion networks over two decades. Am Sociol Rev. 2006;71(3):353–75.
doi: 10.1177/000312240607100301