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      Social Participation and Survival in Widowed Persons: Results of the Taiwan Longitudinal Study on Aging

      , , , ,
      International Journal of Environmental Research and Public Health
      MDPI AG

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          Abstract

          It has been considered that widowed persons have a higher risk of death. This study intended to explore whether social participation could improve this trend. A longitudinal study database was constructed to explore the trend of survival and its change with social participation in widowed persons. The Taiwan Longitudinal Study on Aging (TLSA), based on four consecutive waves of longitudinal follow-up data in 1999, 2003, 2007, and 2011 was linked with the National Death Registry from 1999 through 2012. In total, there were 1417 widowed persons and 4500 nonwidowed persons included in this study, excluding divorced and never-married people. The survival trend analysis was carried out with social participation as the main predictive factor stratified for comparative analysis. Our results showed that the widowed were older than the nonwidowed, were female-dominant, had a lower education level, were more economically stressed, and were less likely to engage in regular exercise, and thus showed generally poorer health; for example, being more vulnerable to having chronic diseases, disability with the Activities of Daily Living (ADL), cognitive impairment with the Short Portable Mental State Questionnaire (SPMSQ), and depression with The Center for Epidemiological Studies-Depression (CES-D). The death risk of the widowed was significantly higher than that of the nonwidowed, but the death trend for those with social participation was significantly lower than that of their counterparts in both the widowed and nonwidowed. After matching with gender and age for widowed persons, the widowed with social participation had a significantly lower risk of death (adjusted hazard ratio (HR), 0.83; 95% confidence interval (CI), 0.71–0.98) compared to the widowed without social participation. It was concluded that social participation can improve the death risk for the widowed, and it is worthily included in health promotion plans and social welfare services for widowed persons.

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          A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients.

          Clinicians whose practice includes elderly patients need a short, reliable instrument to detect the presence of intellectual impairment and to determine the degree. A 10-item Short Portable Mental Status Questionnaire (SPMSQ), easily administered by any clinician in the office or in a hospital, has been designed, tested, standardized and validated. The standardization and validation procedure included administering the test to 997 elderly persons residing in the community, to 141 elderly persons referred for psychiatric and other health and social problems to a multipurpose clinic, and to 102 elderly persons living in institutions such as nursing homes, homes for the aged, or state mental hospitals. It was found that educational level and race had to be taken into account in scoring individual performance. On the basis of the large community population, standards of performance were established for: 1) intact mental functioning, 2) borderline or mild organic impairment, 3) definite but moderate organic impairment, and 4) severe organic impairment. In the 141 clinic patients, the SPMSQ scores were correlated with the clinical diagnoses. There was a high level of agreement between the clinical diagnosis of organic brain syndrome and the SPMSQ scores that indicated moderate or severe organic impairment.
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            Studies of Illness in the Aged

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              Widowhood and depression: explaining long-term gender differences in vulnerability.

              Results from a 1986 national survey (N = 3,614) show that having ever been widowed is associated with current levels of depression and that this association is greater for men than women. Some of this apparent gender difference occurs because men have been widowed for a shorter average period of time than women and the effects of widowhood appear to lessen over time. Widowhood also is associated with different types and amounts of life strain for men and women. The results suggest that the primary mechanism linking widowhood to depression among women is financial strain. Among men, the more critical mechanisms seem to be strains associated with household management. When specific strains occur, they appear to have different effects on respondents who have ever been widowed and those who have not. Taken together, these results suggest that what appears on the surface to be a gender difference in vulnerability to the same life event turns out upon closer examination to occur because widowhood does not affect men and women in the same way.
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                Author and article information

                Contributors
                Journal
                IJERGQ
                International Journal of Environmental Research and Public Health
                IJERPH
                MDPI AG
                1660-4601
                October 2021
                October 19 2021
                : 18
                : 20
                : 10974
                Article
                10.3390/ijerph182010974
                e7a0a06d-2330-4e6d-a1a1-fd0175ca4a03
                © 2021

                https://creativecommons.org/licenses/by/4.0/

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