Self-perceived uselessness and associated factors among older adults in China

Abstract

BackgroundSelf-perceived uselessness is associated with poor health and high mortality among older adults in China. However, it is unclear which demographic, psychosocial, behavioral and health factors are associated with self-perceived uselessness.MethodsData came from four waves (2005, 2008, 2011 and 2014) of the largest nationwide longitudinal survey of the population aged 65 and older in China (26,624 individuals contributed 48,476 observations). This study aimed to systematically investigate factors associated with self-perceived uselessness based on the proposed REHAB framework that includes resources (R), environments (E), health (H), fixed attributes (A) and behaviors (B). Self-perceived uselessness was measured by a single item: “with age, do you feel more useless?” and coded by frequency: high (always and often), moderate (sometimes) and low (seldom and never). Multinomial logistic regression models with low frequency as the reference category were employed to identify REHAB risk factors associated with self-perceived uselessness.ResultsMost factors in the REHAB framework were associated with self-perceived uselessness, although some social environmental factors in the full model were not significant. Specifically, more socioeconomic resources were associated with reduced relative risk ratio (RRR) of high or moderate frequency of self-perceived uselessness relative to low frequency. More environmental family/social support was associated with lower RRR of high frequency of self-perceived uselessness. Cultural factors such as coresidence with children and intergenerational transfer were associated with reduced RRR of high frequency of self-perceived uselessness. Indicators of poor health status such as disability and loneliness were associated with greater RRR of high or moderate frequency of self-perceived uselessness. Fixed attributes of older age and Han ethnicity were associated with increased RRR of high frequency of self-perceived uselessness; whereas optimism and self-control were associated with reduced RRR. Behaviors including regular consumption of alcohol, regular exercise, social participation and leisure activities were associated with reduced RRR of high frequency of self-perceived uselessness.ConclusionsSelf-perceived uselessness was associated with a wide range of factors in the REHAB framework. The findings could have important implications for China to develop and target community health programs to improve self-perceived usefulness among older adults.

Multi-Level Factors Associated with Social Participation among Stroke Survivors: China’s Health and Retirement Longitudinal Study (2011–2015)

“…Researchers are increasingly interested in identifying popular social activities that survivors of stroke engage in across diverse cultures [6,7]. For example, in China, it is a cultural tradition that older Chinese parents reside with adult children and provide assistance to family members, such as taking care of grandchildren [11]. Community-dwelling older Chinese individuals have reported preferred activities such as square dancing and table gambling games such as mahjong, which is played in groups of four [12,13].…”

Changes in perceived uselessness and risks for mortality: evidence from a National sample of older adults in China

“…Based on previous studies, measures of family support and environment also included (i) concordance/discordance between expected living arrangement and actual living arrangement and (ii) intergenerational transfers [13]. First, if an older adult was living alone or with a spouse—and was consistent with his/her expected living arrangement—we categorized them as concordant in living alone or with spouse.…”

“…With among the largest number of older adults in the world, China has gained considerable attention by scholars to better understand the challenges of aging in the context of this nation’s unique social and cultural makeup. Recent studies have now begun to demonstrate an association between perceptions of uselessness and subsequent health and mortality outcomes among older adults in China [ 11 – 13 ]. The research shows that older adults with high perceptions of feeling useless are more likely to exhibit poorer health and higher mortality risks than older adults with low (or no) perceptions of feeling useless [ 11 – 13 ].…”

“…Recent studies have now begun to demonstrate an association between perceptions of uselessness and subsequent health and mortality outcomes among older adults in China [ 11 – 13 ]. The research shows that older adults with high perceptions of feeling useless are more likely to exhibit poorer health and higher mortality risks than older adults with low (or no) perceptions of feeling useless [ 11 – 13 ]. However, it is unclear whether and to what extent changes in perceived uselessness that may accompany aging are associated with mortality risks.…”

Erratum to: Self-perceived uselessness and associated factors among older adults in China

“…After the publication of this work [1] five corrections were discovered in the text. The corrections are as follows:

In the first line of the fourth paragraph in the section, Background, the text “non-Western cultures” should be “Western cultures”.

In the first line of the section, Factors associated with self-perceived uselessness, the text “six sets” should be “five sets”.

In Row 2 of Table 1, the text “Giving money/food to children-yes” should be “Giving money/food to children-no”.

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