Abstract
Few studies focus on the prevalence and related factors of successful aging (SA) among Chinese rural elders living in nursing homes. This study aims to make an operational definition of successful aging, estimate the prevalence of SA, and identify factors related to SA among Chinese rural elders living in nursing homes. Data for this cross-sectional study were collected by face-to-face interviews in five rural public nursing homes. A total of 205 elders aged 60 years and above were asked to answer a series of questions. Descriptive analysis, independent sample t tests, χ 2 tests, and multivariate logistic regression were used to show the prevalence and related factors of SA. The prevalence of SA in this population is 17.6% based on a multidimensional construct composed of: few chronic diseases, good cognitive and physical functioning, good mental health, and active social engagement. The logistic regression results indicate that successful agers are more likely to be younger, married, resilient, and better off economically, whereas gender, education, and social support are not related to SA independently. This model accounts for 45.8% of the variance in SA. These results suggest some tentative recommendations for elders, relevant decision-makers or employees in nursing homes, and administrative bodies. More rigorous longitudinal design is necessary to investigate the causality of the related factors and SA.
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Barczak P, Kane N, Andrews S, Congdon AM, Clay JC, Betts T (1988) Patterns of psychiatric morbidity in a genito-urinary clinic. A validation of the Hospital Anxiety Depression scale (HAD). Br J Psychiatry 152:698–700
Blumenthal J, Burg M, Barefoot J, Williams R, Haney T, Zimet G (1987) Social support, type A behavior, and artery disease. Psychosom Med 49:331–340
Bowling A, Iliffe S (2006) Which model of successful ageing should be used? Baseline findings from a British longitudinal survey of ageing. Age Ageing 35:607–614
Brown SC, Mason CA, Spokane AR, Cruza-Guet MC, Lopez B, Szapocznik J (2009) The relationship of neighborhood climate to perceived social support and mental health in older Hispanic immigrants in Miami, Florida. J Aging Health 21:431–459
Cai J (2012) Aged care and management. Second Military Medical University Press, Shanghai
Calasanti T (2015) Combating ageism: how successful is successful aging? Gerontologist. doi:10.1093/geront/gnv076
Campbell-Sills L, Stein MB (2007) Psychometric analysis and refinement of the Connor-Davidson Resilience Scale (CD-RISC): validation of a 10-item measure of resilience. J Trauma Stress 20:1019–1028
Chen P, Yu ES, Zhang M, Liu WT, Hill R, Katzman R (1995) ADL dependence and medical conditions in Chinese older persons: a population-based survey in Shanghai, China. J Am Geriatr Soc 43:378–383
Cheung F, Wu AMS (2012) An investigation of predictors of successful aging in the workplace among Hong Kong Chinese older workers. Int Psychogeriatr 24:449–464
China (2015) Statistical communiqué of the People’s Republic of China on the 2014 national economic and social development. http://www.stats.gov.cn/english/PressRelease/201502/t20150228_687439.html
Chou K, Chi I (2002) Successful aging among the young-old, old-old, and oldest-old Chinese. Int J Aging Hum Dev 54:1–14
Da Canhota CMN, Piterman L (2001) Depressive disorders in elderly Chinese patients in Macau: a comparison of general practitioners’ consultations with a depression screening scale. Aust N Z J Psychiatry 35:336–344
Dahany MM, Dramé M, Mahmoudi R, Novella JL, Ciocan D, Kanagaratnam L et al (2014) Factors associated with successful aging in persons aged 65 to 75 years. Eur Geriatr Med 5:365–370
de Moraes JFD, de Azevedo E Souza VB (2005) Factors associated with the successful aging of the socially-active elderly in the metropolitan region of Porto Alegre. Rev Bras Psiquiatr 27:302–308
Depp CA, Jeste DV (2006) Definitions and predictors of successful aging: a comprehensive review of larger quantitative studies. Am J Geriatr Psychiatry 14:6–20
Dong X, Simon MA (2010) Health and aging in a Chinese population: urban and rural disparities. Geriatr Gerontol Int 10:85–93
Engel GL (1977) The need for a new medical model: a challenge for biomedicine. Science 196:129–136
Evans RJ (2009) A comparison of rural and urban older adults in Iowa on specific markers of successful aging. J Gerontol Soc Work 52:423–438
Feng D, Ji L, Xu L (2015a) Effect of subjective economic status on psychological distress among farmers and non-farmers of rural China. Aust J Rural Health 23:215–220
Feng Q, Son J, Zeng Y (2015b) Prevalence and correlates of successful ageing: a comparative study between China and South Korea. Eur J Ageing 12:83–94
Ferraro KF, Shippee TP (2009) Aging and cumulative inequality: how does inequality get under the skin? Gerontologist 49:333–343
Fontes AP, Neri AL (2015) Resilience in aging: literature review. Ciên Saúde Colet 20:1475–1495
Gan P, Xie Y, Duan W, Deng Q, Yu X (2015) Rumination and loneliness independently predict six-month later depression symptoms among Chinese elderly in nursing homes. PLoS ONE 10:e137176
Hamid TA, Momtaz YA, Ibrahim R (2012) Predictors and prevalence of successful aging among older Malaysians. Gerontology 58:366–370
Han S, Yun S (2015) Successful aging and the influencing factors in the Korean elderly: focused on family support. J Korean Acad Community Health Nurs 26:372–379
Havighurst RJ (1958) The sociologic meaning of aging. Geriatrics 13:43–50
Hodge AM, English DR, Giles GG, Flicker L (2013) Social connectedness and predictors of successful ageing. Maturitas 75:361–366
Jeste DV, Savla GN, Thompson WK, Vahia IV, Glorioso DK, Martin AVS et al (2013) Association between older age and more successful aging: critical role of resilience and depression. Am J Psychiatry 170:188–196
Jing H, Li J, Li H, Yang Y, Sun F, Han L et al (2014) A philosophical reflection on health care seeking behavior and an exploration into its correlation with social development. Med Philos 35:43–49
Karasawa M, Curhan KB, Markus HR, Kitayama SS, Love GD, Radler BT et al (2011) Cultural perspectives on aging and well-being: a comparison of Japan and the United States. Int J Aging Dev 73:73–98
Katzman R, Zhang M, Ouang-Ya-Qu Wang Z, Liu WT, Yu E et al (1988) A Chinese version of the Mini-Mental State Examination: impact of illiteracy in a Shanghai dementia survey. J Clin Epidemiol 41:971–978
Leung CM, Ho S, Kan CS, Hung CH, Chen CN (1993) Evaluation of the Chinese version of the Hospital Anxiety and Depression Scale: a cross-cultural perspective. Int J Psychosom 40:29–34
Li C, Wu W, Jin H, Zhang X, Xue H, He Y et al (2006) Successful aging in Shanghai, China: definition, distribution and related factors. Int Psychogeriatr 18:551
Li C, Chen M, Chang T, Chou H, Chen M (2015) Social support buffers the effect of self-esteem on quality of life of early-stage cervical cancer survivors in Taiwan. Eur J Oncol Nurs 19:486–494
Lin P, Hsieh C, Cheng H, Tseng T, Su S (2016) Association between physical fitness and successful aging in Taiwanese older adults. PLoS ONE 11:e150389
Martinson M, Berridge C (2015) Successful aging and its discontents: a systematic review of the social gerontology literature. Gerontologist 55:58–69
Meng X, D’Arcy C (2014) Successful aging in Canada: prevalence and predictors from a population-based sample of older adults. Gerontology 60:65–72
Moonesar R, Sammy I, Nunes P, Paul J (2016) Social support in older people: lessons from a developing country. Qual Life Res 25:233–236
Moore RC, Eyler LT, Mausbach BT, Zlatar ZZ, Thompson WK, Peavy G et al (2015) Complex interplay between health and successful aging: role of perceived stress, resilience, and social support. Am J Geriatr Psychiatry 23:622–632
Ng TP, Broekman BFP, Niti M, Gwee X, Kua EH (2009) Determinants of successful aging using a multidimensional definition among Chinese elderly in Singapore. Am J Geriatr Psychiatry 17:407–416
Phelan EA, Anderson LA, LaCroix AZ, Larson EB (2004) Older adults’ views of “successful aging”—how do they compare with researchers’ definitions? J Am Geriatr Soc 52:211–216
Pruchno RA, Wilson-Genderson M, Cartwright F (2010) A two-factor model of successful aging. J Gerontol Ser B Psychol Sci Soc Sci 65B:671–679
Qu B, Li X, Liu J, Mao J (2012) Analysis of the current situation regarding the aging rural population in China and proposed countermeasures. Popul Health Manag 15:181–185
Resnick B, Klinedinst NJ, Yerges-Armstrong L, Choi EY, Dorsey SG (2015) The impact of genetics on physical resilience and successful aging. J Aging Health 27:1084–1104
Riley MW (1998) Successful aging. Gerontologist 38:151
Romo RD, Wallhagen MI, Yourman L, Yeung CC, Eng C, Micco G et al (2013) Perceptions of successful aging among diverse elders with late-life disability. Gerontologist 53:939–949
Roos N, Havens B (1991) Predictors of successful aging: a twelve-year study of Manitoba elderly. Am J Public Health 81:63–68
Rowe JW, Kahn RL (1997) Successful aging. Cerontologist 37:433–440
Scali J, Gandubert C, Ritchie K, Soulier M, Ancelin M, Chaudieu I (2012) Measuring resilience in adult women using the 10-items Connor-Davidson Resilience Scale (CD-RISC): role of trauma exposure and anxiety disorders. PLoS ONE 7:e39879
Strawbridge WJ, Wallhagen MI, Cohen RD (2002) Successful aging and well-being: self-rated compared with Rowe and Kahn. Gerontologist 42:727–733
Thoits PA (2010) Stress and health: major findings and policy implications. J Health Soc Behav 511:S41–S53
Tian T, Chen Y, Zhu J, Liu P (2015) Effect of air pollution and rural-urban difference on mental health of the elderly in China. Iran J Public Health 44:1084–1094
Tovel H, Carmel S (2014) Maintaining successful aging: the role of coping patterns and resources. J Happiness Stud 15:255–270
Underwood M, Lamb SE, Eldridge S, Sheehan B, Slowther A, Spencer A et al (2013) Exercise for depression in elderly residents of care homes: a cluster-randomised controlled trial. Lancet 382:41–49
United Nations (2015) World population ageing 2015. Department of Economic and Social Affair. http://www.un.org/en/development/desa/population/publications/pdf/ageing/PopulationAgeingAndDevelopment2015.pdf
Wang G (2015) Attaches great importance to the problem of rural population aging too rapidly. Explor Free Views 12:28–30
Weir PL, Meisner BA, Baker J (2010) Successful aging across the years: does one model fit everyone? J Health Psychol 15:680–687
Woodford HJ, George J (2007) Cognitive assessment in the elderly: a review of clinical methods. QJM 100:469–484
Wu B, Mao Z, Xu Q (2008) Institutional care for elders in rural China. J Aging Soc Policy 20:218–239
Xie J, Chen Y, Jiang L, Wang S (2011) A comparative study on quality of life, loneliness and self-esteem of the aged in Shantou rest home and community. Chin J Clin Psychol 19:358–359
Yeung WJ, Xu Z (2012) Economic stress, quality of life, and mortality for the oldest-old in China. Soc Indic Res 108:131–152
Yu P, Song X, Shi J, Mitnitski A, Tang Z, Fang X et al (2012) Frailty and survival of older Chinese adults in urban and rural areas: results from the Beijing longitudinal study of aging. Arch Gerontol Geriatr 54:3–8
Zhang Y, Goza FW (2006) Who will care for the elderly in China? J Aging Stud 20:151–164
Zhang J, Li LW (2015) Provincial variation in marketization and successful aging in China: a multilevel analysis. J Popul Ageing 8:203–222
Zimet GD, Powell SS, Farley GK, Werkman S, Berkoff KA (1990) Psychometric characteristics of the Multidimensional Scale of Perceived Social Support. J Pers Assess 55:610–617
Acknowledgements
This study has been approved by the SDU Human Research Protection Program. This work was supported by the Ministry of Education of China under Grant 14YJAZH068; Youth Team of Shandong University under Grant IFYT15008.
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Wu, M., Yang, Y., Zhang, D. et al. Prevalence and related factors of successful aging among Chinese rural elders living in nursing homes. Eur J Ageing 14, 419–428 (2017). https://doi.org/10.1007/s10433-017-0423-6
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DOI: https://doi.org/10.1007/s10433-017-0423-6