Gender-Differentials in Living Arrangement and Well-Being of Older Adults in West Bengal

The quality of life of elderly people has become relevant with the demographic shift that has resulted in greying of population. There are indications that concepts and concerns related to quality of life in older ages are different from the general population. A narrative review of selected literature. Quality of life is described often with both objective and subjective dimensions. The majority of the elderly people evaluate their quality of life positively on the basis of social contacts, dependency, health, material circumstances and social comparisons. Adaptation and resilience might play a part in maintaining good quality of life. Although there are no cultural differences in the subjective dimension of quality of life, in the objective dimension such differences exist. Two major factors to be considered with regard to quality of life in old age are dementia and depression. With all other influences controlled, ageing does not influence quality of life negatively; rather a long period of good quality of life is possible. Therefore, the maintenance and improvement quality of life should be included among the goals of clinical management.

To assess the association between emotional and instrumental support from children and living arrangements with the physical and mental health of older people in Spain. A face-to-face home interview was carried out with 1284 community-dwelling people over 65 (response rate = 83%) randomly sampled according to an age- and sex-stratified sampling scheme in 1993 at Leganés (Spain). Close to 93% of the participants had children and 45% of them coresided with them. Depressive symptoms were assessed by the CES-D (Center for Epidemiologic study depression scale) and self-rated health (SRH) by a single-item question. Emotional support was measured with a six-item scale on affection and reciprocity. Instrumental support was assessed by help received from children in 17 activities of daily living. Four living arrangements were considered: Living with spouse only, living with a spouse and children, widower living alone, and widower living with children. Multivariate analysis controlling for age, gender, education and functional status showed that low emotional support and reception of instrumental aid were significantly associated with poor SRH. Being a widower and sharing living arrangements with children was associated with good SRH. Living arrangements modify some of the associations of support of children with SRH. Depressive symptoms were associated with low emotional support, reception of instrumental help and being a widower who did not share living arrangements with children. For widowers who do not cohabit with children, reception of instrumental aid is associated with low depressive symptomatology. Emotional support from children seems to play an important role in maintaining the physical and mental health of elderly people in Spain. Instrumental support is widely available. Coresidence with children is very common and it is associated with good self-perceived health and low prevalence of depressive symptoms in a culture where family interdependence is highly valued. Families should be protected and encouraged to continue care-giving through a variety of community services and respite care, adapted to their needs and preferences. Research should be undertaken to find more efficient ways to help family caregivers in the Mediterranean context.

This study aims to (1) examine the association of living arrangements and health among oldest-old Chinese, and (2) investigate gender differences in the association of living arrangements and health. Data were from the first two waves of the Chinese Longitudinal Healthy Longevity Survey, which included 9093 Chinese averaging 92 years old. Living arrangements had six mutually exclusive categories: living alone, with spouse, with children, with spouse and children, with others and in institutions. Using multinomial logistic regression, we found that baseline living arrangements are significantly associated with mortality, activities of daily living (ADL) disability, and self-rated health at Wave 2, controlling for baseline health, sociodemographic characteristics and availability of children. Further, the linkages between living arrangements and mortality vary by gender. Among the different living arrangements, having a spouse in the household (either with a spouse only or with both a spouse and children) provides the best health protection. Living alone and living with children are associated with both health advantages and disadvantages. Institutional living lowers mortality risk for men but not women. Living with others provides the least health benefits. Our study has extended the research on living arrangements and health to a unique population-the oldest-old in China-and clarified the health advantages and disadvantages of different living arrangements. Future research should examine the mechanisms linking living arrangements and health, and the experience of institutional living for men and women in China.