Gender-related differences in the multi-pathway effect of social determinants on quality of life in older age—the COURAGE in Europe project

Abstract

PurposeGender-related differences in life expectancy, prevalence of chronic conditions and level of disability in the process of ageing have been broadly described. Less is known about social determinants, which may have different impacts on quality of life in men and women. The investigation aims to reveal gender-related differences in social determinants on quality of life assessed by a multi-pathway model including health, social, demographic and living place characteristics.MethodsThe study group consisted of 5099 participants aged 50+ representing general populations of three different European regions (Finland, Poland, Spain) who participated in COURAGE in EUROPE Project. Standardized tools were used to measure quality of life (WHOQOL-AGE) and social determinants (COURAGE Social Network Index, OSLO-3 Social Support Scale, UCLA Loneliness Scale, participation scale and trust). A multipath model considering exogenous predictors (demographic, economic), mediators (social) and endogenous outcome (QOL) was created to reveal the role of determinants. Gender-related differences were investigated across three age categories: 50–64; 65–79 and 80+.ResultsThe model (RMSEA = 0.058; CFI = 0.939) showed the effects of all of the investigated determinants. Gender-related differences in the association between social constructs and QOL were observed for social networks in the group of 80+, for social support in the group of 50–64 and 65–79 years, and for social participation in the group of 65–79 years. Males benefited more (in QOL) from social networks and social support, and women from social participation.ConclusionsThe research provides valuable knowledge about the role of social determinants in QOL considering complex relations between different social constructs. Additionally, the results showed gender-related differences in the associations between social networks, social support, social participation and QOL, suggesting that men might benefit more from the interventions in the first two. Although our research did not investigate the effects of interventions, the results show directions for future investigations, how to shape social interventions at the population level to improve quality of life of older adults, and thus help achieve successful ageing.Electronic supplementary materialThe online version of this article (doi:10.1007/s11136-017-1530-8) contains supplementary material, which is available to authorized users.

Loneliness among older European adults: results from the survey of health, aging and retirement in Europe

“…This was found to be particularly the case for older women, as compared to men. These findings are in agreement with relevant investigations, which have reported differences in loneliness among European adults associated with being of female gender and older age (Fokkema et al 2012;Tobiasz-Adamczyk et al 2017). Gender and age related variations in loneliness have been widely considered, concomitant with health decline, widowhood, bereavement and solitary living to be mostly prominent among females, adults of advanced age and disadvantaged older people (Fokkema et al 2012;Pinquart and Sorensen 2001a).…”

Dealing With Heteroskedasticity Within the Modeling of the Quality of Life of Older People

“…Especially feeling of loneliness has 1.5 times stronger effect on quality of life among men than among women. While it has been shown before that QOL can be significantly reduced by loneliness among older people (Musich et al, 2015), there are very few studies on gender differences in older people quality of life affected by feeling of loneliness (Tobiasz-Adamczyk et al, 2017). Despite women seem to suffer from loneliness more frequently than men (Beal, 2006;I.…”

“…Analyses are done separately for a group of men for whom regression model is heteroskedastic and for a group of women for whom regression model is homoskedastic. The division into gender is justified because there are some significant gender-related differences in effects of psychosocial factors on older people's quality of life, as shown by Tobiasz-Adamczyk (et al, 2017).…”

Frailty as the Future Core Business of Public Health: Report of the Activities of the A3 Action Group of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA)

“…Males seem to benefit from social support, while women benefit most from social and cultural participation [43,47,48]. Social support and participation are both associated to better QoL and lower levels of frailty.…”