Subjective social status and functional and mobility impairments among older adults: life satisfaction and depression as mediators and moderators

Due to the paucity of existing evidence, this study aims to investigate the relationship between chronic disease, sensory impairment, walking limitation, and difficulty in activities of daily living (ADLs) in community-dwelling older Indians. This cross-sectional study included data from 31,394 individuals aged ≥ 60 years from the 2017 to 2018 Longitudinal Ageing Study in India. Participants were divided into 2 groups: 12,993 with chronic disease, sensory impairment, and a walking limitation, and 18,401 healthy individuals without such conditions. Participants with any chronic disease were further divided into 2 groups: sensory impairment (n = 12,462), and a walking limitation (n = 4745). Self-reported close-ended questionnaires with yes or no were used to assess each chronic disease (such as hypertension, diabetes, lung disorders, joint disorders, or heart disease), sensory impairment (vision or hearing), and walking limitation. A walking limitation was defined as being when a person could only walk at their usual pace for less than 500 meters on a flat surface. ADLs were assessed and classified as physical ADLs including basic physical requirements like dressing. Instrumental ADLs (IADLs) included more complicated community-based tasks like meal preparation. Findings showed that older Indians with chronic disease, sensory impairment, and a walking limitation were more likely to be significantly associated with physical ADLs (adjusted odds ratio [aOR] = 1.85, 95% confidence interval [CI] = 1.34–1.57, P < .0001) and IADLs (aOR = 1.45, 95% CI = 1.70–2.03, P < .0001) than those without such conditions. Among older Indians with chronic disease, sensory impairment was more likely associated with physical ADLs (aOR = 1.98, 95% CI = 1.82–2.16, P < .0001) and IADLs (aOR = 1.26, 95% CI = 1.15–1.37, P < .0001) followed by a walking limitation (aOR = 1.53, 95% CI = 1.42–1.65, P < .0001; aOR = 1.27, 95% CI = 1.17–1.38, P < .0001, respectively). These findings suggest that older Indians with chronic disease, sensory impairment, and walking limitation, can experience increased difficulty in overall and individual physical ADL and IADL than those without these conditions. Older Indians with any chronic condition who had sensory impairment or a walking limitation were also more likely to have difficulty with physical ADLs and IADLs.

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Subjective social status, health and well-being among older adults in China and South Korea: a cross-sectional analysis

Yan,

Wang,

Yang

et al. 2024

BMJ Open

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IntroductionSocial status, which encompasses various psychosocial dimensions, such as income, education and social relationships, can have a significant impact on physical and mental health outcomes. The study aims to explore the association among subjective social status, health and well-being among individuals aged 55 years and older in China and South Korea.ParticipantsSample population included individuals aged 55 years and older: China (n=1779) and South Korea (n=421).Outcome measuresOutcome measures included self-reported health status and well-being which were assessed by life satisfaction and general happiness.ResultsThe percentage of participants who reported a ‘very good’ health condition was higher in South Korea (14.5%) than in China (11.0%). The percentage of participants who reported feeling very satisfied (14.7%) with their life was lower in South Korea (11.8%). In China, 6.7% of the respondents reported their health as ‘very bad’ (rating 5), while in South Korea, this percentage was higher at 18.1%. Regression analysis revealed an inverse association among higher social status and poorer health, lower life satisfaction and lower happiness levels. For example, individuals who placed themselves in the highest social status category had 0.26 times lower odds (95% CI=0.13 to 0.55) of reporting poorer self-rated health status than those in the lowest category. Similarly, compared with individuals who place themselves in the lowest social status category, those who place themselves in the highest social status category have 0.03 times lower odds of reporting lower life satisfaction (95% CI=0.02 to 0.07).ConclusionOverall, the results highlight a significant association among social status, subjective health, life satisfaction and general happiness in both the countries. Health policymakers should identify effective strategies to promote healthy ageing and reduce disparities in health and well-being outcomes among older adults from different social backgrounds.

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Subjective social status and functional and mobility impairments among older adults: life satisfaction and depression as mediators and moderators

Cited by 5 publications

References 74 publications

Friends, neighbors, country, and respect: Status ladders and health behaviors in the United States

Friends, neighbors, country, and respect: Status ladders and health behaviors in the United States

Association between chronic disease, sensory impairment, walking limitation, and activities of daily living of community-dwelling older Indians

Subjective social status, health and well-being among older adults in China and South Korea: a cross-sectional analysis

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