Self-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.
Data 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.
Most 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.
Self-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.
Gruenewald TL, Karlamangla AS, Greendale GA, Singer BH, Seeman TE. Feelings of usefulness to others, disability, and mortality in older adults: the MacArthur Study of Successful Aging. J Gerontol Psychol Sci. 2007;62(1):28–P37. CrossRef
Levy BR, Slade MD, Kasl SV. Longitudinal benefit of positive self-perceptions of aging on functional health. J Gerontol Psychol Sci. 2002;57(5):409–P417. CrossRef
Ranzijin R, Keeves J, Luszcz M, Feather NT. The role of self-perceived usefulness and competence in the self-esteem of elderly adults: Confirmatory factor analyses of the Bachman Revision of Rosenberg’s Self-Esteem Scale. J Gerontol Psychol Sci. 1998;53(2):96–P104. CrossRef
Mutran E, Burke PJ. Feeling “useless”: A common component of young and old adult identities. Res Aging. 1979;1(2):187–212. CrossRef
Chan WK, Hubbard RE. Attitudes to ageing and to geriatrics medicine. Turkish J Geriatr. 2014;17(1):90–4.
Coleman PG, Ivani-Chalian C, Robinson M. Self and meaning in the lives of older people: Cases studies over twenty years. Cambridge: Cambridge University Press; 2015. CrossRef
Okamoto K, Tanaka Y. Subjective usefulness and 6-year mortality risks among elderly persons in Japan. J Gerontol Psychol Sci. 2004;59(5):246–P249. CrossRef
Bai X, Chou N. How is the self-image formed and enhanced among older Chinese people: through assimilation or contrast? Asian J Gerontol Geriatr. 2011;6:22–8.
Levy BR, Myers LM. Relationship between respiratory mortality and self-perceptions of aging. Psychol Health. 2005;20(5):553–64. CrossRef
Levy BR. Mind matters: Cognitive and physical effects of aging self-stereotypes. J Gerontol Ser B Psychol Sci Soc Sci. 2003;58:203–P211. CrossRef
Wurm S, Tesch-Römer C, Tomasik MJ. Longitudinal findings on aging-related cognitions, control beliefs and health in later life. J Gerontol B Psychol Sci Soc Sci. 2007;62:156–P164. CrossRef
Law J, Laidlaw K, Peck D. Is depression viewed as an inevitable consequence of age? The “understandability phenomenon” in older people. Clin Gerontol. 2010;33:194–209. CrossRef
Levy BR, Banaji MR. Implicit ageism. In: Nelson TD, editor. Ageism: Stereotyping and prejudice against older persons. Cambridge: MIT Press; 2004. p. 49–75.
Lakra DC, Ng R, Levy BR. Increased longevity from viewing retirement positively. Ageing Soc. 2012;32:1418–27. CrossRef
Levy BR, Hausdorff JM, Hencke R, Wei JY. Reducing cardiovascular stress with positive self-stereotypes of aging. J Gerontol B Psychol Sci Soc Sci. 2000;55(4):205–P213. CrossRef
Gu D, Feng Q, Sautter JM, Ma L, Yang F, Zhen Z. Concordance and discordance of self-rated and researcher-measured successful aging: Subtypes and associated factors. J Gerontol: Soc Sci. 2016. [online first] doi. 10.1093/geronb/gbw143.
Angus J, Reeve P. Ageism: A threat to “aging well” in the 21st century. J Appl Gerontol. 2006;25(2):137–52. CrossRef
Ko KJ. Predictors of self-perceptions of aging in the young-old: The role of successful aging and parental perceptions. 2008. Dissertation. Department of Psychology, University of Utah.
Fan THD. Beliefs about aging and later life health and well-being among the elderly in Taiwan. 2007. Ph.D. Dissertation. The University of Texas at Austin.
Hu Y. Research on self-perception of aging of the elderly and its influencing factors. Thesis. Shanghai: The 2nd Military Medical University; 2013.
North MS, Fiske ST. Modern attitudes toward older adults in the aging world: A cross-cultural meta-analysis. Psychol Bull. 2015;14(5):993–1021. CrossRef
Gu D, Feng Q. Psychological resilience among Chinese centenarians and its associations with survival and health: A fuzzy set analysis. J Gerontol: Soc Sci. 2016 [online first]. doi: 10.1093/geronb/gbw071
Poon LW, Martin P, Bishop A, et al. Understanding centenarians’ psychosocial dynamics and their contributions to health and quality of life. Curr Gerontol Geriatr Res. 2010. Article ID 680657. doi: 10.1155/2010/680657.
Zeng Y, Shen K. Resilience significantly contributes to exceptional longevity. Curr Gerontol Geriatr Res. 2010. Article ID 525693. doi: 10.1155/2010/525693.
von Humboldt S. Conceptual and methodological issues on the adjustment to aging: Perspectives on aging well. Lisbon: Springer Publisher; 2016. CrossRef
Sarksian CA, Shunkwiller SM, Aguilar I, et al. Ethnic differences in expectations for aging among older adults. J Am Geriatr Soc. 2006;54(8):1277–82. CrossRef
Stenner P, McFarquhar T, Bowling A. Older people and ‘active aging’: Subjective aspects of ageing actively. J Health Psycho. 2011;16(3):467–77. CrossRef
Pinquart M, Sorensen S. How effective are psychotherapeutic and other psychosocial interventions with older adults? J Ment Health Aging. 2001;7(2):207–43.
Cosco TD, Prino AM, Perales J, Stephan BCM, Brayne C. Lay perspectives of successful ageing: A systematic review and meta-ethnography. BMJ Open. 2013;3(6):1–9. CrossRef
Jang Y, Poon LW, Kim S, Shin B. Self-perceptions of aging and health among older adults in Korea. J Aging Stud. 2004;18:485–96. CrossRef
Setterson Jr RA. Social sources of meaning in later life. In: Weiss RS, Bass SA, editors. In Challenges of the third age. Oxford: Oxford University Press; 2002. p. 55–79.
Krause N, Herzog AR, Baker E. Providing support to others and well-being in later life. J Gerontol: Psychol Sci. 1992;47:P300–11. CrossRef
Hori S, Cusack S. Third-age education in Canada and Japan: Attitudes toward aging and participation in learning. Educ Gerontol. 2006;32(6):463–81. CrossRef
Kotter-Gruhn D. Changing negative views of aging: Implications for intervention and translational research. Chapter 8. Annu Rev Gerontol Geriatr. 2015;35:167–86. CrossRef
Stets JE, Turner JH. Handbook of the sociology of emotions. Boston: Springer Science + Business Media, LLC.; 2006. CrossRef
Giles H, Noels K, Ota H, Ng SH, Gallois C, Ryan EB, et al. Age vitality across eleven nations. J Multiling Multicult Dev. 2000;21:308–23. CrossRef
Qi X. Filial obligation in contemporary China: evolution of the culture-system. J Theory Soc Behav. 2015;45(1):141–61. CrossRef
Sung KT. Elder respect: Exploration of ideals and forms in East Asia. J Aging Stud. 2001;15:13–26. CrossRef
Zeng Y, Poston Jr DL, Vlosky DA, Gu D. Healthy Longevity in China: Demographic, Socioeconomic, and Psychological Dimensions. Dordrecht: Springer Publishing; 2008.
Gu D, Yang F, Sautter J. Socioeconomic status as a moderator between frailty and mortality at old ages. BMC Geriatr. 2016;151:1–11. doi: 10.1186/s12877-016-0322-2.
Chen X, Silverstein M. Intergenerational social support and the psychological well-being of older parents in China. Res Aging. 2000;22(1):43–65. CrossRef
Ellis RR, Simmons T. Coresident grandparents and their grandchildren: 2102. In: Current Population Reports. Washington: US. Census Bureau; 2014. p. P20–576.
Logan JR, Bian F. Family values and coresidence with married children in Urban China. Soc Forces. 1999;77(4):1253–82. CrossRef
Sereny M. Living arrangements of older adults in China: The interplay among preferences, realities, and health. Res Aging. 2011;33(2):172–204. CrossRef
Silverstein M, Cong Z, Li S. Intergenerational transfers and living arrangements of older people in rural China: Consequences for psychological well-being. J Gerontol: Soc Sci. 2006;61(5):S256–66. CrossRef
Sung KT. Exploration of actions of filial piety. J Aging Stud. 1998;12:369–86. CrossRef
Takagi E, Silverstein M, Crimmins E. Intergenerational coresidence of older adults in Japan: Conditions for cultural plasticity. J Gerontol: Soc Sci. 2007;62(5):S330–9. CrossRef
Lee E, Mock MR. Asian families: An overview. In: Mcgoldrick M, Giordano J, Garcia-Preto N, editors. Ethnicity & family therapy. 3rd ed. New York: The Guildford Press; 2005. p. 269–89.
Stata version 13.1. StataCorp LP. TX: College Station; 2013.
Winship C, Radbill L. Sampling weights and regression analysis. Sociol Methods Res. 1994;23:230–57. CrossRef
Allison PD. Multiple Regression: A Primer. Thousand Oaks: Pine Forge Press; 1999.
Chatterjee S, Hadi AS. Regression analysis by example. 5th ed. Hoboken: New York; 2012.
Chow N, Bai X. Modernization and its impact on Chinese older people’s perception of their own image and status. Int Soc Work. 2011;54(6):800–15. CrossRef
Nations U. World Population Prospects: The 2015 Revision. New York: The United Nations; 2015.
United Nations. International Day of Older People. 2016. http://www.un.org/en/events/olderpersonsday/. Accessed on 12 Nov 2016.
- Self-perceived uselessness and associated factors among older adults in China
Jessica M. Sautter
- BioMed Central
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
e.Med Kampagnen-Visual, Mail Icon II