Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-26T06:23:27.731Z Has data issue: false hasContentIssue false
  • English
  • Français

Social support and health among older adults – the Singapore Chinese Health Study

Published online by Cambridge University Press:  11 January 2021

Jon Barrenetxea Open the ORCID record for Jon Barrenetxea [Opens in a new window] ,
Yi Yang Open the ORCID record for Yi Yang [Opens in a new window] ,
Kyriakos S. Markides ,
An Pan ,
Woon-Puay Koh  and
Qiushi Feng
Jon Barrenetxea
Affiliation:
Health Services and Systems Research, Duke-NUS Medical School Singapore, Singapore
Yi Yang
Affiliation:
Health Services and Systems Research, Duke-NUS Medical School Singapore, Singapore
Kyriakos S. Markides
Affiliation:
Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, Texas, USA
An Pan
Affiliation:
Department of Epidemiology and Biostatistics, MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
Woon-Puay Koh*
Affiliation:
Health Services and Systems Research, Duke-NUS Medical School Singapore, Singapore Saw Swee Hock School of Public Health, National University of Singapore, Singapore
Qiushi Feng
Affiliation:
Department of Sociology & Centre for Family and Population Research, National University of Singapore, Singapore
*
*Corresponding author. Email: woonpuay.koh@duke-nus.edu.sg
Get access Rights & Permissions [Opens in a new window]

Abstract

While having social support can contribute to better health, those in poor health may be limited in their capacity to receive social support. We studied the health factors associated with social support among community-dwelling older adults in Singapore. We used data from the third follow-up interviews (2014–2016) of 16,943 participants of the Singapore Chinese Health Study, a population-based cohort of older Singapore Chinese. Participants were interviewed at a mean age of 73 years (range 61–96 years) using the Duke Social Support Scale (DUSOCS). We first applied ordinary least squares regression to DUSOCS scores and found that those with instrumental limitations, poor self-rated health, cognitive impairment and depression had lower social support scores. We then applied latent class analysis to DUSOCS answer patterns and revealed four groups of older adults based on the source and amount of social support. Among them, compared to the ‘overall supported’ group (17%) with the highest social support scores and broad support from family members and non-family individuals, the ‘family restricted’ (50%) group had the lowest social support scores and only received support from children. Health factors associated with being ‘family restricted’ were instrumental limitations (odds ratio (OR) = 1.33, 95% confidence interval (CI) = 1.19–1.49), poor self-rated health (OR = 1.40, 95% CI = 1.28–1.53), cognitive impairment (OR = 1.19, 95% CI = 1.04–1.37) and depression (OR = 2.50, 95% CI = 2.22–2.82). We found that while older adults in poor health have lower social support scores, they were more likely to receive a lot of support from children. Our results showed that lower social support scores among Singaporean older adults in poor health may not indicate lack of social support, but rather that social support is restricted in scope and intensified around children. These results may apply to other Asian societies where family plays a central role in elder-care.

Keywords

social relationshipscommunity-dwellingsocial networkspopulation-basedinformal care
Type
Article
Information
Ageing & Society , Volume 42 , Issue 8 , August 2022 , pp. 1921 - 1937
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Agency for Integrated Care (2019) Community of Care: 2018 Yearbook. Agency for Integrated Care (Singapore). Retrieved from https://partners.aic.sg/sites/aicassets/AssetGallery/AICyearbook2018/index.html.Google Scholar
Antonucci, TC, Ajrouch, KJ and Birditt, KS (2013) The Convoy Model: explaining social relations from a multidisciplinary perspective. The Gerontologist 54, 82–92.CrossRefGoogle ScholarPubMed
Ashida, S and Heaney, C (2008) Differential associations of connectedness with structural features of social networks and the health status of older adults. Journal of Aging and Health 20, 872–893.CrossRefGoogle ScholarPubMed
Broadhead, WE, Gehlbach, S, Gruy, FV de and Kaplan, BH (1988) The Duke-UNC Functional Social Support Questionnaire: measurement of social support in family medicine patients. Medical Care 26, 709–723.CrossRefGoogle ScholarPubMed
Burholt, V and Dobbs, C (2014) A support network typology for application in older populations with a preponderance of multigenerational households. Ageing & Society 34, 1142–1169.CrossRefGoogle ScholarPubMed
Chao, S (2014) Functional disability and depressive symptoms: longitudinal effects of activity restriction, perceived stress, and social support. Aging & Mental Health 18, 767–776.CrossRefGoogle Scholar
Chen, R, Simon, MA, Chang, E and Zhen, Y (2014) The perception of social support among U.S. Chinese older adults: findings from the PINE study. Journal of Aging and Health 26, 1137–1154.CrossRefGoogle ScholarPubMed
Department of Statistics (2019) Population Trends, 2019. Singapore: Department of Statistics.Google Scholar
Dyer, AH, Murphy, C, Lawlor, B and Kennelly, SP (2020) Social networks in mild-to-moderate Alzheimer disease: longitudinal relationships with dementia severity, cognitive function, and adverse events. Aging & Mental Health, 1–7. 10.1080/13607863.2020.1745146.Google ScholarPubMed
Evans, N, Allotey, P, Imelda, JD, Reidpath, DD and Pool, R (2018) Social support and care arrangements of older people living alone in rural Malaysia. Ageing & Society 38, 2061–2081.CrossRefGoogle Scholar
Feng, L, Chong, M, Lim, W and Ng, T (2012) The Modified Mini-Mental State Examination test: normative data for Singapore Chinese older adults and its performance in detecting early cognitive impairment. Singapore Medical Journal 53, 458–462.Google ScholarPubMed
Fischer, CS and Beresford, L (2015) Changes in support networks in late middle age: the extension of gender and educational differences. Journals of Gerontology: Psychological Sciences and Social Sciences 70B, 123–131.CrossRefGoogle Scholar
Ge, S, Wu, B, Bailey D and Dong, X (2017) Social support, social strain, and cognitive function among community-dwelling U.S. Chinese older adults. Journals of Gerontology: Biological Sciences and Medical Sciences 72A, 16–21.Google Scholar
Ghimire, S, Singh, DR, Nath, D, Jeffers, EM and Kaphle, M (2018) Adult children's migration and well-being of left behind Nepalese elderly parents. Journal of Epidemiology and Global Health 8, 154–161.CrossRefGoogle ScholarPubMed
Gu, D, Feng, Q and Yeung, WJ (2018) Reciprocal dynamics of solo-living and health among older adults in contemporary China. Journals of Gerontology: Psychological Sciences and Social Sciences 74, 1441–1452.CrossRefGoogle Scholar
Guzman, AB De, Lacson, CLM and Labbao, AI (2015) A structural equation model of the factors affecting morale of a select group of Filipino elderly in a community setting. Educational Gerontology 41, 399–416.CrossRefGoogle Scholar
Hankin, JH, Stram, DO, Arakawa, K, Park, S, Low, S, Lee, H and Yu, MC (2001) Singapore Chinese Health Study: development, validation, and calibration of the quantitative food frequency questionnaire. Nutrition and Cancer 39, 187–195.CrossRefGoogle ScholarPubMed
Hersch, G, Hutchinson, S, Davidson, H, Wilson, C, Maharaj, T and Watson, KB (2012) Effect of an occupation-based cultural heritage control study. American Journal of Occupational Therapy 66, 224–232.CrossRefGoogle ScholarPubMed
Johnson, TP (1991) Mental health, social relations, and social selection: a longitudinal analysis. Journal of Health and Social Behavior 32, 408–423.CrossRefGoogle ScholarPubMed
Katzman, R, Zhang, M, Ouang, YQ, Zhengyu, W, Liu, W, Yu, E, Wong, SC, Salmon, DP and Grant, I (1988) A Chinese version of the mini-mental state examination: impact of illiteracy in a Shanghai dementia survey. Journal of Clinical Epidemiology 41, 971–978.CrossRefGoogle Scholar
Kelly, ME, Duff, H, Kelly, S, Power, JEM, Brennan, S, Lawlor, BA and Loughrey, DG (2017) The impact of social activities, social networks, social support and social relationships on the cognitive functioning of healthy older adults: a systematic review. Systematic Reviews 6, 1–18.CrossRefGoogle ScholarPubMed
Lawton, MP and Brody, EM (1969) Assessment of older people: self-maintaining and Instrumental Activities of Daily Living. The Gerontologist 9, 179–186.CrossRefGoogle ScholarPubMed
Li, T and Zhang, Y (2015) Social network types and the health of older adults: exploring reciprocal associations. Social Science & Medicine 130, 59–68.CrossRefGoogle ScholarPubMed
Liao, J, Muniz-Terrera, G, Head, J and Brunner, EJ (2018) Dynamic longitudinal associations between social support and cognitive function: a prospective investigation of the directionality of associations. Journals of Gerontology: Psychological Sciences and Social Sciences 73B, 1233–1243.Google Scholar
Linzer, DA and Lewis, J (2011) poLCA: an R package for polytomous variable latent class analysis. Journal of Statistical Software 42(10), 1–29.CrossRefGoogle Scholar
Lloyd, L, Tanner, D, Milne, A, Ray, M, Richards, S, Pat, M, Beech, C and Phillips, J (2014) Look after yourself: active ageing, individual responsibility and the decline of social work with older people in the UK. European Journal of Social Work 17, 322–335.CrossRefGoogle Scholar
McLaughlin, D, Vagenas, D, Pachana, NA, Begum, N and Dobson, A (2010) Gender differences in social network size and satisfaction in adults in their 70s. Journal of Health Psychology 15, 671–679.CrossRefGoogle ScholarPubMed
Parkerson, GR (2014) Duke Social Support and Stress Scale (DUSOCS). In Alex C., Michalos (ed). Encyclopedia of Quality of Life and Well-being Research. Netherlands: Springer, Dordrecht. https://doi.org/10.1007/978-94-007-0753-5_3511.Google Scholar
Parkerson, GR Jr., Broadhead, WE and Tse, CK (1991) Validation of the Duke social support and stress scale. Family Medicine 23, 357–360.Google ScholarPubMed
Parkerson, GR Jr., Broadhead, WE and Tse, CK (1992) Quality of life and functional health of primary care patients. Journal of Clinical Epidemiology 45, 1303–1313.CrossRefGoogle ScholarPubMed
Rourke, HMO, Collins, L and Sidani, S (2018) Interventions to address social connectedness and loneliness for older adults: a scoping review. BMC Geriatrics 18, 214–227.Google Scholar
Rozario, PA and Rosetti, AL (2012) ‘Many helping hands’: a review and analysis of long-term care policies, programs, and practices in Singapore. Journal of Gerontological Social Work 55, 641–658.CrossRefGoogle Scholar
Shwe, M, Nyunt, Z, Fones, C, Niti, M and Ng, T (2009) Criterion-based validity and reliability of the Geriatric Depression Screening Scale (GDS-15) in a large validation sample of community-living Asian older adults. Aging & Mental Health 13, 376–382.Google Scholar
Tengku Mohd, T, Yunus, R, Hairi, F, Hairi, N and Wan, YC (2019) Social support and depression among community dwelling older adults in Asia: a systematic review. BMJ Open 9, e026667–e026667. doi:10.1136/bmjopen-2018-026667.CrossRefGoogle ScholarPubMed
Thang, LL and Johan, S (2018) Growing old in Singapore. In Klassen, TR, Higo, M, Dhirathiti, NS and Devasahayam, TW (eds). Ageing in Asia-Pacific: Interdisciplinary and Comparative Perspectives. New York, NY: Routledge, pp. 131–152.CrossRefGoogle Scholar
Thiyagarajan, JA, Prince, M and Webber, M (2014) Social support network typologies and health outcomes of older people in low and middle income countries – a 10/66 Dementia Research Group population-based study. International Review of Psychiatry 26, 476–485.CrossRefGoogle Scholar
Thoits, PA (2011) Mechanisms linking social ties and support to physical and mental health. Journal of Health and Social Behavior 52, 145–161.CrossRefGoogle ScholarPubMed
Tough, H, Siegrist, J and Fekete, C (2017) Social relationships, mental health and wellbeing in physical disability: a systematic review. BMC Public Health 17, 414–432. doi:10.1186/s12889-017-4308-6.CrossRefGoogle ScholarPubMed
Uchino, BN (2009) Understanding the links between social support and physical health of perceived and received support. Perspectives on Psychological Science 4, 236–255.CrossRefGoogle ScholarPubMed
Uchino, BN and Rook, KS (2020) Emotions, relationships, health and illness into old age. Maturitas 139, 42–48.CrossRefGoogle ScholarPubMed
Wang, J, Mann, F, Lloyd-Evans, B, Ma, R and Johnson, S (2018) Associations between loneliness and perceived social support and outcomes of mental health problems: a systematic review. BMC Psychiatry 18, 156–172. doi:10.1186/s12888-018-1736-5.CrossRefGoogle ScholarPubMed
White, AM, Philogene, GS, Fine, L and Sinha, S (2009) Social support and self-reported health status of older adults in the United States. American Journal of Public Health 99, 1872–1878.CrossRefGoogle ScholarPubMed
Yeoh, BSA and Huang, S (2010) Foreign domestic workers and home-based care for elders in Singapore. Journal of Aging & Social Policy 22, 69–88.CrossRefGoogle Scholar