Date of Award

11-16-2009

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

First Advisor

Paul Kirwin

Abstract

This study explores the relationship between living arrangement and psychological wellbeing in retired elderly individuals living in Yancheng, Jiangsu (PR China). Data on mode of residence, socio-economic background, daily activities, and intergenerational dynamics were collected from 200 subjects, and their potential correlations with depression (assessed via the Geriatric Depression Scale Short Version) were analyzed. Univariate as well as logistic regression confirmed mode of residence as a significant predictor of depression in this group. The following depression odds ratios associated with each mode of residence were derived via logistic regression: 1) nuclear household, i.e. living with a spouse only - 1 [reference category], 2) multigenerational households in which a spouse is not present - 4.341, 3) multigenerational households in which a spouse is present - 0.781, and 4) living alone - 3.018. Based on these ratios, we conclude that the traditional model of intergenerational coresidence is not, in itself, associated with less depression. Rather, it is the presence of a sharing spousal in a household (whether single or multigenerational) that protects against elderly depression. Other predictors of depression identified in backward logistic regression included presence of a chronic illness and self assessed wealth status. Additionally, a number of psychosocial variables were identified as independently correlated with depression, but were subsequently selected out by multivariate analysis. These included: educational background, religious affiliation, membership in an organization, attitude toward aging, and family status. Based on this study, we believe that efforts to promote mental wellbeing among today's Chinese elders should be directed toward psychosocial factors that are modifiable (education, building supportive social networks etc.) rather than insisting on the traditional ideal of multigenerational living and dependence on filial piety.

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