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Activities of Daily Living, Depression, and Self-rated Health and Related Factors in Korean Elderly: Focused on Socioeconomic Status and Family Support

Article information

Res Community Public Health Nurs. 2015;26(2):140-149
Publication date (electronic) : 2015 June 30
doi : https://doi.org/10.12799/jkachn.2015.26.2.140
Seieun Oh1, Young Ko2orcid_icon
1Department of Nursing, College of Health Sciences, Dankook University, Cheonan, Korea.
2School of Nursing, Gachon University, Incheon, Korea.
Corresponding author: Ko, Young. School of Nursing, Gachon University, 191 Hambakmoe-ro, Yeonsu-gu, Incheon 406-799, Korea. Tel: +82-32-820-4205, Fax: +82-32-820-4201, youngko@gachon.ac.kr
Received 2015 April 20; Revised 2015 June 13; Accepted 2015 June 23.

Abstract

Purpose

This study was conducted to identify activities of daily living, depression and self-rated health and related factors for Korean Elderly.

Methods

Data from the survey for the Korean Longitudinal Study of Aging in 2010 were used. The data were analyzed using frequencies, weighted proportions, and hierarchical multiple logistic regression.

Results

Significant difference was observed in health status induced by socioeconomic status between men and women, but not among age groups. Socioeconomic status was strongly associated with self-rated health among male and female elders. Being unschooled and low net family asset were significantly related with dependency in activities of daily living and depressive symptoms among men. Only low net family asset was significantly related with depressive symptoms among women. Family support provides a slight decrease to the negative relationship between socioeconomic status and health status, especially depressive symptoms.

Conclusion

This study suggests that interventions to reduce health inequalities should target elderly with lower socioeconomic status and with poor family support, using a gender-specific approach.

Keywords: Aged; Socioeconomic status; Health status disparities; Sex; Family

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Article information Continued

© 2015 Korean Academy of Community Health Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Table 1

Demographic and Socioeconomic Characteristics of Subjects

Variables Categories Men Women Total
n (%) n (%) n (%)
Age (year) 65~74 1,281 (61.3) 1,490 (52.1) 2,771 (56.0)
75~84 673 (32.2) 1,018 (35.6) 1,691 (34.2)
≥85 136 (6.5) 350 (12.2) 486 (9.8)
Education No education 203 (9.7) 967 (33.8) 1,170 (23.7)
≤Elementary school 578 (27.7) 1,159 (40.6) 1,737 (35.1)
Middle school or high school 1,014 (48.5) 660 (23.1) 1,674 (33.8)
≥College 295 (14.1) 71 (2.5) 366 (7.4)
Family net assets (10,000 won) <3,500 349 (16.7) 715 (25.0) 1,064 (21.5)
3,500~9,999 424 (20.3) 660 (23.1) 1,084 (21.9)
10,000~19,999 635 (30.4) 755 (26.4) 1,390 (28.1)
≥20,000 682 (32.6) 727 (25.4) 1,409 (28.5)
Family support Living with supported family 1,151 (55.1) 1,413 (49.5) 2,564 (51.8)
Living with unsupported family 817 (39.1) 837 (29.3) 1,654 (33.4)
Living alone 122 (5.8) 607 (21.2) 729 (14.7)
Number of diagnosed disease 1.0±1.02 1.4±1.12 1.2±1.09
Total 2,090 (100.0) 2,857 (100.0) 4,947 (100.0)

%: weighted.

Table 2

Gender-stratified Prevalence of Having Difficulty in ADLs, Depressive Symptoms and Self-rated Health as 'poor' among Elderly (N=4,947)

Variables Having difficulty in ADLs Depressive symptoms Self-rated health as 'poor'
Men Women Men Women Men Women
n (%) n (%) n (%) n (%) n (%) n (%)
Total 107 (5.1) 186 (6.5)* 144 (6.9) 255 (8.9)* 634 (30.3) 1,317 (46.1)**
Age (year)
 65~74 32 (2.5) 39 (2.6) 74 (5.8) 131 (8.8)** 298 (23.3) 567 (38.1)**
 75~84 53 (7.9) 60 (5.9) 52 (7.7) 97 (9.5) 268 (39.8) 531 (52.2)**
 ≥85 22 (16.2) 87 (24.9)* 18 (13.3) 27 (7.7) 68 (50.0) 219 (62.6)**
Education
 No education 21 (10.4) 111 (11.5) 23 (11.3) 98 (10.1) 97 (47.8) 549 (56.7)*
 ≤Elementary school 33 (5.7) 56 (4.8) 54 (9.3) 110 (9.5) 207 (35.8) 549 (47.4)**
 Middle or high school 46 (4.5) 18 (2.7) 55 (5.4) 45 (6.8) 275 (27.1) 206 (31.2)
 ≥College 7 (2.4) 1 (1.4) 13 (4.4) 3 (4.2) 56 (19.0) 13 (18.6)
Family net assets (10,000 won)
 <3,500 25 (7.2) 63 (8.8) 37 (10.6) 93 (13.0) 149 (42.7) 450 (62.9)**
 3,500~9,999 25 (5.9) 41 (6.2) 30 (7.1) 56 (8.5) 144 (34.0) 308 (46.7)**
 10,000~19,999 43 (6.8) 46 (6.1) 45 (7.1) 60 (7.9) 196 (30.9) 310 (41.1)**
 ≥20,000 14 (2.1) 36 (5.0)** 32 (4.7) 46 (6.3) 145 (21.3) 248 (34.1)**
Family support
 Living with supported family 38 (3.3) 80 (5.7)** 53 (4.6) 86 (6.1) 300 (26.0) 560 (39.6)**
 Living with unsupported family 62 (7.6) 68 (8.1) 70 (8.6) 100 (11.9)** 294 (36.0) 438 (52.3)**
 Living alone 7 (5.8) 37 (6.1) 21 (17.4) 69 (11.4) 40 (33.1) 318 (52.4)**

%: weighted; ADLs=activities of daily living; *p<.05, **p<.01 for different between men and women.

Table 3

Age Groups-stratified Prevalence of Having Difficulty in ADLs, Depressive Symptoms and Self-rated Health as 'poor' among Elderly (N=4,947)

Variables Having difficulty in ADLs Depressive symptoms Self-rated Health as 'poor'
65~74 75~84 ≥85 65~74 75~84 ≥85 65~74 75~84 ≥85
n (%) n (%) n (%) n (%) n (%) n (%) n (%) n (%) n (%)
Total 70 (2.5) 113 (6.7) 109 (22.5) 205 (7.4) 150 (8.9) 46 (9.4) 865 (31.2) 799 (47.3) 288 (59.1)
Education
 No education 20 (5.9) 34 (6.4) 79 (26.5) 48 (14.2) 50 (9.4) 22 (7.4) 163 (48.1) 294 (55.2) 189 (63.2)
 ≤Elementary school 22 (2.3) 45 (7.1) 21 (16.2) 85 (8.7) 63 (10.0) 16 (12.3) 377 (38.7) 311 (49.1) 68 (52.3)
 Middle or high school 28 (2.3) 29 (7.0) 6 (14.6) 64 (5.3) 31 (7.5) 5 (12.2) 294 (24.2) 165 (39.7) 22 (53.7)
 ≥College 0 (0.0) 5 (4.6) 3 (18.8) 8 (3.3) 5 (4.6) 3 (18.8) 31 (12.9) 31 (28.2) 8 (50.0)
Family net assets (10,000 won)
 <3,500 22 (4.5) 31 (7.2) 35 (23.3) 67 (13.8) 44 (10.3) 20 (13.3) 240 (49.3) 261 (61.0) 99 (66.0)
 3,500~9,999 12 (2.2) 28 (6.5) 26 (24.3) 36 (6.6) 42 (9.7) 8 (7.5) 169 (31.0) 210 (48.7) 73 (68.2)
 10,000~19,999 30 (3.5) 36 (8.4) 23 (20.4) 66 (7.8) 27 (6.3) 13 (11.5) 256 (30.2) 188 (43.7) 63 (55.8)
 ≥20,000 7 (0.8)** 18 (4.5) 25 (21.6) 36 (4.0)** 37 (9.2) 5 (4.3) 200 (22.5)** 140 (34.8)** 53 (45.3)**
Family support
 Living with SF 24 (1.6) 15 (4.3) 21 (18.3) 82 (5.3) 45 (5.7) 12 (5.0) 395 (25.7) 334 (42.3) 130 (54.4)
 Living with UF 38 (3.9) 50 (9.0) 42 (32.1) 92 (9.5) 63 (11.4) 15 (11.5) 372 (38.4) 280 (50.5) 81 (61.4)
 Living alone 8 (3.0)** 48 (6.1)* 46 (19.2)** 31 (11.7)** 41 (11.8)** 19 (16.4)** 98 (36.8)** 185 (53.3)** 76 (65.5)

%: weighted; ADLs=activities of daily living; SF=supported family; UF=unsupported family; *p<.05, **p<.01 for different among age group.

Table 4

Adjusted Odds Ratios (95% confidence intervals) of Having difficulty in ADLs, Depressive Symptoms and Self-rated Health as 'poor' among Men (N=2,090)

Variables Having difficulty in ADLs Depressive symptoms Self-rated Health as 'poor'
Model I Model II % Model I Model II % Model I Model II %
Adj. OR (95% CI) Adj. OR (95% CI) Adj. OR (95% CI) Adj. OR (95% CI) Adj. OR (95% CI) Adj. OR (95% CI)
Education
 ≥College 1.00 1.00 1.00 1.00 1.00 1.00
 Middle or high school 1.85 (0.80~4.29) 1.86 (0.80~4.35) 1.12 (0.60~2.09) 1.13 (0.60~2.12) 1.60 (1.12~2.29)* 1.60 (1.11~2.29)* 0.0
 ≤Elementary school 1.83 (0.77~4.37) 1.82 (0.76~4.36) 1.85 (0.98~3.51) 1.85 (0.97~3.52) 2.17 (1.49~3.17)** 2.12 (1.45~3.11)** 4.3
 No education 2.97 (1.18~7.51)* 2.68 (1.05~6.84)* 14.7 2.10 (1.00~4.38)* 2.00 (0.95~4.21) 9.1 3.28 (2.09~5.16)** 3.13 (1.99~4.94)** 0.0
Family net assets (10,000 won)
 ≥20,000 1.00 1.00 1.00 1.00 1.00 1.00
 10,000~19,999 3.20 (1.68~6.11)** 3.16 (1.65~6.05)** 1.8 1.39 (0.86~2.24) 1.30 (0.80~2.10) 1.57 (1.19~2.08)** 1.58 (1.19~2.10)** -1.8
 3,500~9,999 2.26 (1.11~4.58)* 2.25 (1.10~4.59)* -1.6 1.23 (0.72~2.09) 1.42 (0.66~1.96) 1.55 (1.14~2.11)** 1.57 (1.15~2.14)** -3.6
 <3,500 2.72 (1.34~5.53)** 2.49 (1.21~5.12)* 13.4 1.96 (1.18~3.28)* 1.57 (0.92~2.67) 40.6 2.43 (1.77~3.34)** 2.42 (1.75~3.34)** 0.7
Family support
 Living with supported family 1.00 1.00 1.00
 Living with unsupported family 2.29 (1.47~3.57)** 1.83 (1.25~2.66)** 1.53 (1.23~1.90)**
 Living alone 1.29 (0.55~3.04) 3.68 (2.09~6.51)** 0.93 (0.59~1.47)

ADLs=activities of daily living; ; Adj. ORs=adjusted odds ratios; Model I: Adjusted for age, educational level, family net assets, and number of diagnosed disease; Model II: Adjusted for age, educational level, family net assets, number of diagnosed disease and family support; %: Changes in adj. ORs were calculated by [ (adj. OR before controls - adj. OR after controls)/ (adj. OR before controls -1)×100] after adjusting the family support.; *p<.05, **p<.01.

Table 5

Adjusted Odds Ratios (95% confidence intervals) of Having difficulty in ADLs, Depressive Symptoms and Self-rated Health as 'poor' among Women (N=2,857)

Variables Having difficulty in ADLs Depressive symptoms Self-rated Health as 'poor'
Model I
Adj. OR (95% CI)		 Model II
Adj. OR (95% CI)		 % Model I
Adj. OR (95% CI)		 Model II
Adj. OR (95% CI)		 % Model I
Adj. OR (95% CI)		 Model II
Adj. OR (95% CI)		 %
Education
 ≥College 1.00 1.00 1.00 1.00 1.00 1.00
 Middle or high school 1.92 (0.19~18.98) 1.75 (0.20~17.38) 1.47 (0.41~5.31) 1.45 (0.40~5.25) 1.38 (0.72~2.68) 1.35 (0.70~2.62)
 ≤Elementary school 2.34 (0.24~22.59) 2.13 (0.22~20.52) 1.89 (0.53~6.75) 1.79 (0.50~6.40) 2.18 (1.36~4.19)* 2.08 (1.09~4.00)* 8.5
 No education 3.63 (0.37~35.10) 3.23 (0.33~31.27) 2.10 (0.58~7.58) 1.94 (0.54~7.04) 2.71 (1.39~5.26)** 2.59 (1.33~5.02)** 7.0
Family net assets (10,000 won)
 ≥20,000 1.00 1.00 1.00 1.00 1.00 1.00
 10,000~19,999 1.29 (0.80~2.07) 1.34 (0.83~2.17) 1.22 (0.81~1.83) 1.24 (0.82~1.87) 1.33 (1.06~1.68)** 1.36 (1.08~1.72)* -9.1
 3,500~9,999 1.05 (0.64~1.73) 1.14 (0.69~1.88) 1.20 (0.79~1.83) 1.19 (0.78~1.81) 1.43 (1.12~1.81)** 1.44 (1.13~1.84)* -2.3
 <3,500 1.29 (0.81~2.04) 1.52 (0.94~2.46) 1.86 (1.26~2.74)** 1.71 (1.15~2.55)** 17.4 2.58 (2.03~3.27)** 2.63 (2.06~3.36)** -3.2
Family support 1.00 1.00 1.00
 Living with supported family 1.45 (1.01~2.08)* 1.83 (1.34~2.49)** 1.43 (1.19~1.73)**
 Living with unsupported family 0.64 (0.41~1.01) 1.60 (1.12~2.28)** 1.01 (0.81~1.26)
 Living alone

ADLs=activities of daily living; ; Adj. ORs=adjusted odds ratios; Model I: Adjusted for age, educational level, family net assets, and number of diagnosed disease; Model II: Adjusted for age, educational level, family net assets, number of diagnosed disease and family support; %: Changes in adj. ORs were calculated by [ (adj. OR before controls - adj. OR after controls)/ (adj. OR before controls -1)×100] after adjusting the family support.; *p<.05, **p<.01.