| ObjectivesChina is faced with a serious problem of population aging,and the health status of the elderly has attracted much attention.This research based on the data from the multidimensional health survey of the elderly in Xiamen conducted in 2016,analyzes the spouse’s impact on the elderly’s single-dimensional and multi-dimensional health,and explores the spouse health interacting with the degree of marital intimacy to health of the elderly,in order to improve the level of health and quality of life of the elderly,and to promote a healthy aging process of the whole society to provide certain theoretical basis and practical help.MethodsUsing the multi-stage random sampling method,3230 elderly people aged 60 and above and their close relatives were selected in Xiamen City to carry out the investigation,among which the elderly people whose close relatives were spouses were included in this study.Information collected on the elderly included general demographic data,self-reported health,depression,cognitive function,and chronic disease.Spouse information was collected including general demographic data,selfreported health,depression and chronic disease.The multidimensional health of the elderly includes self-reported health,depression,cognitive dysfunction and prevalence of common chronic diseases;Spousal multidimensional health included self-reported health,depression,and prevalence of common chronic diseases.The self-reported health of both the elderly and the spouse is a dichotomous variable.The depressive symptoms of the elderly were assessed by the Geriatric Depression Scale(GDS).A score of 4 is considered depressed.The depressive symptoms of the spouse were assessed by the Center for Epidemiologic Studies Depression Scale(CES-D).A score of 16 is considered depressed.The cognitive function of the elderly was measured by the Montreal Cognitive Assessment Form in Chinese,in which those with illiteracy ≤15 points,primary school education≤20 points,and junior high school or above education ≤23 points were defined as cognitive dysfunction.Chronic disease status of the elderly and their spouses was selfreported,which was defined as having a disease diagnosed by a hospital clinician.Any one of hypertension,diabetes,or hyperlipidemia is defined as having common chronic diseases.SPSS22.0 and MPLUS 7.0 were used for statistical analysis.Enumeration data were described by rate,constituent ratio and other indicators,and the prevalence differences among groups were further compared by χ2 test.Using unconditional logistic regression,the health status of the spouse(self-reported health,depression and chronic disease prevalence)was taken as the independent variable,and the health dimensions of the elderly(self-reported health,depression,cognitive function and chronic disease prevalence)were taken as the dichotomous dependent variable to build the model.At the same time,the influence of spouse’s health status on the health status of the elderly was analyzed by controlling covariates such as age,gender,education level,residence,exercise frequency,social activity and age difference between husband and wife.Furthermore,the product term of the degree of intimacy between couples and independent variables was added to each model to explore the moderating effect of the degree of intimacy between couples.χ2 test was used to analyze the correlation of health evaluation indexes.Structural equation model was used to analyze the influence of spouse health on the multidimensional health of the elderly.α=0.05 was taken as the test level.ResultsAmong the 3,230 elderly households surveyed,1,345(43.9%)of the couples were spouses.Of the 1,345 couples,1,017 provided complete information.The highest age of the elderly was 93 years old and the mean age was 69.15±6.50 years old.55 elderly with depression,accounting for 5.41%;298(29.30%)of the elderly had cognitive dysfunction;486 people(47.79%)were self-reported as healthy;430(42.28%)of the elderly had common chronic diseases.The self-reported health status of the elderly was closely related to the health function of other dimensions,and the spouse’s self-reported health and common chronic diseases were the most closely related(r=0.226,0.161).There was a significant correlation between cognitive dysfunction and depression(r=0.089).There was a strong correlation between depression and spouse depression(r=0.181).The age of the spouses ranged from 41 to 93 years old,with an average age of 66.68±7.50 years old.There were 387(38.05%)who were illiterate or illiterate,242(23.80%)in primary school,388(38.15%)in junior middle school or above,48.67%of the elderly were less than three years old from their spouses,and 842 persons(82.79%)had close relationships with their spouses.462 people(45.43%)were selfreported as healthy,131(12.88%)of the spouses were depressed,and 36.58%of the spouses had common chronic diseases.The risk of depression of the elderly with spouse depression was 3.503 times that of the elderly without spouse depression(OR=3.503).The risk of depression of the elderly with spouse negative self-assessment of health was 2.386 times that of the elderly with spouse negative self-assessment of health.The elderly with no close relationship were more likely to have negative self-evaluation of health(OR=1.746);Older adults with a spouse with a common chronic disease had a 1.459 times higher risk of developing a common chronic disease than those without a spouse(OR=1.459).In addition,those who lived in the suburbs(OR=2.833),did not participate in social activities(OR=0.384),and were not close to their spouses(OR=0.268)had higher rates of depression.The prevalence of cognitive dysfunction was higher in the older age group≥80 years old(OR=3.768)and those living in the suburbs(OR=3.621).Women(OR=0.726)and the elderly who never exercised(OR=1.387)were more negative in their self-rated health.The prevalence of common chronic diseases was higher in the elderly aged 70 to 79 years(OR=0.776)and those living in cities(OR=0.520).The interaction results showed that there was a significant interaction between spouse suffering from common chronic diseases and the degree of intimacy between husband and wife(P=0.01).Intimacy between husband and wife could reduce the influence of spouse suffering from common chronic diseases on depression in the elderly.The results of structural equation model showed that the health status of the spouse had a significant positive predictive effect on the health status of the elderly,and the path coefficient is 0.051.ConclusionsIn this study,by exploring the influence of spouse on single and multiple dimensions of health in the elderly,and the moderating effect of marital intimacy,the following conclusions were drawn:1)the cognitive dysfunction of the elderly is only affected by the elderly’s own factors,such as gender,age,residence,etc.;2)Spouse depression has a greater influence on depression in the elderly,followed by spouse’s self-rated health,spouse’s closeness to the elderly,spouse’s common chronic disease,and spouse’s common chronic disease;3)The health status of the spouse has a significant positive predictive effect on the health status of the elderly;4)The effect of spouse’s chronic diseases on the depression of the elderly was moderated by the degree of intimacy between husband and wife,suggesting that maintaining the intimate relationship between husband and wife plays an important role;5)Gender,education level,exercise and social activities are the factors that affect the self-rated health of the elderly;6)Living in rural areas,no social activities,spouse depression,and lack of intimacy between couples are the risk factors for depression. |
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