An epidemiological profile of elderly suicides in Hong Kong

Suicide rates in Hong Kong increased with age, and the highest suicide rate occurred among the oldest age groups. Hong Kong has one of the highest elderly suicide rates in the world. The elderly suicide rate was four to five times above the average. Furthermore, gender differences were observed among different marital status groups. For example, single males had a much higher rate than single females and married males had a higher rate than their widowed counterparts. The suicide rate for an economically inactive person was six times higher than for an active one. Jumping has become increasingly common and seems to substitute for other methods of suicide. Winter months and the Chinese New Year period had the lowest suicide occurrence. Some explanations are given.     

MRI of the gastrointestinal tract

To test whether the effects of marital status on health differ between never married women and divorced and separated women, this study utilizes prospective panel data for a large national sample of non-institutionalized young women in the U.S. (the National Longitudinal Surveys of Young Women). The women were aged 24-34 at the beginning of two successive five-year follow-up intervals (1978-1983 and 1983-1988). The health effects of marital status were evaluated in regressions which assessed the relationships between initial marital status and subsequent health trends in each follow-up interval. In the first follow-up interval, never married women tended to have worse health trends than divorced and separated women for physical impairments and for overall health problems. However, there were no differences between never married women and divorced and separated women in health trends for psychosomatic symptoms in either follow-up interval or for any health measure in the second follow-up interval. Our analyses of cross-sectional data showed few significant differences in health between never married women and divorced and separated women. Taken together, the evidence from our study and previous studies suggests that differences between never married women and divorced and separated women may vary by age and/or cohort. Evidence for the 1970s and 1980s suggests that, among older women, divorced and separated women may have experienced more harmful health effects than never married women; however, among younger women, this difference may have been absent or possibly reversed.     

Marital status of caregiving daughters and co-residence with dependent parents

The role of caregiving daughters' marital status is examined as it relates to their sharing households with disabled elderly parents. Married daughters fared best in well-being, income, and social support. Never-married women were the most likely to have never moved out of the parental home. Separated/divorced caregivers, more than the married and widowed, had moved into the parent's home rather than the reverse and widowed daughters had lived in re-formed joint households longest. The main reason for re-forming shared households was disability of the parent. Among other reasons were death or withdrawal of previous caregiver and financial problems, with separated/divorced daughters the most likely to mention finances.     

A re-examination of widowhood and morale

Previous research has suggested widowed status to be associated with lower morale or life satisfaction. The effects of marital status on morale relative to five covariates (health, income, age, family interaction, and employment status) were examined with 232 widowed and 363 married women aged 45-74, drawn in a multistage stratified area probability sample of Los Angeles County. Analysis of covariance was utilized with a six-item, factor analyzed measure of morale. Parallel analyses were performed for each of three ethnic groups (blacks, Mexican-American, and white) to examine specific ethnic patterns. In the total sample, poor health was associated with significantly lower morale among widowed than among married women. The analysis with age showed the widowed group catching up and surpassing their married peers on morale at higher ages. Controlling for income and employment status eliminated differences between the marital status groups on morale scores. Higher family interaction was positively associated with morale in both groups, but married women were consistently higher on morale regardless of level of interaction. Most ethnic differences were not significant, but family interaction appeared to be crucial among Mexican-American widows. The findings suggest that lower morale scores found among the widowed may be partly attributable to other factors commonly associated with this status and not due to the role of widowhood per se.     

A review of longitudinal studies of cognitive functions in schizophrenia patients

We examined whether differences in health were associated with different probabilities of marital transitions in a longitudinal study, using Cox proportional hazard analysis. Data on approximately 10,000 Dutch persons of the GLOBE study, aged 15-74 years, were used for this purpose. The study started in 1991 and study subjects have been followed for 4.5 years. Of the four marital transitions studied (marriage among never married and divorced persons, and divorce and bereavement among married persons), only divorce among married persons was associated with health status: married persons who reported four or more subjective health complaints or two or more chronic conditions were, respectively, 1.5 and two times more likely to become divorced during follow-up than persons without these health problems. Since hardly any other studies have examined the role of health selection in marital transition with longitudinal data, more research is required before firm conclusions can be drawn. It can be concluded, however, that the frequently made assumption that health selection contributes only little to the explanation of health differences between marital status groups, seems, at least for the divorced, not justified.     

Hip fracture rates in Hong Kong and the United States, 1988 through 1989

OBJECTIVES: Prior studies have suggested that hip fracture rates are substantially lower in Asian countries than in the United States. However, comparisons have been limited by unavailability of recent data, differences in case definition, lack of data from similar time periods, and small sample sizes. This study sought to examine trends by age and sex, with separate statistics for those aged 85 or older. METHODS: Hospital discharge data were used to obtain hip fracture incidence in Hong Kong and the United States from 1988 through 1989. RESULTS: Within each population, women had higher hip fracture rates than men. Fracture rates in the United States were significantly higher for both sexes than rates in Hong Kong. For persons over the age of 80, rates of hip fracture among White US males exceeded those for Hong Kong women. Inclusion of transferred cases in hip fracture rates minimized differences between the countries. CONCLUSIONS: Despite increasing hip fracture rates in Hong Kong, those rates are still substantially lower than the rates in the United States. Identifying factors responsible for this variation may prove useful in the search for preventive strategies.     

Socioeconomic and spatial differentials in mortality and means of committing suicide in New South Wales, Australia, 1985-91

Analysis of suicide mortality in New South Wales, Australia is undertaken with reference to marital status and occupational status between 1986-89/90 and with reference to the principal means of committing suicide. Not currently married male manual workers were particularly at risk although marital status variations were significant with both genders and at different ages. Between 1985-91 male suicide mortality rates were significantly higher in inland non-metropolitan regions, especially among younger men, and were higher in inner areas of metropolitan Sydney. While there were no significant variations by marital status in the means of committing suicide there were variations between genders, and there were regional and social class variations in the use of guns with males. The use of guns was a factor in the elevated suicide mortality levels among inland rural youth and men, and among farmers and transport workers while the use of poisons was also significant with these occupational groups. The use of poisons was greater among persons committing suicide in the areas of elevated mortality in inner Sydney and the use of guns much lower.     

Loneliness and depression in middle and old age: are the childless more vulnerable?

OBJECTIVES: This study tests whether childlessness is significantly related to greater loneliness or depression among older adults, both alone and in conjunction with marital status. METHODS: Using data from the 1988 National Survey of Families and Households, the relative circumstances of community-dwelling, permanently childless adults and biological parents (with at least one surviving child), 50-84 years old, are compared. Multivariate models are used to test the effects of parental status and combined marital-parental statuses on loneliness and depression, controlling for sociodemographic characteristics. RESULTS: Results of multivariate analyses show no significant, direct effect of childlessness, though a marginally significant effect appears for women. However, small but significant differences are observed within a typology combining marital and parental statuses. Widowed men and women report higher levels of loneliness and depression than married parents regardless of parental status. Divorced parents are also significantly more vulnerable. The subjective well-being of never married, childless men and women is indistinguishable from that of their married peers. DISCUSSION: The results confirm earlier studies, indicating that childlessness is not necessarily linked with diminished subjective well-being among older adults. However, marital status represents an important context within which to understand and evaluate the experience of parental status.     

Delinquent behavior, future divorce or nonmarital childbearing, and externalizing behavior among offspring: A 14-year prospective study.

In a longitudinal study of a national sample, more externalizing behavior problems were found among 222 children from never-married and 142 children from divorced families than among 840 children from married families. However, delinquent behavior reported when future mothers were single, childless adolescents prospectively predicted their future marital status and behavior problems among their offspring 14 years later. Maternal history of delinquent behavior accounted for much, but not all, of the relationship between marital status and children's externalizing behavior. Divorce and nonmarital childbirth do not occur at random, and these findings demonstrate that marital status is predicted by individual characteristics as well as by demographic factors. These findings highlight the importance of cautiously interpreting the much-discussed correlation between marital status and children's behavior problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Leisure-time physical activity and marital status in relation to depression between men and women: A prospective study.

Background: Previous studies have identified the preventive effect of leisure-time physical activity (LTPA) on depression. Women and men have different emotional vulnerabilities. The impact of LTPA on depression varies by gender. Little is known about the impact of LTPA on depression for people with different marital status. Objectives: The objective of this study was to assess the long-term effects of LTPA, changes in LTPA, and marital status on the risk of developing depression for general Canadians. Methods: Data from the biennial National Population Health Survey (NPHS) cycles conducted between 1994/95 and 2004/05 were analyzed in 2008. After excluding individuals with preexisting depression at baseline, respondents were classified as physically active or inactive and then followed up in subsequent cycles of the NPHS to look at risk of developing depression. Individuals who changed their activity level were also examined. Subgroup analyses by different marital status were performed to identify high-risk populations. Results: In 1994/1995, 17,276 participants were included in the NPHS longitudinal panel. Respondents who were inactive were more likely to be older, female, obese, widowed/separated/divorced, not working, low income, and lacking social support. After controlling for potential confounding factors, it was found that LTPA reduced the risk of developing depression for women. The modest risk reduction observed for men was not statistically significant. Women who were active at baseline and two years of follow-up were significantly less likely to report depression at four years of follow-up compared to women who were inactive at baseline and at two years of follow-up. A 51% greater probability of developing depression was observed after two years for women who changed their LTPA from active to inactive compared to women who remained active. No significant results were found for men. Divorced/separated/widowed women who stopped LTPA had 4.2 times the risk of developing depression after two years compared to those who remained active. The risk of developing depression after stopping activity did not vary according to marital status among men. Conclusions: LTPA has preventive effects on depression for women. Reduction in LTPA level is associated with subsequent depression for women. Divorced/separated/widowed women are at particularly high risk of developing depression if LTPA is stopped. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Love, marriage, and divorce: Newlyweds' stress hormones foreshadow relationship changes.

Neuroendocrine function, assessed in 90 couples during their first year of marriage (Time 1), was related to marital dissolution and satisfaction 10 years later. Compared to those who remained married, epinephrine levels of divorced couples were 34% higher during a Time 1 conflict discussion, 22% higher throughout the day, and both epinephrine and norepinephrine were 16% higher at night. Among couples who were still married, Time 1 conflict ACTH levels were twice as high among women whose marriages were troubled 10 years later than among women whose marriages were untroubled. Couples whose marriages were troubled at follow-up produced 34% more norepinephrine during conflict, 24% more norepinephrine during the daytime, and 17% more during nighttime hours at Time 1 than the untroubled. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Chronic diseases in immigrants from Russia (CIS) at a primary care clinic and their sociodemographic characteristics

397 new immigrants to Israel ("olim") were under medical treatment at a primary care clinic during the first year (1990-1991) after their immigration to Israel ("aliyah") from 14 republics of the Commonwealth of Independent States (CIS, formerly the Soviet Union). Most of the olim were between 1-19 years of age. More than three-quarters were married and about a third of the women were widowed or divorced. The other patients were bachelors, separated men or women, or divorced men. More than a third had 16 years or more of education. More than a third of the families consisted of 2 members, while more than three-quarters had both parents, and about a quarter only 1 parent, usually the mother. Half the families had children; more than a quarter of the adults had not been employed in the CIS, while in Israel 58.8% were. 464 diagnoses of chronic diseases had been made in the CIS, (1.2/person), of which 75% were verified in Israel. 185 cases (0.5/person) not previously reported were diagnosed or had developed in Israel. The most frequent were cardiovascular, and next digestive tract disease, followed by endocrine, metabolic and musculoskeletal-connective tissue diseases. The overall prevalence rate of ischemic heart disease among men aged 20 < or = 65 years was 18.8%, compared to 5.8% among veteran Israelis. Among women the rates were 9.5% and 4.0%, respectively. The prevalence of hypertension (> or = 160/95) was 14% among men and 21% among women; in veteran Israelis it was 14% for both men and women. The prevalence of diabetes among men was 4.1%, and 5.4% among veteran Israelis.(ABSTRACT TRUNCATED AT 250 WORDS)     

Does marriage protect older people from distress? The role of equity and recency of bereavement.

The association between marital status and distress was examined in a largely neglected group, namely older people (65 and older; N = 1,649). In this 2-wave study, married persons were less distressed than single persons, but perceived equity within the marriage and recency of bereavement qualified these findings. Married persons who felt inequitably treated were more distressed than persons who had always been single. Married persons reported less distress than recently (= 2 years ago) widowed persons, but only equitably treated married persons reported less distress than persons widowed for more than 2 years. Increased distress between the 2 waves occurred in recently widowed persons, and there was a decrease in distress in persons who were widowed shortly before the 1st wave. No gender effects were found. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marital status and quality in middle-aged women: Associations with levels and trajectories of cardiovascular risk factors.

The current study compared cardiovascular risk profiles and trajectories (i.e., within-person changes) of women who were married or cohabitating and who had high relationship satisfaction with those of women with moderate or low satisfaction and with those of women who were single, divorced, and widowed. Participants were 493 women from the Healthy Women Study, a prospective investigation of health during and after the menopausal transition. Risk factors were measured across more than 5 occasions and 13 years, on average. Data were analyzed using a multilevel modeling technique. Overall, women in relationships with high satisfaction had lower levels of biological, lifestyle, and psychosocial risk factors when compared with the other groups. In some cases, women in satisfying marriages also showed a lower risk trajectory on risk factors relative to other women. Hence, marriage appears to confer health benefits for women, but only when marital satisfaction is high. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A co-twin--control study of response to widowhood

The effects of long-term and recent conjugal bereavement were investigated in a sample of 2,104 Swedish twins followed between 1984 and 1993. In co-twin-control analyses, the bereaved twin experienced significantly more depressive symptoms, more loneliness, and less life satisfaction than the married co-twin. This association existed for recently widowed (< 3 years) of both sexes. Long-term widowed (> 5 years) reported more loneliness than married individuals, and for women there was also a difference in life satisfaction. There were no effects of bereavement on perceived physical health. Individual analyses, which included all respondents regardless of the co-twin's bereavement status, showed the same pattern of results. There was also evidence for an anticipation effect of widowhood indicated by elevated depressive symptoms prior to the spouse's death. Finally, longitudinal analyses showed that it is more stressful to be bereaved when young-old than old-old, but revealed no age differences in adaptation.     

The effects of widowhood on physical and mental health, health behaviors, and health outcomes: The Women's Health Initiative.

This study examined whether widowhood was associated with physical and mental health, health behaviors, and health outcomes using a cross-sectional (N=72,247) and prospective (N=55,724) design in women aged 50-79 years participating in the Women's Health Initiative observational study (85.4% White). At baseline, married women reported better physical and mental health and generally better health behaviors than widowed women. Whereas women who remained married over the 3-year period showed stability in mental health, recent widows experienced marked impairments and longer term widows showed stability or slight improvements. Both groups of widows reported more unintentional weight loss over the 3-year period. Changes in physical health and health behaviors were inconsistent, with generally small effect sizes. Findings underscore the resilience of older women and their capacity to reestablish connections, but point to the need for services that strengthen social support among women who have difficulty during this transition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marital status and abortion

OBJECTIVES: This article examines the marital status of women who obtained abortions between 1974 and 1994, with particular attention to those who were married or in common-law relationships. DATA SOURCES: The data come from Statistics Canada's publications on abortions, in-patient hospital morbidity data, and reports from the United States. ANALYTICAL TECHNIQUES: Crude and age-standardized abortion rates from 1974 to 1994 were calculated by marital status. MAIN RESULTS: While abortion rates were highest for single women, those who were married (including common-law and separated) accounted for over one-quarter of all abortions performed in 1994. Since 1974, the age-standardized abortion rate per 1,000 married women aged 15 to 44 almost doubled from 6.6 to 11.2. For most of these women, it was their first abortion, and the majority had taken at least one pregnancy to term.     

Longitudinal study of marital success and failure.

Administered the Bentler Psychological Inventory, the Bentler Interactive Psychological Inventory, the Sexual Behavior Inventory, and a background questionnaire to 77 newly married couples. Four yrs later these couples were followed up to determine their marital status and satisfaction (the Locke and Wallace Marital Adjustment Scale and a rating scale of 19 potential marital problem areas). Findings indicate that (a) correlational similarity as well as mean differentiation between partners was higher in the still-married group than the divorced group; (b) accuracy of self-perception was marginally reflective of marital success; (c) living together before marriage had no apparent effect on the outcome of marriage; (d) divorced couples appeared to face qualitatively different problems than married couples; and (e) longitudinal prediction of marital adjustment was possible. It is suggested that variation in marital outcome is most accurately predicted from personality and not demographic variables, based largely on data from women. (41 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The cessation of marital intercourse

The authors found that marital coitus had ceased for a definable period (median=8 weeks) in one-third of a sample of 144 men and 221 women who were relatively young and had been married an average of 11 years. An analysis of factors related to the social background and marital relationship of the respondents indicated that the cessation behavior of men is more highly predictable than that of women and that antecedents of this behavior differ markedly between the sexes. The authors suggest that, even among relatively young couples, marital intercourse is discontinous and problematic.