Source Themes

Gender-specific effect of couple-based intervention on behavioral and psychological outcomes of older adults with type 2 diabetes during the COVID-19 partial lockdown in Guangzhou, China

Abstract

This study aimed to evaluate the gender-specific effect of a couple-based intervention on the management behaviors and mental well-being of community-dwelling older adults with type 2 diabetes mellitus during the COVID-19 partial lockdown in Guangzhou. Out of 207 participants involved in a prior randomized controlled trial (Trial no. ChiCTR1900027137), 156 (75%) completed the COVID-19 survey. Gendered differences in management behaviors and depressive symptoms between the couple-based intervention group and the patient-only control group were compared by distance to the high-risk areas cross-sectionally and longitudinally using random intercept models. Cross-sectionally, female patients of the intervention group had more positive behavior change scores (β = 1.53, p = 0.002) and fewer depressive symptoms (β = −1.34, p = 0.02) than the control group. Over time, female patients lived closer to the high-risk areas (<5 km) and showed decreasing depressive symptoms (β = −4.48, p = 0.008) in the intervention group vs. the control group. No statistically significant between-group difference was found for males. Females tended to benefit more from the coupled-based intervention than males did, particularly among these closer to the high-risk areas. Chronic disease management can be better sustained with active spousal engagement.

Social support, social strain and declines in verbal memory: sex-specific associations based on 16-year follow-up of the English Longitudinal Study of Ageing cohort

Abstract

Objectives: Previous investigations of cognitive aging have mainly focused on structural aspects of social relations (e.g. network size and composition), thereby neglecting the role of qualitative aspects of social relations. The current longitudinal study examined sex-specific differences in verbal memory decline by measures of perceived relationship quality (social support/strain) by relationship type. Method: In the English Longitudinal Study of Ageing (ELSA), 10,109 participants aged 50-89 years were assessed at wave 1 (baseline: 2002-03) and followed to wave 9 (2017-18). Verbal memory was assessed by immediate and delayed word-recall tasks. Social support/strain was measured by relationship type (spouse; children; family; friends). Random effects within-between (REWB) modelling was used to separate between- and within-person effects. We estimated associations between social support/strain and (1) baseline levels of memory (main effects), and (2) rate of decline in memory (interaction with time-since-baseline). Results: Longitudinal associations were most prominent for men, specific to relationship type, and showed between- rather than within-person effects. Among men, higher spousal strain was associated with faster memory decline (βbetween-effect×time = -0.043; 95% CI [-0.084, -0.002]; p = .039), whilst greater support from children was associated with slower decline (βbetween-effect×time = 0.020; 95% CI [0.002, 0.039]; p = .033). Men with higher strain from friends showed lower baseline memory (βbetween-effect = -0.382; 95% CI [-0.627, -0.137]; p=.002) and faster decline (βbetween-effect×time = -0.047; 95% CI [-0.095, 0.000]; p = .051). Conclusion: Between-person differences in social support/strain were modestly associated with memory decline, especially among men.