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Social support and health among older adults – the Singapore Chinese Health Study

Published online by Cambridge University Press:  11 January 2021

Jon Barrenetxea
Affiliation:
Health Services and Systems Research, Duke-NUS Medical School Singapore, Singapore
Yi Yang
Affiliation:
Health Services and Systems Research, Duke-NUS Medical School Singapore, Singapore
Kyriakos S. Markides
Affiliation:
Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, Texas, USA
An Pan
Affiliation:
Department of Epidemiology and Biostatistics, MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
Woon-Puay Koh*
Affiliation:
Health Services and Systems Research, Duke-NUS Medical School Singapore, Singapore Saw Swee Hock School of Public Health, National University of Singapore, Singapore
Qiushi Feng
Affiliation:
Department of Sociology & Centre for Family and Population Research, National University of Singapore, Singapore
*
*Corresponding author. Email: woonpuay.koh@duke-nus.edu.sg

Abstract

While having social support can contribute to better health, those in poor health may be limited in their capacity to receive social support. We studied the health factors associated with social support among community-dwelling older adults in Singapore. We used data from the third follow-up interviews (2014–2016) of 16,943 participants of the Singapore Chinese Health Study, a population-based cohort of older Singapore Chinese. Participants were interviewed at a mean age of 73 years (range 61–96 years) using the Duke Social Support Scale (DUSOCS). We first applied ordinary least squares regression to DUSOCS scores and found that those with instrumental limitations, poor self-rated health, cognitive impairment and depression had lower social support scores. We then applied latent class analysis to DUSOCS answer patterns and revealed four groups of older adults based on the source and amount of social support. Among them, compared to the ‘overall supported’ group (17%) with the highest social support scores and broad support from family members and non-family individuals, the ‘family restricted’ (50%) group had the lowest social support scores and only received support from children. Health factors associated with being ‘family restricted’ were instrumental limitations (odds ratio (OR) = 1.33, 95% confidence interval (CI) = 1.19–1.49), poor self-rated health (OR = 1.40, 95% CI = 1.28–1.53), cognitive impairment (OR = 1.19, 95% CI = 1.04–1.37) and depression (OR = 2.50, 95% CI = 2.22–2.82). We found that while older adults in poor health have lower social support scores, they were more likely to receive a lot of support from children. Our results showed that lower social support scores among Singaporean older adults in poor health may not indicate lack of social support, but rather that social support is restricted in scope and intensified around children. These results may apply to other Asian societies where family plays a central role in elder-care.

Type
Article
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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