Biomedical subjects

Merril Silverstein

Publications and source records attributed to Merril Silverstein.

8 recordsLinked to original sources

PubMed2006

Intergenerational transfers and living arrangements of older people in rural China: consequences for psychological well-being.

OBJECTIVE: The migration of working-age adults from rural to urban China has altered traditional patterns of living arrangements and intergenerational support among elderly persons who remain in rural regions. This investigation examined how household composition and support exchanges with adult children influenced the psychological well-being of older parents in rural China. METHODS: Data derived from a 2001 survey of 1,561 parents aged 60 and older living in rural Anhui Province, China. We used multiple regression in order to estimate the effects of multigenerational living arrangements and intergenerational transfers of financial, instrumental, and emotional support on depression and life satisfaction in older parents. RESULT: Older parents living in three-generation households or with grandchildren in skipped-generation households had better psychological well-being than those living in single-generation households. Receiving greater remittances from adult children increased well-being and explained why living with grandchildren was beneficial. Stronger emotional cohesion with children also improved well-being. DISCUSSION: These results suggest that traditional family arrangements are beneficial in rural Chinese society as they represent the fulfillment of a cultural ideal. We discuss implications in the context of the corporate Chinese family, characterized by mutual aid and interdependence across generations, and its adaptation to social change.

Adaptation, Psychological↗

PubMed2006

Attrition of older adults in longitudinal surveys: detection and correction of sample selection bias using multigenerational data.

OBJECTIVE: The purpose of this study was (a) to investigate whether attrition due to death and nonresponse leads to bias in estimated growth-decline trajectories when only complete data are used in longitudinal research, and (b) to examine the extent of the bias and possible solutions. METHODS: The study sample was a subset of the Longitudinal Study of Generations and included data from 208 G1-G2 parent-child dyads and 538 G2-G3 dyads over 30 years. We used a latent growth-decline curve model based on full information maximum likelihood estimation in order to compare parents' and adult children's reports on older respondents' health and intergenerational solidarity by parents' attrition status. RESULT: Results indicated that attrition due to mortality biased estimates of respondents' assessments of their functional health status over time, and parents' perceptions of the quality of the parent-child relationship deteriorated more rapidly among those who died by Time 7, but nonresponse did not seriously bias estimates of these measures. Using proxies, we found that functional impairment increased more rapidly when children reported about parents, especially in advanced old age. DISCUSSION: These results support the use of full information in estimating growth curves where mortality is present but raise concerns when using child proxies to evaluate parental health or the quality of intergenerational relationships.

Adult↗

PubMed2005

Mental, physical and social components in leisure activities equally contribute to decrease dementia risk.

BACKGROUND: There is accumulating evidence in the literature that leisure engagement has a beneficial effect on dementia. Most studies have grouped activities according to whether they were predominantly mental, physical or social. Since many activities contain more than one component, we aimed to verify the effect of all three major components on the dementia risk, as well as their combined effect. METHODS: A mental, social and physical component score was estimated for each activity by the researchers and a sample of elderly persons. The correlation between the ratings of the authors and the means of the elderly subjects' ratings was 0.86. The study population consisted of 776 nondemented subjects, aged 75 years and above, living in Stockholm, Sweden, who were still nondemented after 3 years and were followed for 3 more years to detect incident dementia cases. RESULTS: Multi-adjusted relative risks (RRs) of dementia for subjects with higher mental, physical and social component score sums were 0.71 (95% CI: 0.49-1.03), 0.61 (95% CI: 0.42-0.87) and 0.68 (95% CI: 0.47-0.99), respectively. The most beneficial effect was present for subjects with high scores in all or in two of the components (RR of dementia = 0.53; 95% CI: 0.36-0.78). CONCLUSIONS: These findings suggest that a broad spectrum of activities containing more than one of the components seems to be more beneficial than to be engaged in only one type of activity.

Aged↗

PubMed2005

Latina grandmothers raising grandchildren: acculturation and psychological well-being.

Grandparent involvement in raising grandchildren has become increasingly prevalent and represents the family's strength for managing crises and transitions. This study examined acculturation, socioeconomic resources, and family factors related to well-being among 357 Latina caregiving grandmothers. Positive affect was related to greater language acculturation and factors suggesting participation in mainstream society-income and health. In contrast, higher life satisfaction and lower negative affect were more evident among the less acculturated. These relationships disappeared with controls, explained by greater social resources among less acculturated grandmothers: more were married and had the parent at home; fewer assumed care because of the parent's substance-related problems. The parent's presence in the household was related to a higher level of grandmother's well-being until more sensitive family factors were considered. Furthermore, raising grandchildren with behavior problems was related to the grandmother's negative affect. Results suggest that professions should target economic needs of new immigrants, as well as assisting with troubled grandchildren and dysfunctional parents.

Acculturation↗

PubMed2003

Observing the onset of disability in older adults.

One of the greatest threats to the ability of older adults to live independently is the onset of disability in activities adults perform in their daily lives, such as dressing, eating, toileting, managing one's money, preparing meals and so on. This article examines the onset of disability in older adult Americans using three waves of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey (1993, 1995, 1998; n=4228). We use medical/demographic factors (arthritis, heart disease, diabetes; age, gender, race/ethnicity, wealth), baseline characteristics (affect, cognition, health behaviors, medical insurance), and time-varying covariates (changes in chronic conditions and baseline characteristics) to predict the onset of activities of daily living (ADLs) and instrumental activities of daily living (IADLs) disability, individually and in the aggregate, over time. We find the onset of ADL and IADL disability is a complex process, suggesting important roles for medical, demographic, social, psychological, and behavioral triggers, specifically negative affect, higher body weight, and by the lack of vigorous exercise. We also find that individual ADL and IADL impairments are predicted by a variety of different factors, suggesting that summary measures of disability may be masking a wealth of potentially useful interventions. In general, public health efforts in the area of controlling obesity and treating depressive symptoms should be supported.

Activities of Daily Living↗

PubMed2003

Health-seeking behaviors of elderly Chinese Americans: shifts in expectations.

PURPOSE: This study reported a qualitative analysis of health-seeking behaviors of community-dwelling elderly Chinese Americans on the influences of family network, cultural values, and immigrant experience in their use of health resources. Barriers to health care, pathway of health care, and adaptation of health care by use of self-treatment and Eastern and Western medicines were also examined. DESIGN AND METHODS: The investigators used content analysis to obtain themes and key points of focus group interview data (N = 25) to explore the elderly participants' attitudes, values, and practices in their use of health resources. Survey questionnaires in Chinese were used to compile demographic data. RESULTS: Findings suggested a shift from traditional expectations of filial piety to more dependence on neighbors and friends, and a genuine adaptability to combining Eastern and Western health care modalities. Immigration was not proposed by these Chinese elders as an explanation of shifts in expectations for family support or values. IMPLICATIONS: This study has implications for research, service delivery, and policy making for health care of ethnic elderly persons, particularly in addressing structural and cultural issues in access and compliance.

Aged↗

PubMed2002

Reciprocity in parent-child relations over the adult life course.

OBJECTIVES: This research assessed how parents' transfers of sentiment, time, and financial assets to their adolescent/young adult children affect the children's propensity in middle age to provide social support to their aging parents. We tested whether the mechanism of long-term intergenerational exchange is better modeled as a return on investment, an insurance policy triggered by the longevity or physical frailty of parents, or the result of altruistic (or other nonreciprocal) motivations on the part of adult children. METHODS: Models were examined with 6 waves of data from the University of Southern California Longitudinal Study of Generations. The sample consisted of 501 children who participated in the 1971 survey and who had at least 1 parent surviving in 1985. Growth curve modeling was applied to predict average levels and rates of change in social support provided to mothers and fathers between 1985 and 1997 as a function of early parental transfers of affection, association, and tangible resources to their children. RESULTS: Children who spent more time in shared activities with their mothers and fathers in 1971 provided more support to them on average. Receiving greater financial support from parents in 1971 raised the marginal rate at which support provided by children increased over time. Maternal health operated synergistically with early affection to produce greater levels of support. Both levels and rates of increase in support from children were positive, even for children who received no early transfers from their parents. DISCUSSION: The results offer some support for investment, insurance, and altruistic models of intergenerational exchange. Sharing time in activities provides a direct return to the parent that is characteristic of an investment strategy, whereas financial transfers provide a time-contingent return that is characteristic of an insurance mechanism. That affection triggers greater support to more functionally impaired mothers suggests that emotionally investing in children as a health insurance mechanism may be based on the greater moral equity accorded to mothers. The motivation of adult children to provide social support to their older parents is partially rooted in earlier family experiences and guided by an implicit social contract that ensures long-term reciprocity.

Adolescent↗

PubMed2002

Grandmothers raising grandchildren: family structure and well-being in culturally diverse families.

PURPOSE: This study addressed well-being of grandmothers raising grandchildren in coparenting and custodial households in a sample of African American, Latino, and White grandmothers. DESIGN AND METHODS: A sample of 1,058 grandmothers was recruited through the schools and media. Grandmothers raising or helping to raise school-aged grandchildren in Los Angeles were interviewed, and analyses were conducted within ethnic groups. RESULTS: African American grandmothers experienced equal well-being in coparenting and custodial families; however, if the stresses related to the parents' problems were removed by statistical control, they favored the custodial arrangement. Latino grandmothers had greater well-being in coparenting families, reflecting a tradition of intergenerational living. White custodial grandmothers experienced somewhat higher levels of affect (positive and negative) but showed no difference in other types of well-being. IMPLICATIONS: The cultural lens through which grandparenthood is viewed has a marked impact on the adaptation to custodial or coparenting family structures.

Adaptation, Psychological↗