Functional limitation trajectories and their determinants among women in the Philippines.

BACKGROUND: Limited evidence exists regarding how functional limitation patterns of women in developing countries unfold through midlife and into old age, a critical period during which the tendency to develop severe problems is fomented. OBJECTIVE: Functional limitation prevalence and patterns through midlife into early old age, and their determinants, are examined among women in the Philippines. METHODS: Data from the Cebu Longitudinal Health and Nutrition Study are monitored from 1994 to 2015. Patterns are categorized using group-based trajectory modeling. Predictors of group membership are modeled. RESULTS: About half responding to all survey waves report functional limitation at least once over the study period. Movements in and out of functional limitation states are common. Between age 30 and 70, trajectories are categorized into four groups: 1) robust, 2) late onset, 3) early onset, and 4) recovery. Being married, living in a nuclear household, higher successful birth ratio, and higher education associate with favorable trajectories. More births, higher age at first birth, wealth, and urbanicity associate with less favorable trajectories. CONCLUSION: Many possible routes into and out of functional limitation exist. The manifold patterns can be grouped into common trajectories. A number of earlier life characteristics associate with these trajectories. CONTRIBUTION: This is the first analysis to ascertain common functional limitation trajectories and earlier life predictors among women as they age in a high fertility developing country setting. Recognizing these is an important step toward understanding global health given aging of the population and the likelihood of functional problems developing in women as they move into old age.

Children's Relative Living Proximity and Intergenerational Support to Older Parents in China.

Although research has recognized the influence of geographic proximity on intergenerational support in Chinese families, the effect of siblings' geographic proximity remains unexplored. Guided by the within-family differences approach, this study uses data from the China Health and Retirement Longitudinal Study to examine how the relativity of children's and their siblings' geographic proximity is associated with children's support to older parents and how the association differs by child gender. Results show that living relatively farther among siblings is associated with providing less economic support and have less contact with parents, but this negative effect is less prominent on sons' economic support and daughters' contact with parents. Having siblings living at the same distance also affects children's support behaviors. The findings reveal that support responsibilities could be differentially distributed by children's relative living proximity among siblings and indicate the importance of considering sibling influences when studying intergenerational support in Chinese families.

Dual Trajectories of Social Isolation and Dementia in Older Adults: A Population-Based Longitudinal Study.

Objectives: To identify the interrelations between the trajectories of social isolation and dementia in older adults. Methods: Data came from the National Health and Aging Trends Study 2011-2018 surveys. Group-based dual trajectory modeling was used to examine trajectories and their interrelations. Results: Four trajectories of social isolation-rarely isolated (62.2%), steady increase (13.5%), steady decrease (7.4%), and persistently isolated (16.9%) and dementia risk-persistently low risk (80.4%), increasing with early onset (3.9%), increasing with late onset (4.5%), and persistently high risk (11.2%) emerged. Two-thirds of the low-risk dementia group were in the rarely isolated group. The high-risk dementia group had the most overlap with the decreasing social isolation group (47%), followed by the persistently isolated group (28%). Conclusions: Social isolation and dementia mostly evolved in the same direction. However, the pattern of associations between these trajectories is intricate and may be reversed among long-term dementia survivors.

Time-use Profiles, Chronic Role Overload, and Women's Body Weight Trajectories from Middle to Later Life in the Philippines.

Although chronic life strain is often found to be associated with adverse health outcomes, empirical research is lacking on the health implications of persistent role overload that many women around the world are subject to, the so-called double burden of work and family responsibilities. Using data from the Cebu Longitudinal Health and Nutrition Survey (1994-2012), we examined the linkage between time-use profiles and body mass index (BMI) trajectories for Filipino women over an 18-year span. Out of the four classes of women with differential levels of a combination of work and family duties, the group with the heaviest double burden has the highest average BMI. In addition, those who have remained in this class for three or more waves of data not only have higher BMI on average but also have experienced the steepest rate of increase in BMI upon transition from midlife to old age.

Double burden for women in mid- and later life: evidence from time-use profiles in Cebu, the Philippines.

Using data from the Cebu Longitudinal Health and Nutrition Survey (CLHNS, 1994, 1998, 2002, 2005, 2007, 2012), we utilize latent class analysis (LCA) to develop time use class membership to characterize the degree to which women in Cebu are subject to the double burden of work and family responsibilities in mid and later life. Results suggest that close to a third of the sample are engaged in high intensity work for pay (either outside or home-based) over eighteen years, while combining it with a substantial amount of household chores and with low level of personal time in a span of eighteen years. Our latent transition analysis (LTA) also shows that, with the addition of grandchildren into the household, some women experience a shift in time use class membership by becoming high intensity caregivers or by completely transitioning out of work arena, while others remain double-burdened with active involvement in both work and family responsibilities.

Implications of Changes in Family Structure and Composition for the Psychological Well-Being of Filipino Women in Middle and Later Years.

The health implications of multigenerational coresidence for older adults is a well-researched topic in the aging literature. Much less is known of its impact for women in midlife. We used data from the Cebu Longitudinal Health and Nutrition Study (2002, 2005, 2007, and 2012) to study the influence of transitions in multigenerational household composition on depressive symptoms for women in midlife transitioning into old age. Our initial analysis showed little effect when we use the conventional classification of nuclear versus extended family and transition in and out of extended family. When we described shifts in the family environment by compositional changes, that is, change in the presence and absence of particular family members, we found significant association between depressive symptoms and two types of role transitions: the loss of a spouse in the household and the entry and exit of grandchildren in the household.

Race/Ethnic Differentials in the Health Consequences of Caring for Grandchildren for Grandparents.

OBJECTIVES: The phenomenon of grandparents caring for grandchildren is disproportionately observed among different racial/ethnic groups in the United States. This study examines the influence of childcare provision on older adults' health trajectories in the United States with a particular focus on racial/ethnic differentials. METHOD: Analyzing nationally representative, longitudinal data on grandparents over the age of 50 from the Health and Retirement Study (1998-2010), we conduct growth curve analysis to examine the effect of living arrangements and caregiving intensity on older adults' health trajectories, measured by changing Frailty Index (FI) in race/ethnic subsamples. We use propensity score weighting to address the issue of potential nonrandom selection of grandparents into grandchild care. RESULTS: We find that some amount of caring for grandchildren is associated with a reduction of frailty for older adults, whereas coresidence with grandchildren results in health deterioration. For non-Hispanic black grandparents, living in a skipped generation household appears to be particularly detrimental to health. We also find that Hispanic grandparents fare better than non-Hispanic black grandparents despite a similar level of caregiving and rate of coresidence. Finally, financial and social resources assist in buffering some of the negative effects of coresidence on health (though this effect also differs by race/ethnicity). DISCUSSION: Our findings suggest that the health consequences of grandchild care are mixed across different racial/ethnic groups and are further shaped by individual characteristics as well as perhaps cultural context.