Do stroke services still show sex differences? A multicenter study.

BACKGROUND: The issue of sex differences in stroke has gained concern in the past few years. However, multicenter studies are still required in this field. This study explores sex variation in a large number of patients and compares stroke characteristics among women in different age groups and across different countries. METHODS: This multicenter retrospective cross-sectional study aimed to compare sexes regarding risk factors, stroke severity, quality of services, and stroke outcome. Moreover, conventional risk factors in women according to age groups and among different countries were studied. RESULTS: Eighteen thousand six hundred fifty-nine patients from 9 countries spanning 4 continents were studied. The number of women was significantly lower than men, with older age, more prevalence of AF, hypertension, and dyslipidemia. Ischemic stroke was more severe in women, with worse outcomes among women (p: < 0.0001), although the time to treatment was shorter. Bridging that was more frequent in women (p:0.002). Analyzing only women: ischemic stroke was more frequent among the older, while hemorrhage and TIA prevailed in the younger and stroke of undetermined etiology. Comparison between countries showed differences in age, risk factors, type of stroke, and management. CONCLUSION: We observed sex differences in risk factors, stroke severity, and outcome in our population. However, access to revascularization was in favor of women.

Socioeconomic status, loneliness, and depression among older adults: a cross-sectional study in Spain.

BACKGROUND: The association between socioeconomic status and depression is weaker in older adults than in younger populations. Loneliness may play a significant role in this relationship, explaining (at least partially) the attenuation of the social gradient in depression. The current study examined the relationship between socioeconomic status and depression and whether the association was affected by loneliness. METHODS: A cross-sectional design involving dwelling and nursing homes residents was used. A total of 887 Spanish residents aged over 64 years took part in the study. Measures of Depression (GDS-5 Scale), Loneliness (De Jong-Gierveld Loneliness Scale), Socioeconomic Status (Education and Economic Hardship), and sociodemographic parameters were used. The study employed bivariate association tests (chi-square and Pearson's r) and logistic regression analyses. RESULTS: The percentage of participants at risk of suffering depression was significantly higher among those who had not completed primary education (45.5%) and significantly lower among those with university qualifications (16.4%) (X2 = 40.25;p <.001), and respondents who could not make ends meet in financial terms faced a higher risk of depression (X2 = 23.62;p <.001). In terms of the respondents who experienced loneliness, 57.5% were at risk of depression, compared to 19% of those who did not report loneliness (X2 = 120.04;p <.001). The logistic regression analyses showed that having university qualifications meant a 47% reduction in the risk of depression. This risk was 86% higher among respondents experiencing financial difficulties. However, when scores for the loneliness measure were incorporated, the coefficients relating to education and economic hardships ceased to be significant or were significantly reduced. CONCLUSION: Loneliness can contribute to explaining the role played by socioeconomic inequalities in depression among older adults.

Validation of the Attitudes toward Lying to People with Dementia (ALPD) Questionnaire among Social Workers in Spain.

Gerontological interventions should address the various geriatric syndromes suffered by the elderly, such as neurodegenerative diseases. Therapeutic lying is an effective and humanizing strategy to deal with dementia, used by various disciplines in the social and healthcare fields. This intervention strategy is made up of all the different responses to reality that are given to a person with cognitive impairment. This study analyzes the validity of the Spanish adaptation of the Attitudes toward Lying to People with Dementia (ALPD) questionnaire, given to 253 social workers who directly and indirectly intervened with older people suffering from cognitive impairment in public and private centers in Spain during the year 2022. The results of the validity and reliability analyses support the psychometric quality of ALPD for use in Spanish social workers. The statistical results indicate a good fit of the bifactor model (person-focused and lie-focused) and show the questionnaire to be reliable, with adequate psychometric properties. The article concludes with a discussion of practical, formative, and ethical challenges for social work in the field of geriatric services.

[Prevalence of loneliness among older people living in rural areas. Differences by ethnic group and predictor variables]. / Prevalencia de la soledad en las personas mayores que viven en zonas rurales. Diferencias por grupos étnicos y variables predictivas.

BACKGROUND: Loneliness is one of the most recurrent public health problems in older people. However, there is little data available in Chile on its prevalence in people over 60 years of age living in rural areas and belonging to native or Afro-descendant groups. AIM: To examine the prevalence of loneliness among older people living in rural areas by ethnic group and to analyze the socio-demographic, family, and health variables related to loneliness. METHODS: We interviewed 1,692 elderly people living in Chilean rural areas of the regions of Arica and Parinacota, Tarapacá, Antofagasta, Atacama, Coquimbo, Valparaíso, Los Lagos, Aisén and Magallanes. The instruments applied were the DJGLS-6 loneliness scale, Family-APGAR, questionnaire of 13 most frequent health problems in Chilean older people, and Barthel index. RESULTS: We found a high prevalence of loneliness (over 55%) among Afro-descendants, Quechua, Atacameño, Colla, Chango, Huilliche, Kawesqar and non-indigenous people. Emotional loneliness is the most prevalent among indigenous and non-indigenous older people living in rural areas (≥ 71%). Variables associated with loneliness were being female, age, not having a partner, living alone, family dysfunctionality, and having health problems. CONCLUSIONS: Loneliness in rural areas is higher in older people, and this situation becomes more complex at the crossroads of ethnic-cultural diversity; it is necessary to continue to address this problem that affects biopsychosocial well-being in old age.

Loneliness among Chilean indigenous women: Family, community, and socio-cultural integration as protective factors.

This study examined the incidence of loneliness among Chilean indigenous older adult women (106 Aymara and 180 Mapuche) and how family, community and socio-cultural integration are associated with lower levels of loneliness. A cross-sectional study involving 800 older adults living in a rural context in Chile, of whom 35.8% were indigenous women. The De Jong Gierveld Loneliness Scale (DJGLS-6) were used to assess loneliness and a questionnaire about the maintenance of certain indigenous cultural practices was created. The descriptive findings indicate more loneliness among Mapuche women. Moreover, hierarchical regression models confirmed that women who did not live alone, who participated in social groups and who maintained cultural practices reported lower levels of loneliness, with notable transmission of indigenous knowledge to their children. While, taking part in the indigenous New Year, leading or organizing a ceremony and receiving attention with a health cultural agent were associated with more loneliness. These seemingly contradictory findings are discussed and may be explained by religious changes in indigenous communities; however, this study would confirm that social integration in different dimensions is a protective factor against loneliness.

[Psychometric properties of APGAR-family scale in a multiethnic sample of Chilean older people]. / Propiedades psicométricas de la escala APGAR-familiar en personas mayores residentes en zonas rurales multiétnicas chilenas.

BACKGROUND: The APGAR-family scale is used for the assessment of family functioning in primary health care. AIM: To examine the psychometric properties of the family functioning scale APGAR-family, in a multi-ethnic sample of older Chilean adults. MATERIAL AND METHODS: The scale was applied to 800 participants aged more than 60 years, residing in rural areas of the regions of Arica and Parinacota and La Araucanía. RESULTS: The Cronbach's alpha obtained was 0,992 for the scale composed of five items. The confirmatory factor analysis determined a unifactorial model, whose goodness of fit indices were satisfactory. Namely, weighted least square mean and variance adjusted-χ2 was 20.097 (p < 0.01), comparative fit index was 0.997, Tucker-Lewis index was 0.995 and Root Mean Square Error of Approximation was 0.079 (90% confidence intervals 0.049-0.091). CONCLUSIONS: The APGAR-family is a reliable and appropriate instrument to be applied in older people in Chile, specifically in elderly people residing in rural areas who belong to the Aymara and Mapuche indigenous communities.

Family and community support among older Chilean adults: the importance of heterogeneous social support sources for quality of life.

Family and community social networks act as social resources that promote well-being at advanced ages. In this study, we analyze the association between social support received from personal social networks (social support from various family members and friends) and community social networks (social support from neighbors and the neighborhood, age, ethnic, or religious group peers and formal social support networks) and quality of life (QoL) for a sample of older Chilean persons (n = 777). The results confirm that social support from family (partner, children, and extended family) and friends, integration in the community (neighbors) and social support from informal systems (social groups) are associated with QoL. Moreover, the model including both types of support explains 25.8% of variance in QoL. The results and their possible implications are discussed.

[Validation of the successful aging inventory in chilean older people]. / Validación del inventario de envejecimiento exitoso en personas mayores chilenas.

BACKGROUND: There is a paucity of adequate and validated instruments for the measurement of successful aging for geriatric researchers in Chile. AIM: To validate the “Successful Aging Inventory” (SAI) in Chilean older people. MATERIAL AND METHODS: SAI was answered by 777 older people aged 70 ± 7 years (63% women) living in urban and rural areas, including the highlands of a Northern desert region of Chile. RESULTS: A Cronbach alfa of 0.92 was obtained for the general dimension of successful aging. The figures for each dimension included in the theoretical model (functional performance, intrapsychic factors, gero-transcendence; spirituality; purpose and life satisfaction), and ranged from 0.66 to 0.91. Confirmatory factorial analysis showed that the original inventory model, fits with the data collected from Chilean people. CONCLUSIONS: Successful Aging Inventory (SAI) is a reliable and adequate inventory, which can be used in Chilean older people.

Ageing in Context: An Ecological Model to Understand Social Participation Among Indigenous Adults in Chile.

The social participation of older adults occupies a central position in international discourse regarding ageing, the ecological model makes it possible to examine and assess the different factors that influence the understanding of what encourages social participation by older adults. This study used the ecological model to analyse how personal, community and environmental factors are related to satisfaction with social participation among Chilean older adults, a majority of whom are indigenous, living in rural areas (n = 800). The results confirmed that satisfaction with social participation was related to personal factors (feelings of depression, functioning into basic activities of daily living (ADL) and autonomy), community factors (perceived social support from social group) and environmental factors (accessibility of physical setting within the village). Our findings confirmed a high level of social participation among indigenous adults, with rural and indigenous surroundings appearing to be a factor that protects and promotes social integration.

[Studying loneliness and social support networks among older people: a systematic review in Europe.] / La investigación sobre soledad y redes de apoyo social en las personas mayores: una revisión sistemática en Europa.

OBJECTIVE: During the ageing process the loss of family and social relationships is frequent which conditions loneliness, similarly the current COVID-19 pandemic has generated more social limitations in this age group and has increased the risk factors to trigger feelings of loneliness. This paper aimed to examine how loneliness among older people had been studied in Europe over the last ten years. Specific objectives were: i) to describe the methodological aspects; ii) to identify the scales or questions for the assessment of loneliness; iii) what were the main variables or dimensions that were related to loneliness in old age. METHODS: A total of 1,591 articles were found in WoS and Scopus digital platforms. After initial assessment of titles and abstracts, full text reading and review of the established criteria, 42 scientific articles were finally included in the systematic review. RESULTS: The countries that had carried out the most studies were the Netherlands and Spain. Most of the research was quantitative and uses the De Jong Gierveld Loneliness Scale (DJGLS) and the University of California at Los Angeles (UCLA) Loneliness Scale. The most analysed variables were: marital status, household structure, social support networks, social participation, depression, health problems, co-morbidity and physical functioning. CONCLUSIONS: The scientific interest in studying loneliness, with a focus on social support networks, in older people in Europe and strategically addressing loneliness as a public health problem is confirmed.

OBJETIVO: Durante el proceso de envejecimiento es frecuente la pérdida de relaciones familiares y sociales, lo cual condiciona la soledad. Además, la actual pandemia de la COVID-19 ha generado más limitaciones en las relaciones sociales de este grupo de edad y ha aumentado los factores de riesgo para desencadenar sentimientos de soledad. Este trabajo tuvo el objetivo de examinar cómo se había estudiado la soledad en las personas mayores en Europa en los últimos diez años. Se propusieron como objetivos específicos: i) describir los aspectos metodológicos; ii) identificar las escalas o preguntas para la valoración de la soledad; iii) cuáles eran las principales variables o dimensiones que se relacionaban con la soledad en la vejez, priorizando el rol de las redes de apoyo social. METODOS: Se encontraron 1.591 artículos en total en las plataformas digitales WoS y Scopus. Tras la valoración inicial de los títulos y resúmenes, lectura de texto completo y revisión de los criterios establecidos, al final se incluyeron en la revisión sistemática 42 artículos científicos. RESULTADOS: Los países que más estudios habían realizado eran Países Bajos y España, en su mayoría las investigaciones eran cuantitativas y utilizaban las escalas De Jong Gierveld Loneliness Scale (DJGLS) y University of California at Los Angeles (UCLA) Loneliness Scale. Las variables más analizadas fueron: estado civil, estructura del hogar, redes de apoyo social, participación social, depresión, problemas de salud, comorbilidad y funcionalidad física. CONCLUSIONES: Se confirma el interés científico por estudiar la soledad, con un énfasis central en las redes de apoyo social, en las personas mayores en Europa y abordar estratégicamente la soledad como un problema de Salud Pública.

Loneliness and Psychosocial Resources among Indigenous and Afro-Descendant Older People in Rural Areas of Chile.

(1) Background: loneliness is a problem that becomes increasingly acute in old age, with greater repercussions among socially disadvantaged groups such as indigenous and Afro-descendant older adults. The aim of this research is to analyze the psychosocial variables related to loneliness in old age. (2) Methods: a multi-ethnic sample was involved, with the participation of eight indigenous peoples and Afro-descendant tribal people (n = 1.348). Various gerontological scales previously validated among the Chilean population (De Jong Gierveld Loneliness Scale, Brief Resilient Coping Scale, Health Problems Questionnaire, and Family APGAR questionnaire) and a model are contrasted, establishing the relationship between psychosocial variables and loneliness. (3) Results: Structural equation modeling (SEM) showed the existence of indirect relationships between health problems, via family functioning and resilience, and loneliness. Resilience and family functioning were directly related to loneliness (WLSMV-χ2 (df = 345) = 875.106, p < 0.001; CFI = 0.992; TLI = 0.991; RMSEA = 0.034 [C.I. 90% = 0.031-0.037]). (4) Conclusions: loneliness has cross-culturally affected older Chilean people living in rural areas and it appears that the COVID-19 pandemic has had a negative effect on well-being. This study proves that loneliness is related to several psychosocial variables that can be intervened.

The Relationship between Subjective Aging and Cognition in Elderly People: A Systematic Review.

There is a growing body of evidence on the effects of subjective aging on health, well-being and quality of life. This review aims to synthesize findings about the link between subjective aging and cognition and cognitive decline. Furthermore, it provides an examination of variation sources such as subjective aging construct, cognitive domains, measures employed, age and moderator variables. A systematic search was performed in PubMed, PsychInfo and Web of Science, as well as grey literature searches in Google Scholar, OpenGrey, WorldCat and NDLTD, which resulted in 59 reports being included. Subjective aging is a relevant construct in the explanation and prediction of cognitive aging and cognitive decline in elderly adults. More positive views about own aging and self-perceptions of aging, as well as a younger subjective age, were consistently related to better cognition and lower risk of cognitive decline. However, there were differences due to subjective aging subdimensions and cognitive domains, as well as an effect of age. Additionally, there were concerns about the content validity of some measures employed, such as the Philadelphia Geriatric Center Morale Scale for subjective aging and the Mini Mental State Examination for global cognition. Further studies should employ longitudinal designs with a process-based approach to cognition and precise subjective aging measures.

A systematic review of ageing in place among Indigenous People in Canada, USA, México, Chile and New Zealand.

The ageing in place (AIP) model enjoys widespread recognition in gerontology and has been strongly encouraged through social policy. However, progress remains to be made in terms of analysing AIP for minority groups and groups with diverse life pathways in old age. This systematic review aims to identify studies that address the AIP model in indigenous communities, answering the following questions: In which geographical contexts and for which Indigenous Peoples have AIP been researched? Which physical dimensions are considered in the assessment of AIP? Which social dimensions are considered in the assessment of AIP? This systematic review applied the SALSA (Search, Appraisal, Synthesis and Analysis) method to AIP among Indigenous older adults on the Web of Science, PsycINFO, MEDLINE and Scopus digital platforms for publications from 2011 to 2021. We identified 12 studies conducted in five countries in North and South America and Oceania. The results show that the following elements of the physical environment are assessed: household, neighbourhood, local surroundings or reserve and native territories. Meanwhile, assessed elements of the social environment are as follows: personal characteristics, attachment to place, social networks, social participation and social policies. There is discussion of the need to develop AIP in order to promote successful ageing among Indigenous older adults.

The prevalence of suicide attempt and suicidal ideation and its relationship with aggression and bullying in Chilean adolescents.

Background: Suicide constitutes one of the main mental health problems worldwide, requiring detection, and prevention efforts, especially in the adolescent population. Objective: The purpose of this study was to estimate the prevalence of suicide attempts and suicidal ideation and their relationship with aggressiveness and bullying in Chilean adolescents. Materials and methods: The sample was composed of 728 adolescents schooled from Arica city: 56.6% were males and 43.4% were females. The students attended from de 1st to the 4th year of secondary. The average age of the sample was 15,6 years. The following instruments were used: Okasha's Suicidality Scale, Buss and Perry's Aggressiveness Survey, and the Social Acceptance (School Bullying) sub-test of the Kidscreen-52 Survey. A cross-sectional, descriptive, and correlational design was applied. The sampling was non-probabilistic for convenience. Results: 18.4% of the students reported that they had attempted suicide and 65.6% reported that they had suicidal ideation. The prevalence of suicide attempts was higher than in male adolescents (29,1% vs. 10,2%), and the same prevalence was for suicidal ideation (76,6% vs. 57,3%). Suicide attempts and suicidal ideation were positively and significantly correlated with aggressiveness (r = 0.32, r = 0.48) and bullying (r = 0.37, r = 0.50). Conclusion: The prevalence of suicide attempts and suicidal ideation is both higher in girls than boys. In this sense, girls constitute a risk group. In addition, this study provides evidence that supports the relationship between suicide attempts and suicidal ideation. The results highlight the role that educational institutions should have in terms of prevention and effective approaches.

Income inequalities, social support and depressive symptoms among older adults in Europe: a multilevel cross-sectional study.

This study analysed the association between income inequality and depression from a multilevel perspective among older adults in Europe, including an examination of the role of social support. The data came from Eurostat's European Health Interview Survey (EHIS). Selected participants were aged 65 years or above (n = 68,417) and located in 24 European countries. The outcome variable (depression) was measured using the eight-item Patient Health Questionnaire (PHQ-8). The resulting dataset included individual-level (level-1) and aggregate-level (level 2) exposure variables. Level-1 included income quintiles and social support as exposure variables and sex, age, living alone, limitation in activities of daily living and general activity limitation as control variables. Level 2 included the Gini coefficient, healthcare expenditure and dependency ratio. A multilevel linear regression analysis was performed with maximum likelihood (ML) estimation. All the income quintiles from 1 to 4 showed higher average scores for depression than quintile 5 (the highest). Higher social support scores were associated with lower scores for depression. An interaction was found between income quintile and social support, with higher levels of social support associated with lower scores for depression in quintiles 1 and 2. Higher Gini coefficient scores were associated with higher scores for depression. A significative random slope for social support was also found, meaning that the relationship between social support and depression differed across countries. No significant interaction was found between the Gini coefficient and social support. The study findings suggest that more unequal societies provide a less favourable context for the mental health of older adults. There are also significant country-dependent differences in terms of the relationship between support and mental health among older adults. Supplementary Information: The online version contains supplementary material available at 10.1007/s10433-021-00670-2.

Aging and Family Relationships among Aymara, Mapuche and Non-Indigenous People: Exploring How Social Support, Family Functioning, and Self-Perceived Health Are Related to Quality of Life.

Family relationships play a central role in wellbeing among older adults in Chile. Based on the theory of social production functions, this study examined the relationship between perceived social support from children, partners and relatives, family functioning, self-perceived health and quality of life (QoL) among Chilean older adults. The study used a multi-ethnic sample of Chilean older adults living in rural areas in the regions of Arica and Parinacota (north) and Araucanía (south). A model was analyzed that emphasizes relationships differentiated by the source of support, family functioning and self-perceived health in the explanation of QoL. The results obtained from the structural equation modelling (SEM) analysis showed the existence of indirect relationships of social support from children, partners and other family members via family functioning, while self-perceived health was directly associated with QoL. The findings indicate that family functioning is a main variable in the contrasted model, in addition to confirming the importance of distinguishing the role of the various sources of support. Research is needed to examine in detail intergenerational relationships and other relationships with family members who are significant in the wellbeing of older adults. This research corroborates that family relationships have a specificity that needs to be addressed in gerontological social intervention, as well as continuing along the lines of strengthening or improving existing family ties (more quality) over the quantity of social relationships.

[Effect of guardianship on the quality of life of people with disabilities in Spain.] / Efecto de la tutela en la calidad de vida de personas con discapacidad en España.

OBJECTIVE: Despite the unquestionable progress in the treatment and legal and social recognition of persons with disabilities with modified capacity,the role and social position of the collective still hinders the development of a full life. The objective was to know the possible effect of the guardianship exercise on the quality of life of persons with disabilities who reside permanently in residential centres and whose ordinary guardianship falls to the public FASAD Foundation. METHODS: Correlational quantitative study. The GENCAT quality of life scale adapted so that the population under study itself was in charge of assessing the areas and dimensions related to their bio-psycho-social well-being. The starting hypothesis is was that exists a better perception of the levels of quality of life with a longer time of guardianship protection. In addition, the research questions were, What effects does the tutelary protection exercised by the FASAD Foundation have on the perception of the quality of life of the interviewed subjects? How do the variables (sex, place of residence and time of guardianship) affect the perception of quality of life? What dimensions present in the quality of life analysis are most affected by the variable time of guardianship? For the analysis of the statistical data, was used the SPSS® Statistics 22.0, a descriptive and bivariate exploration was carried out that showed the level of association and correlation between the variables studied. RESULTS: People under guardianship for a period of more than 3 years present better results in all the dimensions studied -except for rights- regardless of their sex or place of residence. Women under guardianship for a period less than 3 years obtained a general percentile of quality of life of 13.6, while those who were under guardianship for a period greater than 3 years obtained 18.9, in the same way it happened with men (14.1 vs 20.7) The ANOVA statistic and the Pearson correlation table confirm the association and relationship between the variable time of care and the general percentiles of quality of life. CONCLUSIONS: The exercise of guardianship has a positive effect on all the dimensions that integrate the quality of life construct. In addition, knowing the self-perception of the quality of life of the people under guardianship favors knowing the true impact of a support and promotion mechanism such as guardianship.

OBJETIVO: Pese al incuestionable avance en el tratamiento y reconocimiento jurídico y social de las personas con discapacidad con la capacidad modificada, el rol y la posición social que ocupa el colectivo aún sigue dificultando el desarrollo de una vida plena. El objetivo fue conocer el posible efecto del ejercicio tutelar sobre la calidad de vida en personas con discapacidad que residen de forma permanente en centros residenciales y cuya tutela ordinaria recae sobre la Fundación de carácter público FASAD. METODOS: Estudio de carácter cuantitativo de tipo correlacional. Se adaptó la escala de calidad de vida GENCAT para que fuese la propia población objeto de estudio la encargada de valorar las áreas y dimensiones relacionadas con su bienestar bio-psico-social. La hipótesis de partida fue que existe una mejor percepción sobre los niveles de calidad de vida a mayor tiempo de protección tutelar. Además, las preguntas de investigación fueron, ¿Qué efectos tiene la protección tutelar ejercida por la Fundación FASAD en la percepción de la calidad de vida de los sujetos entrevistados? ¿Cómo afectan las variables (sexo, lugar de residencia y tiempo de tutela) en la percepción de la calidad de vida? ¿Qué dimensiones presentes en el análisis de la calidad de vida se ven más afectadas por la variable tiempo de tutela? Para el análisis de los datos estadísticos se utilizó el SPSS® Stadistics 22.0, se efectuó una exploración descriptiva y bivariada que mostró el nivel de asociación y correlación entre las variables estudiadas. RESULTADOS: Las personas tuteladas por un período superior a 3 años presentan mejores resultados en todas las dimensiones estudiadas -excepto en derechos- independientemente de su sexo o lugar de residencia. Las mujeres tuteladas por un periodo inferior a 3 años obtuvieron un percentil general de calidad de vida de 13,6, mientras que las que se encontraban tuteladas por un periodo superior a 3 años obtuvieron un 18,9, de la misma forma ocurrió con los hombres (14,1 frente al 20,7). El estadístico ANOVA y la tabla de correlaciones de Pearson refrendan la asociación y relación existente entre la variable tiempo de tutela y los percentiles generales de calidad de vida. CONCLUSIONES: El ejercicio de la tutela tiene un efecto positivo en todas las dimensiones que integran el constructo calidad de vida. Además, conocer la autopercepción sobre la calidad de vida de las propias personas tuteladas favorece conocer el verdadero impacto de un mecanismo de apoyo y promoción cómo es la tutela.

The Social Gradient in Mental Health and Well-Being for Indigenous Older Adults Living in Rural Areas: A Cross-Sectional Comparison With Rural Non-indigenous Population in Chile.

Objectives: To compare differences in depression, loneliness and personal well-being in a sample made up of indigenous (Aymara and Mapuche) and non-indigenous older people resident in original rural territories. Methods: A cross-sectional study involving 800 older adults living in a rural context in Chile, of whom 201 were Aymara, 368 Mapuche and 231 non-indigenous. Validated instruments were included for depression, loneliness and personal well-being (outcome variables). Ordinary least squares regression analyses were performed. Results: Membership of an indigenous group was significantly associated with lower scores for depression and loneliness and higher scores for personal well-being. The interactions of severe deprivation and housing deprivation with indigenous group membership were significantly associated with lower loneliness scores and higher personal well-being scores for Aymara and Mapuche participants. Discussion: Native rural settings and territories may offer a degree of protection to indigenous peoples. Cultural continuity enhanced by rural areas would produce a culturally constructed resilience against deprivation.

Validation of the De Jong Gierveld Loneliness Scale, 6-item version, in a multiethnic population of Chilean older adults.

OBJECTIVE: To analyse the psychometric properties of the De Jong Gierveld Loneliness Scale, 6-item version (DJGLS-6), in a multiethnic sample of older Chilean adults. METHODS: A cross-sectional study was designed using a sample of 800 older people, and 71% were self-declared indigenous. Data quality and acceptability, internal consistency, and construct and structural validity of DJGLS-6 were analysed. The scale was also analysed according to the Rasch model. RESULTS: The DJGLS-6 scored higher for the non-indigenous group than for Aymara and Mapuche (P < .001). KR-20 coefficients (internal consistency) for emotional loneliness subscale reached 0.44 for Aymara and Mapuche and 0.62 for non-indigenous, and from 0.73 (non-indigenous) to 0.86 (Aymara) for social loneliness subscale. The confirmatory factor analysis identified one dimension. None of the two subscales fit the Rasch model. CONCLUSION: The results indicate that DJGLS-6 is a reliable and adequate scale for non-indigenous Chilean older people. However, it should be culturally adapted to indigenous ethnic minorities.