Effect of physical frailty on elder mistreatment in a national survey: examining psychological vulnerability, housework involvement, and financial independence as mediators.

OBJECTIVES: To explore the prevalence of EM in an older Chinese population and examine the mediating role of three psychosocial variables - psychological vulnerability, housework involvement, and financial independence - in the relationship between physical frailty and EM. DESIGN: Cross-sectional analysis. SETTING: The data source was the Third Survey on Chinese Women's Social Status (SCSSW), which is a nationwide decennial survey conducted in 2010. PARTICIPANTS: Community-dwelling adults aged 60 and older who participated in SCSSW (N = 3516). MEASUREMENTS: The past-year prevalence of EM and its seven subtypes, physical frailty, psychological vulnerability, housework involvement, financial independence, and demographic characteristics. RESULTS: The past-year prevalence of EM was 4% among Chinese older adults, with psychological abuse being the most common subtype (3.9%). A higher level of physical frailty had a direct influence on EM. Older adults with higher levels of physical frailty were more likely to have higher levels of psychological vulnerability (anxiety, loneliness, and uselessness) and lower levels of housework involvement, which further correlated with increased risk of EM. Frail Chinese older adults were less likely to have financial independence, which in turn, surprisingly predicted a lower probability of EM. CONCLUSIONS: In this nationally representative sample, we provided the first evidence of the prevalence of EM among Chinese older adults and expanded the global understanding of EM by examining the mediating role of three psychosocial variables. Future studies are warranted to corroborate our findings and identify factors contributing to the complex mechanism of EM.

The impact of changes in China's family patterns on family pension functions.

Using data from the Chinese census and the China Statistical Yearbook, this paper will analyze the historical changes and future trends of family households in China over the past 30 years and explore the changes of family pension functions and corresponding policies. Our analysis yielded 3 notable results. First, in family size miniaturization and structural simplification, 1- and 2-generation family households are the main body of contemporary China. Second, for family aging and changes in living patterns, which primarily manifest as an increase in; the proportion of elderly households and in middle-aged and elderly people in the family, the elderly model and the "multigenerational model" have become the 2 major residence models for the elderly in China. Third, nontraditional families have emerged in large numbers, such as the exclusively elderly family, empty nest family, grandparents family, Double Income, No Kids (DINK) family, older single family, and single-parent family. We argue that in the process of simplification, China's family structure is increasingly showing characteristics of networking. The change in family patterns entails the restoration of traditional functions and taking on new functions of the family by issuing relevant social policies. Only when these social policies are based on family functions and demands can they provide effective help to social members, particularly regarding the family's responsibilities to parent children and support the elderly.

Predicting death quality from life prior to death among older Chinese in a retrospective cohort study.

Background: The pursuit of a good death is crucial in aging societies. This retrospective cohort study investigated the relation between life prior to death and quality of death among older Chinese. Methods: End-of-life data reported by relatives of participants (aged 54 and over) from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) who deceased between January 2011 and June 2019 were utilized. Life prior to death included health condition (morbid or not) and physical functioning (a latent factor with six indicators). Quality of death was assessed by painlessness and consciousness at death. Confirmatory Factor Analysis was employed to examine the factor structure of physical functioning and Structural Equation Modeling to explore associations between life prior to death and death quality based on sex and residence location. Results: Freedom from chronic diseases was found to contribute to high-quality deaths (i.e., being painless and conscious) both directly and indirectly by enhancing physical functioning. Men and women diverged toward end-of-life: women were moderately less liable to illnesses and thus less painful at death. Yet, men functioned much better, and more often remained conscious when dying. Location's effect was weaker: although rural residents were more prone to painful deaths than urban dwellers, this urban-rural divide was slightly narrowed by rural settlers' relative health, which also indirectly led to their slight advantage in consciousness at death. Conclusions: The results suggested that different dimensions of life prior to death predicted quality of death. Additionally, morbidity's effect on functioning and death quality stresses health management's role in improving end-of-life experiences.

China's demographic history and future challenges.

On 28 April 2011, China's state statistics bureau released its first report on the country's 2010 population census. The report states that the total population of mainland China reached 1.3397 billion in 2010, with an annual average population growth rate of 0.57% during the previous 10 years. The share of the total population aged 0 to 14 declined from 22.9% in 2000 to 16.6% in 2010, whereas the proportion aged 65 and above grew from 7.0% to 8.9% during the same period. This indicates that China's population is aging rapidly. The report also shows that China is urbanizing, with nearly half of the population--665.57 million people, or 49.7%--living in urban areas, an increase of 13 percentage points over the 2000 figure. Moreover, about 260 million Chinese people are living away from where they are formally registered, and the overwhelming majority of them (about 220 million) are rural migrants living and working in urban areas but without formal urban household registration status. China is at a demographic turning point: It is changing from an agricultural society into an urban one, from a young society to an old one, and from a society attached to the land to one that is very much on the move.