Lee Hyunjoo, Park Sojung, Kwon Eunsun, Cho Joonyoung
Department of Social Welfare, Daegu University, 201 Deagudae-ro, Gyeongsangbuk-do, Gyeongsan-si 38453, Korea.
George Warren Brown School of Social Work at Washington University in Saint Louis, One Brookings Drive, Saint Louis, MO 63130, USA.
Int J Environ Res Public Health. 2017 Jun 1;14(6):588. doi: 10.3390/ijerph14060588.
This study explored heterogeneous change patterns of South Korean older adults' depressive symptoms by poverty status, focusing on health status and social engagement changes. We used data from four waves (2006-2012) of the Korean Longitudinal Study of Aging (KLoSA). Our sample contained 2461 poor and 1668 non-poor individuals. All were 65 years old or older at baseline. We used latent class growth analysis to identify trajectory groups' depressive symptoms. Multinomial logistic regression was used to examine how a range of changes in health conditions and social engagement was associated with trajectories among poor and non-poor participants. Among the poor, five heterogeneous trajectories with clear patterns were identified: high-to-moderate, stable-high, slightly-increasing, steeply-increasing, and stable-low. Among non-poor, high-to-moderate, steeply-increasing, and stable-low groups were found. A decrease in health conditions was the most vulnerable subgroup's (steeply-increasing) primary risk factor. Poor older adults who reduced participation in, or decreased contact with, social networks were likely to belong to the steeply-increasing group. Our study provides impetus for organizational and/or environmental support systems to facilitate social engagement among poor older adults. Future research should examine whether the significance of social engagement among poor elders applies in less-developed and developed countries.
本研究探讨了韩国老年人抑郁症状按贫困状况划分的异质性变化模式,重点关注健康状况和社会参与度的变化。我们使用了韩国老年纵向研究(KLoSA)四期(2006 - 2012年)的数据。我们的样本包括2461名贫困个体和1668名非贫困个体。所有个体在基线时均为65岁及以上。我们使用潜在类别增长分析来确定轨迹组的抑郁症状。多项逻辑回归用于检验健康状况和社会参与度的一系列变化如何与贫困和非贫困参与者的轨迹相关联。在贫困者中,识别出了五种具有清晰模式的异质性轨迹:高到中度、稳定高、轻微增加、急剧增加和稳定低。在非贫困者中,发现了高到中度、急剧增加和稳定低组。健康状况下降是最脆弱亚组(急剧增加组)的主要风险因素。减少参与社会网络或与社会网络接触减少的贫困老年人可能属于急剧增加组。我们的研究为组织和/或环境支持系统促进贫困老年人的社会参与提供了动力。未来的研究应考察贫困老年人中社会参与的重要性在欠发达国家和发达国家是否适用。