Sociodemographic characteristics and functional health among Thai older adults in skipped generation households.

A substantial number of skipped generation households (SGHHs), where grandparents live with grandchildren in the absence of the middle generation, is observed in Thailand. The functional health (FH) of older adults with SGHHs is a concern because many of them take care of their grandchildren. While some studies have indicated the socioeconomic vulnerabilities of SGHHs, a social value on intergenerational exchange is considered favourable to SGHHs. This study examined the FH of older adults in SGHHs in comparison with those in other living arrangements, after adjusting for sociodemographic variables based on a population-based survey in Thailand. A total of 41,752 adults aged ≥60 years were selected for the analysis from the 2017 Survey of Older Persons in Thailand (SOPT). The living arrangements considered were SGHHs, living alone, living with a spouse only and co-residing with children with or without grandchildren. The FH was evaluated based on basic activities of daily living (ADL), functional ability and instrumental ADL, and analysed according to living arrangements using multiple regression analysis. The proportion of older adults in SGHHs in Thailand was 8.9%. Among them, 72.9% were in rural areas, 88.7% did not attain primary education and 53.9% were in two poorer quintiles of wealth status. After adjustment for sociodemographic variables, the FH of older adults in SGHHs was significantly higher than that of those co-residing with children with or without grandchildren, but significantly lower than that of those living alone or with a spouse only. The study highlighted that despite better FH than those who co-reside with children, sociodemographic characteristics of older adults in SGHHs seem to be at a disadvantage. Attention should be paid to social services to help families in SGHHs.