Effects of Health-Related Behaviors and Changes on Successful Aging among Indonesian Older People
Abstract
:1. Introduction
1.1. Heath-Related Behaviors and Successful Aging
1.2. Changes in Health-Related Behaviors and Successful Aging
1.3. Gender Differences in Health-Related Behaviors and Successful Aging
1.4. Background in Indonesia
2. Materials and Methods
2.1. Data and Sample
2.2. Measures
2.2.1. Successful Aging
- No chronic diseases: Nine chronic diseases were assessed by self-reporting, including hypertension, diabetes, asthma, heart attack, liver, stroke, cancer, arthritis, and gout. The variable was coded as 0 (having disease) or 1 (not having any disease).
- No physical function difficulties: IADLs were used to determine physical functioning. IADL items included shopping for personal needs, preparing food, and taking medications. Each item was coded 0 (easy), 1 (somewhat difficult), and 2 (unable to do) and then summed. The total score ranged 0–6 and was then recoded as 0 (having any difficulty) or 1 (having no difficulty).
- No depressive symptoms: The Center of Epidemiological Studies Depression Scale (CESD)-10 was used to measure depressive symptoms. Each item was scored from 0 to 3, and the total score ranged 0~30. A total score of >10 was defined as having depressive symptoms (yes = 1; no = 0) [75].
- Intact cognitive function: Cognitive function was measured by the Telephone Survey of Cognitive Status (TICS) [76] using the following assessments: (1) awareness of the date (scored 0~2); (2) awareness of the day of the week (scored 0~1); (3) word recall of 10 nouns (scored 0~9); and (4) second time to repeat 10 nouns (scored 0~9). A score of ≤6 was indicative of impaired cognitive function, and a score more than 6 was defined as intact (1 = intact; 0 = impaired).
- Having social support: Living with spouse and children (yes = 1; no = 0).
- Having social participation: Social participation was defined as involvement in five types of community groups or activities in the previous 12 months (yes/no): community meetings, volunteer labor, programs to improve the neighborhood, religious activities, and Arisans. An Arisan is a group of people who contribute money on a regular basis over a set period of time. After the money has been raised, one of the members will be proclaimed the winner, and the winner will be responsible for holding the next meeting. The Arisan helps people save money, build friendships, and increase social interactions [77]. Social participation was described as those who participating in at least one type of community activity. The coding of social participation was defined as yes (1) or no (0).
2.2.2. Related Factors
2.3. Analysis
3. Results
4. Discussion
4.1. Successful Aging in Indonesia
4.2. Smoking and Smoking Changes and Successful Aging
4.3. Physical Activity and Changes and Successful Aging
4.4. Protein Intake and Changes and Successful Aging
4.5. Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Acknowledgments
Conflicts of Interest
References
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Variables | Baseline (2007) | Follow-Up (2014) |
---|---|---|
Age | ||
Age 60–69 | 84.4 | --- |
Age 70+ | 15.6 | --- |
Sex | ||
Female | 52.1 | --- |
Male | 47.9 | --- |
Education | ||
College, university, and above | 4.7 | --- |
Senior high school | 8.3 | --- |
Junior high school | 6.7 | --- |
No education to elementary school | 51.1 | --- |
No formal education | 29.2 | --- |
Monthly expenditure at baseline | ||
USD 2.98~26.91 | 25.1 | --- |
USD 26.92~39.62 | 22.0 | --- |
USD 39.63~56.50 | 20.4 | --- |
USD 56.51~91.45 | 18.7 | --- |
USD 91.43+ | 13.7 | --- |
Ethnicity | --- | |
Javanese | 48.6 | --- |
Non-Javanese | 51.4 | --- |
Religion | ||
Islam | 87.2 | --- |
Others (Catholic, Protestant, Hindu, Buddhism) | 12.9 | --- |
Place of residence | ||
Urban | 43.4 | 50.7 |
Rural | 56.6 | 49.3 |
Health Insurance | ||
Yes | 29.1 | 52.3 |
No | 70.9 | 47.7 |
Health-related behaviors | ||
Smoking | ||
Yes | 55.1 | 47.6 |
No | 44.9 | 52.4 |
Physical activity | ||
Low | 56.6 | 51.4 |
Medium | 18.9 | 22.7 |
High | 24.5 | 25.9 |
Protein intake | ||
High | 61.8 | 53.7 |
low | 38.2 | 46.3 |
Successful Aging | ||
Chronic disease numbers | ||
Having chronic disease | 36.6 | 43.8 |
No chronic disease | 63.4 | 56.2 |
Physical function | ||
Having physical difficulty | 6.7 | 42.3 |
No physical function difficulty | 93.3 | 57.7 |
Depressive symptoms | ||
Having depressive symptoms | 2.1 | 16.5 |
No depressive symptoms | 97.9 | 83.5 |
Cognitive function | ||
Impaired cognitive function | 44.7 | 60.0 |
No cognitive impairment | 55.3 | 40.0 |
Social support | ||
No social support | 30.3 | 42.9 |
Having social support | 69.7 | 57.1 |
Social participation | ||
No social participation | 5.0 | 20.8 |
Having social participation | 95.0 | 79.2 |
Overall Successful aging | ||
Failed | 76.4 | 94.4 |
Successful | 23.6 | 5.6 |
Variables Baseline-Followup | Total (n = 1289) | Males (n = 617) | Females (n = 672) | |||
---|---|---|---|---|---|---|
N | % | N | % | N | % | |
Smoking | *** | |||||
No–No | 616 | 47.8 | 82 | 13.3 | 534 | 79.5 |
No–Yes | 99 | 7.7 | 58 | 9.4 | 41 | 6.1 |
Yes–No | 67 | 5.2 | 38 | 6.2 | 29 | 4.3 |
Yes–Yes | 507 | 39.3 | 439 | 71.2 | 68 | 10.1 |
Protein intake | ||||||
Low–Low | 308 | 23.9 | 135 | 21.9 | 173 | 25.7 |
Low–High | 184 | 14.3 | 99 | 16.0 | 85 | 12.6 |
High–Low | 288 | 22.3 | 133 | 21.6 | 155 | 23.1 |
High–High | 509 | 39.5 | 250 | 40.5 | 259 | 38.5 |
Physical activity | ** | |||||
Stable | 517 | 40.5 | 223 | 36.6 | 294 | 44.1 |
Reduced | 335 | 26.2 | 160 | 26.2 | 175 | 26.2 |
Increased | 425 | 33.3 | 227 | 37.2 | 198 | 29.7 |
Successful Aging Indicators | Total | Men | Women |
---|---|---|---|
2007 | |||
No chronic disease | 63.4% *** | 70.3% | 57.1% |
No physical function difficulty | 93.3% | 93.9% | 92.8% |
No depressive symptoms | 97.9% | 98.7% | 97.2% |
No cognitive impairment | 55.3% *** | 61.6% | 49.1% |
Having social support | 69.7% *** | 91.6% | 49.7% |
Having social participation | 95.0% *** | 90.3% | 99.4% |
Overall successful aging | 23.6% *** | 32.8% | 14.7% |
2014 | |||
No chronic disease | 56.2% *** | 61.3% | 51.5% |
No physical function difficulty | 57.7% *** | 48.6% | 66.1% |
No depressive symptoms | 83.5% | 84.6% | 82.4% |
No cognitive impairment | 40.0% *** | 48.1% | 32.6% |
Having social support | 57.1% *** | 83.6% | 32.7% |
Having social participation | 79.2% * | 81.7% | 76.9% |
Overall successful aging | 5.6% *** | 8.9% | 2.5% |
Variables at Baseline | No Chronic Disease | No Physical Difficulty | Intact Cognitive Function | No Depressive Symptoms | Having Social Support | Having Social Participation | Overall Successful Aging |
---|---|---|---|---|---|---|---|
Demographics | |||||||
Age | |||||||
Age 60–69 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Age 70+ | 1.36 (0.82–2.27) | 0.6 7(0.42–1.07) | 0.25 (0.14–0.44) *** | 1.10 (0.58–2.09) | 0.66 (0.37–1.17) | 0.55 (0.32–0.95) * | 0.21 (0.04–0.89) * |
Education at baseline | 0.75 (0.61–0.91) ** | 0.93 (0.77–1.13) | 1.97 (1.57–2.46) *** | 1.22 (0.93–1.61) | 0.97 (0.75–1.25) | 1.44 (1.10–1.89) ** | 1.27 (0.92–1.75) |
Monthly expenditure at baseline | 0.85 (0.74–0.99) * | 1.08 (0.94–1.24) | 1.00 (0.86–1.16) | 0.91 (0.75–1.10) | 0.95 (0.79–1.15) | 1.10 (0.92–1.32) | 0.86 (0.67–1.11) |
Place of residence at baseline | |||||||
Urban | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Rural | 0.98 (0.65–1.48) | 0.89 (0.60–1.31) | 0.81 (0.54–1.21) | 0.65 (0.38–1.12) | 1.06 (0.62–1.79) | 1.38 (0.84–2.27) | 1.04 (0.52–2.07) |
Ethnicity | |||||||
Non-Javanese | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Javanese | 0.99 (0.68–1.43) | 0.86 (0.61–1.22) | 0.93 (0.64–1.35) | 1.19 (0.74–1.92) | 1.00 (0.62–1.60) | 1.95 (1.22–3.10) ** | 1.09 (0.59–2.01) |
Health insurance at baseline | |||||||
No | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Yes | 0.77 (0.47–1.28) | 0.97 (0.60–1.56) | 0.88 (0.52–1.47) | 1.04 (0.52–2.05) | 0.78 (0.43–1.41) | 1.39 (0.73–2.68) | 0.76 (0.32–1.76) |
Demographic Changes | |||||||
Changes of residence | |||||||
Stable | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Changed | 1.05 (0.54–2.03) | 1.69 (0.90–3.17) | 1.11 (0.58–2.11) | 0.95 (0.42–2.10) | 0.46 (0.22–0.95) * | 0.86 (0.39–1.89) | 0.74 (0.21–2.61) |
Changes of health insurance | |||||||
Stable | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
From no to yes | 0.56 (0.36–0.86) ** | 0.98 (0.65–1.48) | 1.25 (0.81–1.93) | 0.78 (0.45–1.35) | 2.26 (1.19–4.31) * | 1.04 (0.61–1.76) | 0.81 (0.38–1.73) |
From yes to no | 1.85 (0.83–4.11) | 0.85 (0.42–1.72) | 1.19 (0.56–2.52) | 0.75 (0.29–1.93) | 1.21 (0.51–2.87) | 1.03 (0.39–2.69) | 1.85 (0.58–5.86) |
Health-Related Behavior and Changes | |||||||
Smoking at baseline | |||||||
No | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Yes | 0.67 (0.37–1.21) | 1.13 (0.66–1.93) | 1.13 (0.63–2.02) | 1.24 (0.59–2.57) | 0.21 (0.06–0.70) * | 1.51 (0.76–3.01) | 0.61 (0.27–1.36) |
Smoking changes | |||||||
Stable and started smoking | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Quitting smoking | 0.41 (0.18–0.91) * | 1.12 (0.54–2.35) | 0.82 (0.37–1.82) | 1.81 (0.60–5.41) | 0.22 (0.55–0.89) * | 1.49 (0.58–3.81) | 0.36 (0.09–1.43) |
Physical activity at baseline | |||||||
Low | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Medium | 1.83 (1.12–2.99) * | 0.56 (0.36–0.88) * | 1.38 (0.87–2.19) | 1.47 (0.81–2.70) | 1.29 (0.68–2.44) | 1.50 (0.82–2.76) | 1.51 (0.70–3.27) |
High | 1.67 (0.90–3.09) | 0.58 (0.32–1.03) | 1.81 (0.98–3.34) | 1.33 (0.59–2.96) | 0.65 (0.31–1.36) | 1.25 (0.60–2.61) | 0.98 (0.35–2.74) |
Physical activity changes | |||||||
Stable | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Reduced | 0.73 (0.41–1.30) | 1.52 (0.89–2.57) | 0.75 (0.43–1.31) | 1.23 (0.58–2.61) | 1.02 (0.51–2.04) | 0.83 (0.42–1.63) | 0.87 (0.35–2.15) |
Increased | 1.33(0.87–2.05) | 0.93(0.62–1.39) | 0.97(0.63–1.49) | 1.04(0.61–1.78) | 1.17(0.66–2.07) | 1.98(1.15–3.42) * | 0.71(0.34–1.44) |
Protein intake changes | |||||||
Low stable | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Low to high | 0.84 (0.46–1.55) | 2.18 (1.24–3.83) ** | 1.17 (0.64–2.12) | 1.32 (0.60–2.89) | 0.93 (0.44–1.94) | 0.91 (0.44–1.87) | 1.19 (0.41–3.45) |
High to low | 1.09 (0.62–1.92) | 1.12 (0.67–1.86) | 1.09 (0.63–1.88) | 0.86 (0.44–1.68) | 0.76 (0.39–1.49) | 0.99 (0.50–1.95) | 1.41 (0.55–3.60) |
High stable | 0.65 (0.39–1.09) | 1.14 (0.71–1.84) | 1.28 (0.77–2.13) | 1.23 (0.64–2.35) | 1.32 (0.68–2.56) | 0.87 (0.46–1.61) | 1.65 (0.68–4.00) |
Variables | No Chronic Disease | No Physical Difficulty | Intact Cognitive Function | No Depressive Symptoms | Having Social Support | Having Social Participation | Overall Successful Aging |
---|---|---|---|---|---|---|---|
Demographics | |||||||
Age at baseline | |||||||
Age 60–69 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Age 70+ | 1.02 (0.64–1.60) | 0.69 (0.44–1.09) | 0.33 (0.17–0.67) ** | 1.16 (0.63–2.10) | 0.35 (0.20–0.64) ** | 1.13 (0.67–1.91) | <0.01 (0.00–0.00) |
Education at baseline | 0.84 (0.68–1.04) | 1.05 (0.85–1.30) | 2.52 (1.94–3.27) *** | 1.08 (0.83–1.41) | 1.07 (0.86–1.33) | 1.72 (1.27–2.34) *** | 2.24 (1.25–4.01) ** |
Monthly expenditure at baseline | 0.85 (0.75–0.96) * | 1.03 (0.90–1.18) | 1.14 (0.98–1.32) | 1.00 (0.84–1.17) | 0.91(0.79–1.04) | 1.11 (0.95–1.30) | 0.79 (0.50–1.25) |
Place of residence at baseline | |||||||
Urban | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Rural | 1.18 (0.83–1.69) | 1.06 (0.73–1.54) | 0.78 (0.52–1.18) | 0.89 (0.56–1.43) | 1.29 (0.88–1.90) | 0.74 (0.48–1.14) | 0.89 (0.23–3.34) |
Ethnicity | |||||||
Non-Javanese | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Javanese | 1.39 (0.99–1.95) | 0.95 (0.67–1.34) | 0.78 (0.52–1.17) | 1.28 (0.82–1.98) | 1.70 (1.19–2.45) ** | 2.23 (1.47–3.39) *** | 0.52 (0.16–1.71) |
Health insurance at baseline | |||||||
No | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Yes | 0.84 (0.53–1.32) | 1.26 (0.78–2.02) | 0.62 (0.95–2.74) | 0.93 (0.53–1.65) | 1.10 (0.67–1.79) | 1.46 (0.80–2.67) | 0.93 (0.20–4.18) |
Demographic Changes | |||||||
Changes of residence | |||||||
Stable | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Changed | 0.14 (0.82–2.60) | 0.96 (0.53–1.75) | 0.73 (0.36–1.46) | 0.66 (0.34–1.28) | 1.29 (0.71–2.33) | 1.95 (0.93–4.06) | 4.51 (1.05–19.25) * |
Changes of health insurance | |||||||
Stable | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
From no to yes | 0.94 (0.63–1.40) | 1.37 (0.90–2.08) | 1.55 (0.98–2.43) | 1.42 (0.84–2.42) | 1.32 (0.87–2.01) | 0.97 (0.61–1.55) | 0.76 (0.18–3.16) |
From yes to no | 2.02 (1.01–4.02) * | 1.08 (0.53–2.19) | 0.66 (0.30–1.45) | 1.93 (0.73–5.12) | 0.66 (0.31–1.42) | 0.75 (0.31–1.78) | 1.78 (0.26–12.01) |
Health-Related Behavior and changes | |||||||
Smoking at baseline | |||||||
No | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Yes | 0.89 (0.55–1.43) | 0.95 (0.58–1.53) | 0.99 (0.55–1.76) | 0.9 4(0.51–1.72) | 0.70 (0.41–1.18) | 0.69 (0.41–1.17) | 0.68 (0.07–6.01) |
Smoking changes | |||||||
Stable and started smoking | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Quitting smoking | 0.99 (0.50–1.93) | 1.84 (0.86–3.93) | 0.95 (0.41–2.22) | 1.07 (0.45–2.53) | 0.44 (0.18–1.04) | 1.19 (0.54–2.62) | 3.85 (0.84–17.48) |
Physical activity at baseline | |||||||
Low | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Medium | 1.87 (0.94–3.70) | 1.04 (0.52–2.06) | 0.98 (0.44–2.19) | 0.86 (0.37–2.00) | 1.01 (0.48–2.10) | 1.59 (0.71–3.58) | 1.36 (0.08–21.42) |
High | 1.45 (0.76–2.75) | 1.03 (0.54–1.99) | 1.22 (0.58–2.59) | 0.78 (0.35–1.71) | 1.58 (0.82–3.06) | 1.27 (0.59–2.75) | 2.79 (0.24–32.31) |
Physical activity changes | |||||||
Stable | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Reduced | 0.97 (0.51–1.84) | 0.98 (0.51–1.87) | 1.36 (0.64–2.89) | 1.31 (0.60–2.86) | 0.62 (0.32–1.20) | 1.32 (0.61–2.87) | 2.81 (0.30–26.21) |
Increased | 1.45 (0.98–2.13) | 1.21 (0.81–1.81) | 1.75 (1.11–2.76) * | 1.28 (0.77–2.13) | 1.20 (0.80–1.82) | 1.79 (1.12–2.84) * | 2.80 (0.53–14.67) |
Protein intake and changes | |||||||
Low stable | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Low to high | 0.80 (0.45–1.42) | 0.50 (0.28–0.89) * | 0.66 (0.32–1.35) | 1.05 (0.49–2.62) | 1.19 (0.64–2.20) | 1.50 (0.75–3.00) | 0.66 (0.09–4.83) |
High to low | 1.29 (0.81–2.05) | 0.82 (0.50–1.33) | 1.09 (0.62–1.89) | 1.10 (0.59–2.05) | 1.15 (0.70–1.90) | 1.28 (0.75–2.19) | 0.67 (0.10–4.20) |
High stable | 0.84 (0.54–1.30) | 0.71 (0.45–1.13) | 1.04 (0.62–1.76) | 0.75 (0.43–1.32) | 1.21 (0.75–1.93) | 1.44 (0.86–2.42) | 0.80 (0.17–3.65) |
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Oktaviani, L.W.; Hsu, H.-C.; Chen, Y.-C. Effects of Health-Related Behaviors and Changes on Successful Aging among Indonesian Older People. Int. J. Environ. Res. Public Health 2022, 19, 5952. https://doi.org/10.3390/ijerph19105952
Oktaviani LW, Hsu H-C, Chen Y-C. Effects of Health-Related Behaviors and Changes on Successful Aging among Indonesian Older People. International Journal of Environmental Research and Public Health. 2022; 19(10):5952. https://doi.org/10.3390/ijerph19105952
Chicago/Turabian StyleOktaviani, Lisa Wahidatul, Hui-Chuan Hsu, and Yi-Chun Chen. 2022. "Effects of Health-Related Behaviors and Changes on Successful Aging among Indonesian Older People" International Journal of Environmental Research and Public Health 19, no. 10: 5952. https://doi.org/10.3390/ijerph19105952