Complete Mental Health among Older Adults and Vulnerable Populations - - PowerPoint PPT Presentation

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Complete Mental Health among Older Adults and Vulnerable Populations - - PowerPoint PPT Presentation

Aug 02, 2023 185 likes •882 views

Complete Mental Health among Older Adults and Vulnerable Populations Esme Fuller-Thomson, MSW, PhD Director, Institute for Life Course & Aging Professor & Sandra Rotman Endowed Chair Factor-Inwentash Faculty of Social Work

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Complete Mental Health among Older Adults and Vulnerable Populations

Esme Fuller-Thomson, MSW, PhD Director, Institute for Life Course & Aging Professor & Sandra Rotman Endowed Chair Factor-Inwentash Faculty of Social Work Cross-Appointed to Faculties of Medicine & Nursing

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With many thanks to my co-authors

Complete Mental Health & Older Adults Bailey Hollister & David Burnes Among Older Immigrants Hongmei Tong Among Formerly Suicidal Canadians Philip Baiden

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Or is it “Freedom 55”?

Photo by Elisa Costa

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My Search for Inspiring Older Women

 How to age with grace?  I could only find a few examples in the public

record:

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Who is this and why might she be inspiring?

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Who is this and why might she be inspiring?

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The Queen Mum

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Who is this and why might she be inspiring?

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What was Georgina Harwood doing on her 100th birthday?

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And of course, her skydiving took a toll ...

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She rested for two days and then…

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Many of us are lucky to have inspiring women in our lives

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Lessons Learned from Inspiring Women?

 Outward focus – a sense of purpose in life  Physically active & energetic  Many are spiritual  Sense of humour  Tenacity – Sticking to their goals  Invests in social relationships, particularly

parenting.

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Complete Mental Health: What does it comprise?

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Mental Illness: The Whack-a-Mole Problem

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Corey Keyes’ Definition of Complete Mental Health

A. Happiness or Life Satisfaction B. Well Being

Social Psychological

C. Absence in last year of

Mental Illness (depression, anxiety, bipolar) Substance Dependence Suicidal Thoughts/Attempts

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Canadian Community Health Survey- Mental Health

Participants: Sample of 20,465 Canadians community-dwellers

 Nationally representative sample (2012)  5,222 older adults  Response Rate=68.9%

Measures: Mental Health: WHO-CIDI Scales

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How Are Older Adults Doing?

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Percent in Complete Mental Health?

Adults<65=?

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Percent in Complete Mental Health?

Adults<65=71.6%

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Percent in Complete Mental Health?

Adults<65=71.6% Older Adults=79.2%

(p<.001)

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Older Adults Adjusted Odds of Complete Mental Health?

55% higher odds

OR=1.55; (95% CI=1.40-1.72)

after controlling for 22 potential risk factors for CMH

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What is Associated with Older Adults’ Complete Mental Health?

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Women 39% higher odds than men

OR=1.39 (1.17, 1.65)

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Physically active older adults have 57% higher odds of CMH

OR=1.57(95% CI=1.34, 1.83)

Photo by Elisa Costa

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Those who turn to religion to cope with difficulties have 56% higher

  • dds of CMH
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History of substance abuse associated with 40% low

  • wer odds of CMH
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Married older adults have 26% higher

  • dds than unmarried/divorced

OR=1.26 (95% CI=1.07, 1.48)

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Those with a confidant have 5X the odds of CMH

OR=5.19 (95% CI=3.73, 7.24)

Photo by http://eastcoastclub.blogspot.ca/

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Social Support

(Marital status & confidant)

explains 4.6% of variation in Complete Mental Health

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Physical health characteristics explains 6.5% of variation in CMH

 Those with good to excellent health have 57% higher

  • dds of CMH than those in fair or poor health

 Those in chronic pain have 17% low

  • wer odds of CMH

 Those with chronic sleep problems have 36% low

  • wer
  • dds of CMH

 Those with functional limitations have 37% low

  • wer odds
  • f CMH
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History of mental illness explain 3.8% of variance in CMH

Those who ever had major depression have 66% lower

  • dds of CMH

Those who ever had Generalized Anxiety Disorder have 57% lower

  • dds of CMH
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Cumulatively, all these factors explained 19% of variation in CMH among Canadians aged 65+

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Conclusions

 Older adults are more likely to be in Complete

Mental Health than younger adults

 Current physical health & social support &

history of mental illness are key factors in older adults’ mental health

 Corey Keyes scale is highly reliable and works in

large surveys.

 Interventions to improve social support &

decrease pain, insomnia and disability may hold promise for increasing CMH

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Factors Associated with Complete Mental Health among Older Immigrants in Canada

Esme Fuller-Thomson, PhD, MSW & Hongmei Tong, PhD. RSW

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What % of older adults (65+) are immigrants? 30 % or 1.36 million of the 4.55 million older Canadians are immigrants

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What % of Older Adults are Visible Minorities?

484,000=10% of older Canadians are visible minorities

(and 95% of older visible minority Canadians are immigrants)

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Research Objectives

1) To identify the prevalence of Complete Mental Health (CMH) among Canadian immigrants aged 55 and over in comparison to non-immigrants 2) To determine factors associated with CMH among

  • lder immigrants.
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Canadian Community Health Survey- Mental Health

Participants:

 Canadian Community Health Survey – Mental Health CCHS-MH 2012  Nationally representative sample (2012) sample of adults aged 55+  Total: 9, 524 older adults; Response Rate=68.9%  Non-immigrants: 7947  Recent immigrants (19 years or less since immigration): 147  Long-term immigrants (20 years or more since immigration): 1530

Measures: Mental Health

 Mental Health Continuum Short Form (MHC-SF)  WHO-CIDI Scales

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Percent of those 55+ in Complete Mental Health?

  • Non-Immigrants?
  • Recent immigrants (<20 years here)?
  • Long-term Immigrants (20+ yrs here)?
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Percent of those 55+ in Complete Mental Health?

  • Non-Immigrants? 76.1%
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Percent of those 55+ in Complete Mental Health?

  • Non-Immigrants? 76.1%
  • Recent immigrants 75.9%
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Percent of those 55+ in Complete Mental Health?

  • Non-Immigrants? 76.1%
  • Recent immigrants 75.9%
  • Long-term Immigrants 79.8%
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Long-Term Immigrants 21% Higher Odds of Complete Mental Health than non-immigrants

(95% CI=1.06-1.40) after controlling for 13 potential risk factors for CMH

Recent Immigrants Comparable to Non-Immigrants (OR=0.97)

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Immigrants earning >$80,000 per year have 76% higher odds of CMH than those with <$20,000

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Immigrants without functional limitations 2.3 times higher odds of CMH than those with limitations

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Immigrants without chronic pain have 51% higher odds of CMH than those with chronic pain

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Immigrants without chronic insomnia have 2.8 times higher odds of CMH compared to those with insomnia

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Physical health characteristics explains 9.3% of variation in CMH

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Other Factors Associated with CMH among Older Immigrants

 Current physical health & martial status more

likely to have CMH

 Those with a confidant have 5X the odds of

CMH

 Those with a history of substance abuse are

much less likely to be in CMH.

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Implications?

 Interventions to

 Improve social support  Decrease chronic pain  Address insomnia and  Decrease disability levels

May hold promise for increasing CMH among

  • lder immigrants.
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Formerly Suicidal Canadians

 CCHS-MH – 2,884 respondents had seriously

considered suicide at some time.

Baiden P, Fuller-Thomson E. (2016). Factors Associated with Achieving Complete Mental Health among Individuals with Lifetime Suicidal Ideation. Suicide Life Threat Behav.

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What % of Formerly Suicidal Canadians are now in CMH?

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What % of Formerly Suicidal Canadians are now in CMH?

38%

Remember that CMH is a very high standard! – If you are only happy once a week, you would not qualify.

  • 72% of all formerly suicidal had NO

THOUGHTS OF SUICIDE in the past year.

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Factors associated with HIGHER CMH among formerly suicidal Canadians:

 Being older  Being a woman  Having a higher income  Turning to spirituality or religion to cope with

problems

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Those with a confidant have 7X the odds

  • f CMH
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Factors associated with LOWER CMH among formerly suicidal Canadians:

 Chronic pain  Insomnia  History of Alcohol Dependence

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Projects Underway:

 Complete Mental Health Among

 Older widows  Arthritis patients with disabling chronic pain  Cancer patients and cancer survivors

 Canadians with former substance dependence problems.

 Formerly depressed Canadians (39% in CMH)

 Published in Psychiatry Research with Senyo Agbeyaka, Deb LaFond,

Merc Bern-Klug  Survivors of Childhood Maltreatment

 SSHRC grant with Deb Goodman and Barbara Fallon

 First Nations Canadians (small grant with Rose Cameron)

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Researchers are happier when they study complete mental health rather than mental illness

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Thank you:

 Michael Cummings for many of the photos  Statistics Canada for use of the CCHS-MH  Sandra Rotman Endowed Chair for funding

& Thank you for listening!

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Physical Health in the Later Years:

How much progress have we made?

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Life Expectancy

In 1900

Canada 49 UK 46 Ukraine 37 Greece 40 India 23 China Not avail.

In 1950 In 2013

68 84 69 83 62 76 66 83 36 69 45 77

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What % live in private dwellings?

(not in nursing homes or seniors’ residences )

 At age 65 and older?

 92%

 At age 90 and older?

 56.5%

 At age 100 and older?

 34.0%

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What % of those age 65 and older are WITHOUT dementia

 85% don’t have dementia

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What % of older women are free of chronic pain?

 Living in institutions:

 61%

 Living in the community:

 69%