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Reviewed research
Authors Byles J, Vo K, Thomas L, Mackenzie L, Kendig H
Review Date March 2016
Citation Australasian Journal on Ageing 2016 (in press); DOI: 10.1111/ajag.12234
Background
With Australia’s ageing population there is increasing interest in the health and well-being of our older members of society. As men’s life expectancy increases, a larger number are living to very old age and an increasing proportion live alone, having survived their partner. Previous research suggests that older men who live alone may have greater health needs and poorer health behaviours compared to those living with a partner.
Aim
This study aimed to describe and compare mental health and physical functioning of community-dwelling men aged 70 years and over who live alone, and those who live with their partner.
Methods
A sub-analysis of baseline data collected in the New South Wales (NSW) 45 and Up Study was conducted. Men aged 70 years and older who did not live in a nursing home or hostel were included.
Partner status was measured with the self-reported question, ‘What best describes your current situation?’ Participants were classified into two groups: living with a partner (married, de facto) and not living with a partner (single, widowed, divorced, separated). Mental health was measured by the Kessler Psychological Distress Scale (K 10) and physical health by the Medical Outcome Short Form 36 (SF 36) physical functioning (PF) subscale score.
Chi-square tests were used to compare partnered and non-partnered men in terms of five-year age categories (70-74, 75-79, 80-84, >85), socioeconomic factors and health-related variables. Linear regression was used to examine the association between partner status and high K 10 scores (indicating poorer mental health), and also with mean SF 36 PF scores (from a total 100; higher scores indicate higher levels of physical functioning).
Results
The sample consisted of 37 690 men with 8594 (23%) reporting that they did not live with a partner. Overall, 1403 (4.7%) of men had a high/very high K 10 score and the mean SF 36 PF score was 73.1.
Within each age group, except 85 and over, men not living with a partner were more likely to have a high K 10 score and a lower SF 36 PF score compared to those who lived with a partner.
After adjusting for age, area of residence, current housing, education, smoking status, alcohol consumption and body mass index, men not living with a partner had higher odds of having a high K 10 score (OR = 1.3; 99% CI: 1.1-1.5) and had lower mean SF 36 PF scores (mean difference = -1.3; SE = 0.4).
Conclusion
Consistent with previous research, this study found that men who did not live with a partner had poorer physical health and were more likely to have poorer mental health compared to those who lived with a partner. After the age of 85, the two groups of men did not differ in their physical and mental health which may have been the product of survival or participation bias, or a reflection of the prevalence of conditions and disabilities at very old age. Public health programs and clinicians need to consider relationship status when addressing older men’s mental and physical needs.
Points to Note
- Australia has an ageing population, and previous research suggests that older men living alone may have greater health needs and poorer health behaviours compared to partnered men.
- This study found that men living without a partner had poorer mental and physical health. However, this effect was not observed in men aged 85 and older.
- This study may be limited by the use of self-report measures in a population at risk of poor memory, and the lack of access to information on relationship quality and length of time men had been single for.
- Public health programs and clinicians needs to consider relationship status when addressing mental and physical health in elderly men.
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