DEPRESSION, FUNCTIONAL DISABILITY, AND ACCESSING HEALTH CARE AMONG OLDER MEN AND WOMEN IN GHANA AND SOUTH AFRICA

Abstract Objectives. To inform a preventive approach to mild depression among older Ghanaians and South Africans, this study will investigate the association and possible variabilities between mild depression, functional disability, accessing health care, sociodemographic, and socioeconomic factors across genders in both countries. Methods. Cross-sectional wave 1 (2007-2010) data from WHO’s Study on Global Ageing and Adult Health (SAGE) are used, and a sample of 3871 for Ghana and 3076 for South Africa are analyzed. Binary multiple logistic regression is used to identify the association between mild depression, functional disability status, socioeconomic and sociodemographic factors, and health status. Results. The proportion of mild depression (MD) is 3.78% and 8.15% for older Ghanaian men and women, and 2.29% and 11.91% for South African older men and women, respectively. At 95% CI, increased severity (mild and high levels) of functional disability are associated with increased odds of MD in Ghanaian and South African older men and women. Apart from South African older men, older people in the study who do not receive healthcare when needed have increased odds of MD. Sociodemographic and socioeconomic factors are also associated with MD. Discussion. An untreated, persistent MD may lead to worse conditions with fatal outcomes. Since, mental health care is lacking in both countries, this study recommends policies directed towards support for formal and informal long-term care, and healthcare access to reduce the risks of depression. Thus, this study’s findings may provide relevant information for managing depression among older Ghanaians and South Africans.

GSA 2019 Annual Scientific Meeting 2.3%, and 3.9% of the primary caregiver was spouse, son/ daughter-in-law, daughter/son-in-law, grandchildren, and housekeeper.For widowed persons, 60.2%, 21.1%, 9.9%, and 5.9% of the primary caregiver was son/daughter-in-law, daughter/son-in-law, grandchildren, and housekeeper, respectively.Multivariable-adjusted model showed that, among married older adults, son/daughter-in-law and daughter/son-in-law as the primary caregiver was associated with 41% (95% confidence interval [CI]=6%-87%) and 67% (95%CI=10%-154%) higher mortality than spouse as the primary caregiver, respectively.For widowed persons, daughter/son-in-law and grandchildren as the primary caregiver was associated with 12% (95%CI=3%-20%) and 14% (95%CI=2%-24%) lower mortality than son/daughter-in-law as the primary caregiver, respectively.Majority of disabled older adults in China relied on their spouse and children to care for them.Type of primary caregiver was associated with death in both married and widowed persons.More resources need to be allocated to disabled Chinese older adults with poor survival outcomes.

COGNITIVE AND HEARING IMPAIRMENTS IN OLDER ADULTS: EVIDENCE FROM THE HEALTH AND RETIREMENT STUDY
Jessica S. West, 1 and Scott Lynch 1 , 1. Duke University, Durham, North Carolina, United States As the number of older adults increases, increased prevalence of cognitive and sensory impairments pose growing public health challenges.Research on the relationship between hearing impairment and cognition, however, is minimal and has yielded mixed results, with some studies finding that hearing impairment is associated with cognitive decline, and others reporting that the association is weak or non-existent.Most of this research has been conducted outside of the U.S., and the few U.S.-based longitudinal studies have relied mostly on small, non-representative samples involving short follow-up periods.Further, despite known gendered patterns in cognitive and hearing impairments, no studies to date have examined whether the relationship between the two varies by gender.Our study addresses these weaknesses in the literature by utilizing nine waves of the Health and Retirement Study (1998-2014; n=14,169), a large, nationally representative, longitudinal study that facilitates examination of long-term interrelationships between hearing and cognitive impairments.In this study, we use autoregressive latent trajectory (ALT) methods to model: 1) the relationship between hearing impairment and cognitive decline, and 2) sex differences in the relationship.ALT models enable us to determine whether hearing impairment and cognitive impairment are associated, net of their common tendency simply to co-trend with age.Results indicate that hearing and cognitive impairments are strongly interrelated processes that trend together over time.Moreover, hearing impairment has an increasing impact on cognitive impairment across age while the effect of cognitive impairment on hearing impairment levels out over time.Sex differences in these patterns are discussed.

DEPRESSION, FUNCTIONAL DISABILITY, AND ACCESSING HEALTH CARE AMONG OLDER MEN AND WOMEN IN GHANA AND SOUTH AFRICA
Candidus C. Nwakasi, 1 and J. Scott Brown 1 , 1. Miami University, Oxford, Ohio, United States Objectives.To inform a preventive approach to mild depression among older Ghanaians and South Africans, this study will investigate the association and possible variabilities between mild depression, functional disability, accessing health care, sociodemographic, and socioeconomic factors across genders in both countries.Methods.Cross-sectional wave 1 (2007-2010) data from WHO's Study on Global Ageing and Adult Health (SAGE) are used, and a sample of 3871 for Ghana and 3076 for South Africa are analyzed.Binary multiple logistic regression is used to identify the association between mild depression, functional disability status, socioeconomic and sociodemographic factors, and health status.Results.The proportion of mild depression (MD) is 3.78% and 8.15% for older Ghanaian men and women, and 2.29% and 11.91% for South African older men and women, respectively.At 95% CI, increased severity (mild and high levels) of functional disability are associated with increased odds of MD in Ghanaian and South African older men and women.Apart from South African older men, older people in the study who do not receive healthcare when needed have increased odds of MD.Sociodemographic and socioeconomic factors are also associated with MD.
Discussion.An untreated, persistent MD may lead to worse conditions with fatal outcomes.Since, mental health care is lacking in both countries, this study recommends policies directed towards support for formal and informal long-term care, and healthcare access to reduce the risks of depression.Thus, this study's findings may provide relevant information for managing depression among older Ghanaians and South Africans.

HEALTH BEHAVIORS AND PSYCHOLOGICAL WELL-BEING ALLEVIATE DIABETES-RELATED DISABILITY DETERIORATION
Yi-Hsuan Tsai, 1 and Ching-Ju Chiu 1 , 1. Institute of Gerontology, National Cheng Kung University, Tainan, Taiwan Diabetes is known to increase the risk of disability, which may be buffered by health behaviors and psychological factors.However, few existing studies examine how these factors affect disability in diabetic patients over time.The present study assessed the extent to which diabetes affected disability with age and how that effects differed by health behaviors and psychological well-being in older Taiwanese.The data of 5131 adults aged 50 and older were drawn from the 1996-2007 Taiwan Longitudinal Study on Aging.A cohort sequential multilevel modeling was employed to explore the effects of sociodemographic, comorbidities, lifestyle, and psychosocial factors in mediating and moderating the link between diabetes and disability.Disability was measured by mobility limitation in 1999, 2003, and 2007, while health behaviors and psychological factors were measured in 1996, 1999, and 2003 to be lagged time-varying covariates in random effect model analyses.Our results showed that adults with diabetes had more mobility limitation (β(diabetes) =3.031, P<.001) and progressed each year with ageing (β(diabetes*age) =0.061, P<.005).Exercising more than four times a week reduced the risk of disability by 51 % in diabetic patients (β(diabetes*exercise≥4 times) =-1.220,P<0.05).Social participation (β(social participation)=-0.631,P<.005), stress (β(stress)=0.651,P<.001) and Innovation in Aging, 2019, Vol. 3, No. S1