Whose education counts? The added impact of adult-child education on physical functioning of older Taiwanese

Objectives. Research has implicated education as an important predictor of physical functioning in old age. Older adults in Taiwan tend to experience tight familial integration and high rates of adult-child coresidency-much more so than is typical in Western cultures-which might imply additional influences stemming from the education of children. This could arise in a number of ways for instance, through the sharing of health-related information between child and parent, the quality of caregiving efforts, monetary assistance for medical and other services, or other psychosocial avenues. Despite this probable association, such hypotheses have rarely been tested. In this study, a nationally representative survey of older Taiwanese was used to examine these concurrent effects. Methods. Outcome variables include the existence of any functional limitations (dichotomously measured) and the severity of functional disorders (ordinally measured). Dichotomous and ordinal logistic models were used. Results. Results suggest that, after adjusting for age, sex, and other factors, both child and respondent education associate with the existence of limitations, but the child's education is more important than the parent's when predicting severity of limitations. Discussion. This implies that models ignoring social network characteristics in determining health outcomes of older adults may be misspecified, at least in some non-Western societies, and calls for further testing in other societies as well.