1
|
Medford A, Skirbekk V, Strand BH. Trends in ages at death of Norwegian centenarians: the 1870-1904 birth cohorts. Scand J Public Health 2023:14034948231206529. [PMID: 37899540 DOI: 10.1177/14034948231206529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
BACKGROUND With rapidly rising life expectancy and ageing populations, interest has grown in the survival patterns and ages at death at the highest ages. In Scandinavia, the accumulation of very old population segments coupled with long-established, high-quality population registers permit meaningful analysis. METHODS This study is based on individual level data from extinct Norwegian birth cohorts using data obtained from the Norwegian Civil Register System. We assess trends in the ages at death of centenarians in Norway for cohorts born between 1870 and 1904 for evidence of any secular increase using quantile regression. RESULTS We observed that there is no upward trend in centenarian lifespans, in line with recent observations in Sweden, but contrary to the upward trend at the very highest percentiles as observed in Denmark. CONCLUSIONS The available evidence suggests that the stagnation in centenarian lifespans may be partly due to the failure to find ways of dealing with neurodegenerative diseases.
Collapse
Affiliation(s)
- Anthony Medford
- Center on Population Dynamics, University of Southern Denmark, Denmark
| | | | | |
Collapse
|
2
|
Sun F, Zimmer Z, Zajacova A. Educational Differences in Life Expectancies With and Without Pain. J Gerontol B Psychol Sci Soc Sci 2023; 78:695-704. [PMID: 36242782 PMCID: PMC10066743 DOI: 10.1093/geronb/gbac169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES This study computes years and proportion of life that older adults living in the United States can expect to live pain-free and in different pain states, by age, sex, and level of education. The analysis addresses challenges related to dynamics and mortality selection when studying associations between education and pain in older populations. METHODS Data are from National Health and Aging Trends Study, 2011-2020. The sample contains 10,180 respondents who are age 65 and older. Pain expectancy estimates are computed using the Interpolated Markov Chain software that applies probability transitions to multistate life tables. RESULTS Those with higher educational levels expect not only a longer life but also a higher proportion of life without pain. For example, a 65-year-old female with less than high school education expects 18.1 years in total and 5.8 years, or 32% of life, without pain compared with 23.7 years in total with 10.7 years, or 45% of life without pain if she completed college. The education gradient in pain expectancies is more salient for females than males and narrows at the oldest ages. There is no educational disparity in the percent of life with nonlimiting pain. DISCUSSION Education promotes longer life and more pain-free years, but the specific degree of improvement by education varies across demographic groups. More research is needed to explain associations between education and more and less severe and limiting aspects of pain.
Collapse
Affiliation(s)
- Feinuo Sun
- Global Aging and Community Initiative, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Zachary Zimmer
- Global Aging and Community Initiative, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
- Department of Family Studies and Gerontology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Anna Zajacova
- Department of Sociology, University of Western Ontario, London, Ontario, Canada
| |
Collapse
|
3
|
Echagüe de Mendez G, Sosa de Sforza L, Funes P, Díaz RV, Ferrero M, Cardozo O, Florentín M, Orué E, Franco R. Estado de salud y nutrición del adulto mayor que concurre al Hospital Geriátrico del Seguro Social en la Asunción. Paraguay. INVESTIGACIÓN CLÍNICA 2023. [DOI: 10.54817/ic.v64n1a05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
The increase in the population of older adults and their more significant demand for health care in Paraguay requires a multidimensional evaluation to identify risks or deteriorating conditions. The objective of this research was to evaluate the health and nutrition status of a sample of older adults who attended the Geriatric Hospital of the Social Security for outpa-tient consultation. The research had a cross-sectional descriptive observational design, which included 108 older adults who underwent the Comprehensive Geriatric Assessment (CGA) and whose nutritional parameters were evaluated. Their average age was 71 years, with a predominance of females. According to their BMI, 64% were overweight or obese. As for the CGA, 18% presented a nutritional risk, 43% had mild dependence on activities of daily living and 12% on instrumental activities, 18% had a cognitive deficit, 6% had depression, and 30% had social risk. The population was characterized by a high prevalence of overweight and hypertension and a low frequency of risk of malnutrition. The most significant limitations were in the basic activities of daily life and social risk. Being female and being overweight were significantly associated with ba-sic functional limitations. This work was one of the first in the country on am-bulatory older adults, allowing the establishment of a baseline for areas where health is compromised or at risk of decline and the development of preventive strategies and actions to promote healthy aging.
Collapse
Affiliation(s)
- Gloria Echagüe de Mendez
- Universidad Nacional de Asunción- Instituto de Investigaciones en Ciencias de la Salud (UNA-IICS). San Lorenzo, Paraguay
| | - Liliana Sosa de Sforza
- Universidad Nacional de Asunción- Instituto de Investigaciones en Ciencias de la Salud (UNA-IICS). San Lorenzo, Paraguay
| | - Patricia Funes
- Universidad Nacional de Asunción- Instituto de Investigaciones en Ciencias de la Salud (UNA-IICS). San Lorenzo, Paraguay
| | - Ramona Valentina Díaz
- Universidad Nacional de Asunción- Instituto de Investigaciones en Ciencias de la Salud (UNA-IICS). San Lorenzo, Paraguay
| | - Margarita Ferrero
- Hospital Geriátrico “Prof. Dr. Gerardo Buongermini” - Instituto de Previsión Social (IPS). Asunción, Paraguay
| | - Osvaldo Cardozo
- Hospital Geriátrico “Prof. Dr. Gerardo Buongermini” - Instituto de Previsión Social (IPS). Asunción, Paraguay
| | - Marilina Florentín
- Hospital Geriátrico “Prof. Dr. Gerardo Buongermini” - Instituto de Previsión Social (IPS). Asunción, Paraguay
| | - Estela Orué
- Hospital Geriátrico “Prof. Dr. Gerardo Buongermini” - Instituto de Previsión Social (IPS). Asunción, Paraguay
| | - Rosa Franco
- Hospital Geriátrico “Prof. Dr. Gerardo Buongermini” - Instituto de Previsión Social (IPS). Asunción, Paraguay
| |
Collapse
|
4
|
Can Sex Differences in Old Age Disabilities be Attributed to Socioeconomic Conditions? Evidence from a Mapping Review of the Literature. JOURNAL OF POPULATION AGEING 2022. [DOI: 10.1007/s12062-022-09395-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
AbstractOld age disabilities are more common among women than men, and adverse socioeconomic conditions are associated with a higher prevalence of disabilities among older adults. The goal of this study was to complete a mapping review of the available evidence assessing the extent to which the observed sex differences in older adults’ disabilities can be attributed to sex differences in socioeconomic status. We searched three databases for articles published between 2009 and 2019, and after screening and looking at eligibility criteria, 6 articles were included in the review. For those studies that did not directly analyse the contribution of socioeconomic conditions, we used the ‘difference method’ to estimate the proportion of the sex gap in disabilities among older adults that could be attributed to socioeconomic conditions. Our review demonstrated that women generally have a higher prevalence of disabilities than men. In several studies, these differences could be partly attributed to sex differences in the distribution of socioeconomic conditions. We also find great elasticity in the magnitude of both the sex gap in disabilities and in the proportion that could be attributed to differences in socioeconomic conditions.
Collapse
|
5
|
Veenstra M, Aartsen M. Life-course income trajectories of men and women in Norway: implications for self-rated health in later life. Eur J Public Health 2022; 32:542-547. [PMID: 35708604 PMCID: PMC9341848 DOI: 10.1093/eurpub/ckac055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Socioeconomic inequalities in health are well-established, but studies addressing lagged effects of income or of fluctuations in income over the life course are relatively rare. The current study aims to (i) identify and describe life-course income trajectories for men and women who are currently in later life; and (ii) assess the association of income trajectories with self-rated health in older adults. METHODS The study sample consisted of 1625 men and 1634 women born between 1937 and 1955 who participated in the third wave of the Norwegian Life course, Ageing and Generation Study. Latent class growth analyses were used to estimate dominant income trajectories from ages 30 through 62 in men and women. Stepwise logistic regression analyses were specified to analyze the association of income trajectories with self-rated health in later life. RESULTS Four trajectories in women and three trajectories in men were estimated as dominant patterns of income over the life course. Differences in the level of income were considerable at age 30 and accumulated over time. Continued exposure to low income showed statistically significant higher odds for poor self-rated health in older men and women. This association remained significant after taking differences in educational attainment, working life, family formation and accumulated wealth into account. CONCLUSION The findings suggested remarkable rigidity in income groups that had formed by age 30. A significant share of men and women remain mired in relatively low-income status across the life course with negative implications for health in later life.
Collapse
Affiliation(s)
- Marijke Veenstra
- NOVA-Norwegian Social Research, OsloMet-Oslo Metropolitan University, Norway.,Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - Marja Aartsen
- NOVA-Norwegian Social Research, OsloMet-Oslo Metropolitan University, Norway
| |
Collapse
|
6
|
|
7
|
Changes in socioeconomic differentials in old age life expectancy in four Nordic countries: the impact of educational expansion and education-specific mortality. Eur J Ageing 2022; 19:161-173. [PMID: 35663915 PMCID: PMC9156635 DOI: 10.1007/s10433-022-00698-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2022] [Indexed: 01/25/2023] Open
Abstract
Overall progress in life expectancy (LE) depends increasingly on survival in older ages. The birth cohorts now reaching old age have experienced considerable educational expansion, which is a driving force for the social change and social inequality. Thus, this study examines changes in old age LE by educational attainment in the Nordic countries and aims to find out to what extent the change in national LEs is attributable to education-specific mortality and the shifting educational composition. We used national register data comprising total 65 + populations in Denmark, Finland, Norway and Sweden to create period life tables stratified by five-year age groups (65-90 +), sex and educational attainment. Difference in LE between 2001 and 2015 was decomposed into the contributions of mortality changes within each educational group and changes in educational composition. Increasing LE at all ages and in all educational groups coincided with persistent and growing educational inequalities in all countries. Most of the gains in LE at age 65 could be attributed to decreased mortality (63-90%), especially among those with low education, the largest educational group in most countries. The proportion of the increase in LE attributable to improved education was 10-37%, with the highest contributions recorded for women in Norway and Sweden. The rising educational levels in the Nordic countries still carry potential for further gains in national LEs. However, the educational expansion has contributed to uneven gains in LE between education groups, which poses a risk for the future increase of inequalities in LE. Supplementary Information The online version contains supplementary material available at 10.1007/s10433-022-00698-y.
Collapse
|
8
|
Tynkkynen LK, Pulkki J, Tervonen-Gonçalves L, Schön P, Burström B, Keskimäki I. Health system reforms and the needs of the ageing population—an analysis of recent policy paths and reform trends in Finland and Sweden. Eur J Ageing 2022; 19:221-232. [PMID: 35465210 PMCID: PMC9012246 DOI: 10.1007/s10433-022-00699-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2022] [Indexed: 01/08/2023] Open
Abstract
AbstractPopulation ageing with an increasing number of people experiencing complex health and social care needs challenges health systems. We explore whether and how health system reforms and policy measures adopted during the past two decades in Finland and Sweden reflect and address the needs of the older people. We discuss health system characteristics that are important to meet the care needs of older people and analyse how health policy agendas have highlighted these aspects in Finland and Sweden. The analysis is based on “most similar cases”. The two countries have rather similar health systems and are facing similar challenges. However, the policy paths to address these challenges are different. The Swedish health system is better resourced, and the affordability of care better ensured, but choice and market-oriented competition reforms do not address the needs of the people with complex health and social care needs, rather it has led to increased fragmentation. In Finland, the level of public funding is lower which may have negative impacts on people who need multiple services. However, in terms of integration and care coordination, Finland seems to follow a path which may pave the way for improved coordination of care for people with multiple care needs. Intensified monitoring and analysis of patterns of health care utilization among older people are warranted in both countries to ensure that care is provided equitably.
Collapse
Affiliation(s)
| | - Jutta Pulkki
- Faculty of Social Sciences, Health Sciences, Tampere University, Tampere, Finland
| | | | - Pär Schön
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Bo Burström
- Department of Global Public Health, Equity and Health Policy Research Group, Karolinska Institutet, Stockholm, Sweden
| | - Ilmo Keskimäki
- Finnish Institute for Health and Welfare, Helsinki, Finland
| |
Collapse
|
9
|
Fuchs J, Gaertner B, Prütz F. Limitations in activities of daily living and support needs - Analysis of GEDA 2019/2020-EHIS. JOURNAL OF HEALTH MONITORING 2022; 7:6-25. [PMID: 35434501 PMCID: PMC9009067 DOI: 10.25646/9570] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/04/2022] [Indexed: 11/16/2022]
Abstract
Being able to perform activities of daily living is an important component of a person's ability to function. If these activities are impaired, support is needed. Using data from GEDA 2019/2020-EHIS, we present how many people aged 55 and older living in private households in Germany experience limitations in activities of daily living. Severe limitations in basic (fundamental) activities (e.g. food intake) are reported by 5.8% of women and 3.7% of men. The proportion increases with age as 13.4% of women and 9.0% of men aged 80 and older experience limitations. Severe limitations of instrumental activities of daily living (e.g. grocery shopping) are rather rare in participants less than 80 years of age. But at age 80 and older the proportion rises to 35.9% of women and 21.0% of men. A total of 68.1% of afflicted women and 57.5% of men receive help and support related to limitations of basic activities. Women are also more likely to report a lack of support (48.8% vs. 43.2%). The situation is slightly better with regard to instrumental activities. The results of GEDA 2019/2020-EHIS show in which areas of daily life older and very old people are impaired, give an impression of who is affected particularly strongly and indicate where support services are insufficient. As such, these results provide clues as to where support can be provided to enable older people to keep living in their own homes for a long time.
Collapse
Affiliation(s)
- Judith Fuchs
- Corresponding author Dr Judith Fuchs, Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 62–66, 12101 Berlin, Germany, E-mail:
| | | | | |
Collapse
|
10
|
Marcus E, Anders A, Per G, Karin M. Occupational differences in mortality and life expectancy persist after retirement and throughout life. Scand J Public Health 2022:14034948221081628. [PMID: 35331067 DOI: 10.1177/14034948221081628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS There are substantial differences in remaining life expectancy at higher ages between occupational groups. These differences may be the effect of work-related exposures, lifestyle factors of workers in specific occupations, socioeconomic position or a combination of this. The scope of this paper is the extent to which occupational differences in remaining life expectancy persist after retirement, which would suggest that occupational exposures alone are not likely to explain all the difference. METHODS All individuals born between 1925 and 1939 who reported occupational information in the Census 1985 and were residents in Sweden to the end of 2020 or who died were included and followed for death until 2020. The Nordic Classification of Occupations was used to create nine occupational groups. Partial life expectancy and age-specific death rates were applied to examine mortality differentials. RESULTS This study showed substantial differences in partial life expectancy across the occupational cohorts with the biggest difference being about 2 years. The mortality differences persisted with increasing age, both when measured as absolute numbers as well as relative numbers. CONCLUSIONS The lack of convergence in mortality at high ages suggests that factors associated with lifestyle may play a larger role than occupational factors for the mortality differences between occupational groups at high ages. However, it cannot be ruled out that long-lasting effects of earlier occupational exposures also contribute. Regardless of the exact mechanism, we conclude that there is room for further reduction in mortality at high ages and, thus, for further improvement in life expectancy.
Collapse
Affiliation(s)
- Ebeling Marcus
- Unit of Epidemiology, Karolinska Institutet, Sweden.,Laboratory of Population Health, Max Planck Institute for Demographic Research, Germany
| | - Ahlbom Anders
- Unit of Epidemiology, Karolinska Institutet, Sweden.,Centre for Occupational and Environmental Medicine, Region Stockholm, Sweden
| | - Gustavsson Per
- Centre for Occupational and Environmental Medicine, Region Stockholm, Sweden.,Unit of Occupational Medicine, Karolinska Institutet, Sweden
| | - Modig Karin
- Unit of Epidemiology, Karolinska Institutet, Sweden
| |
Collapse
|
11
|
Damaskinos P, Koletsi-Kounari C, Mamai-Homata H, Papaioannou W. Social, Clinical and Psychometric Factors Affecting Self-Rated Oral Health, Self-Rated Health and Wellbeing in Adults: A Cross-Sectional Survey. Health (London) 2022. [DOI: 10.4236/health.2022.141009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
|
12
|
Enroth L, Fors S. Trends in the Social Class Inequalities in Disability and Self-Rated Health: Repeated Cross-Sectional Surveys from Finland and Sweden 2001-2018. Int J Public Health 2021; 66:645513. [PMID: 34744593 PMCID: PMC8565263 DOI: 10.3389/ijph.2021.645513] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 04/20/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: To assess time trends in the social class inequalities and in total inequality in disability and self-rated health (SRH) in two oldest old populations. Methods: The data came from the Finnish Vitality 90+ Study (2001, 2003, 2007, 2010, 2014 and 2018; n = 5,440) and from the Swedish Panel Study of Living Conditions of the Oldest Old (2002, 2004, 2011 and 2014; n = 1,645). Inequalities in mobility and activities of daily living (ADL) disability and SRH were examined cross-sectionally and over time using relative and absolute measures. Results: Lower social classes had greater mobility and ADL disability and worse SRH than higher social classes and the inequalities tended to increase over time. Findings were remarkably similar in both studies and with absolute and relative measures. Total inequality, referring to the variance in health outcome in the total population, remained stable or decreased. Conclusion: The study suggests that the earlier findings of improved mobility and ADL are largely driven by the positive development in higher social classes while findings of decline in SRH are related to the worsening of SRH in lower social classes
Collapse
Affiliation(s)
- Linda Enroth
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center, Tampere University, Tampere, Finland
| | - Stefan Fors
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Center for Epidemiology and Community Medicine, Region Stockholm, Sweden
| |
Collapse
|
13
|
Veenstra M, Herlofson K, Aartsen M, Hansen T, Hellevik T, Henriksen G, Løset GK, Vangen H. Cohort Profile: The Norwegian Life Course, Ageing and Generation Study (NorLAG). Int J Epidemiol 2021; 50:728-729i. [PMID: 33496326 PMCID: PMC8271209 DOI: 10.1093/ije/dyaa280] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 12/15/2020] [Indexed: 11/23/2022] Open
Affiliation(s)
- Marijke Veenstra
- Norwegian Social Research (NOVA), Oslo Metropolitan University, Oslo, Norway
| | - Katharina Herlofson
- Norwegian Social Research (NOVA), Oslo Metropolitan University, Oslo, Norway
| | - Marja Aartsen
- Norwegian Social Research (NOVA), Oslo Metropolitan University, Oslo, Norway
| | - Thomas Hansen
- Norwegian Social Research (NOVA), Oslo Metropolitan University, Oslo, Norway
| | - Tale Hellevik
- Norwegian Social Research (NOVA), Oslo Metropolitan University, Oslo, Norway
| | | | - Gøril Kvamme Løset
- Norwegian Social Research (NOVA), Oslo Metropolitan University, Oslo, Norway
| | - Hanna Vangen
- Norwegian Social Research (NOVA), Oslo Metropolitan University, Oslo, Norway
| |
Collapse
|
14
|
Socio-economic inequality in long-term care: a comparison of three time periods in the Netherlands. AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x21000647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
As a result of the rapid ageing of societies, meeting the demands for long-term care has become increasingly difficult. In the Netherlands, informal care is recognised as a key element to compensate for cut-backs in formal care provision. Formal, informal and privately paid long-term care services, however, are not used equally across socio-economic status (SES) groups and whether these inequalities have been reduced or exacerbated over time has not been researched. This study investigates to what extent educational and income inequalities in the use of formal, informal and privately paid care have changed over time. Data from the Longitudinal Aging Study Amsterdam (LASA) was used from three points in time: 1995 (N = 787), 2005 (N = 550) and 2015 (N = 473). Participants were between 75 and 85 years of age and living independently. The results indicate that lower SES groups are consistently more likely to use formal and informal care, and less likely to use privately paid care compared to higher SES groups. An increase in inequality was only found in the use of informal care; while informal care use is stable among lower SES groups, it decreases steeply among higher SES groups. These findings highlight the importance of education for explaining variation and changes over time in care use. Governmental efforts to mobilise informal care-givers might be outweighed by trends towards less long-term care.
Collapse
|
15
|
彭 顺, 付 茜, 冯 星. [Association between education and the onset of disability in activities of daily living in middle-aged and older Chinese adults: The mediator role of social participation]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2021; 53:549-554. [PMID: 34145859 PMCID: PMC8220058 DOI: 10.19723/j.issn.1671-167x.2021.03.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To investigate the association between educational attainment and the onset of disability in activities of daily living (ADL), and to explore the mediating effect of social participation on such association. METHODS A longitudinal dataset was drawn from the China Health and Retirement Longitudinal Study (CHARLS, 2015 to 2018). The measurements of educational attainment, social participation and other covariates were identified from 2015, while the outcome measurement of ADL disability was constructed with data from survey 2018. Descriptive analyses were conducted, and basic characteristics and social engagement of the respondents were compared between illiterates and non-illite-rates using Chi-square test. Logistic regression was used to investigate the associations of educational attainment and social participation on the onset of ADL disability. Mediation analysis was employed to examine the mediator role of the social participation on the linkage from being illiterate to the ADL disability onset. RESULTS A total of 11 359 adults aged 45 years and above were included in the sample, of whom 3 222 were illiterates. The incidence of the onset of ADL disability of illiterates and non-illiterates were 10.4% and 6.2%, respectively. Among these respondents, only half of them were involved in social activities. Of all the 8 social activities, the percentage of interacting with friends (34. 1%) was the highest, and the lowest percentage was observed in participating in an educational or training course (0.6%). Moreover, the percentages of participation in all these 8 social activities among illiterates were significantly lower than that of their educated counterparts (all P < 0.001). The illiterate middle-aged and older adults were less likely to develop ADL disability in the follow-up period [adjusted odds ratio (aOR)=1.22, 95%CI: 1.02-1.45], and social participation was significantly associated with ADL disability onset (aOR=0.73, 95%CI: 0.63-0.85). Findings from mediation analysis illustrated that social participation accounted for 12.22% of the adverse effect of being illiterate on ADL disability onset. CONCLUSION Social participation could buffer the negative effect of being illiterate on ADL disability onset in middle-aged and older adults, suggesting that engagement in social activities might have impact on prevention of impairments in physical function, especially for middle-aged and older illiterates.
Collapse
Affiliation(s)
- 顺壮 彭
- />北京大学公共卫生学院卫生政策与管理系,北京 100191Department of Health Policy and Management, Peking University School of Public Health, Beijing 100191, China
| | - 茜茜 付
- />北京大学公共卫生学院卫生政策与管理系,北京 100191Department of Health Policy and Management, Peking University School of Public Health, Beijing 100191, China
| | - 星淋 冯
- />北京大学公共卫生学院卫生政策与管理系,北京 100191Department of Health Policy and Management, Peking University School of Public Health, Beijing 100191, China
| |
Collapse
|
16
|
Vaarst J, Boyle E, Vestergaard S, Hvid LG, Strotmeyer ES, Glynn NW, Caserotti P. Does physical performance and muscle strength predict future personal and nursing care services in community-dwelling older adults aged 75+? Scand J Public Health 2021; 49:441-448. [PMID: 33467973 DOI: 10.1177/1403494820979094] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
AIM The objective of this study was to investigate if grip strength or the short physical performance battery could predict the rate of receiving two different types of home care services: (a) personal care and (b) home nursing care for community-dwelling older adults aged 75+ years. METHODS A secondary data analysis of a prospective cohort study including 323 community-dwelling older adults. Measures of grip strength and the short physical performance battery were incorporated in a nationally regulated preventive home visit programme. Referral to personal and home nursing care were obtained from an administrative database with an average follow-up of 4.1 years. The rate of receiving the individual home care services and the study measures were determined using multivariable Cox proportional hazards models controlling for a priori selected covariates (age, sex, living status, obesity, smoking and prior use of home care). RESULTS The mean age was 81.7 years with 58.8% being women. The rate of receiving personal care differed between the short physical performance battery groups but not between the grip strength groups after adjusting for all covariates with hazard ratios (95% confidence intervals) of 1.90 (1.29-2.81) and 1.41 (0.95-2.08), respectively. The rate of receiving home nursing care differed between both the short physical performance battery and grip strength groups after adjusting for all covariates with hazard ratios of 2.03 (1.41-2.94) and 1.48 (1.01-2.16), respectively. CONCLUSIONS The short physical performance battery was associated with the rate of receiving both personal care and home nursing care. The short physical performance battery can be used to predict home care needs of community-dwelling older adults aged 75+ years.
Collapse
Affiliation(s)
- Jonathan Vaarst
- Department of Sports Science and Clinical Biomechanics and the Center for Active and Healthy Ageing, University of Southern Denmark, Odense, Denmark
| | - Eleanor Boyle
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Sonja Vestergaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Lars G Hvid
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Elsa S Strotmeyer
- Department of Epidemiology Pittsburgh, University of Pittsburgh, Pittsburgh, USA
| | - Nancy W Glynn
- Department of Epidemiology Pittsburgh, University of Pittsburgh, Pittsburgh, USA
| | - Paolo Caserotti
- Department of Sports Science and Clinical Biomechanics and the Center for Active and Healthy Ageing, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
17
|
Mjørud M, Selbæk G, Bjertness E, Edwin TH, Engedal K, Knapskog AB, Strand BH. Time from dementia diagnosis to nursing-home admission and death among persons with dementia: A multistate survival analysis. PLoS One 2020; 15:e0243513. [PMID: 33275638 PMCID: PMC7717539 DOI: 10.1371/journal.pone.0243513] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 11/22/2020] [Indexed: 12/28/2022] Open
Abstract
Objectives To estimate transition times from dementia diagnosis to nursing-home (NH) admission or death and to examine whether sex, education, marital status, level of cognitive impairment and dementia aetiology are associated with transition times. Design Markov multistate survival analysis and flexible parametric models. Setting Participants were recruited from the Norwegian Registry of Persons Assessed for Cognitive Symptoms (NorCog) in specialist healthcare between 2008 and 2017 and followed until August 2019, a maximum of 10.6 years follow-up time (mean 4.4 years, SD 2.2). Participants’ address histories, emigration and vital status were retrieved from the National Population Registry from time of diagnosis and linked to NorCog clinical data. Participants 2,938 home-dwelling persons with dementia, ages 40–97 years at time of diagnosis (mean 76.1, SD 8.5). Results During follow-up, 992 persons (34%) were admitted to nursing-homes (NHs) and 1,556 (53%) died. Approximately four years after diagnosis, the probability of living in a NH peaked at 19%; thereafter, the probability decreased due to mortality. Median elapsed time from dementia diagnosis to NH admission among those admitted to NHs was 2.28 years (IQR 2.32). The probability of NH admission was greater for women than men due to women´s lower mortality rate. Persons living alone, particularly men, had a higher probability of NH admission than cohabitants. Age, dementia aetiology and severity of cognitive impairment at time of diagnosis did not influence the probability of NH admission. Those with fewer than 10 years of education had a lower probability of NH admission than those with 10 years or more, and this was independent of the excess mortality in the less-educated group. Conclusion Four years after diagnosis, half of the participants still lived at home, while NH residency peaked at 19%. Those with fewer than 10 years of education were less often admitted to NH.
Collapse
Affiliation(s)
- Marit Mjørud
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
- * E-mail:
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Espen Bjertness
- Faculty of Medicine, Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Trine Holt Edwin
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Knut Engedal
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | | | - Bjørn Heine Strand
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| |
Collapse
|
18
|
Strozza C, Pasqualetti P, Egidi V, Loreti C, Vannetti F, Macchi C, Padua L. Health profiles and socioeconomic characteristics of nonagenarians residing in Mugello, a rural area in Tuscany (Italy). BMC Geriatr 2020; 20:289. [PMID: 32799807 PMCID: PMC7429096 DOI: 10.1186/s12877-020-01689-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 08/03/2020] [Indexed: 01/14/2023] Open
Abstract
Background Health, as defined by the WHO, is a multidimensional concept that includes different aspects. Interest in the health conditions of the oldest-old has increased as a consequence of the phenomenon of population aging. This study investigates whether (1) it is possible to identify health profiles among the oldest-old, taking into account physical, emotional and psychological information about health, and (2) there are demographic and socioeconomic differences among the health profiles. Methods Latent Class Analysis with covariates was applied to the Mugello Study data to identify health profiles among the 504 nonagenarians residing in the Mugello district (Tuscany, Italy) and to evaluate the association between socioeconomic characteristics and the health profiles resulting from the analysis. Results This study highlights four groups labeled according to the posterior probability of determining a certain health characteristic: “healthy”, “physically healthy with cognitive impairment”, “unhealthy”, and “severely unhealthy”. Some demographic and socioeconomic characteristics were found to be associated with the final groups: older nonagenarians are more likely to be in worse health conditions; men are in general healthier than women; more educated individuals are less likely to be in extremely poor health conditions, while the lowest-educated are more likely to be cognitively impaired; and office or intellectual workers are less likely to be in poor health conditions than are farmers. Conclusions Considering multiple dimensions of health to determine health profiles among the oldest-old could help to better evaluate their care needs according to their health status.
Collapse
Affiliation(s)
- Cosmo Strozza
- Interdisciplinary Centre on Population Dynamics, University of Southern Denmark, J.B. Winsløws Vej 9B, 2nd floor, 5000, Odense C, Denmark. .,Department of Statistical Sciences, Sapienza University of Rome, Viale Regina Elena 295, 00161, Rome, Italy.
| | - Patrizio Pasqualetti
- Fatebenefratelli Foundation for Health Research and Education, Via della Lungaretta 177, 00153, Rome, Italy
| | - Viviana Egidi
- Department of Statistical Sciences, Sapienza University of Rome, Viale Regina Elena 295, 00161, Rome, Italy
| | - Claudia Loreti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00136, Rome, Italy
| | - Federica Vannetti
- IRCCS Fondazione Don Carlo Gnocchi, Via di Scandicci 269, 50143, Florence, Italy
| | - Claudio Macchi
- IRCCS Fondazione Don Carlo Gnocchi, Via di Scandicci 269, 50143, Florence, Italy
| | | | - Luca Padua
- Department of Geriatrics, Neurosciences and Orthopaedics, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168, Rome, Italy.,UOC Neuroriabilitazione ad Alta Intensità, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00136, Rome, Italy
| |
Collapse
|
19
|
Kliegel M, Iwarsson S, Wahrendorf M, Minicuci N, Aartsen MJ. The European Journal of Ageing at the beginning of the Decade of Healthy Ageing. Eur J Ageing 2020; 17:1-2. [PMID: 32158367 DOI: 10.1007/s10433-020-00557-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
| | | | - Morten Wahrendorf
- 3Medical Faculty, Department of Medical Sociology, Heinrich-Heine-University, Düsseldorf, Germany
| | | | - Marja J Aartsen
- 5NOVA-Norwegian Social Research, Oslo Metropolitan University, Oslo, Norway
| |
Collapse
|