The effect of retirement on elderly cognitive functioning

Influencing factors, gender differences and the decomposition of inequalities in cognitive function in Chinese older adults: a population-based cohort study

BACKGROUND

Evidence remains limited and inconsistent for assessing cognitive function in Chinese older adults (CFCOA) and inequalities in cognitive function in Chinese older adults (ICFCOA) and exploring their influencing factors and gender differences. This study aimed to identify influencing factors and inequality in CFCOA to empirically explore the existence and sources of gender differences in such inequality and analyse their heterogeneous effects.

METHODS

Based on data from the China Health and Retirement Longitudinal Study (CHARLS) for three periods from 2011 to 2015, recentered influence function unconditional quantile regression (RIF-UQR) and recentered influence function ordinary least squares (RIF-OLS) regression were applied to assess influencing factors of CFCOA, while grouped treatment effect estimation, Oaxaca-Blinder decomposition, and propensity score matching (PSM) methods were conducted to identify gender differences in ICFCOA and influencing factors, respectively.

RESULTS

The results showed heterogeneous effects of gender, age, low BMI, subjective health, smoking, education, social interactions, physical activity, and household registration on CFCOA. Additionally, on average, ICFCOA was about 19.2-36.0% higher among elderly females than among elderly males, mainly due to differences in characteristic effects and coefficient effects of factors such as marital status and education.

CONCLUSIONS

Different factors have heterogeneous and gender-differenced effects on CFCOA and ICFCOA, while the formation and exacerbation of ICFCOA were allied to marital status and education. Considering the severe ageing and the increasing incidence of cognitive decline, there is an urgent need for the government and society to adopt a comprehensive approach to practically work for promoting CFCOA and reducing ICFCOA.

The effect of retirement on health behaviors

This paper analyzes the effect of retirement on health behaviors using three nationally representative U.S. datasets. Findings show a decrease in drinking at the intensive margin, particularly for males. Individuals change their composition of exercise behaviors upon retirement, with varying effects of retirement depending on exercise intensity and gender. Dining patterns also change, with changes in eating out among men and more time spent on food preparation. Finally, although retirement increases time spent watching TV and movies as well as time spent sleeping, it reduces overall sedentary time.

Does (re-)entering the labour market at advanced ages protect against cognitive decline? A matching difference-in-differences approach

BACKGROUND

While prolonged labour market participation becomes increasingly important in ageing societies, evidence on the impacts of entering or exiting work beyond age 65 on cognitive functioning is scarce.

METHODS

We use data from two large population-representative data sets from South Korea and the USA to investigate and compare the effects of the labour market (re-)entry and exit by matching employment and other confounder trajectories prior to the exposure. We chose the Korean Longitudinal Study of Aging (N=1872, 2006-2020) for its exceptionally active labour participation in later life and the Health and Retirement Study (N=4070, 2006-2020) for its growing inequality among US older adults in labour participation. We use the matching difference-in-differences (DID) method, which allows us to make causal claims by reducing biases through matching.

RESULTS

We find general positive effects of entering the labour market in South Korea (DID estimate: 0.653, 95% CI 0.167 to 1.133), while in the USA such benefit is not salient (DID estimate: 0.049, 95% CI -0.262 to 0.431). Exiting the late-life labour market leads to cognitive decline in both South Korea (DID estimate: -0.438, 95% CI -0.770 to -0.088) and the USA (DID estimate: -0.432, 95% CI -0.698 to -0.165).

CONCLUSIONS

Findings suggest that Korean participants cognitively benefited from late-life labour market participation, while US participants did not. Differences in participant characteristics and reasons for labour market participation may have led to the differential findings. We found the negative effects of exiting the late-life labour force in both countries.

The effects of an increase in the retirement age on health care costs: evidence from administrative data

In this paper, we use unique health record data that cover outpatient care and the associated costs to quantify the health care costs of a sizable increase in the retirement age in Germany. For the identification, we exploit a sizable cohort-specific pension reform which abolished an early retirement program for all women born after 1951. Our results show that health care costs significantly increase by about 2.9% in the age group directly affected by the increase in the retirement age (women aged 60-62). We further show that the cost increase is mainly driven by the following specialist groups: Ophthalmologists, general practitioners (GPs), neurology, orthopedics, and radiology. While the effects are significant and meaningful on the individual level, we show that the increase in health care costs is modest relative to the positive fiscal effects of the pension reform. Specifically, we estimate an aggregate increase in the health costs of about 7.7 million euro for women born in 1952 aged 60-62 which amounts to less than 2% of the overall positive fiscal effects of the pension reform.

Retirement age and disability status as pathways to later-life cognitive impairment: Evidence from the Norwegian HUNT Study linked with Norwegian population registers

BACKGROUND

Research shows that retirement age is associated with later-life cognition but has not sufficiently distinguished between retirement pathways. We examined how retirement age was associated with later-life dementia and mild cognitive impairment (MCI) for people who retired via the disability pathway (received a disability pension prior to old-age pension eligibility) and those who retired via the standard pathway.

METHODS

The study sample comprised 7210 participants from the Norwegian Trøndelag Health Study (HUNT4 70+, 2017-2019) who had worked for at least one year in 1967-2019, worked until age 55+, and retired before HUNT4. Dementia and MCI were clinically assessed in HUNT4 70+ when participants were aged 69-85 years. Historical data on participants' retirement age and pathway were retrieved from population registers. We used multinomial regression to assess the dementia/MCI risk for women and men retiring via the disability pathway, or early (<67 years), on-time (age 67, old-age pension eligibility) or late (age 68+) via the standard pathway.

RESULTS

In our study sample, 9.5% had dementia, 35.3% had MCI, and 28.1% retired via the disability pathway. The disability retirement group had an elevated risk of dementia compared to the on-time standard retirement group (relative risk ratio [RRR]: 1.64, 95% CI 1.14-2.37 for women, 1.70, 95% CI 1.17-2.48 for men). MCI risk was lower among men who retired late versus on-time (RRR, 0.76, 95% CI 0.61-0.95).

CONCLUSION

Disability retirees should be monitored more closely, and preventive policies should be considered to minimize the dementia risk observed among this group of retirees.

The impact of self-employment on mental health of the younger elderly in China

BACKGROUND

With the prolongation of the life expectancy of the Chinese population and the intensification of the aging process of the population, the mental health problems of the elderly have become increasingly prominent. This study aims to explore whether self-employment can promote and how to promote the mental health of the elderly.

METHOD

Based on the 2018 China Longitudinal Aging Social Survey (CLASS) data, this paper uses OLS model and KHB method to verify the impact of self-employment on the mental health of the younger elderly and its mechanism.

RESULTS

The results indicate that self-employment can significantly reduce the depression tendency of the younger elderly and promote their mental health. Heterogeneity analysis shows that self-employment has a more significant positive impact on the mental health of the younger elderly who are self-rated healthy, free of chronic diseases and low-level medical service utilization. The mechanism shows that self-employment can indirectly improve the mental health of the younger elderly through income growth effect and self-worth realization effect, in which the self-worth realization effect is greater than the economic effect. It illustrates that with the development of China's economy, the elderly are pursuing more intrinsic values brought by self-employment than economic benefits.

CONCLUSION

In view of the above research results, it is suggested to encourage the elderly to actively participate in social activities, provide policy support for the younger elderly to engage in self-employment, increase government support as well as health guarantee level, and improve the subjective initiative of the elderly to participate in self-employment, so that the society can truly realize the healthy aging of "being useful and productive for the elderly".

Cognitive Performance Deficits Are Associated with Clinically Significant Depression Symptoms in Older US Adults

Accumulating research has described cognitive impairment in adults with depression, however, few studies have focused on this relationship during older adulthood. Our cross-sectional study investigated the association between cognitive function performance and clinically significant depression symptoms in older adults. We analysed the data from the 2011 to 2014 National Health and Nutrition Examination Survey on older (aged 60 years and above) US adults. Cognitive function was assessed as a composite score and on a test-by-test basis based on the Consortium to Establish a Registry for Alzheimer's Disease Word List Learning Test, the Word List Recall Test, and Intrusion Word Count Test, the Animal Fluency Test, and the Digit Symbol Substitution Test (DSST). Depression was defined as clinically significant depression symptoms based on the standard cut-off point of the Patient Health Questionnaire-9 (PHQ-9) score of 10 or greater. Adjusted-logistic regression analysis was employed using survey weights to examine the former relationships. Sociodemographic factors, in addition to medical history and status in terms of self-reported chronic illness and the incidence of stroke or memory-cognitive function loss, were considered as covariates. Among 1622 participants of a survey-weighted 860,400 US older adults, cognitive performance was associated with clinically significant depression symptoms (p = 0.003) after adjustment. Most prominently, older adults with significant cognitive deficits had approximately two and a half times (OR: 2.457 [1.219-4.953]) higher odds for a PHQ-9 score above threshold compared to those with the highest performance. Particularly, those with lowest DSST score had increased odds of almost four times (OR: 3.824 [1.069-13.678]). Efforts to decipher the underlying aetiology of these negative disparities may help create opportunities and interventions that could alleviate the risks from depression, cognitive impairment, and associated consequences in older adults at a population level.

Does retirement (really) increase informal caregiving? Quasi-experimental evidence from Australia

This paper analyzes the impact of retirement on informal care provision using nationally representative panel data from Australia. To establish causality, we exploit the gender and cohort specific eligibility age for the Australian Age Pension. We find no evidence of an impact of retirement (status or duration) on co-residential or extra-residential unpaid care provided by older individuals. The null effect of retirement on informal caregiving does not differ by the type of care recipient. Furthermore, we demonstrate that older people who postpone retirement reduce the amount of time they spend on other non-market activities to resolve the time conflict between unpaid care and extended employment. Our analysis indicates that the Australian Age Pension reform aimed at working career prolongation has not crowded out the supply of informal care.

No "honeymoon phase": whose health benefits from retirement and when

Does retirement lead to a short, transitory health boost, followed by a stable longer-run effect? The short-run effect has been hypothesized to be a kind of honeymoon effect, that is followed by a longer-run effect that may be either positive or negative. We examine the time path of the health effect of retirement and study effect heterogeneities between individuals along several dimensions. Moreover, we study a broad range of health outcomes, all in order to come to an understanding of the effect patterns that lie behind the diverse findings reported in previous research. For identification we use a fixed effects instrumental variable approach in which the normal and early retirement age thresholds serve as instruments. Using data for 10 countries from the Survey of Health, Retirement and Ageing in Europe (SHARE), we find that retiring both at the normal and early retirement eligibility ages significantly improves all the health aspects we consider. Other than hypothesized, results do not show a honeymoon phase-like transitory health boost. Instead, especially blue-collar workers go through an adjustment period after retiring, in which their health worsens. Afterwards, health stabilizes and improves, so that retirement has a health preserving effect in the longer run. This beneficial health effect of retirement occurs across all occupational groups, across a range of health outcomes, and for both sexes, though there are a number of heterogeneities between groups regarding which health outcomes are particularly affected.

Late-career unemployment and cognitive abilities

We study the effect of unemployment on cognitive abilities among individuals aged between 50 and 65 in Europe. To this end, we exploit plant closures and use flexible event-study estimations together with an experimentally elicited measure of fluid intelligence, namely word recall. We find that, within a time period of around eight years after the event of unemployment, cognitive abilities only deteriorate marginally - the effects are insignificant both in statistical and economic terms. We do, however, find significant effects of late-career unemployment on the likelihood to leave the labor force, and short-term effects on mental health problems such as depression and sleep problems.

Busyness, mental engagement, and stress: Relationships to neurocognitive aging and behavior

Considerable research identifies benefits of sustaining mental engagement in older adulthood. Frequent social, mental, and physical activities (e.g., exercise) and lifestyle factors that bolster cognitive reserve (i.e., education, occupation complexity) have been associated with cognitive benefits and delayed onset of dementia. Nevertheless, the relationship between general daily levels of busyness and cognition has been relatively understudied. Open questions remain about whether a causal link exists between a busy lifestyle and mental prowess, the relationship between busyness and stress, and methodological approaches to measure and track busyness levels. Here, the existing evidence is considered, along with future directions for research aimed at characterizing the effects of a busy lifestyle on neurocognitive aging and behavior.

Retirement, social support and mental well-being: a couple-level analysis

Social support is increasingly acknowledged as an important resource for promoting well-being. We test whether social support changes around retirement. We also examine whether social support moderates dynamics in mental well-being around retirement and consider both own and spouse's retirement drawing on a unique longitudinal, couple-level data set from Australia. We observe descriptively no effect of own or spouse's retirement on social support. However, those with high social support do experience a small but statistically significant improvement in mental well-being post retirement. Using pension eligibility as an instrument, we find that own retirement causally improves mental well-being for women and by a similar degree for those with low/high social support. We also estimate responses to life satisfaction and find evidence that spill-over benefits from spousal retirement are larger for individuals with low social support.

Subjective hearing handicap is associated with processing speed and visuospatial performance in older adults without severe hearing handicap

OBJECTIVE

Age-related hearing loss is a common disorder with significant consequences for quality of life. This study assessed the Hearing Handicap Inventory for the Elderly (HHIE) and cognition (Mini Mental State Exam; MMSE, Logical Memory; LM, Symbol Search; SS, Stroop Test; ST, and Mental Rotation; MR) to investigate which cognitive domains are most strongly involved with hearing self-assessment in older adults.

METHODS

The HHIE and cognitive measures were administered to 196 older adults (average age = 67.7 ± 4.3 years, male 56, female 140) without cognitive impairment and without severe hearing handicap. We conducted permutation tests of multiple regression analysis of the standardized scores on the HHIE and cognitive tests.

RESULTS

HHIE showed a significant negative correlation between processing speed performance on the SS (standardized β = -0.095, adjusted p = 0.04) and visuospatial performance on the MR (standardized β = -0.145, adjusted p = 0.04), and no correlation between the scores of the HHIE and either episodic memory performance on the LM (standardized β = 0.060, adjusted p = 0.22) or executive function performance on the ST (standardized β = 0.053, adjusted p = 0.32).

CONCLUSION

People reporting higher hearing handicaps should watch for poor cognitive function in processing speed and visuospatial abilities. These results imply that higher HHIE can have adverse effects on age-related cognitive decline.

Does retirement reduce familiarity with Information and Communication Technology?

This paper analyses the effect of retirement on the familiarity with Information and Communication Technology (ICT) of older individuals. We argue that inability to cope with ICT might represent a threat for older individuals' social inclusion. To account for the potential endogeneity of retirement with respect to familiarity with ICT, we instrument retirement decision with the age-eligibility for early and statutory retirement pension schemes. Using data from the Survey of Health, Ageing and Retirement in Europe, we show that retirement reduces the computer literacy and the frequency of internet utilization for men and women. This finding is robust to the inclusion as control factors of health, cognition and social network indicators, which the literature has shown to be affected by retirement. Overall, the reduction in the familiarity with ICT after retirement tends to be stronger in the long-run.

Cross-national Differences in the Association Between Retirement and Memory Decline

OBJECTIVE

Retirement is a potential trigger for cognitive aging as it may be a stressful life event accompanied by changes in everyday activities. However, the consequences of retirement may differ across institutional contexts which shape retirement options. Comparing memory trajectories before and after retirement in 17 European countries, this study aims to identify cross-national differences in the association between retirement and memory decline.

METHOD

Respondents to the longitudinal Survey of Health, Aging, and Retirement in Europe (SHARE; N = 8,646) aged 50+ who were in paid work at baseline and retired during the observation period completed up to 6 memory assessments (immediate and delayed word recall) over 13 years. Three-level (time points, individuals, and countries) linear mixed models with country-level random slopes for retirement were estimated to evaluate whether memory decline accelerated after retirement and if this association differed between countries.

RESULTS

On average, retirement was associated with a moderate decrement in word recall (b = -0.273, 95% CI -0.441, -0.104) and memory decline accelerated after retirement (b = -0.044, 95% CI -0.070, -0.018). Significant between-country heterogeneity in memory decline after retirement existed (variance = 0.047, 95% CI (0.013, 0.168). Memory decline after retirement was more rapid in Italy, Greece, Czech Republic, Poland, Portugal, and Estonia compared to Northern and Central European countries.

DISCUSSION

Memory decline postretirement was faster in Mediterranean and eastern European countries, which are characterized by less generous welfare systems with comparatively low pension benefits. Evaluation of resources that could protect retirees from memory decline would be valuable.

Effect of retirement on cognitive function: a systematic review and meta-analysis

The study aimed to determine the longitudinal association between retirement and cognitive function, including global cognition and memory-related skills. This is a systematic review of longitudinal studies on the association between retirement and cognitive function, using Medline (via PubMed), Scopus, Web of Science and PsycINFO databases from inception to April 2020 and longitudinal studies on the association between retirement and cognitive function. The Newcastle-Ottawa Scale was used to assess risk of bias of included studies. Effect size (ES) and 95% CI were calculated using Cohen's d index. Meta-regressions were calculated on the basis of sample characteristics: percentage of women, years of follow-up and age at baseline. A total of 23 longitudinal studies were included in this systematic review. The pooled ES for the association of retirement with global cognition and memory-related skills was -0.01 (95% CI -0.02 to 0.00; I²: 0.0%) and -0.09 (95% CI -0.16 to 0.01; I²: 93%), respectively. Meta-regression analyses showed that length of follow-up, percentage of women in the sample and mean age at baseline did not influence the longitudinal association between retirement and adults' memory-related skills. The results of this study indicate that retirement has no negative effects on adults' global cognition and slightly adversely influences memory-related skills. Moreover, this association does not seem to be influenced by some demographic and study characteristics.