Recursos económicos y calidad de vida en la población mayor

Active ageing profiles among older adults in Spain: A Multivariate analysis based on SHARE study

Background

Following the active ageing model based on the Health, Lifelong Learning, Participation and Security pillars, this research has a twofold objective: i) to classify older adults according to active ageing profiles, taking into account the four pillars, and ii) to ascertain the relationship between the profiles and personal and contextual factors, as well as well-being and quality of life in old age.

Methods

A study sample of 5,566 Spanish older adults who participated in wave 6 of the Survey of Health, Ageing and Retirement in Europe (SHARE) was included. Data were analysed in different steps applying several statistical analyses (Principal Component, Cluster, Discriminant, Multiple Correspondence and bivariate analysis with Pearson chi-square and ANOVA).

Results

Five older adult profiles were obtained (I: with moderate activity; II: quasi-dependents; III: with active ageing-limiting conditions; IV: with diverse and balanced activity; V: with excellent active ageing conditions). The first three profiles were characterised by subjects with a high average age, low educational level, who were retired or housewives, and who perceived a moderate level of loneliness, satisfaction with the social network and quality of life, as well as having a larger family network, but living in small households or alone. In contrast, the latter two profiles showed better personal and contextual conditions, well-being and quality of life.

Discussion and conclusions

The multidimensional approach to active ageing followed in this article has revealed the presence of several older adult profiles, which are confined to groups with better or worse active ageing conditions. In this context, if ageing is a process that reflects the previous way of life, intervention priorities will have to consider actions that promote better conditions during the life cycle.

[Socioeconomic inequalities in health among the elderly population in Spain]

OBJECTIVE

To examine socioeconomic inequalities in health in the older population in Spain.

METHOD

A systematic search and review of the literature published between 2000 and 2017 in English and Spanish was conducted in Social Science Citation Index, Sociology Database, Scopus, PubMed and Embase. Primary and secondary studies analysing these inequalities in Spain were included. Two researchers were responsible for the selection of the studies and the extraction of the information (first author, year of publication, region, design, population/sample, socioeconomic and health indicators used, and main results).

RESULTS

A total of 89 articles were included, corresponding to 87 studies. Of the studies, 81.6% were cross-sectional, 88.5% included only non-institutionalised population and 35.6% were carried out at a national level. The studies analysed social inequalities in the following health indicators: functional status (n=29), morbidity (n=19), self-perceived health (n=18), mental and emotional health (n=10), cognitive status (n=7), quality of life (n=9), mortality (n=15) and life expectancy (n=2). Socioeconomic inequalities were detected in all of them, although the magnitude varied depending on the socioeconomic and health indicator used. The educational level and the ecological indexes were the indicators that detected more inequalities in health. The impact of inequalities by sex was different in functional status, morbidity, self-perceived health, mental and emotional health and mortality.

CONCLUSION

There are socioeconomic inequalities in health among the elderly population and their magnitude varies by sex in some of the health indicators. The increase in educational level and the maintenance of sufficient pensions can be key policies that contribute to the reduction of inequalities in this population group.

[Social inequalities in health among the elderly population: review of indicators used in Spain]

OBJECTIVE

To identify the indicators of social position used to evaluate inequalities in health among the population aged 65 and over in Spain.

METHOD

A systematic search of the literature published in English and Spanish since 2000 in health and social databases was carried out. Primary and secondary studies analyzing these inequalities in Spain were included. The indicators used were identified, as well as the advantages and limitations pointed out by the authors. The main findings were synthesized in a review of the literature.

RESULTS

We included 87 studies, described in 89 articles. The socioeconomic indicators employed were both individual and ecological. Among the former, educational level was the most analyzed socioeconomic variable (n=73). Other individual variables used were occupation (n=17), objective economic level (n=16), subjective economic level (n=4), housing and household material wealth (n=6), relationship with work activity (n=5), and mixed measures (n=5). Among the ecological indicators, simple (n=3) and complex indices (n=7) were identified. The latter had been constructed based on several indicators, such as educational level and unemployment. Inequalities in multiple health indicators were analyzed, self-perceived health being the only indicator assessed according to all the socioeconomic indicators described.

CONCLUSIONS

A wide variety of indicators is identified for the evaluation of social inequalities in health among the elderly population. There have not been sufficiently assessed from a gender perspective; this is a line of interest for future research.

[Health inequalities in self-perceived health among older adults in Spain]

OBJECTIVE

Recent publications have concluded that there are social health inequalities in people older than 65 years in Spain, especially among women and people with low socioeconomic status. Self-perceived health is an indicator that is related to the possibility of chronic disease, the use of health services, and mortality. The aim of this study was to assess inequalities in self-perceived health in relation to age, gender, socioeconomic factors, and functional dependence.

METHODS

A systematic review was conducted following the PRISMA criteria. An exhaustive search was performed in PubMed, WOK, Science Direct, EMBASE, IME, Cochrane, JSTOR, Ovid, Proquest, the BMJ Group and in Spanish doctoral theses up to April 2013. The quality of the studies was assessed by two independent editors through the Berra Tool.

RESULTS

A total of 20 documents were selected. These studies were in agreement in the deterioration of self-perceived health among older people (except the oldest), in those with functional dependence, lower socioeconomic status, and in women.

CONCLUSIONS

This review shows that, among older people, inequalities in self-perceived health due to socioeconomic status and gender have persisted in time. Future research is needed to cast light on the factors determining the persistence of these inequalities among older people, so that specific health policies can be designed for this sector of the population.