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Cecchini V, Agahi N. Does losing family members in midlife matter for late-life mental and cognitive health? A longitudinal study of older Swedes spanning 30 years. Aging Ment Health 2024:1-9. [PMID: 38644675 DOI: 10.1080/13607863.2024.2341877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 04/05/2024] [Indexed: 04/23/2024]
Abstract
OBJECTIVES Mental and cognitive health is crucial to ensure well-being in older age. However, prolonged periods of stress, grief, and bereavement might compromise mental health balance, leading to profound changes. This study investigated the sex-stratified associations between midlife bereavement experiences (e.g. sibling loss, spousal loss, and multiple losses) and late-life depression (LLD) and cognitive impairment. METHOD Linked data from the Swedish Level-of-Living Survey and the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) were used. Multiple logistic regressions were performed to examine the associations between midlife bereavement and LLD (n = 1078) and cognitive impairment (n = 995), separately. RESULTS Sibling loss and multiple losses in midlife were associated with lower odds of LLD, especially among women. Among men, sibling loss in midlife was associated with lower odds of cognitive impairment, while the experience of two losses among women suggested an increased (but non-significant) risk of cognitive impairment. Interaction analyses did not show significant effects between bereavement and gender on LLD and cognitive impairment. CONCLUSION Midlife bereavement might have gendered implications on LLD and cognitive impairment, but associations need to be confirmed by well-powered studies. Further research is warranted to elucidate the association between multiple midlife losses and reduced LLD risk.
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Affiliation(s)
- Valeria Cecchini
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Neda Agahi
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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2
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Ekezie PE, Eriksson U, Shaw BA, Agahi N, Nilsen C. Is the mental health of older adults receiving care from their children related to their children's dual burden of caregiving and work stress? A linked lives perspective. Aging Ment Health 2023; 27:1796-1802. [PMID: 36137944 DOI: 10.1080/13607863.2022.2126820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 09/16/2022] [Indexed: 11/01/2022]
Abstract
OBJECTIVES Mental health problems are a major concern in the older population in Sweden, as is the growing number of older adults aging alone in their homes and in need of informal care. Using a linked lives perspective, this study explored if older parents' mental health is related to their children's dual burden of informal caregiving and job strain. METHODS Data from a nationally representative Swedish survey, SWEOLD, were used. Mental health problems in older age (mean age 88) were measured with self-reported 'mild' or 'severe' anxiety and depressive symptoms. A primary caregiving adult child was linked to each older parent, and this child's occupation was matched with a job exposure matrix to assess job strain. Logistic regression analyses were conducted with an analytic sample of 334. RESULTS After adjusting for covariates, caregiving children's lower job control and greater job strain were each associated with mental health problems in their older parents (OR 2.52, p = 0.008 and OR 2.56, p = 0.044, respectively). No association was found between caregiving children's job demands and their older parents' mental health (OR 1.08, p = 0.799). CONCLUSION In line with the linked lives perspective, results highlight that the work-life balance of informal caregiving adult children may play a role in their older parent's mental health.
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Affiliation(s)
- Promise E Ekezie
- Institute of Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Ulrika Eriksson
- Institute of Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Benjamin A Shaw
- Division of Community Health Sciences, University of Illinois Chicago School of Public Health, Chicago, IL, USA
| | - Neda Agahi
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Charlotta Nilsen
- Institute of Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stress Research Institute, Stockholm University, Stockholm, Sweden
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Augustsson E, Von Saenger I, Agahi N, Kåreholt I, Ericsson M. Impact of the COVID-19 pandemic on Swedish adults aged 77 years and older: Age differences in lifestyle changes. Scand J Public Health 2023:14034948231172249. [PMID: 37151122 PMCID: PMC10170261 DOI: 10.1177/14034948231172249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
AIMS This study aimed to describe the impact of the COVID-19 pandemic on lifestyle and social activities among older adults in Sweden, with a special focus on differences between the 'younger old' (aged 77-84) and 'older old' (aged 85-109). METHODS This study is based on a nationally representative sample of older adults (aged ⩾77 years) in Sweden (SWEOLD). Data were collected between May 2021 and April 2022, when many recommendations were removed but the virus was still classified as a public health disease. We studied occurrences and differences between the two age groups in several lifestyle factors and social activities. RESULTS The younger old displayed larger changes in lifestyles because of the pandemic than the older old. Most changes were found in social interactions with family. CONCLUSIONS
Our results highlight the large heterogeneity within the Swedish population aged ⩾77 years, and that the younger old experienced a bigger lifestyle change than the older old. Previous activity levels might be important to consider in order to understand how regulations may affect the older population. Finally, our findings indicate large age differences in Internet use, which require attention to prevent digital exclusion of an already vulnerable group.
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Affiliation(s)
- Erika Augustsson
- Aging Research Center, Karolinska Institute and Stockholm University, Sweden
| | | | - Neda Agahi
- Aging Research Center, Karolinska Institute and Stockholm University, Sweden
| | - Ingemar Kåreholt
- Aging Research Center, Karolinska Institute and Stockholm University, Sweden
- Aging Research Network, Jönköping University, Sweden
| | - Malin Ericsson
- Aging Research Center, Karolinska Institute and Stockholm University, Sweden
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Eyjólfsdóttir HS, Agahi N, Fritzell J, Lennartsson C. Physical functioning as a predictor of retirement: Has its importance changed over a thirty-year period in Sweden? Eur J Ageing 2022; 19:1417-1428. [PMID: 36692770 PMCID: PMC9729518 DOI: 10.1007/s10433-022-00725-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2022] [Indexed: 01/26/2023] Open
Abstract
Many countries, including Sweden, are implementing policies aimed at delaying retirement and encouraging older workers to remain on the labour market for longer. During recent decades, there have been several major reforms to the pension and social security systems in Sweden. Moreover, the nature of occupations has shifted towards more non-manual and sedentary activities, older women are today almost as active in the labour market as men in Sweden, and physical functioning has improved over time. In this study, we investigate whether the importance of physical functioning as a predictor for retirement has changed over time, for women and men, respectively. We used four waves of nationally representative data from The Swedish Level of Living Survey from 1981, 1991, 2000, and 2010, together with income register data. We found that greater severity of musculoskeletal pain and mobility limitations increased the likelihood of retirement in all waves. Results from logistic regression models with average marginal effects and predictive margins showed that there is a trend towards physical functioning becoming less important for retirement towards the end of the study period, especially for women, when controlling for occupational-based social class, age, adverse physical working conditions, and job demands. People, especially women, reporting impaired physical functioning did not retire to the same extent as in previous decades. This indicates that people stayed longer in the labour market despite impaired physical functioning, which may have repercussions on well-being and quality of life.
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Affiliation(s)
- Harpa S. Eyjólfsdóttir
- Aging Research Center, Karolinska Institutet and Stockholm University, Tomtebodavägen 18 A, 171 65 Solna, Sweden
| | - Neda Agahi
- Aging Research Center, Karolinska Institutet and Stockholm University, Tomtebodavägen 18 A, 171 65 Solna, Sweden
| | - Johan Fritzell
- Aging Research Center, Karolinska Institutet and Stockholm University, Tomtebodavägen 18 A, 171 65 Solna, Sweden
| | - Carin Lennartsson
- Aging Research Center, Karolinska Institutet and Stockholm University, Tomtebodavägen 18 A, 171 65 Solna, Sweden ,Swedish Institute for Social Research, Stockholm University, Stockholm, Sweden
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5
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Baumann I, Cabib I, Eyjólfsdóttir HS, Agahi N. Part-time work and health in late careers: Evidence from a longitudinal and cross-national study. SSM Popul Health 2022; 18:101091. [PMID: 35493408 PMCID: PMC9046889 DOI: 10.1016/j.ssmph.2022.101091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/09/2022] [Accepted: 03/31/2022] [Indexed: 11/29/2022] Open
Abstract
In this exploratory study, we examine how older workers' part-time employment and health are associated in four countries promoting this type of employment in late careers but with a different welfare regime: the United States, Germany, Sweden, and Italy. Using data from two large representative panel surveys and conducting multichannel sequence analysis, we identified the most typical interlocked employment and health trajectories for each welfare regime and for three different age groups of women and men. We found that there is more heterogeneity in these trajectories in countries with a liberal welfare regime and among older age groups. Overall, women are more strongly represented in the part-time employment trajectories associated with lower health levels. In countries with a social-democratic or corporatist welfare regime, part-time employment in late careers tends to be associated with good health. Our findings suggest that the combination of a statutory right to work part-time in late careers with a more generous welfare regimes, may simultaneously maintain workers’ health and motivate them to remain active in the labor force. We explore older people’ part-time work and health trajectories in four countries. Trajectories are more heterogeneous in liberal countries and among older groups. Women are overrepresented in part-time employment and poor health trajectories. In social-democratic countries part-time employment tends to go along with good health. Policies that allow part-time employment in late careers may be positive for health.
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Affiliation(s)
- Isabel Baumann
- Institute of Public Health, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Switzerland
- Centre for the Interdisciplinary Study of Gerontology and Vulnerability (CIGEV), University of Geneva, Switzerland
- National Centre of Competence in Research “Overcoming Vulnerability: Life Course Perspectives” (NCCR LIVES), University of Geneva, Switzerland
| | - Ignacio Cabib
- Instituto de Sociología & Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Chile
- Centro UC Estudios de Vejez y Envejecimiento, Pontificia Universidad Católica de Chile, Chile
- Corresponding author. Avenida Vicuna Mackenna, 4860, Casilla 306, Correo 22, Macul, Santiago, Chile.
| | - Harpa S. Eyjólfsdóttir
- Aging Research Center, Karolinska Institutet and Stockholm University, Tomtebodavägen 18 A, 171 65, Solna, Sweden
| | - Neda Agahi
- Aging Research Center, Karolinska Institutet and Stockholm University, Tomtebodavägen 18 A, 171 65, Solna, Sweden
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Sundberg L, Agahi N, Wastesson JW, Fritzell J, Fors S. Increasing inequalities in disability-free life expectancy among older adults in Sweden 2002-2014. Scand J Public Health 2021:14034948211062309. [PMID: 34965792 DOI: 10.1177/14034948211062309] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND In an aging society with increasing old age life expectancy, it has become increasingly important to monitor the health development in the population. This paper combines information on mortality and disability and explores educational inequalities in disability-free life expectancy in the aging population in Sweden, and to what extent these inequalities have increased or decreased over time. METHODS A random sample of the Swedish population aged 77 years and above (n=2895) provided information about disability in the population in the years 2002, 2004, 2011 and 2014. The prevalence of disability was assessed by five items of personal activities of daily living and incorporated in period life tables for the corresponding years, using the Sullivan method. The analyses were stratified by sex and educational attainment. Estimates at ages 77 and 85 years are presented. RESULTS Disability-free life expectancy at age 77 years increased more than total life expectancy for all except men with lower education. Women with higher education had a 2.7-year increase and women with lower education a 1.6-year increase. The corresponding numbers for men were 2.0 and 0.8 years. The educational gap in disability-free life expectancy increased by 1.2 years at age 77 years for both men and women. CONCLUSIONS While most of the increase in life expectancy was years free from disability, men with lower education had an increase of years with disability. The educational differences prevailed and increased over the period as the gains in disability-free life expectancy were smaller among those with lower education.
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Affiliation(s)
- Louise Sundberg
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Neda Agahi
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Jonas W Wastesson
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Johan Fritzell
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Stefan Fors
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden
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Agahi N, Morin L, Virtanen M, Pentti J, Fritzell J, Vahtera J, Stenholm S. Heavy alcohol consumption before and after negative life events in late mid-life: longitudinal latent trajectory analyses. J Epidemiol Community Health 2021; 76:360-366. [PMID: 34556543 PMCID: PMC8921586 DOI: 10.1136/jech-2021-217204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 09/08/2021] [Indexed: 11/04/2022]
Abstract
Background People who experience negative life events report more heavy alcohol consumption compared with people without these experiences, but little is known about patterns of change within this group. This study aims to identify trajectories of heavy alcohol consumption before and after experiencing either divorce, or severe illness or death in the family. Furthermore, the aim is to examine characteristics of individuals belonging to each trajectory. Methods Longitudinal study of public sector employees from the Finnish Retirement and Aging Study with up to 5 years of annual follow-ups (n=6783; eligible sample n=1393). Divorce and severe illness or death in the family represented negative life events. Heavy alcohol consumption was categorised as >14 units/week. Results Based on latent trajectory analysis, three trajectories of heavy drinking were identified both for divorce and for severe illness or death in the family: ‘No heavy drinking’ (82% illness/death, 75% divorce), ‘Constant heavy drinking’ (10% illness/death, 13% divorce) and ‘Decreasing heavy drinking’ (7% illness/death, 12% divorce). Constant heavy drinkers surrounding illness or death in the family were more likely to be men, report depression and anxiety and to smoke than those with no heavy drinking. Constant heavy drinkers surrounding divorce were also more likely to be men and to report depression compared with those with no heavy drinking. Conclusions Most older workers who experience divorce or severe illness or death in the family have stable drinking patterns regarding heavy alcohol consumption, that is, most do not initiate or stop heavy drinking.
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Affiliation(s)
- Neda Agahi
- Aging Research Center, Karolinska Institute/Stockholm University, Solna, Sweden
| | - Lucas Morin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Solna, Sweden.,Inserm CIC 1431, University Hospital of Besançon, Besançon, France
| | - Marianna Virtanen
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland.,Division of Insurance Medicine, Karolinska Institute, Solna, Sweden
| | - Jaana Pentti
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Johan Fritzell
- Aging Research Center, Karolinska Institute/Stockholm University, Solna, Sweden
| | - Jussi Vahtera
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Sari Stenholm
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
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8
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Tigerstedt C, Agahi N, K Bye E, Ekholm O, Härkönen J, Jensen HR, Lau CJ, Makela P, Moan IS, Parikka S, Raninen J, Vilkko A, Bloomfield K. Comparing older people’s drinking habits in four Nordic countries: Summary of the thematic issue. Nordic Studies on Alcohol and Drugs 2020; 37:434-443. [PMID: 35310771 PMCID: PMC8899063 DOI: 10.1177/1455072520954326] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 07/27/2020] [Indexed: 11/17/2022] Open
Abstract
Aim: The present article summarises status and trends in the 21st
century in older people’s (60–79 years) drinking behaviour in
Denmark, Finland, Norway and Sweden and concludes this thematic
issue. Each country provided a detailed report analysing four
indicators of alcohol use: the prevalence of alcohol consumers,
the prevalence of frequent use, typical amounts of use, and the
prevalence of heavy episodic drinking (HED). The specific aim of
this article is to compare the results of the country
reports. Findings: Older people’s drinking became more common first in Denmark in the
1970s and then in the other countries by the 1980s. Since 2000
the picture is mixed. Denmark showed decreases in drinking
frequency, typically consumed amounts and HED, while in Sweden
upward trends were dominant regarding prevalence of consumers
and frequency of drinking as well as HED. Finland and Norway
displayed both stable indicators except for drinking frequency
and proportion of women consumers where trends increased. In all
four countries, the gender gap diminished with regard to
prevalence and frequency of drinking, but remained stable in
regard to consuming large amounts. In Norway the share of
alcohol consumers among women aged 60–69 years exceeded the
share among men. During the late 2010s, Denmark had the highest
prevalence of alcohol consumers as well as the highest
proportion drinking at a higher frequency. Next in ranking was
Finland, followed by Sweden and Norway. This overall rank
ordering was observed for both men and women. Conclusion: As the populations aged 60 years and older in the Nordic countries
continue to grow, explanations for the drivers and consequences
of changes in older people’s drinking will become an
increasingly relevant topic for future research. Importantly,
people aged 80 years and older should also be included as an
integral part of that research.
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Affiliation(s)
| | - Neda Agahi
- Karolinska Institutet, Stockholm, Sweden
| | - Elin K Bye
- Norwegian Institute of Public Health, Oslo, Norway
| | - Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Janne Härkönen
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Heidi Rosendahl Jensen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Cathrine Juel Lau
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Denmark
| | - Pia Makela
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Suvi Parikka
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jonas Raninen
- Swedish council for information on alcohol and other drugs, Stockholm, Sweden
| | | | - Kim Bloomfield
- Centre for Alcohol and Drug Research, Aarhus University, Denmark
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Raninen J, Agahi N. Trends in older people’s drinking habits, Sweden 2004–2017. Nordic Studies on Alcohol and Drugs 2020; 37:459-469. [PMID: 35310773 PMCID: PMC8899064 DOI: 10.1177/1455072520954336] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 07/27/2020] [Indexed: 12/26/2022] Open
Abstract
Aims: To examine if and how the drinking habits of older people aged 60–79 years in
Sweden have changed during 2004–2017, with a specific focus on age groups
and gender. Data and measures: A Swedish, nationally representative, repeated cross-sectional telephone
survey covering the years 2004–2017 (n = 225,134) was used.
Four aspects of alcohol consumption were investigated: proportion of alcohol
consumers, frequency of drinking, amount per drinking occasion, and
prevalence of heavy episodic drinking. Results: Three of the four measures investigated showed increases in alcohol
consumption in the older age groups, particularly among women. Proportion of
alcohol consumers, frequency of drinking and prevalence of heavy episodic
drinking during the past month increased in most older age groups among both
women and men, while the average amount per drinking occasion remained
stable. Thus, total consumption in older age groups has increased over time,
since the proportion of drinkers and the frequency of drinking has
increased. Increases were particularly marked among women and in the age
groups 70–74 and 75–79 years. In age groups below 60 years, these measures
showed either declines or stability. Conclusions: There has been a steady increase in alcohol consumption across all the older
age groups studied, which implies that the changing drinking habits are not
isolated only to certain birth cohorts. Instead there seems to be a
continuous shift in older people’s drinking habits which can be expected to
continue. However, these increases are from very low levels, and older
people’s drinking is still at modest levels. Public health implications must
be studied further.
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Affiliation(s)
- Jonas Raninen
- CAN (Swedish Council for Information on Alcohol and Other Drugs), Stockholm, Sweden; Karolinska Institutet, Stockholm, Sweden; School of Social Sciences, Unit of Social Work, Södertörn University, Huddinge, Sweden; and Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Neda Agahi
- Karolinska Institutet, Stockholm, Sweden
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Abstract
Objectives: This study investigates the association between living alone and mortality over a recent 19-year period (1992-2011). Method: Data from a repeated cross-sectional, nationally representative (Sweden) study of adults ages 77 and older are analyzed in relation to 3-year mortality. Results: Findings suggest that the mortality risk associated with living alone during old age increased between 1992 and 2011 (p = .076). A small increase in the mean age of those living alone is partly responsible for the strengthening over time of this association. Throughout this time period, older adults living alone consistently reported poorer mobility and psychological health, less financial security, fewer social contacts, and more loneliness than older adults living with others. Discussion: Older adults living alone are more vulnerable than those living with others, and their mortality risk has increased. They may have unique service needs that should be considered in policies aiming to support aging in place.
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Affiliation(s)
- Benjamin A Shaw
- University at Albany (State University of New York), Rensselaer, NY, USA
| | - Lena Dahlberg
- Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Dalarna University, Falun, Sweden
| | - Charlotta Nilsen
- Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Neda Agahi
- Karolinska Institutet and Stockholm University, Stockholm, Sweden
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11
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Nilsen C, Andel R, Agahi N, Fritzell J, Kåreholt I. Association between psychosocial working conditions in mid-life and leisure activity in old age. Scand J Public Health 2020; 49:168-175. [DOI: 10.1177/1403494820901404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims: Leisure activity helps people engage with life, and it promotes health and well-being as we age. This study investigated whether individuals with active jobs (high psychological demands, high control) in mid-life were more active during leisure time in old age compared with those with less active jobs. Methods: Two individually linked Swedish surveys were used ( N=776) with 23 years of follow-up. Data were analysed with logistic regression. Results: Having an active job in mid-life was associated with greater engagement in intellectual/cultural, social and physical activity in old age, even when leisure activity in mid-life was taken into account. Conclusions: The results suggest that active jobs in mid-life may be replaced by active leisure during retirement. Active job conditions may promote engagement in society in old age, which in turn may have positive health consequences.
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Affiliation(s)
- Charlotta Nilsen
- Aging Research Center, Karolinska Institutet/Stockholm University, Sweden
| | - Ross Andel
- School of Aging Studies, University of South Florida, USA
- International Clinical Research Center, St. Anne’s University Hospital, Czech Republic
- Department of Neurology, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Czech Republic
| | - Neda Agahi
- Aging Research Center, Karolinska Institutet/Stockholm University, Sweden
| | - Johan Fritzell
- Aging Research Center, Karolinska Institutet/Stockholm University, Sweden
| | - Ingemar Kåreholt
- Aging Research Center, Karolinska Institutet/Stockholm University, Sweden
- Institute of Gerontology, School of Health and Welfare, Aging Research Network – Jönköping (ARN-J), Jönköping University, Sweden
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12
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Eyjólfsdóttir HS, Baumann I, Agahi N, Lennartsson C. Correction to: How to Measure Retirement Age? A Comparison of Survey and Register Data. Population Ageing 2020. [DOI: 10.1007/s12062-020-09269-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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13
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Agahi N, Fors S, Fritzell J, Shaw BA. Smoking and Physical Inactivity as Predictors of Mobility Impairment During Late Life: Exploring Differential Vulnerability Across Education Level in Sweden. J Gerontol B Psychol Sci Soc Sci 2019; 73:675-683. [PMID: 27449220 DOI: 10.1093/geronb/gbw090] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 07/05/2016] [Indexed: 11/13/2022] Open
Abstract
Objectives To test whether older adults from high and low educational groups are differentially vulnerable to the impact of smoking and physical inactivity on the progression of mobility impairment during old age. Methods A nationally representative sample of older Swedish adults (n = 1,311), aged 57-76 years at baseline (1991), were followed for up to 23 years (2014). Multilevel regression was used to estimate individual trajectories of mobility impairment over the study period and to test for differences in the progression of mobility impairment on the basis of smoking status, physical activity status, and level of education. Results Compared to nonsmokers, heavy smokers had higher levels and steeper increases in mobility impairment with advancing age. However, there were only small and statistically nonsignificant differences in the impact of heavy smoking on mobility impairment in high versus low education groups. A similar pattern of results was found for physical inactivity. Discussion Differential vulnerability to unhealthy behaviors may vary across populations, age, time-periods, and health outcomes. In this study of older adults in Sweden, low and high education groups did not differ significantly in their associations between heavy smoking or physical inactivity, and the progression of mobility impairment.
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Affiliation(s)
- Neda Agahi
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Sweden
| | - Stefan Fors
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Sweden
| | - Johan Fritzell
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Sweden
| | - Benjamin A Shaw
- Department of Health Policy, Management, and Behavior, School of Public Health, University at Albany, Rensselaer, New York
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Eyjólfsdóttir HS, Baumann I, Agahi N, Fritzell J, Lennartsson C. Prolongation of working life and its effect on mortality and health in older adults: Propensity score matching. Soc Sci Med 2019; 226:77-86. [PMID: 30849673 DOI: 10.1016/j.socscimed.2019.02.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 01/17/2019] [Accepted: 02/16/2019] [Indexed: 11/28/2022]
Abstract
Many countries are raising the age of pension eligibility because of increases in life expectancy. Given the social gradient in life expectancy and health, it is important to understand the potential late-life health effects of prolonging working life and whether any effects differ by socioeconomic position. We examined the effect of prolonging working life beyond age 65 on mortality and a series of indicators of late-life physical health (the ability to climb stairs without difficulty, self-rated health, ADL limitations, and musculoskeletal pain) in a representative sample of the Swedish population. In addition to average effects, we also examined heterogeneous effects, for instance by occupational social class. To do this, we use propensity score matching, a method suitable for addressing causality in observational data. The data came from two linked Swedish longitudinal surveys based on nationally representative samples with repeated follow-ups; The Swedish Level of Living Survey and the Swedish Panel Study of Living conditions of the Oldest Old, and from national income and mortality registries. The analytical sample for the mortality outcome included 1852 people, and for late-life physical health outcomes 1461 people. We found no significant average treatment effect on the treated (ATT) of working to age 66 or above on the outcomes, measured an average of 12 years after retirement: mortality (ATT -0.039), the ability to climb stairs (ATT -0.023), self-rated health (ATT -0.009), ADL limitations (ATT -0.023), or musculoskeletal pain (ATT -0.009) in late life. Analyses of whether the results varied by occupational social class or the propensity to prolong working life were inconclusive but suggest a positive effect of prolonging working life on health outcomes. Accordingly, more detailed knowledge about the precise mechanisms underlying these results are needed. In conclusion, working to age 66 or above did not have effect on mortality or late-life physical health.
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Affiliation(s)
- H S Eyjólfsdóttir
- Aging Research Center, Karolinska Institutet and Stockholm University, Sweden.
| | - I Baumann
- Center for Health Sciences, Zurich University of Applied Sciences, Switzerland; National Center of Competence in Research "Overcoming Vulnerability: Life Course Perspectives", Switzerland
| | - N Agahi
- Aging Research Center, Karolinska Institutet and Stockholm University, Sweden
| | - J Fritzell
- Aging Research Center, Karolinska Institutet and Stockholm University, Sweden
| | - C Lennartsson
- Aging Research Center, Karolinska Institutet and Stockholm University, Sweden
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15
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Agahi N, Dahlberg L, Lennartsson C. Social integration and alcohol consumption among older people: A four-year follow-up of a Swedish national sample. Drug Alcohol Depend 2019; 196:40-45. [PMID: 30660938 DOI: 10.1016/j.drugalcdep.2018.12.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 12/13/2018] [Accepted: 12/18/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Today's older people drink more alcohol than earlier cohorts of older people. Social integration has been identified as an important factor for older people's drinking, but the association is complex. This study investigates both high and low levels of social integration and their associations with longitudinal patterns of alcohol consumption among older women and men. METHODS Longitudinal nationally representative data of older Swedish women and men aged over 65 - the Swedish Level of Living Survey (LNU) and Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) - from 2010/2011 and 2014 (n = 1048). Associations between social contacts and social activities at baseline and longitudinal patterns of drinking frequency were examined with multinomial logistic regression analyses. RESULTS Men reported drinking alcohol more often than women, but the most common drinking frequency among both women and men was to drink monthly or less. Drinking habits were generally stable over time. People with high levels of social activity at baseline were more likely to have a stable daily or weekly drinking frequency or increased drinking frequency over the four-year follow-up period, particularly women. People with low levels of social contacts and/or social activities were less likely to have a stable daily or weekly drinking frequency, compared to people in the low and stable drinking frequency group. CONCLUSIONS Alcohol consumption is embedded in a social context, older people drink in social situations and social integration predicts continued drinking patterns.
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Affiliation(s)
- Neda Agahi
- Aging Research Center, Karolinska Institutet/Stockholm University, Tomtebodavägen 18A, 171 65, Solna, Sweden.
| | - Lena Dahlberg
- Aging Research Center, Karolinska Institutet/Stockholm University, Tomtebodavägen 18A, 171 65, Solna, Sweden; Dalarna University, School of Education, Health and Social Studies, 791 88, Falun, Sweden.
| | - Carin Lennartsson
- Aging Research Center, Karolinska Institutet/Stockholm University, Tomtebodavägen 18A, 171 65, Solna, Sweden.
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16
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Morin L, Wastesson J, Agahi N, Johnell K. Advanced Topics for End-of-Life Care. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- L Morin
- Aging Research Center, Karolinska Institutet
| | - J Wastesson
- Aging Research Center, Karolinska Institutet
| | - N Agahi
- Aging Research Center, Karolinska Institutet
| | - K Johnell
- Aging Research Center, Karolinska Institutet
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Agahi N, Kelfve S, Hassing L, Johansson B, Lindwall M. TRAJECTORIES OF ALCOHOL CONSUMPTION IN RELATION TO RETIREMENT TRANSITION IN SWEDEN. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- N Agahi
- Aging Research Center, Karolinska Institutet, Stockholm, Stockholms Lan,Sweden
| | - S Kelfve
- Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden; Aging Research Center, Karolinska Institutet/Stockholm University, Stockholm, Sweden
| | - L Hassing
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - B Johansson
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - M Lindwall
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
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18
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Eyjólfsdóttir H, Baumann I, Agahi N, Fritzell J, Lennartsson C. Prolongation of working life and physical functioning in old age in Sweden. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.05.289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Sundberg L, Agahi N, Fritzell J, Fors S. Why is the gender gap in life expectancy decreasing? The impact of age- and cause-specific mortality in Sweden 1997-2014. Int J Public Health 2018; 63:673-681. [PMID: 29654335 PMCID: PMC6015620 DOI: 10.1007/s00038-018-1097-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 03/27/2018] [Accepted: 04/05/2018] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES To enhance the understanding of the current increase in life expectancy and decreasing gender gap in life expectancy. METHODS We obtained data on underlying cause of death from the National Board of Health and Welfare in Sweden for 1997 and 2014 and used Arriaga's method to decompose life expectancy by age group and 24 causes of death. RESULTS Decreased mortality from ischemic heart disease had the largest impact on the increased life expectancy of both men and women and on the decreased gender gap in life expectancy. Increased mortality from Alzheimer's disease negatively influenced overall life expectancy, but because of higher female mortality, it also served to decrease the gender gap in life expectancy. The impact of other causes of death, particularly smoking-related causes, decreased in men but increased in women, also reducing the gap in life expectancy. CONCLUSIONS This study shows that a focus on overall changes in life expectancies may hide important differences in age- and cause-specific mortality. It also emphasizes the importance of addressing modifiable lifestyle factors to reduce avoidable mortality.
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Affiliation(s)
- Louise Sundberg
- Aging Research Center, Karolinska Institute and Stockholm University, Gävlegatan 16, 13330, Stockholm, Sweden.
| | - Neda Agahi
- Aging Research Center, Karolinska Institute and Stockholm University, Gävlegatan 16, 13330, Stockholm, Sweden
| | - Johan Fritzell
- Aging Research Center, Karolinska Institute and Stockholm University, Gävlegatan 16, 13330, Stockholm, Sweden
| | - Stefan Fors
- Aging Research Center, Karolinska Institute and Stockholm University, Gävlegatan 16, 13330, Stockholm, Sweden
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Dahlberg L, Agahi N, Schön P, Lennartsson C. Planned and Unplanned Hospital Admissions and Their Relationship with Social Factors: Findings from a National, Prospective Study of People Aged 76 Years or Older. Health Serv Res 2018; 53:4248-4267. [PMID: 29952093 PMCID: PMC6232498 DOI: 10.1111/1475-6773.13001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To examine the relationship between social factors and planned and unplanned hospital admissions among older people. DATA SOURCES/STUDY SETTING 2011 data from the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) and data from the Swedish National Patient Register until December 31, 2012. STUDY DESIGN The study had a prospective design. Data were analyzed via Cox proportional hazard regressions with variables entered as blocks (social factors, sociodemographic and ability factors, health factors). DATA COLLECTION Data were collected via interviews with people aged 76+ (n = 931). PRINCIPAL FINDINGS Living in institutions was negatively associated with planned admissions (hazard ratio (HR): 0.29; confidence interval (CI): 0.09-0.88), while being in receipt of home help was positively associated with unplanned admissions (HR: 1.57; CI: 1.15-2.14). Low levels of social contacts and social activity predicted unplanned admissions in bivariate analyses only. Higher ability to deal with public authorities was positively associated with planned admissions (HR: 1.77; CI: 1.13-2.78) and negatively associated with unplanned admissions, although the latter association was only significant in the bivariate analysis. CONCLUSIONS Hospital admissions are not only due to health problems but are also influenced by the social care situation and by the ability to deal with public authorities.
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Affiliation(s)
- Lena Dahlberg
- Aging Research Center, Karolinska Institutet & Stockholm University, Stockholm, Sweden.,School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Neda Agahi
- Aging Research Center, Karolinska Institutet & Stockholm University, Stockholm, Sweden
| | - Pär Schön
- Aging Research Center, Karolinska Institutet & Stockholm University, Stockholm, Sweden
| | - Carin Lennartsson
- Aging Research Center, Karolinska Institutet & Stockholm University, Stockholm, Sweden
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Shaw BA, Fors S, Fritzell J, Lennartsoon C, Agahi N. Who Lives Alone During Old Age? Trends in the Social and Functional Disadvantages of Sweden's Solitary Living Older Adults. Res Aging 2017; 40:815-838. [PMID: 29241401 DOI: 10.1177/0164027517747120] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study identifies specific social and functional disadvantages associated with living alone during old age in Sweden and assesses whether these associations have changed during recent decades. Data came from repeated cross-sectional surveys of Swedish adults aged 77+ during 1992-2014. Findings indicate that several types of disadvantage are consistently associated with the probability of living alone including financial insecurity and having never married for women and having never married and mobility impairment for men. Also for older men, low education has become an increasing strong determinant of living alone. These findings suggest that older adults who live alone are a subgroup that is particularly, and in some cases increasingly, vulnerable with respect to social and functional status. This has important policy implications related to addressing the needs of this growing subgroup as well as methodological implications for studies on the health effects of living alone.
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Affiliation(s)
- Benjamin A Shaw
- 1 Department of Health Policy, Management, and Behavior, Center for Social and Demographic Analysis, School of Public Health, University at Albany, State University of New York, Rensselaer, NY, USA
| | - Stefan Fors
- 2 Aging Research Center, Karolinska Institutet, Solna, Sweden
- 3 Aging Research Center, Stockholm University, Stockholm, Sweden
| | - Johan Fritzell
- 2 Aging Research Center, Karolinska Institutet, Solna, Sweden
- 3 Aging Research Center, Stockholm University, Stockholm, Sweden
| | - Carin Lennartsoon
- 2 Aging Research Center, Karolinska Institutet, Solna, Sweden
- 3 Aging Research Center, Stockholm University, Stockholm, Sweden
| | - Neda Agahi
- 2 Aging Research Center, Karolinska Institutet, Solna, Sweden
- 3 Aging Research Center, Stockholm University, Stockholm, Sweden
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Dahlberg L, Agahi N, Lennartsson C. Lonelier than ever? Loneliness of older people over two decades. Arch Gerontol Geriatr 2017; 75:96-103. [PMID: 29220739 DOI: 10.1016/j.archger.2017.11.004] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 09/20/2017] [Accepted: 11/12/2017] [Indexed: 10/18/2022]
Abstract
To live with feelings of loneliness has negative implications for quality of life, health and survival. This study aimed to examine changes in loneliness among older people, both with regard to prevalence rates, and socio-demographic, social and health-related correlates of loneliness. This study had a repeated cross-sectional design and was based on the nationally representative Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD). Analyses of trends in loneliness covered the years 1992, 2002, 2004, 2011 and 2014, and included people aged 77 years or older (n=2 572). Analyses of correlates of loneliness covered 2004 and 2014, and included people aged 70 years or older (n=1 962). Logistic regression analyses were conducted with findings presented as average marginal effects. Contrary to what is often assumed, there has been no increase in loneliness among older people over time (1992-2014). Regression analyses for 2004 and 2014 showed that social and health-related correlates were more strongly associated with loneliness than socio-demographic correlates. Psychological distress was most strongly associated with loneliness, followed by widowhood. Most associations between the correlates and loneliness were stable over time.
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Affiliation(s)
- Lena Dahlberg
- Aging Research Center, Karolinska Institutet/Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden; School of Education, Health and Social Studies, Dalarna University, 791 88 Falun, Sweden.
| | - Neda Agahi
- Aging Research Center, Karolinska Institutet/Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden
| | - Carin Lennartsson
- Aging Research Center, Karolinska Institutet/Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden
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23
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Affiliation(s)
- C Nilsen
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - R Andel
- Aging Research Center, Karolinska Institutet and Stockholm University, Tampa, United States
| | - N Agahi
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - J Fritzell
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - I Kåreholt
- Aging Research Network – Jönköping (ARN-J), Jönköping, Sweden
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Nilsen C, Agahi N, Shaw BA. Does the association between leisure activities and survival in old age differ by living arrangement? J Epidemiol Community Health 2017; 72:1-6. [PMID: 29079586 DOI: 10.1136/jech-2017-209614] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 09/11/2017] [Accepted: 10/05/2017] [Indexed: 11/03/2022]
Abstract
BACKGROUND Government policies to promote ageing in place have led to a growing frail population living at home in advanced old age, many of whom live alone. Living alone in old age is associated with adverse health outcomes, but we know little about whether it moderates the health impact of other risk and protective factors. Engagement in leisure activities is considered critical to successful ageing. We investigated whether the association between different types of leisure activities and survival in non-institutionalised older adults (aged 76 and above) differs by living arrangement and gender. METHODS We used the Swedish Panel Study of Living Conditions of the Oldest Old study from 2011 and the Swedish Cause of Death Register (until 30 June 2014) to conduct Cox regression analyses (n=669). Incident mortality was 30.2% during the follow-up period. RESULTS Overall level of leisure activity was not significantly associated with survival in either living arrangement, but some specific leisure activities, and associations, were different across gender and living arrangement. More specifically, certain social activities (participation in organisations and having relatives visit) were associated with longer survival, but only in men living alone. In women, most results were statistically non-significant, with the exception of solving crosswords being associated with longer survival in women living with someone. CONCLUSION In order to facilitate engagement with life, interventions focusing on leisure activities in the oldest age groups should take gender and living arrangement into consideration when determining the type of activity most needed.
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Affiliation(s)
- Charlotta Nilsen
- Aging Research Center, (Karolinska Institutet/Stockholm University), Stockholm, Sweden
| | - Neda Agahi
- Aging Research Center, (Karolinska Institutet/Stockholm University), Stockholm, Sweden
| | - Benjamin A Shaw
- Center for Social and Demographic Analysis, School of Public Health, University at Albany, State University of New York, Albany, New York, USA
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Nilsen C, Agahi N, Shaw B. AGING IN PLACE: CAN LEISURE PARTICIPATION ENHANCE SURVIVAL? Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- C. Nilsen
- Aging Research Center (Karolinska Institutet/Stockholm University), Stockholm, Sweden,
| | - N. Agahi
- Aging Research Center (Karolinska Institutet/Stockholm University), Stockholm, Sweden,
| | - B.A. Shaw
- University at Albany, Albany, New York
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Shaw B, Agahi N, Fors S, Lennartsson C, Fritzell J. WHO LIVES ALONE? TRENDS OVER TIME IN THE CHARACTERISTICS OF SWEDEN’S SOLITARY LIVING OLDER ADULTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - N. Agahi
- Aging Research Center, Stockholm, Sweden
| | - S. Fors
- Aging Research Center, Stockholm, Sweden
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Abstract
OBJECTIVE The aim of this study was to explore the relationship between work stressors in late midlife and physical functioning in old age. METHOD Two linked nationally representative Swedish surveys were used: the 1991 Level of Living Survey (age 57-65) and the 2011 Swedish Panel Study of Living Conditions of the Oldest Old. Work stressors were measured with the job demand-control model and physical functioning in old age with physical performance tests, lung function tests, and self-reported mobility. Ordered logistic and linear regressions were performed ( n = 166-214). RESULTS High demands, low control, and high strain (i.e., high demands combined with low control) were associated with limited physical functioning in women. Low control and passive jobs were associated with limited physical functioning in men. DISCUSSION Work stressors in late midlife are important predictors of physical functioning in older adults. However, women and men seem to be vulnerable to different work stressors.
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Affiliation(s)
| | - Neda Agahi
- 1 Aging Research Center, Stockholm, Sweden
| | - Ingemar Kåreholt
- 1 Aging Research Center, Stockholm, Sweden.,2 Jönköping University, Sweden
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Abstract
BACKGROUND Information on the extent to which older people's increasing life expectancy is characterized by good or poor health is important for policy and fiscal planning. This study explores trends in health expectancies among the oldest old in Sweden from 1992 to 2011. METHODS Cross-sectional health expectancy estimates at age 77 were obtained for 1992, 2002, 2004 and 2011 by Sullivan's method. Health expectancy was assessed by severe disability, mild disability and mobility problems. Changes in health expectancies were decomposed into the contributions attributed to changes of mortality rates, and changes in disability and mobility prevalence. Mortality data were obtained from Statistics Sweden and prevalence data from two nationally representative surveys, the Swedish Panel Study of Living Conditions of the Oldest Old and the Survey of Health, Ageing and Retirement in Europe. RESULTS Years free from severe disability, mild disability and mobility problems increased in both men and women. Decomposition analysis indicates that the increase was mainly driven by the change in health status rather than change in mortality. In relation to total life expectancy, the general patterns suggest that women had a compression of health problems and men an expansion. CONCLUSION Men's life expectancy increased more than women's; however, the increased life expectancy among men was mainly characterized by disability and mobility problems. The results suggest that the gender gap in health expectancy is decreasing.
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Affiliation(s)
- Louise Sundberg
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Neda Agahi
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Johan Fritzell
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Stefan Fors
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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Modig K, Virtanen S, Ahlbom A, Agahi N. Stable or improved health status in the population 65 years and older in Stockholm, Sweden – an 8-year follow-up of self-reported health items. Scand J Public Health 2016; 44:480-9. [DOI: 10.1177/1403494816636248] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2016] [Indexed: 11/16/2022]
Affiliation(s)
- Karin Modig
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Suvi Virtanen
- Department of Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Anders Ahlbom
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Neda Agahi
- Aging Research Center, Karolinska Institutet & Stockholm University, Stockholm, Sweden
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Agahi N, Kelfve S, Lennartsson C, Kåreholt I. Alcohol consumption in very old age and its association with survival: A matter of health and physical function. Drug Alcohol Depend 2016; 159:240-5. [PMID: 26775285 DOI: 10.1016/j.drugalcdep.2015.12.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 12/18/2015] [Accepted: 12/22/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Alcohol consumption in very old age is increasing; yet, little is known about the personal and health-related characteristics associated with different levels of alcohol consumption and the association between alcohol consumption and survival among the oldest old. METHODS Nationally representative data from the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD, ages 76-101; n=863) collected in 2010/2011 were used. Mortality was analyzed until 2014. Alcohol consumption was measured with questions about frequency and amount. Drinks per month were calculated and categorized as abstainer, light-to-moderate drinker (0.5-30 drinks/month) and heavy drinker (>30 drinks/month). Multinomial logistic regressions and Laplace regressions were performed. RESULTS Compared to light-to-moderate drinkers, abstainers had lower levels of education and more functional health problems, while heavy drinkers were more often men, had higher levels of education, and no serious health or functional problems. In models adjusted only for age and sex, abstainers died earlier than drinkers. Among light-to-moderate drinkers, each additional drink/month was associated with longer survival, while among heavy drinkers, each additional drink/month was associated with shorter survival. However, after adjusting for personal and health-related factors, estimates were lower and no longer statistically significant. CONCLUSIONS The association between alcohol consumption and survival in very old age seems to have an inverse J-shape; abstention and heavy use is associated with shorter survival compared to light-to-moderate drinking. To a large extent, differences in survival are due to differences in baseline health and physical function.
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Affiliation(s)
- Neda Agahi
- Aging Research Center, Karolinska Institutet/Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden.
| | - Susanne Kelfve
- Aging Research Center, Karolinska Institutet/Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden; Department of Sociology, Stockholm University, 106 91 Stockholm, Sweden
| | - Carin Lennartsson
- Aging Research Center, Karolinska Institutet/Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden
| | - Ingemar Kåreholt
- Aging Research Center, Karolinska Institutet/Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden; Institute for Gerontology, School of Health and Welfare, Jönköping University, Box 1026, 551 11 Jönköping, Sweden
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Kelfve S, Lennartsson C, Agahi N, Modig K. Do postal health surveys capture morbidity and mortality in respondents aged 65 years and older? A register-based validation study. Scand J Public Health 2015; 43:348-55. [DOI: 10.1177/1403494815575340] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2015] [Indexed: 11/16/2022]
Abstract
Aims: Non-response to population surveys is a common problem in epidemiological and public health research. Systematic non-response threatens the validity of results. Researchers rarely evaluate the magnitude of systematic non-response because of limited access to population data. This study explores how well morbidity and mortality in postal survey respondents aged 65 years and older represented that of the target population. Methods: The 2010 Stockholm Public Health Survey and the Swedish Population Register were linked to the Cause of Death Register and the National Patient Register in Sweden. Differences were analysed between the response group and the corresponding population in mortality, hospital admission, days spent in hospital and number of diagnoses. Finally, data were weighted for non-response to see if this improved generalizability. Results: Non-response increased with age, and this increase was more pronounced among women than men. Respondents were marginally less often admitted to hospital, hospitalized fewer days and had slightly fewer diagnoses than the population, in particular after age 80. Significantly fewer women died in the response group than in the population as a whole. In terms of mortality among men and in terms of hospitalizations for most age groups, the respondents represented the population fairly well. Non-response weighting adjustment did not improve generalizability. Conclusions: Postal questionnaires are likely to capture morbidity (hospitalization) among women and men aged 65-80 years old and mortality among men, while morbidity after age 80 and mortality in women are likely to be underestimated.
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Affiliation(s)
- Susanne Kelfve
- Aging Research Center, Karolinska Institutet & Stockholm University, Sweden
- Department of Sociology, Stockholm University, Sweden
| | - Carin Lennartsson
- Aging Research Center, Karolinska Institutet & Stockholm University, Sweden
| | - Neda Agahi
- Aging Research Center, Karolinska Institutet & Stockholm University, Sweden
| | - Karin Modig
- Institute of Environmental Epidemiology, Karolinska Institutet, Sweden
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Lafolie P, Agahi N. [Ethical review of research in the grey area. The Ethical Review Act should be widened and case management more efficient]. Lakartidningen 2015; 112:C9CL. [PMID: 25710225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The present legal definition of the term research creates problems with what can be considered for ethical vetting by the Research Ethical Review Board. The Ethical Review Act should be revised in order for student projects involving patients or quality assurance in healthcare to be accepted for ethical vetting by the Board.
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Affiliation(s)
- Pierre Lafolie
- Clinical Pharmacology - Dep of Medicine - Solna Stockholm, Sweden Clinical Pharmacology - Dep of Medicine - Solna Stockholm, Sweden
| | - Neda Agahi
- Aging Research Center (ARC) - Karolinska Institutet Stockholm, Sweden Aging Research Center (ARC) - Karolinska Institutet Stockholm, Sweden
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Agahi N, Shaw BA, Fors S. Social and economic conditions in childhood and the progression of functional health problems from midlife into old age. J Epidemiol Community Health 2014; 68:734-40. [PMID: 24759781 PMCID: PMC4112427 DOI: 10.1136/jech-2013-203698] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Childhood living conditions have been found to predict health and mortality in midlife and in old age. This study examines the associations between social and economic childhood conditions and the onset and progression of functional health problems from midlife into old age, and the extent to which potential associations are mediated by educational attainment and smoking. METHODS Data from the Level of Living Survey and the Swedish Panel Study of Living Conditions of the Oldest Old were merged to create a longitudinal data set with five repeated measures from 1968 to 2004 (n=1765, aged 30-50 years and free from functional health problems at baseline). Multilevel regression models were used to analyse retrospective reports of social and economic conditions in childhood (eg, conflicts or economic problems in the family) in relation to the progression of functional health problems over the 36-year period. RESULTS Results showed that social and economic disadvantages in childhood were associated with an earlier onset and a faster progression of functional health problems from midlife into old age. Subsequent models showed that differences in educational attainment, but not smoking, explained much of the association between childhood disadvantages and trajectories of functional health problems. CONCLUSIONS According to these results, adverse social and economic conditions in childhood affect the development of functional health problems from midlife into old age indirectly through less favourable life careers, including lower education. Creating equal opportunities for educational attainment may help reduce the long-term effects of disadvantaged childhood conditions and postpone functional health problems.
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Affiliation(s)
- Neda Agahi
- Aging Research Center, Karolinska Institutet/Stockholm University, Stockholm, Sweden
| | - Benjamin A Shaw
- School of Public Health, University of Albany, State University of New York, New York, USA
| | - Stefan Fors
- Aging Research Center, Karolinska Institutet/Stockholm University, Stockholm, Sweden
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Lennartsson C, Agahi N, Hols-Salen L, Kelfve S, Kareholt I, Lundberg O, Parker MG, Thorslund M. Data Resource Profile: The Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD). Int J Epidemiol 2014; 43:731-8. [DOI: 10.1093/ije/dyu057] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Shaw BA, McGeever K, Vasquez E, Agahi N, Fors S. Socioeconomic inequalities in health after age 50: are health risk behaviors to blame? Soc Sci Med 2013; 101:52-60. [PMID: 24560224 DOI: 10.1016/j.socscimed.2013.10.040] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 10/25/2013] [Accepted: 10/29/2013] [Indexed: 11/25/2022]
Abstract
Recent studies indicate that socioeconomic inequalities in health extend into the elderly population, even within the most highly developed welfare states. One potential explanation for socioeconomic inequalities in health focuses on the role of health behaviors, but little is known about the degree to which health behaviors account for health inequalities among older adults, in particular. Using data from the Health and Retirement Study (N = 19,245), this study examined the degree to which four behavioral risk factors - smoking, obesity, physical inactivity, and heavy drinking - are associated with socioeconomic position among adults aged 51 and older, and whether these behaviors mediate socioeconomic differences in mortality, and the onset of disability among those who were disability-free at baseline, over a 10-year period from 1998 to 2008. Results indicate that the odds of both smoking and physical inactivity are higher among persons with lower wealth, with similar stratification in obesity, but primarily among women. The odds of heavy drinking decrease at lower levels of wealth. Significant socioeconomic inequalities in mortality and disability onset are apparent among older men and women; however, the role that health behaviors play in accounting for these inequalities differs by age and gender. For example, these health behaviors account for between 23 and 45% of the mortality disparities among men and middle aged women, but only about 5% of the disparities found among women over 65 years. Meanwhile, these health behaviors appear to account for about 33% of the disparities in disability onset found among women survivors, and about 9-14% among men survivors. These findings suggest that within the U.S. elderly population, behavioral risks such as smoking and physical inactivity contribute moderately to maintaining socioeconomic inequalities in health. As such, promoting healthier lifestyles among the socioeconomically disadvantaged older adults should help to reduce later life health inequalities.
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Affiliation(s)
- Benjamin A Shaw
- School of Public Health, University at Albany, One University Place, Rensselaer, NY 12144, USA.
| | - Kelly McGeever
- School of Public Health, University at Albany, One University Place, Rensselaer, NY 12144, USA.
| | - Elizabeth Vasquez
- School of Public Health, University at Albany, One University Place, Rensselaer, NY 12144, USA.
| | - Neda Agahi
- Aging Research Center, Karolinska Institutet/Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden.
| | - Stefan Fors
- Aging Research Center, Karolinska Institutet/Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden.
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Agahi N, Lennartsson C, Kåreholt I, Shaw BA. Trajectories of social activities from middle age to old age and late-life disability: a 36-year follow-up. Age Ageing 2013; 42:790-3. [PMID: 24064237 DOI: 10.1093/ageing/aft140] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES to examine the association between 34-year trajectories of social activity, from middle age to old age and late-life disability. METHODS data from the Swedish Level of Living Survey (LNU) and the Swedish Panel Study of the Oldest Old (SWEOLD) were used. LNU data from 1968, 1981, 1991 and 2000 were merged with SWEOLD data from 1992, 2002 and 2004 to create a longitudinal data set with five observation periods. Trajectories of social activities covered 1968-2002, and late-life disability was measured in 2004. The sample consisted of 729 individuals aged 33-61 at baseline (1968), who participated in at least four observation periods and who were free from mobility limitations at baseline. Four trajectories of social activity were identified and used as predictors of late-life disability. RESULTS reporting low/medium levels of social activity from mid-life to old age was the most common trajectory group. Persons reporting continuously low/medium or decreasing levels of social activity had higher odds ratios for late-life disability (OR = 2.33 and OR = 2.15, respectively) compared with those having continuously high levels of activity, even when adjusting for age, sex and mobility limitations, and excluding persons with baseline mobility limitations. CONCLUSIONS results suggest that the disability risk associated with social activities is related to recent levels of activity, but also that risk may accumulate over time, as indicated by the higher disability risk associated with the continuously low/medium level social activity trajectory.
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Affiliation(s)
- Neda Agahi
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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Shaw BA, Agahi N. Smoking and physical inactivity patterns during midlife as predictors of all-cause mortality and disability: A 39-year prospective study. Eur J Ageing 2013; 11:195-204. [PMID: 25309303 DOI: 10.1007/s10433-013-0298-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
This study estimated the long-term mortality hazards and disability risks associated with various combinations of smoking and physical inactivity measured over time in a sample of middle-aged adults. Data came from a national sample of Swedish adults, originally interviewed in 1968 and followed until 2007 (N=1,682). Smoking and physical activity status were measured at baseline and 13 years later (1981). Different patterns of change and stability in smoking and physical inactivity over this 13 year period were used as predictors of mortality through 2007. Also, associations between different patterns of these health behaviors and the odds of disability (measured in 2004) were estimated among survivors (n=925). Results suggest that mortality rates were elevated among persistent (HR=1.7; 95% CI=1.5, 2.0) and new smokers (HR=2.5; 95% CI=1.6, 4.1), but not among discontinued smokers. However, mortality rates remained elevated among discontinued smokers who were also persistently inactive (HR=1.9; 95% CI=1.3, 2.6). Additional findings suggest that persistent physical inactivity during midlife was associated with increased odds of late-life disability (OR=1.8; 95% CI=1.1, 2.7), but that smoking had no clear additive or multiplicative effects on disability. As such, these findings indicate that while persistent smoking during midlife primarily impacts subsequent mortality, persistent physical inactivity during midlife appears to counteract the survival benefits of smoking cessation, while also imposing a long-term risk on late life disability among those who do survive to old age.
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Affiliation(s)
- Benjamin A Shaw
- School of Public Health, University at Albany, One University Place, Rensselaer, NY 12144,
| | - Neda Agahi
- Aging Research Center, Karolinska Institutet/Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden,
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Agahi N, Fors S, Parker MG. Health trends among the oldest old in Sweden 1992-2011. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt126.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Fors S, Lennartsson C, Agahi N, Parker MG, Thorslund M. [Interview study on the living conditions of the very old. Elderly acquire more health problems, but they manage everyday life better]. Lakartidningen 2013; 110:1403-1405. [PMID: 23980380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- Stefan Fors
- Aging Research Center, Karolinska institutet och Stockholms universitet.
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Agahi N, Shaw BA. Smoking trajectories from midlife to old age and the development of non-life-threatening health problems: a 34-year prospective cohort study. Prev Med 2013; 57:107-12. [PMID: 23648525 PMCID: PMC3714327 DOI: 10.1016/j.ypmed.2013.04.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Revised: 04/26/2013] [Accepted: 04/27/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine how trajectories of smoking observed over a 34-year period, were associated with the progression of mobility impairment, musculoskeletal pain, and symptoms of psychological distress from midlife to old age. METHOD The Swedish Level of Living Survey (LNU) and the Swedish Panel Study of the Oldest Old (SWEOLD) were merged to create a nationally representative longitudinal sample of Swedish adults (aged 30-50 at baseline; n=1060), with four observation periods, from 1968 through 2002. Five discrete smoking trajectory groups were treated as predictors of variation in health trajectories using multilevel regression. RESULTS At baseline, there were no differences in mobility impairment between smoking trajectory groups. Over time all smokers, particularly persistent and former heavy smokers, exhibited faster increases in mobility problems compared with persistent non-smokers. Additionally, all smoking groups reported more pain symptoms than the non-smokers, at baseline and over time, but most of these differences did not reach statistical significance. Persistent heavy smokers reported elevated levels of psychological distress at baseline and over time. CONCLUSION Smokers, and even some former smokers, who survive into old age appear to be at increased risk for non-life-threatening conditions that can diminish quality of life and increase demands for services.
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Affiliation(s)
- Neda Agahi
- Aging Research Center, Karolinska Institutet/Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden.
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Thorslund M, Wastesson JW, Agahi N, Lagergren M, Parker MG. The rise and fall of women's advantage: a comparison of national trends in life expectancy at age 65 years. Eur J Ageing 2013; 10:271-277. [PMID: 24319404 PMCID: PMC3851807 DOI: 10.1007/s10433-013-0274-8] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The female advantage in life expectancy (LE) is found worldwide, despite differences in living conditions, the status of women and other factors. However, this advantage has decreased in recent years in low-mortality countries. Few researchers have looked at the gender gap in LE in old age (age 65) in a longer historical perspective. Have women always had an advantage in LE at old age and do different countries share the same trends? Life expectancy data for 17 countries were assessed from Human Mortality Database from 1751 to 2007. Since most of the changes in LE taking place today are driven by reductions of old age mortality the gender difference in LE was calculated at age 65. Most low-mortality countries show the same historical trend, a rise and fall of women’s advantage in LE at age 65. Three phases that all but two countries passed through were discerned. After a long phase with a female advantage in LE at 65 of <1 year, the gender gap increased significantly during the twentieth century. The increase occurred in all countries but at different time points. Some countries such as England and France had an early rise in female advantage (1900–1919), while it occurred 50 years later in Sweden, Norway and in the Netherlands. The rise was followed by a more simultaneous fall in female advantage in the studied countries towards the end of the century, with exceptions of Japan and Spain. The different timing regarding the increase of women’s advantage indicates that country-specific factors may have driven the rise in female advantage, while factors shared by all countries may underlie the simultaneous fall. More comprehensive, multi-disciplinary study of the evolution of the gender gap in old age could provide new hypotheses concerning the determinants of gendered differences in mortality.
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Affiliation(s)
- Mats Thorslund
- Aging Research Center, Karolinska Institutet and Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden
| | - Jonas W Wastesson
- Aging Research Center, Karolinska Institutet and Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden
| | - Neda Agahi
- Aging Research Center, Karolinska Institutet and Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden
| | | | - Marti G Parker
- Aging Research Center, Karolinska Institutet and Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden
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Abstract
Aims: The aims of the study are twofold: (i) to explore the impact of socioeconomic position, as measured 13 years earlier, on cognitive functioning and mobility impairment in later life, and (ii) to explore the extent to which obesity and smoking status can explain socioeconomic inequalities in cognitive and mobility impairments in later life. Methods: Data from a nationally representative sample of Swedish adults aged 56–76 in 1991 who were re-interviewed 13 years later in 2004, was analysed to explore the impact of socioeconomic position, smoking, and obesity on cognitive and physical functioning in late life. Results: The results showed that both smoking and obesity in late mid-life were stratified by socioeconomic position. Moreover, the results showed significant associations between socioeconomic position and both cognitive and physical functioning in later life. However, these inequalities in late life function could only partially be explained by the socioeconomic differences in smoking and obesity. Conclusions: The findings of this study suggest that socioeconomic differences in the rates of smoking and obesity may explain some, but not all, of the socioeconomic inequalities in physical and cognitive functioning during old age.
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Affiliation(s)
- Stefan Fors
- Aging Research Center, Karolinska Institutet and Stockholm University, Sweden
- Department of Social Work, Stockholm University, Sweden
| | - Neda Agahi
- Aging Research Center, Karolinska Institutet and Stockholm University, Sweden
| | - Benjamin A Shaw
- Department of Health Policy, Management and Behavior, School of Public Health, University at Albany, USA
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Shaw BA, Agahi N. A prospective cohort study of health behavior profiles after age 50 and mortality risk. BMC Public Health 2012; 12:803. [PMID: 22989155 PMCID: PMC3503621 DOI: 10.1186/1471-2458-12-803] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Accepted: 09/12/2012] [Indexed: 11/10/2022] Open
Abstract
Background This study examines the mortality risk associated with distinct combinations of multiple risk behaviors in middle-aged and older adults, and assesses whether the mortality risks of certain health behaviors are moderated by the presence of other risk behaviors. Methods Data for this prospective cohort study are from the Health and Retirement Study (HRS), a nationwide sample of adults older than 50 years. Baseline data are from respondents (n = 19,662) to the 1998 wave of the HRS. Twelve distinct health behavior profiles were created, based on each respondent’s smoking, physical activity, and alcohol use status in 1998. Mortality risk was estimated through 2008 using Cox regression. Results Smoking was associated with elevated risk for mortality within all behavioral profiles, but risk was greatest when combined with heavy drinking, both for middle-aged (ages 51–65) and older (ages 66+) adults. Profiles that included physical inactivity were also associated with increased mortality risk in both age groups. However, the impact of inactivity was clearly evident only among non-smokers; among smokers, the risk of inactivity was less evident, and seemingly overshadowed by the risk of smoking. Moderate drinking was protective relative to abstinence among non-smokers, and relative to heavy drinking among smokers. Conclusions In both middle-aged and older adults, multiple unhealthy behaviors increase mortality risk. However, the level of risk varies across unique combinations of unhealthy behaviors. These findings highlight the role that lifestyle improvements could play in promoting healthy aging, and provide insight into which behavioral combinations should receive top priority for intervention.
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Affiliation(s)
- Benjamin A Shaw
- School of Public Health, University at Albany, One University Place, Rensselaer, NY 12144, USA.
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Shaw BA, Agahi N, Krause N. Are changes in financial strain associated with changes in alcohol use and smoking among older adults? J Stud Alcohol Drugs 2012; 72:917-25. [PMID: 22051205 DOI: 10.15288/jsad.2011.72.917] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE This study aimed to assess whether changes in levels of financial strain are associated with changes in alcohol use and smoking among older adults. METHOD Multilevel analyses were conducted using longitudinal data from a randomly selected national sample of older adults (N = 2,352; 60% female). The data were collected in six waves during the period of 1992-2006. We estimated associations between within-person changes in levels of financial strain and the odds of engaging in heavy drinking and smoking, while also testing for the moderating effects of gender, education, and age. RESULTS A direct association was observed between changes in levels of financial strain and the odds of heavy drinking, particularly among elderly men (odds ratio [OR] = 1.31) and those with low levels of education (OR = 1.27). A direct association between changes in levels of financial strain and the odds of smoking was also evident, particularly among the young-old (i.e., age 65 at baseline; OR = 1.44). CONCLUSIONS Exposure to financial strain places some groups of older adults at increased risk for unhealthy drinking and smoking. If the current global financial crisis leads to increases in experiences of financial strain among older adults, alcohol and smoking problems can also be expected to increase in this population.
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Affiliation(s)
- Benjamin A Shaw
- Department of Health Policy, Management, and Behavior, School of Public Health, State University of New York at Albany, One University Place, Rensselaer, New York 12144-3456, USA.
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Agahi N, Silverstein M, Parker MG. Late-Life and Earlier Participation in Leisure Activities: Their Importance for Survival Among Older Persons. Activities, Adaptation & Aging 2011. [DOI: 10.1080/01924788.2011.596758] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Abstract
OBJECTIVES This study examines the association between participation in leisure activities and mortality risk among older men and women. METHODS A representative sample of 1,246 men and women ages 65 to 95, interviewed in 1991-1992, were followed for 12 years. Cox regressions analyzed mortality risk. RESULTS Participating in only a few activities doubled mortality risk compared to those with the highest participation levels, even after controlling for age, education, walking ability, and other health indicators. Women had a dose-response relationship between overall participation and survival. Strong associations with survival were found for engagement in organizational activities and study circles among women and hobby activities and gardening among men. DISCUSSION Results suggest gender differences in the association between leisure activities and mortality. Women display a decreasing mortality risk for each additional activity. Social activities have the strongest effects on survival among women, whereas men seem to benefit from solitary activities.
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Affiliation(s)
- Neda Agahi
- Aging Research Center, Karolinska Institutet/Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden.
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Abstract
OBJECTIVE Continuity in habits, activities, and roles is important upon entering old age according to the continuity theory of aging. Few studies have investigated patterns of leisure participation over an extended period of time among older adults. This study examines changes in nine different leisure activities in a nationally representative sample of individuals followed over a 34-year period in Sweden. METHODS We used longitudinal data from three waves of an interview survey that followed 495 individuals from 1968 to 2002. Individuals were aged 43-65 in 1968 and 77-99 in 2002. We conducted logistic regression analyses on each of the leisure activities. RESULT For the panel followed, a decline in participation rates was the most common pattern over time. Analyses at the individual level showed that late-life participation was generally preceded by participation earlier in life. Previous participation, both 10 and 34 years earlier, predicted late-life participation. The modifying effect of functional status in late life was small. DISCUSSION In accordance with the continuity theory of aging, leisure participation in old age is often a continuation of previous participation. However, there is considerable variation among both activities and individuals.
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Affiliation(s)
- Neda Agahi
- Aging Research Center, Karolinska Institute and Stockholm University, Stockholm, Sweden.
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