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Kung CSJ, Steptoe A. Internet use and psychological wellbeing among older adults in England: a difference-in-differences analysis over the COVID-19 pandemic. Psychol Med 2023; 53:5356-5358. [PMID: 36177888 PMCID: PMC9551182 DOI: 10.1017/s0033291722003208] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/20/2022] [Accepted: 09/26/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Longitudinal evidence on how Internet use affects the psychological wellbeing of older adults has been mixed. As policymakers invest in efforts to reduce the digital divide, it is important to have robust evidence on whether encouraging Internet use among older adults is beneficial, or potentially detrimental, to their wellbeing. METHODS We observe depressive symptoms and loneliness of adults aged 50 + in the nationally representative English Longitudinal Study of Ageing, from before (2018/19) to during the coronavirus disease 2019 (COVID-19) pandemic (June/July and November/December 2020). Our quasi-experimental difference-in-differences strategy compares within-individual wellbeing changes between older adults who desired to use the Internet more but experienced barriers including lack of skills, access, and equipment, with regular Internet users who did not desire to use the Internet more. To reduce selection bias, we match both groups on demographic and socioeconomic characteristics that are predictive of Internet use. We assume that in the absence of COVID-19 - a period of increased reliance on the Internet - the wellbeing trajectories of both groups would have followed a common trend. RESULTS Compared with matched controls (N = 2983), participants reporting barriers to Internet use (N = 802) experienced a greater increase in the likelihood of depressive symptoms from before to during the pandemic, but not worse loneliness levels. This effect was stronger for women, those aged above 65 years, and those from lower-income households. CONCLUSIONS Besides enabling access to digital services, efforts to ensure older adults continue to be engaged members of an increasingly digital society could deliver returns in terms of a buffer against psychological distress.
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Affiliation(s)
- Claryn S. J. Kung
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Andrew Steptoe
- Research Department of Epidemiology and Public Health, University College London, London, UK
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Kung CSJ, Zhu J, Zaninotto P, Steptoe A. Changes in retirement plans in the English older population during the COVID-19 pandemic: The roles of health factors and financial insecurity. Eur J Ageing 2023; 20:22. [PMID: 37310592 DOI: 10.1007/s10433-023-00770-1] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2023] [Indexed: 06/14/2023] Open
Abstract
Over the course of 2020 and 2021, the COVID-19 pandemic disrupted lives globally. In the UK, unemployment rate continued to increase during and post-lockdown periods, and job security and financial wellbeing deteriorated. It is important to understand whether individual decisions related to retirement plans have changed systematically as a result of the pandemic, especially among older adults who experienced greater rates of pandemic unemployment. Using the English Longitudinal Study of Ageing, this article examines changes in retirement plans of older adults during the COVID-19 pandemic and estimates the impact of health and financial circumstances on these changes. In June/July 2020, 5% of 2095 participants reported planning earlier retirement, while 9% reported planning later retirement. We found that poor self-rated health and financial insecurity were associated with intentions to postpone retirement. Additional risk of later retirement associated with poor health was detected among those experiencing financial insecurity. In November/December 2020, 7% of 1845 participants reported planning earlier retirement, while 12% reported planning later retirement. We found that poor health was predictive of a lower relative risk of later retirement, while depressive symptomology and financial insecurity predicted a higher relative risk of later retirement. The findings imply a contextual role of health factors in, and a persistent influence of financial insecurity on, retirement planning in the older population.
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Maharani A, Sinclair DR, Chandola T, Bower P, Clegg A, Hanratty B, Nazroo J, Pendleton N, Tampubolon G, Todd C, Wittenberg R, O'Neill TW, Matthews FE. Household wealth, neighbourhood deprivation and frailty amongst middle-aged and older adults in England: a longitudinal analysis over 15 years (2002-2017). Age Ageing 2023; 52:7093109. [PMID: 36995138 PMCID: PMC10061942 DOI: 10.1093/ageing/afad034] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND frailty is a condition of reduced function and health due to ageing processes and is associated with a higher risk of falls, hospitalisation, disability and mortality. OBJECTIVE to determine the relationship between household wealth and neighbourhood deprivation with frailty status, independently of demographic factors, educational attainment and health behaviours. DESIGN population-based cohort study. SETTING communities in England. SUBJECTS in total 17,438 adults aged 50+ from the English Longitudinal Study of Ageing. METHODS multilevel mixed-effects ordered logistic regression was used in this study. Frailty was measured using a frailty index. We defined small geographic areas (neighbourhoods) using English Lower layer Super Output Areas. Neighbourhood deprivation was measured by the English Index of Multiple Deprivation, grouped into quintiles. Health behaviours included in this study are smoking and frequency of alcohol consumption. RESULTS the proportion of respondents who were prefrail and frail were 33.8% [95% confidence interval (CI) 33.0-34.6%] and 11.7 (11.1-12.2)%, respectively. Participants in the lowest wealth quintile and living in the most deprived neighbourhood quintile had 1.3 (95% CI = 1.2-1.3) and 2.2 (95% CI = 2.1-2.4) times higher odds of being prefrail and frail, respectively, than the wealthiest participants living in the least deprived neighbourhoods Living in more deprived neighbourhood and poorer wealth was associated with an increased risk of becoming frail. Those inequalities did not change over time. CONCLUSIONS in this population-based sample, living in a deprived area or having low wealth was associated with frailty in middle-aged and older adults. This relationship was independent of the effects of individual demographic characteristics and health behaviours.
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Affiliation(s)
- Asri Maharani
- National Institute for Health Research (NIHR) Older People and Frailty Policy Research Unit, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK
| | - David R Sinclair
- National Institute for Health Research (NIHR) Older People and Frailty Policy Research Unit, Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne NE4 5PL, UK
| | - Tarani Chandola
- Faculty of Social Sciences, The University of Hong Kong, Pokfulam Road, Hong Kong 999077, Hong Kong
| | - Peter Bower
- National Institute for Health Research (NIHR) Older People and Frailty Policy Research Unit, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK
| | - Andrew Clegg
- Academic Unit for Ageing and Stroke Research, Bradford Institute for Health Research, School of Medicine, University of Leeds, Leeds LS2 9JT, UK
| | - Barbara Hanratty
- National Institute for Health Research (NIHR) Older People and Frailty Policy Research Unit, Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne NE4 5PL, UK
| | - James Nazroo
- Cathie Marsh Institute for Social Research, School of Social Sciences, Faculty of Humanities, University of Manchester, Manchester M13 9PL, UK
| | - Neil Pendleton
- National Institute for Health Research (NIHR) Older People and Frailty Policy Research Unit, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK
| | - Gindo Tampubolon
- Global Development Institute, School of Environment, Education and Development, School of Social Sciences, Faculty of Humanities, University of Manchester, Manchester M13 9PL, UK
| | - Chris Todd
- National Institute for Health Research (NIHR) Older People and Frailty Policy Research Unit, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK
| | - Raphael Wittenberg
- National Institute for Health Research (NIHR) Older People and Frailty Policy Research Unit, Care Policy and Evaluation Centre, London School of Economics and Political Science, London WC2A 2AE, UK
| | - Terence W O'Neill
- National Institute for Health Research (NIHR) Older People and Frailty Policy Research Unit, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK
| | - Fiona E Matthews
- National Institute for Health Research (NIHR) Older People and Frailty Policy Research Unit, Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne NE4 5PL, UK
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Yang X, Cheng C, Ma W, Jia C. Longitudinal association of lung function with frailty among older adults: the English Longitudinal Study of Ageing. Eur Geriatr Med 2023; 14:173-180. [PMID: 36536112 DOI: 10.1007/s41999-022-00732-3] [Citation(s) in RCA: 1] [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] [Received: 08/17/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE To investigate the effect of baseline lung function on the trajectory of frailty over time. METHODS This longitudinal study included 3,658 adults aged 60 and over (average age 70.4 years old and 46.4% males) at baseline from the English Longitudinal Study of Ageing. Lung function indicators included forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1), both measured at baseline examination. Frailty was defined based on Fried's frailty phenotype criteria, the measurement was repeated for four times. Linear mixed-effect regression model was applied to estimate the association of baseline lung function with the trajectory of frailty over time. RESULTS Frailty score increased significantly over time (β = 0.030, P < 0.001). Linear mixed-effect regression model identified significant interactions between FVC (β =- 0.018, P < 0.001) or FEV1 (β =- 0.022, P < 0.001) and time on frailty. CONCLUSION Poor baseline lung function might accelerate the speed of frailty. Lung function might be an important predictor of the development and progression of frailty among older adults.
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Affiliation(s)
- Xuan Yang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, No. 44 Wenhuaxi Road, Jinan, 250012, Shandong, China
| | - Chunxiao Cheng
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, No. 44 Wenhuaxi Road, Jinan, 250012, Shandong, China
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, No. 44 Wenhuaxi Road, Jinan, 250012, Shandong, China.
| | - Chongqi Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, No. 44 Wenhuaxi Road, Jinan, 250012, Shandong, China.
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Wang X, Jiang J, Hu Y, Qin LQ, Hao Y, Dong JY. Art Engagement and Risk of Type 2 Diabetes: Evidence From the English Longitudinal Study of Ageing. Int J Public Health 2023; 68:1605556. [PMID: 36891222 PMCID: PMC9986253 DOI: 10.3389/ijph.2023.1605556] [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] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/30/2023] [Indexed: 02/22/2023] Open
Abstract
Objectives: To examine the prospective association between art engagement and the risk of type 2 diabetes. Methods: Adults aged ≥50 from the English Longitudinal Study of Ageing were asked about the frequency of art engagement, including going to the cinema, the art gallery or museum, and the theatre, a concert, or the opera. Cox proportional hazards regression models were used to examine the risk of type 2 diabetes associated with art engagement. Results: During a median follow-up of 12.2 years, we identified 350 cases of type 2 diabetes from 4,064 participants through interviews. After multivariable adjustment, compared with people who never went to the cinema, those going to the cinema frequently had a significantly lower risk of developing type 2 diabetes (HR = 0.61, 95% CI: 0.44-0.86). After further adjustment for socioeconomic factors, the association was slightly attenuated but remained statistically significant (HR = 0.65, 95% CI: 0.46-0.92). Similar results were found for going to the theatre, a concert, or the opera. Conclusion: Frequent art engagement may be associated with a lower risk of type 2 diabetes, which was independent of individuals' socioeconomic factors.
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Affiliation(s)
- Xiaowen Wang
- Peking University Center for Public Health and Epidemic Preparedness & Response, Peking University, Beijing, China.,Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Jie Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Li-Qiang Qin
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
| | - Yuantao Hao
- Peking University Center for Public Health and Epidemic Preparedness & Response, Peking University, Beijing, China
| | - Jia-Yi Dong
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
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Palmer MF. Associations of discontinuation of care: A longitudinal analysis of the English Longitudinal Study of Ageing? Health Soc Care Community 2022; 30:e445-e460. [PMID: 33242379 DOI: 10.1111/hsc.13225] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 08/25/2020] [Accepted: 10/09/2020] [Indexed: 06/11/2023]
Abstract
Informal carers play a vital part to ensuring that individuals in need of care, due to illness or disability, continue to experience a good quality of life. Care provision has been studied extensively, however, little is known about the associations of discontinuing care. This knowledge is important not only to ensure that informal carers are supported, even after caring episode, but also to ensure the care-recipients are not left without support. By conducting longitudinal analysis of the English Longitudinal Study of Ageing (ELSA), this paper uniquely starts to unveil the associations of discontinuing the caring role and the patterns of care provision prior to discontinuing. A multivariable binary regression analysis was conducted of the ELSA waves 7 (2015) to 8 (2017), total sample size of N = 6,687. 10.5% (n = 701) respondents were identified as discontinued carers. The dependent variable was care provided in wave 7 but not in wave 8 (a discontinued carer), compared to providing care in both waves (a continuing carer). Socio-demographic, such as age, gender, marital status, economic activity and health acted and caring patterns, such as intensity and relationship with care-recipient, acted as independent variables. Results showed nearly 30% of discontinued carers had provided care to a spouse. Nearly a quarter of continuing carers had transitioned between care-recipients, which raises the question of a potential 'Serial Carer Trajectory'. The regression analysis noted that being divorced or widowed increased the odds of discontinuing care. Providing 20-49 hr of care per week was associated with lower odds of discontinuing the role. This paper suggests that policymakers should take a holistic approach to policies to support carers through all stages of their caring journey, including after discontinuing the caring role. This could ensure carers settle into life post-caring and continue to feel valued and recognised.
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Rafnsson SB, Maharani A, Tampubolon G. Social Contact Mode and 15-Year Episodic Memory Trajectories in Older Adults With and Without Hearing Loss: Findings from the English Longitudinal Study of Ageing. J Gerontol B Psychol Sci Soc Sci 2021; 77:10-17. [PMID: 33606882 DOI: 10.1093/geronb/gbab029] [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] [Received: 06/17/2020] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES Frequent social contact benefits cognition in later life although evidence is lacking on the potential relevance of the modes chosen by older adults, including those living with hearing loss, for interacting with others in their social network. METHOD 11,418 participants in the English Longitudinal Study of Ageing provided baseline information on hearing status and social contact mode and frequency of use. Multilevel growth curve models compared episodic memory (immediate and delayed recall) at baseline and longitudinally in participants who interacted frequently (offline only or offline and online combined), compared to infrequently, with others in their social network. RESULTS Frequent offline (B=0.23; SE=0.09) and combined offline and online (B=0.71; SE=0.09) social interactions predicted better episodic memory after adjustment for multiple confounders. We observed positive, longitudinal associations between combined offline and online interactions and episodic memory in participants without hearing loss (B=0.50, SE=0.11) but not with strictly offline interactions (B=0.01, SE=0.11). In those with hearing loss, episodic memory was positively related to both modes of engagement (offline only: B=0.79, SE=0.20; combined online and offline: B=1.27, SE=0.20). Sensitivity analyses confirmed the robustness of these findings. DISCUSSION Supplementing conventional social interactions with online communication modes may help older adults, especially those living with hearing loss, sustain, and benefit cognitively from, personal relationships.
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Affiliation(s)
- Snorri Bjorn Rafnsson
- Geller Institute of Ageing and Memory, School of Biomedical Sciences, University of West London, London, United Kingdom
| | - Asri Maharani
- Division of Nursing, Midwifery & Social Work, University of Manchester, Manchester, United Kingdom
| | - Gindo Tampubolon
- Global Development Institute and Manchester Institute for Collaborative Research on Ageing, University of Manchester, Manchester, United Kingdom
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Rafnsson SB, Fowkes G. Positive and negative well-being of older adults with symptomatic peripheral artery disease: A population-based investigation. JRSM Cardiovasc Dis 2021; 9:2048004020961717. [PMID: 33520199 DOI: 10.1177/2048004020961717] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/27/2020] [Accepted: 08/31/2020] [Indexed: 01/07/2023] Open
Abstract
Objective We investigated positive and negative subjective well-being in relation to lower-extremity peripheral artery disease (PAD) in a sample of older adults. Method 4760 participants in the English Longitudinal Study of Ageing (ELSA) provided baseline data on symptomatic PAD, sociodemographic characteristics, lifestyle risk factors, and co-morbid conditions. Baseline and two-year follow-up data were available for life satisfaction, quality of life, and depressive symptoms. Results Participants with PAD symptoms had lower baseline levels of life satisfaction (β = -0.03, p < .05) and quality of life (β = -0.04, p < .01), and more depressive symptoms (β = 0.03, p < .05). These associations remained statistically significant in multivariate analyses. Baseline PAD did not, however, influence well-being levels at two-year follow-up. Discussion Greater awareness of the potential for chronic vascular morbidity to disrupt the lives of older adults is needed to inform effective multidisciplinary support and interventions that help maintain the quality of life of those affected.
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Affiliation(s)
- Snorri Bjorn Rafnsson
- Geller Institute of Ageing and Memory, School of Biomedical Sciences, University of West London, London, UK
| | - Gerry Fowkes
- Usher Institute for Population Health Sciences, University of Edinburgh, Edinburgh, UK
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Victor CR, Pikhartova J. Lonely places or lonely people? Investigating the relationship between loneliness and place of residence. BMC Public Health 2020; 20:778. [PMID: 32456626 PMCID: PMC7251825 DOI: 10.1186/s12889-020-08703-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [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] [Received: 08/25/2019] [Accepted: 04/14/2020] [Indexed: 12/03/2022] Open
Abstract
Background Loneliness in later life is largely presented as a problem of the individual focusing upon antecedents such as demographic or health factors. Research examining the role of the broader living environments is much rarer. We examined the relationship between loneliness and three dimensions of the lived environment: geographical region, deprivation, and area classification (urban or rural). Methods Our sample consisted of 4663 core members (44% males) aged 50+ (wave 7 mean age 72.8, S.D. = 7.1) present both in waves 3 (2006) and 7 (2014) of the English Longitudinal Study of Ageing (ELSA). Loneliness was measured using two approaches, individual and area-based, and both waves included these questions. Individual-based (self-reported) loneliness was assessed using the three item University of California Los Angeles (UCLA) scale (ranging from 3 = not lonely to 9 = lonely) with a score of 6+ defining loneliness. We also used a novel question which asked participants to evaluate how often they felt lonely in their area of residence (area-based; ranging from 1 = often to 7 = never, using cut off 4+ to define loneliness). The lived environment was classified in three different ways: the Index of Multiple Deprivation (IMD), Government Office Regions (GOR), and area classification (urban or rural). Covariates with established relationship with loneliness including demographic factors, social engagement and health, were included in the analyses. Results In wave 7, the prevalence of individual-based loneliness was 18% and area-based was 25%. There was limited congruence between measures: 68% participants reported no individual- or area-based loneliness and 9% reported loneliness for both measures. After adjusting for individual co-variates only one significant relationship was observed between loneliness and area -based characteristics. A significant association was observed between area-based loneliness and deprivation score, with higher levels of loneliness in more deprived areas (OR = 1.4 for highest quintile of deprivation). Conclusions Our results indicate that loneliness in older adults is higher in the most deprived areas independent of individual-level factors. In order to develop appropriate interventions further research is required to investigate how area-level factors combine with individual-level loneliness vulnerability measures to generate increased levels of loneliness in deprived areas.
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Affiliation(s)
- Christina R Victor
- College of Health and Life Sciences, Department of Clinical Sciences, Kingston Lane, Brunel University London, Uxbridge, Middlesex, UB8 3PH, UK.
| | - Jitka Pikhartova
- College of Health and Life Sciences, Department of Clinical Sciences, Kingston Lane, Brunel University London, Uxbridge, Middlesex, UB8 3PH, UK. .,Department of Epidemiology and Public Health, University College London, WC1E 6BT, London, UK.
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Rovio SP, Pahkala K, Raitakari OT. Cognitive Decline Before and After Incident Coronary Heart Disease: Opportunity to Intervene Cognitive Function Trajectories. J Am Coll Cardiol 2019; 73:3051-3053. [PMID: 31221252 DOI: 10.1016/j.jacc.2019.04.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 04/09/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Suvi P Rovio
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, and the Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, and the Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland; Paavo Nurmi Centre, Sports & Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, and the Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
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11
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Poole L, Jackowska M. The association between depressive and sleep symptoms for predicting incident disease onset after 6-year follow-up: findings from the English Longitudinal Study of Ageing. Psychol Med 2019; 49:607-616. [PMID: 29807551 PMCID: PMC6378411 DOI: 10.1017/s0033291718001290] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 04/10/2018] [Accepted: 04/18/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND The independent effects of depressive symptoms and sleep problems for future physical illness risk have yet to be studied systematically across a variety of disease endpoints. METHODS We analysed data from 7395 participants (65.81 ± 9.39 years; 54.8% female) from the English Longitudinal Study of Ageing (ELSA). Baseline was wave 4 and participants were followed up for 6 years until wave 7. Sleep was measured using an adapted version of the Jenkins Sleep Problems questionnaire and depressive symptoms using the Centre for Epidemiological Studies Depression scale. Participants with the illness of interest at baseline [coronary heart disease (CHD), cancer, diabetes/high blood glucose, arthritis] were excluded from models predicting the onset of that illness at follow-up. Logistic regression was used, entering depressive symptoms and sleep problems simultaneously into models controlling for a wide range of covariates. RESULTS In fully adjusted models depressive symptoms predicted incident CHD (OR 1.11, 95% CI 1.04-1.20, p = 0.004) and diabetes/high blood glucose (OR 1.13, 95% CI 1.04-1.22, p = 0.002) independent of sleep problems; both depressive symptoms (OR 1.10, 95% CI 1.04-1.16, p = 0.002) and sleep problems (OR 1.14, 95% CI 1.02-1.26, p = 0.019) predicted incident arthritis. CONCLUSIONS Sleep problems and depressive symptoms, and a combination of both, were differentially associated with physical illness onset 6 years later. Our findings highlight the importance of taking into account somatic and affective experiences when looking across a variety of different physical illnesses.
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Affiliation(s)
- Lydia Poole
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
| | - Marta Jackowska
- Department of Psychology, University of Roehampton, London, SW15 4JD, UK
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12
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Finney N, Marshall A. Is migration in later life good for wellbeing? A longitudinal study of ageing and selectivity of internal migration. Area (Oxf) 2018; 50:492-500. [PMID: 30555170 PMCID: PMC6282955 DOI: 10.1111/area.12428] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/09/2018] [Indexed: 06/09/2023]
Abstract
Migration scholarship has recently paid attention to lifecourse and non-economic effects of moving house. Yet consideration of the effects of internal migration in later life has been relatively neglected despite their implications for social and spatial inequalities. Thus we address two questions: how trajectories of wellbeing in later life vary for movers and non-movers, and how the event of moving affects wellbeing. In both cases we distinguish between "voluntary" and "involuntary" movers. We use 10 years (2002-2012) of the English Longitudinal Study of Ageing (ELSA) to analyse trends in wellbeing for age cohorts and to examine how wellbeing changes through the event of moving. The Control, Autonomy, Selfrealisation and Pleasure (CASP-19) measure of wellbeing is used. We find that, after controls for demographic and socio-economic characteristics, involuntary movers have lower levels of wellbeing than stayers or voluntary movers; and involuntary movers experience a stabilisation in the decline in wellbeing following migration which is not seen for voluntary movers. So, migration in later life is good for wellbeing, maintaining advantageous wellbeing trajectories for voluntary movers and improving wellbeing trajectories for involuntary movers. These findings imply a rich potential of ELSA and similar longitudinal datasets for examining residential mobility; the need for ageing inequalities studies to take more account of residential mobility; the need for internal migration scholarship to pay greater attention to reason for move; and for policy to consider the potentially beneficial effects of residential mobility in later life, particularly for those in adverse circumstances.
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Affiliation(s)
- Nissa Finney
- School of Geography and Sustainable DevelopmentUniversity of St AndrewsSt AndrewsFifeUK
| | - Alan Marshall
- School of Social and Political ScienceUniversity of EdinburghEdinburghUK
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13
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Poole L, Steptoe A. Depressive symptoms predict incident chronic disease burden 10 years later: Findings from the English Longitudinal Study of Ageing (ELSA). J Psychosom Res 2018; 113:30-36. [PMID: 30190045 DOI: 10.1016/j.jpsychores.2018.07.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [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: 03/26/2018] [Revised: 07/18/2018] [Accepted: 07/18/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To assess the association between depressive symptoms and incident chronic illness burden in prospective longitudinal analyses. METHODS We analysed data from 2472 participants (62.88 ± 8.49 years old; 50.8% female) from the English Longitudinal Study of Ageing (ELSA). Depressive symptoms were measured using the Centre for Epidemiological Studies Depression (CES-D) scale at baseline in 2004, and participants were followed up for 10 years. Participants with prevalent illness at baseline (coronary heart disease [CHD], other cardiac illness, stroke, cancer, diabetes/high blood glucose, arthritis, lung disease, osteoporosis and Parkinson's disease) were excluded from models predicting illness burden (the sum of illnesses reported) over follow-up. Linear regression was used controlling for a wide range of covariates. RESULTS The mean chronic illness burden was 0.57, with 43.1% experiencing at least one incident physical illness. Baseline continuous CES-D score was a significant predictor of incident chronic illness burden up to 10 years later (incident rate ratio = 1.05, 95% confidence intervals = 0.05-0.21, p = .003), independent of sociodemographic, behavioural, cognitive and clinical covariates. Sensitivity analyses excluding participants who developed a chronic illness within the 2 years following baseline corroborated the main results. CONCLUSION Depressive symptoms were associated with greater incident chronic illness burden 10 years later. These findings have clinical implications for the treatment of depression in physically healthy older adults.
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Affiliation(s)
- Lydia Poole
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, United Kingdom.
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, United Kingdom
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Tampubolon G, Nazroo J, Keady J, Pendleton N. Dementia across local districts in England 2014 to 2015. Int J Geriatr Psychiatry 2018; 33:1127-1131. [PMID: 29869343 DOI: 10.1002/gps.4903] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 01/04/2018] [Accepted: 04/13/2018] [Indexed: 11/08/2022]
Abstract
BACKGROUND The number of older people needing dementia care is projected to rise rapidly, and local districts are now charged with responding to this need. But evidence on local area factors of dementia is scarce. We studied the odds of dementia prevalence and its individual risk factors enriched with area factors. MATERIALS AND METHODS This study analysed objectively assigned dementia prevalence in people aged 60 and over living in community in England, drawing data from the English Longitudinal Study of Ageing 2014 to 2015 and local districts statistics using multilevel logistic models. Dementia status is ascertained using a modified version of the Telephone Interview for Cognitive Status. A number of individual risk factors were considered including social determinants, internet use, social connections, and health behaviours; 2 contextual factors were included: the index of multiple deprivation and land use mix. RESULTS The prevalence of dementia by this method is 8.8% (95% confidence interval 7.7%-9.2%) in older adults in England. Maps of dementia prevalence across districts showed prevalent areas. In the full model, no area characteristics were significant in predicting dementia prevalence. Education, social connections, internet use, and moderate to vigorous physical activity showed protective associations. CONCLUSION Dementia in older adults in England is largely predicted by individual characteristics, although some districts have a large share of their population with dementia. Given the health and social care costs associated with dementia, differential interventions and support to districts and to groups of individuals defined by these characteristics seem warranted.
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Affiliation(s)
- Gindo Tampubolon
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - James Nazroo
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - John Keady
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Neil Pendleton
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
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Graham E, Au B, Schmitz N. Depressive symptoms, prediabetes, and incident diabetes in older English adults. Int J Geriatr Psychiatry 2017; 32:1450-1458. [PMID: 27892613 DOI: 10.1002/gps.4634] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 09/08/2016] [Revised: 10/27/2016] [Accepted: 10/28/2016] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The objective of this study was to assess the risk of diabetes in older adults with elevated depressive symptoms, prediabetes, or both. METHOD This study included 4129 participants from the English Longitudinal Study of Ageing. Participants were followed from Wave 2 (2004-2005) to Wave 6 (2012-2013). The 8-item Centre for Epidemiologic Studies Depression (CESD) scale was used to measure depressive symptoms in the past week, which were categorized as no/low, mild, or high. Normal glucose levels and prediabetes were defined using baseline haemoglobin A1c measurements. Incident diagnosed diabetes was reported by participants. Cox regression estimated hazard ratios of incident diabetes associated with depressive symptoms and prediabetes. RESULTS A total of 157 participants were diagnosed with diabetes over a mean of 6.7 years. Relative to participants with normal glucose levels and no/low depressive symptoms at baseline, the adjusted hazard ratios were 0.85 (95% CI 0.40-1.82) and 1.62 (95% CI 0.84-3.15) for those with normal glucose levels and mild depressive symptoms and normal glucose levels and high depressive symptoms. The adjusted hazard ratios for participants with prediabetes and no/low depressive symptoms, mild depressive symptoms, and high depressive symptoms were 4.84 (95% CI 3.08-7.60), 7.17 (95% CI 4.00-12.88), and 7.77 (95% CI 4.33-13.93), respectively. CONCLUSIONS Older adults with elevated depressive symptoms and prediabetes have an increased risk of diabetes compared to those with only one of these risk factors. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Eva Graham
- Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Bonnie Au
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Norbert Schmitz
- Douglas Mental Health University Institute, Montreal, Quebec, Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,Montreal Diabetes Research Centre, Montreal, Quebec, Canada
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Abstract
OBJECTIVES To prospectively investigate the impact of transitions in informal caregiving on emotional well-being over two years in a large population study of older people. METHODS Information on provision of unpaid care in 2004/2005 and 2006/2007 was available for 6571 participants in the English Longitudinal Study of Ageing. Three well-being domains were also assessed on each occasion: life satisfaction (measured with the Satisfaction with Life Scale); quality of life (assessed with the CASP-19 scale); and depression symptoms (measured using the Centers for Epidemiologic Studies Depression Scale). Multivariable analyses of the impact on well-being of two-year caregiving transitions (caregiving entry and caregiving exit, or continued caring) were conducted separately for spousal/child carers and carers of other family/non-relatives. RESULTS Compared to non-caregiving, entry into spousal/child caregiving was associated with decline in quality of life (B = -1.60, p < .01) whereas entry into caregiving involving other kin relations increased life satisfaction (B = 1.02, p < .01) and lowered depression symptoms (B = -0.26, p < .05). Contrary to expectations, caregiving exit was related to increased depression in both spousal/child (B = 0.44, p < .01) and non-spousal/child (B = 0.25, p < .05) carers. Continued spousal/child caregiving was also related to decline in quality of life (B = -1.24, p < .05). Other associations were suggestive but non-significant. CONCLUSION The emotional impact of different caregiving transitions in later life differs across kin relationships; notably, spousal and child carers' well-being was consistently compromised at every stage of their caregiving career over the two-year study period.
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Affiliation(s)
- Snorri Bjorn Rafnsson
- a Department of Epidemiology and Public Health , University College London , London , UK
| | - Aparna Shankar
- a Department of Epidemiology and Public Health , University College London , London , UK
| | - Andrew Steptoe
- a Department of Epidemiology and Public Health , University College London , London , UK
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