European Journal of Ageing

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Online ISSN: 1613-9380
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Working hours by age and gender; Swiss Household Panel (1999–2020)
Self-rated health by age and gender; Swiss Household Panel (1999–2020)
This study investigated how individual trajectories of self-rated health (SRH) and working hours among older workers in Switzerland are interrelated and how this relationship varies based on occupation. We used data from the Swiss Household Panel to analyze the long-term trajectories of older workers measured in terms of working hours and SRH. The sample included more than 4000 workers aged 50 to 65(men)/64(women). We ran a bivariate response multilevel model for growth that allowed the examination of between- and within-individual changes over time. On a between-individual level, we found that the upper non-manual workers were the most heterogeneous occupational group in terms of working hours and the lower non-manual workers were the most heterogeneous occupational group in terms of health. Within all occupational groups, we found a significant relationship between the level of working hours and level of SRH. The individual-level statistics showed consistently strongest effects for manual workers. This result confirms our hypothesis that labor force participation in individuals of the manual occupational group is more sensitive to their health status. Our findings contribute to the debate regarding the importance of older workers’ health in the context of the extension of working life.
The aim of the study is to investigate psychosocial factors that are associated with positive and negative coping with stress, as well as with worries about and perceived threat by COVID-19 to enable us to provide adequate support for oldest-old individuals. A paper–pencil-based survey assessed COVID-19 worries and perceived threat, depression, anxiety, somatization, social support, loneliness, resilience, positive and negative coping in a sample of n = 197 oldest-old individuals (78–100 years). Linear multivariate and binary logistic regression analyses were conducted. Individuals with high levels of resilience were more likely to feel self-efficient when coping with stress. High levels of depression, anxiety and loneliness were associated with feeling more helpless when coping with stress. However, oldest-old individuals who felt lonely also experienced situations where they felt competent in stress coping. Being male and experiencing high levels of social support was more likely associated with high levels of worries due to COVID-19. Increased age and higher levels of depression were associated with lower levels of perceived personal threat, whereas higher somatization scores were more likely associated with higher perceived personal threat. Findings suggest that mental health factors may shape the way oldest-old individuals cope with pandemic-related stress. Resilience might be an important factor to take into account when targeting an improvement in positive coping with stress. Oldest-old individuals who have higher levels of depression, anxiety and feel lonely may be supported by adapting their coping skill repertoire to reduce the feeling of helplessness when coping with stress.
It is increasingly urgent to retain older workers in the workforce. In the present study, we analysed the prospective associations between employees’ perceptions of their managers’ attitudes towards older workers, and of having experienced age discrimination in the labour market with the risk of loss of paid work before the state pension age. Questionnaire data from 10,320 currently employed workers aged 50 + on perceptions of managers’ attitudes towards older workers and perceived age discrimination were collected at baseline in the SeniorWorkingLife study. Data on labour market affiliation were obtained from national registers at baseline and two-year follow-up. Results show that the perception of negative attitudes was prospectively associated with an increased risk of loss of paid work for three of the five negative attitudes “older workers create conflicts, their qualifications are outdated, and they cannot keep up with the pace and development”. Perception of positive attitudes was prospectively associated with a reduced risk of loss of paid work. The perception of age discrimination was prospectively associated with an increased risk of loss of paid work. The results strengthen existing evidence on associations between ageism and labour market attachment, by applying a longitudinal design and including actual change in labour market participation. However, some negative attitudes may be more detrimental to the older workers’ labour market participation. Employees’ positive perceptions of managers’ attitudes reduced the risk. Good relations between employees and managers appear to be important for retaining older workers in the labour market.
Sample structure, ELSA, waves 6–9 Attrition sample includes people who died or were lost to follow-up
Boxplots of care intensity and functional limitations according to trajectory memberships (N = 13,425) Left panel: sample distribution of the hours of long-term care according to the trajectories of care intensity; Right panel: sample distribution of the number of functional limitations according to the trajectories of care needs; The box covers the interquartile range; The horizontal line splitting the box is the median; The two whiskers extend to the 10th percentile and 90th percentile of the distribution, respectively
Trajectory memberships of long-term care needs and intensity (N = 13,425) Upper left panel: Trajectories of predicted care needs (measured by the number of functional limitations) according to age; Upper right panel: Trajectories of predicted care intensity (measured by weekly h of unpaid and formal care) according to age; lower left panel: proportion of people in different trajectories of care intensity conditional on trajectories of care needs; lower right panel: average h of care according to marital status and age in older people following the high-needs trajectory (95% confidence interval plotted on the mean)
Trajectory memberships of long-term care intensity according to sources of care (N = 13,425) Upper left panel: Trajectories of predicted informal care intensity according to age; Upper right panel: Trajectories of predicted formal care intensity according to age; lower left panel: average h of informal care according to marital status and age in older people following the high-needs trajectory (95% CI plotted on the mean); lower right panel: average h of formal care according to marital status and age in older people following the high-needs trajectory (95% CI plotted on the mean)
Sample characteristics in wave 6
This study investigates the developmental trajectories of long-term care needs and utilisation in older people aged 65 years and over in England. The data came from the English Longitudinal Survey of Ageing (ELSA, waves 6–9, 2012–2018, N = 13,425). We conducted dual trajectory analyses to cluster people’s trajectories of care needs (measured by functional disability) and utilisation into distinct groups. We conducted logistic regression analyses to identify the factors associated with trajectory memberships. We identified three trajectories of long-term needs (low, medium, and high) and three trajectories of care utilisation (low, medium, and high). Both care needs and care hours increased with age, but the speed of increase varied by trajectory. Females, minority ethnic groups, people with low wealth, and those experiencing housing problems were more likely to follow the joint trajectories characterised by higher care needs and higher care intensity. People with low or medium care needs stayed in the same trajectories of care utilisation. In contrast, people in the high-needs trajectory followed divergent trajectories of care utilisation: 63% of them followed the trajectory of high care intensity and the rest (37%) followed the trajectory of medium care intensity. Lack of spouse care was the leading predictor of trajectory divergence (OR = 3.57, p < 0.001). Trajectories of care needs and utilisation are highly heterogeneous in later life, which indicates persistent inequalities over time. Single people with multiple functional limitations face an acute and enduring risk of inadequate care and unmet needs. The amount of support is as important as the availability of support.
Retirement-aged workers with chronic conditions are increasingly engaged in late-life careers in the policy context of delayed retirement initiative. However, it remains uncertain as to how chronic conditions and employment-based social health insurance interact to affect health-related working capacity and late career participation in this group of people. Using data from the China Health and Retirement Longitudinal Study (CHARLS) and the discrete choice model, this study finds that chronic conditions are negatively associated with health-related working capacity (– 0.400, p < 0.01) and late-life career participation (– 0.170, p < 0.01). Employment-based health insurance is positively associated with health-related working capacity of retirement-aged workers (0.432, p < 0.01), but is negatively associated with their late-life career participation (– 1.027, p < 0.01). Moreover, employment-based health insurance could weaken the negative associations between chronic conditions and health-related working capacity (interaction = 0.285, p < 0.05) and late-life career participation (interaction = 0.251, p < 0.05). More fine-grained policies for delayed retirement are needed to focus on the long-neglected health of retirement-aged workers with chronic conditions.
Persistent inequalities in access to community-based support limit opportunities for independent living for older people with care needs in Europe. Our study focuses on investigating how gender, widowhood and living arrangement associate with the probability of receiving home and community-based care, while accounting for the shorter-term associations of transitions into widowhood (bereavement) and living alone, as well as the longer-term associations of being widowed and living alone. We use comparative, longitudinal data from the Survey of Health, Ageing and Retirement in Europe (collected between 2004 and 2015 in 15 countries) specifying sex-disaggregated random-effects within-between models, which allow us to examine both cross-sectional and longitudinal associations among widowhood, living arrangements and community-based care use. We find widowhood and living alone are independently associated with care use for both older women and men, while bereavement is associated with higher probability of care use only for women. Socio-economic status was associated with care use for older women, but not for men in our sample. The gender-specific associations we identify have important implications for fairness in European long-term care systems. They can inform improved care targeting towards individuals with limited informal care resources (e.g. bereaved older men) and lower socio-economic status, who are particularly vulnerable to experiencing unmet care needs. Gender differences are attenuated in countries that support formal care provision, suggesting gender equity can be promoted by decoupling access to care from household and family circumstances. Supplementary information: The online version contains supplementary material available at 10.1007/s10433-022-00717-y.
COVID-19 mitigation efforts had the potential to exacerbate loneliness among older adults, particularly for the unpartnered or childless, yet specific studies on loneliness among these groups during the COVID-19 pandemic are lacking. Using data from the Survey of Health, Ageing and Retirement in Europe (SHARE) collected before (October 2019-March 2020) and during the pandemic (June-August 2020), we examine two loneliness outcomes: (1) "have you felt lonely recently?" (both datasets) and (2) "have you felt lonelier than before the pandemic?" (2020), and examine differences by partnership and parenthood status. Before COVID-19, those who lacked one tie but had the other (unpartnered parents or partnered childless) were at highest loneliness risk. During COVID-19, unpartnered and childless-especially unpartnered-remain at higher risk for loneliness, entering loneliness, and not "exiting" loneliness. We discuss these findings in light of family norms and needs in pandemic and non-pandemic times and provide recommendations for future research. Supplementary information: The online version contains supplementary material available at 10.1007/s10433-022-00718-x.
Flowchart illustrating the number of participants and exclusion criteria
Lifelong learning offers an opportunity for mature employees to stay adept in the light of changing demands, to promote health and counteract physical and cognitive decline. This intervention study evaluates the effects of a multi-component training programme for employees aged 50+ , focussing on competence expectations, stress management, cognitive, metacognitive and psychomotoric training. Effects were evaluated in a longitudinal control group design with follow-up after six months (24 training groups, n = 247, participants per group: M = 13.04, SD = 2.44; control group, n = 199). To control for experimenter effects the same programme was administered to 6 additional groups by trained instructors (n = 54, participants per group: M = 11.83, SD = 3.37). To validate effects of the multi-component training 12 supplementary groups were included, with 4 groups each focusing on either the competence (n = 49, participants per group: M = 15.00, SD = 0.00) or cognitive (n = 43, participants per group: M = 14.25, SD = 1.50) or stress management components (n = 41, participants per group: M = 14.50, SD = 0.58). Data of 633 adults (mean age: M = 55.03, SD = 3.71 years) were analysed. Participants reported high acceptance of the programme. The multi-component training programme was effective regarding improvements in subjective health, self-concept of professional competence, self-efficacy, coping with stress and cognitive abilities with long-term effects for the latter four. Trainings administered by trained instructors had similar effects to those administered by the programme's designers. The single-component trainings led to specific effects in the focused areas, overall comparable to those of the multi-component training. Unexpectedly, cognitive effects were obtained by all single-component trainings. Subjective health and self-efficacy were only promoted by the multi-component training, indicating broader effects. The results are discussed with respect to strengths and limitations of the study, possible mechanisms underlying the effects, suggestions for further research as well as for the training's implementation in business practice.
Age simulation suits (ASS) are widely used to simulate sensory and physical restrictions that typically occur as people age. This review has two objectives: First, we synthesize the current research on ASS in terms of the ob-served psychological and physical effects associated with ASS. Second, we analyse indicators able to estimate the validity of ASS in simulating “true” ageing processes. Following the PRISMA guidelines, eight electronic databases were searched (BASE, Cinhal, Cochrane, Google Scholar, ProQuest, PsychINFO, Pubmed, and Web of Science). Qualitative and quantitative studies addressing effects of ASS interventions regarding psychological outcomes (i.e., empathy, attitudes) or physical parameters (i.e., gait, balance) were included. The Mixed Meth-ods Appraisal Tool (MMAT) was applied for quality assessment. Of 1890 identified citations, we included 94 for full-text screening and a total of 26 studies was examined. Publication years ranged from 2001 to 2021. Study populations were predominantly based on students in health-related disciplines. Results suggest that ASS can initiate positive effects on attitudes toward (dweighted=0.33) and empathy for older adults (dweighted=0.54). Physical performance was significantly reduced; however, there is only little evidence of a realistic simulation of typical ageing processes. Although positive effects of ASS are supported to some extent, more diverse study popula-tions and high-quality controlled designs are needed. Further, validation studies examining whether the simula-tion indeed reflects “real” ageing are needed and should build on reference data generated by standardized geri-atric assessments or adequate comparison groups of older adults.
The prevalence of depressive symptoms decreases from late adolescence to middle age adulthood. Furthermore, despite significant losses in motor and cognitive functioning, overall emotional well-being tends to increase with age, and a bias to positive information has been observed multiple times. Several causes have been discussed for this age-related development, such as improvement in emotion regulation, less regret, and higher socioeconomic status. Here, we explore a further explanation. Our minds host mental models that generate predictions about forthcoming events to successfully interact with our physical and social environment. To keep these models faithful, the difference between the predicted and the actual event, that is, the prediction error, is computed. We argue that prediction errors are attenuated in the middle age and older mind, which, in turn, may translate to less negative affect, lower susceptibility to affective disorders, and possibly, to a bias to positive information. Our proposal is primarily linked to perceptual inferences, but may hold as well for higher-level, cognitive, and emotional forms of error processing.
Physical fitness measures among poor, moderate, good and excellent work ability groups expressed as means and their 95% confidence intervals, adjusted for age, gender and occupational status
Background With advancing age, physical capacity gradually decreases which may lead to decreased work ability, if the physical work requirements remain the same. Examination of the importance of physical fitness for work ability among aging workers will help to find potential strategies to promote work ability in old age. The aim of this study was to investigate the association between physical fitness and work ability among aging workers. Methods Aging workers (n = 288, mean age 62.5, 83% women) from the Finnish Retirement and Aging study underwent cardiorespiratory, muscular fitness and functional testing. Work ability was inquired on a scale 0–10 from poor to excellent. Association between physical fitness indicators and work ability was examined using ordinary least squares regression, taking into account age, gender, occupational status, heavy physical work, body mass index and accelerometer-measured daily total physical activity. Results VO2peak, modified push-up test and maximal walking speed were positively associated with work ability (β = 0.51, 95% confidence interval (CI) 0.29–0.74, β = 0.46, 95% CI 0.26–0.66 and β = 0.23, 95% CI 0.07–0.39, respectively), while chair rise test time was inversely associated with work ability (β = −0.23, 95% CI −0.39–−0.06). No associations were found between hand grip strength or sit-up test and work ability. Conclusions Cardiorespiratory fitness, upper body strength, and lower extremity function were positively associated with work ability. Good physical fitness may help to maintain work ability among aging workers.
Marginal Effects at the mean of having stopped caring, cared less, no change in care, or cared more for the determinant Do I want to? indicated by caregivers’ worries about the care recipient during compared to before the lockdown (‘less’ indicates feeling less worried and ‘more’ indicates feeling more worried) based on the multinominal multilevel regression
Marginal Effects at the mean of having stopped caring, cared less, no change in care, or cared more for the determinant Do I have to? indicated by changes in formal care provided to the care recipient during compared to before the lockdown based on the multinominal multilevel regression
Marginal Effects at the mean of having stopped caring, cared less, no change in care, or cared more for the determinant Can I? indicated by caregivers’ assessment whether they felt restricted in their care provision by the measurements of the Dutch government to control the corona virus (‘agree’ indicates feeling highly restricted, and ‘disagree’ indicates not feeling restricted) based on the multinominal multilevel regression
Informal care, meaning taking health-related care of people in their own social network, is a topic that gets more and more attention in social science research because the pressure on people to provide informal care is rising due to ageing societies and policy changes. The Informal Care Model developed by Broese van Groenou and de Boer (2016) provides a theoretical foundation to understand under what conditions a person provides informal care. We test this theoretical model by applying it to intrapersonal changes in informal care provision during the first COVID-19 lockdown in the Netherlands in Spring 2020. Data from the LISS panel from two time points, March 2020 and data from July over the period of April/May 2020, were analysed with multinominal multilevel regression analysis (N = 1270 care situations of 1014 caregivers). Our results showed that the individual determinants (Do I have to?, Do I want to?, and especially Can I?) discussed in the Informal Care Model (apart from a series of control variables) are contributing substantially to the understanding of intrapersonal changes in care provision during the first lockdown and by that, we found empirical support for the theoretical model. We conclude that on top of its original purpose to explain between-individual differences in informal caregiving using static indicators, the Informal Care Model is also useful to explain intrapersonal changes in informal caregiving using dynamic indicators.
Consumer choice models have been introduced in eldercare services in several Western welfare societies. Choice models in eldercare emphasise the importance of individuals’ abilities to make informed choices and therefore entail a risk for increased inequalities among older adults with care needs. In the Nordic countries, such inequality risks are in stark contrast to universal policy ambitions of equal access to care services. Care managers, who are responsible for needs assessment for eldercare services, have a central role in implementing policies and, thus, have first-hand experience of their impact on older adults’ access to care. The aim of this study was to explore care managers’ experiences of how user choice affects older adults’ access to care services in three Nordic cities: Copenhagen, Tampere, and Stockholm. These cities were purposely selected as forerunners in marketisation, with different ways of implementing choice models. Semi-structured interviews with care managers were conducted in Copenhagen, Tampere, and Stockholm and analysed thematically. The findings indicate there are difficulties related to older adults’ ability to access information needed to make informed choices, as well as limitations in choice related to available services and personal finances. Further, care managers find that older adults’ abilities to overcome these difficulties are shaped by their health, education, language skills, and assistance from relatives. In order to reduce the risk of choice models increasing the gap between older adults with different resources and capabilities, there is a need to develop accessible information, as well as models for professional guidance.
Users of residential care services, % of 80 + , 2000-most recent year. Sources: Residential care— SOCI22: People aged 65 + living in institutions or service housing, by unit, age, time and reporting country, for the period 2000–16. This is supplemented with national data for the period 2017–2020. Note that Danish data before 2004 and after 2008 are not comparable due to a change in the how to account for residential care
Users of home care, % of 80 + , 2000-most recent year. Sources: OECD Health Care Statistics (xxxx) and Socialstyrelsen (2021). Note In Denmark and Finland, this includes only those who receive regular home care services, not intermediate services
With the extensive long-term care services for older people, the Nordic countries have been labelled ‘caring states’ as reported (Leira, Welfare state and working mothers: the Scandinavian experience, Cambridge University Press, Cambridge, 1992). The emphasis on services and not cash benefits ensures the Nordics a central place in the public service model (Anttonen and Sipilä, J Eur Soc Policy 6:87–100, 1996). The main feature of this ideal model is public social care services, such as home care and residential care services, which can cover the need for personal and medical care, as well as assistance with household chores. These services are provided within a formally and professionally based long-term care system, where the main responsibility for the organization, provision and financing of care traditionally lays with the public sector. According to the principle of universalism (in: Antonnen et al. (eds), Welfare state, universalism and diversity, Elgar, Cheltenham, 2013), access to benefits such as home care and residential care is based on citizenship and need, not contributions nor merit. Also, care services should be made available for all and generally be used by all, with no stigma associated. Vabø and Szebehely (in: Anttonen (ed), Welfare State, universalism and diversity, Edward Elgar Publishing, London, 2012)) further argue that the Nordic service universalism is more than merely issues of eligibility and accessibility, in that it also encompasses whether services are attractive, affordable and flexible in order to meet a diversity of needs and preferences. However, recent decades have seen a continuous tendency towards prioritization of care for the most frail, contributing to unmet need, informalization of care and privatization in the use of topping up with market-based services. These changes have raised questions about increasing inequalities within Nordic long-term care systems. We investigate in the article what effect changes have for equality across social class and gender, for users and informal carers. The article is based on analysis of comparable national and international statistics and a review of national research literature and policy documents.
Population ageing with an increasing number of people experiencing complex health and social care needs challenges health systems. We explore whether and how health system reforms and policy measures adopted during the past two decades in Finland and Sweden reflect and address the needs of the older people . We discuss health system characteristics that are important to meet the care needs of older people and analyse how health policy agendas have highlighted these aspects in Finland and Sweden. The analysis is based on “most similar cases”. The two countries have rather similar health systems and are facing similar challenges. However, the policy paths to address these challenges are different. The Swedish health system is better resourced, and the affordability of care better ensured, but choice and market-oriented competition reforms do not address the needs of the people with complex health and social care needs, rather it has led to increased fragmentation. In Finland, the level of public funding is lower which may have negative impacts on people who need multiple services. However, in terms of integration and care coordination, Finland seems to follow a path which may pave the way for improved coordination of care for people with multiple care needs. Intensified monitoring and analysis of patterns of health care utilization among older people are warranted in both countries to ensure that care is provided equitably.
Increase in mid-year population and change in educational structure for 65 + population in Denmark, Finland, Norway and Sweden between 2001–2005 and 2011–2015
Increase in life expectancy at age 65 and 80 by level of education in Denmark, Finland, Norway and Sweden between 2001–2005 and 2011–2015
Increase in life expectancy at age 65 between 2001–2005 and 2011–2015 decomposed into the contributions of changes in education-specific mortality and educational structure of the populations in Denmark, Finland, Norway and Sweden
Overall progress in life expectancy (LE) depends increasingly on survival in older ages. The birth cohorts now reaching old age have experienced considerable educational expansion, which is a driving force for the social change and social inequality. Thus, this study examines changes in old age LE by educational attainment in the Nordic countries and aims to find out to what extent the change in national LEs is attributable to education-specific mortality and the shifting educational composition. We used national register data comprising total 65 + populations in Denmark, Finland, Norway and Sweden to create period life tables stratified by five-year age groups (65-90 +), sex and educational attainment. Difference in LE between 2001 and 2015 was decomposed into the contributions of mortality changes within each educational group and changes in educational composition. Increasing LE at all ages and in all educational groups coincided with persistent and growing educational inequalities in all countries. Most of the gains in LE at age 65 could be attributed to decreased mortality (63-90%), especially among those with low education, the largest educational group in most countries. The proportion of the increase in LE attributable to improved education was 10-37%, with the highest contributions recorded for women in Norway and Sweden. The rising educational levels in the Nordic countries still carry potential for further gains in national LEs. However, the educational expansion has contributed to uneven gains in LE between education groups, which poses a risk for the future increase of inequalities in LE. Supplementary information: The online version contains supplementary material available at 10.1007/s10433-022-00698-y.
Hospital discharge of older people in need of both medical and social care following their hospital stay requires extensive coordination. This study aims to examine and compare the views of nurses in three Nordic cities on the influence of sociodemographic factors and having close relatives, for the hospital discharge and post hospital care of older people with complex health and social care needs. Thirty-five semi-structured interviews (Copenhagen n = 11, Tampere n = 8, Stockholm n = 16) with nurses were conducted. The nurses were identified through the researchers' networks, invitation and snowball sampling, and recruited from hospitals, primary care practices, home care units, home nursing units, and geriatric departments. The interviews were transcribed and analysed using thematic analysis. Interpretations were discussed and agreed within the team. Four main themes and 13 sub-themes were identified. Across the cities, informants reported that the patient's health status, rather than their gender or ethnicity, steered the discharge date and further care. Care costs, commonly reported in Tampere but also in Copenhagen and Stockholm including costs for medications and home help, were considered barriers for disadvantaged older people. Home situation, local arrangements and differences in collaboration between healthcare professionals at different sites also influenced the hospital discharge. Generally, the patient's health status steered the hospital discharge and post-hospital care. Close relatives were regarded important and a potential advantage. Some informants tried to compensate for the absence of close relatives, highlighting the importance of care systems that can compensate for this to minimise avoidable inequity. Supplementary information: The online version contains supplementary material available at 10.1007/s10433-022-00701-6.
Average marginal effects on loneliness for all social exclusion variables by country and for total sample, estimated from Tables 2, 3, and 4
Several factors associated with loneliness are also considered indicators of social exclusion. While loneliness has been proposed as an outcome of social exclusion, there is limited empirical evidence of a link. This study examines the associations between social exclusion indicators and loneliness in older adults (60+ years) in four Nordic countries. Data from four waves of the European Social Survey were pooled, providing a total of 7755 respondents (Denmark n = 1647; Finland n = 2501, Norway n = 1540; Sweden n = 2067). Measures of loneliness, demographic characteristics, health, and eight indicators of social exclusion were selected from the survey for analysis. Country-specific and total sample hierarchical logistic regression models of loneliness were developed. Significant model improvement occurred for all models after social exclusion indicators were added to models containing only demographic and health variables. Country models explained between 15.1 (Finland) and 21.5% (Sweden) of the variance in loneliness. Lower frequency of social contacts and living alone compared to in a two-person household was associated with a higher probability of loneliness in all countries, while other indicators were associated with loneliness in specific countries: lower neighbourhood safety (Sweden and Denmark); income concern (Sweden and Finland); and no emotional support (Denmark, Finland, and Sweden). A robust relationship was apparent between indicators of social exclusion and loneliness with the direction of associations being highly consistent across countries, even if their strength and statistical significance varied. Social exclusion has considerable potential for understanding and addressing risk factors for loneliness. Supplementary information: The online version contains supplementary material available at 10.1007/s10433-022-00692-4.
Path models for the TUTs and SITUTs
This study aimed to assess the effects of aging on mind wandering (MW) using a sustained attention to response task (SART) with a low cognitive demand. All task-unrelated thoughts (TUTs) and the subcategory of stimulus-independent thoughts (SITUTs) were examined across the adult life span. The relationship between MW, cognitive variables (attention, inhibition, working memory), and non-cognitive variables (mindfulness, psychological well-being, and anxiety) was investigated. The sample included 210 healthy participants from 20 to 89 years old. The overall results showed few or no age-related changes in both TUTs and SITUTs. Path analyses revealed that the effect of age on both TUTs and SITUTs was only indirect and mediated by attentional resources, as well as by some aspects of psychological well-being (i.e., emotional competence), which had a direct effect, however. These findings raise doubts about any age-related differences between young and older adults' MW. Changes in MW across the adult life span are thus discussed along with the method and tasks used to assess it and different variables affecting it.
Flow diagram of analytical sample Note: HR = heart rate; HRV = heart rate variability; year = 2008–2010
Supportive family and friendship ties can serve different functions and thus might show different associations with an individual's health. Particularly, older adults might show varying health benefits of different types of supportive ties depending on their marital and retirement status. Our aim is to analyze relationships between different types of supportive social ties and autonomic nervous system (ANS) function, a physiological indicator of health that can help to establish the biological plausibility of the association-measured by heart rate variability (HRV). We present cross-sectional linear regression analyses of a German cohort of community-dwelling older adults (2008-2010; n = 1,548; mean age = 68.7 years). Our findings indicate that supportive friendship ties show significant positive associations (i.e., higher HRV) in individuals that are either not married or above retirement age. Supportive family ties show significant positive associations in individuals below retirement age. Significant results vanish or are reduced after accounting for behavioral/physical and psychological/cognitive indicators. We conclude that programs supporting the development or maintenance of friendship ties might be especially beneficial in unmarried older adults and adults above retirement age. Supplementary information: The online version contains supplementary material available at 10.1007/s10433-021-00638-2.
Kaplan-Meyer survival curves for mortality *P value from log rank test
This study investigated whether fear of falling (FOF) measured by two different instruments, the Falls Efficacy Scale-International (FES-I) and the single question on FOF and activity restriction (SQ-FAR), is associated with mortality at 6-year follow-up. Participants ( n = 1359, 58.6% women) were community-dwelling persons enrolled in the Lausanne cohort 65 + , aged 66 to 71 years at baseline. Covariables assessed at baseline included demographic, cognitive, affective, functional and health status, while date of death was obtained from the office in charge for population registration. Unadjusted Kaplan Meyer curves were performed to show the survival probability for all-cause mortality according to the degree of FOF reported with FES-I and SQ-FAR, respectively. Bivariable and multivariable Cox regression analyses were performed to assess hazard ratios, using time-in-study as the time scale variable and adjusting for variables significantly associated in bivariable analyses. During the 6-year follow-up, 102 (7.5%) participants died. Reporting the highest level of fear at FES-I (crude HR 3.86, 95% CI 2.37–6.29, P < .001) or “FOF with activity restriction” with SQ-FAR (crude HR 2.42, 95% CI 1.44-4.09, P = .001) were both associated with increased hazard of death but these associations did not remain significant once adjusting for gender, cognitive, affective and functional status. As a conclusion, although high FOF and related activity restriction, assessed with FES-I and SQ-FAR, identifies young-old community-dwelling people at increased risk of 6-year mortality, this association disappears when adjusting for potential confounders. As a marker of negative health outcomes, FOF should be screened for in order to provide personalized care and reduce subsequent risks.
Association variables based on Cramer’s V
Nomogram dichotomous frailty
The aim of this cross-sectional study was to develop a Frailty at Risk Scale (FARS) incorporating ten well-known determinants of frailty: age, sex, marital status, ethnicity, education, income, lifestyle, multimorbidity, life events, and home living environment. In addition, a second aim was to develop an online calculator that can easily support healthcare professionals in determining the risk of frailty among community-dwelling older people. The FARS was developed using data of 373 people aged ≥ 75 years. The Tilburg Frailty Indicator (TFI) was used for assessing frailty. Multivariate logistic regression analysis showed that the determinants multimorbidity, unhealthy lifestyle, and ethnicity (ethnic minority) were the most important predictors. The area under the curve (AUC) of the model was 0.811 (optimism 0.019, 95% bootstrap CI = −0.029; 0.064). The FARS is offered on a Web site, so that it can be easily used by healthcare professionals, allowing quick intervention in promoting quality of life among community-dwelling older people.
PRISMA flowchart of review process
Intergenerational solidarity and cultures
Intergenerational interactions and exchange are major components of grandparenting, and the present study sought to examine how the intergenerational solidarity framework has been used to investigate grandparenting practices across the lifespan and in different cultures. This framework is widely used across cultures and provides a basis to discuss the future of grandparenting research, considering cultural intermingling and changes in society. Following PRISMA-ScR guidelines, we searched three databases (PsycInfo, PubMed, and Web of Science). Finally, 42 empirical studies that met the inclusion criteria were included in this scoping review. They were published between 1991 and 2020 and assessed intergenerational solidarity between grandparents and their grandchildren. Our findings show that research on grandparenting based on the intergenerational solidarity framework has increased in the last 30 years, and that this model provides a comprehensive approach to studying grandparenting across the lifespan in different cultures. The present study identified cross-cultural differences in the prevalence of the types of intergenerational solidarity. Affectual solidarity was shown to be the most studied dimension of intergenerational solidarity in North America, Europe and Israel, while normative solidarity was the most represented in Asian studies. The only Australian study investigated affectual and functional solidarity. This model is thus suitable for studying grandparenting, but further studies are needed to investigate changes in intergenerational solidarity between grandparents and their grandchildren at different stages of development and account for cultural specificities.
Flow chart. Scoping review on older people’s arts activities
Number of publications on older adult's participation in artistic activities, by year of publication. Period 1960–2020. N = 129
This scoping review analyses existing literature on older adults’ participation in artistic activities. It identifes gaps in this research topic and suggests new directions for research. We followed the fve-step process defned by Arksey and O’Malley (2005) and extended by Levac et al. (2010). Four electronic databases were searched, and 129 peer-reviewed articles were included in the scoping review. Research into older adults’ participation in artistic activities has grown in the last ten years. However, empirical papers tend to focus on the outcomes of older people’s participation in artistic activities, in particular the benefts. Most papers centred on facilitators to examine the antecedents of this type of participation among people in late life. Research about experiences, potentially negative consequences or barriers to older adults’ participation in artistic activities have been largely overlooked. We identifed several gaps in the literature, which we classifed as: related to the artistic activities that were considered; the potential costs and barriers for older adults’ participation in artistic activities; older adults’ voices and their diversity; the life course perspective; and a contextual view of research on the topic. These gaps suggest challenges that future research on older adults’ participation in artistic activities should consider. Keywords: Participation in artistic activities · Older people · Active aging · Scoping review
Population ageing poses growing challenges to social security systems, in particular to public pension funds. The study analyses how Working Life Expectancy (WLE) and Healthy Working Life Expectancy (HWLE) in terms of three health indicators developed in Germany. Based on the German Socio-Economic Panel (GSOEP) from 2002 to 2018 ( n = 211,141), time trends in labour force rates, mental and physical Health-Related Quality of Life (HRQoL), self-rated health (SRH) and the respective combinations (health indicator*labour force) were analysed for all respondents aged 18–74. WLE and HWLE were calculated using the Sullivan method. WLE and HWLE in men and women at age 18 and 50 clearly increased over time. These increases in HWLE were found in terms of all three health indicators. This development was mainly driven by the clear increase of the labour force rates, since the shares of individuals with good and satisfactory SRH or average and good HRQoL remained largely stable over time. The results show that from a health perspective there have been potentials for increases in WLE during the past two decades and that increasingly more healthy life years are spent economically active. However, life years in the labour force but in poor health have increased, too. The absence of clear improvements in health emphasises the importance of current and future preventive measures to maintain health, especially among the middle-aged and older labour force.
Life satisfaction change from age 40 to age 90
Positive affect change from age 40 to age 90
Negative affect (reversed) change from age 40 to age 90
Engagement change from age 40 to age 90
This paper explores qualifications to the much-discussed paradox that although aging is associated with multiple physical and social losses, subjective well-being (SWB) is stable or increasing in later life. We explore age-related changes in cognitive, affective, and eudaimonic dimensions in three waves of data spanning up to 15 years from the Norwegian NorLAG study (N = 4,944, age 40 − 95). We employ fixed-effect models to examine the nature and predictors of aging effects on SWB. Results indicate a general pattern of stability well into older age, but negative changes in advanced age across well-being measures. Declines in SWB are less pronounced and with a later onset for the cognitive compared with the other measures. Loss of health, a partner, and friends are robust predictors of declining SWB. Women report both more negative affect and engagement than men, and these differences increase with age. In conclusion, while increasing SWB from midlife to the mid-70 s attests to the adaptive behaviors and coping resources of young-old adults, the significant downturns in SWB in advanced age point to limits to psychological adjustment when health-related and social threats and constraints intensify.
It is frequently assumed that the inheritance of wealth undermines economic activity. If such an assumption is valid, the expected wave of bequests may have a negative impact on labour market activity of heirs, what might further weaken the financing of state pension systems. This paper provides a detailed review of the empirical findings on the associations of inheritances with labour market activity, that is labour force participation status and working hours, and presents own analyses based on the survey of health, ageing, and retirement in Europe. We find that the receipt of an inheritance is not related to labour force participation in general. Inheritance expectations even have a small, but statistically significant positive effect on remaining in the labour force for men. Women who expect an inheritance tend to reduce working hours, but the effect of having received an inheritance is not significant, neither for men nor for women. We conclude that the receipt of an inheritance will not affect labour market decisions, so that the expected wave of bequests will not undermine active ageing policies.
Flow chart study selection process
Study characteristics of the included studies (n = 20)
Intervention components of included reablement intervention studies (n = 20)
This systematic review aimed to provide an overview of reablement interventions according to the recently published ReAble definition and their effect on Activities of Daily Living (ADL). In addition, the most common and promising features of these reablement interventions were identified. Four electronic bibliographic databases were searched. Articles were included when published between 2002 and 2020, which described a Randomised or Clinical Controlled Trial of a reablement intervention matching the criteria of the ReAble definition, and had ADL functioning as an outcome. Snowball sampling and expert completion were used to detect additional publications. Two researchers screened and extracted the identified articles and assessed methodological quality; discrepancies were resolved by discussion and arbitration by a third researcher. Twenty relevant studies from eight countries were included. Ten of these studies were effective in improving ADL functioning. Identifying promising features was challenging as an equal amount of effective and non-effective interventions were included, content descriptions were often lacking, and study quality was moderate to low. However, there are indications that the use of more diverse interdisciplinary teams, a standardised assessment and goal-setting method and four or more intervention components (i.e. ADL-training, physical and/or functional exercise, education, management of functional disorders) can improve daily functioning. No conclusions could be drawn concerning the effectiveness on ADL functioning. The common elements identified can provide guidance when developing reablement programmes. Intervention protocols and process evaluations should be published more often using reporting guidelines. Collecting additional data from reablement experts could help to unpack the black box of reablement.
Conceptual framework of the work-to-retirement process Notes: The ovals represent main elements of labour market participation (employed, pension receiver and other) and the vertical dashed line represents the statutory retirement age (SRA). The numbered areas indicated by the partly overlapping main elements and the SRA represent further elements of the work-to-retirement process
Conceptual framework of the work-to-retirement process with a model example of specifications Notes: The ovals represent main elements of labour market participation (employed, pension receiver and other) and the vertical dashed line represents the statutory retirement age (SRA). The numbered areas indicated by the partly overlapping main elements and the SRA represent further elements of the work-to-retirement process. A model example of specifications of these elements is presented within the boxes traversing these areas.
The way in which retirement is conceptualized and measured is likely to influence the research findings. The previous literature has addressed a wide range of elements related to the complex work-to-retirement process, such as early, late and partial retirement, statutory retirement, work disability and unemployment paths to retirement, or different types of bridge employment. However, conceptual clarity in terms of connections between the different elements is called for. We introduce a conceptual framework of the work-to-retirement process to guide its future measurement. Together with information on the statutory retirement age, the main elements of the framework are based on employment and pension receipt, acknowledging that these may overlap. The framework is flexible to the user, providing the possibility to add various specifications—e.g. of types of employment, types of pension receipt, unemployment, and being outside the labour force—depending on the study context and aims. The framework highlights the complexity of the work-to-retirement process, bringing forth its multifaceted, multiphased and multidirectional features. Accounting for such complexity in later-life labour market dynamics helps to elaborate what is actually addressed when investigating “retirement”. Our conceptual framework can be utilized to enhance well-defined, precise and comparable measurement of the work-to-retirement process in studies.
Share of participants aged 50 + reporting a deterioration in health status following the first wave of the COVID-19 pandemic, European countries and Israel
The COVID-19 pandemic has created challenges in providing medical care for people with health conditions other than COVID-19. The study aims to assess the prevalence of older adults’ reportage of decline in health relative to pre-pandemic and to identify its determinants. The study is based on the Survey of Health, Ageing and Retirement in Europe (SHARE) data collected during the pandemic. It comprised 51,778 people in twenty-seven European countries and Israel. Participants were asked about changes in their health status relative to pre-pandemic. Bivariate analysis and logistic regression were used to identify factors associated with worsening of health. Nine percent of people (average age 70 years) reported a worsening of health relative to pre-pandemic. A logistic regression revealed a significant relation of the probability of a downturn in health to forgoing, postponing, or being denied an appointment for medical care. Multiple chronic illnesses, developing COVID-19, having at least one form of psychosocial distress, higher age, and lower economic capacity were also found significantly related to the probability of a decline in health. Older adults’ comprehensive health needs must be addressed even when healthcare services are under strain due to pandemic outbreaks. Policymakers should attend to the healthcare needs of people whose vulnerability to the pandemic is amplified by chronic health conditions and low socioeconomic status. Public healthcare systems may experience a massive rebound of demand for health care, a challenge that should be mitigated by delivery of healthcare services and the provision of the financial resources that they need.
Published statements per country over time
The Covid-19 pandemic, with its adverse implications for older adults, has generated unprecedented public interest in issues around age and ageing globally. We systematically investigated the responses of national gerontological and geriatric societies (NGGS) to emerging challenges during the first wave of the pandemic. Framed within traditional research topics in gerontology, the aim was to identify the spectrum of focal points and positions directed towards governments, policy makers, researchers and society. A comprehensive, two-phased data collection strategy generated N=22 position statements of NGGS affiliated to the International Association of Gerontology and Geriatrics. Using Ayalon and colleagues’ (2020) thematic categorisation of gerontological research, we applied quantitative and qualitative content analysis to analyse ‘calls for action’ within the statements. The content of NGGS’ position statements show a high level of agreement on the salient topics during the first wave of the pandemic and reveal shared values such as equality, diversity and inclusion of older adults and the discipline of gerontology to be an applied one with relevance to policy and practice. The results can support future interdisciplinary research in gerontology post Covid-19, based on a vision to contribute to a more equitable and inclusive society for people of all ages.
In Europe, the epidemiological transition has already taken place, while the demographic transition continues. Life expectancy at 65 is expanding for both women and men. The primary aim of this work is to identify the factors associated with life expectancy at 65 for women and men in Europe. The second aim is to confirm the influence of cultural factors on life expectancy. Finally, the link between spending on pensions, soil pollution, and life expectancy is also tested. Data for 31 European countries for the period 2004–2018 have been collected to estimate a linear panel data model. Life expectancy at 65 for women and men is the dependent variable. Independent variables are grouped into socioeconomic, cultural, and environmental conditions. The main result of this work is the importance of GDP per capita, and education and pension expenditure in explaining the heterogeneity of life expectancy at 65 across countries. Other significant results include the association of cultural characteristics, air pollution, and soil pollution with life expectancy. The design of policies for older adults and the improvement of their health and active life should consider not only differences in education but cultural characteristics, too. European directives that disregard people’s cultural differences may not have the expected result.
Experiences of pet ownership and companion animal interactions, adults aged 55 + , SHARE Switzerland, 2017, n = 529 (The figure shows the weighted proportions of the perceptions and experiences of respondents on each human-animal interactions item. Data from SHARE wave 7, release version: 7.1.1.)
While interactions with pets may yield significant emotional, social, and physical benefits, taking care of them can also be demanding and experienced as a burden, especially among persons with physical restrictions or economically disadvantaged individuals. This study investigates pet ownership and corresponding perceptions and experiences in a nationally representative sample of adults aged 55 years and older in Switzerland. We use data from a questionnaire on human-animal interactions from 1832 respondents administered during wave 7 (2017) in the Swiss country study of the Survey of Health, Ageing, and Retirement in Europe. Multivariable associations between pet ownership and pet owners’ corresponding perceptions and experiences with respondents’ socio-demographic characteristics were estimated using probit and ordered probit models. Slightly more than one-third of adults aged 55 years and older reported owning a pet. Pet owners reported mostly positive experiences with pet ownership, with women showing higher pet bonding levels than men. Moreover, pet ownership was less common among adults aged 75 and older and individuals living in apartments. At the same time, older pet owners aged 75 and above, pet owners living in apartments, and pet owners without a partner reported more positive perceptions and experiences of owning a pet. These findings suggest that promoting pet ownership may help individual well-being and feelings of companionship, especially among women, older adults, and individuals without a partner but also points toward potential selection effects into pet ownership. Financial costs of pet ownership appear to be an important challenge for some older pet owners, notably those with relatively low levels of education and more limited financial resources.
Average self-rated health among volunteers and non-volunteers by age group. Note: Cross-sectional averages, not controlled for covariates
OLS and fixed effects regression coefficients of volunteering on self-rated health by model specification and age group. Note: Estimates derived from different regression models without control variables (Bivariate); including dummies for survey year (Year dummies); controlled for female, age, married, paid job, retired, labor earnings (ln); and educational level in ISCED-97 levels (Covariates); and both dummies for survey year and control variables (Covariates + Year dummies). Estimates by age groups are derived from full models with control variables and year dummies. All models are estimates with (FE) and without (OLS) fixed effects for individual respondents
Coefficients from first-difference regression models of Δ volunteering on Δ self-rated health. Note: Estimates derived from different regression models: without control variables (Bivariate); including dummies for survey year (Year dummies); including dummies for survey year, dummies for survey and dummies for country of residence (Year, survey, and country dummies); controlled for female, age, married, paid job, retired, labor earnings (ln) and educational level in ISCED-97 levels (Covariates); both control variables and dummies for survey year (Covariates + Year dummies); and control variables, dummies for survey year, dummies for survey, and dummies for country of residence (Covariates + Year, survey, and country dummies). Estimates by age groups are derived from full models with control variables and year, survey, and country dummies
Health advantage of volunteering by decile of health, fixed effects quantile regression results. Note: Estimates derived from regression models including fixed effects for individual respondents and controlled for age, married, paid job, retired, labor earnings (ln), and educational level in ISCED-97 levels
There is a vast literature on the health benefits associated with volunteering for volunteers. Such health advantages are likely to vary across groups of volunteers with different characteristics. The current paper aims to examine the health advantages of volunteering for European volunteers and explore heterogeneity in the association between volunteering and health. We carry out a mega-analysis on microdata from six panel surveys, covering 952,026 observations from 267,212 respondents in 22 European countries. We provide open access to the code we developed for data harmonization. We use ordinary least squares, fixed effects, first difference, and fixed effect quantile regressions to estimate how volunteering activities and changes therein are related to self-rated health for different groups. Our results indicate a small but consistently positive association between changes in volunteering and changes in health within individuals. This association is stronger for older adults. For respondents 60 years and older, within-person changes in volunteering are significantly related to changes in self-rated health. Additionally, the health advantage of volunteering is larger for respondents in worse health. The advantage is largest at the lowest decile and gradually declines along the health distribution. The magnitude of the association at the first decile is about twice the magnitude of the association at the ninth decile. These results suggest that volunteering may be more beneficial for the health of specific groups in society. With small health advantages from year to year, volunteering may protect older and less healthy adults from health decline in the long run.
The literature on subjective memory concerns (SMC) as a predictor for future cognitive decline is varied. Furthermore, recent research has pointed to additional complexity arising from variability in the experience of SMC themselves (i.e. whether they are remitting or sustained over time). We investigated the associations between SMC and objectively measured cognition in an Australian population-based cohort. Four waves (4-year intervals between waves) of data from 1236 participants (aged 62.4 ± 1.5 years, 53% male) were used. We categorized participants as experiencing SMC, when they indicated that their memory problems might interfere with their day-to-day life and/or they had seen a doctor about their memory. SMC was categorized as “no” reported SMC, “remitting”, “new-onset” or “sustained” SMC. Cognitive assessment of immediate and delayed recall, working memory, psychomotor speed, attention and processing speed were assessed using a neuropsychological battery. Eighteen percent of participants were characterised as having SMC: 6% (77) “remitting”, 6% (77) “new-onset” and 6% (69) “sustained” SMC. There was no consistent evidence for an association between SMC and subsequent decline in cognition. However, SMC was associated with poorer performance on contemporaneous tasks of attention and processing speed compared to “no” SMC. Asking about SMC may indicate a current decline in cognitive function but, in this sample at least, did not indicate an increased risk of future decline.
Overall age, period, and cohort effects on ADL limitations
Predicted cohort variations in gender disparity in ADL limitations
Predicted cohort and period trends in residence disparity in ADL limitations
This study aims to investigate the age, period, and cohort effects on trends in activities of daily living (ADL) disability among Chinese older adults; and to explore these three temporal effects on gender and residence disparities in disability. We utilized multiple cross-sectional waves of the Chinese Longitudinal Healthy Longevity Survey data (1998–2018), including 89,511 participants aged above 65 years old. Our measurement of disability is the number of ADL items (dressing, bathing, indoor transferring, toileting, eating, and continence) participants can’t perform independently. Hierarchical age-period-cohort cross-classified random effects models were conducted to investigate age, period and cohort trends in ADL disability. Results showed that ADL disability increased with age at an increasing rate. A V-shaped cohort trend and a fluctuated period trend were identified. Females and urban residents were associated with more ADL limitations. When age increased, the gender and residence gaps in disability further increased. The cohort-based gender and residence inequalities in ADL limitations converged with successive cohorts. The period-based residence gap in ADL limitations diverged throughout the 20-year period, while the corresponding period-based change in gender disparity was not significant. These findings suggested that age, period, and cohort had different and independent effects on ADL disability among Chinese older adults. The age effect on trends in ADL is stronger compared to period and cohort effects. The gender and residence disparities in disability increased with age and decreased with successive cohorts. These patterns might help inform healthcare planning and the priorities for medical resource allocation accordingly.
Visual summary of cross-lagged models 2 to 4 (n = 140). All models are adjusted for age, sex, and education at all three time points. Covariate effects and within-time associations of the main variables are not shown but can be found on the OSF. Autoregressive effects can be found in Table 2. All coefficients are standardized ** p < .01; * p < .05
Studies show the importance of the personal experience of meaning in life for older adults, but adults with dementia have been largely excluded from this research. The current study examined the longitudinal predictive effect of meaning in life for the psychological and cognitive functioning of older adults with Alzheimer’s disease and whether cognitive decline predicted presence of meaning in life. On three yearly measurement occasions, presence of meaning in life, depressive symptoms, life satisfaction, and cognitive functioning were assessed in structured interviews with a convenience sample of 140 older adults with Alzheimer’s disease from nine nursing homes in Belgium. Cross-lagged panel and latent growth curve models were used to analyze the longitudinal relationships between the variables. Over the three measurement waves, participants with higher presence of meaning reported lower depressive symptoms one year later. Presence of meaning and life satisfaction predicted each other over time, but only between the first and second wave. The analyses showed no strong evidence for a longitudinal association between meaning in life and cognitive functioning in either direction. The findings emphasize the importance of the experience of meaning in life for the psychological functioning of older adults with Alzheimer’s disease. The lack of evidence for associations between meaning and cognitive functioning questions the prevailing view that intact cognitive abilities are a necessity for experiencing meaning. More attention to the potential of meaning interventions for persons with dementia is warranted.
Flow-chart of study inclusion criteria; abbreviations: n: number; SHARE: Survey of Health, Ageing and Retirement in Europe; the 14 countries were: Austria, Belgium, Czech Republic, Denmark, Estonia, France, Germany, Israel, Italy, Luxembourg, Slovenia, Spain, Sweden and Switzerland
Associations between neighbourhood characteristics and falls risk at 2-year follow-up: stratified analyses. Odds ratios and 95% confidence intervals are calculated by binary logistic regression; analyses were adjusted for (Model 4): age, sex, vandalism or crime, clean area, feeling part, helpful neighbours, easy accessibility to services, education, self-rated health, heart attack, hypertension, high cholesterol, stroke, diabetes, chronic lung disease, cancer, Parkinson’s, cataracts, hip fracture, other fractures, cognitive impairment, affective/emotional disorder, any arthritis, anti-hypertensives, drugs for pain, psychotropic drugs, living alone, difficulty in making ends meet, poor vision, poor hearing, country dummies, area (rural versus urban), functional status, physical activity, maximum grip strength; falls at baseline and dizziness, faints or blackout at baseline. Panel A corresponds to supplementary Table S14; panel B to supplementary Table S16; panel C to supplementary Table S17; panel D to Table 4
We investigated the association between perceived neighbourhood characteristics and falls in community-dwelling adults, using data from Wave 5 and 6 of the Survey of Health, Ageing and Retirement in Europe (SHARE). We included 25,467 participants aged 50 to 103 years (mean age 66.2 ± 9.6, 58.5% women), from fourteen European countries (Austria, Belgium, Czech Republic, Denmark, Estonia, France, Germany, Israel, Italy, Luxembourg, Slovenia, Spain, Sweden, Switzerland). At baseline, we recorded individual-level factors (socio-demographic, socio-economic and clinical factors), contextual-level factors (country, urban versus rural area, European region) and perceived neighbourhood characteristics (vandalism or crime, cleanliness, feeling part of neighbourhood, helpful neighbours, accessibility to services) for each participant. We recorded falls in the six months prior to the baseline and 2-year follow-up interviews. The associations between neighbourhood characteristics and falls were analysed by binary logistic regression models; odds ratios (95% confidence intervals) were calculated. Participants reporting-versus not reporting-vandalism or crime had an increased falls risk of 1.16 (1.02–1.31) at follow-up, after full adjustment; lack of cleanliness, feeling part of the neighbourhood, perceiving neighbours as helpful and difficult accessibility to services were not associated with falls. Vandalism or crime was consistently associated with increased falls risks in women, adults without functional impairment and urban areas residents. In conclusion, adverse neighbourhood environments may account for inequality in falls risk among middle-aged and older adults and could be added to fall risk stratification tools.
Fitted SEM model for ‘internet use’ (IU), including IU frequency and IU activity. Note. IU Activity 1 = navigating/searching the internet; IU Activity 2 = email; IU Activity 3 = e-government services; IU Activity 4 = maintaining contact with (grand) children; IU Activity 5 = social media; IU Activity 6 = Skype; IU Activity 7 = online shopping; IU Activity 8 = online banking; IU Activity 9 = online administration; Net income cat1 = €1250–2000; Net income cat2 =  > €2000
Although research on sociodemographic correlates of internet use in older adults without and with pronounced cognitive impairment is already quite extensive, much less is known about the relationship between cognitive frailty (CF) and this behaviour. As CF is associated to multidimensional frailty aspects, this study explored the relationship between internet use and CF, operationalised as Subjective Cognitive Impairment, in older adults by means of a comprehensive explanatory model including sociodemographic factors and multiple frailty measures. The dataset included a sample of community-dwelling 60 + older adults that were included in the Belgian Ageing Studies (BAS) and that completed survey questions on (i) internet use frequency and (ii) internet activities. Multidimensional frailty was measured with the CFAI-Plus. The analysis comprised a structural equation modelling (SEM) procedure. Internet use was frequent; however, it became less frequent with higher CF. Moreover, the latter used less tablets as compared to the no-low CF group. Navigating the web, sharing email and online banking were the most frequently reported activities. Tele-communicating with Skype, online shopping and using e-government services were the least frequent. Age, female gender, lower income and living with a partner were also negatively associated with internet use. To conclude, CF, along with other frailty and sociodemographic factors, was negatively related to internet use in older adults. Future research should focus, amongst others, on the dynamic processes underlying internet use in the population of older adults affected by CF.
Descriptive analyses of the study variables
Pearson correlations of the main study variables
Relying on the age segregation theory (limited contact between age groups), this study examined the temporal reciprocal associations between age integration—the inclusion of older and younger people in one’s personal network—and one's self-perceptions of aging (SPA). Data came from the 2014 and 2017 waves of the German Ageing Survey and focused on adults aged 60 and above (N = 5239). Age composition of the network was assessed as the number of kin and non-kin in the social network who are either more than 10 years older or more than 10 years younger than the respondent. A latent change score model assessed the bidirectional associations. The results showed that adults who had younger social network members, both kin and non-kin, had better SPA 3 years later. A positive SPA at baseline also predicted a higher number of younger non-kin and older non-kin relationships over time. These results stress the role of SPA in adults' social network as well as the role of age integration in shaping adults' SPA. Practitioners and policy makers should encourage connections between people of different ages and should strive to decrease the age segregation in society.
Data selection scoping review vital communities
Older people today are more likely to age in their own private living environment. However, many face declining health and/or other issues that affect their ability to live independently and necessitate additional support. Such support can be provided by formal networks, but a considerable part can also be offered by informal networks of older people themselves. Going beyond these networks, older people can additionally and perhaps even more substantially benefit from vital communities . Nevertheless, even though this term is increasingly common in the literature, its meaning remains indistinct. A more thorough understanding of this concept might provide valuable knowledge that health care professionals, researchers and community workers can use to offer meaningful and effective support. The purpose of this paper is to draw on existing empirical research on vital communities to build knowledge of the different descriptions and dimensions of the concept. Arksey and O’Malley’s scoping review methodology was adopted. Our search, conducted on 23 March 2020 and updated on 06 January 2021, yielded 4433 articles, of which six articles were included in the scoping review. We deduced that the conceptualisation of a vital community is based on three dimensions: the aim of a vital community, the processes behind a vital community and the typical characteristics of a vital community. None of the selected studies have mapped all three dimensions. Nevertheless, we assume that understanding all three matters when vital communities aim to contribute to the quality of life of people ageing in place.
Flowchart of literature search and study selection process
A number of linguistic and cognitive deficits have been reported during the course of Alzheimer's disease (AD) and its preceding stage of mild cognitive impairment (MCI), with some deficits appearing years before onset of clinical symptoms. It continues to be a critical task to identify tools that may serve as an early marker of pathology that are also reliably able to distinguish AD from normal ageing. Given the limited success of classic psychometric cognitive testing, a novel approach in assessment is warranted. A potentially sensitive assessment paradigm is discourse processing. The aim of this review was to synthesize original research studies investigating comprehension of discourse in AD and MCI, and to evaluate the potential of this paradigm as a promising avenue for further research. A literature search targeting studies with AD or MCI groups over 60 years of age was conducted in PubMed, Web of Science, and PsycINFO databases. Eight articles with good quality were included in the review. Six measures of discourse comprehension-naming latency, summary, lesson, main idea, proportion of inferential clauses, true/false questions-were identified. All eight studies reported significant deficits in discourse comprehension in AD and MCI groups on five of the six measures, when compared to cognitively healthy older adults. Mixed results were observed for associations with commonly used cognitive measures. Given the consistent findings for discourse comprehension measures across all studies, we strongly recommend further research on its early predictive potential, and discuss different avenues for research. Supplementary information: The online version contains supplementary material available at 10.1007/s10433-021-00619-5.
Although there is a large body of evidence documenting the benefits of engagement in formal volunteering among older people, research assessing the specific aspects of the volunteering experience that are associated with these benefits is limited. Accordingly, the objective of this study was to (i) examine the aspects of volunteering that predict improvements or declines in older people's psychological outcomes over time and (ii) assess the extent to which demographic characteristics and time spent engaging in informal volunteering moderate the relationship between aspects of volunteering and potential outcomes. At Time 1, non-volunteering Australian older adults completed measures assessing their subjective well-being, eudemonic well-being, and psychological resources and were asked to commence volunteering. At Time 2 (six months later), participants completed the same measures and reported on their volunteering experiences. Among the 108 older adults who provided usable data at both time points (average age = 69.86 years, 64% women), the degree to which participants felt overwhelmed by their volunteer work significantly predicted declines in subjective well-being and psychological resources. The perceived importance of the cause for which participants reported volunteering and the perceived meaningfulness of the specific activities undertaken predicted improvements in these outcomes. Volunteering roles for older adults that (i) are not considered overwhelming, (ii) fulfil their desire to volunteer for a cause about which they are genuinely concerned, and (iii) involve activities perceived to be meaningful are likely to produce the favourable psychological outcomes. Supplementary information: The online version contains supplementary material available at 10.1007/s10433-021-00618-6.
Age-standardised all-cause a and cardiovascular b mortality rate by gender and by cardiovascular risk profile. Notes. Bars represent 95% confidence interval. Mortality rates were computed through direct standardisation, using Veneto Region at 1st January 2007 as the standard population
Hazard ratios of all-cause a and cardiovascular b mortality by gender, age class, and cardiovascular risk profile. Abbreviations: HR, Hazard ratio; 95%CI, 95% Confidence interval. Notes: Models adjusted for educational level (≥ 5 vs < 5 years), monthly income (< vs. ≥ 500€), living arrangements (living with somebody vs living alone vs living in nursing home), chronic obstructive pulmonary disease, osteoarticular diseases, cancer, cognitive impairment, cardiovascular diseases
The age- and gender-related cardio-metabolic changes may limit the applicability of guidelines for the prevention of cardiovascular diseases (CVD) in older people. We investigated the association of cardiovascular risk profile with 20-year all-cause and CVD-mortality in older adults, focusing on age- and gender-specific differences. This prospective study involved 2895 community-dwelling individuals aged ≥65 years who participated in the Pro.V.A study. The sum of achieved target levels (smoking, diet, physical activity, body weight, blood pressure, lipids, and diabetes) recommended by the European Society of Cardiology 2016 guidelines was assessed in each participant. From this sum, cardiovascular risk profile was categorised as very high (0-2), high (3), medium (4), low (5), and very low (6-7 target levels achieved). All-cause and CV mortality data over 20 years were obtained from health registers. At Cox regression, lower cardiovascular risk profile was associated with reduced 20-year all-cause mortality in both genders, with stronger results for women (HR = 0.42 [95%CI:0.25-0.69] and HR = 0.61 [95%CI:0.42-0.89] for very low vs. very high cardiovascular risk profile in women and men, respectively). This trend was more marked for CVD mortality. Lower cardiovascular risk profile was associated with reduced all-cause and CVD mortality only in men < 75 years, while the associations persisted in the oldest old women. A lower cardiovascular risk profile, as defined by current guidelines, may reduce all-cause and CVD mortality in older people, with stronger and longer benefits in women. These findings suggest that personalised and life-course approaches considering gender and age differences may improve the delivery of preventive actions in older people. Supplementary information: The online version contains supplementary material available at 10.1007/s10433-021-00620-y.
Alternative models for structure of the MOS-SSS scale
The aim of this study was to explore the factor structure of the MOS-SSS in a sample of community-dwelling Spanish older adults. The sample comprised 406 community-dwelling older adults aged between 65 to 99 years old (Mage = 74.88, SD = 6.75). Confirmatory factor analysis (CFA) was performed, and four possible models were compared: the one-factor, the three-factor, the four-factor and the five-factor model, using an additional analysis with a second-order factor. The internal consistency reliability and convergent validity of the scale were also assessed. For the 19-item MOS-SSS scale, the five-factor model had the best fit to the data. All five subscales of the MOS-SSS showed adequate internal consistency, good convergent and discriminant validity. These findings contribute to the literature on the factor structure of the MOS-SSS in Spanish older adults. The MOS-SSS is a reliable and valid scale that can be used to assess Spanish older adults’ social support perception for social services, health and in research contexts.
Theoretical Model Displaying the Intervening Role of Need-based Experiences in the Relations from Ego Integrity and Despair to Psychological Functioning, including the Role of Protective and Risk Factors. Note The arrows from the protective and risk factors to the study variables represent both main effects (on need-based experiences and psychological functioning) and moderating effects
Structural Model Depicting the Intervening Role of Need-based Experiences in the Relations from Ego Integrity and Despair to Psychological Functioning. Note Correlations between the outcomes were allowed but are not shown for reasons of clarity. *p < .05; **p < .01; ***p < .001
Graphical Representation of the Interaction Effect, including Standardized Simple Slopes
Structural Model Depicting the Intervening Role of Specific Need-based Experiences in the Relations from Ego Integrity and Despair to Psychological Functioning. Note Standardized coefficients concerning the satisfaction of, respectively, autonomy, competence, and relatedness are reported sequentially and separated by a slash. Significant standardized coefficients are indicated in bold. Correlations between the outcomes were allowed but are not shown for reasons of clarity
The COVID-19 pandemic has affected people across the world, with important heterogeneity among older adults in how they respond to the challenges associated with this crisis. Relying on a cross-fertilization between Erikson’s personality theory and Self-Determination Theory, this study aimed to examine possible sources of resilience (i.e., ego integrity and need satisfaction) and vulnerability (i.e., despair) in older adults’ (mal)adjustment, thereby additionally considering the role of multiple risk and protective factors (e.g., gender and marital status). During the second month of the lockdown period in Belgium, 693 older adults (Mage = 70.06, SD = 4.48, range: 65 – 89 years, 62.1% female) filled out online questionnaires concerning the study variables, while also completing assessments of several important sociodemographic factors. Structural equation modeling suggested that both ego integrity and despair related to indicators of well-being and psychological distress through experienced need satisfaction. Additionally, we found several factors to protect (e.g., higher perceived income) or diminish (e.g., being widowed) older adults’ well-being during these challenging times, with little evidence for a moderating role of these factors in associations between the psychological variables. Theoretical and practical implications of these results are discussed.
Top-cited authors
Dorly J H Deeg
  • Amsterdam University Medical Center
Tineke A. Abma
  • Leiden University Medical Centre
Hans Jonsson
  • Karolinska Institutet
Fenna van Nes
  • Amsterdam University of Applied Sciences/Centre for Applied Research on Education
Theo G. van Tilburg
  • Vrije Universiteit Amsterdam