| 1. |
- Celeste, R. K., et al.
(författare)
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Social Mobility and Tooth Loss : A Systematic Review and Meta-analysis
- 2022
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Ingår i: Journal of Dental Research. - : SAGE Publications. - 0022-0345 .- 1544-0591. ; 101:2, s. 143-150
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Forskningsöversikt (refereegranskat)abstract
- This study systematically reviews the evidence of the association between life course social mobility and tooth loss among middle-aged and older people. PubMed, Scopus, Embase, and Web of Science were systematically searched in addition to gray literature and contact with the authors. Data on tooth loss were collated for a 4-category social mobility variable (persistently high, upward or downward mobility, and persistently low) for studies with data on socioeconomic status (SES) before age 12 y and after age 30 y. Several study characteristics were extracted to investigate heterogeneity in a random effect meta-analysis. A total of 1,384 studies were identified and assessed for eligibility by reading titles and abstracts; 21 original articles were included, of which 18 provided sufficient data for a meta-analysis with 40 analytical data sets from 26 countries. In comparison with individuals with persistently high social mobility, the pooled odds ratios (ORs) for the other categories were as follows: upwardly mobile, OR = 1.73 (95% CI, 1.53 to 1.95); downwardly mobile, OR = 2.52 (95% CI, 2.19 to 2.90); and persistently low, OR = 3.96 (95% CI, 3.13 to 5.03). A high degree of heterogeneity was found(I2 > 78%), and subgroup analysis was performed with 17 study-level characteristics; however, none could explain heterogeneity consistently in these 3 social mobility categories. SES in childhood and adulthood is associated with tooth loss, but the high degree of heterogeneity prevented us from forming a robust conclusion on whether upwardly or downwardly mobile SES may be more detrimental. The large variability in effect size among the studies suggests that contextual factors may play an important role in explaining the difference in the effects of low SES in different life stages (PROSPERO CRD42018092427).
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| 2. |
- Darin-Mattsson, Alexander, et al.
(författare)
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Are Occupational Complexity and Socioeconomic Position Related to Psychological Distress 20 Years Later?
- 2015
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Ingår i: Journal of Aging and Health. - : Sage Publications. - 0898-2643 .- 1552-6887. ; 27:7, s. 1266-1285
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To assess occupational complexity in midlife in relation to psychological distress in older adulthood (69+ years) and explore the role of socioeconomic position.Method: Baseline data from the Swedish Level of Living Survey and follow-up data from the Swedish Longitudinal Study ofLiving Conditions of the Oldest Old were combined, resulting in 20+ years of follow-up. Data were analyzed using ordered logistic regressions.Results: Higher occupational complexity was associated with less psychological distress 20 years later adjusted for age, sex, follow-up year, hours worked the year before baseline, and psychological distress at baseline. Higher socioeconomic position yielded the same pattern of results. Socioeconomic position partially accounted for the association between occupational complexity and psychological distress.Discussion: With social gradient not easily amenable to modification, efforts to increase engagement at work may offer a viable option to attenuate the influence of work environment on psychological distress later in life.
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| 3. |
- Darin-Mattsson, Alexander, et al.
(författare)
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Different indicators of socioeconomic status and their relative importance as determinants of health in old age
- 2017
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Ingår i: International Journal for Equity in Health. - : BioMed Central. - 1475-9276. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Socioeconomic status has been operationalised in a variety of ways, most commonly as education, social class, or income. In this study, we also use occupational complexity and a SES-index as alternative measures of socioeconomic status. Studies show that in analyses of health inequalities in the general population, the choice of indicators influence the magnitude of the observed inequalities. Less is known about the influence of indicator choice in studies of older adults. The aim of this study is twofold: i) to analyse the impact of the choice of socioeconomic status indicator on the observed health inequalities among older adults, ii) to explore whether different indicators of socioeconomic status are independently associated with health in old age.Methods: We combined data from two nationally representative Swedish surveys, providing more than 20 years of follow-up. Average marginal effects were estimated to compare the association between the five indicators of SES, and three late-life health outcomes: mobility limitations, limitations in activities of daily living (ADL), and psychological distress.Results: All socioeconomic status indicators were associated with late-life health; there were only minor differences in the effect sizes. Income was most strongly associated to all indicators of late-life health, the associations remained statistically significant when adjusting for the other indicators. In the fully adjusted models, education contributed to the model fits with 0-3% (depending on the outcome), social class with 0-1%, occupational complexity with 1-8%, and income with 3-18%.Conclusions: Our results indicate overlapping properties between socioeconomic status indicators in relation to late-life health. However, income is associated to late-life health independently of all other variables. Moreover, income did not perform substantially worse than the composite SES-index in capturing health variation. Thus, if the primary objective of including an indicator of socioeconomic status is to adjust the model for socioeconomic differences in late-life health rather than to analyse these inequalities per se, income may be the preferable indicator. If, on the other hand, the primary objective of a study is to analyse specific aspects of health inequalities, or the mechanisms that drive health inequalities, then the choice of indicator should be theoretically guided.
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| 4. |
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| 5. |
- Darin-Mattsson, Alexander, et al.
(författare)
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Linking financial hardship throughout the life-course with psychological distress in old age : Sensitive period, accumulation of risks, and chain of risks hypotheses.
- 2018
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Ingår i: Social Science and Medicine. - : Elsevier. - 0277-9536 .- 1873-5347. ; 201, s. 111-119
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Tidskriftsartikel (refereegranskat)abstract
- The primary objective was to investigate the life course hypotheses - sensitive period, chain of risks, and accumulation of risks - in relation to financial hardship and psychological distress in old age. We used two Swedish longitudinal surveys based on nationally representative samples. The first survey includes people 18-75 years old with multiple waves, the second survey is a longitudinal continuation, including people 76 + years old. The analytical sample included 2990 people at baseline. Financial hardship was assessed in childhood (retrospectively), at the mean ages of 54, 61, 70, and 81 years. Psychological distress (self-reported anxiety and depressive symptoms) was assessed at the same ages. Path analysis with WLSMV estimation was used. There was a direct path from financial hardship in childhood to psychological distress at age 70 (0.26, p = 0.002). Financial hardship in childhood was associated with increased risk of psychological distress and financial hardship both at baseline (age 54), and later. Financial hardship, beyond childhood, was not independently associated with psychological distress at age 81. Higher levels of education and employment decreased the negative effects of financial hardship in childhood on the risk of psychological distress and financial hardship later on. There was a bi-directional relationship between psychological distress and financial hardship; support for health selection was slightly higher than for social causation. We found that psychological distress in old age was affected by financial hardship in childhood through a chain of risks that included psychological distress earlier in life. In addition, financial hardship in childhood seemed to directly affect psychological distress in old age, independent of other measured circumstances (i.e., chains of risks). Education and employment could decrease the effect of an adverse financial situation in childhood on later-life psychological distress. We did not find support for accumulation of risks when including tests of all hypotheses in the same model.
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| 6. |
- Darin-Mattsson, Alexander
(författare)
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Set for life? Socioeconomic conditions, occupational complexity, and later life health
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Life expectancy has increased in the western parts of the world and more people reach old age. Some groups of people have benefitted more of the increase in life expectancy and have better health than others. Because of biological, psychological, behavioral, and social factors over the life course, adverse health accumulates in later life. Most societies are socially structured and people higher in the social structure tend to have better health. People’s position in the social hierarchy is commonly assessed by socioeconomic position (indicated by education, social class [occupation based], and income). Labor market stratification plays a central role in stratifying people in to socioeconomic positions. An important factor in the labor market stratification is the level of complexity of work. All these stratification principles could play a role in shaping the risk of adverse later life health. Identifying factors associated with later life health has become more important because of the growing number of people that reach old age. The overall aim of this thesis was to investigate the relationships between socioeconomic conditions, the complexity level of peoples’ work (measured as occupational complexity), and health in late life by studying 1) the association between complexity of work during midlife and later life health and 2) health inequalities in late life attributable to differences in socioeconomic position. All studies used individually linked data from the Swedish Level of Living Survey (LNU) and the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD). Results from study I showed that higher occupational complexity in midlife decreased the odds of psychological distress 20 years later. Socioeconomic position partly accounted for the association between occupational complexity and psychological distress. Still, occupational complexity may play a role in shaping the risk of psychological distress in old age. Results from study II showed that the magnitude and direction of the effect sizes, for education, social class, and occupational complexity were similar in relation to later life health (psychological distress and physical functioning). Income was more strongly associated with late life health than the other indicators of socioeconomic position. The income-health association was also the only one that remained significant in the mutually adjusted models. Thus, if the primary objective to include socioeconomic position is to statistically adjust for socioeconomic position, income may be the preferable single indicator. However, if the primary objective of a study is to analyze socioeconomic health inequalities, and the underlying mechanisms that drive these inequalities, then the choice of how to measure socioeconomic position should be carefully considered. Results from study III initially showed that occupational complexity scores aggregated from across the working life and different trajectories of occupational complexity were associated with physical function (as indicated by mobility and ADL limitations) in late life. Adjusting for socioeconomic position diminished the association. This suggest that the association was confounded (or possibly mediated in the case of income) through socioeconomic position. Results from study IV showed that financial hardship in childhood increased the risk of psychological distress in late life (at mean age of 81 years). This was partly explained by a direct association from financial hardship in childhood to psychological distress in later life. In addition, chains of risks were found between financial hardship in childhood and psychological distress in later life. This means that financial hardship in childhood increased the risk of a) psychological distress in midlife, b) lower levels of education, c) unemployment in midlife, and d) financial hardship in midlife, which, in turn, increased the risk of psychological distress in later life. In summary, the results from this thesis showed that there are socioeconomic health inequalities in later life. Lower socioeconomic position in midlife and financial hardship in childhood increase the risk of adverse later life health. Moreover, higher occupational complexity in midlife was investigated, and showed, to play a role in shaping the risk of psychological distress in late life. In contrast, the results showed that occupational complexity is not associated with physical functioning. Occupational complexity play a role in determining socioeconomic position, however, it does not capture an aspect of general life chances that comes with higher socioeconomic position and is relevant for health, beyond that of education, social class, and income.
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| 7. |
- Dekhtyar, Serhiy, et al.
(författare)
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Genetic risk of dementia mitigated by cognitive reserve : A cohort study
- 2019
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Ingår i: Annals of Neurology. - : Wiley. - 0364-5134 .- 1531-8249. ; 86:1, s. 68-78
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Tidskriftsartikel (refereegranskat)abstract
- Objective We investigated whether cognitive reserve modifies the risk of dementia attributable to apolipoprotein epsilon 4 (APOE-epsilon 4), a well-known genetic risk factor for dementia. Methods We followed 2,556 cognitively intact participants aged >= 60 years from the ongoing prospective community-based Swedish National Study on Aging and Care in Kungsholmen (SNAC-K). Dementia was ascertained through clinical and neuropsychological assessments and diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria. Structural equation modeling was used to generate a cognitive reserve indicator from 4 previously validated contributors: early life education, midlife substantive work complexity, late life leisure activities, and late life social networks. Cox proportional hazard models estimated dementia risk in relation to cognitive reserve indicator. The interaction between the cognitive reserve indicator and APOE-epsilon 4 was assessed on multiplicative and additive scales. Results After an average of 6.3 years (range = 2.1-10.7) of follow-up, 232 dementia cases were ascertained. Relative to individuals in the lowest tertile of cognitive reserve indicator, those with moderate and high reserve were at a reduced risk of dementia. There was no multiplicative interaction between APOE-epsilon 4 status and cognitive reserve indicator (p = 0.113). Additive interaction was statistically significant. Relative to APOE-epsilon 4 carriers with low cognitive reserve, epsilon 4 carriers with high reserve had a reduced risk of dementia (hazard ratio [HR] = 0.28, 95% confidence interval [CI] = 0.13-0.59). The magnitude of risk reduction was similar in epsilon 4 noncarriers with a high cognitive reserve indicator (HR = 0.24, 95% CI = 0.15-0.40). Interpretation Lifelong engagement in reserve-enhancing activities attenuates the risk of dementia attributable to APOE-epsilon 4. Promoting cognitive reserve might be especially effective in subpopulations with high genetic risk of dementia. ANN NEUROL 2019
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| 8. |
- Harber-Aschan, Lisa, 1987-, et al.
(författare)
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Socioeconomic differences in older adults’ unplanned hospital admissions : the role of health status and social network
- 2023
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Ingår i: Age and Ageing. - 0002-0729 .- 1468-2834. ; 52:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: the socioeconomic distribution of unplanned hospital admissions in older adults is poorly understood. We compared associations of two life-course measures of socioeconomic status (SES) with unplanned hospital admissions while comprehensively accounting for health, and examined the role of social network in this association.Methods: in 2,862 community-dwelling adults aged 60+ in Sweden, we derived (i) an aggregate life-course SES measure grouping individuals into Low, Middle or High SES based on a summative score, and (ii) a latent class measure that additionally identified a Mixed SES group, characterised by financial difficulties in childhood and old age. The health assessment combined measures of morbidity and functioning. The social network measure included social connections and support components. Negative binomial models estimated the change in hospital admissions over 4 years in relation to SES. Stratification and statistical interaction assessed effect modification by social network.Results: adjusting for health and social network, unplanned hospitalisation rates were higher for the latent Low SES and Mixed SES group (incidence rate ratio [IRR] = 1.38, 95% confidence interval [CI]: 1.12–1.69, P = 0.002; IRR = 2.06, 95% CI: 1.44–2.94, P < 0.001; respectively; ref: High SES). Mixed SES was at a substantially greater risk of unplanned hospital admissions among those with poor (and not rich) social network (IRR: 2.43, 95% CI: 1.44–4.07; ref: High SES), but the statistical interaction test was non-significant (P = 0.493).Conclusion: socioeconomic distributions of older adults’ unplanned hospitalisations were largely driven by health, although considering SES dynamics across life can reveal at-risk sub-populations. Financially disadvantaged older adults might benefit from interventions aimed at improving their social network.
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| 9. |
- Kelfve, Susanne, et al.
(författare)
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Increased alcohol use over the past 20 years among the oldest old in Sweden
- 2014
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Ingår i: Nordic Studies on Alcohol and Drugs. - : SAGE Publications. - 1455-0725 .- 1458-6126. ; 31:3, s. 245-260
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Tidskriftsartikel (refereegranskat)abstract
- AIMS - Increased alcohol consumption among old people, reported in many countries, will likely present a major challenge to public health and policy in the future. In Sweden, current knowledge about old people's alcohol consumption is incomplete because of limited historical data and a dearth of nationally representative studies. We describe the frequency of alcohol consumption among the oldest old in Sweden over a 20-year period by sex, age, education, living situation, mobility and Activities of Daily Living. METHODS - We used repeated cross-sectional survey data from the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD), conducted in 1992, 2002 and 2011. The samples were nationally representative of the Swedish population aged 77+, with response rates of 95.4%, 84.4% and 86.2% (total n = 2007). Self-reported consumption frequency was measured with the question How often do you drink alcoholic beverages, such as wine, beer or spirits? RESULTS - Frequency of alcohol consumption increased among the oldest old from 1992 to 2011. The proportion reporting no or less-than-monthly alcohol consumption decreased, whereas the proportion reporting weekly consumption increased. This was true for men, women and most age and educational groups. The period change in consumption frequency was not explained by changes in demographic factors, living situation or functional capacity during the study period. CONCLUSIONS - Alcohol use increased among the oldest old in Sweden during the 20-year study period. More liberal attitudes toward alcohol could contribute to the increased use. The increase in weekly alcohol consumers suggests an increase in the number of older risk consumers.
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| 10. |
- Kåreholt, Ingemar, 1960-, et al.
(författare)
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Are socioeconomic position and working conditions before retirement age related to physical function 20 years later after retirement?
- 2015
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Ingår i: Differences, Inequalities and Sociological Imagination: ESA 2015 12th conference of the European Sociological Association. - : European Sociological Association (ESA). I nstitute of Sociology of the Czech Academy of Scienc es (IS CAS). - 9788073302726 ; , s. 107-107
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Konferensbidrag (refereegranskat)abstract
- INTRODUCTION: Socioeconomic position and working situation are two factors associated to health inequalities and to each other.AIM: To study how socioeconomic position and working conditions 20+ years earlier associates to physical functioning after retirement age.DATA: Swedish nationally representative samples, from 1968, 1981, and 1991 were re-interviewed 1992, 2002, and 2011 (76+) with 20-24 years follow-up time (women, n=431; men, n=450).METHOD: Ordered logistic regressions, censored normal regression, and ordinary OLS regressions will be used.VARIABLES: Physical function: Self-reported mobility, objective tests of lung function and general physical function.Socioeconomic position: Education, income, cash margin, social class based on occupation, and an index based on all measures.Psychosocial working conditions: job control, psychological demands, high strain (low control+high demands) and work complexity regarding data (information), people, and substantive (general) complexity.Controls: age, sex, follow-up year, mobility at baseline, and hours worked.RESULTS: Job control, work complexity with data and people and all measures of SEP, were significantly associated to the three measures of physical function. Controlling for working conditions, the only significant associations was between general physical function and cash margin and the socioeconomic index respectively. When controlling for socioeconomic position, job control was significantly associated to less limitations in mobility and general physical functioning, substantive complexity and complexity with data were associated to less mobility limitations.CONCLUSIONS: Both socioeconomic position, work related stress, and work complexity were associated to physical function in old age, but only partly independent of each other. The strongest single factor is job control.
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