| 1. |
- Agahi, Neda, et al.
(författare)
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Smoking and Physical Inactivity as Predictors of Mobility Impairment During Late Life : Exploring Differential Vulnerability Across Education Level in Sweden
- 2018
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Ingår i: The journals of gerontology. Series B, Psychological sciences and social sciences. - : Oxford University Press (OUP). - 1079-5014 .- 1758-5368. ; 73:4, s. 675-683
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To test whether older adults from high and low educational groups are differentially vulnerable to the impact of smoking and physical inactivity on the progression of mobility impairment during old age.Methods: A nationally representative sample of older Swedish adults (n = 1,311), aged 57-76 years at baseline (1991), were followed for up to 23 years (2014). Multilevel regression was used to estimate individual trajectories of mobility impairment over the study period and to test for differences in the progression of mobility impairment on the basis of smoking status, physical activity status, and level of education.Results: Compared to nonsmokers, heavy smokers had higher levels and steeper increases in mobility impairment with advancing age. However, there were only small and statistically nonsignificant differences in the impact of heavy smoking on mobility impairment in high versus low education groups. A similar pattern of results was found for physical inactivity.Discussion: Differential vulnerability to unhealthy behaviors may vary across populations, age, time-periods, and health outcomes. In this study of older adults in Sweden, low and high education groups did not differ significantly in their associations between heavy smoking or physical inactivity, and the progression of mobility impairment.
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| 2. |
- Amurwon, Jovita, et al.
(författare)
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"It's Like I Never Had a Child of My Own": Care and Support for the Elderly in a Changing Socioeconomic Context in Rural Uganda
- 2019
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Ingår i: Journals of Gerontology, Series B. - : Oxford University Press (OUP). - 1079-5014 .- 1758-5368. ; 74, s. 1483-1491
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Individual households remain important for elderly care and support in resource-limited settings. Factors such as availability of young people and ownership of assets are important for care and support for the elderly. This article examines changing trends in accessing care and support for the elderly in a context of socioeconomic changes such as increasing school attendance and outmigration of youth from rural areas.Method: Rich data from the life stories of individuals from 22 households in rural Uganda collected in 2009-2010 were analyzed.Results: The elderly were lacking care and support, as the youth experienced increasing schooling and outmigration. The loss of young adults from HIV infection deprived the elderly of care and support, and increased their responsibilities of caring for the sick and the orphans. Mitigating factors included remittances and asset ownership. The availability of free health care encouraged people to stay in households to utilize these resources while also caring for the elderly members.Discussion: With the current socioeconomic transformations, the rules and resources used in the traditional care system no longer serve as a "safety network" for the elderly. Adaptation efforts from individual households cannot deal with the multiple concurrent changes. Programs to increase education should consider investing in additional social programs, especially for those who are negatively impacted by increased access to education.
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| 3. |
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| 4. |
- Andel, Ross, et al.
(författare)
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The Role of Midlife Occupational Complexity and Leisure Activity in Late-Life Cognition
- 2015
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Ingår i: The journals of gerontology. Series B, Psychological sciences and social sciences. - : Oxford University Press (OUP). - 1079-5014 .- 1758-5368. ; 70:2, s. 314-321
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To examine whether occupational complexity of working with data or people, and cognitive or social leisure activity at midlife predicted cognition in advanced old age.METHODS: We used 810 eligible participants from Longitudinal Study of Living Conditions of the Oldest Old, a Swedish nationally representative study of individuals aged 77+ with cognitive assessments (an abridged version of the Mini-Mental State Exam) administered in 1992 and 2002 and linked to information about their midlife occupation and leisure activities collected in 1968 and 1981. A bootstrapping technique was applied to examine the direct and interactive associations of occupational complexity and leisure activity with late-life cognition.RESULTS: Controlling for demographic and health-related factors from childhood, midlife, and late life, we found that greater work complexity, both with people and with data, and greater participation in cognitive or social leisure activities independently related to better late-life cognitive scores. The complexity-cognition link was moderated by leisure activity such that the cognitive benefit related to the complexity of work-especially complexity of working with people-was rendered insignificant when participation in leisure activities-especially social activities-was above average.DISCUSSION: Results are discussed in terms of using work complexity to compensate for lack of leisure activity as well as in terms of promoting leisure engagement to compensate for long-term cognitive disadvantage imposed by working in less challenging occupations.
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| 5. |
- Barbabella, Francesco, et al.
(författare)
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Socioeconomic Predictors of the Employment of Migrant Care Workers by Italian Families Assisting Older Alzheimer's Disease Patients : Evidence From the Up-Tech Study
- 2016
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Ingår i: The journals of gerontology. Series B, Psychological sciences and social sciences. - : Oxford University Press (OUP). - 1079-5014 .- 1758-5368. ; 71:3, s. 514-525
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The availability of family caregivers of older people is decreasing in Italy as the number of migrant care workers (MCWs) hired by families increases. There is little evidence on the influence of socioeconomic factors in the employment of MCWs.METHOD: We analyzed baseline data from 438 older people with moderate Alzheimer's disease (AD), and their family caregivers enrolled in the Up-Tech trial. We used bivariate analysis and multilevel regressions to investigate the association between independent variables-education, social class, and the availability of a care allowance-and three outcomes-employment of a MCW, hours of care provided by the primary family caregiver, and by the family network (primary and other family caregivers).RESULTS: The availability of a care allowance and the educational level were independently associated with employing MCWs. A significant interaction between education and care allowance was found, suggesting that more educated families are more likely to spend the care allowance to hire a MCW.DISCUSSION: Socioeconomic inequalities negatively influenced access both to private care and to care allowance, leading disadvantaged families to directly provide more assistance to AD patients. Care allowance entitlement needs to be reformed in Italy and in countries with similar long-term care and migration systems.
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| 6. |
- Finkel, Deborah, et al.
(författare)
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Gender Differences in Longitudinal Trajectories of Change in Physical, Social, and Cognitive/Sedentary Leisure Activities
- 2018
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Ingår i: The journals of gerontology. Series B, Psychological sciences and social sciences. - : Oxford University Press. - 1079-5014 .- 1758-5368. ; 73:8, s. 1491-1500
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Tidskriftsartikel (refereegranskat)abstract
- Objective: We examined changes in participation in cognitive, social, and physical leisure activities across middle and older adulthood and tested moderation of trajectories of change in participation by gender.Method: In all, 1,398 participants in the Swedish Adoption/Twin Study of Aging (SATSA) completed a 7-item leisure activity questionnaire up to 4 times over 17 years. Mean baseline age was 64.9 years (range = 36-91); 59% were women. Factor analysis identifed physical, social, and cognitive/sedentary leisure activity participation factors. Age-based latent growth curve models adjusted for marital status, gender, education, depressive symptoms, and physical health were used.Results: Overall, results indicated stability in social activities, increase in cognitive/sedentary activities, and decrease in physical activities, as well as accelerated decline in all three types of activities after about the age of 70 years. Social activity remained mostly stable for women and declined for men. Women reported higher levels of cognitive/sedentary leisure activity across the study. Both men and women declined in physical leisure activity. Variance in leisure activities increased with age; men demonstrated more variance in social activities and women in physical activities.Conclusions: Understanding change in leisure activities with age and by gender can have important implications for interventions and for use of leisure activity data in epidemiological research.
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| 7. |
- Finkel, Deborah, et al.
(författare)
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Sex differences in genetic and environmental influences on longitudinal change in functional ability in late adulthood
- 2015
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Ingår i: The journals of gerontology. Series B, Psychological sciences and social sciences. - : Oxford University Press (OUP). - 1079-5014 .- 1758-5368. ; 70:5, s. 709-717
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. To determine the extent to which genetic and environmental factors contribute to individual and gender differences in aging of functional ability.Method. Twenty assessments of functional ability are collected as part of the longitudinal Swedish Adoption/Twin Study of Aging from 859 twins aged 50–88 at the first wave. Participants completed up to 6 assessments covering a 19-year period. Factor analysis was used to create 3 factors: flexibility, fine motor skills, and balance.Results. Latent growth curve analysis demonstrated increasing disability and variability after age 70. For flexibility, results indicated significant sex differences in mean change trajectories but no sex differences in components of variance. No sex differences were found for fine motor movement. For balance, there were no sex differences in mean change trajectories; however, there was significant genetic variance for changes in balance in women after age 70 but not for men.Discussion. Although idiosyncratic environmental influences account for a large part of increasing variance, correlated and shared rearing environmental effects were also evident. Thus, both microenvironmental (individual) and macroenvironmental (family and cultural) effects, as well as genetic factors, affect maintenance of functional ability in late adulthood.
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| 8. |
- Granbom, Marianne, et al.
(författare)
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Household Accessibility and Residential Relocation in Older Adults
- 2019
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Ingår i: Journals of Gerontology - Series B Psychological Sciences and Social Sciences. - : Oxford University Press (OUP). - 1079-5014. ; 74:7, s. 72-83
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesIt is unclear how home environmental factors influence relocation decisions. We examined whether indoor accessibility, entrance accessibility, bathroom safety features, housing type, and housing condition were associated with relocations either within the community or to residential care facilities.MethodsWe used prospective data over 4 years from the nationally representative National Health and Aging Trends Study in the United States of Medicare beneficiaries 65 years and older living in the community (N = 7,197). We used multinomial regression analysis with survey weights.ResultsOver the 4 years, 8.2% of the population moved within the community, and 3.9% moved to residential care facilities. After adjusting for demographics and health factors, poor indoor accessibility was found to be associated with moves within the community but not to residential care facilities. No additional home environmental factors were associated with relocation.DiscussionOne-floor dwellings, access to a lift, or having a kitchen, bedroom, and bathroom on the same floor may help older adults age in place. Understanding which modifiable home environmental factors trigger late-life relocation, and to where, has practical implications for developing policies and programs to help older adults age in their place of choice.
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| 9. |
- Hossin, Muhammad Zakir, et al.
(författare)
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Is the Association Between Late Life Morbidity and Disability Attenuated Over Time? Exploring the Dynamic Equilibrium of Morbidity Hypothesis
- 2019
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Ingår i: The journals of gerontology. Series B, Psychological sciences and social sciences. - : Oxford University Press (OUP). - 1079-5014 .- 1758-5368. ; 74:8, s. 97-106
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Tidskriftsartikel (refereegranskat)abstract
- Objective:There is evidence suggesting that the prevalence of disability in late life has declined over time while the prevalence of chronic diseases has increased. The dynamic equilibrium of morbidity hypothesis suggests that these patterns are due to the attenuation of the morbidity-disability link over time. This study aimed to test this assumption empirically.Methods:Data were drawn from three repeated cross-sections of SWEOLD, a nationally representative survey of the Swedish population aged 77 years and older. Poisson regression models were fitted to assess the trends in the prevalence of Activities of Daily Living (ADL) disability, Instrumental ADL (IADL) disability, and selected groups of chronic conditions. The changes in the associations between chronic conditions and disabilities were examined on both multiplicative and additive scales.Results:Between 1992 and 2011, the prevalence of both ADL and IADL disabilities decreased whereas the prevalence of nearly all chronic morbidities increased. Significant attenuations of the morbidity-disability associations were found for cardiovascular diseases, metabolic disorders, poor lung function, and psychological distress.Discussion:In agreement with the dynamic equilibrium of morbidity hypothesis, this study concludes that the morbidity-disability associations among the Swedish older adults largely waned between 1992 and 2011.
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| 10. |
- Kelfve, Susanne
(författare)
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Underestimated Health Inequalities Among Older People-A Consequence of Excluding the Most Disabled and Disadvantaged
- 2019
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Ingår i: The journals of gerontology. Series B, Psychological sciences and social sciences. - : Oxford University Press (OUP). - 1079-5014 .- 1758-5368. ; 74:8, s. e125-E134
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The present study analyzed whether estimates of health inequalities in old age are sensitive to the exclusion of people living in institutions and nonuse of proxy interviews. Method: Pooled data from the 2004 wave (n = 1,180, aged 69-100, primarily interviewed over the phone) and the 2011 wave (n = 931, aged 76-101, primarily interviewed face-to-face) of the Swedish Panel Study of Living Conditions of the Oldest Old were used to compare absolute and relative differences in disability and mortality between people with compulsory education and people with more than compulsory education. Results: Both absolute and relative health inequalities would have been underestimated in a survey that excluded institutionalized people and proxy-interviewed community dwellers. The same patterns were found in men and women and regardless of the mode of data collection (telephone or face-to-face interview). The degree of underestimation was lower in those 85 years and older than in those 69 to 84 years. Discussion: A survey that only includes people who live in the community and can participate without the help of a proxy might give the impression that those with low levels of education have less extensive health disadvantages than they actually have.
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