European Journal of Ageing最新文献

Immigrants with a chronic disease may have a higher burden of multimorbidity than their native-born counterparts due to the unique experiences in their origin and the receiving countries. In this study, we provide a descriptive overview of inequalities in multimorbidity between immigrant and native-born older adults with chronic diseases in Europe. Our analysis includes individuals aged 50-79 years who participated in the Survey of Health, Ageing, and Retirement in Europe (SHARE) from Waves 2 through 9. We first estimate the prevalence of multimorbidity among person-years with each of eight chronic diseases and then compare the prevalence between native-born and immigrant populations by computing the relative risk. Overall, immigrants with chronic diseases have a higher prevalence of multimorbidity compared to native-born individuals with the condition, a trend typically more pronounced among women. In particular, both immigrant men and women have a pronounced risk of multimorbidity with stomach ulcers compared to their native-born counterparts. In subgroup analyses by regions of origin and residence, we find that immigrants from Eastern Europe or Asia/Oceania and those living in Northern Europe have particular disadvantages in multimorbidity to their native-born counterparts, especially for disease combinations that include stomach ulcers. Our findings can help identify the target populations and health conditions that should be prioritized in efforts to reduce health disparities between native-born and immigrant older adults in Europe.

'Vitality' refers to healthy aging beyond medical measures, but long-term data on vitality is scarce. Hence, we examined individual vitality patterns over 20 years, and their lifestyle and health characteristics, using predefined and data-driven methods. We used data of 3,013 adults aged 26-70 at their first vitality measurement from the Doetinchem Cohort Study examined up to 5 times from 1995 to 2019 at 5-year intervals. Vitality was based on the SF-36 vitality scale, with scores > 50 indicating good vitality. Long-term vitality patterns were defined by two approaches, predefined and data-driven, and compared using cross-tabulation and Cramér's V. The predefined patterns were: persistent good, persistent poor, worsening, improving, and varying vitality. The lifestyle and health characteristics related to these patterns were identified by multivariate multinomial logistic regression, using persistent good vitality as the reference at both baseline (t1) and 20-year follow-up (t5). Data-driven analysis revealed patterns similar to the predefined method with varying vitality split in two variants. There was fair agreement between the approaches (Cramér's V: 0.49). Most participants exhibited persistent good vitality: 61% in the predefined, and 78% in the data-driven approach. Compared to the persistent good vitality group, others were characterized by younger age and poor health, including pain, chronic conditions, and particularly high prevalence of poor mental health. Sex, education, household and work status, along with lifestyle factors, played a role in only some patterns. Most adults showed persistent good vitality over 20 years, with good mental health as a key characteristic of long-term vitality.

Despite its increasing prevalence worldwide, ageing without children remains insufficiently studied. This article presents a scoping review of existing qualitative research examining the social aspects of childlessness in midlife and later adulthood. A total of 3444 papers were retrieved from nine electronic databases (Web of Science, PubMed, CINAHL Complete, APA PsycINFO, SocINDEX, Academic Search Complete, Humanities International Complete, Scopus, and Embase) and supplemented with a grey literature search using Google Scholar. Twenty-five articles were included. Four interconnected themes were found to relate to the experiences of childless adults in midlife and later adulthood: (1) living within structural contexts highlights how social norms, life course disadvantages, and policy frameworks affect well-being, access to services, and parenthood possibilities; (2) navigating care and support captures the varied ways childless adults access support through informal and formal care systems; (3) making sense of childlessness focuses on how individuals interpret their childless status; and (4) carving out control describes how individuals adapt to non-parenthood. These findings demonstrate the diversity, complexity, and evolving nature of childlessness experiences among middle-aged and older adults. However, this review also revealed several gaps in the existing literature, highlighting areas for future examination, such as experiences of childlessness among LGBTQ + individuals, how policy frameworks shape lived experiences, and how targeted support interventions may address the needs of childless populations.

Purpose: The objectives of this study were to ascertain the prevalence of vision and/or hearing impairment and investigate their association with cognitive impairment in nursing home residents in Switzerland.

Methods: The sample comprised individuals aged 65-105 (mean = 84.0 and SD = 7.2) newly admitted for long-term care in one of 715 Swiss nursing homes from 2010 to 2019 (N = 132,880). Items from the Minimum Data Set of the Resident Assessment Instrument Swiss Version 2.0 assessed occurrence of hearing impairment (HI), vision impairment (VI), and dual sensory impairment (DSI, both HI and VI). We conducted logistic regression analyses to examine associations of each sensory impairment to cognitive impairment, controlling for medical and demographic factors.

Results: Sensory impairment was present in 57.28% of residents (HI 19.16%, VI 15.13%, and DSI: 22.99%) and cognitive impairment in 57.29%. The likelihood of cognitive impairment was greatest for DSI (prevalence ratio (PR) 1.58; 95% confidence interval (CI) 1.56-1.60), followed by HI (PR 1.35; 95% CI 1.33-1.37) and VI (PR 1.18; 95% CI 1.16-1.20). The average marginal effect for DSI on cognitive impairment exceeded the sum of effects for HI and VI. Stratified models revealed that male sex, younger age, and higher medical comorbidity were associated with increased likelihood of cognitive impairment in DSI.

Conclusion: Sensory impairments are prevalent among newly admitted nursing home residents. While HI and VI are independently associated with cognitive impairment, an interactive burden emerges when they co-occur as dual sensory impairment.

The transition to retirement has been shown to be accompanied by increased sleep duration and improved sleep quality. In addition, some studies suggest accelerated decline in cognitive function in post-retirement years. However, less is known about their interconnectedness. The aim of this study was to examine the concurrent changes in sleep and cognitive function during retirement transition. The study population consisted of 250 public sector workers (mean age before retirement 63.1 years, standard deviation 1.4) from the Finnish Retirement and Aging study. The participants used a wrist-worn ActiGraph accelerometer, responded to the Jenkins Sleep Problem Scale and underwent cognitive testing annually before and after retirement. Computerized Cambridge Neuropsychological Test Automated Battery (CANTAB®) was used to evaluate learning and memory, working memory, sustained attention and information processing, executive function and cognitive flexibility, and reaction time. Cognitive function improved in all cognitive domains, except for reaction time, during 1-year retirement transition period. The improvement was temporary in learning and memory, working memory and executive function and cognitive flexibility, which plateaued in post-retirement years. The participants were categorized into constantly short (49%), increasing (20%), decreasing (6%), and constantly mid-range (25%) sleep duration; and constantly without (36%), increasing (10%), decreasing (16%), and constantly with (38%) sleep difficulties. There were no associations between changes in sleep duration or sleep difficulties and cognitive function during retirement transition. Cognitive function improves temporarily during transition to retirement, but the improvement is independent of changes in sleep characteristics.

Widowhood represents a major life transition that can profoundly impact the mental health of older adults. However, limited research has explored how the duration of widowhood relates to depressive symptoms. This study examines the mediating roles of sleep duration and dietary diversity in the association between widowhood duration and depressive symptoms. Data were drawn from 2008 adults aged 65 and older participating in the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Linear regression-based mediation analysis was conducted to test the hypothesized pathways. Results revealed a significant positive association between widowhood duration and depressive symptoms. Specifically, among individuals widowed for more than 10 years, both sleep duration and dietary diversity served as mediators-albeit in gender-specific ways. Dietary diversity mediated the association in men, whereas sleep duration exhibited a suppression effect in women. These findings underscore the importance of tailored interventions to support the psychological well-being of widowed older adults. Family and community-based caregivers should prioritize improving dietary quality among long-term widowed men and enhancing sleep health among widowed women. Gender-sensitive strategies may be critical in mitigating the long-term psychological consequences of widowhood in later life.

The use of global or composite cognitive measures is extended in both clinical and academic settings. In this line, several population-based surveys include measures of cognition that have frequently been combined into a single score. However, some methodological aspects of this practice have gone unnoticed. One of such aspects has been to provide evidence of the measurement invariance of the combined measure across countries involved in the surveys. Using data from the Survey of Health, Ageing and Retirement in Europe (SHARE), this study aims at providing evidence of the factor structure of a Global Cognitive Performance (GCP) measure and testing whether this structure remains invariant across 27 European countries and Israel. The sample was composed of 55,569 adults aged between 60 and 102 years old (M = 72.07, SD = 7.97). 56.58% were female. Confirmatory Factor Analysis was used to establish the measurement model of GCP in the general sample and within each country. Afterwards, measurement invariance across countries was evaluated using the traditional as well as the alignment approach. The unidimensional model of GCP deemed an adequate fit to the data in the general sample as well as within each country, except for Malta, which was excluded from further analyses. After dismissing full measurement invariance, we studied approximate measurement invariance using alignment. 31.85% of factor loading estimates were noninvariant, while 54.81% of item intercept estimates showed deviations from invariance. Given evidence of items' intercepts and factor loadings noninvariance, researchers working with SHARE data should abstain from making cross-country comparisons of GCP. Some plausible explanations for noninvariance of items' intercepts are further discussed.

Self-perceptions of aging are important predictors of health and longevity. These perceptions are shaped by internal developmental processes and broader social contexts. Using eight waves of pooled panel data from the Chinese Longitudinal Healthy Longevity Survey (1998-2018), this study examines inter- and intra-cohort variations in older adults' self-perceptions of aging among a sample of older adults aged between 65 and 99 at baseline survey (baseline mean age = 80, N = 38,663), born between 1898 and 1949. The results show an overall cohort-based decline in positive self-perceptions of aging, with a potential reversal for the latest-born cohort (1945-1949). Net of cohort effects, older adults experience a decline in positive self-perceptions of aging as they age. Better socioeconomic status is associated with more positive self-perceptions of aging, but it does not slow down age-related declines. These patterns remain after adjusting for demographic characteristics, life course events (e.g., marriage, living arrangements, place of residence), attrition, and health. The findings highlight the interplay between historical contexts and internal development processes in shaping self-perceptions of aging. It also underscores the need for tailored intervention programs addressing different stages of aging.

A relocation to a nursing home is a major life transition in older age, with potential impacts on cognitive functioning and quality of life. In line with psychosocial models of successful aging, we investigated how older adults adapted to this major life transition. Using data collected at nine nursing homes in Geneva, Switzerland, we studied changes in cognitive functioning (i.e., short-term, long-term, and working memory, verbal fluency, prospective memory, and inductive reasoning) and quality of life (i.e., emotional and social loneliness, depressive symptoms, and purpose in life) in cognitively healthy older adults. Moreover, we exploratorily studied whether relational resources (e.g., participation in activities) impacted these changes. Forty-seven nursing home residents, aged 59 to 99 years (M = 85.55, SD = 9.43, 36 women), completed a neuropsychological test battery and self-report questionnaires approximately one, three, and six months after relocation. Repeated Measures ANOVAs indicated that short-term and long-term memory declined and (emotional) loneliness increased during the first three months after relocation. Yet, no differences were found between the first and last assessment of those indicators. Other factors did not show significant changes over time. Exploratory analyses revealed that visits of friends and participation in activities may play an important role in the impact of- and adaptation to this life transition. Although our results suggest preserved psychosocial adaptational capacities in nursing home residents, we should remain vigilant for the potential negative short-term and long-term impacts of major life transitions in this vulnerable population of older adults.

Background: Studies on changes in characteristics and survival of nursing home residents (NHRs) are rare. Therefore, this study aims to analyze ten-year trends in newly admitted German NHRs.

Methods: For this retrospective cohort study, claims data of a regional German health insurance fund was used to identify all residents aged 65 years and older newly admitted to a nursing home between 2011 and 2020 (with a follow-up period ending on December 31, 2021). Characteristics of NHRs were analysed descriptively and stratified by 5 two-year cohorts. Survival times and mortality were assessed by applying the Kaplan-Meier-method and a cox regression was used.

Results: A total of 113,929 residents were newly admitted between 2011 and 2020 (69% female; mean age 83.8 years). Over the years, the proportion of men and the mean age slightly increased. Prevalence of dementia remained nearly stable (45-48%) while cancer prevalence raised from 30 to 37%. Overall, median survival time decreased from 745 days in 2011/2012 to 615 days in 2019/2020. Survival times in residents with dementia decreased significantly (median survival from 790 to 651 days) while it remained nearly unchanged in cancer patients (from 444 to 410 days).

Conclusions: We found that survival after nursing home admission decreased in Germany from 2011 to 2020, which was accompanied by shorter survival in residents with dementia and by an increasing proportion of those with cancer, who already experience higher mortality. There is a growing need to integrate palliative care in nursing homes and to also provide appropriate care for older patients with cancer outside nursing homes.