Late-Life Suicidal Ideation in Nordic and Central-European Countries: Gender Differences and Risk Factors from the SHARE Study.

A number of studies have demonstrated that suicidal ideation in late life is associated with early-life circumstances. However, the importance of early-life circumstances in predicting suicidal ideation is not entirely clear. This study aims to use a machine learning approach to evaluate the importance of 32 early-life circumstances from six domains in predicting suicidal ideation in old age. The data in this study come from a cross-national longitudinal survey, the Survey of Health, Aging and Retirement in Europe (SHARE). Participants recalled information on early-life circumstances in SHARE wave 7 and reported suicidal ideation in SHARE wave 8. The XGBoost model was employed to evaluate the importance of 32 circumstances in six domains (early-life socioeconomic status, early-life health and healthcare, early-life relationship, etc.) in predicting the suicidal ideation of middle-aged and older adults over 50. There were 46,498 participants in this study, of which 26,672 (57.36%) were females and 19,826 (42.64%) were males. XGBoost showed a strong predictive performance, with an area under the curve of 0.80 and accuracy of 0.77. Top predictors were mainly in the domains of childhood relationship, childhood socioeconomic status, childhood health, and healthcare. In particular, having a group of friends most critically influences suicidal ideation in old age. These findings suggest that early-life circumstances may modestly predict suicidal ideation in late life. Preventive measures can be taken to lower the risk of suicidal ideation in middle-aged and older individuals.

BackgroundThe promotion of physical activity (PA) plays a major role for healthy ageing even in older age. There is a lack of cross-sectional and longitudinal studies explicitly dealing with barriers and drivers to PA in older adults. Therefore the aims of this study are a) to determine the prevalence of insufficient physical activity (IPA) in 65 to 75-year-olds in Europe and to identify factors associated with IPA in cross-section and b) to identify longitudinal risk factors for IPA in prior active persons.MethodsThis study is using data of the Survey of Health, Ageing and Retirement in Europe (SHARE). SHARE is a cross-national panel database including individual data of the non-institutionalised population aged 50+ from 27 European countries. For the present paper, we included a cohort that participated in all first four waves of SHARE (2004–2011) aged 65-to-75–years at wave four (male n = 1761, female n = 2085) from 10 European countries. To identify cross-sectional and longitudinal associations, we calculated prevalence odds ratios and hazard ratios with 95% confidence intervals.ResultsThe prevalence of IPA in 65–75-year-olds varied widely between countries, ranging from 55.4% to 83.3% in women and from 46.6% to 73.7% in men. IPA was associated with several intrapersonal factors and strength of association was similar for men and women for almost all investigated factors. Statistically significant associated with IPA were socioeconomic factors as low educational level (own and parental) and financial difficulties (male: POR: 1.60: 95%-CI: 1.26–2.03; female: POR: 1.58; 95%-CI: 1.26–1.97) and health-related factors as e.g. number of chronic diseases (male: POR: 1.34: 95%-CI: 1.23–1.45; female: POR: 1.31; 95%-CI: 1.21–1.42). Interpersonal only the size of social network was associated with IPA (male and female: POR: 0.88, 95%-CI: 0.81–0.95). Longitudinally in a fully adjusted model, only grip strength (HR: 0.99; CI-95%: 0.98–0.99) and BMI (HR: 1.02; CI-95%: 1.00–1.04) were statistically significant risk factors for IPA.ConclusionsPA promotion programs for older adults should incorporate the heterogeneity of health status and physical condition that can typically occur in this age group.

Background Highest rates of suicide in older adults are a major public health hazard in many industrialized societies. The current study aims to provide an overview of demographic, psycho-social, and health-related risks for suicidal ideation among European older adults. Methods Study builds on secondary data analysis using data drawn from the Survey of Health, Aging and Retirement in Europe (SHARE) wave 7.0. A total sample of 33,719 older adults, aged 65+, were analyzed. Risk factors included socio-demographic variables, psychological distress, and health conditions. Descriptive statistics and ANOVA were used to provide information about prevalence and demographic correlates of passive suicidal ideation. Standardized significant path coefficients were examined between predicting variables and suicidal ideation. Results Suicide ideation was at its highest level among older adults from France, Poland, Spain, Germany, Italy, and Belgium. Highest rates of suicidal ideation were found among widowed, but also married couples, aged between 65 and 70, and older adults living in rural area. Results also reinforced that elderly's suicidal ideation was universally associated with poor health, limited access to activities, a lack of social contact, and worse subjective well-being. The path from depression to suicidal ideation was significant with a larger magnitude. Conclusions Passive suicidal ideation is a critical mental health index. In order to diminish the likelihood of suicide thoughts and acts in older adults, national policy should integrate psychological services in elderly care to help older adults better cope with depressive symptoms and long-term health problems. Local government should foster local support groups for elderly and promote suicide prevention-intervention program for those elderly seeking help.

The primary aim of this study is to thoroughly investigate the prevalence and determinants of loneliness among older adults in the Baltic-Nordic region. Utilizing high-quality data sources and employing a methodologically rigorous approach, the study endeavors to enhance our understanding of how loneliness manifests and varies across different cultural and socio-economic contexts within these regions. By identifying key factors influencing loneliness, including demographic, social, and economic variables, the research seeks to contribute significantly to the existing body of knowledge on loneliness and inform targeted public health strategies and interventions tailored to the unique needs of older adults in the Baltic and Nordic countries. This research, centered on older adults aged 67 and above within the Baltic-Nordic region, draws upon data from the Survey of Health, Ageing and Retirement in Europe (SHARE), specifically its eighth wave conducted between June and August 2020. The demographic analysis of this study covers a diverse sample of 5,313 participants from the Baltic and Nordic regions. Specifically, the sample includes 2,377 participants from Nordic countries, namely Sweden, Denmark, and Finland, and 2,936 from the Baltic countries of Estonia, Latvia, and Lithuania. The investigation extends to the financial well-being of households, involving an analysis of 3,925 individuals, with 1,748 from Nordic countries and 2,177 from Baltic countries. Although Iceland is categorized as a Nordic country, the analysis within this study is conducted separately due to the unavailability of SHARE data for this region. Instead, the HL20 study, focusing on the health and well-being of the older adult population in Iceland, contributes data for 1,033 respondents. This methodological distinction allows for a comprehensive understanding of regional differences, highlighting the importance of specialized approaches to examine the intricate dynamics of loneliness and well-being across the Baltic-Nordic region. The study reveals significant regional variations in loneliness among older adults during the COVID-19 outbreak, with the Baltic countries (Estonia, Latvia, Lithuania) reporting a lower prevalence of loneliness compared to the Nordic countries (Sweden, Denmark, Finland). Iceland, while grouped with the Nordic countries, was analysed separately. Employment emerges as a key factor in reducing loneliness across all regions, suggesting the benefits of social interactions and structured routines. Gender and marital status significantly influence loneliness, with notable disparities in the Baltic region and smaller gaps in the Nordic countries, reflecting the impact of societal and cultural norms. Additionally, educational attainment and health status show varied associations with loneliness, highlighting the complex interplay of individual and societal factors in these regions.

To describe disability severity transitions in the ageing population in Switzerland using an overall functioning score to define four disability severity states (no, mild, moderate and severe) and death, and to investigate the association of multimorbidity and further predictors with these transitions. Secondary analysis of the Swiss version of the Survey of Health, Ageing and Retirement in Europe (SHARE). Switzerland. Community-dwelling population aged 50+ with at least two interviews in SHARE (N=3505). Not applicable. Primary outcome measures are the disability severity as assessed by a previously developed overall functioning score, and death status as assessed by the SHARE end-of-life interview. Transition analysis between disability severity states and death was conducted using multistate Markov models. The association between predictor variables and transition intensities was quantified using the proportional hazards assumption. Two distinct operationalisations of multimorbidity (count, burden) were used and analysed according to two separate models (A, B). The findings for both models were similar: Estimated HRs for transition intensities suggest that being multimorbid or having a higher disease burden score increases the risk of transitioning to higher disability severity states and death for most transitions (HRs between 0.90 and 2.34 for model A compared with not being multimorbid; HRs between 0.95 and 1.46 for model B for a one-point increase in the disease burden score). In addition, most transitions to higher disability severity states and death are more likely for higher age (HRs between 1.00 and 1.14 for model A, and between 1.00 and 1.15 for model B for a 1 year increase in age), and transitions to death are less likely for women, compared with men (HRs between 0.34 and 0.88 for model A, and between 0.38 and 0.71 for model B). This study is a first attempt to understand disability severity transitions in the older population in Switzerland. Although we believe that such an approach is suitable to inform resource allocation to LTC, rehabilitation and prevention, more detailed information on contextual factors will be important to consider for future research. Moreover, our study contributes to the discussion on how to operationalise multimorbidity in healthy ageing research.

Beyond the "European health divide": Functional limitation disparities among older adults in Central and Eastern Europe.

The Survey of Health, Ageing and Retirement in Europe (SHARE) is a unique multidisciplinary and cross-national panel database of ex ante harmonized microdata on health, socioeconomic status, and social and family networks covering most of the European Union and Israel. To date, SHARE has collected five waves of data in 2-year intervals since 2004, including current living circumstances and retrospective life histories. A sixth wave is currently (2015) in the field. Four additional waves are planned until 2024. More than 230,000 interviews conducted so far give a broad picture of life after age 50, measuring physical and mental health, both objectively and subjectively; economic and noneconomic activities, income, and wealth by sources; intergenerational transfers of time and money within and outside of the family; as well as life satisfaction and well-being. The data are available to the scientific community free of charge at www.share-project.org after registration. SHARE is harmonized with the US Health and Retirement Study (HRS) and the English Longitudinal Study of Ageing (ELSA) and has become a role model for several aging surveys worldwide. SHARE’s scientific power is based on its panel design that grasps the dynamic character of the aging process, its multidisciplinary approach that delivers the full picture of the individual and societal aging, and its cross-nationally ex ante harmonized design that permits international comparisons of health, economic, and social outcomes in Europe and the USA. Due to their harmonization, the SHARE data and their international sisters encompass a worldwide “historical laboratory” to assess the effects of different policies on health, socioeconomic status, and well-being after age 50. To date (May 2015), more than 1,200 SHARE-based publications assess the chances and challenges of individual and societal aging by exploiting the links between health, economic, and social conditions over the life course observable in SHARE. Among the key findings is a European North–South gradient in many more dimensions than previously documented. In addition to the well-known income gradient, the health and wellbeing differences between North and South contradict mortality data and folklore about healthy Mediterranean lifestyle. SHARE has sparked an entire new area of research by revealing a strong correlation between early retirement and the loss of cognitive abilities, social contacts, and well-

Evidence indicates an association between frailty and hospitalisation. However, hospital admissions occur repeatedly over time in old age, and most research has only focussed on single hospital admission. This study examines how frailty influences subsequent hospital use—both the risk of hospital admission and the duration of overnight stays—among community-dwelling adults aged 65 years and older across ten European countries over a 14-year period. Seven waves of data from the Survey of Health, Ageing and Retirement in Europe (SHARE) were used. Frailty was measured at baseline (wave 1) using the sex-specific SHARE Frailty Instrument, classifying participants as robust, prefrail, or frail. Hospital admission and length of stay during the past 12 months were measured at waves 2, 4, 5, 6, 7, and 8. Logistic mixed models was fitted to estimate the risk of hospital admission, and negative binomial mixed models to calculate the duration of hospital stays. Baseline frailty was associated with an increased risk of hospital admission over 14 years, yet among those who were hospitalised, frailty was not strongly related to longer stays. These findings suggest that frailty predicts whether older adults are admitted to hospital but is less informative regarding how long they remain once hospitalised. Routine frailty screening in primary care may help identify those at greatest risk and enable better-targeted community interventions to prevent avoidable hospitalisations and improve health outcomes for older people.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10433-026-00914-z.

Association between internet exclusion and depressive symptoms among older adults: panel data analysis of five longitudinal cohort studies

We aimed to describe gender and region differences in the prevalence of binge drinking and in the association between binge drinking and well-being, among older adult Europeans. This is a cross-sectional study using the Survey of Health, Ageing and Retirement in Europe (SHARE) wave 4, conducted between 2011 and 2012, including 58 489 individuals aged 50 years or older. Sixteen European countries were grouped in four drinking culture regions: South, Central, North and East. We categorized drinking patterns as: never, former, no-binge and binge drinkers. We used the CASP-12 questionnaire to measure well-being. To assess the association between binge drinking and well-being, we fitted two-level mixed effects linear models. The highest percentage of binge drinkers was found in Central Europe (17.25% in men and 5.05% in women) and the lowest in Southern Europe (9.74% in men and 2.34% in women). Former, never and binge drinkers had a significant negative association with well-being as compared with no-binge drinkers. There was a significant interaction in this association by gender and region. Overall, associations were generally stronger in women and in Southern and Eastern Europe. The negative association of binge drinking with well-being was especially strong in Southern European women (β = -3.80, 95% CI: -5.16 to - 2.44, P value <0.001). In Southern and Eastern European countries the association between binge drinking and well-being is stronger, especially in women, compared with Northern and Central Europe. Cultural factors (such as tolerance to drunkenness) should be further explored.

Although engagement in productive activities is associated with favourable outcomes with respect to the health and well-being of older individuals, the association between such activities and depression in older populations remains relatively unexplored. The purpose of this study was to evaluate the association among five productive activities (paid work, formal volunteering, caregiving, informal helping and caring for grandchildren) with depression in older adults in 14 European countries. This cross-sectional study used the first two waves of data collected by the Survey of Health, Ageing and Retirement in Europe and analysed a total sample of 7238 relatively healthy community residents aged 60 years and older from 14 European countries. The Survey of Health, Ageing and Retirement in Europe excluded potential participants with a past history of depression, cognitive impairment and physical limitations. Depression was categorised using the EURO-D instrument, and associations with participating in productive activities were investigated. Depression was less prevalent among those individuals who were employed or self-employed and those who participated in formal volunteering or informal helping, whereas caregiving was associated with a higher risk of depression. Caring for grandchildren was not associated positively or negatively with depression. Formal volunteering and caregiving remained associated with depression after adjustment for age, sex, marital status, education, economic status, country and presence of long-term illness. Availability of formal volunteering may be important in reducing depression risk, whereas caregiving is associated with a higher risk of depression in older European adults. Further research is required to clarify the direction of causation and evaluate interventions.

BackgroundPatients with Alzheimer's disease or dementia are at increased risk for COVID-19 hospitalization and mortality. However, no study has examined whether memory function is associated with COVID-19 outcomes in general older adults.MethodsData were obtained from SHARE (the Survey of Health, Ageing and Retirement in Europe), HRS (the Health and Retirement Study), and ELSA (the English Longitudinal Study of Ageing), three prospective and representative cohorts of non-institutionalized adults aged 50 years and older in 25 European countries plus Israel, the United States, and the United Kingdom, respectively. Memory function was measured with immediate and delayed 10-words recall tests. Associations of 10-words recall with COVID-19 hospitalization and mortality were assessed using logistic models adjusted for age, sex, race, body mass index, smoking, physical activity, household income, education level, and chronic conditions.Figure 1.Determination of the study sample.COVID-19, coronavirus disease 2019; ELSA, the English Longitudinal Study of Ageing; HRS, the Health and Retirement Study; SHARE, the Survey of Health, Ageing and Retirement in Europe.ResultsA total of 4062 participants with COVID-19 infection from SHARE, 1349 from HRS, and 278 from ELSA were included in the analysis. 610 (15.0%) in SHARE, 142 (10.5%) in HRS, and 39 (14.0%) in ELSA were hospitalized, and 102 (2.5%) died of COVID-19 or related complications in SHARE. The adjusted odds ratios (aORs) for COVID-19 hospitalization were 1.15 (95% CI, 1.09-1.22) in SHARE, 1.07 (95% CI, 0.94-1.21) in HRS, and 1.34 (95% CI, 1.02-1.77) in ELSA, per word decrease in immediate 10-words recall. For delayed 10-words recall, the corresponding aORs were 1.11 (95% CI, 1.06-1.17), 1.12 (95% CI, 1.01-1.24), and 1.25 (95% CI, 1.01-1.55), respectively. The aORs for COVID-19 mortality were 1.07 (95% CI, 0.94-1.21) and 1.14 (95% CI, 1.01-1.28) per word decrease in immediate and delayed 10-words recall in SHARE, respectively. Results were relatively robust to missing data of covariates, exclusion of cases based on symptoms alone, or exclusion of cases with Alzheimer's disease or dementia.ConclusionThis study shows that low memory performance, as measured by 10-words recall, is independently associated with an increased risk of COVID-19 hospitalization and mortality in adults aged 50 years and older.DisclosuresAll Authors: No reported disclosures

BackgroundSocial participation and digital use are associated with reduced depression risk among older adults, but most supporting evidence does not consider both time-invariant and time-varying confounders and is inconsistent. We aimed to evaluate the impact of social participation and digital use on the incidence of depressive symptoms among older adults by a multi-country cohort considering both time-invariant and time-varying counfounders.MethodsWe used data from four nationally representative observational studies across 18 countries (2008–2021): the Health and Retirement Study (HRS), the Survey of Health, Aging and Retirement in Europe (SHARE), the China Health and Retirement Longitudinal Study (CHARLS), and the Mexican Health and Aging Study (MHAS). Participants aged 50 years or older without depressive symptoms at baseline and without related behaviors pre-baseline were included. Interested exposure social participation and digital use were measured by specific questions. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D) and the European Depression Scale (EURO-D). Targeted maximum likelihood estimation method was applied to estimate adjusted relative risks (RRs) and 95% confidence intervals (CIs) for the long-term impact of exposure on depressive symptoms onset.ResultsA total of 69,186 eligible participants were included. At baseline, 77.0%, 44.0%, 34.2%, and 49.8% of participants were exposed to social participation in HRS, SHARE, CHARLS, and MHAS, respectively, and these proportions were 55.7%, 55.9%, 4.5%, and 69.9% for digital use exposure. During follow-up, a total of 18,245 (26.4%) individuals developed depressive symptoms. The RRs (95% CI) of depression risk under social participation versus no social participation were 0.80 (0.68–0.93) in HRS, 0.80 (0.74–0.87) in SHARE, 0.86 (0.77–0.96) in CHARLS, and 0.93 (0.85–1.02) in MHAS. Compared with no digital use, the RRs (95% CI) of depression risk under digital use were 0.88 (0.72–1.08) in HRS, 0.85 (0.77–0.93) in SHARE, 0.75 (0.60–0.92) in CHARLS, and 0.88 (0.79–0.98) in MHAS.ConclusionsEngagement in social participation and digital use are associated with a reduced incidence of depressive symptoms in older adults. In the digital world, besides social participation, promoting digital use for social connection may be an effective strategy for depression prevention in ageing populations.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12916-026-04846-4.

In the Survey of Health, Ageing and Retirement in Europe (SHARE) (http://www.share-project.org), health measures were constructed based on a careful consultation process of health experts and previous health surveys. However, there have been limited efforts to examine the comparability of health data in SHARE. Therefore, we aim to compare self-reports of health based on incidence and prevalence of health outcomes in SHARE to estimates from parallel national and trans-national health surveys. Prevalence of health outcomes in SHARE measured at baseline (2004/2005) were compared to prevalence estimates from the European Health Interview Survey (EHIS) (2006-2009), national Health Interview Surveys (HIS) (1997-2003), the European Social Survey (ESS) (2004/2005), the EU Statistics on Income and Living Conditions (EU-SILC) (2005) and the disability ad hoc module added to the European Union Labour Force Survey (EU-LFS-disability) (2002). Components of each of these surveys provide an element of comparison for a particular health dimension in SHARE. Across countries, agreement between surveys was described for self-perceived health, long-standing illness, global activity limitations, diabetes, hypertension, asthma, lung diseases, depression and overweight by age group, gender and educational level. First results show substantial variation in the comparability of health prevalence assessed by SHARE with other health surveys, depending on the health indicator of interest. For instance, a good agreement with SHARE was found for self-reported diagnosed diseases assessed by EHIS and for overweight based on self-reported weight and height by EHIS and HIS. On the other hand, for self-perceived health, the agreement between SHARE and other surveys was poor. Furthermore, agreement varied across countries, making country-specific comparisons between surveys less reliable. Lack of agreement between surveys is studied in more detail concerning systematic differences in survey design, sampling strategies, responses and assessment modes. Investigating time trends will evaluate whether differences in prevalence of health indicators between surveys will also affect agreement among trends over time in prevalence of health measures across age, gender and education. These additional analyses will complete this first assessment of the quality of SHARE data on health. Besides, this research will highlight the overlap and complementarity between SHARE and other national and trans-national health surveys. By recognising health measures that could be harmonised between surveys and measures that are more exclusive, we could exploit the opportunities offered by having multiple measures of health in different surveys.

2012 as the European Year for Active Ageing and Solidarity between Generations. This action indicates an increased awareness of the urgency to make progress in finding solutions to what some perceive as the ''problems'' of ageing societies. However, ageing societies also present opportunities for Europe. Based on the premise that Europeans are living longer and staying healthier than ever before, the European Commission states that the time has come to realise these opportunities. Hence, the main aims of this year are stated as: maintaining the vitality of older people, enhancing their involvement in society and removing barriers between generations. The emphasis clearly is on employability and workability, given the dramatic demographic shifts in the workforce all over Europe, but also on living independently, health care, social services, adult learning, volunteering, housing, IT services and transport. Under the flag of Europe, a series of initiatives are launched, ranging from conferences and events, information campaigns to exchange of information and best practice. Many national, regional and local authorities as well as social partners and businesses in Europe launch initiatives in parallel. These initiatives should raise awareness, stimulate debate and have a real impact on fostering a sustainable active ageing culture.