Swedish Longitudinal Study Research Articles

Are Trajectories of Preferred Retirement Ages Associated with Health, Work Ability and Effort–Reward Imbalance at Work? Findings from a 6-Year Swedish Longitudinal Study

Abstract Preferred retirement age (PRA) is one key dimension when studying retirement decision-making. However, little is known concerning how PRA develops over the late career years. This study used a person-centered approach to longitudinally investigate trajectories of PRA and how they differ in self-rated health, perceived work ability, and effort–reward imbalance (ERI) at baseline levels and over 6 years. The study used data from four waves (2010, 2012, 2014, and 2016) of the Swedish Longitudinal Occupational Survey of Health. The sample consisted of 1,510 individuals aged 50–55 in 2010, who answered to the questionnaire for those in paid work (including self-employment) at the baseline and at least one of the following waves. Results from the latent class growth curve modeling show both within- and between-person variability in PRA over the 6-year span. We found four distinct trajectories, which differed both at the baseline levels and in the patterns of change in PRA: “C1: normative, relatively stable PRA” (42% of all participants); “C2: considerably early, increasing PRA” (6% of the participants); “C3: late, relatively stable PRA” (4% of the participants); and “C4: early, increasing PRA” (49% of the participants). Participants revealed a clear preference for retirement before the age of 65. Trajectories comprising earlier PRA showed poorer self-rated health, poorer work ability, and higher levels of ERI at the baseline and over time. The findings reinforce the importance of healthy work environments that promote work ability and facilitate a balance between efforts and rewards for encouraging longer working lives.

Antibiotic use during coronavirus disease 2019 intensive care unit shape multidrug resistance bacteriuria: A Swedish longitudinal prospective study.

High frequency of antimicrobial prescription and the nature of prolonged illness in COVID-19 increases risk for complicated bacteriuria and antibiotic resistance. We investigated risk factors for bacteriuria in the ICU and the correlation between antibiotic treatment and persistent bacteria. We conducted a prospective longitudinal study with urine from indwelling catheters of 101 ICU patients from Uppsala University Hospital, Sweden. Samples were screened and isolates confirmed with MALDI-TOF and whole genome sequencing. Isolates were analyzed for AMR using broth microdilution. Clinical data were assessed for correlation with bacteriuria. Length of stay linearly correlated with bacteriuria (R2 = 0.99, p ≤ 0.0001). 90% of patients received antibiotics, primarily the beta-lactams (76%) cefotaxime, piperacillin-tazobactam, and meropenem. We found high prevalence of Enterococcus (42%) being associated with increased cefotaxime prescription. Antibiotic-susceptible E. coli were found to cause bacteriuria despite concurrent antibiotic treatment when found in co-culture with Enterococcus. Longer stays in ICUs increase the risk for bacteriuria in a predictable manner. Likely, high use of cefotaxime drives Enterococcus prevalence, which in turn permit co-colonizing Gram-negative bacteria. Our results suggest biofilms in urinary catheters as a reservoir of pathogenic bacteria with the potential to develop and disseminate AMR.

Predictors of do-not-attempt-resuscitation decisions in patients with infratentorial or large supratentorial intracerebral hemorrhages and consequences thereafter: a register-based, longitudinal study in Sweden

ObjectivesDo-not-attempt-resuscitation (DNAR) decisions for patients with infratentorial or large supratentorial intracerebral hemorrhages (ICHs) pose clinical and ethical challenges. We aimed to investigate factors associated with DNAR decisions in patients with infratentorial or large (≥30 mL) supratentorial ICH, and differences in complications, treatment, and mortality.Materials & methodsThis longitudinal, observational study comprised all patients treated for ICH at three stroke units in Gothenburg, Sweden, between November 2014 and June 2019. Patients were identified in the local stroke register, and additional data were collected from medical records and national registries. Mortality rates were followed 1 year after incident ICHs. Factors associated with DNAR decisions, and one-year mortality were explored.ResultsOf 307 included patients, 164 received a DNAR decision. Most (75%) decisions were made within 24 h. DNAR decisions were associated with higher age, pre-stroke dependency, stroke severity, and intraventricular hemorrhage. Patients without DNAR decisions received thrombosis prophylaxis, oral antibiotics, and rehabilitative evaluations more frequently. The one-year survival probability was 0.16 (95% confidence interval [CI] 0.11–0.23) in patients with DNAR decisions, and 0.87 (95% CI 0.81–0.92) in patients without DNAR decision. DNAR decisions, higher age, stroke severity, hematoma volume, and comorbidities were associated with increased one-year mortality. Thrombosis prophylaxis and living alone were associated with a lower hazard.ConclusionThe majority of DNAR decisions for patients with infratentorial or large supratentorial ICH were made within 48 h. Higher age, pre-stroke dependency, high stroke severity, and intraventricular hemorrhage predicted receiving a DNAR decision. DNAR decisions were strongly associated with increased short- and long-term mortality.

Social network and severe lower respiratory tract infections in older adults: findings from a Swedish longitudinal population-based study

ObjectivesTo investigate the association between social network and the risk and prognosis of severe lower respiratory tract infections (LRTIs) in older adults. MethodsData from Swedish hospital records were matched with the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K). Social network was operationalized as social connections and social support, based on different self-reported variables, and categorized as low, medium, and high. The risk of severe LRTI and related outcomes were assessed using Cox, Poisson, and logistic regression models where appropriate. ResultsA total of 362 individuals experienced LRTI-related hospitalizations between 2001 and 2016 (479 total hospitalizations). High levels of social support decreased the hazard of incident LRTI by 29% (hazard ratio 0.71, 95% confidence interval [CI] 0.52-0.96), the hospital length of stay by 21% (incidence rate ratio 0.79, 95% CI 0.65-0.97), and the risk of 30-day mortality by 92% (odds ratio 0.08, 95% CI 0.01-0.68), but was a risk factor for 30-day readmission (odds ratio 3.16, 95% CI 1.38-7.24). High levels of social connections were associated with a higher risk of incident LRTI in women and those with dementia and/or slow walking speed (Pinteraction <0.05). ConclusionOlder individuals’ quality of social support seems to be a stronger determinant of LRTI incidence and prognosis than the quantity of their social connections. These findings may inform evidence-based policies aimed at preventing LRTIs in older adults.

Sickness absence in relation to first childbirth in nulliparous women, employed in the education and care branches in the public or private sectors: A Swedish longitudinal cohort study.

BackgroundPregnancy and childbirth entail increased risks of sickness absence (SA). Many women work in education and care, two branches characterised by high SA levels; it is not known if the link between childbirth and SA in these branches differs between private and public sectors. We examined SA and disability pension (DP) in relation to childbirth among women working in the education and care branches, and if these patterns differed between public and private sectors.MethodsWe performed a Swedish register-based cohort study. Study participants were nulliparous women living in Sweden in December 2004 and employed in education or care (n = 120,013). We compared SA/DP in the three years before and after 2005 among women who had no childbirth during follow-up (B0), had one childbirth in 2005 and no more (B1), and had one childbirth in 2005 and at least one more during follow-up (B1+). Analyses were performed for all and by public or private sector.ResultsOf all studied women, 70% worked in the public sector. Women in B1 and B1+ had, except for the year before childbirth, comparable or lower mean combined SA/DP days than women in the B0 group; women in the B1+ group had, except for the year before childbirth, the lowest mean level of SA/DP. We observed no substantial differences in these patterns between public and private sectors.ConclusionsPatterns of SA/DP among nulliparous women who did or did not give birth did not differ substantially between public and private sectors among women in the educational and care branches.

Same-sex mothers' experiences of equal treatment, parenting stress and disclosure to offspring: a population-based study of parenthood following identity-release sperm donation.

What are the experiences of same-sex mothers following identity-release sperm donation regarding equal treatment in society, parenting stress and disclosure to child? Mothers predominantly reported equal treatment in society, low levels of parenting stress and early disclosure of the donor conception to the child, and half of the couples had also informed the child of his/her right to obtain the donor's identity. The number of two-mother families is increasing, and previous studies have reported about challenges related to heteronormativity, discrimination and the status of the non-birth mother. Same-sex mothers have been found to disclose the child's donor conception earlier than different-sex parents, but little is known regarding disclosure of the child's right to obtain identifying information about the donor. The present study concerns the fourth wave of data collection of a nation-wide longitudinal study. A total of 143 same-sex mothers (73% response rate) following identity-release sperm donation completed individual surveys when their donor-conceived child had reached age 7. These women represent a total of 82 couples who had undergone sperm donation treatment. The study is part of the longitudinal Swedish Study on Gamete Donation (SSGD). Couples accepted for gamete donation treatment at seven Swedish University hospitals were recruited between 2005 and 2008 and were requested to complete postal surveys during four waves of data collection. The present study sample includes same-sex mothers who completed a survey when their donor-conceived child had reached 7 years of age. Data were collected with the Swedish Parenting Stress Questionnaire (SPSQ), and study-specific items on experiences of treatment in society and disclosure behavior. Group comparisons (birth mothers vs non-birth mothers) were conducted using Chi2-tests, independent t-tests and Mann-Whitney U-tests, and written comments provided for open-response items were analyzed by qualitative content analysis. The mothers were generally open about the child's donor conception and the large majority (>80%) reported being treated positively and in the same way as other parents. However, satisfaction with treatment in health care settings was significantly lower than that reported in contacts with the child's school and recreational activities (P < 0.001) and open-response comments indicate that this may be related predominantly to heteronormative language and assumptions. Birth mothers and non-birth mothers reported similar treatment in society and similar levels of parenting stress. All but one couple had already talked with their 7-year-old child about his/her conception with donor sperm. Half of the couples had also informed the child about his/her opportunity to obtain identifying information about the donor, and remaining couples planned later disclosure. Children's reactions were generally described as neutral, positive or characterized by interest and curiosity. The present study was performed within the context of the Swedish legislation on identity-release donation, which limits the generalizability to same-sex couples using anonymous or known sperm donors. Although no evidence of attrition bias was found, it is possible that those couples who initially declined participation in the SSGD (23%) or dropped out at the fourth wave of data collection (27%) differ from the study sample in terms of variables that we were unable to control for. The present finding that most same-sex mothers in a population-based sample experience equal treatment in society is encouraging and validates previous results from predominantly qualitative studies. Nevertheless, the fact that a subgroup experiences discrimination and less favorable treatment indicates that further action is needed, particularly in child health care settings. The present study is the first to report on the timing of parents' disclosure of the child's right to identifying donor information and suggests that disclosure during preschool ages is feasible and does not appear to be related to negative consequences. In view of the increased availability and use of identity-release donation, there is a pressing need to investigate parents' intentions, behaviors and needs with regard to talking with their child about his/her opportunity to obtain the donor's identity. Financial support from the Swedish Research Council (2013-2712) and the Swedish Research Council for Health, Working Life and Welfare (2014-00876). There are no conflicts of interest to declare. N/A.

Mental health in individuals with self-reported psychiatric symptoms during the COVID-19 pandemic: Baseline data from a swedish longitudinal cohort study

ObjectiveIndividuals with psychiatric disorders may be both vulnerable and sensitive to rapid societal changes that have occurred during the COVID-19 pandemic. To fully understand these impacts, repeated measurements of these individuals are warranted. The current longitudinal study set out to perform monthly assessment of individuals with common psychiatric disorders using established questionnaires with a possibility for them to self- rate their symptoms, over time.MethodsRecruitment of individuals who identified themselves as struggling with mental health problems, living in Sweden between July 2020 and June 2021 using an online survey. The individuals answered questions on demographics, psychiatric history, current psychiatric symptoms (e.g., Patient Health Questionnaire, PHQ-9; General Anxiety Disorder, GAD-7), somatic health, health-care contacts and any changes therein during the pandemic. Monthly, longitudinal assessments are still ongoing (consenting participants provide data for 1 year), and here we present descriptive statistics from the baseline measurement. All measurements from baseline (>400 items), and follow-ups are presented in detail.ResultsA total of 6.095 participants (average age 35 years) submitted complete baseline data. Marital status (43% single) and number of years of education (48% highest degree being high school) were evenly distributed in this population. The most common lifetime psychiatric disorder in the sample was depressive disorder (80.5%) and generalized anxiety disorder (45.9%), with a substantial proportion having severe symptoms of depression. (30.5%) and anxiety (37.1%). Lifetime suicidal ideation (75.0%) and non-suicidal self-harm (57.7%) were prevalent in the group and 14.5% reported drug use during the pandemic. Allergies (36.8%) were the most common somatic condition, followed by irritable bowel syndrome (18.7%). For those having experienced a traumatic event, 39% showed symptoms during the pandemic indicating PTSD. Regarding contact with mental health services during the pandemic, 22% had established a new contact, and 20% reported to have increased their psychiatric medication compared to before the pandemic.ConclusionBaseline data collected during the pandemic from individuals in Sweden with pre-existing psychiatric disorders demonstrate that this sample represents a population suitable for an investigation on the long-term impact of the pandemic, as intended by the longitudinal investigation that is ongoing. Follow-up questionnaires over a 12-month period are being collected and will indicate how the health and well-being of this population was impacted during the changes and uncertainties that have been characteristic of the past 2 years.

Psychosocial job stressors and risk of suicidal behavior - an observational study among Swedish men.

This study aimed to explore the relationship between psychosocial job stressors and suicidal behavior (fatal and non-fatal) among Swedish men while controlling for potential confounders. Population-based Swedish longitudinal cohort study of male conscripts without previous self-harm (N=1 483 310) enlisting 1968-2002. Conscription examinations included measures of IQ, stress resilience and psychiatric diagnoses. Job demand-control (JDC) exposure was assessed using the Swedish Job Exposure Matrix linked to specific occupations. Suicidal behavior among men aged 30-64 was identified in the National Hospital Register (non-fatal self-harm) and Swedish Cause of Death Register (suicide) during follow-up 2002-2014. Cox regression models were used to estimate associations between JDC category and suicidal behavior. In fully adjusted models, passive jobs (low demand-low control) showed the highest risk of suicidal behavior [hazard ratio (HR) 1.33, 95% confidence interval (CI) 1.25-1.43] compared to those with low strain (low demand-high control), followed by high strain (high demand-low control) (HR 1.12, 95% Cl 1.03-1.22). A lower risk of suicidal behavior was found in the active category, where levels of both demand and control are high (HR 0.64, 95% Cl 0.60-0.70). Separate analyses for suicide as outcome revealed a lower risk of suicide in persons with active jobs (high demands-high control). The passive category showed a higher risk for suicide, but the association did not remain after adjustment for stress resilience and IQ. These results show that psychosocial job stressors among men are associated with risk for suicidal behavior. Improving job control has the potential to decrease suicidal behavior for this group.

Problem gambling and anxiety disorders in the general swedish population – a case control study

Co-occurring psychiatric comorbidity is high among problem gamblers, and anxiety disorders has repeatedly been linked to problem gambling. Less conclusive, however, is the association between problem gambling and specific anxiety disorders. The aim of this study is to examine the association between problem gambling and specific anxiety disorders in subgroups of gender, age and socio-economic status (SES) in the general Swedish population. A case-control design was employed - nested in the Swedish longitudinal gambling study cohort. All anxiety disorders studied - Panic Disorder, Social Phobia, Generalized Anxiety Disorder (GAD) and Post-Traumatic Stress Disorder (PTSD), were significantly associated with problem gambling, however the pattern differed across subgroups. Social Phobia was the anxiety disorder most commonly associated with problem gambling across subgroups. The strongest associations between problem gambling and various anxiety disorders were found in participants under the age of 25, among females, and in the group with middle SES. In those groups three of the four anxiety disorders studied were significantly associated with problem gambling, with different patterns. Quite remarkably, participants under the age of 25 had three times higher risk of having had GAD compared to their controls. Efforts to prevent an escalation of either gambling or anxiety could target the presented vulnerable groups specifically.

Future time perspective and personality trait change during the retirement transition: Insights from a six-wave longitudinal study in Sweden.

The present study examined associations between two future time perspective (FTP) dimensions (perceived opportunities and perceived time) and the Big Five personality traits during older adulthood, a developmental period that has received limited attention in personality development. Specifically, it tested whether FTP dimensions were cross-sectionally associated with personality traits, as well as if they predicted changes on those traits during a time when participants were transitioning to retirement. Participants from the Health, Ageing and Retirement Transitions in Sweden (HEARTS) study (N = 5,913, Mage = 63.09 years) reported on their FTP at the initial assessment and on their Big Five personality traits on six assessments 1 year apart. Latent growth curve models were fit to examine FTP as a predictor of level and change in the Big Five traits over time, with perceived time and opportunities included as unique predictors. Results found that broader FTP was associated with higher extraversion, agreeableness, openness to experience, and conscientiousness, but lower neuroticism initially. However, results indicated associations were stronger and sometimes only significant for perceived opportunities not time. Regarding FTP as a predictor of personality trait change, modest evidence was found that perceived opportunities predicted changes in neuroticism and openness over time. The present study extends past work by showing the importance of capturing different components of FTP when examining personality traits during older adulthood. Research needs to further explore the longitudinal predictive effects of FTP, focusing on more proximal assessments and how FTP changes during retirement. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Is there a social gradient in how youth with mental disorder perform academically? Findings from a Swedish longitudinal register-based study

BackgroundIt is well established that academic achievement and other school-related outcomes are associated with mental health status in children and youths. However, few studies have examined the influence of socioeconomic background on the relationship between poor childhood/adolescent mental health and school performance. From an equity perspective, it is important to explore how school-related outcomes are affected for young people with mental disorder and if these outcomes differ depending on gender and socioeconomic background. This study aimed to investigate social gradients in the prospective association between childhood/adolescent mental disorder and academic achievement.MethodsThis register based study used data from the Umeå SIMSAM Lab of linked Swedish registers on all children born between 1990 and 1994 and their parents (N = 642 558). The outcome was school grades achieved upon compulsory school graduation (age 15/16). Mental disorder was indicated by number of hospitalisations due to ICD classified mental disorders and prescription of psychoanaleptic drugs. Indicators of socioeconomic position were parental level of education and family income in four categories respectively. Parental history of mental disorder was controlled for. Linear regressions, including interaction analyses, were performed.ResultsMental disorder in childhood/adolescence was related to lower grades, particularly in boys. The drop in academic achievement among youth with mental disorder was more pronounced among girls in mid SEP categories than among their less and more advantaged peers. A less clear interaction pattern was identified in boys.ConclusionsBased on theory and existing research we expected a typical social gradient in the strength of the association between mental disorder and academic achievement. However, we identified a U-shaped social gradient among girls. Analyses of the links between mental health and academic outcomes need to take both gender and social position into account. More research is needed to investigate these patterns further.

Psychological distress after esophageal cancer surgery and the predictive effect of dispositional optimism: a nationwide population-based longitudinal study

PurposeTo examine the trajectory of psychological distress from 1 to 2 years after esophageal cancer surgery, and whether dispositional optimism could predict the risk of postoperative psychological distress.MethodsThis Swedish nationwide longitudinal study included 192 patients who had survived for 1 year after esophageal cancer surgery. We measured dispositional optimism with the Life Orientation Test-Revised (LOT-R) 1 year post-surgery and psychological distress with the Hospital Anxiety and Depression Scale 1, 1.5, and 2 years post-surgery. Latent growth curve models were used to assess the trajectory of postoperative psychological distress and to examine the predictive validity of dispositional optimism.ResultsOne year after surgery, 11.5% (22 of 192) patients reported clinically significant psychological distress, and the proportion increased to 18.8% at 1.5 years and to 25.0% at 2 years post-surgery. Higher dispositional optimism predicted a lower probability of self-reported psychological distress at 1, 1.5, and 2 years after esophageal cancer surgery. For each point increase in the LOT-R sum score, the odds of psychological distress decreased by 44% (OR, 0.56; 95% CI, 0.40 to 0.79).ConclusionThe high prevalence and longitudinal increase of self-reported psychological distress after esophageal cancer surgery indicate the unmet demands for timely psychological screening and interventions. Measuring dispositional optimism may help identify patients at higher risk of developing psychological distress, thereby contributing to the prevention of postoperative psychological distress.

Post‐injury benzodiazepine and opioid use among older adults involved in road traffic crashes: A Swedish register‐based longitudinal study

Psychotropic drugs like opioids and benzodiazepines are prescribed for traumas resulting from road traffic crashes and the risk of developing an addiction deserves consideration. This study aims to shed light on how the consumption of those drugs evolves over time among older road traffic injury (RTI) victims. We conducted a nationwide Swedish register-based longitudinal study to identify trajectories of post-RTI psychotropic drug use. All individuals aged 50 years and older who had a hospital visit for an RTI from 2007 to 2015 were followed up during a 2-year period; those who used the drugs prior to the RTI were excluded. Trajectories were identified by performing latent class trajectory analysis on drug dispensation data for opioids and benzodiazepines separately (66 034 and 66 859 adults, respectively, in total). Three trajectories were identified for opioids and four for benzodiazepines. The largest group in both instances included people with no-use/minimal use throughout the follow-up (81.3% and 92.8%). "Sporadic users" were more frequent among users of opioids (16.7%) than benzodiazepines (4.3%), whereas "chronic users" were found in similar proportions (2.0% and 1.8%). "Delayed chronic use" characterized the fourth group of benzodiazepine users (1.0%). Several trajectories of psychotropic drug use were identified after RTI, from limited to chronic. Although chronic use was uncommon, a better understanding of the factors likely to increase that risk is warranted given the seriousness of the problem.

Changes in leisure-time physical activity during the adult life span and relations to cardiovascular risk factors-Results from multiple Swedish studies.

To evaluate how self-reported leisure-time physical activity (PA) changes during the adult life span, and to study how PA is related to cardiovascular risk factors using longitudinal studies. Several Swedish population-based longitudinal studies were used in the present study (PIVUS, ULSAM, SHE, and SHM, ranging from hundreds to 30,000 participants) to represent information across the adult life span in both sexes. Also, two cross-sectional studies were used as comparison (EpiHealth, LifeGene). PA was assessed by questionnaires on a four or five-level scale. Taking results from several samples into account, an increase in PA from middle-age up to 70 years was found in males, but not in females. Following age 70, a decline in PA was seen. Young adults reported both a higher proportion of sedentary behavior and a higher proportion high PA than the elderly. Females generally reported a lower PA at all ages. PA was mainly associated with serum triglycerides and HDL-cholesterol, but also weaker relationships with fasting glucose, blood pressure and BMI were found. These relationships were generally less strong in elderly subjects. Using data from multiple longitudinal samples the development of PA over the adult life span could be described in detail and the relationships between PA and cardiovascular risk factors were portrayed. In general, a higher or increased physical activity over time was associated with a more beneficial cardiovascular risk factor profile, especially lipid levels.

Trajectories of participation, mental health, and mental health problems in adolescents with self-reported neurodevelopmental disorders

Purpose Having a neurodevelopmental disorder (NDD) increases the risk of mental health problems and lower participation. We investigated the trajectories of mental health problems and participation in adolescents with NDD and compared these with trajectories for peers without NDD. In addition, the relationship between participation, mental health (well-being), and mental health problems were investigated. Materials and methods Data from a Swedish longitudinal survey study (LoRDIA) was used and adolescents with and without self-reported NDD were followed from 12/13 to 17 years, in three waves. Mental health problems were measured using the Strength and Difficulties Questionnaire, and well-being was measured with the Mental Health Continuum short form. Results Adolescents with NDD experience more mental health problems than adolescents without NDD. Hyperactivity, a key feature of NDD, remains stable, while emotional problems and psychosomatic complaints, increase over time for girls, independent of NDD. Participation is stable over time but is more related to well-being than to NDD or mental health problems. Conclusions Gender is an important factor with girls exhibiting more problems. Mental health explains more of the variation in participation than mental health problems and NDD. Probably participation intervention can enhance mental health which may protect from mental health problems. Implications for rehabilitation Mental health, i.e., emotional-, social-, and psychological well-being is more strongly related to participation and to reduced levels of mental health problems than having an NDD or not, thus assessing mental health separately from measuring NDD is important. Interventions focusing on participation may lead to higher mental health and having high mental health (flourishing) may facilitate participation. Girls with self-reported NDD seem to have a higher burden of mental health problems, especially if they also are languishing, i.e., having low mental health, therefore a strong focus on this group is needed both in research and clinical practice. Half of all adolescents are flourishing, independently of NDD or not, even if they are experiencing some symptoms of mental health problems, adolescents with NDD who are also languishing, have much higher ratings of mental health problems.

Personality and reasoning ability during retirement age: Report from a Swedish population-based longitudinal study

We examined the association between personality and level and change in reasoning ability in a population-based sample of older adults (62–68 years) using a three-year annual follow-up longitudinal study design (HEARTS; N = 3851). Personality traits were measured using the Mini-IPIP scale and reasoning using a short form of Raven’s Matrices. Findings from a structural equation model, controlling for age, education, and sex, revealed that higher levels on extraversion, conscientiousness, and neuroticism were associated with lower reasoning ability (βs: −0.17 to −0.09). Higher levels of openness were associated with better reasoning (β: 0.16). We found no association with rate of change. This evidence replicates previous findings demonstrating that personality traits are associated with individual differences in cognition among older adults.

How do educational disparities in smoking develop during early life? A Swedish longitudinal study

Smoking contributes to health inequalities, but how social inequalities in smoking develop in early life remains unclear. This study examines how measures of education attained over the early life course (representing socioeconomic position of origin, socioeconomic position of destination, and in-between) contribute to smoking behavior in a Swedish longitudinal sample. We used data obtained from the Swedish Level-of-Living Surveys in addition to national register data. Young adults (aged 20–28, n = 749) self-reported their educational attainment and smoking behavior (initiation and cessation) in 2010. Ten years earlier, their parents self-reported their own education and smoking behavior. We used linked register data on school performance in adolescence (in grade 9). Logistic regression models showed that lower parental education, lower adolescent school performance, and low young adult educational attainment were respectively associated with young adult smoking initiation. The association between parental education and young adult smoking initiation was explained by adolescent school performance and not parental smoking. Young adult smoking cessation was associated with high parental education and high adolescent school performance (marks in the top quartile), but only school performance remained significant in the final model, which included all measures of education and parental smoking. Results suggest that school performance in adolescence (which connects adolescents’ socioeconomic position of origin with their destination) may play an important role in how educational disparities in smoking form over the life course.

Interdependent pathways between socioeconomic position and health: A Swedish longitudinal register-based study

Health inequalities are generated by the conditions in which people are born, grow, live, work and age. From a life-course perspective, these conditions are formed by complex causal relationships with mutual and intertwined paths between socioeconomic position and health. This study attempts to disentangle some of these processes by examining pathways between socioeconomic position and health across the life-course. We used yearly Swedish national register data with information from over 31 years for two cohorts born 1941–1945 and 1961–1965. We analyzed associations between several indicators of childhood and adult socioeconomic position and health, measured by number of in-patient hospitalizations. We estimated within- and between-person associations using random intercept cross-lagged panel models. The results showed bi-directional associations between socioeconomic position and health that varied in strength across the life-course. Age variations in the associations were primarily observed when individuals aged into or out of age-stratified institutions. In ages where transitions from education to the labor market are common, the associations from health to income and education were strong. Around and after retirement age, the between-person association from health to income was weak, while the association from income to health strengthened. Within-person estimates showed no association between income and subsequent hospitalization among older persons, indicating no direct causal effect of income change on health in this age group. For persons of middle age, the associations were of similar strength in both directions and present at both the between- and within-person level. Our findings highlight the importance of theoretical frameworks and methods that can incorporate the interplay between social, economic, and biological processes over the life-course in order to understand how health inequalities are generated.

Higher Dispositional Optimism Predicts Better Health-Related Quality of Life After Esophageal Cancer Surgery: A Nationwide Population-Based Longitudinal Study

PurposeTo assess whether higher dispositional optimism could predict better health-related quality of life (HRQL) after esophageal cancer surgery.MethodsThis Swedish nationwide longitudinal study included 192 patients who underwent esophagectomy for cancer. The exposure was dispositional optimism measured by the Life Orientation Test-Revised (LOT-R) at 1 year post-surgery. Patients were categorized into four subgroups (very low, moderately low, moderately high, and very high dispositional optimism) based on the quartile of the LOT-R sum score. The outcome was HRQL assessed by the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30) and Quality of Life Questionnaire-Esophago-Gastric module 25 (QLQ-OG25) at 1, 1.5, and 2 years post-surgery. Linear mixed-effects models, adjusted for potential confounders, were used to examine the mean score difference (MSD) with 95% confidence interval of HRQL among the four patient subgroups.ResultsPatients with very high dispositional optimism reported clinically relevantly better global quality of life, emotional function, and social function (MSD range 10–16) and less severe symptoms in pain, dyspnea, diarrhea, eating difficulty, anxiety, dry mouth, trouble with taste, worry about weight loss, and self-doubt about body image (MSD range − 9 to − 22) than patients with lower dispositional optimism. Patients with moderately high dispositional optimism reported clinically and statistically significantly better global quality of life (MSD 10) and less severe diarrhea (MSD − 9) than patients with lower dispositional optimism. Adjusted MSDs were constant over the three time points in all aspects except for eating difficulty.ConclusionsMeasuring dispositional optimism could help identify patients at higher risk of poor HRQL recovery after esophageal cancer surgery.

Language/cognitive predictors of literacy skills in 12-year-old children on the autism spectrum

Aim Some school age children with autism spectrum disorder (ASD) struggle with literacy development, yet, the individual differences are major and not well understood. Moreover, literacy attainment is multi-faceted and literacy skills and difficulties manifest in more than one way. The aim of this study was to describe this variability and to identify language/cognitive predictors of different literacy skills. Methods We assessed different literacy skills (word reading accuracy, reading fluency, reading comprehension, and spelling), along with a set of language/cognitive predictor skills (listening comprehension, rapid automatized naming, phonological awareness and nonverbal cognitive ability), in 12-year-old children with ASD without intellectual disability recruited from a longitudinal study in Sweden. Results There was great heterogeneity (from floor to ceiling levels) in literacy skills, with a statistically increased prevalence of poor reading comprehension and reading fluency compared with population norms. In regression analyses, it was shown that concurrent language/cognitive predictor skills (e.g. phonological awareness) were differentially associated with literacy subskills. Moreover, a longitudinal analysis showed that preschool language problems were associated with poor word reading accuracy and spelling in middle school. Conclusions The results confirm previous findings as well as provide new knowledge regarding profiles of literacy (difficulties) in children with ASD; interestingly, the identified predictors of literacy skills in ASD resembled those identified as important in general reading (and dyslexia) research, which might indicate that similar kinds of support and training would be beneficial.