Retirement In Europe Research Articles

Longitudinal relationship between grip strength and cognitive function in a European population older than 50 years: A cross-lagged panel model

ObjectivesThe aim of this study was to investigate the dynamic longitudinal relationship between grip strength and cognitive function. Methods6175 participants aged ≥50 years were included in the study using three waves of follow-up data from the Survey of Health, Ageing, and Retirement in Europe in 2015 (T1), 2017 (T2) and 2019 (T3). Cognitive function was assessed using numeracy, verbal fluency, immediate recall, delayed recall and total. The cross-lagged panel model was used for analysis. ResultsThere was a correlation between grip strength and cognitive function. Standardized path coefficient from numeracy T1 to grip strength T2 was 0.017 (p = 0.003), and from numeracy T2 to grip strength T3 was 0.014 (p = 0.012). Standardized path coefficient from grip strength T1 to numeracy T2 was 0.096 (p < 0.001), and from grip strength T2 to numeracy T3 was 0.113 (p < 0.001). Other indicators of cognitive function had similar relationships with grip strength. ConclusionsThe study found a statistically significant longitudinal and bidirectional relationship between grip strength and cognitive function in a sample of people aged ≥50 years from several European countries.

End-of-life health literacy, knowledge and behaviours towards advance care planning among older adults: cross-sectional evidence from Switzerland

IntroductionPopulation ageing, technological advancements and an increasing emphasis on patient empowerment imply that individuals are increasingly confronted with intricate end-of-life decisions. Personal end-of-life health literacy skills may help empower individuals...

The longitudinal reciprocal association between depression and physical activity in old age: The role of lifetime cumulative adversity

ObjectiveThis study investigated the reciprocal nature of the depression–physical activity relationship with reference to lifetime cumulative adversity (LCA), over a period of 8 years across 5 time points in aging. MethodBased on data from the Survey of Health Ageing and Retirement in Europe (SHARE), the sample included 21,996 participants between the ages of 50 and 100 years (M = 65.5, SD = 9.1). The analysis was designed as a random intercept cross-lagged panel model. The trajectories measured were depression and physical activity. The independent variable, LCA, was created by the sum of stressful events, and the analyses controlled for background characteristics. ResultsThe findings revealed that physical activity significantly reduced the risk for depression at two time points along the study, whereas depression significantly reduced future physical activity during the entire period examined. Further, a higher level of LCA was associated with lower baseline levels of physical activity and higher levels of depression (β = −0.04, p < 0.001; β = 0.12, p < 0.001; respectively). ConclusionsThe results support a bidirectional relation between physical activity and depression, with stronger evidence for depression to physical activity. Interventions targeting the vulnerable population with a history of cumulative adversity, and utilizing techniques to mitigate depressive symptoms, may help to decrease the risk for physical inactivity and other health consequences in this population.

Older adults’ mental health during the COVID-19 pandemic: The association with social networks

This study examined the impact of different social networks on the mental health outcomes of older adults during the COVID-19 pandemic. Participants were 25,534 older adults from the Survey of Health, Ageing and Retirement in Europe (SHARE). The study identified five social network profiles (family, friends, spouse, diverse, others) and a “no network” group. Findings showed that, compared to the no network profile, those with spouse and family profiles are more protected against depression and loneliness during the COVID-19. In turn, individuals within friends and diverse profiles had a similar likelihood of feeling depressed, anxious, and lonely. Friends and diverse profiles had higher likelihood of suffering more anxious or lonelier than before the COVID-19 compared to the no network profile. The study further discusses possible explanations about why these profiles, which typically served as mental health protectors, were significantly affected by the unique circumstances of the COVID-19 pandemic.

Longitudinal Quantiles of Frailty Trajectories Considering Death: New Insights into Sex and Cohort Differences in the Reference Curves for Frailty Progression of Older European.

Most previous studies of frailty trajectories in older adults focus on the average trajectory and ignore death. Longitudinal quantile analysis of frailty trajectories permits the definition of reference curves, and the application of mortal cohort inference provides more realistic estimates than models that ignore death. Using data from individuals aged 65 or older (n = 25446) from the Survey of Health, Ageing, and Retirement in Europe (SHARE) from 2004 to 2020, we derived repeated values of the Frailty Index (FI) based on the accumulation of health deficits. We applied weighted Generalized Estimating Equations to estimate the quantiles of the FI trajectory, adjusting for sample attrition due to death, sex, education, and cohort. The FI quantiles increased with age and progressed faster for those with the highest level of frailty (β^a0.9 = 0.0229, p < .001; β^a0.5 = 0.0067, p < .001; H0: βa0.5=βa0.9, p < .001). Education was consistently associated with a slower progression of the FI in all quantiles (β^ae0.1 = -0.0001, p < .001; β^ae0.5 =-0.0004, p < .001; β^ae0.9 = -0.0003, p < .001) but sex differences varied across the quantiles. Women with the highest level of frailty showed a slower progression of the FI than men when considering death. Finally, no cohort effects were observed for the FI progression. Quantile FI trajectories varied by age, sex, education, and cohort. These differences could inform the practice of interventions aimed at older adults with the highest level of frailty.

Longitudinal reciprocal associations between volunteering, health and well-being: evidence for middle-aged and older adults in Europe.

There is substantial evidence on the importance of voluntary activities for the health of middle-aged and older adults. Evidence on the effects of health and well-being on volunteering is more limited. This study examines reciprocal longitudinal associations between voluntary and/or charity activities and 21 indicators related to physical health, well-being, cognitive impairment and daily life functioning among middle-aged and older adults. Longitudinal data were collected between 2011 and 2020 from a sample of 19 821 middle-aged and older adults from 15 countries participating in the Survey of Health, Ageing and Retirement in Europe. An outcome-wide analysis and an exposure-wide analysis were applied and generalized estimating equations were used. Robustness analyses were conducted. Voluntary and/or charity activities almost every week or more often were prospectively associated with greater emotional well-being, reduced risks of limitations in activities of daily living and of being diagnosed with Alzheimer's disease at a 6-year follow-up. Positive reverse associations were found from emotional well-being to volunteering. Limitations in daily life activities, increased loneliness, high blood cholesterol, hypertension and chronic lung disease were found to impede participation in voluntary and/or charity activities over time. Feedback loops between voluntary and/or charity activities and well-being and limitations in daily activities may exist. Understanding the reciprocal nature of the relationship between volunteering and health and well-being can help identify strategies to encourage volunteering among middle-aged and older adults with specific health conditions and to target health promotion efforts towards volunteers.

Association between formal social participation and cognitive function in middle-aged and older adults: a longitudinal study using SHARE data

ABSTRACT Formal social participation significantly impacts health and well-being, potentially mitigating cognitive decline, although not consistently across all studies. Existing research often focuses solely on baseline participation levels, and age-related differences have primarily been explored among the Asian population. Therefore, this longitudinal study aims to assess the association between formal social participation and cognition across different age groups in individuals aged 50+ living in Europe and Israel, while capturing the dynamic nature of formal social participation. We use data from three waves (four, six, and eight) of the Survey of Health, Ageing, and Retirement in Europe (SHARE), comprising 85,601 respondents. Linear mixed-effects models were applied. The results show that participation in formal social activities mitigates cognitive decline in middle-aged and older adults, especially among those aged 70 to 79 and 80+. These findings support the need for social policies promoting formal social activities, for lasting cognitive health benefits.

Double (Dis)Advantage: The Cumulative Role of Parental Resources and the Institutional Context in Intergenerational Time and Money Transfers

Abstract This study addresses an underexplored mechanism of social inequality transmission, namely, intergenerational transfers from older parents to their adult children in terms of (i) money and (ii) time (specifically, devoted to sporadic or regular childcare). A yet unaddressed question in the literature is whether these two resources are transferred in a cumulative (i.e., both resources being transferred) or compensatory (i.e., only one resource being transferred) manner and how such cumulation or compensation depends on parental income and the wider institutional context. Filling this lacuna, this study investigates whether grandparents who have fewer financial resources compensate for their lack of opportunities to provide financial transfers to their adult children by transferring more time to their children, or whether higher-income parents are more likely to transfer both more time and money than lower-income parents, resulting in greater advantage among their receiving children (cumulation). Drawing on six waves of the Survey of Health, Ageing and Retirement in Europe, this study analyzes transfers from more than 53,000 grandparents aged 50 or older to their adult children across European countries. The findings show that higher-income parents, relative to lower-income parents, are more likely to provide both time (more precisely, sporadic childcare) and financial support to their adult children, yielding evidence for the cumulation of transfers. Further, evidence of a double (dis)advantage emerges, as social gradients in (financial and regular time) transfers are more pronounced in contexts with smaller public expenditures on formal childcare and a more unequal distribution of household incomes.

Longitudinal associations between sensory and cognitive functioning in adults 60 years or older in Sweden and Denmark

BackgroundThe objective of this study is to explore the bidirectional, longitudinal associations between self-reported sensory functions (hearing/vision) and cognitive functioning among older adults in Sweden and Denmark during the period 2004–2017. MethodsThe study is based on data from The Survey of Health, Ageing and Retirement in Europe and consists of 3164 persons aged 60 to 93 years. Within-person associations between sensory and cognitive functions were estimated using random intercept cross-lagged panel models. ResultsThe results indicated that cognitive and sensory functions were associated within their respective domains over time. The results on the bidirectional associations between sensory functions and cognition over time showed weak and statistically non-significant estimates. ConclusionOur study showed no clear evidence for cross-lagged effects between sensory functions and cognitive functioning. Important to note, however, is that using longitudinal data to estimate change within persons is a demanding statistical test and various factors may have contributed to the absence of conclusive evidence in our study. We discuss several of these factors.

Physical activity, sedentary behavior, and sleep across lifespan in adults across European countries: Background and design

Introduction&#x0D; Regular physical activity (PA) has benefits for health throughout the lifespan. PA benefits musculoskeletal, cardio metabolic health, and overall well-being (Kapoor et al., 2022). However, data from 2017 shows that about 55-83% of women and 47-74% of men from European countries (EU) do not meet these guidelines (Lübs et al,. 2018). Moreover, adults at the age of 40-54 (aOR: 0.65, 95% CI: 0.52-0.81) and 55-64 (aOR: 0.61, 95% CI: 0.49-0.77) are less likely to have moderate or high levels of PA in comparison with those 18-24 years of age. (Nikitara et al., 2021). Sedentary behavior (SB) including activities such as watching television, playing computer games, browsing the internet has increased (Wang et al., 2019). Canada has an established track record in the development of 24-hour movement guidelines on PA, SB, and sleep. They have previously release guidelines for all age groups. Following Canada’s lead, several jurisdictions including Australia, New Zealand, South Africa have incorporated the 24-hour movement concepts (Tremblay, 2020). There is a lack of data for 24-hour behavior guideline in the European context. There are no specific recommendations on SB and sleep. Therefore, this project will present the background, methods and design of a 24-hour movement summary of behaviors (PA, SB and sleep) in Europe.&#x0D; Methods&#x0D; We will utilize existing PA, SB and sleep data from the World Health Organization on European adults 18+. Analysis using mean, median, and 95% confidence Intervals, will be complemented by frequency distributions and histograms. These will be stratified by age and sex subgroups for a more comprehensive overview.&#x0D; Results&#x0D; The findings from this research have the potential to inform surveillance efforts, shape policies and public health strategies, improve overall well-being, and contribute to the development of evidence-based guidelines.&#x0D; Discussion/Conclusion&#x0D; Implications of this research may inform researchers on further questions to pursue, policy makers in resource allocation, and practitioners on where to focus intervention efforts.&#x0D; References&#x0D; Kapoor, G., Chauhan, P., Singh, G., Malhotra, N., &amp; Chahal, A. (2022). Physical activity for health and fitness: Past, present and future. Journal of Lifestyle Medicine, 12(1), 9-14. https://doi.org/10.15280/jlm.2022.12.1.9&#x0D; Lübs, L., Peplies, J., Drell, C., &amp; Bammann, K. (2018). Cross-sectional and longitudinal factors influencing physical activity of 65 to 75-year-olds: A pan European cohort study based on the survey of health, ageing and retirement in Europe (SHARE). BMC Geriatrics, 18, Article 94. https://doi.org/10.1186/s12877-018-0781-8&#x0D; Nikitara, K., Odani, S., Demenagas, N., Rachiotis, G., Symvoulakis, E. K., &amp; Vardavas, C. (2021). Prevalence and correlates of physical inactivity in adults across 28 European countries. European Journal of Public Health, 31(4), 840-845. https://doi.org/10.1093/eurpub/ckab067&#x0D; Tremblay, M. S. (2020). Introducing 24-hour movement guidelines for the early years: A new paradigm gaining momentum. Journal of Physical Activity and Health, 17(1), 92-95. https://doi.org/10.1123/jpah.2019-0401&#x0D; Wang, N. X., Chen, J., Wagner, N., Rebello, S. A., Petrunoff, N., Owen, N., &amp; Müller‐Riemenschneider, F. (2019). Understanding and influencing occupational sedentary behavior: A mixed-methods approach in a multiethnic Asian population. Health Education &amp; Behavior, 47(3), 419-429. https://doi.org/10.1177/1090198119885431

Does Pre-existing Diabetes Correlate with Long COVID-19 in Europe? Evidence from the Analysis of the Survey of Health, Ageing and Retirement in Europe's Corona Surveys.

A substantial proportion of those infected with COVID-19 are presenting with persistent symptoms, referred to as long COVID-19. Emerging evidence suggests that the presence of pre-existing chronic conditions, such as diabetes, may increase the risk of long COVID-19. To investigate whether having pre-existing diabetes increases the risk of developing long COVID-19 in the population of middle-aged and older adults (≥50 years old) in Europe, while assessing if this relationship can be accounted for or is modified by the known long COVID-19 and diabetes risk factors (age, sex, hospitalization, pre-existing hypertension, and weight status). A population-based longitudinal prospective study involving a sample of respondents aged 50 years and older (n = 4,004) with probable or confirmed COVID-19 infection from 27 countries that participated in both waves 7 and 8 of the Survey of Health, Ageing and Retirement in Europe and its 2020 and 2021 Corona Surveys. Logistic regression modeling was performed. Overall, 66.8% of the respondents affected by COVID-19 infection reported at least one long COVID-19 symptom; 55.2% were female, and the average age was 64.6 years; 13.2% had pre-existing diabetes. Respondents with pre-existing diabetes had significantly higher odds of developing long COVID-19, compared to those without diabetes (OR = 1.37; 95% CI = 1.12, 1.68). This relationship remained significant (OR = 2.00; 98% CI = 0.25, 1.14) after adjusting for sex (OR = 1.64 for females; 95% CI = 1.43, 1.88), hospitalization for COVID-19 illness (OR = 3.19; 95% CI = 2.41, 4.23), pre-existing hypertension (OR = 1.17; 95% CI = 1.01, 1.36), and overweight (OR = 1.31; 95% CI = 1.11, 1.56) and obese (OR = 1.77; 95% CI = 1.44, 2.19) weight status. The effect of pre-existing diabetes on the risk of long COVID-19 is moderated by age; it was highest at the age of 50 (OR = 2.00; 95% CI = 1.28, 3.14), and then, it declined with age. There is a relationship between pre-existing diabetes and long COVID-19, even after controlling for literature-based confounding factors, with age having a moderating effect on this relationship.

Cognitive abilities and engagement in advance care planning among older adults: Results of a Swiss populational study.

Individuals often wait until the last moment to plan their end-of-life (EOL) care. Yet, decision-making capacity decreases with age, which could compromise engagement in and the effectiveness of advance care planning (ACP). Little is known about the association between cognitive abilities and the steps involved in the multifaceted process of ACP in older adults. The present study aims to better understand the association of global cognitive competence with engagement in ACP in a nationally representative sample of older adults in Switzerland. Global cognitive competence was measured via verbal fluency, immediate and delayed memory, basic calculation skills, and temporal orientation. Engagement in ACP included approving advance directives, having discussed EOL preferences, having a living will, and having a health care proxy. We analyzed data of 1,936 respondents aged 55+ from a paper-and-pencil questionnaire that was administered as part of Wave 6 (2015) of the Survey of Health, Ageing and Retirement in Europe in Switzerland using logistic regression models. Respondents with reduced global cognitive competence are less likely to have discussed their EOL preferences with others and to have a living will. Our results also indicate an interaction between age and cognition with respect to having a living will. Individuals with lower global cognitive competence in the oldest age group-adults aged 75 and older-are less likely to have a living will. Our findings highlight that low global cognitive competence can be seen as a barrier to engagement in ACP, particularly among adults 75 years and older. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Association Between Cognitive Reserve and Cognitive Trajectories Among Older Adults.

Prior studies on cognitive reserve (CR) and cognitive trajectories are limited and have had conflicting results. Furthermore, most studies have used a single measure of CR that may not reflect a comprehensive exposure. The objective of this study is to determine the impact of individual and composite CR measures on cognitive decline over a 6-year period. We studied 55,340 participants from 16 European countries, aged 50 and older, who participated in the Survey of Health, Aging, and Retirement in Europe. We used cognitive measures (including immediate memory, delayed memory, verbal fluency, and numeracy) and 3 CR factors (education, occupation, and cognitive activities) collected in 4 waves from 2011 to 2017. Structural equation modeling was used to construct the composite CR score, analyzed as tertile. Linear mixed-effect models were used to examine the study aims. At baseline, the highest composite CR tertile was associated with a higher cognition score than the middle and lowest CR tertiles (β: -0.28, 95% confidence interval [CI]: -0.29 to -0.26; β: -0.71, 95% CI: -0.72 to -0.70, respectively), as well as for all individual cognitive domains. At longitudinal results, compared with the lowest CR, the highest but not the middle CR tertile demonstrated a slower 6-year decline in global cognition (β: -0.02, 95 % CI: -0.03 to -0.01), as well as in all cognitive domains (p < .05). A composite CR could be a protective factor for cognitive performance and cognitive decline, and it is more sensitive and inclusive than an individual CR indicator alone.

Children's Opportunities and Constraints in European Parent Care Over Time: A Within-Family Approach.

The role of children's caregiving has received substantial attention in studies on care in old age. Previous research shows that children's care provision is strongly intertwined with both their individual and siblings' situation regarding employment and geographic parent-child distance. This study uses data from six waves of the Survey of Health, Ageing and Retirement in Europe (SHARE), taking a within-family approach, to examine how caregiving is (re-)distributed between siblings over time. The provision of continuous parent care is observed more frequent and volatile in European countries with a family-based care system. The results from family fixed-effects regression models demonstrate that children working less than siblings persist in caregiving more. Living closest to parents facilitates children to keep up care efforts, while changing to living closest enhances the start of parent care. This study suggests that geographic distance is vital in the long-term organization of parent care between siblings.

Vyresnio amžiaus asmenų naudojimasi internetu, laisvalaikio veiklų ir atminties gebėjimų lyginamoji analizė Baltijos šalyse

Advances in the healthcare system and socioeconomic progress have led to longer life expectancy, resulting in an ageing population and societal challenges for policymakers. Active ageing, promoted by the United Nations Economic Commission for Europe through the Active Ageing Index, highlights Capacity and Enabling Environment for Active Ageing. Information and Communication Technology (ICT) use is crucial, enabling participation in social, economic, and cultural activities (UNECE, 2020). Research indicates cognitive changes in ageing, especially memory deterioration, associating these changes with genetics, education, and professional and leisure activities (Stern, 2009). According to research, ICT positively affects cognition, enhancing memory (Almeida et al., 2012; Benge et al., 2023), but may also pose cognitive issues (Nagam, 2023). Prioritizing cognitive health among the elderly in social policies is vital, with ICT playing a key role. The present study aimed to assess the links between Internet use and memory performance after controlling for demographic factors and leisure activities. Data from the Survey of Health, Ageing, and Retirement in Europe’s 8th Wave (Börsch-Supan, 2022) included 2320 individuals aged 65–100 from Baltic countries. Memory was assessed using a modified Rey’s Auditory Verbal Learning Test. Participation in leisure activities was assessed by asking respondents if they had taken part in any of the listed activities in the past year, and Internet use was assessed by asking about Internet use in the past 7 days. Significant associations were found between memory, leisure activities, and Internet use. Internet use predicted memory capacity in older adults, remaining significant after controlling for demographics, health, and leisure activities. The current findings show that Internet use might be valuable in predicting memory functioning among older adults and can potentially contribute to the protection of cognitive function.

Live longer, work longer? An investigation of the health capacity to work at older ages in Denmark using combined register and survey data

Publicly funded pension systems are facing the challenge of remaining financially sustainable without lowering pensions. Raising the statutory retirement age gradually in line with the increase in life expectancy has been a key measure to solve the problem. The implicit assumption is that the additional years of life are lived in good health, or as a minimum that health status is compatible with work. However, some individuals may not have the ability to work. Furthermore, a uniform retirement age ignores the different exposures to morbidity and mortality risks across social groups. Consequently, it is important to examine whether the health of older individuals will allow them to continue working and whether there is significant heterogeneity in the ability to work. Combining the Survey of Health, Ageing and Retirement in Europe (SHARE) with data from the Danish registers enables us to create a composite health index that includes an extensive range of health indicators. Utilising the health capacity to work approach, we estimate the health capacity to work among Danes aged 55 and above. We divide health capacity into physical and mental health. We investigate heterogeneity in health capacity across educational and occupational attainment. Substantial additional work capacity is found for older Danes. Depending on the type of health index applied, the health capacrk varies. There is evidence of a socio-economic gradient in work capacity. Results thereby show that policies that intend to utilise the additional work capacity should consider heterogeneity in health.HighlightsWe provide new evidence of the health capacity work in Denmark.The combination of survey and register data allow for comprehensive health indices.There is substantial additional health capacity to work.There is variation across health indices.There is variation across educational and occupational attainment.

Gender inequalities in social club participation in Europe: the role of women’s empowerment at the country level

This study examines gender inequalities in the degree of engagement in social clubs of older people and how women’s participation relates to their empowerment at the country level. Combined individual-level data from the Survey of Health, Ageing and Retirement in Europe (SHARE) and country-level data from the Women’s Political Empowerment Index (WPEI) are used in analyzing 41,185 non-working individuals aged 65–84 across 19 countries. Multilevel regression analyses are conducted to address these aims. We detect notable between-country variations in levels of participation. Substantial differences in the WPEI reflect marked contextual cross-country differences in gender equality. In roughly half of the 19 countries, no gender differences in social club participation are detected; however, women are more likely to participate in social clubs in the more gender-egalitarian countries of France, Denmark, Luxembourg and the Netherlands, whereas in three countries – Italy, Czech Republic and Croatia – more men than women participate in social clubs. Cross-country gender differences in social club participation point to the importance of cultural factors in influencing opportunities for active ageing.

Self- and interviewer-reported cognitive problems in relation to cognitive decline and dementia: results from two prospective studies.

Little is known regarding the association of interviewer-reported cognitive problems (ICP) with age-related cognitive decline. We aimed to investigate the independent associations of ICP and the combined associations of ICP andself-reported cognitive problems (SCP) with subsequent cognitive decline and dementia in two prospective cohort studies. We included 10,976 Chinese (age = 57.7 ± 8.7) and 40,499 European (age = 64.6 ± 9.4) adults without dementia from the China Health and Retirement Longitudinal Study (CHARLS) and the Survey of Health, Ageing, and Retirement in Europe (SHARE). Self-rated memory (5-point scale) and interviewer-rated frequencies of asking for clarification (6-point scale) were used to define SCP and ICP (dichotomized). Outcomes included objective cognitive test scores (z-score transformation) and incident dementia. Generalized estimating equation models were performed to evaluate mean differences in objective cognitive decline. Logistic and Cox regression models were used to estimate the relative risk of dementia. Results from two cohorts were pooled using the random-effects models. ICP was associated with faster cognitive decline in CHARLS (βCHARLS = -0.025 [-0.044, -0.006] z-score/year). ICP and SCP were also independently associated with higher risk of dementia in two cohorts (pooled relative risk for SCP = 1.73 [1.30, 2.29]; pooled relative risk for ICP = 1.40 [1.10, 1.79]). In the joint analysis, participants with coexistence of SCP and ICP had the fastest cognitive decline (βCHARLS = -0.051 [-0.080, -0.021]; βSHARE = -0.024 [-0.043, -0.004]; pooled β = -0.035 [-0.061, -0.009] z-score/year) and highest risk of dementia (ORCHARLS = 1.77 [1.42, 2.20]; HRSHARE = 2.94 [2.42, 3.59]; pooled relative risk = 2.29 [1.38, 3.77]). The study suggested that interviewer-reported cognitive problems may be early indicators of cognitive decline and dementia in middle-aged and older adults. Acombination of self- and interviewer-reported cognitive problems showed the strongest associations with cognitive decline and dementia.

A behavioral gap in survival beliefs

AbstractLife span uncertainty (longevity risk) impacts several economic decisions. Individuals can form and revise their survival beliefs making use of behavioral heuristics. We propose a model of sentiment, in which individuals are assumed to switch between optimistic and pessimistic expectations of their health. When optimism is persistent in the face of health shocks, or when individuals are more likely to change their sentiment from pessimistic to optimistic than otherwise, our model predicts survival underestimation at young ages and overestimation at old ages. An empirical analysis based on the longitudinal data from Survey of Health, Ageing and Retirement in Europe validates our model.

Uptake of COVID-19 and influenza vaccines in relation to preexisting chronic conditions in the European countries

BackgroundThe suboptimal uptake of COVID-19 and influenza vaccines among those with non-communicable chronic diseases is a public health concern, because it poses a higher risk of severe illness for individuals with underlying health conditions, emphasizing the need to address barriers to vaccination and ensure adequate protection for this vulnerable population. In the present study, we aimed to identify whether people with chronic illnesses are more likely to get vaccinated against COVID-19 and influenza in the European Union.MethodsCross-sectional data on 49,253 men (n = 20,569) and women (n = 28,684) were obtained from the ninth round of the Survey of Health, Ageing and Retirement in Europe (June – August, 2021). The outcome variables were self-reported COVID-19 and influenza vaccine uptake status. The association between the uptake of the vaccines and six preexisting conditions including high blood pressure, high blood cholesterol, chronic lung disease, diabetes, chronic bronchitis, and asthma was estimated using binary logistic regression methods.ResultsThe vaccination coverage for COVID-19 ranged from close to 100% in Denmark (98.2%) and Malta (98.2%) to less than 50% in Bulgaria (19.1%) and Romania (32.7%). The countries with the highest percentage of participants with the influenza vaccine included Malta (66.7%), Spain (63.7%) and the Netherlands (62.5%), and those with the lowest percentage included Bulgaria (3.7%), Slovakia (5.8%) and Poland (9.2%). Participants with high blood pressure were 3% less likely [Risk difference (RD) = -0.03, 95% CI = -0.04, -0.03] to report taking COVID-19 and influenza [RD = -0.03, 95% CI= -0.04, -0.01] vaccine. Those with chronic lung disease were 4% less likely [RD = -0.04, 95% CI= -0.06, -0.03] to report taking COVID-19 and 2% less likely [RD= -0.02, 95% CI = -0.04, -0.01] to report taking influenza vaccine. Men and women with high blood pressure were 3% less likely to have reported taking both of the vaccines.ConclusionsCurrent findings indicate a suboptimal uptake of COVID-19 and influenza vaccines among adult men and women in the EU countries. Those with preexisting conditions, including high blood pressure and chronic lung disease are less likely to take the vaccines.