Survey Of Health , Ageing And Retirement In Europe Research Articles

Can countries shape the association between cumulative adversity and old-age health?

IntroductionThe present study examined the relationships of Lifetime Cumulative Adversity (LCA) and country inequalities, as well as the interactions between them, with the self-rated health (SRH) in old age.MethodsUsing data from the Survey of Health, Aging and Retirement in Europe (SHARE), the study regressed self-rated health on Lifetime Cumulative Adversity and country-level inequality indices across European countries in two points in time. The analysis also considered adversity–inequality interactions, controlling for confounders. The sample was comprised of 28,789 adults, aged 50 to 80, from 25 European countries and Israel.ResultsThe findings pointed out that LCA is negatively associated with SRH, but democracy and welfare regimes modify the ill effects of LCA on health. These effects are reduced as the LCA level increases. The effects remained significant over two measurement time-points over three years, showing that life-course trajectories may be shaped by individual accumulated risk exposure to stress, along with inequalities at the society level.DiscussionThe study provides constructive and important guidance for decreasing the harmful effect of lifetime adversity in old age, by the modification of the country’s welfare policies.

Which support is provided in which country? Patterns among older adults in Europe

This paper proposes comparative research on support provided outside the household by older adults in Europe. In studying social support, the network perspective is widely used, investigating, in particular, the ego-centered support networks of individuals. The analysis is based on data from Wave 7 of the Survey of Health Ageing and Retirement in Europe (SHARE). It examines the characteristics of ego-support networks of individuals aged 65 and over in 12 European countries, which are grouped into a novel welfare regime typology. Through Multiple Correspondence Analysis, we jointly looked into the categorical variables describing the recipients (alters) of the support provided by older adults and the welfare regime classification. As a main result, countries grouped in “High degree of familialism by default” category specialized in supporting family-related alters, particularly with childcare or personal care. In contrast, the elders in countries belonging to “High degree of de-familialisation” typology provided a more varied but less demanding support, to non-relatives alters and less oriented to care. The analyses show that the SHARE provides a solid opportunity to face the topic.

The Effect of Informal Caregiving on Depression: An Asymmetric Panel Fixed-Effects Analysis of In-Home and Out-Of-Home Caregivers Across Europe

ABSTRACT Previous research has shown that providing intensive informal care can have a negative effect on an individual’s mental health. However, few studies have been able to draw a precise comparison between the experiences of in-home and out-of-home caregivers. This study used data from 16 countries collected from 2011–2019 as part of the Survey of Health, Ageing and Retirement in Europe (SHARE) to conduct asymmetric panel fixed-effects models that examined within-person variation in depression scores after a respondent started providing daily or almost daily personal care either inside or outside of their home. The results substantiated previous findings that in-home caregivers experience more pronounced increases to their reported depressive symptoms after starting to provide daily personal care than do out-of-home caregivers. In addition, in-home caregivers in countries with greater governmental responsibility for long-term care provision (The Northern and Central Clusters) reported fewer increases to their depressive symptoms after starting to provide care than caregivers in countries where long-term care responsibility predominantly rests on families (The Southern and Eastern Cluster). Further, Northern Cluster countries most successfully shrank the pool of out-of-home care providers. Together, these findings underscore the context-specific nature of caregiver wellbeing.

Determinants of Telemedicine Service Use Among Middle-Aged and Older Adults in Germany During the COVID-19 Pandemic: Cross-Sectional Survey Study.

The occurrence of the COVID-19 pandemic demanded fast changes in the delivery of health care. As a result, significant growth in the use of telemedicine services occurred. Research, especially from nationally representative German samples, is needed to better understand determinants of telemedicine use. The purpose of this study was to identify determinants of telemedicine service use among middle-aged and older adults during the COVID-19 pandemic in Germany. Cross-sectional, nationally representative data were taken from the German sample of the Survey of Health, Ageing and Retirement in Europe (SHARE). The German Corona Survey 2 (n=2039), which was conducted between June and August 2021, was used for this study. Reporting experience with remote medical consultations during the COVID-19 pandemic served as the outcome measure. Associations with socioeconomic, psychological, social, health-related, and COVID-19-related determinants were examined using multiple Firth logistic regressions. Psychological factors including feeling nervous, anxious, or on edge (odds ratio [OR] 1.61, 95% CI 1.04-2.50; P=.03), feeling sad or depressed (OR 1.62, 95% CI 1.05-2.51; P=.03) and feelings of loneliness (OR 1.66, 95% CI 1.07-2.58; P=.02) were positively associated with telemedicine use. Moreover, forgoing medical treatment because of being afraid of being infected by SARS-CoV-2 (OR 1.81, 95% CI 1.10-2.97; P=.02) and describing limitations because of a health problem as severe were positively associated with the outcome (OR 2.11, 95% CI 1.12-4.00; P=.02). Socioeconomic and social factors were not significantly associated with telemedicine use in our sample. Middle-aged and older individuals in Germany seem to use telemedicine services according to psychological needs and health limitations. Especially when psychological symptoms are experienced, telemedicine seems to be a promising service option in this age group. Future research is needed to confirm these initial findings in postpandemic circumstances.

Unraveling the dynamics of loneliness in the Baltic-Nordic region: a comparative analysis in the wake of COVID-19.

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.

Sensory impairments and depressive symptoms in Europe: a cross-national cohort study

Objectives To investigate the associations between sensory impairments and the development of depressive symptoms across sex, age, and European regions, and to examine the mediating role of cognitive function, activities of daily living (ADL), and physical activity. Method A cohort study including 56,847 Europeans aged 50+ participating in at least two waves of the Survey of Health, Ageing and Retirement in Europe (SHARE). Associations were analyzed using mixed effects logistic regression models considering several confounders. Results Overall, 17.8% developed depressive symptoms. Compared to participants with good vision and hearing, those with vision impairment (VI) (odds ratio (OR) = 1.35, 95% confidence interval (CI) 1.27–1.44), hearing impairment (HI) OR = 1.32, 95% CI 1.21–1.43, and dual sensory impairment (DSI, i.e. VI and HI) (OR = 1.93, 95% CI 1.75–2.13) had increased odds of depressive symptoms. The associations were consistent across sex and European regions but became stronger with advancing age among men. Dose-response relationships were found for all associations. Mediation analyses revealed that preventing cognitive decline, ADL limitations, and physical inactivity would eliminate 15.0%, 11.5%, and 21.4% of the total effect for VI, HI, and DSI, respectively. Conclusion Our findings emphasize the importance of preventing sensory impairments to avoid depressive symptoms.

A Longitudinal Study of the Effect of Memory on the Quality of life of European Adults and Older Adults

AbstractAmong studies conceptualizing quality of life (QoL) as the subjective measure of one’s well-being, evidence suggests a link between cognitive impairment and diminished quality of life. However, the direction of the association is not clear, and most studies have employed a global measure of cognition, which can mask subtle domain-specific declines. In this study, we aim at examining the longitudinal associations between memory and QoL in a representative sample of adults and older adults in Europe and Israel, employing data from the Survey of Health, Ageing and Retirement in Europe (SHARE). The sample was composed by 56,616 respondents aged 50 or older at the beginning of the study period. A Parallel-Process Latent Growth Model (PP LGM) of memory and QoL conditioned on the effects of age, gender, educational level, physical inactivity, depressive symptomatology and social activity participation, was tested. Results displayed a trajectory of decline for both memory and QoL, with higher initial levels of memory associated with higher initial levels of QoL, and steeper decline in memory associated with steeper decline in QoL. Moreover, a positive effect of initial memory onto QoL trend over time was found, indicating that better memory is associated to better QoL in the future, but the opposite did not occur. Results also provide evidence of gender differences. All in all, this work found evidence supporting the longitudinal effect of memory on QoL, which may have consequences for intervention implementation, given that actions for alleviating age-related memory impairment could also have a positive impact onto older adults’ QoL.

Clear as a bell? Policy stringency and elderly health during Covid-19

This paper investigates how restriction policies have impacted elderly self-assessed health (SAH) in Europe during the pandemic, and how the Covid-19 infection interacts with policy stringency to modulate the SAH deterioration. Using the Survey of Health, Aging and Retirement in Europe (SHARE) between October 2019 and August 2021, including 9,034 adults aged 50 years and above, alongside with a stringency index from the Oxford's Coronavirus Government Response Tracker (OxCGRT), we design both an adjusted probit model and a recursive bivariate probit model to test for endogeneity of Covid-19 infection. Estimations results show a bell curve between stringency and SAH degradation: a deleterious effect of restrictions at low levels of stringency up to a tipping point after which more stringent policies become protective. Covid-19 infection moderates this association. Depending on individuals' initial health, the effect of restrictions is uneven: highly stringent policies become damaging for individuals most likely to enter a vulnerabilization path, for whom the bell curve is thus inverted. Overall, this study shows clear patterns of association between policy stringency and perceived health among older Europeans, and highlights the potential trade-off between targeting as many people as possible, those in poor health or those on the edge of vulnerability.

Trajectories of job resources and the timing of retirement

Abstract Job resources benefit and motivate workers and, therefore, facilitate longer working lives. Yet, little is known about how job resources develop over time and how, in turn, trajectories of job resources are associated with retirement timing. Accordingly, this study examines job resource trajectories of older workers and to what extent these trajectories are related to when people retire. Using data from the Survey of Health, Ageing and Retirement in Europe (SHARE), growth mixture models are conducted to examine the trajectory of three job resources, namely autonomy, skill development opportunities and recognition, from age 50 until workers retired or dropped out of the survey. Four trajectories of job resources are found: stable high resources, stable low skill development opportunities, stable low recognition and stable low resources. The results of the subsequent event history analysis of retirement timing show that older workers with trajectories of job resources characterized by stable low recognition and stable low resources are at higher risk of earlier retirement compared to those with other trajectories. The findings shed light on the importance of job resource trajectories for promoting longer working lives.

Healthy Lifespan Statistics Derived From Cross-Sectional Prevalence Data Using the Sullivan Method are Informative Summary Measures of Population Health

Health expectancy (HE), commonly derived from cross-sectional prevalence data using the Sullivan method, serves as the most frequently used summary measure of population health. Like lifespan distribution statistics, which are often discussed alongside life expectancy (LE) in demographic studies, analogous statistics on healthy lifespans can provide valuable information on population health. We examine whether healthy lifespan distribution statistics beyond HE can be estimated based on cross-sectional prevalence data and the life table, the data inputs of the Sullivan method. To do so, we treat the Sullivan method as an extension of the stationary population model to health and distinguish between health conditions with and without recovery from the state of decreased health. Our empirical demonstration is based on the prevalence of chronic diseases in selected European countries in 2017 from the Survey of Health, Ageing and Retirement in Europe (SHARE), as well as on life tables from EUROSTAT. We find that the Sullivan method, when considered as an extension of the stationary population model to health, allows for the estimation of a healthy survival distribution and its statistics, beyond HE, for health characteristics with no recovery from the state of decreased health. We show that for such health conditions, the method requires that the number of persons in full health in a stationary population does not increase with age. We argue that for such health dimensions, HE conditional on being in good health at the life table radix age is of relevance for health policy interventions. In our empirical application, we show that the conditional and unconditional measures of HE can give substantially different pictures of population health. Furthermore, we show that across European countries, in contrast to the negative relationship between LE and lifespan inequality, higher HE is associated with greater inequality in healthy years lived when conditional on being healthy at age 50. Overall, the Sullivan method, when considered as an extension of the stationary population model, proves to be a valuable tool for deriving summary statistics of population health beyond HE, which are highly relevant to public policy. * This article belongs to a special issue on “Levels and Trends of Health Expectancy: Understanding its Measurement and Estimation Sensitivity”.

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.

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

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.

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.

Inconsistencies in self-reported diabetes in a large panel study: the Survey of Health, Ageing and Retirement in Europe (SHARE)

BackgroundThe validity of self-reported chronic conditions has been assessed by comparing them with medical records or register data in several studies. However, the reliability of self-reports of chronic diseases has less often been examined. Our aim was to assess the proportion and determinants of inconsistent self-reports of diabetes in a long panel study.MethodsSHARE (Survey of Health, Ageing and Retirement in Europe) includes 140,000 persons aged ≥ 50 years from 28 European countries and Israel. We used data from waves 1 to 7 (except wave 3) collected between 2004 and 2017. Diabetes was assessed by self-report. An inconsistent report for diabetes was defined as reporting the condition in one wave, but denying it in at least one later wave. The analysis data set included 13,179 persons who reported diabetes, and answered the question about diabetes in at least one later wave. Log-binomial regression models were fitted to estimate crude and adjusted relative risks (RR) with 95% confidence intervals (CI) for the associations between various exposure variables and inconsistent report of diabetes.ResultsThe proportion of persons with inconsistent self-reports of diabetes was 33.0% (95% CI: 32.2%—33.8%). Inconsistencies occurred less often in persons taking antidiabetic drugs (RR = 0.53 (0.53—0.56)), persons with BMI ≥ 35 kg/m2 versus BMI < 25 kg/m2 (RR = 0.70, (0.64—0.77)), and poor versus excellent subjective health (RR = 0.87 (0.75—1.01)). Inconsistencies occurred more often in older persons (RR = 1.15 (1.12—1.18) per 10 years increase of age), and persons not reporting their age at diabetes onset (RR = 1.38 (1.31—1.45)).ConclusionIn SHARE, inconsistent self-report of diabetes is frequent. Consistent reports are more likely for persons whose characteristics make diabetes more salient, like intake of antidiabetic medication, obesity, and poor subjective health. However, lack of attention in answering the questions, and poor wording of the items may also play a role.

Volunteering and instrumental support during the first phase of the pandemic in Europe: the significance of COVID-19 exposure and stringent country’s COVID-19 policy

BackgroundThe COVID-19 control policies might negatively impact older adults’ participation in volunteer work, instrumental support provision, and the likelihood of receiving instrumental support. Studies that quantify changes in these activities and the related factors are limited. The current study aimed to examine the level of volunteering, instrumental support provision and receipt before and during the first phase of the COVID-19 pandemic in Europe and to determine whether older adults’ volunteering, instrumental support provision and receipt were associated with individual exposure to COVID-19 and the stringency of country’s COVID-19 control policy during the first phase of the COVID-19 pandemic.MethodsA cross-sectional survey using data from the Survey of Health, Ageing and Retirement in Europe (SHARE) Corona Survey 1 was designed to focus on community-dwelling Europeans aged ≥50 years. History of participation in volunteering work and instrumental support provision or receipt was assessed from the previous SHARE Wave data. The country’s COVID-19 control policy stringency index (S-Index) was from the Oxford COVID-19 Government Response Tracker database. A total of 45,669 respondents from 26 European countries were included in the volunteering analysis. Seventeen European countries were included in the analyses of instrumental support provision (N = 36,518) and receipt (N = 36,526). The multilevel logistic regression model was fitted separately to analyse each activity.ResultsThe level of volunteering and instrumental support provision was lower during the pandemic, but instrumental support receipt was higher. The country S-Index was positively associated with support provision (OR:1.13;95%CI:1.02–1.26) and negatively associated with support receipt (OR:0.69;95%CI:0.54–0.88). Exposure to COVID-19 was positively associated with support receipt (OR:1.64;95%CI:1.38–1.95). COVID-19 exposure on close ones positively associated with volunteering (OR:1.47;95%CI:1.32–1.65), support provision (OR:1.28;95%CI:1.19–1.39), and support receipt (OR:1.25;95%CI:1.15–1.35).ConclusionsThe COVID-19 pandemic impacted older Europeans’ volunteering, instrumental support provision, and instrumental support receipt from outside their household. When someone close to them was exposed to COVID-19, older Europeans were likely to receive instrumental support and to volunteer and provide instrumental support. A stricter country’s COVID-19 control policy might motivate older adults to provide instrumental support, but it prevents them from receiving instrumental support from outside their households.

Exploring factors associated with self-rated health in individuals with diabetes and its impact on quality of life: Evidence from the Survey of Health, Ageing, and Retirement in Europe.

Self-rated health (SRH), a measure of self-reported general health, is a robust predictor of morbidity and mortality in various populations, including people with diabetes. Diabetes is negatively associated with SRH and quality of life (QoL). Little is known about how people with diabetes rate their health and which aspects influence the rating. Also, the predictive value of SRH on future QoL has not yet been evaluated. We analyzed data from 46 592 participants of the Survey of Health, Ageing and Retirement in Europe (SHARE). Using linear regression, we aimed to determine which sociodemographic, socioeconomic, medical, social, mental, and health behavior factors determine SRH in people with diabetes. In addition, we analyzed the predictive value of SRH on future QoL using the generalized estimating equations procedure. We determined that country, current job situation, hospitalization, pain, polypharmacy, memory, eyesight, activities of daily living, number of chronic diseases, and depression are all linked to SRH. Together these variables explained 38% of the SRH's variance, whereas depression, pain, and memory had the greatest influence on SRH of people with diabetes. We also found that SRH independently predicted future QoL, supported by a regression coefficient of β = -1.261 (Wald chi-square test, χ2 = 22.097, df = 1, p < .05). As SRH is linked to future QoL, we conclude that incorporating SRH assessment into medical evaluations can help health care professionals gaining a more comprehensive understanding of an individual's health trajectory and supporting patients to enhance their QoL.

Assessment of circulating apoE4 levels from dried blood spot samples in a large survey setting.

The apolipoprotein E (APOE) ε4 allele is associated with high risk for Alzheimer's disease. It is unclear whether individual levels of the circulating apoE4 protein in ε4 carriers confer additional risk. Measuring apoE4 protein levels from dried blood spots (DBS) has the potential to provide information on genetic status as well as circulating levels and to include these measures in large survey settings. We developed a multiplex immunoassay to detect apoE4 protein levels in DBS from 15,974 participants, aged 50+ from Wave 6 of the Survey of Health, Ageing and Retirement in Europe (SHARE). The apoE4 protein signal was presented in two separable distributions. One distribution corresponded to carriers of at least one copy of the ε4 allele. Fieldwork cofounders affected protein levels but did not explain individual differences. Future research should investigate how genotype and apoE4 level interact with lifestyle and other variables to impact cognitive aging.

A prospective association between social isolation and cognitive performance among older adults in Europe: the role of loneliness and poor oral health

Objectives The relationship between social isolation, loneliness, and tooth loss and cognition in older people is poorly understood. We examine how social isolation and cognitive performance are associated prospectively among older adults, as well as how tooth loss and loneliness are related to this association. Methods Using data from 26,168 participants aged ≥50 from the Survey of Health, Ageing and Retirement in Europe (SHARE), we explored the association between social isolation, loneliness, tooth loss and cognition. We used bootstrapping with resampling strategies for testing a moderated mediating model. Results Higher social isolation was associated with poorer cognitive performance (B = −0.20, 95% CI = −0.03, −0.01; R 2 =0.60), an association mediated by the respondent’s number of missing teeth (B = −0.001, 95% CI = −0.002, −0.001). Higher levels of social isolation were associated with a greater number of missing teeth, and a higher number of missing teeth was linked with poorer cognition. We also found that loneliness moderated the relationship between social isolation and both the number of missing teeth (B = −0.11, p = 0.047) and cognitive performance. Conclusion In later life, social isolation and loneliness are associated with shoddy oral health and poor cognitive status. Clinicians and policymakers should be aware of both the association between social isolation and feelings of loneliness on dentition and oral health and their relationship to the cognitive status of older adults.