Survey Of Health , Ageing And Retirement In Europe Research Articles

The impact of loneliness on quality of life in people with Parkinson's disease: results from the Survey of Health, Ageing and Retirement in Europe.

Loneliness is a growing issue for public health in an aging society. However, there is a lack of research on loneliness in people with Parkinson's disease (PwPD). We analyzed cross-sectional and longitudinal data from wave 5 (N = 559 PwPD) and 6 (N = 442 PwPD) from the Survey of Health, Ageing and Retirement in Europe (SHARE). Loneliness was assessed using the three-item version of the Revised UCLA Loneliness Scale. Descriptive statistics, group comparisons, multiple linear regressions, and generalized estimating equation analysis were performed to explore loneliness prevalence, its relationship with other factors, and its impact on Quality of Life (QoL) in PwPD. Depending on the used cut-off, the prevalence of loneliness in PwPD ranged from 24.1 to 53.8%. These prevalences were higher compared to people without PD. Loneliness was mainly linked to decreased functional abilities, weaker grip strength, more symptoms of depression, and country of residence. Loneliness was also associated with current QoL and predicts future QoL in PwPD, highlighting its impact on well-being. Addressing loneliness could potentially improve QoL for PwPD, making it a modifiable risk factor that clinicians and policy-makers should consider.

Arabic translation and cultural adaptation of sedentary behavior, dietary habits, and preclinical mobility limitation questionnaires: A cognitive interview study.

Developing global evidence on the influence of health-related behaviors (e.g., sedentary behavior, diet) and mobility limitations on health requires global consortia from diverse sets of countries. Thus, the purpose was to translate and culturally adapt (i) the Sedentary Behavior Questionnaire (SBQ); (ii) the Dietary Habits Questionnaire adapted from the Survey of Health, Aging and Retirement in Europe (SHARE) study; (iii) the Preclinical Mobility Limitation questionnaire for use in the Saudi Arabian context. 50 adult Saudi participants (mean age 41.7±9.6, 48% female) participated in this study. We followed a systematic cross-cultural adaptation process that involved forward translation, synthesis, back-translation, expert panel, and pre-testing (cognitive interviewing). Four rounds of cognitive interviews were held with 40 participants for the SBQ, SHARE questionnaire, and the Preclinical Mobility Limitation questionnaire, an additional round was needed for the Preclinical Mobility Limitation questionnaire. Descriptive data (means ± standard deviations and frequencies with percentages) were reported for characteristics. With some minor changes to the questionnaires, the SBQ, Dietary Habits, and Preclinical Mobility Limitation questionnaires were translated and cross-culturally adapted into Arabic. 100% of the participants confirmed that the resulting Arabic versions of the SBQ, Dietary Habits questionnaire, and Preclinical Mobility Limitation questionnaires were appropriate and fully understandable for Arabic speakers in communicating the intended meanings of the items in each. For example, item SBQ1, 'Watching television (including videos on VCR/DVD)' was changed to 'Sitting and watching television or videos (including smartphones, tablets)'. The SBQ, Dietary Habits questionnaire, and Preclinical Mobility Limitation questionnaire were successfully cross-culturally adapted into Arabic and are now ready for use in Saudi Arabian.

Sex differences in vision and hearing impairments across age and European regions : Findings from SHARE.

Although sensory impairments are common conditions among older people, research often fails to consider the role of sex. We examined sex differences in vision impairment and hearing impairment across age and European regions. We conducted across-sectional study based on apooled sample of 65,656 females and 54,881 males aged 50years and older participating in the Survey of Health, Ageing and Retirement in Europe (SHARE) from 2004-2020. Logistic regression models with robust standard errors providing odds ratios (OR) and 95% confidence intervals (CI) were used to examine associations. European females had generally higher odds of vision impairment (OR 1.16, 95% CI 1.12-1.21) but lower odds of hearing impairment than European males (OR 0.70, 95% CI 0.67-0.73). The female disadvantage in vision increased with advancing age, whereas the female advantage in hearing decreased. No overall sex difference in vision was found in northern Europe, but females had more vision impairments than males in southern (OR 1.23, 95% CI 1.14-1.32), western (OR 1.14, 95% CI 1.08-1.21) and eastern (OR 1.10, 95% CI 1.02-1.20) Europe. Females were healthier than males in terms of hearing in all regions, with the largest female advantage in northern Europe (OR 0.58, 95% CI 0.53-0.64). Our findings demonstrate an overall consistent pattern of sex differences in sensory impairments across Europe showing an increasing female disadvantage in vision and adecreasing female advantage in hearing with advancing age.

Spousal concordance in adverse childhood experiences and the association with depressive symptoms in middle-aged and older adults: findings across China, the US, and Europe.

Adverse childhood experiences (ACEs) are associated with higher depressive risks in adulthood. Whether respondents' ACEs are associated with their own depressive symptoms in adulthood and whether this association extends to their spouses' depressive symptoms remain unexplored. Data were from China Health and Retirement Longitudinal Study (CHARLS), the Health and Retirement Study (HRS), and the Survey of Health, Ageing and Retirement in Europe (SHARE). ACEs were categorized into overall, intra-familial, and extra-familial ACEs. Correlations of couples' ACEs were calculated using Cramer's V and partial Spearman's correlation. Associations of respondents' ACEs with spousal depressive symptoms were assessed using logistic regression, and mediation analyses were conducted to explore the mediating role of respondents' depressive symptoms. Significant associations between husbands' ACEs and wives' depressive symptoms, with odds ratios (ORs) and 95% confidence intervals (CIs) of 2.09 (1.36-3.22) for 4 or more ACEs in CHARLS, and 1.25 (1.06-1.48) and 1.38 (1.06-1.79) for 2 or more ACEs in HRS and SHARE. However, wives' ACEs were associated with husbands' depressive symptoms only in CHARLS and SHARE. Findings in intra-familial and extra-familial ACEs were consistent with our main results. Additionally, respondents' depressive symptoms mediated more than 20% of the effect of respondents' ACEs on spousal depressive symptoms. We found that ACEs were significantly correlated between couples. Respondents' ACEs were associated with spousal depressive symptoms, with respondents' depressive symptoms mediating the association. The bidirectional implications of ACEs on depressive symptoms should be considered within household and effective interventions are warranted.

Physical activity matters for everyone’s health, but individuals with multimorbidity benefit more

Multimorbidity, defined as the presence of two or more chronic conditions, is increasingly prevalent and is a major contributor to ill health in old age. Physical activity (PA) is a key protective factor for health and individuals with multimorbidity could particularly benefit from engaging in PA. However, direct evidence that PA has greater health benefits in people with multimorbidity is lacking. The objective of the present study was to investigate whether the associations between PA and health were more pronounced in individuals with (vs. without) multimorbidity. We used data from 121,875 adults aged 50 to 96 years (mean age = 67 ± 10 years, 55% women) enrolled in the Survey of Health, Ageing and Retirement in Europe (SHARE). Multimorbidity and PA were self-reported. Health indicators were assessed using tests and validated scales. Variables were measured up to seven times over a 15-year period. Confounder-adjusted linear mixed-effects models were used to investigate the moderating role of multimorbidity on the associations of PA with the levels and trajectories of health indicators across aging. Results showed that multimorbidity was associated with declines in physical, cognitive, and mental health, as well as poorer general health. Conversely, PA was positively associated with these health indicators. We found a significant interaction between multimorbidity and PA, revealing that positive associations between PA and health indicators were strengthened in people with multimorbidity – although this stronger association became less pronounced in advanced age. These findings suggest that the protective role of PA for multiple health indicators is enhanced in individuals with multimorbidity.

ASSOCIATION OF HANDGRIP STRENGTH WITH CARDIOMETABOLIC MULTIMORBIDITY: FINDINGS FROM FOUR LONGITUDINAL COHORT STUDIES

Objective: Cardiometabolic multimorbidity is an increasing public health burden and clinical concern. However, predictors for the development of cardiometabolic multimorbidity are poorly understood. We aimed to investigate the association between handgrip strength and the risk of cardiometabolic multimorbidity among adults aged 50 years or above from high-income and low- and middle-income countries. Design and method: In this multicohort study, we extracted individual-level data from four longitudinal cohort studies that included nationally representative samples across 20+ countries, including the Health and Retirement Study (HRS), the English Longitudinal Study of Aging (ELSA), the Survey of Health, Ageing and Retirement in Europe (SHARE), and the China Health and Retirement Longitudinal Study (CHARLS). Handgrip strength was measured following a homogeneous procedure, in which the maximum measurements of dominant hand were used and expressed in absolute units (kg) for subsequent analysis. Cardiometabolic multimorbidity was defined as the simultaneous occurrence of two or more of the following conditions: type 2 diabetes, stroke, and heart diseases. Cox proportional hazards models were performed to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs). Results: We included 50,118 participants recruited between 2011 and 2019 with a median follow-up of 7.6 years. The incident rates of cardiometabolic multimorbidity in participants from HRS, ELSA, SHARE, and CHARLS were 9.1%, 4.0%, 3.1%, and 2.7%, respectively. After adjusting for sociodemographic characteristics, lifestyle factors, and vascular risk factors, the HRs (95% CIs) of per SD increment in handgrip strength for cardiometabolic multimorbidity were 0.80 (0.73-0.87) in HRS, 0.62 (0.55-0.71) in ELSA, 0.69 (0.64-0.75) in SHARE, and 0.85 (0.75-0.96) in CHARLS. Those associations remained statistically significant for separate outcomes including diabetes, heart diseases, and stroke in all four cohorts. Conclusions: Higher grip strength was associated with a range of cardiometabolic outcomes as well as cardiometabolic multimorbidity regardless of whether they live in high-income or low- and middle-income countries. Further work on the use of grip strength in risk scores or risk screening is needed to establish its potential clinical utility.

Longitudinal Relationship Between Handgrip Strength and Cognitive Function in a European Multicentric Population Older Than 50Years.

The aim of this study was to analyze the bidirectional association between handgrip strength (HGS) and cognitive performance in different cognitive functions in a European population and to evaluate the predictive validity of HGS for the risk of future cognitive impairment in aging individuals. This was a prospective cohort study conducted using data on individuals over 50years of age from the Survey of Health, Aging and Retirement in Europe (SHARE). HGS measures and scores in numeracy, recall, and verbal fluency were repeated and analyzed biannually for 4years and were used in generalized estimating equations to test the bidirectional association, categorized by sex. Of the 8236 individuals included, 55.73% were women with a mean age of 67.55 (standard deviation [SD] = 8.4) years and 44.27% were men with a mean age of 68.42 (SD = 7.7) years. HGS predicted cognitive decline in both sexes, except for numeracy in men, even after adjustments. The strongest association with HGS in women was in verbal fluency (β = .094; 95% CI = 0.039 to 0.151), whereas the strongest association with HGS in men was in delayed verbal recall (β = .095; 95% CI = 0.039 to 0.151). Conversely, the greatest cognitive predictor of HGS decline was verbal fluency in men (β = .796; 95% CI = 0.464 to 1.128), and in women (β = .801; 95% CI= 0.567 to 1.109). There is a significant and bidirectional association between HGS and different cognitive functions in a European multicentric population. This bidirectional association differed between sexes. Both men and women who presented with cognitive decline also showed early changes in their HGS measures, and vice versa, but there still were differences between the sexes. These findings reinforce that HGS may be a simple and inexpensive method to identify early signs of cognitive decline, and that studies and rehabilitation strategies should be more sex specific.

Influence of chronic diseases on the occurrence of depression: A 13-year follow-up study from the Survey of Health, Ageing and Retirement in Europe

The causal association between chronic diseases and depression remains unclear. This study aimed to explore the effects of types and number of chronic diseases on the risk of depression using data from the Survey of Health, Ageing and Retirement in Europe (SHARE). A self-admitted questionnaire was used to obtain data on 14 predefined chronic diseases and the European-Depression Scale (EURO-D) was used to assess depression. Among the 16,080 baseline depression-free participants aged 50+, 31.29% (5032) developed depression over 13 years. Multivariate Cox regression models showed that individuals with any chronic diseases were at higher risk of new onset depression compared to disease-free participants. The risk of new onset depression increased with an increasing number of diseases among both younger (50–64) and older (65+) adults. Individuals with heart attack, stroke, diabetes, chronic lung disease, and arthritis were at increased risk of depression across age groups. However, some age-specific associations were observed, with cancer increasing depression risk among younger- and peptic ulcer, Parkinson's disease and cataracts increasing depression risk among older adults. These findings highlight the importance of managing chronic diseases, especially among those with more than two diseases, to prevent the development of depression among middle-aged and older adults.

Predicting missed health care visits during the COVID-19 pandemic using machine learning methods: evidence from 55,500 individuals from 28 European countries

BackgroundPandemics such as the COVID-19 pandemic and other severe health care disruptions endanger individuals to miss essential care. Machine learning models that predict which patients are at greatest risk of missing care visits can help health administrators prioritize retentions efforts towards patients with the most need. Such approaches may be especially useful for efficiently targeting interventions for health systems overburdened during states of emergency.MethodsWe use data on missed health care visits from over 55,500 respondents of the Survey of Health, Ageing and Retirement in Europe (SHARE) COVID-19 surveys (June – August 2020 and June – August 2021) with longitudinal data from waves 1–8 (April 2004 – March 2020). We compare the performance of four machine learning algorithms (stepwise selection, lasso, random forest, and neural networks) to predict missed health care visits during the first COVID-19 survey based on common patient characteristics available to most health care providers. We test the prediction accuracy, sensitivity, and specificity of the selected models for the first COVID-19 survey by employing 5-fold cross-validation, and test the out-of-sample performance of the models by applying them to the data from the second COVID-19 survey.ResultsWithin our sample, 15.5% of the respondents reported any missed essential health care visit due to the COVID-19 pandemic. All four machine learning methods perform similarly in their predictive power. All models have an area under the curve (AUC) of around 0.61, outperforming random prediction. This performance is sustained for data from the second COVID-19 wave one year later, with an AUC of 0.59 for men and 0.61 for women. When classifying all men (women) with a predicted risk of 0.135 (0.170) or higher as being at risk of missing care, the neural network model correctly identifies 59% (58%) of the individuals with missed care visits, and 57% (58%) of the individuals without missed care visits. As the sensitivity and specificity of the models are strongly related to the risk threshold used to classify individuals, the models can be calibrated depending on users’ resource constraints and targeting approach.ConclusionsPandemics such as COVID-19 require rapid and efficient responses to reduce disruptions in health care. Based on characteristics available to health administrators or insurance providers, simple machine learning algorithms can be used to efficiently target efforts to reduce missed essential care.

Physical activity mediates the effect of education on mental health trajectories in older age

ObjectiveWhy people with lower levels of educational attainment have poorer mental health than people with higher levels can partly be explained by financial circumstances. However, whether behavioral factors can further explain this association remains unclear. Here, we examined the extent to which physical activity mediates the effect of education on mental health trajectories in later life. MethodsData from 54,818 adults 50 years of age or older (55 % women) included in the Survey of Health, Aging and Retirement in Europe (SHARE) were analyzed using longitudinal mediation and growth curve models to estimate the mediating role of physical activity (baseline and change) in the association between education and mental health trajectories. Education and physical activity were self-reported. Mental health was derived from depressive symptoms and well-being, which were measured by validated scales. ResultsLower education was associated with lower levels and steeper declines in physical activity over time, which predicted greater increases in depressive symptoms and greater decreases in well-being. In other words, education affected mental health through both levels and trajectories of physical activity. Physical activity explained 26.8 % of the variance in depressive symptoms and 24.4 % in well-being, controlling for the socioeconomic path (i.e., wealth and occupation). ConclusionsThese results suggest that physical activity is an important factor in explaining the association between low educational attainment and poor mental health trajectories in adults aged 50 years and older.

Cared and uncared populations: understanding unmet care needs of older adults (65+) across different social care systems in Europe

Population care needs are dynamic. They change throughout individuals’ life courses and are related to the population structure. These needs are particularly demanding during population ageing and may vary depending on how societies cope with them. In this study, we explored the unmet social care needs of individuals in twelve European countries with different social care systems. We used data from the seventh wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) to conduct a cross-sectional study of individuals aged 65 and over with care needs (n = 7136). Unmet care needs were measured from an absolute approach. We fitted binomial regression models to explain the relative importance of individuals’ characteristics, health status and different social care systems on unmet needs. The absolute measure shows that 53.02% of the analytical sample faced unmet care needs as they reported limitations and did not receive help. The prevalence of unmet care needs is higher for men than women and for younger than older individuals. Furthermore, we found that individuals living in Mediterranean social care systems have the highest prevalence of these unmet needs. This analysis contributes to the ongoing debate about the challenges posed by ageing populations and their relationship with care.

Transition to retirement impact on depressive symptoms: results from a longitudinal analysis within the Survey of Health, Ageing and Retirement in Europe (SHARE) project

Transition to retirement impact on depressive symptoms: results from a longitudinal analysis within the Survey of Health, Ageing and Retirement in Europe (SHARE) project

Transition to retirement impact on smoking habit: results from a longitudinal analysis within the Survey of Health, Ageing and Retirement in Europe (SHARE) project

BackgroundIn an ageing society, retirement impacts on behavioural risk factors and health outcomes should be carefully assessed. Scant evidence exists from longitudinal studies on the short- and long-term consequences of the transition to retirement on smoking habit.MethodsWe conducted a longitudinal study based on the Survey of Health, Ageing and Retirement in Europe (SHARE) data from 27 European countries plus Israel collected in 2004–2020. To estimate relative risks (RR) and corresponding 95% confidence intervals (CI) for smoking status and intensity at seven time periods before and after retirement, we fitted adjusted generalised estimating equation (GEE) models for repeated measures.ResultsWe selected a cohort of 8998 individuals employed at baseline and retired at follow-up (median follow-up time: 9 years; maximum: 16 years). As compared to the year of retirement, the RR of smoking was 1.59 (95% CI 1.44–1.76) at 10 years or more before retirement, 1.35 (95% CI 1.25–1.46) from 5 to 9 years before retirement, and 1.18 (95% CI 1.10–1.27) from 1 to 4 years before retirement. Smoking steadily decreased after retirement, being 0.94 (95% CI 0.87–1.01) from 1 to 4 years after retirement, 0.76 (95% CI 0.69–0.84) from 5 to 9 years, and 0.58 (95% CI 0.46–0.74) 10 years or more after retirement. In smokers, the estimated number of cigarettes smoked/day decreased from about 27 cigarettes/day at 10 years or more before retirement to 9 cigarettes/day at 10 years or more after retirement (p trend < 0.001).ConclusionLongitudinal data suggest that lifestyles might favourably change with retirement. Further studies are needed to direct healthy ageing promotion policies better.

Support for Older Parents in Need in Europe: The Role of the Social Network and of Individual and Relational Characteristics.

Adult children form the backbone of informal care for older parents. To date, limited attention has been paid to the complex mechanism of providing support to older parents. The present study investigated mezzo- and micro-level correlates of provision of support to older parents. The focus was on the child-parent relationship in childhood and in the present. Data were derived from the Survey of Health, Ageing and Retirement in Europe (SHARE). The analytic sample comprised respondents who participated in SHARE Waves 6-8 and reported having an unhealthy mother (N = 1,554) or father (N = 478). We used hierarchical logistic regression to address 3 models including individual resources, child-parent characteristics, and social resources. We conducted separate analyses for mothers and fathers. Providing support to a parent depended primarily on personal resources followed by the quality of the relationship with the parent. A larger social network of the care provider was also related to increased likelihood of providing support. Support to a mother was associated with positive evaluations of the relationship with her in the present and in childhood. At the same time, negative evaluations of the relationship with the father in childhood were negatively related to providing support to him. The findings point to a multidimensional mechanism, in which adult children's resources are a prominent factor in shaping caregiving behaviors toward their parents. Clinical efforts should focus on adult children's social resources and the quality of the child-parent relationship.

Oral health, anxiety symptoms and depressive symptoms: findings from the survey of health, ageing and retirement in Europe.

There is limited knowledge regarding the association between oral health and mental health in terms of depressive symptoms and particularly anxiety symptoms. Therefore, our aim was to close this gap in knowledge. Cross-sectional data were used from wave 5 of the pan-European Survey of Health Ageing, and Retirement in Europe (SHARE) (n = 62 358 observations). The Beck Anxiety Inventory was used to quantify anxiety symptoms and the Euro-D was used to measure depressive symptoms. Oral health was quantified based on the presence of missing natural teeth, the number of missing natural teeth and the extent of replaced teeth. It was adjusted for several covariates in regression analysis. Multiple linear regressions revealed that the presence of missing natural teeth was associated with higher anxiety symptoms (β = 0.11, P < 0.001) and higher depressive symptoms (β = 0.22, P < 0.001) among the total sample. Among individuals with at least one missing natural tooth, the number of missing natural teeth was positively associated with higher anxiety symptoms (β = 0.02, P < 0.001) and higher depressive symptoms (β = 0.02, P < 0.001) - and fully replaced teeth (compared to not at all replaced teeth) were associated with lower anxiety symptoms (β = -0.35, P < 0.001) and lower depressive symptoms (β = -0.36, P < 0.001). Our study stresses the association between lower oral health and lower mental health among older adults in Europe. Future studies based on longitudinal data are required.

Multimorbidity increases the risk of dementia: a 15 year follow-up of the SHARE study.

the literature regarding the association between multimorbidity and dementia is still unclear. Therefore, we aimed to explore the potential association between multimorbidity at the baseline and the risk of future dementia in the SHARE (Survey of Health, Ageing and Retirement in Europe) study, a large European research survey, with a follow-up of 15years. in this longitudinal study, multimorbidity was defined as the presence of two or more chronic medical conditions, among 14 self-reported at the baseline evaluation. Incident dementia was ascertained using self-reported information. Cox regression analysis, adjusted for potential confounders, was run and hazard ratios (HRs), with their 95% confidence intervals (CIs), that were estimated in the whole sample and by 5 year groups. among 30,419 participants initially considered in wave 1, the 23,196 included participants had a mean age of 64.3years. The prevalence of multimorbidity at baseline was 36.1%. Multimorbidity at baseline significantly increased the risk of dementia in the overall sample (HR = 1.14; 95% CI: 1.03-1.27) and in participants younger than 55years (HR = 2.06; 95% CI: 1.12-3.79), in those between 60 and 65years (HR = 1.66; 95% CI: 1.16-2.37) and in those between 65 and 70years (HR = 1.54; 95% CI: 1.19-2.00). In the overall sample, high cholesterol levels, stroke, diabetes and osteoporosis increased the risk of dementia, particularly if present among participants between 60 and 70years of age. multimorbidity significantly increases the risk of dementia, particularly in younger people, indicating the need for early detection of multimorbidity for preventing cognitive worsening.

COVID-19 precautionary behaviors and vaccine acceptance among older individuals: The role of close kin

The family plays a central role in shaping health behaviors of its members through social control and support mechanisms. We investigate whether and to what extent close kin (i.e., partner and children) matter for older people in taking on precautionary behaviors (e.g., wearing a mask) and vaccination during the COVID-19 pandemic in Europe. Drawing on data from the Survey of Health, Ageing and Retirement in Europe (SHARE), we combine its Corona Surveys (June to September 2020 and June to August 2021) with pre-COVID information (October 2019 to March 2020). We find that having close kin (especially a partner) is associated with a higher probability of both adopting precautionary behaviors and accepting a COVID-19 vaccine. Results are robust to controlling for other potential drivers of precautionary behaviors and vaccine acceptance and to accounting for coresidence with kin. Our findings suggest that policymakers and practitioners may differently address kinless individuals when promoting public policy measures.

Do All Savings Matter Equally? Saving Types and Emotional Well-Being Among Older Adults: Evidence from Panel Data

AbstractIll-being and mental ill-health have been on the rise in both Europe and the United States, especially among middle-aged and older adults. Although financial security has been shown to play a protective role in emotional well-being, little is known about the protective role of different types of family assets on mental health and well-being. Using longitudinal survey data from the Survey of Health, Aging and Retirement in Europe (SHARE) collected between 2004 and 2017, we examined the role of different types of family assets in emotional well-being and depression. A multivariate proportional hazard model with time-varying covariates was used. We found that family assets may play a significant protective role against depression, loneliness, and a decreased quality of life. Different forms of family assets may play diverse roles in protecting against the risks of ill-being and mental ill-health; however, their roles in increasing the chances of overcoming ill-being are less pronounced. Promotion of saving behaviours and proper financial management can help protect against adverse well-being and health outcomes in middle-aged and older adults.

The Quality of Life of the European Population: SHARE Data-based Analysis

The quality of life, well-being and deprivation are significant factors affecting the ageing European population. The fifth (2013) wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) covers the two indices of (material and social) deprivation along with various life quality and satisfaction indicators measuring (subjective and objective) well-being. Using the SHARE data, the present paper examines the 50+ population in 13 EU member states and Switzerland, emphasizing the relationships between distinctive characteristics. The gender gap is quantified for both the whole sample and particular age groups. Statistical comparisons between old and new EU countries are limited since only three of the latter (Estonia, Slovenia and the Czech Republic) took part in the 2013 SHARE survey.

The Longitudinal Association between Co-Residential Care Provision and Healthcare Use among the Portuguese Population Aged 50 and Over: A SHARE Study.

Co-residential care is associated with poor caregiver health and a high burden. Although Portugal relies heavily on co-residential care by individuals aged 50 and over, studies on the impact of co-residential care provision on Portuguese caregivers' healthcare use are lacking. This study aims to analyze the impact of co-residential care (spousal and non-spousal care) on healthcare use of the Portuguese population aged 50 plus. Data from waves 4 (n = 1697) and 6 (n = 1460) of the Survey of Health, Ageing and Retirement in Europe (SHARE) were used. Negative Binomial Generalized Linear Mixed Models with random (individual level) and fixed (covariates) effects were performed. The results show that the number of visits to the doctor decrease significantly over time for the co-residential spousal caregivers as compared to the non-co-residential caregivers. This result highlights the fact that the Portuguese co-residential spousal caregiver group is at a higher risk of not using healthcare, thus jeopardizing their own health and continuity of care. Promoting more accessible healthcare services and implementing public policies adjusted to the needs of informal caregivers are important to improve the health and healthcare use of Portuguese spousal co-residential caregivers.