We examined whether changes in different forms of social participation were associated with changes in depressive symptoms in older Europeans. We used lagged individual fixed-effects models based on ...data from 9,068 persons aged ≥50 years in wave 1 (2004/2005), wave 2 (2006/2007), and wave 4 (2010/2011) of the Survey of Health, Ageing and Retirement in Europe (SHARE). After we controlled for a wide set of confounders, increased participation in religious organizations predicted a decline in depressive symptoms (EURO-D Scale; possible range, 0-12) 4 years later (β = -0.190 units, 95% confidence interval: -0.365, -0.016), while participation in political/community organizations was associated with an increase in depressive symptoms (β = 0.222 units, 95% confidence interval: 0.018, 0.428). There were no significant differences between European regions in these associations. Our findings suggest that social participation is associated with depressive symptoms, but the direction and strength of the association depend on the type of social activity. Participation in religious organizations may offer mental health benefits beyond those offered by other forms of social participation.
Objectives The aim of this study was to get insight into the role of poor health, unhealthy behaviors, and unfavorable work characteristics on exit from paid employment due to disability pension, ...unemployment, and early retirement among older workers. Methods Respondents of the longitudinal Survey of Health, Ageing, and Retirement in Europe (SHARE) in 11 European countries were selected when (i) aged between 50 years and the country-specific retirement age, (ii) in paid employment at baseline, and (iii) having information on employment status during the 4-year follow-up period (N=4923). Self-perceived health, health behaviors, and physical and psychosocial work characteristics were measured by interview at baseline. Employment status was derived from follow-up interviews after two and four years. Cox proportional hazards regression analyses were used to identify determinants of unemployment, disability pension, and early retirement. Results Poor health was a risk factor for disability pension hazard ratio (HR) 3.90, 95% confidence interval (95% CI) 2.51—6.05, and a lack of physical activity was a risk factor for disability pension (HR 3.05, 95% CI 1.68—5.55) and unemployment (HR 1.84, 95% CI 1.13—3.01). A lack of job control was a risk factor for disability pension, unemployment, and early retirement (HR 1.30—1.77). Conclusions Poor health, a lack of physical activity, and a lack of job control played a role in exit from paid employment, but their relative importance differed by pathway of labor force exit. Primary preventive interventions focusing on promoting physical activity as well as increasing job control may contribute to reducing premature exit from paid employment.
Abstract Objective In Europe, the demand for informal care is high and will increase because of the ageing population. Although caregiving is intended to contribute to the care recipient's health, ...its effects on the health of older European caregivers are not yet clear. This study explores the association between providing informal personal care and the caregivers' health. Method Data were used from the longitudinal cohort (2004/2005–2010/2011) of the Survey of Health, Ageing and Retirement in Europe (SHARE) (n = 7858). Generalized estimating equations were used to explore the longitudinal association of informal care and the caregiver's health using poor self-rated health (less than good), poor mental health (EURO-D score for depression ≥ 4), and poor physical health (≥ 2 health complaints). Results Providing informal personal care was significantly associated with poor mental health (OR = 1.23, 95% CI = 1.04–1.47) and poor physical health (OR = 1.18, 95% CI = 1.01–1.38), after adjusting for various socio-demographic and health-related factors. No statistical significant association was found for self-rated health in the adjusted models. Conclusion Providing informal personal care may negatively influence the caregiver's mental and physical health. More awareness of the beneficial and detrimental effects of caregiving among policy makers is needed to make well-informed decisions concerning the growth of care demands in the ageing population.
Cross-sectional studies have reported associations between social support and health, but prospective evidence is less conclusive. This study aims to investigate the associations of positive and ...negative experiences of social support with current and future lifestyle factors, biological risk factors, self-perceived health and mental health over a 10-year period.
Data were from 4,724 Dutch men and women aged 26-65 years who participated in the second (1993-1997) and in the third (1998-2002) or fourth (2003-2007) study round of the Doetinchem Cohort Study. Social support was measured at round two using the Social Experiences Checklist. Health was assessed by several indicators such as smoking, alcohol consumption, physical activity, fruit and vegetable intake, overweight, hypertension, hypercholesterolemia, self-perceived health and mental health. Tertiles of positive and negative experiences of social support were analysed in association with repeated measurements of prevalence and incidence of several health indicators using generalised estimating equations (GEE).
Positive and negative experiences of social support were associated with prevalence and incidence of poor mental health. For the lowest tertile of positive support, odds ratios were 2.74 (95% CI 2.32-3.23) for prevalent poor mental health and 1.86 (95% CI 1.39-2.49) for incident poor mental health. For the highest tertile of negatively experienced support, odds ratios for prevalent and incident poor mental health were 3.28 (95% CI 2.78-3.87) and 1.60 (95% CI 1.21-2.12), respectively. Low levels of positive experiences of social support were also associated with low current intake of fruits and vegetables, but not with future intake. Negative experiences of social support were additionally associated with current smoking, physical inactivity, overweight and poor self-perceived health. Furthermore, high levels of negative experiences of social support were associated with future excessive alcohol consumption (OR 1.42; 95% CI 1.10-1.84), physical inactivity (95% CI 1.28; 1.03-1.58) and poor self-perceived health (OR 1.36; 95% CI 1.01-1.82).
This study showed that social support might have a beneficial effect on lifestyle and health, with negative experiences of social support affecting lifestyle and health differently from positive experiences of social support.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Cross-national comparisons of health in European countries provide crucial information to monitor health and disease within and between countries and to inform policy and research priorities. ...However, variations in estimates might occur when information from cross-national European surveys with different characteristics are used. We compared the prevalence of very good or good self-perceived health across 10 European countries according to three European surveys and investigated which survey characteristics contributed to differences in prevalence estimates.
We used aggregate data from 2004 to 2005 of respondents aged 55-64 years from the European Union Statistics on Income and Living Conditions (EU-SILC), the Survey of Health, Ageing and Retirement in Europe (SHARE) and the European Social Survey (ESS). Across the surveys, self-perceived health was assessed by the same question with response options ranging from very good to very bad.
Despite a good correlation between the surveys (intraclass correlation coefficient: 0.77), significant differences were found in prevalence estimates of very good or good self-perceived health. The survey response, sample size and survey mode contributed statistically significantly to the differences between the surveys. Multilevel linear regression analyses, adjusted for survey characteristics, showed a higher prevalence for SHARE (+6.96, 95% CIs: 3.14 to 10.8) and a lower prevalence (-3.12; 95% CIs: -7.11 to 0.86) for ESS, with EU-SILC as the reference survey.
Three important health surveys in Europe showed substantial differences for presence of very good or good self-perceived health. These differences limit the usefulness for direct comparisons across studies in health policies for Europe.
Background:
Research on the costs of healthcare provision has so far focused on insurer costs rather than out-of-pocket costs. Out-of-pocket costs may be important to patients making medical ...decisions.
Aim:
To investigate the self-reported out-of-pocket costs associated with healthcare in the last year of life of older adults in Europe.
Design:
A post-death survey, part of the Survey of Health, Ageing, and Retirement in Europe, completed by proxy respondents in four waves from 2005 to 2012.
Setting/participants:
Proxy respondents for 2501 deceased adults of 55 years or over. Data from 13 European countries and four waves from 2005 to 2012 were used.
Results:
The proportion of people with out-of-pocket costs ranged from 21% to 96% in different European Union countries. Out-of-pocket costs ranged from 2% to 25% of median household income. Secondary and institutional care was most often the largest contributor to out-of-pocket costs, with care received in a care home being the most expensive type of care in 11 of 13 countries. Multilevel analyses showed that limitations in more than two activities of daily living (coefficient = 6.47, 95% confidence interval = 1.81–11.14) and a total hospitalization time of 3–6 months (coefficient = 14.66; 95% confidence interval = 0.97–28.35) or more than 6 months (coefficient = 31.01; 95% confidence interval = 11.98–50.15) were associated with higher out-of-pocket costs. In total, 24% of the variance on a country level remained unexplained.
Conclusion:
Variation in out-of-pocket costs for healthcare in the last year of life between European countries indicates that countries face different challenges in making healthcare in the last year of life affordable for all.
Samenvatting
Inleiding
In dit onderzoek kijken we naar de prevalentie van restklachten, ervaren gezondheid, en mentale en fysieke gezondheid twaalf maanden na een COVID-19-besmetting bij personen die ...wel en niet zijn opgenomen in het ziekenhuis vanwege een COVID-19-besmetting.
Methode
We hebben een online vragenlijstonderzoek gedaan bij personen die positief getest zijn bij de GGD’en Noord- en Oost-Gelderland en Gelderland-Midden (
n
= 8232) en bij patiënten die opgenomen zijn geweest in ziekenhuis Rijnstate (
n
= 125).
Resultaten
De opgenomen personen rapporteren vaker restklachten (83,5%) en ervaren gemiddeld meer restklachten (3–4 klachten) dan niet-opgenomen personen (45,9% en 1–2 klachten). Ziekenhuisopname vergroot de kans op een slechte ervaren gezondheid (oddsratio (OR) = 2,50; 95%-betrouwbaarheidsinterval (BI) 1,84–3,38) en meer beperking bij lichte (OR = 2,34; 95%-BI 1,77–3,10), matige (OR = 1,80; 95%-BI 1,37–2,35) en forse fysieke inspanning (OR = 2,57; 95%-BI 1,97–3,36), maar niet op een slechte mentale gezondheid (OR = 1,32; 95%-BI 0,94–1,86).
Conclusie
Personen die zijn opgenomen in het ziekenhuis vanwege een COVID-19-besmetting bezitten twaalf maanden na besmetting vaker en meer restklachten dan niet-opgenomen personen. Daarnaast heeft ziekenhuisopname invloed op de ervaren gezondheid en beperking van fysieke inspanning twaalf maanden na besmetting.
Introduction In view of the growing number of older people in our society and the related consequences for health and well-being, research focussing on healthy ageing is essential. Already, the ...associations between supportive social relationships and healthy ageing have been established. However, there is as yet no consensus about whether or not it is the structure of the social network, its function- ing or a combination that is most important for health, and in addition, about which aspects of structure and function are important. Aim The main objective of this thesis was to investigate aspects of the structure and functioning of social relationships and their influence on mental, physical and social health in older people. This was relevant to obtain scientific evidence for practice-based research to support local policy making on healthy ageing. Methods Different characteristics and functions of social relationships, such as frequency of contact, different sources of social network ties, satisfaction with relationships, positive and negative perceptions of social support and social engagement have been analysed in cross-sectional and prospective studies. Cross-sectional data are from six community health services in the eastern part of the Netherlands. The overall sample size constituted of 24,936 people aged 65 and over (response 79%). Prospective data are from the Doetinchem Cohort Study. The first examination round (1987-1991) comprised 12,448 men and women aged 20 to 59 years. The overall response rate was 62% for the baseline measurement and 79%, 75% and 78% for rounds 2, 3 and 4 respectively. Results Cross-sectional analyses showed that satisfaction with the social contacts was strongly related to physical (OR 2.36; 95% CI 2.11-2.64), mental (OR 4.65; 95% CI 4.20-5.15) and self-perceived health (OR 2.52; 95% CI 2.29-2.78). Longitudinal analyses underlined this finding by showing that unfavourable levels of social support were predictive for health-compromising behaviours and poor health over a 10-year period of follow-up, and for increased mortality risk over a 15- year period of follow-up (HR 1.57; 95% CI 1.03-2.39). Furthermore, neighbours were found to be an important source of the social network ties of older people in relation to physical (OR 1.87; 95% CI 1.68-2.07), mental (OR 1.53; 95% CI 1.39-1.69) and self-perceived health (OR 1.42; 95% CI 1.30-1.54). Further exploration of the relationship between social support and loneliness using structural equation modelling identified that social support in everyday situations may serve as a good start- ing point for health promotion activities to prevent loneliness. To better target health promotion activities for healthy ageing, analyses were performed to group older people into subgroups with similar social engagement activity patterns. Five clusters were identified: 1) less socially engaged elderly; 2) less socially engaged caregivers; 3) socially engaged caregivers; 4) leisure-engaged elderly; and 5) productive-engaged elderly. Older people who were not engaged in any social activity other than the care for a sick person, were identified as a possible target group, given the relatively high share of unhealthy people among them. In this non-socially engaged target group, the prevalence of loneliness was 48%, compared to 30% in the socially engaged groups; poor self-perceived health: 41% compared to 14%; poor mental health: 25% compared to 9%; poor physical health: 27% compared to 2%. Conclusion Well-functioning social relationships were favourably associated with health. By integrating all results, the local data have strengthened the scientific evidence-base for local policy making and have contributed to the development of an evidence-based community intervention supporting social participation among older people.
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