scholarly journals Factors associated with symptoms of anxiety and depression in five cohorts of community-based older people: the HALCyon (Healthy Ageing across the Life Course) Programme

2011 ◽  
Vol 41 (10) ◽  
pp. 2057-2073 ◽  
Author(s):  
C. R. Gale ◽  
A. Aihie Sayer ◽  
C. Cooper ◽  
E. M. Dennison ◽  
J. M. Starr ◽  
...  
Keyword(s):  
Older People ◽  
Life Course ◽  
Physical Function ◽  
Birth Cohort ◽  
Depression Scale ◽  
Later Life ◽  
Healthy Ageing ◽  
Anxiety And Depression ◽  
Increased Risk ◽  
The Life Course

BackgroundSymptoms of anxiety and depression are common in older people, but the relative importance of factors operating in early and later life in influencing risk is unclear, particularly in the case of anxiety.MethodWe used data from five cohorts in the Healthy Ageing across the Life Course (HALCyon) collaborative research programme: the Aberdeen Birth Cohort 1936, the Caerphilly Prospective Study, the Hertfordshire Ageing Study, the Hertfordshire Cohort Study and the Lothian Birth Cohort 1921. We used logistic regression to examine the relationship between factors from early and later life and risk of anxiety or depression, defined as scores of 8 or more on the subscales of the Hospital Anxiety and Depression Scale, and meta-analysis to obtain an overall estimate of the effect of each.ResultsGreater neuroticism, poorer cognitive or physical function, greater disability and taking more medications were associated in cross-sectional analyses with an increased overall likelihood of anxiety or depression. Associations between lower social class, either in childhood or currently, history of heart disease, stroke or diabetes and increased risk of anxiety or depression were attenuated and no longer statistically significant after adjustment for potential confounding or mediating variables. There was no association between birth weight and anxiety or depression in later life.ConclusionsAnxiety and depression in later life are both strongly linked to personality, cognitive and physical function, disability and state of health, measured concurrently. Possible mechanisms that might underlie these associations are discussed.

scholarly journals Frailty, depression, and anxiety in later life

2012 ◽  
Vol 24 (8) ◽  
pp. 1265-1274 ◽  
Author(s):  
Aine M. Ní Mhaoláin ◽  
Chie Wei Fan ◽  
Roman Romero-Ortuno ◽  
Lisa Cogan ◽  
Clodagh Cunningham ◽  
...  
Keyword(s):  
At Risk ◽  
Older People ◽  
Depression Scale ◽  
Later Life ◽  
Anxiety Symptoms ◽  
Community Dwelling ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Increased Risk ◽  
Clinically Significant

ABSTRACTBackground: Anxiety and depression are common in older people but are often missed; to improve detection we must focus on those elderly people at risk. Frailty is a geriatric syndrome inferring increased risk of poor outcomes. Our objective was to explore the relationship between frailty and clinically significant anxiety and depression in later life.Methods: This study had a cross-sectional design and involved the assessment of 567 community-dwelling people aged ≥60 years recruited from the Technology Research for Independent Living (TRIL) Clinic, Dublin. Frailty was measured using the Fried biological syndrome model; depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale; and anxiety symptoms measured using the Hospital Anxiety and Depression Scale.Results: Higher depression and anxiety scores were identified in both pre-frail and frail groups compared to robust elders (three-way factorial ANOVA, p ≤0.0001). In a logistic regression model the odds ratio for frailty showed a significantly higher likelihood of clinically meaningful depressive and anxiety symptoms even controlling for age, gender and a history of depression or anxiety requiring pharmacotherapy (OR = 4.3; 95% CI 1.5, 11.9; p = 0.005; OR = 4.36; 95% CI 1.4, 13.8; p = 0.013 respectively).Conclusions: Our findings suggest that even at the earliest stage of pre-frailty, there is an association with increased symptoms of emotional distress; once frailty develops there is a higher likelihood of clinically significant depression and anxiety. Frailty may be relevant in identifying older people at risk of deteriorating mental health.

scholarly journals Adverse events over the life course and later-life wellbeing and depressive symptoms in older people

2020 ◽  
pp. 1-15
Author(s):  
Sol Richardson ◽  
Ewan Carr ◽  
Gopalakrishnan Netuveli ◽  
Amanda Sacker
Keyword(s):  
Life Satisfaction ◽  
Adverse Events ◽  
Older People ◽  
Life Course ◽  
Psychological Health ◽  
Depression Scale ◽  
Later Life ◽  
Epidemiological Studies ◽  
Random Effects Models ◽  
The Life Course

ABSTRACT Objectives: Exposures to adverse events are associated with impaired later-life psychological health. While these associations depend on the type of event, the manner in which associations for different event types depend on when they occur within the life course has received less attention. We investigated associations between counts of adverse events over the life course, and wellbeing and mental health outcomes in older people, according to their timing (age of occurrence), orientation (self or other) and, both their timing and orientation. Design: Linear and logistic random-effects models for repeated observations. Setting: England, 2002–2015. Participants: A total of 4,208 respondents aged >50 years with 22,146 observations across Waves 1–7 of the English Longitudinal Study of Ageing. Measurements: Cumulative adversity was measured by counts of 16 types of events occurring within four age ranges over the life course using retrospective life history data. These were categorized into other- (experienced through harms to others) and self-oriented events. Outcomes included CASP-12 (control, autonomy, self-realization, and pleasure), the eight-item Centre of Epidemiological Studies Depression Scale, and self-appraised subjective life satisfaction. Results: Additional adverse events were associated with lower CASP-12 and life satisfaction scores, and higher odds of probable depressive caseness. In childhood, other-oriented events had a larger negative association with later-life wellbeing than self-oriented events; the converse was found for events occurring in adulthood. Conclusions: Events occurring at all life course stages were independently associated with both later-life wellbeing and depression in a cumulative fashion. Certain age ranges may represent sensitive periods for specific event types.

Associations between life-course frailty and later-life heart size and function in the 1946 NSHD British birth cohort-an epidemiological study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C.C Topriceanu ◽  
J.C Moon ◽  
R Hardy ◽  
A.D Hughes ◽  
N Chaturvedi ◽  
...  
Keyword(s):  
Life Course ◽  
Birth Cohort ◽  
Frailty Index ◽  
Later Life ◽  
Left Ventricular ◽  
Step Change ◽  
Deficit Accumulation ◽  
Heart Size ◽  
And Function ◽  
The Life Course

Abstract Background Cardiovascular diseases are an important component of the multi-morbidity syndrome which is associated with negative health outcomes resulting in a major societal economic burden. An objective way to assess multi-morbidity is to calculate a frailty index based on medical deficit accumulation. Late-life frailty has been validated to predict mortality, but little is known about the association between life-course frailty and cardiovascular health in later-life. Purpose To study the association between life-course frailty and later-life heart size and function using data from the world's longest running birth cohort with continuous follow-up. Methods A 45-deficit frailty index (FI) was calculated at 4 age-intervals across the life-course (0 to 16 years old, 19 to 44 years old, 45 to 54 years old and 60 to 64 years old) in participants from the UK 1946 Medical Research Council (MRC) National Survey of Heath and Development (NSHD) birth cohort. The life-course frailty indices (FI0_16, FI19_44, FI45_54 and FI60_64) reflect the cumulative medical deficits at the corresponding age-intervals. They were used to derive FImean and FIsum reflecting overall-life frailty. The step change in deficit accumulation between age-intervals was also calculated (FI2-1, FI3-1, FI4-1, FI3-2, FI4-2, FI4-3). Echocardiographic data at 60–64 years provided: E/e' ratio, ejection fraction (EF), myocardial contraction fraction index (MCFi) and left ventricular mass index (LVmassi). Generalized linear mixed models with gamma distribution and log link assessed the association between FIs and echo parameters after adjustment for sex, socio-economic position and body mass index. Results 1.805 NSHD participants were included (834 male). Accumulation of a single deficit had a significant impact (p<0.0001 to p<0.049) on LVmassi and MCFi in all the life-course FIs and overall FIs. LVmassi increased by 0.89% to 1.42% for the life-course FIs and by 0.36%/1.82% for FIsum and FImean respectively. MCFi decreased by 0.62% to 1.02% for the life-course FIs and by 0.33%/ 1.04%. for FIsum and FImean respectively. One accumulated deficit translated into higher multiplicative odds (13.2 for FI60-64, 2.1 for FI4-1, 75.4 for FI4-2 and 78.5 for FI4-3) of elevated filling pressure (defined as E/e' ratio >13, p<0.0.005 to p<0.02).A unit increase in frailty decreased LV EF (%) by 11%/12% for FI45-54 and FI60-64 respectively, by 10% to 12% for FI2-1, FI3-1, FI4-1 and FI4-2, and 4%/15% for FIsum and FImean respectively (p<0.0014 to p<0.044). Conclusion Frailty during the life-course, overall life-frailty and the step change in deficit accumulation is associated with later-life cardiac dysfunction. Frailty strain appears to have its greatest impact on pathological myocardial hypertrophy (high LVmassi and low MCFi) potentially paving the way to later-life systolic or diastolic dysfunction in susceptible individuals. Funding Acknowledgement Type of funding source: None

Sex in an ideology of love

2017 ◽  
Author(s):  
Torbjörn Bildtgård ◽  
Peter Öberg
Keyword(s):  
Older People ◽  
Life Course ◽  
Case Studies ◽  
Intimate Relationships ◽  
Later Life ◽  
Sexual Intimacy ◽  
Sexual Norms ◽  
Gerontological Research ◽  
The Life Course ◽  
Loving Relationship

Until recently the sex life of older people was more or less invisible in family and gerontological research. This chapter contributes to breaking this silence by focusing on the role and meaning of sex in intimate relationships in later life. Based on biographical case studies, the chapter investigates how sexual norms have changed over the life course of contemporary cohorts of older people and how they have experienced this change. The chapter considers sexual intimacy as part of new intimate relationships established late in life and questions the persistent assumption that older people who date are primarily looking for companionate relationships. It is shown that older people’s ideas about sex are deeply embedded in an ideology of love, where sex tends to be viewed as a natural part of a loving relationship, while sex outside of a loving relationship – also in a loveless marriage – is frowned on.

scholarly journals Life-course burden of health deficits associates with later-life heart size and function in the 1946 British birth cohort

2020 ◽  
Author(s):  
Constantin-Cristian Topriceanu ◽  
James C Moon ◽  
Rebecca Hardy ◽  
Nishi Chaturvedi ◽  
Alun Hughes ◽  
...  
Keyword(s):  
Life Course ◽  
Birth Cohort ◽  
Later Life ◽  
Myocardial Contraction ◽  
Left Ventricular ◽  
Heart Size ◽  
Time Periods ◽  
And Function ◽  
The Life Course ◽  
Myocardial Contraction Fraction

Aim: To study the association between the life course accumulation of health deficits and later life heart size and function using data from the 1946 National Survey of Heath and Development (NSHD) British birth cohort, the longest running birth cohort with continuous follow up in the world. Methods and Results: A multidimensional health deficit index (DI) looking at 45 health deficits was serially calculated at 4 time periods of the life course in NSHD participants (0 to 16, 19 to 44, 45 to 54 and 60 to 64 years), and from these the mean and total DI for the life course was derived (DImean, DIsum). The step change in deficit accumulation from one time period to another was also calculated. Echocardiographic data at 60-64 years provided: ejection fraction (EF), left ventricular mass indexed to body surface area (LVmassi, BSA), myocardial contraction fraction indexed to BSA (MCFi) and E/e. Generalized linear models assessed the association between DIs and echocardiographic parameters after adjustment for sex, socioeconomic position and body mass index. 1,375 NSHD participants were included (46.47% male). For each single new deficit accumulated at any one of the 4 time periods of the life course, LVmassi increased by 0.91 to 1.44% (p<0.013), while MCFi decreased by 0.6 to 1.02% (p<0.05 except at 45 to 54 years). One unit increase in DI at age 45 to 54 and 60 to 64 decreased LV EF by 11 to 12% (p<0.013). A single deficit step change occurring between 60-64 years and one of the earlier time periods, translated into significantly higher odds (2.1 to 78.5, p<0.020) of elevated LV filling pressure defined as E/e>13. Conclusion: The accumulation of health deficits at any time period of the life course associates with a maladaptive cardiac phenotype in older age, dominated by myocardial hypertrophy and poorer function. The burden of health deficits appears to strain the myocardium potentially leading to future cardiac dysfunction. Keywords: frailty; cardiovascular disease; ejection fraction; left ventricular mass index; myocardial contraction fraction; E/e.

scholarly journals Socio-economic position at four time points across the life course and all-cause mortality: updated results from the Uppsala Birth Cohort Multigenerational Study

2020 ◽  
Vol 11 (1) ◽  
pp. 27-54
Author(s):  
Amy Heshmati ◽  
Gita D Mishra ◽  
Anna Goodman ◽  
Ilona Koupil
Keyword(s):  
Life Course ◽  
Birth Cohort ◽  
Later Life ◽  
University Hospital ◽  
Sensitive Period ◽  
Saturated Model ◽  
All Cause Mortality ◽  
Economic Position ◽  
The Life Course ◽  
Multigenerational Study

Socio-economic position (SEP) is associated with all-cause mortality across all stages of the life course; however, it is valuable to distinguish at what time periods SEP has the most influence on mortality. Our aim was to investigate whether the effect of SEP on all-cause mortality accumulates over the life course or if some periods of the life course are more important. Our study population were from the Uppsala Birth Cohort Multigenerational Study, born 1915–29 at Uppsala University Hospital, Sweden. We followed 3,951 men and 3,601 women who had SEP at birth available, during childhood (at age ten), in adulthood (ages 30–45) and in later life (ages 50–65) from 15 September 1980 until emigration, death or until 31 December 2010. We compared a set of nested Cox proportional regression models, each corresponding to a specific life course model (critical, sensitive and accumulation models), to a fully saturated model, to ascertain which model best describes the relationship between SEP and mortality. Analyses were stratified by gender. For both men and women the effect of SEP across the life course on all-cause mortality is best described by the sensitive period model, whereby being advantaged in later life (ages 50–65 years) provides the largest protective effect. However, the linear accumulation model also provided a good fit of the data for women suggesting that improvements in SEP at any stage of the life course corresponds to a decrease in all-cause mortality.

scholarly journals Transitions, generations andinformal learning in later life

2012 ◽  
Vol 18 (4) ◽  
pp. 29
Author(s):  
John Field
Keyword(s):  
Older Adults ◽  
Older People ◽  
Life Course ◽  
Demographic Change ◽  
Life Histories ◽  
Later Life ◽  
Identity Change ◽  
Social Scientists ◽  
Life Chances ◽  
The Life Course

The nature of transitions across the lifecourse is changing, as are the ways in which these transitions are understoodand investigated by social scientists. Much earlier debate on older adults’ transitions has tended to be rooted in acco-unts of relatively fixed social roles and age-based social stages. However, while we can detect some tendencies towardsdestandardization and restandardization of the lifecourse in later life, we can also see significant continuities in theinfluences of socio-economic position, gender, and ethnicity, as well as of generational position, that continue to affectpeople’s life chances, as well as the expectations and experiences of transition of older people. The paper examines theinterplay of these complex and contradictory structural positions and cultural locations on transitions, and considersthe ways in which older people use and understand learning, formally and informally, as a way of exercising agencyand recreating meaning. It will draw on recent research into the life histories of adults in Scotland, a relatively smallcountry with a typically European pattern of demographic change. The study was concerned with agency, identity,change and learning across the life course, and this paper will concentrate on the evidence relating to experiences oftransition in later life. It will particularly focus on the idea of ‘educational generations’ as a key concept that helps usunderstand how adults use and interpret learning in later life.

scholarly journals PRECARITY AND LATER LIFE: UNDERSTANDING NEW INEQUALITIES AND RISKS IN LATER LIFE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S588-S588
Author(s):  
Dale Dannefer ◽  
Christopher Phillipson ◽  
Dale Dannefer
Keyword(s):  
Older People ◽  
Life Course ◽  
Social Dynamics ◽  
Later Life ◽  
Academic Disciplines ◽  
Potential Contribution ◽  
Term Care ◽  
Economic Changes ◽  
Individual Level ◽  
The Life Course

Abstract This symposium addresses debates around the theme of precarity and its implications for understanding social and economic changes affecting the lives of older people. To date, the concept of precarity has been applied to several subpopulations by various academic disciplines but has yet to be systematically applied to later life. The symposium will give particular attention to the extent to which the lens provided by precarity can illuminate different types of inequalities experienced through the life course and reflected in public policies directed at older people. Chris Phillipson reviews theoretical perspectives relating to precarity, examining their potential contribution for the development of critical gerontology. His paper also considers the extent to which the concept of ‘precarious ageing’ offers a competing or complementary view to theories of ‘active’ and ‘successful ageing’. Larry Polivka examines the growing precarity of life for older Americans emanating from austerity budgets and privatization of public services. The paper suggests that policies such as health care and long term care are in jeopardy, creating a glide path toward the extension of precarious employment into a precarious retirement for millions of older people. Wenxuan Huang examines how the focus on agency and other individual-level foci obscure understanding of social dynamics. Finally, Amanda Grenier draws on a scoping review of precarity to outline conceptual distinctions between frailty, vulnerability, and precarity. She presents reflections on what these concepts offer in terms of understandings of late life the study of disadvantage across the life course.

Le dinamiche del reddito nella terza etŕ

2009 ◽  
pp. 139-156
Author(s):  
katherine Hill
Keyword(s):  
Steady State ◽  
Longitudinal Study ◽  
Older People ◽  
Life Course ◽  
Low Income ◽  
Later Life ◽  
Personal Resources ◽  
Financial Situation ◽  
The Life Course ◽  
Insight Into

- Later life can be seen as period of income stability compared to other stages of the life course, and a key issue for older people in low income households is that they have limited means of pro-actively improving their financial situation. This article draws on a qualitative longitudinal study which explored how older people experienced changes in their financial circumstances across a two year period. The findings demonstrate that even where people did not feel that their financial circumstances had changed overall, this did not necessarily indicate a steady state. The study explored the interrelationship between changes in income and outgoings, as well as changing needs, and this article provides an insight into how social and personal resources are drawn on to help manage financial change and maintain stability. In doing so, it illustrates the extent of work that can be involved in maintaining a steady state in constrained circumstances.

Transitions in kitchen living: past experiences and present use

2018 ◽  
Author(s):  
Sheila Peace ◽  
Martin Maguire ◽  
Colette Nicolle ◽  
Russ Marshall ◽  
John Percival ◽  
...  
Keyword(s):  
Older People ◽  
Life Course ◽  
Home Environment ◽  
Generational Differences ◽  
Personal Autonomy ◽  
Later Life ◽  
Past Experiences ◽  
The Life Course

This chapter discusses the domestic kitchen in the lives of older people whose ages range across four decades and who were born between 1919 and 1948. They were living in various types of housing from detached to terraced; from maisonette to flat; from mainstream to supportive. By looking at past experiences of the kitchen across the life course gendered and generational differences are seen that contribute to kitchen living in the 21st century. Examining use of the most recent kitchen shows how biopsychosocial factors come together with design and on-going adaptation being both enabling and disabling. The kitchen is seen as a mainstay of the home environment and in later life central to maintaining personal autonomy

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