Longitudinal Association Between Education and Disability in Older Adults Living in Iceland

Abstract BACKGROUND: Disabilities among older adults are associated with cumulative adversities such as low socioeconomic status (SES), poor nutrition, and lack of access to medical care and education. However, there is little evidence on the long-term association between education and disability status among older adults in Iceland. The aim of the study was to examine the association between mid-life education and prevalence of disability in activities of daily living (ADL) and mobility disability in late-life using 25 years of longitudinal data. METHODS: A large community-based population residing in Reykjavik, Iceland participated in a longitudinal study with an average of 25 years of follow-up (N=5764, mean age 77±6 yrs, 57.7% of women) Mid-life education was categorized into 2 groups (primary and secondary versus college and university). Disability status in late life was defined with ADL and mobility disability with a binary outcome (no difficulty versus any difficulty). Logistic regression analysis was used to examine the association. RESULTS: After controlling for age and gender, and midlife health risk factors, those who had high education at mid-life were less likely to have ADL disability (Odds Ratio (OR) = 0.75, 95% Confidence Interval (CI): 0.64 ~ 0.88, P ≤ 0.001) and mobility disability (OR = 0.72, 95% CI: 0.61 ~ 0.86, P < 0.001) compared with those who had low education in mid-life. CONCLUSION: People with high mid-life education were less likely to have ADL and mobility disability after 25 years later.

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The Association Between Midlife Education and Depressive Symptoms in Late Life: The AGES-Reykjavik Study

Innovation in Aging ◽

10.1093/geroni/igab046.1098 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 284-284

Author(s):

Milan Chang ◽

Chiharu Nishizuka ◽

Hrafnhildur Eymundsdottir ◽

Sigurveig Sigurdardottir ◽

Alfons Ramel ◽

...

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Depressive Symptomatology ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Late Life ◽

Later Life ◽

College And University ◽

Longitudinal Association ◽

Life Education

Abstract Background Disability and depression are associated with cumulative health adversities such as socioeconomic status (SES), nutrition, medical care, and education among older adults. However, there is little evidence on the longitudinal association between mid-life education level with a disability and depressive symptoms in older adults in Iceland. The aim of the study was to examine the association between mid-life education and prevalence of activity of daily living (ADL) dependency and high depressive symptoms in late-life. Methods A large community-based population residing in Reykjavik, Iceland (n=4991, 57.3% women, 76.9±5.8 yrs) participated in a longitudinal study with an average of 25 years of follow-up. Mid-life education was categorized into 4 groups (primary, secondary, college, and university). ADL dependency and high depressive symptoms were assessed on average 25 (±4) years later. The 5-item ADL dependency score ranged between 0 (no difficulty) and 18. Depressive symptoms were assessed by the 15-item Geriatric Depression Scale (GDS). Results After controlling for demographic and health-related risk factors, those with higher education at mid-life were significantly less likely to have high depressive symptomatology (6 or higher GDS scores, Odds Ratio (OR) = 0.65, 95% Confidence Interval (CI): 0.52 ~ 0.82, P < 0.0001). However, mid-life education was not associated with ADL dependency in later life. Conclusion Our study shows that mid-life education is associated with depressive symptoms 25 years later, while no association found with ADL dependency among Icelandic older adults.

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Longitudinal Implications of Social Integration for Age and Gender Differences in Late-Life Physical Functioning

The International Journal of Aging and Human Development ◽

10.1177/0091415020980755 ◽

2020 ◽

pp. 009141502098075

Author(s):

Masahiro Toyama ◽

Heather R. Fuller ◽

Jonix Owino

Keyword(s):

Older Adults ◽

Gender Differences ◽

Social Integration ◽

Physical Functioning ◽

Longitudinal Research ◽

Hierarchical Linear Model ◽

Late Life ◽

Age And Gender ◽

Age And Gender Differences ◽

And Gender

Social integration has documented benefits for late-life health; yet, little is known about its impacts on trajectories of physical functioning. This study examines age and gender differences in the longitudinal associations between social integration and activities of daily living (ADLs) using a hierarchical linear model with three waves of survey data collected over 4 years from the Social Integration and Aging Study ( N = 400; baseline mean age = 80.3). Findings indicated some interaction effects of age, gender, and/or social integration on ADL trajectories. Among those of more advanced age, women showed greater increases in ADL limitations than men, and individuals with lower social integration experienced greater increases in ADL limitations than those with higher social integration. Neither of these patterns were found among younger older adults. This study highlights the benefits of longitudinal research on social integration and the need to explore practical interventions for promoting social integration particularly among the oldest older adults.

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Associations of Hearing Loss and Depressive Symptoms With Incident Disability in Older Adults: Health, Aging, and Body Composition Study

The Journals of Gerontology Series A ◽

10.1093/gerona/gly251 ◽

2018 ◽

Vol 75 (3) ◽

pp. 531-536 ◽

Cited By ~ 7

Author(s):

Nicole M Armstrong ◽

Jennifer A Deal ◽

Joshua Betz ◽

Stephen Kritchevsky ◽

Sheila Pratt ◽

...

Keyword(s):

Older Adults ◽

Hearing Loss ◽

Body Composition ◽

Depressive Symptoms ◽

Mobility Disability ◽

Body Composition Study ◽

Increased Risk ◽

Health Aging ◽

Composition Study ◽

Adl Disability

Abstract Background Depressive symptoms and hearing loss (HL) are independently associated with increased risk of incident disability; whether the increased risk is additive is unclear. Methods Cox Proportional Hazards models were used to assess joint associations of HL (normal, mild, moderate/severe) and late-life depressive symptoms (defined by a score of ≥8 on the 10-item Center for Epidemiologic Studies-Depression scale) with onset of mobility disability (a lot of difficulty or inability to walk ¼ mile and/or climb 10 steps) and any disability in activities of daily living (ADL), among 2,196 participants of the Health, Aging and Body Composition Study, a cohort of well-functioning older adults aged 70–79 years. Models were adjusted for age, race, sex, education, diabetes, hypertension, and body mass index. Results Relative to participants with normal hearing and without depressive symptoms, participants without depressive symptoms who had mild or moderate/severe HL had increased risk of incident mobility and ADL disability (hazard ratio [HR] for mobility disability, mild HL:1.34, 95% confidence interval [CI]: 1.09, 1.64 and HR for mobility disability, moderate/severe HL: 1.37, 95% CI: 1.08, 1.75 and HR for ADL disability, mild HL: 1.32, 95% CI: 1.08, 1.63, and HR for ADL disability, moderate/severe HL: 1.42, 95% CI: 1.11, 1.82). Among participants with depressive symptoms, mild HL (HR: 1.71, 95% CI: 1.09, 2.70) was associated with increased risk of incident mobility disability. Conclusions Independent of depressive symptoms, risk of incident disability was greater in older adults with HL, regardless of severity. Further research into HL interventions may delay disability onset.

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IMPACT OF SOCIAL SUPPORT AND STRAIN ON DEPRESSIVE SYMPTOMS: MARITAL STATUS AND GENDER DIFFERENCES

Innovation in Aging ◽

10.1093/geroni/igz038.3350 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S919-S919

Author(s):

Deborah Carr ◽

Yeonjung Jane Lee

Keyword(s):

Social Support ◽

Older Adults ◽

Depressive Symptoms ◽

Marital Status ◽

Late Life ◽

Well Being ◽

Negatively Associated ◽

Fine Grained ◽

And Gender ◽

The Impact

Abstract Social relationships are a well-established correlate of late-life well-being. Extensive research finds social support is associated with fewer depressive symptoms, yet few studies distinguish fine-grained types of support from spouse, children, other family and friends, nor whether these linkages differ by gender and marital status. Studies exploring coarse associations between support and well-being may conceal gender and marital status differences. We use data from two waves of the Health and Retirement Study (HRS; 2006 and 2010) to study fine-grained linkages between diverse types of relationship strain and support and depressive symptoms (CESD) among adults aged 51+. The results show that the association between support/strain and depressive symptoms varies based on the source of support. For instance, among married/partnered older adults, spousal support is negatively associated with depressive symptoms whereas friend strain is positively associated with depressive symptoms. Among widowed respondents, friend support is negatively associated with depressive symptoms. These marital status patterns differed by gender however, such that the impact of friend strain on depressive symptoms was especially large for divorced men. Our results suggest that no single form of social support (or strain) is uniformly protective (or distressing), so services and interventions to enhance late-life mental health should more fully consider older adults’ social location, including gender and marital status. For current cohorts of older adults, who have lower rates of marriage and childbearing than their predecessors, it is critically important to understand both the levels and impacts of alternative sources of support from other kin and friends.

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What are sociodemographic and gender determinants of non-fatal self-harm in older adults users and non-users of antidepressants? A national population-based study

10.21203/rs.2.20076/v1 ◽

2020 ◽

Author(s):

Khedidja Hedna ◽

Johan Fastbom ◽

Ingmar Skoog ◽

Gunnel Hensing ◽

Margda Waern

Keyword(s):

Higher Education ◽

Older Adults ◽

Late Life ◽

Nordic Countries ◽

Antidepressant Therapy ◽

Factors Associated ◽

Total Cohort ◽

Increased Risk ◽

Self Harm ◽

And Gender

Abstract Background Late-life self-harm (SH) is often linked to depression. However, very few studies have explored the role of other factors and their interaction with depression in the occurrence of late-life SH. The objective of this research was to examine sociodemographic and gender factors associated with non-fatal SH, in older adults with and without antidepressant therapy. Methods We used national longitudinal register data from a total cohort of all Swedish residents aged ≥75 years between 2006-2014 (N=1,413,806). Using personal identity numbers, we linked individuals' data from numerous national registers. We identified all those with at least one episode of non-fatal self-harm (regardless of level of intent to die) and matched 50 controls to each case. A nested case–control design was used to investigate the sociodemographic factors associated with non-fatal SH in the total cohort and among antidepressant users and non-users. Risk factors were analysed in adjusted conditional logistic regression models for the entire cohort and by gender. Results In all, 2242 individuals had at least one episode of a non-fatal SH (980 men and 1262 women). In the total cohort, being married was a protective factor for non-fatal SH in men but not in women. A higher non-fatal SH risk was found in antidepressant users from outside Nordic countries (IRR: 1.44; 95% CI: 1.11-1.86), and in non-users of antidepressants from other Nordic countries (IRR: 1.58; 95% CI: 1.08-2.29). Antidepressant users with higher education had an increased risk of non-fatal SH (IRR: 1.34; 95% CI: 1.12-1.61), in both men and women. Conclusions Being married did not mitigate risk of self-harm in older women. Foreign country of birth and higher education were associated with increased risk of non-fatal SH. Healthcare professionals and social workers must be informed about high-risk groups for suicidal behaviour, and ensure they are adequately monitored both in term of antidepressant therapy and access to psychosocial support.

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What are sociodemographic and gender determinants of non-fatal self-harm in older adults users and non-users of antidepressants? A national population-based study

10.21203/rs.2.20076/v2 ◽

2020 ◽

Author(s):

Khedidja Hedna ◽

Johan Fastbom ◽

Ingmar Skoog ◽

Gunnel Hensing ◽

Margda Waern

Keyword(s):

Higher Education ◽

Older Adults ◽

Late Life ◽

Nordic Countries ◽

Antidepressant Therapy ◽

Factors Associated ◽

Total Cohort ◽

Increased Risk ◽

Self Harm ◽

And Gender

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Dietary Patterns and Self-reported Incident Disability in Older Adults

The Journals of Gerontology Series A ◽

10.1093/gerona/gly211 ◽

2018 ◽

Vol 74 (8) ◽

pp. 1331-1337 ◽

Cited By ~ 4

Author(s):

Puja Agarwal ◽

Yamin Wang ◽

Aron S Buchman ◽

David A Bennett ◽

Martha C Morris

Keyword(s):

Older Adults ◽

Sex Education ◽

Functional Disability ◽

Cox Proportional Hazards ◽

Hazard Ratio ◽

Mobility Disability ◽

The Mediterranean ◽

Adl Disability ◽

The Mind ◽

Mind Diet

Abstract Background or Objectives Disability in older adults is associated with low quality of life and higher mortality. Diet may be a potentially important public health strategy for disability prevention in aging. We examined the relations of the Mediterranean, Dietary Approaches to Stop Hypertension (DASH), and Mediterranean–DASH Intervention for Neurodegenerative Delay (MIND) diets to functional disability in the Rush Memory and Aging Project. Methods A total of 809 participants (mean age = 80.7 ± 7.2 years, 74% female) without functional disability at baseline were followed for an average of 5.3 years. Standardized measures for self-reported disability including, activities of daily living ADL), instrumental ADL, and mobility disability were assessed annually. The diet scores were computed based on a validated food frequency questionnaire administered at baseline. Results In Cox proportional hazards models adjusted for age, sex, education, smoking, physical activity, and total calories, the second (hazard ratio = 0.75, 95% CI: 0.60–0.95) and third tertiles (hazard ratio = 0.67, 95% CI: 0.53–0.86) of MIND diet scores had lower rates of ADL disability compared to the lowest tertile (p for trend = .001), whereas only the third tertiles of the Mediterranean (hazard ratio = 0.73, 95% CI: 0.57–0.94) and DASH (hazard ratio = 0.75, 95% CI: 0.59–0.95) diets were significantly associated with ADL disability. Instrumental ADL disability was inversely and linearly associated with the MIND diet score only (p for trend = .04). Mobility disability was associated with the MIND (p for trend = .02), Mediterranean (p for trend = .05) and DASH (p for trend = .02) diet scores. Conclusion These findings are encouraging that diet may be an effective strategy for the prevention of functional disability in older adults.

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MOBILITY AND PHYSICAL ACTIVITY IN OLDER ADULTS: OBSERVATIONAL AND INTERVENTION RESEARCH

Innovation in Aging ◽

10.1093/geroni/igz038.1605 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S429-S430

Author(s):

Patricia M Bamonti ◽

Jonathan Bean

Keyword(s):

Physical Activity ◽

Older Adults ◽

Social Engagement ◽

Late Life ◽

Intervention Research ◽

Future Research ◽

Physical And Mental Health ◽

National Guidelines ◽

Mobility Disability ◽

The Impact

Abstract Mobility disability is associated with considerable morbidity and mortality in late life. Physical activity [PA] is a modifiable behavior that can reduce mobility disability, as well as improve physical and mental health outcomes in older adults. However, only a minority of older adults meet the minimum PA requirements based on national guidelines. Research examining factors impacting PA and mobility in late life, as well as novel interventions to increase PA and improve mobility is essential to enhancing health and wellbeing. This symposium will provide an overview of observational and intervention research focused on understanding factors associated with PA and mobility, as well as intervention research designed to increase PA and improve mobility in older adults. First, Dr. Lien Quach will present research examining the impact of social engagement in reducing the risk of mobility decline among older adults with mild cognitive impairment. Second, Dr. Patricia Bamonti will examine psychological factors related to uptake and adherence of pulmonary rehabilitation in older Veterans. Third, Dr. Stephanie Robinson will explore engagement, feasibility, acceptability, and change in PA following a web-based intervention in middle-aged and older adult patients with COPD. Fourth, Dr. Elisa Ogawa will present research examining the feasibility and acceptability of an exergaming intervention compared to an exercise control condition among older adults at risk for falls. The symposium will conclude with discussion led by Jonathan Bean, MD, MPH, who will highlight implications of findings across studies and identify areas for future research.

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Lifecourse socioeconomic changes and late-life cognition in a cohort of U.S.-born and U.S. immigrants: findings from the KHANDLE study

BMC Public Health ◽

10.1186/s12889-021-10976-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Rachel L. Peterson ◽

Kristen M. George ◽

Paola Gilsanz ◽

Elizabeth Rose Mayeda ◽

M. Maria Glymour ◽

...

Keyword(s):

Older Adults ◽

Episodic Memory ◽

Cultural Capital ◽

Semantic Memory ◽

Low Socioeconomic Status ◽

Late Life ◽

Financial Capital ◽

Socioeconomic Changes ◽

The U.S ◽

Verbal Episodic Memory

Abstract Background Low socioeconomic status (SES) in early and late life has been associated with lower late-life cognition. Less is known about how changes in SES from childhood to late life are associated with late-life cognition, especially among diverse populations of older adults. Methods In a multi-ethnic sample (n = 1353) of older adults, we used linear regression to test associations of change in comprehensive measures of SES (financial, cultural, and social domains) from childhood to late life with semantic memory, episodic memory, and executive function. We tested whether the association between SES trajectory and late-life cognition differed by populations who resided in the U.S. during childhood or immigrated to the U.S. as adults. Results Participants with low childhood/high late-life financial capital had better semantic memory (β = 0.18; 95% CI: 0.04, 0.32) versus those with low financial capital in both childhood and late life, regardless of childhood residence. We observed a significant interaction in the association of verbal episodic memory and cultural capital by childhood residence (p = 0.08). Participants with a foreign childhood residence had higher verbal episodic memory if they had low childhood/high late-life cultural capital (β = 0.32; 95% CI: 0.01, 0.63), but lower verbal episodic memory if they had high childhood/low late-life cultural capital (β = − 0.40; 95% CI: − 0.94, 0.13). Having high lifecourse social capital was associated with better verbal episodic memory scores among those with a U.S. childhood (β = 0.34; 95% CI: 0.14, 0.55), but lower verbal episodic memory among those with a foreign childhood (β = − 0.10; 95% CI: − 0.51, 0.31). Conclusions High financial and cultural capital in late life is associated with better cognition, regardless of early childhood SES or childhood residence.

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What are the sociodemographic and gender determinants of non-fatal self-harm in older adult users and non-users of antidepressants? A national population-based study

10.21203/rs.2.20076/v3 ◽

2020 ◽

Author(s):

Khedidja Hedna ◽

Johan Fastbom ◽

Ingmar Skoog ◽

Gunnel Hensing ◽

Margda Waern

Keyword(s):

Older Adults ◽

Late Life ◽

Sociodemographic Factors ◽

Nordic Countries ◽

Men And Women ◽

Factors Associated ◽

Total Cohort ◽

Increased Risk ◽

Self Harm ◽

And Gender

Abstract Background Late-life self-harm (SH) is often linked to depression. However, very few studies have explored the role of other factors and their interaction with depression in the occurrence of late-life SH. The objective of this research was to examine sociodemographic and gender factors associated with non-fatal SH, in older adults with and without antidepressant therapy.Methods We used national longitudinal register data from a total cohort of all Swedish residents aged ≥75 years between 2006-2014 (N=1,413,806). Using personal identity numbers, we linked individuals' data from numerous national registers. We identified all those with at least one episode of non-fatal self-harm (regardless of level of intent to die) and matched 50 controls to each case. A nested case–control design was used to investigate sociodemographic factors associated with non-fatal SH in the total cohort and among antidepressant users and non-users. Risk factors were analysed in adjusted conditional logistic regression models for the entire cohort and by gender.Results In all, 2242 individuals had at least one episode of a non-fatal SH (980 men and 1262 women). Being unmarried was a risk factor for non-fatal SH in men but not in women. Among users of antidepressants, higher non-fatal SH risk was observed in those born outside the Nordic countries (IRR: 1.44; 95% CI: 1.11–1.86), whereas in AD non-users increased risk was seen in those from Nordic countries other than Sweden (IRR: 1.58; 95% CI: 1.08–2.29). Antidepressant users with higher education had an increased risk of non-fatal SH (IRR: 1.34; 95% CI: 1.12–1.61), in both men and women. Conclusions Foreign country of birth was associated with increased risk for non-fatal SH in older adults with and without AD therapies. Being married was a protective factor for non-fatal SH in men. The complex association between sociodemographic factors and use of antidepressants in the occurrence of self-harm in older men and women indicates the need for multifaceted tailored preventive strategies including healthcare and social services alike.

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