scholarly journals Trends Over Two Decades in Life Expectancy With Complex Health Problems Among Older Swedes: Implications for The Provision of Integrated Medical and Social Care

2021 ◽  
Author(s):  
Bettina Meinow ◽  
Peng Li ◽  
Domantas Jasilionis ◽  
Anna Oksuzyan ◽  
Louise Sundberg ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Social Care ◽  
Population Aging ◽  
Oldest Old ◽  
Panel Study ◽  
Health Problems ◽  
Health Expectancy ◽  
Swedish Population ◽  
Nationally Representative ◽  
Complex Health Problems

Abstract Background Due to population aging, it is essential to examine to what extent rises in life expectancy (LE) consist of healthy or unhealthy years. Most health expectancy studies have been based on single health measures and have shown divergent trends. We used a multi-domain indicator, complex health problems (CHP), indicative of the need for integrated medical and social care, to investigate how LE with and without CHP developed in Sweden between 1992 and 2011. We also addressed whether individuals with CHP more commonly lived in the community in 2011 compared to earlier years. Methods CHP were defined as having severe problems in at least two of three health domains related to the need for medical and/or social care: symptoms/diseases, cognition/communication, and mobility. The Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD), a nationally representative survey of the Swedish population aged ≥ 77 years with waves in 1992, 2002 and 2011 (n ≈ 2000), was used to estimate the prevalence of CHP. Age- and gender-specific death rates were obtained from the Human Mortality Database. The Sullivan method was deployed to calculate the remaining life expectancy with and without CHP. The estimates were decomposed to calculate the contribution of changes from morbidity and mortality to the overall trends in LE without CHP. Results Between 1992 and 2011, both total LE (+ 1.69 years [95% CI 1.56;1.83] and LE without CHP (+ 0.84 years [-0,87;2.55]) at age 77 increased for men, whereas LE at age 77 increased for women (+ 1.33 [1.21;1.47]) but not LE without CHP (-0.06 years [-1.39;1.26]). When decomposing the trend, we found that the increase in LE with CHP was mainly driven by an increase in the prevalence of CHP. Among individuals with CHP the proportion residing in residential care was lower in 2011 (37%) compared to 2002 (58%) and 1992 (53%).

Associations between and coexistence of disadvantages in the oldest old people in Sweden: Patterns of change between 1992 and 2011

2018 ◽  
Vol 28 (3) ◽  
pp. 197-210 ◽  
Author(s):  
Josephine Heap ◽  
Johan Fritzell ◽  
Carin Lennartsson
Keyword(s):  
Physical Health ◽  
Psychological Health ◽  
Oldest Old ◽  
Functional Limitations ◽  
Health Problems ◽  
Financial Resources ◽  
Old People ◽  
Political Resources ◽  
Physical Health Problems ◽  
Nationally Representative

This study explored changes in the associations between and coexistence of disadvantages in several dimensions of living conditions in the oldest old people in Sweden. We used nationally representative data from 1992 (n = 537), 2002 (n = 621) and 2011 (n = 931). Indicators of limited social resources, limited political resources, limited financial resources, psychological health problems, physical health problems and functional limitations were used. The probability of reporting coexisting disadvantages tended to increase and was particularly elevated in 2002. Physical health problems became more common, and functional limitations, limited financial resources and limited political resources became less common during the studied period. Associations between health-related disadvantages remained fairly stable, whereas associations including other kinds of disadvantages varied somewhat over the studied period. These changes suggest that in general, the composition of coexisting disadvantages is likely to have altered over time. Consequently, the challenges faced by disadvantaged groups in 2011 may have been different from those in 1992. Moreover, the healthcare and social care services directed to older people have undergone significant changes during the past decades. These changes to the system accentuate the vulnerability of people experiencing coexisting disadvantages.

Work Stressors in Late Midlife and Physical Functioning in Old Age

2016 ◽  
Vol 29 (5) ◽  
pp. 893-911 ◽  
Author(s):  
Charlotta Nilsen ◽  
Neda Agahi ◽  
Ingemar Kåreholt
Keyword(s):  
Old Age ◽  
Physical Functioning ◽  
Oldest Old ◽  
Panel Study ◽  
Work Stressors ◽  
Nationally Representative ◽  
Level Of Living ◽  
Demand Control ◽  
The Relationship ◽  
Late Midlife

Objective: The aim of this study was to explore the relationship between work stressors in late midlife and physical functioning in old age. Method: Two linked nationally representative Swedish surveys were used: the 1991 Level of Living Survey (age 57-65) and the 2011 Swedish Panel Study of Living Conditions of the Oldest Old. Work stressors were measured with the job demand–control model and physical functioning in old age with physical performance tests, lung function tests, and self-reported mobility. Ordered logistic and linear regressions were performed ( n = 166-214). Results: High demands, low control, and high strain (i.e., high demands combined with low control) were associated with limited physical functioning in women. Low control and passive jobs were associated with limited physical functioning in men. Discussion: Work stressors in late midlife are important predictors of physical functioning in older adults. However, women and men seem to be vulnerable to different work stressors.

scholarly journals Complex health problems in the oldest old in Sweden 1992–2002

2006 ◽  
Vol 3 (2) ◽  
pp. 98-106 ◽  
Author(s):  
Bettina Meinow ◽  
Marti G. Parker ◽  
Ingemar Kåreholt ◽  
Mats Thorslund
Keyword(s):  
Oldest Old ◽  
Health Problems ◽  
Complex Health Problems

Childhood living conditions, education and health among the oldest old in Sweden

2015 ◽  
Vol 36 (3) ◽  
pp. 631-648 ◽  
Author(s):  
HANNA BERNDT ◽  
STEFAN FORS
Keyword(s):  
Old Age ◽  
Oldest Old ◽  
Health Problems ◽  
Living Conditions ◽  
Education And Health ◽  
Childhood Conditions ◽  
Adverse Childhood ◽  
Low Education ◽  
Study Population ◽  
Nationally Representative

ABSTRACTThe objectives were to investigate the associations between social and financial living conditions in childhood, education and morbidity in old age. The study population (N = 591; 76+ years old) was assembled from two nationally representative Swedish surveys, in 1968 and 2011, that together made longitudinal analysis possible. Morbidity in old age comprised self-reported measures of musculoskeletal disorders, cardiovascular disease, self-rated health and impaired mobility. There were no independent associations between adverse childhood living conditions and morbidity. However, adverse childhood living conditions were associated with an increased likelihood of low education. Moreover, low education was associated with a higher probability of health problems in old age. The results did not show any associations between adverse childhood conditions and late-life morbidity. However, adverse childhood conditions were associated with lower levels of education which, in turn, was associated with health problems and attrition from the study. These results suggest that adverse childhood conditions may indeed be associated with health and survival in old age, but mainly through mechanisms acting earlier in the lifecourse.

scholarly journals Complex health problems among the oldest old in Sweden: increased prevalence rates between 1992 and 2002 and stable rates thereafter

2015 ◽  
Vol 12 (4) ◽  
pp. 285-297 ◽  
Author(s):  
Bettina Meinow ◽  
Ingemar Kåreholt ◽  
Mats Thorslund ◽  
Marti G. Parker
Keyword(s):  
Oldest Old ◽  
Health Problems ◽  
Prevalence Rates ◽  
Complex Health Problems

Demographic Dimensions of Global Aging

2000 ◽  
Vol 21 (5) ◽  
pp. 541-558 ◽  
Author(s):  
KEVIN KINSELLA
Keyword(s):  
Life Expectancy ◽  
Population Aging ◽  
Oldest Old ◽  
Later Life ◽  
Private Institutions ◽  
Public And Private ◽  
Health Trends ◽  
Institutional Responses ◽  
First Time ◽  
Global Aging

Population aging in the 20th century represents a human success story; for the first time in history, populations have the luxury of aging. Aging, however, also poses a myriad of challenges to public and private institutions that must adapt to a changing age structure. This article highlights national and regional similarities and differences in the global aging process, focusing on demographic and health trends that are likely to shape future institutional responses in the eldercare arena. Among the topics considered are the importance of past fertility patterns, changes in life expectancy and healthy life expectancy, the feminization of later life, the growth of the “oldest old,” and changing national disease profiles associated with the epidemiological transition.

scholarly journals Assessment of Appropriateness of Cardiovascular Preventive Medication in Adults ≥ 75 years

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 524-524
Author(s):  
Milly van der Ploeg ◽  
Rosalinde Poortvliet ◽  
Jacobijn Gussekloo ◽  
Yvonne Drewes
Keyword(s):  
Blood Pressure ◽  
Side Effects ◽  
Life Expectancy ◽  
Clinical Decision Making ◽  
Preventive Treatment ◽  
Health Problems ◽  
Negative Consequences ◽  
Clinical Scenarios ◽  
Preventive Medication ◽  
Complex Health Problems

Abstract Physicians are confronted with dilemma’s on cardiovascular preventive medication for older people with complex health problems. With accumulation of diseases, limitations and shortening life expectancy, questions arise for whom cardiovascular preventive treatment is still appropriate (the expected benefits of treatment exceeds the negative consequences by a sufficiently wide margin resulting that treatment is worth doing). There is a need for more guidance in clinical situations. With the RAND/UCLA appropriateness method (RUAM), we investigated the appropriateness of cardiovascular preventive medication in adults ≥ 75 years. The RUAM is a systematic, formalized method, to combine available scientific evidence with the collective judgment of experts. Fourteen interdisciplinary panelists (9 physicians representing 6 medical disciplines, 1 medical ethics expert, 1 pharmacist and 3 older adults [lay man]), discussed and rated the appropriateness of starting and stopping of three medication groups (cholesterol lowering, blood pressure lowering and thrombocyte aggregation inhibitors) for different clinical scenarios (combinations of cardiovascular history, systolic blood pressure, complexity of health problems, age, life-expectancy, side-effects). Depending on the medication group, different patterns of appropriateness judgments across the clinical scenarios were found. In general, absence of cardiovascular disease, presence of complex health problems, a short life-expectancy or hindering side-effects were important factors to judge cardiovascular preventive medication as inappropriate. Results were summarized into colored reading maps. These findings can offer more guidance in clinical decision making about cardiovascular preventive treatment for adults ≥ 75 years.

scholarly journals Lifetime Disadvantages after Childhood Adversity: Health Problems Limiting Work and Shorter Life

2018 ◽  
Vol 680 (1) ◽  
pp. 259-277 ◽  
Author(s):  
James N. Laditka ◽  
Sarah B. Laditka
Keyword(s):  
African American ◽  
Heart Disease ◽  
Life Expectancy ◽  
Work Disability ◽  
White Women ◽  
Panel Study ◽  
Childhood Adversity ◽  
Income Dynamics ◽  
Race Ethnicity ◽  
Nationally Representative

We examine how childhood adversity relates to work disability and life expectancy, using 1999 to 2015 data from the Panel Study of Income Dynamics. We estimate the probabilities of work disability and death, adjusting for age, sex, race/ethnicity, and education in a nationally representative sample of African American, Hispanic, and white women and men. We find that people in all these groups who experienced high-adversity childhoods (individuals with four or more of six adversity indicators) had significantly more work disability and shorter lives than those who experienced no adversity. These findings provide evidence that childhood adversity is associated with substantial disability and a reduction in life expectancy of at least a decade. Childhood adversity was generally associated with more lost years of life for men than for women, and more disability for women than for men. The results are robust, even when controlling for diabetes, heart disease, depression, obesity, and sedentary behavior.

scholarly journals Do socioeconomic inequalities in pain, psychological distress and oral health increase or decrease over the life course? Evidence from Sweden over 43 years of follow-up

2017 ◽  
Vol 72 (2) ◽  
pp. 160-167 ◽  
Author(s):  
Roger Keller Celeste ◽  
Johan Fritzell
Keyword(s):  
Psychological Distress ◽  
Oral Health ◽  
Life Course ◽  
Musculoskeletal Pain ◽  
Oldest Old ◽  
Panel Study ◽  
Ordinary Least Squares ◽  
Socioeconomic Inequalities ◽  
Nationally Representative ◽  
The Life Course

BackgroundInequalities over the life course may increase due to accumulation of disadvantage or may decrease because ageing can work as a leveller. We report how absolute and relative socioeconomic inequalities in musculoskeletal pain, oral health and psychological distress evolve with ageing.MethodsData were combined from two nationally representative Swedish panel studies: the Swedish Level-of-Living Survey and the Swedish Panel Study of Living Conditions of the Oldest Old. Individuals were followed up to 43 years in six waves (1968, 1974, 1981, 1991/1992, 2000/2002, 2010/2011) from five cohorts: 1906–1915 (n=899), 1925–1934 (n=906), 1944–1953 (n=1154), 1957–1966 (n=923) and 1970–1981 (n=1199). The participants were 15–62 years at baseline. Three self-reported outcomes were measured as dichotomous variables: teeth not in good conditions, psychological distress and musculoskeletal pain. The fixed-income groups were: (A) never poor and (B) poor at least once in life. The relationship between ageing and the outcomes was smoothed with locally weighted ordinary least squares, and the relative and absolute gaps were calculated with Poisson regression using generalised estimating equations.ResultsAll outcomes were associated with ageing, birth cohort, sex and being poor at least once in live. Absolute inequalities increased up to the age of 45–64 years, and then they decreased. Relative inequalities were large already in individuals aged 15–25 years, showing a declining trend over the life course. Selective mortality did not change the results. The socioeconomic gap was larger for current poverty than for being poor at least once in life.ConclusionInequalities persist into very old age, though they are more salient in midlife for all three outcomes observed.

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