Objectives This study aimed to assess whether cumulative disadvantage in childhood misfortune and... more Objectives This study aimed to assess whether cumulative disadvantage in childhood misfortune and adult-life socioeconomic conditions influence the risk of frailty in old age and whether welfare regimes influence these associations. Method Data from 23,358 participants aged 50 years and older included in the longitudinal SHARE survey were used. Frailty was operationalized according to Fried’s phenotype as presenting either weakness, shrinking, exhaustion, slowness, or low activity. Confounder-adjusted mixed-effects logistic regression models were used to analyze associations of childhood misfortune and life-course socioeconomic conditions with frailty. Results Childhood misfortune and poor adult-life socioeconomic conditions increased the odds of (pre-)frailty at older age. With aging, differences narrowed between categories of adverse childhood experiences (driven by Scandinavian welfare regime) and adverse childhood health experiences (driven by Eastern European welfare regime), b...
International Journal of Environmental Research and Public Health, 2021
Older adults face particular risks of exclusion from social relationships (ESR) and are especiall... more Older adults face particular risks of exclusion from social relationships (ESR) and are especially vulnerable to its consequences. However, research so far has been limited to specific dimensions, countries, and time points. In this paper, we examine the prevalence and micro- and macro-level predictors of ESR among older adults (60+) using two waves of data obtained four years apart across 14 European countries in the Survey of Health, Ageing and Retirement in Europe (SHARE). We consider four ESR indicators (household composition, social networks, social opportunities, and loneliness) and link them to micro-level (age, gender, socioeconomic factors, health, and family responsibilities) and national macro-level factors (social expenditures, unmet health needs, individualism, social trust, and institutional trust). Findings reveal a northwest to southeast gradient, with the lowest rates of ESR in the stronger welfare states of Northwest Europe. The high rates of ESR in the southeast a...
The links between loneliness and overall morbidity and mortality are well known, and this has pro... more The links between loneliness and overall morbidity and mortality are well known, and this has profound implications for quality of life and health and welfare budgets. Most studies have been cross-sectional allowing for conclusions on correlates of loneliness, but more recently, some longitudinal studies have revealed also micro-level predictors of loneliness. Since the majority of studies focused on one country, conclusions on macro-level drivers of loneliness are scarce. This chapter examines the impact of micro- and macro-level drivers of loneliness and loneliness change in 11 European countries. The chapter draws on longitudinal data from 2013 and 2015 from the Survey of Health, Aging, and Retirement in Europe (SHARE), combined with macro-level data from additional sources. The multivariable analysis revealed the persistence of loneliness over time, which is a challenge for service providers and policy makers. Based on this cross-national and longitudinal study we observed that ...
Articles Being socially connected is a universal human need, but a substantial number of older me... more Articles Being socially connected is a universal human need, but a substantial number of older men and women are or become excluded from these connections in later life. Exclusion from social relations (ESR) is unwanted as it undermines people's ability to lead a healthy, active, and independent life. Policies to reduce this form of exclusion have been limited in effectiveness, due in part to a broader lack of knowledge about the dynamics of social exclusion in older ages and the intersection of social exclusion with gender constructions. To advance our understanding of ESR in later life, we develop a heuristic model based on theories and previous empirical studies. Considering the gendered constructing forces of ESR in older age that can potentially lead to loneliness and reduced health and wellbeing, the model identifies individual drivers, such as biopsychosocial conditions, personal standards and life- -course transitions, and macro-level drivers, such as norms and welfare s...
Cross-national studies in Europe reveal sharp regional differences in the prevalence of lonelines... more Cross-national studies in Europe reveal sharp regional differences in the prevalence of loneliness among older adults, with the highest prevalence of loneliness in Eastern European countries. In this study, we investigate an alternative explanation for differences in loneliness prevalence based on differences in trust. Many of the Eastern European countries were ruled by totalitarian regimes that undermined people’s trust in other people and in the system, potentially leading to higher loneliness prevalence. Data are derived from the sixth round of the European Social Survey conducted in 2012, based on 12,042 respondents, of which 4827 live in post-totalitarian countries and 7215 in other European countries and Israel. We estimate a path model with trust in people, trust in the system, and social engagement included as latent variables and one dichotomous outcome (lonely or not). We control for age, gender, health limitations, marital status, income adequacy, and education. The resu...
Objectives This article aimed to assess associations of childhood socioeconomic conditions (CSC) ... more Objectives This article aimed to assess associations of childhood socioeconomic conditions (CSC) with the risk of frailty in old age and whether adulthood socioeconomic conditions (ASC) influence this association. Methods Data from 21,185 individuals aged 50 years and older included in the longitudinal Survey of Health, Ageing, and Retirement in Europe were used. Frailty was operationalized as a sum of presenting weakness, shrinking, exhaustion, slowness, or low activity. Confounder-adjusted multilevel logistic regression models were used to analyze associations of CSC and ASC with frailty. Results While disadvantaged CSC was associated with higher odds of (pre-)frailty in women and men (odds ratio [OR] = 1.73, 95% confidence interval [CI] 1.34, 2.24; OR = 1.84, 95% CI 1.27, 2.66, respectively), this association was mediated by ASC. Personal factors and demographics, such as birth cohort, chronic conditions, and difficulties with activities of daily living, increased the odds of bei...
Research has indicated the need to consider the ageing process with technology adoption by older ... more Research has indicated the need to consider the ageing process with technology adoption by older adults. This study examined psychological, health, social and demographic predictors with starting and stopping Internet use by older adults (2002–2012). Data were used from the Longitudinal Aging Study Amsterdam, and Cox regression analyses were done to test predictors over time with starting or stopping Internet use. The results indicated that older adults starting to use the Internet (11.6%) outnumbered those who stopped (3.1%). Psychological, health, social and demographic predictors separately predicted starting and stopping Internet use. Starting use was predicted by lower age, higher education, normal cognition and living alone. The predictors in stopping use were being younger, having a high sense of mastery and being higher educated. The results need to be interpreted as indicative due to the small number of stoppers. Suggestions are made on how to improve usability.
The journals of gerontology. Series B, Psychological sciences and social sciences, Jan 17, 2016
Integration into social networks is an important determinant of health and survival in late adult... more Integration into social networks is an important determinant of health and survival in late adulthood. We first identify different types of non-kin networks among older adults and second, investigate the association of these types with survival rates. Official register information on mortality is combined with data from the Longitudinal Aging Study Amsterdam (LASA). The sample includes 2,440 Dutch respondents aged 54-85 at baseline in 1992 and six follow-ups covering a time span of 20 years. Using latent class analysis, respondents are classified into distinct types of non-kin networks, based on differences in number and variation of non-kin relations, social support received from non-kin, and contact frequency with non-kin. Next, membership in network types is related to mortality in a Cox proportional hazard regression model. There are four latent types of non-kin networks that vary in network size and support. These types differ in their associations with mortality, independent o...
Depression often co-occurs in late-life in the context of declining cognitive functions, but it i... more Depression often co-occurs in late-life in the context of declining cognitive functions, but it is not clear whether specific depression symptom dimensions are differentially associated with cognitive abilities. The study sample comprised 3107 community-dwelling older adults from the Longitudinal Aging Study Amsterdam (LASA). We applied a Multiple Indicators Multiple Causes (MIMIC) model to examine the association between cognitive abilities and latent dimensions of the Center for Epidemiologic Studies Depression Scale (CES-D), while accounting for differential item functioning (DIF) due to age, gender and cognitive function levels. A factor structure consisting of somatic symptoms, positive affect, depressed affect, and interpersonal difficulties fitted the data well. Higher levels of inductive reasoning were significantly associated with lower levels of depressed affect and somatic symptoms, whereas faster processing speed was significantly associated with lower levels of somatic ...
Journal of epidemiology and community health, Nov 17, 2016
This study examines to what extent education, occupation and income are associated with the multi... more This study examines to what extent education, occupation and income are associated with the multidimensional process of successful ageing, encompassing trajectories of physical, mental and social functioning in old age. We employed 16-year longitudinal data from 2095 participants aged 55-85 years at baseline in the Dutch, nationally representative Longitudinal Aging Study Amsterdam. For 9 indicators of successful ageing, separate Latent Class Growth models were used to identify subgroups of older adults with a 'successful' trajectory. A 'Successful Aging Index' expressed the number of indicators for which individual respondents had a successful trajectory (range 0-9). Using multivariate regression models, we investigated associations between socioeconomic position and the Successful Ageing Index, and with separate indicators of successful ageing. Higher education, occupational skill level and income were independently associated with higher numbers of successful traj...
The goal of this research is to test whether often observed correlates of loneliness in older age... more The goal of this research is to test whether often observed correlates of loneliness in older age are related to onset of loneliness longitudinally. Despite the increasing number of longitudinal studies, the investigation of factors that are related to onset of loneliness is still limited. Analyses are based on data of the TamELSA study, which is a population-based prospective study
Objectives The study investigates whether the disadvantaged position of men in the adverse conseq... more Objectives The study investigates whether the disadvantaged position of men in the adverse consequences of widowhood for health and mortality also exists for changes in cognitive health. Methods We used data of up to 1,269 men and women aged 65 years and older who participated in the Longitudinal Aging Study Amsterdam in 3-yearly assessments between 1992 and 2012 (5,123 person-observations). All were married and without cognitive impairment (Mini-Mental State Examination ≥ 24) at baseline and up to 419 lost their spouse. In fixed effects regression models, the effect of spousal loss on change in four domains of cognitive functioning was estimated independently of age-related cognitive change. Results For women, a robust temporary decrease was found in the second year after spousal loss in the reasoning domain, but not in global cognitive functioning, processing speed, or memory. No robust effects were found for men. Discussion Considering that only one cognitive domain was affected ...
This editorial serves a double purpose. It introduces the articles and commentary comprising this... more This editorial serves a double purpose. It introduces the articles and commentary comprising this thematic issue on old-age exclusion, and simultaneously aims to make a concise contribution to the discussion on the relation between agency of older people and old-age exclusion. While indeed it is clear that limitations of agency due to a lack of resources in old age or age discrimination lead to exclusion of older people, the relationship between reduced agency and exclusion is less clear in the case of internalized age norms. It ends with a plea for surveys studying older populations to pay more attention to older people’s identities and life goals, opinions and reasons for action.
In Romania, inequalities in health and wellbeing between younger and older Romanians are substant... more In Romania, inequalities in health and wellbeing between younger and older Romanians are substantial, and an important reason for inequalities may be the higher risk of social exclusion among older adults. After the fall of Communism in 1989, the many transformations in economic structures and welfare regimes contributed to enhanced levels of social exclusion, in particular among the older generations. Social exclusion is a multidimensional problem with substantial effects on the mental wellbeing of people. The present study examines age differences in mental wellbeing and evaluates to what extent differences can be explained by age and social exclusion, while controlling for a number of potential confounders. Data are from the fourth wave (2016) of the European Quality of Life Survey. Data for Romania include 1004 people aged between 18 and 85 years old, of which 726 are included in the analyses (only complete cases). In the study sample, 259 were 55 years or older. Mental wellbein...
Objectives This study aimed to assess whether cumulative disadvantage in childhood misfortune and... more Objectives This study aimed to assess whether cumulative disadvantage in childhood misfortune and adult-life socioeconomic conditions influence the risk of frailty in old age and whether welfare regimes influence these associations. Method Data from 23,358 participants aged 50 years and older included in the longitudinal SHARE survey were used. Frailty was operationalized according to Fried’s phenotype as presenting either weakness, shrinking, exhaustion, slowness, or low activity. Confounder-adjusted mixed-effects logistic regression models were used to analyze associations of childhood misfortune and life-course socioeconomic conditions with frailty. Results Childhood misfortune and poor adult-life socioeconomic conditions increased the odds of (pre-)frailty at older age. With aging, differences narrowed between categories of adverse childhood experiences (driven by Scandinavian welfare regime) and adverse childhood health experiences (driven by Eastern European welfare regime), b...
International Journal of Environmental Research and Public Health, 2021
Older adults face particular risks of exclusion from social relationships (ESR) and are especiall... more Older adults face particular risks of exclusion from social relationships (ESR) and are especially vulnerable to its consequences. However, research so far has been limited to specific dimensions, countries, and time points. In this paper, we examine the prevalence and micro- and macro-level predictors of ESR among older adults (60+) using two waves of data obtained four years apart across 14 European countries in the Survey of Health, Ageing and Retirement in Europe (SHARE). We consider four ESR indicators (household composition, social networks, social opportunities, and loneliness) and link them to micro-level (age, gender, socioeconomic factors, health, and family responsibilities) and national macro-level factors (social expenditures, unmet health needs, individualism, social trust, and institutional trust). Findings reveal a northwest to southeast gradient, with the lowest rates of ESR in the stronger welfare states of Northwest Europe. The high rates of ESR in the southeast a...
The links between loneliness and overall morbidity and mortality are well known, and this has pro... more The links between loneliness and overall morbidity and mortality are well known, and this has profound implications for quality of life and health and welfare budgets. Most studies have been cross-sectional allowing for conclusions on correlates of loneliness, but more recently, some longitudinal studies have revealed also micro-level predictors of loneliness. Since the majority of studies focused on one country, conclusions on macro-level drivers of loneliness are scarce. This chapter examines the impact of micro- and macro-level drivers of loneliness and loneliness change in 11 European countries. The chapter draws on longitudinal data from 2013 and 2015 from the Survey of Health, Aging, and Retirement in Europe (SHARE), combined with macro-level data from additional sources. The multivariable analysis revealed the persistence of loneliness over time, which is a challenge for service providers and policy makers. Based on this cross-national and longitudinal study we observed that ...
Articles Being socially connected is a universal human need, but a substantial number of older me... more Articles Being socially connected is a universal human need, but a substantial number of older men and women are or become excluded from these connections in later life. Exclusion from social relations (ESR) is unwanted as it undermines people's ability to lead a healthy, active, and independent life. Policies to reduce this form of exclusion have been limited in effectiveness, due in part to a broader lack of knowledge about the dynamics of social exclusion in older ages and the intersection of social exclusion with gender constructions. To advance our understanding of ESR in later life, we develop a heuristic model based on theories and previous empirical studies. Considering the gendered constructing forces of ESR in older age that can potentially lead to loneliness and reduced health and wellbeing, the model identifies individual drivers, such as biopsychosocial conditions, personal standards and life- -course transitions, and macro-level drivers, such as norms and welfare s...
Cross-national studies in Europe reveal sharp regional differences in the prevalence of lonelines... more Cross-national studies in Europe reveal sharp regional differences in the prevalence of loneliness among older adults, with the highest prevalence of loneliness in Eastern European countries. In this study, we investigate an alternative explanation for differences in loneliness prevalence based on differences in trust. Many of the Eastern European countries were ruled by totalitarian regimes that undermined people’s trust in other people and in the system, potentially leading to higher loneliness prevalence. Data are derived from the sixth round of the European Social Survey conducted in 2012, based on 12,042 respondents, of which 4827 live in post-totalitarian countries and 7215 in other European countries and Israel. We estimate a path model with trust in people, trust in the system, and social engagement included as latent variables and one dichotomous outcome (lonely or not). We control for age, gender, health limitations, marital status, income adequacy, and education. The resu...
Objectives This article aimed to assess associations of childhood socioeconomic conditions (CSC) ... more Objectives This article aimed to assess associations of childhood socioeconomic conditions (CSC) with the risk of frailty in old age and whether adulthood socioeconomic conditions (ASC) influence this association. Methods Data from 21,185 individuals aged 50 years and older included in the longitudinal Survey of Health, Ageing, and Retirement in Europe were used. Frailty was operationalized as a sum of presenting weakness, shrinking, exhaustion, slowness, or low activity. Confounder-adjusted multilevel logistic regression models were used to analyze associations of CSC and ASC with frailty. Results While disadvantaged CSC was associated with higher odds of (pre-)frailty in women and men (odds ratio [OR] = 1.73, 95% confidence interval [CI] 1.34, 2.24; OR = 1.84, 95% CI 1.27, 2.66, respectively), this association was mediated by ASC. Personal factors and demographics, such as birth cohort, chronic conditions, and difficulties with activities of daily living, increased the odds of bei...
Research has indicated the need to consider the ageing process with technology adoption by older ... more Research has indicated the need to consider the ageing process with technology adoption by older adults. This study examined psychological, health, social and demographic predictors with starting and stopping Internet use by older adults (2002–2012). Data were used from the Longitudinal Aging Study Amsterdam, and Cox regression analyses were done to test predictors over time with starting or stopping Internet use. The results indicated that older adults starting to use the Internet (11.6%) outnumbered those who stopped (3.1%). Psychological, health, social and demographic predictors separately predicted starting and stopping Internet use. Starting use was predicted by lower age, higher education, normal cognition and living alone. The predictors in stopping use were being younger, having a high sense of mastery and being higher educated. The results need to be interpreted as indicative due to the small number of stoppers. Suggestions are made on how to improve usability.
The journals of gerontology. Series B, Psychological sciences and social sciences, Jan 17, 2016
Integration into social networks is an important determinant of health and survival in late adult... more Integration into social networks is an important determinant of health and survival in late adulthood. We first identify different types of non-kin networks among older adults and second, investigate the association of these types with survival rates. Official register information on mortality is combined with data from the Longitudinal Aging Study Amsterdam (LASA). The sample includes 2,440 Dutch respondents aged 54-85 at baseline in 1992 and six follow-ups covering a time span of 20 years. Using latent class analysis, respondents are classified into distinct types of non-kin networks, based on differences in number and variation of non-kin relations, social support received from non-kin, and contact frequency with non-kin. Next, membership in network types is related to mortality in a Cox proportional hazard regression model. There are four latent types of non-kin networks that vary in network size and support. These types differ in their associations with mortality, independent o...
Depression often co-occurs in late-life in the context of declining cognitive functions, but it i... more Depression often co-occurs in late-life in the context of declining cognitive functions, but it is not clear whether specific depression symptom dimensions are differentially associated with cognitive abilities. The study sample comprised 3107 community-dwelling older adults from the Longitudinal Aging Study Amsterdam (LASA). We applied a Multiple Indicators Multiple Causes (MIMIC) model to examine the association between cognitive abilities and latent dimensions of the Center for Epidemiologic Studies Depression Scale (CES-D), while accounting for differential item functioning (DIF) due to age, gender and cognitive function levels. A factor structure consisting of somatic symptoms, positive affect, depressed affect, and interpersonal difficulties fitted the data well. Higher levels of inductive reasoning were significantly associated with lower levels of depressed affect and somatic symptoms, whereas faster processing speed was significantly associated with lower levels of somatic ...
Journal of epidemiology and community health, Nov 17, 2016
This study examines to what extent education, occupation and income are associated with the multi... more This study examines to what extent education, occupation and income are associated with the multidimensional process of successful ageing, encompassing trajectories of physical, mental and social functioning in old age. We employed 16-year longitudinal data from 2095 participants aged 55-85 years at baseline in the Dutch, nationally representative Longitudinal Aging Study Amsterdam. For 9 indicators of successful ageing, separate Latent Class Growth models were used to identify subgroups of older adults with a 'successful' trajectory. A 'Successful Aging Index' expressed the number of indicators for which individual respondents had a successful trajectory (range 0-9). Using multivariate regression models, we investigated associations between socioeconomic position and the Successful Ageing Index, and with separate indicators of successful ageing. Higher education, occupational skill level and income were independently associated with higher numbers of successful traj...
The goal of this research is to test whether often observed correlates of loneliness in older age... more The goal of this research is to test whether often observed correlates of loneliness in older age are related to onset of loneliness longitudinally. Despite the increasing number of longitudinal studies, the investigation of factors that are related to onset of loneliness is still limited. Analyses are based on data of the TamELSA study, which is a population-based prospective study
Objectives The study investigates whether the disadvantaged position of men in the adverse conseq... more Objectives The study investigates whether the disadvantaged position of men in the adverse consequences of widowhood for health and mortality also exists for changes in cognitive health. Methods We used data of up to 1,269 men and women aged 65 years and older who participated in the Longitudinal Aging Study Amsterdam in 3-yearly assessments between 1992 and 2012 (5,123 person-observations). All were married and without cognitive impairment (Mini-Mental State Examination ≥ 24) at baseline and up to 419 lost their spouse. In fixed effects regression models, the effect of spousal loss on change in four domains of cognitive functioning was estimated independently of age-related cognitive change. Results For women, a robust temporary decrease was found in the second year after spousal loss in the reasoning domain, but not in global cognitive functioning, processing speed, or memory. No robust effects were found for men. Discussion Considering that only one cognitive domain was affected ...
This editorial serves a double purpose. It introduces the articles and commentary comprising this... more This editorial serves a double purpose. It introduces the articles and commentary comprising this thematic issue on old-age exclusion, and simultaneously aims to make a concise contribution to the discussion on the relation between agency of older people and old-age exclusion. While indeed it is clear that limitations of agency due to a lack of resources in old age or age discrimination lead to exclusion of older people, the relationship between reduced agency and exclusion is less clear in the case of internalized age norms. It ends with a plea for surveys studying older populations to pay more attention to older people’s identities and life goals, opinions and reasons for action.
In Romania, inequalities in health and wellbeing between younger and older Romanians are substant... more In Romania, inequalities in health and wellbeing between younger and older Romanians are substantial, and an important reason for inequalities may be the higher risk of social exclusion among older adults. After the fall of Communism in 1989, the many transformations in economic structures and welfare regimes contributed to enhanced levels of social exclusion, in particular among the older generations. Social exclusion is a multidimensional problem with substantial effects on the mental wellbeing of people. The present study examines age differences in mental wellbeing and evaluates to what extent differences can be explained by age and social exclusion, while controlling for a number of potential confounders. Data are from the fourth wave (2016) of the European Quality of Life Survey. Data for Romania include 1004 people aged between 18 and 85 years old, of which 726 are included in the analyses (only complete cases). In the study sample, 259 were 55 years or older. Mental wellbein...
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