Social Status and Mortality With Activity of Daily Living Disability in Later Life

Objectives. The aim of this study was to assess which social status factors predispose a person to dying with activity of daily living (ADL) disability in later life. Methods. We followed 243 deceased members of the Swiss Interdisciplinary Longitudinal Study on the Oldest Old annually up to 8 years before their deaths. Using a multilevel regression, we analyzed age at death, gender, occupational category, and geographic area as potential factors predisposing a person to ending life with ADL disability. Results. Disability scores showed a substantial increase as death approached. Individuals from a lower occupational category were at higher risk of ADL disability and experienced a greater functional decline prior to death compared to those from higher occupational categories. Discussion. Consistent with the cumulative disadvantage theoretical framework, the health differential between the occupational categories seems to be exacerbated prior to deat

Do "Young-Old” Exercisers Feel Better Than Sedentary Persons? A Cohort Study in Switzerland

From a "successful aging” perspective, the subjective feeling of well-being is as important as "objective” health. Physical exercise is seen as being an effective way of staying healthy, but its link with well-being in a normal aging population remains largely unexplored. Based on two randomized surveys of the aging population, conducted in 1979 and 1994, respectively, with questionnaires including retrospective questions on activities and health, two cohorts of young-old (aged 64-74) were selected (cohort 1, born 1905-1914, N = 949; cohort 2, born 1920-1929, N = 602) and split into four groups, corresponding to their exercising trajectories (long-term exercisers LE, new exercisers NE, quitters Q, sedentary S). The link between the four trajectories and two indicators of well-being (self-rated health, self-assessed depression scale) was examined by means of regression analyses. In both cohorts, the LE group had a higher level of well-being than the Q and the S. The study also throws light on the case of the quitters (Q), who showed the lowest level of well-being. Scant research has hitherto been done on the causes and repercussions of abandoning exercis

Prognosis of Functional Recovery 1 Year After Hip Fracture: Typical Patient Profiles Through Cluster Analysis

Background. Many investigators have identified distinct medical, demographic and psychosocial prefracture conditions that influence the functional outcome of patients surgically treated for a fracture of the hip. However, to design efficient intervention care programs addressing the needs of these patients, at optimal economic and social costs, more information is required on the typical combinations of prognostic determinants actually encountered. Methods. Data on specific descriptors of the prefracture status and on mobility and functioning 1 year after surgical intervention were collected by interview from 253 consecutive patients hospitalized for a fracture of the proximal femur. Cluster analysis was used to form homogeneous groups of patients with similar profiles in terms of the 13 predictive variables and the 7 outcome variables significantly interrelated. The modeling procedure generated four clusters of patients with a typical profile sharply contrasted by their structure. Results. Subjects of two clusters could walk without difficulty and were functionally independent prior to their hip fracture. One year later, however, mobility and functioning were only fully recovered by the members of one cluster. The majority of predictors were of less favorable prognostic value for the members of the second cluster. The other two clusters regrouped patients with impaired prefracture mobility that were either unaltered or even aggravated 1 year later. Conclusions. Cluster analysis identified typical profiles of elderly hip fracture patients. Close scrutiny of their respective global structure, in terms of combined prognostic determinants and outcomes, may help to develop specific management strategies that are more efficiently adapted to these different groups of patient

Transitions dans le parcours de vie et construction des inégalités

Tout au long de leur existence, les individus suivent des chemins singuliers dont les trajectoires ne sont pas le simple fait de la seule volonté ou du hasard. Ces cheminements se révèlent souvent générateurs d'inégalités entre individus, notamment au cours des transitions des âges de la vie (enfance, adolescence, âge adulte, grand âge), ou lors de différentes étapes (mariage, divorce, deuil, etc). C'est afin de mieux comprendre les modalités et les combinaisons d'influence à l'origine des inégalités dans les parcours de vie, que les éditeurs de cet ouvrage ont réuni des chercheurs issus des sciences psychologiques, sociales et économiques, afin de croiser leurs regards sur la manière dont ces inégalités se creusent ou se réduisent au fil des trajectoires. Cet ouvrage interdisciplinaire met en relief la richesse d'une approche des inégalités dans la perspective dynamique du parcours de vie.Peer reviewe

Beyond the antinomy: work versus leisure?: the process of cultural mutation in industrial societies during the twentieth century

In this paper the author attempts to highlight the socio-historical logic of the dialectic between (paid) labour and free time among industrial societies with a market economy. The main stages of a cultural mutation are shown and related to changes in the global social structure. On the eve of post-industrial society, a new orientation toward life (ethos), which developed within the framework of free time, privacy and leisure activities, has come to dominate all sectors of human life. The possibility that this new orientation could help to overcome the antinomy between work (as paid labour) and free-time activities is discussed

La retraite et après? : vieillesse entre science et conscience

Leçon d'adieu du professeur Christian Lalive d'Epinay. «Il y a plus d'un quart de siècle, quand j'ai commencé à m'intéresser à la problématique du vieillissement des personnes âgées, des collègues me dirent que je m'attaquais à un sujet plein d'avenir. Voici qu'aujourd'hui, alors que je me trouve sur le seuil d'une des transitions les plus tranchantes de la vie – ne parle-t-on pas de retraite couperet? –, cet avenir m'a rattrapé, ou peut-être est-ce moi qui ai rejoint mon avenir? Aussi m'a-t-il paru évident que je devais consacrer cette leçon d'adieu à faire le point des quelques savoirs dont je dispose sur cet avenir, et à partager avec vous certaines des interrogations et, disons-le, des angoisses qu'il suscite.