Income-related inequalities in physical and cognitive health domains over the later life course: Longitudinal evidence from the U.S. (1992–2016)

<jats:p> This study aims to investigate changes in the income–health gradient over the later life course. We test the age-as-leveler, the cumulative advantage/disadvantage, and the persistent inequality pattern for physical and cognitive health domains, and analyze whether these patterns are gendered. We used HRS data (1992–2016) and Poisson growth curve models to predict multimorbidity (33,860 participants) as an indicator of physical health and memory (25,291 participants) as an indicator of cognitive health. We disentangled the within-participant from the between-participant effects. For multimorbidity, the income–health gradient weakened as individuals aged; whereas for memory, the income–health gradient strengthened as individuals aged. The cumulative advantage/disadvantage of higher/lower income on memory may be more pronounced among women than men. Findings were confirmed by sensitivity analyses. Findings suggest that the support for the age-as-leveler or cumulative advantage/disadvantage pattern may depend on health domains and the effect strength may depend on gender. </jats:p&gt

Evolution of the income-related gap in health with old age: evidence from 20 countries in European and Chinese panel datasets

<jats:title>Abstract</jats:title><jats:p>Some studies show that the protective effect of higher income on health <jats:italic>weakens</jats:italic> with old age (age-as-leveller pattern), whereas others show that it <jats:italic>strengthens</jats:italic> with old age (cumulative advantage/disadvantage pattern). Many existing studies are limited in that they use single-country and/or single-timepoint designs. To overcome these limitations and better understand how the income-health gradient evolves in older age, we used cross-national and longitudinal data of the Survey of Health, Ageing and Retirement in Europe (2004–2019, <jats:italic>N</jats:italic> = 73,407) and the China Health and Retirement Longitudinal Study (2011–2018, <jats:italic>N</jats:italic> = 10,067). We operationalised health using multimorbidity and three alternative indicators (functional disability, mobility disability, and memory). We performed Poisson growth curve modelling to capture the between-participant effects of age and the within-participant effects of aging. We obtained three consistent and robust findings for Europe (patterns were observed in most countries) and China. First, the protective effect of higher income on multimorbidity, functional disability, and mobility disability was weaker for older than for younger adults (between-participant age-as-leveller pattern). Second, only the protective effect of higher income on mobility disability weakened over the later life course (within-participant age-as-leveller pattern). Third, the protective effect of higher income on memory was stronger for older than for younger adults and strengthened over the later life course (between-participant and within-participant cumulative advantage/disadvantage pattern). Longitudinal data, growth curve modelling distinguishing the between-participant from within-participant effect, and adjustments for potential confounders based on the hypothesised causal structure enabled us to better navigate the landscape of causal inference. Findings suggest that the income-related gap in physical health but not in cognitive health narrows in old age for both Europe and China.</jats:p&gt

Patterns of control beliefs in chronic fatigue syndrome: results of a population-based survey

BACKGROUND: Chronic fatigue syndrome (CFS) represents a unique clinical challenge for patients and health care providers due to unclear etiology and lack of specific treatment. Characteristic patterns of behavior and cognitions might be related to how CFS patients respond to management strategies. METHODS: This study investigates control beliefs in a population-based sample of 113 CFS patients, 264 individuals with insufficient symptoms or fatigue for CFS diagnosis (ISF), and 124 well individuals. RESULTS: Controlling for personality and coping, individuals with low confidence in their problem-solving capacity were almost 8 times more likely to be classified as ISF and 5 times more likely to be classified as CFS compared to being classified as well. However there was a wide distribution within groups and individuals with “low confidence” scores were found in 31.7% of Well individuals. Individuals with low levels of anxiety and who were more outgoing were less likely to be classified as ISF or CFS. CONCLUSIONS: These findings suggest that fostering control beliefs could be an important focus for developing behavioral management strategies in CFS and other chronic conditions

Exposure to the 1959–1961 Chinese famine and risk of non-communicable diseases in later life: A life course perspective

<jats:p>Child undernutrition and later-life non-communicable diseases (NCDs) are major global health issues. Literature suggests that undernutrition/famine exposure in childhood has immediate and long-term adverse health consequences. However, many studies have theoretical and methodological limitations. To add to the literature and overcome some of these limitations, we adopted a life course perspective and used more robust methods. We investigated the association between exposure to the 1959–1961 Chinese famine and later-life NCDs and if this association depends on: life stage at exposure, famine severity, and sex. We conducted a secondary data analysis of a large-scale, nationally representative, longitudinal study—the China Health and Retirement Longitudinal Study (2011–2018, 11,094 participants). We measured famine exposure/severity using self-reported experience, life stage using age at exposure, and health using the number of NCDs. We performed Poisson growth curve models. We obtained three findings. First, compared with unexposed participants, those exposed before age 18 had a higher risk of later-life NCDs, particularly if exposed in-utero (IRR = 1.90, 95% CI [1.70, 2.12], <jats:italic>p</jats:italic> < .001) and in the “first 1,000 days” of life (IRR = 1.86, 95% CI [1.73, 2.00], <jats:italic>p</jats:italic> < .001; for 0–6 months group, IRR = 1.95, 95% CI [1.67, 2.29], <jats:italic>p</jats:italic> < .001). Second, the famine effects among participants moderately and severely exposed were similar (IRR = 1.18, 95% CI [1.09, 1.28], <jats:italic>p</jats:italic> < .001 and IRR = 1.24, 95% CI [1.17, 1.32], <jats:italic>p</jats:italic> < .001). Third, the famine effects did not differ between females and males (IRR = 0.98, 95% CI [0.90, 1.07], <jats:italic>p</jats:italic> = .703). In an individual’s life course, in-utero and the “first 1,000 days” are a particularly sensitive time period with marked long-term implications for NCDs if undernutrition/famine is experienced in this period. However, this window remains open until young adulthood. This highlights the need to invest more in preventing and treating child/adolescent undernutrition to tackle later-life NCDs.</jats:p&gt

Physical, cognitive, social and mental health in near-centenarians and centenarians living in New York City: findings from the Fordham Centenarian Study

Background: Despite their strong increase, the population of the very old, including near-centenarians and centenarians, represent an unstudied and underserved population. Available studies mostly concentrate on predictors of exceptional longevity, but rarely extend their focus to other areas of functioning. Also, little is known about what contributes to experiencing a quality life in very old age. The present population-based study aims at providing a comprehensive picture of key domain of functioning, including physical, cognitive, social and mental function in very old individuals and to determine predictors of mental health indicators. Methods: A total of 119 individuals aged 95 to 107 living in private dwellings and residential care facilities were recruited based on the New York City Voters Registry. Participants answered questions regarding their health and activities of daily living. Their cognitive functioning was determined using the Mini-Mental State Examination and the Global Deterioration Scale. Social resources were measured with number of children and the Lubben Scale. Mental health was assessed with the Geriatric Depression Scale and the Satisfaction with Life Scale. Results: An unexpectedly large proportion of the sample lived in the community. On average, cognitive functioning was high. Although five diseases were reported on average, participants reported good health. Functional status was reduced. Most participants had at least one person for communication/social support. On average, depression was below cut-off, and most participants reported high life satisfaction. Regression analyses indicated that individual differences in depression were associated with subjective health, IADL and relatives support. For life satisfaction, subjective health, ADL and number of children were most important. Demographic characteristics, number of illnesses or cognitive status were not significant. Conclusions: Despite reduced levels of physical functioning and social resources, very old participants were in good mental health suggesting high resilience and ability to adapt to age-associated challenges. That a large proportion of them lived in the community further highlights their desire for leading an autonomous life, which may have been facilitated by New York service culture. More research is necessary to provide guidance for the development of well-suited services for this very old population

Valuation of Life Among Old and Very Old Adults: Comparison Between Germany and Japan

Background and Objectives: Valuation of life (VOL) represents a construct capturing individuals’ active attachment to their life. The majority of studies on VOL were conducted in North America and Europe where personal autonomy and independence are highly valued, leaving open the question about the relevance of this construct in interdependence-oriented cultures. Using a framework of cross-cultural and life-span theories, the present study compared levels and predictors of VOL between the young-old and old-old individuals from Germany and Japan. Research Design and Methods: Two hundred fifty-seven Germans and 248 Japanese, matched by age, gender, education, and IADL, answered a 5-item VOL scale and shared information on sociodemographic, social, and health resources. Results: Germans’ VOL levels were higher than in Japanese participants. Both culture- and age-moderated predictions of VOL: education was significant only in the young-old Japanese, and close social partners mattered in the old-old, not in the young-old. Health determined VOL irrespective of culture and age. Discussion and Implications: The findings suggest that cultural values and aging processes should be considered to better understand how individuals value their life and to help older adults to feel that his/her life is meaningful and worth living

A comparison of perceived uselessness between centenarians and non-centenarians in China

Abstract Background Self-perceived uselessness is associated with poorer health in older adults. However, it is unclear whether there is a difference in self-perceived uselessness between centenarians and non-centenarians, and if so, which factors contributed to the difference. Methods We used four waves of a nationwide longitudinal dataset from 2005 to 2014 in China to investigate these research goals. We first performed multinomial logit regression models to examine the risk of the high or moderate frequency of self-perceived uselessness relative to the low frequency among centenarians (5778 persons) in comparison with non-centenarians aged 65–99 (20,846 persons). We then conducted a cohort analysis for those born in 1906–1913, examining differences in self-perceived uselessness between those centenarians and those died between ages 91 and 99 during 2005–2014. Results Compared to persons aged 65–79, centenarians had 84% (relative risk ratio (RRR) = 1.84, 95% CI:1.69–2.01) and 35% (RRR = 1.35, 95% CI: 1.25–1.46) higher risk to have the high frequency and the moderate frequency of feeling useless versus low frequency, respectively, when only demographic factors were controlled for. However, centenarians had 31% (RRR = 0.69, 95% CI: 0.54–0.88), 43% (RRR = 0.57, 95% CI: 0.49–0.68), and 25% (RRR = 0.75, 95% CI: 0.67–0.83) lower risk, respectively, to have the high frequency of self-perceived uselessness relative to the low frequency when a wide set of study covariates were controlled for. In the case of the moderate versus the low frequency of self-perceived uselessness, the corresponding figures were 18% (RRR = 0.82, 95% CI: 0.66–1.02), 22% (RRR = 0.78, 95%CI: 0.67–0.90), and 13% (RRR = 0.87, 95% CI: 0.79–0.96), respectively. The cohort analysis further indicates that those who became centenarians were 36–39% less likely than those died at ages 91–94 to report the high and the moderate frequencies of self-perceived uselessness versus the low frequency; no difference was found between centenarians and those died at ages 95–99. In both period and cohort analyses, behavioral and health-related factors affected the perception substantially. Conclusions Overall, centenarians were less likely to perceive themselves as useless compared to non-centenarians of younger birth cohorts when a wide set of covariates were considered and non-centenarians of the same birth cohort. How centenarians manage to do so remains an open question. Our findings may help improve our understanding about the longevity secrets of centenarians

Talking to the dead in the classroom. How a supposedly psychic event impacts beliefs and feelings

Paranormal beliefs (PBs) are common in adults. There are numerous psychological correlates of PBs and associated theories, yet, we do not know whether such correlates reinforce or result from PBs. To understand causality, we developed an experimental design in which participants experience supposedly paranormal events. Thus, we can test an event’s impact on PBs and PB-associated correlates (Mohr, Lesaffre, & Kuhn, 2018). Here, 419 naïve students saw a performer making contact with a confederate’s deceased kin. We tested participants’ opinions and feelings about this performance, and whether these predicted how participants explain the performance. We assessed participants’ PBs and repetition avoidance (PB related cognitive correlate) before and after the performance. Afterwards, participants rated explanations of the event and described their opinions and feelings (open-ended question). Overall, 65% of participants reported having witnessed a genuine paranormal event. The open-ended question revealed distinct opinion and affect groups, with reactions commonly characterized by doubt and mixed feelings. Importantly, paranormal explanations were more likely when participants reported their feelings than when not reported. Beyond these results, we replicated that 1) higher pre-existing PBs were associated with more psychic explanations (confirmation bias), and 2) PBs and repetition avoidance did not change from before to after the performance. Yet, PBs reminiscent of the actual performance (spiritualism) increased