Changes in the household structure of the Finnish elderly by age, sex and educational attainment in 1987–2035

While the growth of the elderly population is both inevitable and predictable, the experience of old age is changing rapidly. Changes in living arrangements and family forms as well as cohorts’ changing experiences of socioeconomic environments over the life-course will shape the experience of old age and have a substantial impact on the well-being, health and care needs of the elderly population. According to the latest population projections by Statistics Finland, the number of older Finns (65 and older) and old-age dependency ratio are likely to increase particularly rapidly in the next 20 years or so. However, little is known about the future prospects of living arrangements of older Finns. We use an 11% longitudinal sample of Finns aged 40 years and older drawn from population registration data to evaluate changes in living arrangements of 65+ Finnish men and women from 1987 to 2011 and project living arrangements to 2035 by educational level. We estimate proportions in various living arrangements and calculate multistate life table estimates of years lived in particular states. Projections are based on dynamic transition probability forecasts in LIPRO with constant and variable rates. We show that living alone at older ages is currently more common among women than men: about 40% and 60% of women aged 65–79 and 80+ respectively, and about 20–30% of corresponding men live alone. These proportions are likely to start to decline slowly among women but increase among men under 80. Other living arrangements are becoming increasingly rare. Because of major changes in the access to further education the number of basic educated older people is declining rapidly. Educational differences in living arrangements are small among women, but among men living with a partner has been more common among the higher educated, although this advantage is decreasing. Of the remaining life expectancy at age 65 in 1987 women could expect to live about 40% with a partner; with the proportion increasing slightly to 2011 and 2035. Among men, these proportions were much higher in 1987 in all educational groups, but have declined slowly among the basic and secondary educated and quite markedly among the tertiary educated. Conversely, the much longer life expectancy of living alone among women as compared to men has narrowed somewhat. Overall, we know that the future elderly population will be better educated than ever before and is more likely to live with a spouse or partner. Future living arrangement distributions of older people are strongly determined, in particular, by past household behavior and, to a lesser extent, future changes in mortality. If life expectancy differences between men and women continue to converge in the long run, the proportion of remaining years of life spent living with a partner will increase among women and living alone will increase among men. However, it remains to be seen whether the better educated and partnered future elderly will benefit from the same social, functioning, health and mortality advantages as the well-educated elderly and partnered of today. In the past 25 years, some of these differences have remained sur-prisingly persistent; for example, despite large distributional changes in these characteristics, the strong health benefits of education and living with a spouse remain. Thus, if the past is a guide for the future, we may expect to see a better functioning elderly population as a consequence of these demographic changes

The association between neighborhood characteristics and mental health in old age – register based study of urban areas in three European countries

This study aimed to fill the gap in research regarding the longitudinal studies on the association between urban neighborhood characteristics and mental health of older populations. Individual level register-based data sets from Finland (10 largest cities), Sweden (Stockholm), and Italy (Turin) including satellite based land cover data were used. The data included sociodemographic individual information on population aged 50+, their antidepressant purchases, and socioeconomic and physical characteristics regarding area of residence. We followed individuals for antidepressant purchases for 5 years in 2001-2015, depending on dataset, and used hierarchical negative binomial models to assess whether there was an association between social and physical area characteristics and antidepressant use and to what extent was this association attributable to individual sociodemographic characteristics of the residents and whether the findings were consistent across countries. We found weak and inconsistent evidence of high levels of area characteristics related to dense physical urban structure being predictive of increased antidepressant use in ages above 50. However, generally the extent to which antidepressant use was clustered by areas in the studied contexts was minimal

Association between neighbourhood characteristics and antidepressant use at older ages: A register-based study of urban areas in three European countries

Background: Research evidence on the association between neighbourhood characteristics and individual mental health at older ages is inconsistent, possibly due to heterogeneity in the measurement of mental-health outcomes, neighbourhood characteristics and confounders. Register-based data enabled us to avoid these problems in this longitudinal study on the associations between socioeconomic and physical neighbourhood characteristics and individual antidepressant use in three national contexts. Methods: We used register-based longitudinal data on the population aged 50+ from Turin (Italy), Stockholm (Sweden), and the nine largest cities in Finland linked to satellite-based land-cover data. This included individual-level information on sociodemographic factors and antidepressant use, and on neighbourhood soci

Determination of Odor Detection Threshold in the Göttingen Minipig

The aim of the study was to examine the ability of Göttingen minipigs to acquire an olfaction-based operant conditioning task and to determine the detection threshold for ethyl acetate and ethanol. We used an automated olfactometer developed for rodents to train and test 14 pigs. Odor sampling and reliable responding were obtained after three to fifteen 160-trial sessions. Successful transfer of the task from ethyl acetate to ethanol was achieved in 1–4 sessions. Detection threshold for ethyl acetate varied between 10−2% and 10−6% v/v and for ethanol between 0.1% and 5 × 10−6% v/v. The results provide evidence that minipigs can successfully acquire 2-odorant discrimination using a food-rewarded instrumental conditioning paradigm for testing olfactory function. This olfactory discrimination paradigm provides reliable measures of olfactory sensitivity and thereby enables detection of changes in olfaction in a porcine model of Alzheimer's disease currently being developed

Assessing learning and memory in pigs

In recent years, there has been a surge of interest in (mini) pigs (Sus scrofa) as species for cognitive research. A major reason for this is their physiological and anatomical similarity with humans. For example, pigs possess a well-developed, large brain. Assessment of the learning and memory functions of pigs is not only relevant to human research but also to animal welfare, given the nature of current farming practices and the demands they make on animal health and behavior. In this article, we review studies of pig cognition, focusing on the underlying processes and mechanisms, with a view to identifying. Our goal is to aid the selection of appropriate cognitive tasks for research into pig cognition. To this end, we formulated several basic criteria for pig cognition tests and then applied these criteria and knowledge about pig-specific sensorimotor abilities and behavior to evaluate the merits, drawbacks, and limitations of the different types of tests used to date. While behavioral studies using (mini) pigs have shown that this species can perform learning and memory tasks, and much has been learned about pig cognition, results have not been replicated or proven replicable because of the lack of validated, translational behavioral paradigms that are specially suited to tap specific aspects of pig cognition. We identified several promising types of tasks for use in studies of pig cognition, such as versatile spatial free-choice type tasks that allow the simultaneous measurement of several behavioral domains. The use of appropriate tasks will facilitate the collection of reliable and valid data on pig cognition

Making progress with the automation of systematic reviews: Principles of the International Collaboration for the Automation of Systematic Reviews (ICASR)

Systematic reviews (SR) are vital to health care, but have become complicated and time-consuming, due to the rapid expansion of evidence to be synthesised. Fortunately, many tasks of systematic reviews have the potential to be automated or may be assisted by automation. Recent advances in natural language processing, text mining and machine learning have produced new algorithms that can accurately mimic human endeavour in systematic review activity, faster and more cheaply. Automation tools need to be able to work together, to exchange data and results. Therefore, we initiated the International Collaboration for the Automation of Systematic Reviews (ICASR), to successfully put all the parts of automation of systematic review production together. The first meeting was held in Vienna in October 2015. We established a set of principles to enable tools to be developed and integrated into toolkits. This paper sets out the principles devised at that meeting, which cover the need for improvement in efficiency of SR tasks, automation across the spectrum of SR tasks, continuous improvement, adherence to high quality standards, flexibility of use and combining components, the need for a collaboration and varied skills, the desire for open source, shared code and evaluation, and a requirement for replicability through rigorous and open evaluation. Automation has a great potential to improve the speed of systematic reviews. Considerable work is already being done on many of the steps involved in a review. The 'Vienna Principles' set out in this paper aim to guide a more coordinated effort which will allow the integration of work by separate teams and build on the experience, code and evaluations done by the many teams working across the globe

Why is care use declining? Changes in residential long-term care between 1999 and 2018 in Finland

Background Residential long-term care (LTC) coverage has declined in many countries over the past decade. However, it is unclear to what extent the decline is attributable to a smaller proportion of older people entering or shorter time spent in LTC, and if the change has been similar across sociodemographic groups. This study analysed changes in life expectancy in LTC at age 65, the proportion ever entering, and years spent in LTC among those who entered, and quantified the contributions of changing rates of admission, mortality and exit to the change in life expectancy in LTC. Methods We analysed linked population register data that covered all Finnish residents aged 65+ between 1999 and 2018 (n = 2,016,987) on dates of entries to and exits from LTC, dates of death, and sociodemographic characteristics. We estimated transition rates between home, LTC and death, and calculated multistate life tables by sex, marital status and education across four periods 1999-2003, 2004-2008, 2009-2013 and 2014-2018. Results Life expectancy in LTC increased from 0.75 to 0.89 years among men and from 1.61 to 1.83 years among women between 1999-2003 and 2003-2008. The increase was mainly attributable to declining rates of exit from LTC, and thereby longer time spent in LTC for those who entered. Life expectancy in LTC started declining in 2009-2013 and reached 0.80 years among men and 1.51 years among women in 2014-2018. The decline mainly related to an increasing death rate in LTC. In all periods, declining mortality in the community contributed to an increase in life expectancy in LTC, but this was offset by steady declines in admission rates. Life expectancy in LTC changed similarly across marital status and education groups. Conclusions Recent declines in LTC use - driven by lower rates of entry and higher mortality in LTC when entered - imply that across sociodemographic strata it is has become more difficult to find LTC placement and older people enter LTC in ever worse health. Key messages • Overall LTC use increased in early 2000s despite declining admission rates. The increase was mainly due to declining exit rate from LTC indicating longer time spent in LTC for those who entered. • The recent shortening of life expectancy in LTC derives from entering LTC at a later stage and closer to death, indicating greater level of disability and worse health at the time of entry

The association between income and psychotropic drug purchases: individual fixed effects analysis of annual longitudinal data in 2003–2013

Background: Previous cross-sectional studies show that low income is associated with poor mental health. However, longitudinal research has produced varying results. We assess whether low income is associated with increased psychotropic drug use after accounting for confounding by observed time-varying, and unobserved stable individual differences. Methods: The longitudinal register-based data comprises an 11% nationally representative random sample of Finnish residents aged 30–62 years between the years 2003 and 2013. The analytic sample includes 337,456 individuals (2,825,589 person–years). We estimate the association between annual income and psychotropic purchasing using ordinary-least-squares and fixed effects models, the latter controlling for all unobserved time-invariant individual characteristics. Results: The annual prevalence of psychotropic purchasing was 15%; 13% among men and 18% among women. Adjusted for age squared, sex and calendar year, the doubling of income decreased the probability of purchases by 4 percentage points (95% confidence interval: 4,4) in the ordinary-least-squares model. We observed no association after further adjusting for observed sociodemographic characteristics and unobserved individual differences in the fixed effects specification. Conclusions: Following adjustment for an extensive set of confounders, no contemporaneous association between variations in annual individual income and psychotropic drug purchasing was observed. Similar results were obtained irrespective of baseline income level and sex. The results imply that indirect selection based on preexisting individual characteristics plays a major role in explaining the association between variations in income measured over the short term, and psychotropic drug purchases. The association appears largely attributable to unobserved, stable individual characteristics. See video abstract at, http://links.lww.com/EDE/B463