Health impact of providing informal care in Portugal

Background: Middle-aged and older adults play an important role in the provision of informal support, however, the impact on the health of those individuals who provide informal care is unclear. The main objectives of this study are: (1) to assess the prevalence of co-residential caregiving provided by individuals aged 50+; (2) to analyze differences between the group of Portuguese co-residential caregivers and the group of Portuguese non-caregivers; (3) to examine the longitudinal effect of providing informal care on the health of co-residential informal caregivers in Portugal. Methods Data from wave 4 and wave 6 of the Survey of Health Ageing and Retirement in Europe (SHARE) were used. A linear mixed model and a generalized mixed model were used to analyze the longitudinal effect of providing informal care on the health (physical health and depressive symptoms) of Portuguese individuals aged 50 + . Results In both SHARE waves analyzed, Portugal had the highest percentage of co-residential caregivers aged 50+. At baseline, the Portuguese co-residential caregiver population, compared to non-caregivers, has a lower percentage of employed individuals (14.9% compared to 25.7%) and a higher percentage of individuals with four or more depressive symptoms (56.4% compared to 35.5%). The caregivers also have a lower quality of life (CASP-12) (30.93 compared to 32.59). Marginal differences in educational levels between the caregiver and non-caregiver groups were also found, with co-residential caregivers having lower levels of education (72.3% have ISCED 0–2 compared to 64.7%), lower levels of cognitive function (− 2.321 compared to − 1.784), lower levels of physical health (− 0.180 compared to − 0.076) and lower engagement in moderate or vigorous physical activity (14.9% compared to 21.5%). Longitudinal models reveal that providing care within the household is not associated with physical health (b = 0.048; se = 0.035; p = 0.167), but is associated with depressive symptoms (OR = 1.609; 95% CI = 1.141–2.271; p = < 0.010). Conclusions Portugal has the highest percentage of co-residential caregivers aged 50+. In that country, providing informal care to a household member is associated with depressive symptoms. Portuguese policymakers should therefore promote programs to prevent and alleviate the depressive symptoms experienced by individuals aged 50+, who provide co-residential care.PINFRA/22209/2016; VS/2009/0562; Fundação Calouste Gulbenkian. SHARE data collection has been primarily funded by the European Commission through FP5 (QLK6-CT-2001-00360), FP6 (SHARE-I3: RII-CT-2006-062193, COMPARE: CIT5-CT-2005-028857, SHARELIFE: CIT4-CT-2006-028812) and FP7 (SHARE-PREP: N°211909, SHARELEAP: N°227822, SHAREM4: N°261982). Additional funding from the German Ministry of Education and Research, the U.S. National Institute on Aging (U01_AG09740-13S2, P01_AG005842, P01_AG08291, P30_AG12815, R21_AG025169, Y1-AG-4553-01, IAG_BSR06–11, OGHA_04–064) and from various national funding sources is gratefully acknowledged (see www.share-project.org). In Portugal, the SHARE project has been funded by Calouste Gulbenkian Foundation and by FCT / MCTES through national funds (PIDDAC) and co-financed by the European Regional Development Fund (ERDF), through the Operational Program PORNorte and PORLisboa, AACN° 01 / SAICT / 2016, Application n° 022209 - DATALA

Do European co-residential caregivers aged 50+ have an increased risk of frailty?

One important health challenge associated with ageing is frailty, which has been acknowledged as a new public health priority. However, only a few studies have explored the relationship between providing care at older ages and frailty. The main objective of this study is to assess whether there is an association between providing co-residential care and frailty, according to gender and from a European cross-sectional perspective, among the population aged 50+. Data from 17 European countries that participated in wave 6 of the Survey of Health, Ageing and Retirement in Europe (SHARE) is used (N = 52,073). Multinomial logistic regressions were used to estimate caregivers' chances of frailty. The results show that the prevalence of pre-frailty and frailty differs according to the caregiver's status, gender and the European region. The highest prevalence of pre-frailty was found in the group of female caregivers from Northern countries (57.3%), and the highest prevalence of frailty was found in the group of female caregivers from Southern countries (29.3%). Providing co-residential care is positively associated with the risk of being pre-frail in women, in all European regions (Northern: OR 1.724, 95% CI 1.190-2.496; Central: OR 1.213, 95% CI 1.010-1.456; Eastern: OR 1.227, 95% CI 1.031-1.460; Southern: OR 1.343, 95% CI 1.103-1.634), and with being frail for both genders in the Southern region (female: OR 1.527, 95% CI 1.060-2.200; male: OR 1.644, 95% CI 1.250-2.164). The results of this study suggest that female co-residential caregivers are a greater risk of being pre-frail in all European regions except Southern Europe, where male and female co-residential caregivers are a greater risk of being frail, compared with non-caregivers. European policy makers should create political measures to prevent and reverse frailty among European co-residential caregivers.European Commission. Grant Numbers: QLK6‐CT‐2001‐00360, RII‐CT‐2006‐062193, CIT5‐CT‐2005‐028857, CIT4‐CT‐2006‐028812, 211909, 227822, 261982; Horizon 2020. Grant Numbers: 676536, 654221; DG Employment, Social Affairs & Inclusion; German Ministry of Education and Research; Max Planck Society for the Advancement of Science; U.S. National Institute on Aging. Grant Numbers: U01_AG09740‐13S2, P01_AG005842, P01_AG08291, P30_AG12815, R21_AG025169, Y1‐AG‐4553‐01, IAG_BSR06‐11, OGHA_04‐064, HHSN271201300071C

A study of the association between the stringency of covid-19 government measures and depression in older adults across Europe and Israel

Background: The COVID-19 pandemic is having major adverse consequences for the mental health of individuals worldwide. Alongside the direct impact of the virus on individuals, government responses to tackling its spread, such as quarantine, lockdown, and physical distancing measures, have been found to have a profound impact on mental health. This is manifested in an increased prevalence of anxiety, depression, and sleep disturbances. As older adults are more vulnerable and severely affected by the pandemic, they may be at increased psychological risk when seeking to protect themselves from COVID-19. Methods: Our study aims to quantify the association between the stringency of measures and increased feelings of sadness/depression in a sample of 31,819 Europeans and Israelis aged 65 and above. We hypothesize that more stringent measures make it more likely that individuals will report increased feelings of sadness or depression. Conclusions: We found that more stringent measures across countries in Europe and Israel affect the mental health of older individuals. The prevalence of increased feelings of sadness/depression was higher in Southern European countries, where the measures were more stringent. We therefore recommend paying particular attention to the possible effects of pandemic control measures on the mental health of older people.Funding awarded to SHARE-Portugal: Calouste Gulbenkian Foundation; and FCT/MCTES through National Funds (PIDDAC); and the European Regional Development Fund (ERDF) through the Operational Program PORNorte and PORLisboa (AAC number 01/SAICT/2016, application number 022209 – DATALAB); and SHARE-DEV3 (GA nº 676536)Funding award to SHARE (all countries): European Commission, DG RTD through FP5 (QLK6-CT-2001-00360), FP6 (SHARE-I3: RII-CT-2006-062193, COMPARE: CIT5-CT-2005-028857, SHARELIFE: CIT4-CT-2006-028812), FP7 (SHARE-PREP: GA N°211909, SHARE-LEAP: GA N°227822, SHARE M4: GA N°261982, DASISH: GA N°283646) and Horizon 2020 (SHARE-DEV3: GA N°676536, SHARE-COHESION: GA N°870628, SERISS: GA N°654221, SSHOC: GA N°823782) and by DG Employment, Social Affairs & Inclusion through VS 2015/0195, VS 2016/0135, VS 2018/0285, VS 2019/0332, and VS 2020/0313. Additional funding from the German Ministry of Education and Research, the Max Planck Society for the Advancement of Science, the U.S. National Institute on Aging (U01_AG09740-13S2, P01_AG005842, P01_AG08291, P30_AG12815, R21_AG025169, Y1-AG-4553-01, IAG_BSR06-11, OGHA_04-064, HHSN271201300071C, RAG052527A) and from various national funding source

Spousal care and pain among the population aged 65 years and older: a European analysis

Background:Spousal care is the most important source of informal care inold age.Nevertheless, despite the growing importance of this issue, the association betweenproviding spousal care inside the household and pain remains unexplored in Europe.Objective and Methods:This study aims to estimate the prevalence of pain reportedby spouse caregivers aged 65 plus that provide care inside the household and toinvestigate the association between providing spousal care and pain. Data from 17European countries that participated in wave 6 of the Surveyof Health, Aging andRetirement in Europe (SHARE) is used. The analyses are basedon 26,301 respondentsaged 65 years and older who provide informal care inside the household to theirspouse/partner exclusively (N=1,895) or do not provide any informal care (inside oroutside the household) (24,406). Descriptive statistics and multilevel logistic regressions(individual-level as level 1, and country as level 2) were performed.Results:Overall, spouse caregivers report pain more often (63.4%) than theirnon-caregiver‘s counterparts (50.3%). Important differences in the prevalence of painamong spouse caregivers were found between countries, withPortugal (80.3%), Spain(74.6%), France (73%), Italy (72.4%), and Slovenia (72.1) showing the highest prevalenceof pain, and Denmark (36%), Switzerland (41.5) and Sweden (42.3%), the lowest. Resultsfrom multilevel logistic regressions show that European individuals aged 65+who providespousal care have an increased likelihood of reporting pain(OR 1.30; CI=1.13–1.48).Conclusion:Our results suggest that in Europe, spouse caregivers aged 65+are atgreater risk of experiencing pain. Therefore, European policymakers should considerspouse caregivers as a health priority group, and take measures to ensure they receivecomprehensive health and socio-economic supportVS/2009/0562; Fundação Calouste Gulbenkian; PINFRA/22209/2016; SHARE-DEV

The longitudinal association between co-residential care provision and healthcare use among the Portuguese population aged 50 and over: a SHARE study

Co-residential care is associated with poor caregiver health and a high burden. Although Portugal relies heavily on co-residential care by individuals aged 50 and over, studies on the impact of co-residential care provision on Portuguese caregivers’ healthcare use are lacking. This study aims to analyze the impact of co-residential care (spousal and non-spousal care) on healthcare use of the Portuguese population aged 50 plus. Data from waves 4 (n = 1697) and 6 (n = 1460) of the Survey of Health, Ageing and Retirement in Europe (SHARE) were used. Negative Binomial Generalized Linear Mixed Models with random (individual level) and fixed (covariates) effects were performed. The results show that the number of visits to the doctor decrease significantly over time for the co-residential spousal caregivers as compared to the non-co-residential caregivers. This result highlights the fact that the Portuguese co-residential spousal caregiver group is at a higher risk of not using healthcare, thus jeopardizing their own health and continuity of care. Promoting more accessible healthcare services and implementing public policies adjusted to the needs of informal caregivers are important to improve the health and healthcare use of Portuguese spousal co-residential caregivers.This paper uses data from SHARE waves 4 and 6 (https://doi.org/10.6103/SHARE.w4.710, https://doi.org/10.6103/SHARE.w6.710). The SHARE data collection has been funded by the European Commission, DG RTD through FP5 (QLK6-CT-2001-00360), FP6 (SHARE-I3: RII-CT-2006- 062193, COMPARE: CIT5-CT-2005-028857, SHARELIFE: CIT4-CT-2006-028812), FP7 (SHARE-PREP: GA N◦211909, SHARE-LEAP: GA N◦227822, SHARE M4: GA N◦261982, DASISH: GA N◦283646) and Horizon 2020 (SHARE-DEV3: GA N◦676536, SHARE-COHESION: GA N◦870628, SERISS: GA N◦654221, SSHOC: GA N◦823782, SHARE-COVID19: GA N◦101015924) and by DG Employment, Social Affairs & Inclusion through VS 2015/0195, VS 2016/0135, VS 2018/0285, VS 2019/0332, and VS 2020/0313. Additional funding from the German Ministry of Education and Research, the Max Planck Society for the Advancement of Science, the U.S. National Institute on Aging (U01_AG09740- 13S2, P01_AG005842, P01_AG08291, P30_AG12815, R21_AG025169, Y1-AG-4553-01, IAG_BSR06-11, OGHA_04-064, HHSN271201300071C, RAG052527A) and from various national funding sources is gratefully acknowledged (see https://share-eric.eu/data/data-access/citation-requirements, accessed on 20 February 2023). In Portugal, this study was financially supported by Calouste Gulbenkian Foundation and by the Portuguese Foundation for Science and Technology through national funds (PIDDAC) and co-financed by the European Regional Development Fund (ERDF), through the Operational Programme PORNorte and PORLisboa, AAC No 01/SAICT/2016, Application No 022209-DATALAB

Modelos longitudinais para momentos de inovação em psicoterapia

Dissertação de mestrado em EstatísticaO paciente diagnosticado com depressão/ ansiedade, submetido ao tratamento com sessões de terapia, passa por mudanças psicológicas e comportamentais, as quais foram denomi- nadas momentos de inovação (MIs). A motivação desse estudo foi estudar corno esses momentos de inovação contribuem para a melhora do paciente. Para tal, usamos os mo- delos longitudinais, onde se leva em consideração a correlação existente entre as medidas de um mesmo indivíduo. O objetivo principal é a aplicação de modelos longitudinais para a análise dos momentos de inovação em sessões de psicoterapia, e suas relações com outras variáveis de interesse (sintomatologia, aliança paciente - terapeuta e retornos ao problema). Os dados do presente estudo, são provenientes de um serviço de psicologia da cidade de Braga - PT, na qual foram observados 63 pacientes diagnosticados com de- pressão/ ansiedade, ao longo de 20 sessões de terapia, e, em cada sessão, recolheram-se informações sobre a sintomatologia (OQI0), a aliança que se forma entre paciente-terapeuta (WAI), os momentos de inovação (MIs) e os retornos ao problema (RPMs). As sessões de terapia foram realizadas pelos métodos cognitivo ou narrativo, onde analisamos a sua in- fluência sobre as variáveis psicoterapêuticas. Após as análises, concluímos que as variáveis psicoterapêuticas estão a influenciar urnas às outras, com exceção dos RP Ms corno predito- res da sintomatologia e da aliança paciente-terapeuta. Os momentos de inovação foram di- vididos em dois grupos (high e low) e analisamos a sua influência na sintomatologia OQI0. OS MI.high são significativos para explicar a sintomatologia, enquanto que os MI.low não o são.The patient diagnosed with depression/anxiety, submitted to treatment with therapy sessions, undergoes psychological and behavioral changes, which are called moments of innovation (MIs). The motivation of this study was to study how these moments of innovation contribute to the improvement of the patient. For this, we use the longitudinal models, which take into account the correlation between measurements of the same individual. The main objective is the application of longitudinal models for the analysis of moments of innovation in sessions of psychotherapy, and their relations with other variables of interest (symptomatology, patient - therapist alliance and returns to the problem). The data from the present study come from a psychology service in the city of Braga - PT, in which 63 patients diagnosed with depression/anxiety were observed during 20 sessions of therapy, and in each session, information was collected about the symptomatology (OQ10), the alliance that forms between patient-therapist (WAI), moments of innovation (MIs) and returns to the problem (RPMs). The sessions of therapy were carried out by the cognitive or narrative methods, we analyzed their influence on the psychotherapeutic variables. After the analysis, we conclude that the psychotherapeutic variables are influencing each other, except for the RPMs as predictors of the symptomatology and the patient-therapist alliance. The moments of innovation were divided into two groups (high and low) and we analyzed their influence on the symptomatology OQ10. The MI.high is significant to explain the symptomatology, whereas the MI.low is not

25. The impact of living alone on physical and mental health: Does loneliness matter?

[Excerpt] Living alone is an increasingly common phenomenon in ageing populations. The death of a spouse and the tendency of older people and their adult children to maintain independent lifestyles are noted as the main causes for this gradual increase in solo living in recent decades (Victor et al., 2000). However, the impact of living alone on the physical and mental health of older people is still unclear. Research on this subject shows that older people who live alone have a high risk of experiencing loneliness (Park et al., 2017). As noted by ShiovitzEzra (2015), loneliness is defined as a feeling of distress that stems from the perception that the quantity and/or the quality of one’s social ties is/are insufficient. A review of several studies concluded that loneliness is associated with poor physical and mental health (Courtin and Knapp, 2017; Shiovitz-Ezra, 2015). Given the increase in solo living among older Europeans, it is important to study the impact of living alone on their physical and mental health, taking into account the role of loneliness in this relationship over time.Fundação Calouste Gulbenkian; PINFRA/22209/2016; SHARE-DEV

Uma metodologia para a caracterização rápida da vegetação em levantamentos terrestres para fins de interpretação de imagens de sensoriamento remoto

Monitoring of secondary succession by remote sensing techniques depends on intensive field work. In this study is tested the point-centered quarter method in order to estimate important structural data in secondary forest stands in southern Brazil. These data are expected to correlate with spectral signature of regeneration stages in Landsat-7 images.Pages: 1781-178