Is grandparental childcare socio-economically patterned? Evidence from the English longitudinal study of ageing

Grandparents play a vital role in providing childcare to families. Qualitative research and evidence from parents raise concerns that it is grandparents who are socio-economically disadvantaged who provide grandchild care more regularly, perform more intensive tasks, and care out of financial necessity. However, no European studies have investigated these issues at population level. This study is based on grandparents aged 50+ who looked after grandchildren. Data are from wave 8 of the nationally representative English Longitudinal Study of Ageing (2016/2017). We exploit newly collected information on frequency of grandchild care, activities, and reasons for care. Using multinomial regressions, we first examined the extent to which grandparents’ socio-economic characteristics (wealth and education) are associated with frequency of grandchild care. Second, using logistic regressions, we investigated whether wealth and education are associated with activities and reasons for grandchild care. Overall, grandparents from disadvantaged socio-economic backgrounds were more likely to provide more regular childcare. Similarly, grandparents in the lowest wealth quartile were more involved in hands-on activities (cooking, taking/collecting grandchildren to/from school), whereas highly educated grandparents were more likely to help grandchildren with homework. Finally, better-off grandparents were more likely to look after grandchildren to help parents and provide emotional support and less likely to report difficulty in refusing to provide care. Our findings show that grandparental childcare varies by socio-economic status with more intensive childcare activities falling disproportionately on those with fewer resources, and this may act to exacerbate existing socio-economic inequalities in later life

The experience of older people with multimorbidity during the COVID-19 pandemic

The risk of severe COVID-19 disease is known to be higher in older individuals with multiple long-term health conditions (multimorbidity). In this briefing, we report the latest findings from the English Longitudinal Study of Ageing COVID-19 Substudy on the experiences of older people with multimorbidity during the pandemic. Not all people with multimorbidity would be classified as clinically vulnerable. We found that 35% of older individuals with multimorbidity were instructed by the NHS or their GP to shield (staying at home at all times and avoiding any face-to-face contact) on account of their vulnerability, and the majority were largely compliant with this advice. Relative to study members without multimorbidity, respondents with multimorbidity were more likely to report poor sleep quality, eating less, and being worried about not having enough food and other essentials. Unhealthy behaviours (sitting time, physical inactivity etc), poor mental health, and loneliness deteriorated considerably during the lockdown and in the two months following the lockdown. Access to medications among people with multimorbidity was not a problem, however, a fifth of individuals with multimorbidity did not have access to community health, social care services and support from other health professionals (e.g., dentist, podiatrist). When considering policies which advise people to shield or self-isolate because of their COVID-19 risk, it is important for policymakers to acknowledge that older people with multiple long-term health conditions are at higher risk of experiencing greater mental distress and worry, of engaging in unhealthy behaviours and are less likely to access health services when needed; all these factors together could potentially influence disease progression

Looking after grandchildren: gender differences in 'when,' 'what,' and 'why': Evidence from the English Longitudinal Study of Ageing

Background: Grandparents play a vital role in providing childcare to families. However, little is known about when grandmothers and grandfathers look after grandchildren, what they do with them, and why. / Objective: Using novel questions on grandparenting, we first describe the periodicity of grandchild care, activities undertaken with/for grandchildren, and motivations for such care to then assess if there are gender differences. / Methods: We used wave 8 (2016/17) of the nationally-representative English Longitudinal Study of Ageing. The extent to which the periodicity, activities, and motivations are gendered was assessed using logistic regressions. Analyses were carried out on the entire sample of grandparents who provide childcare as well as on coresiding grandparent couples where both grandparents provide grandchild care. / Results: More than 50% of grandparents looked after grandchildren, with the majority doing so throughout the year and about one in four during school holidays. Few gender differences were observed in the periodicity of grandchild care and reasons for looking after grandchildren, with almost two-thirds reporting that they wanted to help parents go to work and give them a break. However, when activities undertaken for/with grandchildren were analysed, clear gender differences emerged. Overall, grandmothers were more likely to report caring and helping activities (e.g., cooking, caring when sick, helping with homework, and collecting them from school) than grandfathers, even when they coresided. / Contribution: Our study is the first to document, at a population level, gender differences in the periodicity of grandchild care, what grandparents do when they look after grandchildren, and why they provide such care

Associations of pet ownership with biomarkers of ageing: population based cohort study.

OBJECTIVE: To examine the prospective relation between animal companionship and biomarkers of ageing in older people. DESIGN: Analyses of data from the English Longitudinal Study of Ageing, an ongoing, open, prospective cohort study initiated in 2002-03. SETTING: Nationally representative study from England. PARTICIPANTS: 8785 adults (55% women) with a mean age of 67 years (SD 9) at pet ownership assessment in 2010-11 (wave 5). MAIN OUTCOME MEASURE: Established biomarkers of ageing in the domains of physical, immunological, and psychological function, as assessed in 2012-13 (wave 6). RESULTS: One third of study members reported pet ownership: 1619 (18%) owned a dog, 1077 (12%) a cat, and 274 (3%) another animal. After adjustment for a range of covariates, there was no evidence of a clear association of any type of pet ownership with walking speed, lung function, chair rise time, grip strength, leg raises, balance, three markers of systemic inflammation, memory, or depressive symptoms. CONCLUSION: In this population of older adults, the companionship of creatures great and small seems to essentially confer no relation with standard ageing phenotypes

Multimorbidity, access to services and diagnosis of new health conditions during the COVID-19 pandemic

Excess deaths from conditions other than COVID-19 have been reported during the COVID-19 pandemic. Reduced access to health and social care services during lockdown may have disproportionately affected older people and those with multiple medical conditions. The English Longitudinal Study of Ageing COVID-19 Substudy provided an opportunity to evaluate older people’s experiences of receiving needed health and social care, and changes in reported anxiety, depression and loneliness. We found that the rates of diagnosis of new conditions during the pandemic in the second half of 2020 were substantially different from the pre pandemic rates reported in 2018 to 2019. Rates of newly diagnosed dementia dropped to below half the pre pandemic rate for reasons that are not clear. The increased isolation during lockdown may have meant that cognitive decline went unnoticed by friends and relatives, or barriers to accessing healthcare may have been experienced more by those with early dementia. Conversely, other conditions were diagnosed more frequently than before the pandemic, including arthritis, chronic lung disease, diabetes and hypertension. Again, the reasons for these increases are not clear, but fewer opportunities for physical activity and social interaction may have played a part. Those with multiple medical conditions were more likely to be unable to access healthcare, and 1 in 5 of them had a hospital operation or treatment STUDY RESULT 2 cancelled. We found that mental health worsened during the pandemic, with higher reported rates of anxiety, depression and loneliness, and again the rise was steeper for respondents with multimorbidity. These results show that older people experienced poor mental health and difficulty accessing basic health care during the pandemic, and those with multiple conditions and early dementia had the greatest difficulties. Particular attention should be paid to the health needs of these vulnerable groups as health care access improves and the backlog of cancelled and delayed care is addressed

Changes in vitamin D levels and depressive symptoms in later life in England

Inadequate vitamin D levels have been associated with increased risk of depression. However, most of these studies are cross-sectional and failed to investigate the effect of changes in vitamin D levels. This study aimed to investigate the longitudinal association of changes in serum 25-hydroxyvitamin D levels with depressive symptoms in 3365 participants of the English Longitudinal Study of Ageing, a large nationally-representative study of older adults. Based on their vitamin D levels at baseline and follow-up (sufficient ≥ 50 nmol/L; insufficient < 50 nmol/L), participants were classified as follows: with sufficient levels at both waves; with sufficient levels at baseline but not at follow-up; with insufficient levels at baseline but ≥ 50 nmol/L at follow-up; and with levels < 50 nmol/L at each time point. Depressive symptoms were measured using the 8-point CES-D scale. Data were analysed using logistic regression models. Compared with those with sufficient levels of vitamin D at both waves, only those with insufficient levels throughout were more likely to report elevated depressive symptoms (OR = 1.39, 95% CI = 1.00–1.93). Becoming or no longer being vitamin D deficient was, in the short term, not associated with elevated depressive symptoms. Further evidence is required on whether vitamin D supplementation might contribute to the prevention or treatment of depression as well as on the duration of time for changes in vitamin D levels to lead to detectable changes in depressive symptoms

Cognitive function trajectories and their determinants in older people:8 years of follow-up in the English Longitudinal Study of Ageing

BACKGROUND: Maintaining cognitive function is an important aspect of healthy ageing. In this study, we examined age trajectories of cognitive decline in a large nationally representative sample of older people in England. We explored the factors that influence such decline and whether these differed by gender. METHODS: Latent growth curve modelling was used to explore age-specific changes, and influences on them, in an 8-year period in memory, executive function, processing speed and global cognitive function among 10 626 participants in the English Longitudinal Study of Ageing. We run gender-specific models with the following exposures: age, education, wealth, childhood socioeconomic status, cardiovascular disease, diabetes, physical function, body mass index, physical activity, alcohol, smoking, depression and dementia. RESULTS: After adjustment, women had significantly less decline than men in memory (0.011, SE 0.006), executive function (0.012, SE 0.006) and global cognitive function (0.016, SE 0.004). Increasing age and dementia predicted faster rates of decline in all cognitive function domains. Depression and alcohol consumption predicted decline in some cognitive function domains in men only. Poor physical function, physical inactivity and smoking were associated with faster rates of decline in specific cognitive domains in both men and women. For example, relative to study members who were physically active, the sedentary experienced greater declines in memory (women −0.018, SE 0.009) and global cognitive function (men −0.015, SE 0.007 and women −0.016, SE 0.007). CONCLUSIONS: The potential determinants of cognitive decline identified in this study, in particular modifiable risk factors, should be tested in the context of randomised controlled trials

Are a lack social relationships and cigarette smoking really equally powerful predictors of mortality? Analyses of data from two cohort studies

Publisher Copyright: © 2021 The AuthorsObjective: The suggestion from cross-review comparison that lower levels of social integration (social isolation, loneliness) and cigarette smoking are equally powerful predictors of premature mortality has been promulgated by policy organisations and widely reported in the media. For the first time, we examined this assertion by simultaneously comparing these associations using data from two large cohort studies. Study design: Individual-participant analyses of two large prospective cohort studies. Methods: Participants in UK Biobank and the English Longitudinal Study of Ageing reported loneliness, social-isolation and smoking behaviours using standard scales at baseline. Cause-specific mortality was ascertained via linkage to national registries. We used Cox regression analyses to compute a relative index of inequality to summarise the relation between these baseline characteristics and mortality experience. Results: Mean age at baseline was 56.5 years in the 466,876 (273,452 women) Biobank participants and 66.1 years in the 7505 (4123 women) English Longitudinal Study of Ageing members. In Biobank, a mean duration of mortality surveillance of 6.6 years gave rise to a total of 13,072 deaths, while in the English Longitudinal Study of Ageing, 1183 deaths occurred after a mean of 7.7 years. In ascending magnitude, loneliness, social isolation then cigarette smoking were associated with an increased risk of mortality from all-causes and all cancers combined. When cardiovascular disease mortality was the endpoint of interest, both smoking and social isolation, though not loneliness, revealed similar relationships. Conclusions: Contrary to cross-review comparisons, in the present datasets it appears that poor social integration is in fact less strongly linked to total mortality than cigarette smoking.Peer reviewe

State of the art of BNP and NT-proBNP immunoassays: The CardioOrmoCheck study

To evaluate differences in analytical performance and clinical results of BNP and NT-proBNP immunoassays, a proficiency testing program, called CardioOrmoCheck study, has been organized since 2005 under the patronage of the Study Group of the Cardiovascular Biomarkers of the Italian Society of Clinical Biochemistry (SIBIOC). On average more than 100 Italian laboratories were involved in the annual 2005–2011 cycles. In total, 72 study samples were distributed and measured by participant laboratories for a total of 6706 results. A great difference in between-method variability was found between BNP (43.0 CV%) and NT-proBNP (8.7 CV%) immunoassays. However, with the only exception of the POCT method for BNP assay, all immunoassay methods showed an imprecision≤10 CV% at the cut-off levels (i.e. 100 ng/L for BNP and 400 ng/L for NT-proBNP assay, respectively). Furthermore, CardioOrmoCheck study demonstrated that the most popular BNP immunoassays are affected by large systematic differences (on average more than 2 folds between TRIAGE Beckman-Coulter and ADVIA Centaur Siemens methods), while the agreement between NT-proBNP methods was better. CardioOrmoCheck study demonstrates that there are marked differences in analytical performance and measured values in particular among commercialmethods for BNP assay. These findings suggest that it may be not reasonable to recommend identical cut-off or decision values for all BNP immunoassays

Association of cognitive function with cause-specific mortality in middle and older age:Follow-up of Participants in the English Longitudinal Study of Ageing

We examined the little-tested associations between general cognitive function in middle and older age and later risk of death from chronic diseases. In the English Longitudinal Study of Ageing (2002–2012), 11,391 study participants who were 50–100 years of age at study induction underwent a battery of cognitive tests and provided a range of collateral data. In an analytical sample of 9,204 people (4,982 women), there were 1,488 deaths during follow-up (mean duration, 9.0 years). When we combined scores from 4 cognition tests that represented 3 acknowledged key domains of cognitive functioning (memory, executive function, and processing speed), cognition was inversely associated with deaths from cancer (per each 1-standard-deviation decrease in general cognitive function score, hazard ratio = 1.21, 95% CI: 1.10, 1.33), cardiovascular disease (hazard ratio = 1.71, 95% CI: 1.55, 1.89), other causes (hazard ratio = 2.07, 95% CI: 1.79, 2.40), and respiratory illness (hazard ratio = 2.48, 95% CI: 2.12, 2.90). Controlling for a range of covariates, such as health behaviors and socioeconomic status, and left-censoring to explore reverse causality had very little impact on the strength of these relationships. These findings indicate that cognitive test scores can provide relatively simple indicators of the risk of death from an array of chronic diseases and that these associations appear to be independent of other commonly assessed risk factors