Health

Social isolation and loneliness: prospective associations with functional status in older adults

Journal article looking at the relationship between mother's mental health and childhood behaviour using the Millennium Cohort Study

Visual impairment becomes more prevalent with age. Rather than a uniform decline in vision with age, the strength and direction of change varies between people. This study applies an analytical method that posits multiple trajectories in eyesight, allowing for a more specific description of developmental course of this health outcome and its relationship with social position. The analysis uses the responses of 2956 respondents, aged 60 years and over, followed over 8 years (five observations) as part of the English longitudinal study of ageing. At each observation respondents self-reported their general vision. Optimal matching (sequence analysis), hierarchical clustering, and multinomial logistic regression were used to describe the sequential data, produce a typology of vision trajectories, and examine the socio-demographic characteristics associated with different trajectories. Eight distinctive clusters of trajectories were identified. The probability of reporting different types of vision trajectory varies with a change in age; however, the magnitude of the age effect is associated with social position. Visual impairment in older people is an increasingly relevant area for policy focus, with the rapid growth and diversity of the older population. Identifying factors underpinning the patterning of changes in visual function is essential for developing evidence-based policy, which both meets the needs of those most at risk and increases cost-effectiveness of public health interventions.

Due to an expected increase of people in need of care, sound knowledge about health effects of informal care provision is becoming more and more important. Theoretically, there might be positive as well as negative health effects due to caregiving to relatives. Moreover, we suppose that such health effects differ by national context - since care is differently organized in Europe - and depend on the social setting in which the care relationship takes place. Using data from the Survey of Health, Ageing and Retirement (SHARE, waves 1, 2, 3, and 5) and from the English Longitudinal Study of Ageing (ELSA, waves 2-5) we examined the connection between informal caregiving and self-perceived as well as mental health in a country comparative perspective. Taking advantage of the longitudinal structure of the data, pooled ordinary least squares (OLS) and fixed-effects models (FEM) were estimated. Our results show distinct differences in the relationship between reported health and the provision of informal care depending on whether individuals give care to someone inside or outside the household. Caregivers inside the household reported worse health, caregivers from outside the household reported better health than non-caregivers. We find that this correlation is largely due to selection into caregiving: people in worse health took up care inside while people in better health took up care outside the household. However, in most countries people who started caregiving inside the household experienced a decline in their mental health. This suggests that caregiving inside the household results in psychological stress irrespective of the type of welfare state. The results regarding self-perceived health and caregiving outside the household are less distinct. All in all our results show that health consequences of caregiving vary not only between different welfare regimes but also between countries of similar welfare state types.

FINISH Impact Evaluation Report

Recent evidence suggests that low vitamin D concentrations are associated with increased levels of inflammatory markers. However, there are limited studies investigating associations between vitamin D levels and inflammatory markers in the general population and much of this evidence in older adults is inconclusive. Therefore, this study investigates the cross-sectional association of serum 25-hydroxyvitamin D (25(OH)D) levels with inflammatory markers in 5870 older English adults from wave 6 (2012-2013) of the English Longitudinal Study of Ageing (ELSA). ELSA is a large prospective observational study of community-dwelling people aged 50 years and over in England. Serum 25(OH)D levels, C-reactive protein (CRP) levels, plasma fibrinogen levels, white blood cell count (WBC), age, season of blood collection, waist circumference, total non-pension household wealth, measures of health and health behaviours that included depression, number of cardiovascular, non-cardiovascular conditions and difficulties in activities of daily living, smoking, and physical activity were measured. There was a significant negative association between low 25(OH)D levels (≤30 nmol/l) and CRP (OR 1·23, 95 % CI 1·00, 1·51) and WBC (OR 1·35, 95 % CI 1·13, 1·60) that remained after adjustment for a wide range of covariates of clinical significance. However, for fibrinogen, the association did not remain significant when waist circumference was entered in the final model. Our findings showed that 25(OH)D levels were associated with two out the three inflammatory markers investigated. The independent and inverse association between serum 25(OH)D levels and inflammation suggests a potential anti-inflammatory role for vitamin D in older English individuals from the general population.

The English Longitudinal Study of Ageing (ELSA) (Steptoe et al. 2013a) is a multidis- ciplinary panel study that collects a comprehensive array of measures on a representative sample of men and woman aged 50 and over who are living in England. Repeated measures covering health, economics, psychology, lifestyle, and social connections are collected from the same individuals over time, allowing researchers to study the dynamics of the aging process.

Cross-sectional analyses of adiposity and sleep duration in younger adults suggest that increased adiposity is associated with shorter sleep. Prospective studies have yielded mixed findings, and the direction of this association in older adults is unclear. We examined the cross-sectional and potential bi-directional, prospective associations between adiposity and sleep duration (covariates included demographics, health behaviours, and health problems) in 5,015 respondents from the English Longitudinal Study of Ageing (ELSA), at baseline and follow-up. Following adjustment for covariates, we observed no significant cross-sectional relationship between body mass index (BMI) and sleep duration [(unstandardized) B = -0.28 minutes, (95% Confidence Intervals (CI) = -0.012; 0.002), p = 0.190], or waist circumference (WC) and sleep duration [(unstandardized) B = -0.10 minutes, (95% CI = -0.004; 0.001), p = 0.270]. Prospectively, both baseline BMI [B = -0.42 minutes, (95% CI = -0.013; -0.002), p = 0.013] and WC [B = -0.18 minutes, (95% CI = -0.005; -0.000), p = 0.016] were associated with decreased sleep duration at follow-up, independently of covariates. There was, however, no association between baseline sleep duration and change in BMI or WC (p > 0.05). In older adults, our findings suggested that greater adiposity is associated with decreases in sleep duration over time; however the effect was very small.

Physical inactivity in relation to self-rated eyesight: cross-sectional analysis from the English Longitudinal Study of Ageing.

he consequences of self-reported vision change in later-life: evidence from the English Longitudinal Study of Ageing

Informal caregiving transitions, subjective wellbeing and depressed mood: Findings from the English Longitudinal Study of Ageing

BACKGROUND: Since our knowledge of the associations between socioeconomic position (SEP) over the life course and inflammatory and metabolic markers, which are excellent predictors of cardiovascular disease, remains limited, we examined the association between social mobility over the life course and these markers at older ages.

OBJECTIVE: There is increasing evidence for weight-based discrimination against persons with obesity. This study aimed to examine the physiological impact of perceived weight discrimination on cortisol in hair, an indicator of chronic stress exposure.

BACKGROUND: we aimed to develop and validate a population-representative 10-year mortality risk index for older adults in England.

Early-Life Exposure to the Great Smog of 1952 and the Development of Asthma

Sexuality after a cancer diagnosis: A population-based study

Early-life exposure to the great smog of 1952 and the development of asthma.

OBJECTIVE: To test whether the number of reports of enjoyment of life over a four year period is quantitatively associated with all cause mortality, and with death from cardiovascular disease and from other causes. DESIGN AND SETTING: Longitudinal observational population study using the English Longitudinal Study of Ageing (ELSA), a nationally representative sample of older men and women living in England. PARTICIPANTS: 9365 men and women aged 50 years or older (mean 63, standard deviation 9.3) at recruitment. MAIN OUTCOME MEASURES: Time to death, based on mortality between the third phase of data collection (wave 3 in 2006) and March 2013 (up to seven years). RESULTS: Subjective wellbeing with measures of enjoyment of life were assessed in 2002 (wave 1), 2004 (wave 2), and 2006 (wave 3). 2264 (24%) respondents reported no enjoyment of life on any assessment, with 1833 (20%) reporting high enjoyment on one report of high enjoyment of life, 2063 (22%) on two reports, and 3205 (34%) on all three occasions. 1310 deaths were recorded during follow-up. Mortality was inversely associated with the number of occasions on which participants reported high enjoyment of life. Compared with the no high enjoyment group, the hazard ratio for all cause mortality was 0.83 (95% confidence interval 0.70 to 0.99) for two reports of enjoyment of life, and 0.76 (0.64 to 0.89) for three reports, after adjustment for demographic factors, baseline health, mobility impairment, and depressive symptoms. The same association was observed after deaths occurring within two years of the third enjoyment measure were excluded (0.90 (0.85 to 0.95) for every additional report of enjoyment), and in the complete case analysis (0.90 (0.83 to 0.96)). CONCLUSIONS: This is an observational study, so causal conclusions cannot be drawn. Nonetheless, the results add a new dimension to understanding the significance of subjective wellbeing for health outcomes by documenting the importance of sustained wellbeing over time.

Relationship between employment histories and frailty trajectories in later life: evidence from the English Longitudinal Study of Ageing

Why is multiple micronutrient powder ineffective at reducing anaemia among 12–24 month olds in Colombia? Evidence from a randomised controlled trial