TY - JOUR T1 - Association of perceived job security and chronic health conditions with retirement in older UK and US workers. JF - European Journal of Public Health Y1 - 2022 A1 - Mutambudzi, Miriam A1 - Flowers, Paul A1 - Demou, Evangelia KW - attenuation KW - Chronic disease KW - community health centers KW - ELSA KW - epidemiologic studies KW - health outcomes KW - insecurity KW - labor market KW - Safety KW - Sister studies KW - Social Welfare KW - Survival Analysis KW - Workplace AB -

BACKGROUND: The relationship between job insecurity, chronic health conditions (CHCs) and retirement among older workers are likely to differ between countries that have different labor markets and health and social safety nets. To date, there are no epidemiological studies that have prospectively assessed the role of job insecurity in retirement incidence, while accounting for CHC trajectories in two countries with different welfare systems. We investigated the strength of the association between baseline job insecurity and retirement incidence over an 11-year period while accounting for CHC trajectories, among workers 50-55 years of age at baseline in the UK and USA.

METHODS: We performed Cox proportional hazards regression analysis, using 2006-2016 data from the Health and Retirement Study (US cohort, n = 570) and English Longitudinal Study on Aging (UK cohort n = 1052).

RESULTS: Job insecurity was associated with retirement after adjusting for CHC trajectories (HR = 0.69, 95% CI = 0.50-0.95) in the UK cohort only. CHC trajectories were associated with retirement in both cohorts; however, this association was attenuated in the US cohort, but remained significant for the medium-increasing trajectory in the UK cohort (HR = 1.41, 95% CI = 1.01-1.97) after adjustment for all covariates. Full adjustment for relevant covariates attenuated the association between job insecurity and retirement indicating that CHCs, social and health factors are contributing mechanistic factors underpinning retirement incidence.

CONCLUSIONS: The observed differences in the two cohorts may be driven by macro-level factors operating latently, which may affect the work environment, health outcomes and retirement decisions uniquely in different settings.

VL - 32 IS - 1 ER - TY - RPRT T1 - A Cross-Country Comparison of Old Age Financial Readiness in Asian Countries vs. the United States: The Case of Japan and the Republic of Korea Y1 - 2022 A1 - Ehrlich, Isaac A1 - Yin, Yong KW - financial readiness KW - JSTAR KW - KLoSA KW - Sister studies AB - We pursue a cross-country comparison of relative financial readiness of older households in Japan and the Republic of Korea relative to the US. Our comparative analysis, using macro-level and harmonized longitudinal household financial data, covers the principal financial channels of old age support: public and private pension plans, family support, and self-management of private financial portfolios. We find that while all three countries have similar public pension systems, older Americans benefit from more developed and better-funded public and private pension systems, as well as individual management of risky financial portfolios. We find that educational and health attainments of household heads and household wealth lead to a greater tendency to hold and manage risky assets. Our decomposition analysis also shows that the gap in stock ownership in Asian countries relative to the US is attributable to lower development levels of financial and pension markets. However, these gaps are shrinking more recently. JF - NBER Working Papers PB - National Bureau of Economic Research CY - Cambridge, MA ER - TY - JOUR T1 - Associations between education and dementia in the Caribbean and the United States: An international comparison. JF - Alzheimer's & Dementia Y1 - 2021 A1 - Li, Jing A1 - Llibre-Guerra, Jorge J A1 - Harrati, Amal A1 - Weiss, Jordan A1 - Jiménez-Velázquez, Ivonne Z A1 - Acosta, Daisy A1 - Llibre-Rodriguez, Juan de Jesús A1 - Liu, Mao-Mei A1 - William H Dow KW - Caribbean KW - Dementia KW - Education KW - Hispanics KW - Sister studies AB -

Introduction: Despite high dementia prevalence in Hispanic populations globally, especially Caribbean Hispanics, no study has comparatively examined the association between education and dementia among Hispanics living in the Caribbean Islands and older adults in the United States.

Methods: We used data on 6107 respondents aged 65 and older in the baseline wave of the population-based and harmonized 10/66 survey from Cuba, the Dominican Republic, and Puerto Rico, collected between 2003 and 2008, and 11,032 respondents aged 65 and older from the U.S.-based Health and Retirement Study data in 2014, a total of 17,139 individuals. We estimated multivariable logistic regression models examining the association between education and dementia, adjusted for age, income, assets, and occupation. The models were estimated separately for the Caribbean population (pooled and by setting) and the U.S. population by race/ethnicity (Hispanic, Black, and White), followed by pooled models across all populations.

Results: In the Caribbean population, the relative risk of dementia among low versus high educated adults was 1.45 for women (95% confidence interval [CI] 1.17, 1.74) and 1.92 (95% CI 1.35, 2.49) for men, smaller compared to those in the United States, especially among non-Hispanic Whites (women: 2.78, 95% CI 1.94, 3.61; men: 5.98, 95% CI 4.02, 7.95).

Discussion: The differential associations between education and dementia across the Caribbean and US settings may be explained by greater disparities in social conditions in the United States compared to the Caribbean, such as access to health care, healthy behaviors, and social stressors, which serve as potentially important mediators.

VL - 7 IS - 1 ER - TY - JOUR T1 - Comparisons of disease cluster patterns, prevalence and health factors in the USA, Canada, England and Ireland. JF - BMC Public Health Y1 - 2021 A1 - Hernandez, Belinda A1 - Voll, Stacey A1 - Nathan A Lewis A1 - McCrory, Cathal A1 - White, Arthur A1 - Stirland, Lucy A1 - Kenny, Rose Anne A1 - Reilly, Richard A1 - Hutton, Craig P A1 - Griffith, Lauren E A1 - Kirkland, Susan A A1 - Graciela Muñiz Terrera A1 - Scott M Hofer KW - disease clusters KW - ELSA KW - Latent Class Analysis KW - multimorbidity KW - Sister studies KW - TILDA AB -

BACKGROUND: Identification of those who are most at risk of developing specific patterns of disease across different populations is required for directing public health policy. Here, we contrast prevalence and patterns of cross-national disease incidence, co-occurrence and related risk factors across population samples from the U.S., Canada, England and Ireland.

METHODS: Participants (n = 62,111) were drawn from the US Health and Retirement Study (n = 10,858); the Canadian Longitudinal Study on Ageing (n = 36,647); the English Longitudinal Study of Ageing (n = 7938) and The Irish Longitudinal Study on Ageing (n = 6668). Self-reported lifetime prevalence of 10 medical conditions, predominant clusters of multimorbidity and their specific risk factors were compared across countries using latent class analysis.

RESULTS: The U.S. had significantly higher prevalence of multimorbid disease patterns and nearly all diseases when compared to the three other countries, even after adjusting for age, sex, BMI, income, employment status, education, alcohol consumption and smoking history. For the U.S. the most at-risk group were younger on average compared to Canada, England and Ireland. Socioeconomic gradients for specific disease combinations were more pronounced for the U.S., Canada and England than they were for Ireland. The rates of obesity trends over the last 50 years align with the prevalence of eight of the 10 diseases examined. While patterns of disease clusters and the risk factors related to each of the disease clusters were similar, the probabilities of the diseases within each cluster differed across countries.

CONCLUSIONS: This information can be used to better understand the complex nature of multimorbidity and identify appropriate prevention and management strategies for treating multimorbidity across countries.

VL - 21 IS - 1 ER - TY - JOUR T1 - Sex differences in functional limitations and the role of socioeconomic factors: a multi-cohort analysis JF - The Lancet Healthy Longevity Y1 - 2021 A1 - Mikaela Bloomberg A1 - Aline Dugravot A1 - Benjamin Landré A1 - Annie Britton A1 - Andrew Steptoe A1 - Archana Singh-Manoux A1 - Séverine Sabia KW - Activities of Daily Living KW - ELSA KW - Functional limitations KW - Sex differences KW - SHARE KW - Sister studies KW - Socioeconomic factors KW - TILDA AB - Summary Background Women are more likely to have functional limitations than are men, partly because of greater socioeconomic disadvantage. However, how sex differences vary by severity of functional limitations remains unclear. We examined sex differences in functional limitations, with attention to socioeconomic factors and severity of limitations. Methods Longitudinal data on limitations in basic activities of daily living (ADL) and instrumental activities of daily living (IADL) and mobility activities were drawn from 62 375 participants from 14 countries. For ADL, IADL, and mobility, participants were categorised based on number of limited activities (0, 1, 2, or ≥3). Sex differences in limitations in four birth cohorts (1895–1929, 1930–38, 1939–45, and 1946–60) were analysed before and after adjustment for socioeconomic factors (education and labour force status). Findings The prevalence of IADL and ADL limitations was higher in women than in men. After adjustment for socioeconomic factors, this sex difference was attenuated. The sex difference in IADL limitations at age 75 years (in the 1895–1929 cohort) was 3·7% before adjustment for socioeconomic factors (95% CI 2·6–4·7) and 1·7% (1·1–2·2) after adjustment. For ADL, the sex difference in limitations at age 75 years (in the 1895–1929 cohort) was 3·2% (2·3–4·1) before adjustment for socioeconomic factors and 1·4% (0·9–1·8) after adjustment. Sex differences in mobility limitations (16·1%, 95% CI 14·4–17·7) remained after adjustment for socioeconomic factors (14·3%, 12·7–15·9). After age 85 years, women were more likely to have three or more IADL or mobility limitations and men were more likely to have one or two limitations. Interpretation Socioeconomic factors largely explain sex differences in IADL and ADL limitations but not mobility. Sex differences in mobility limitations in midlife are important targets for future research and interventions. Funding National Institute on Aging, UK National Institute for Health Research, European Commission, and US Social Security Administration. VL - 2 IS - 12 ER - TY - JOUR T1 - Subjective Age and Verbal Fluency among Middle Aged and Older Adults: A Meta-Analysis of Five Cohorts JF - Archives of Gerontology and Geriatrics Y1 - 2021 A1 - Yannick Stephan A1 - Angelina R Sutin A1 - Martina Luchetti A1 - Damaris Aschwanden A1 - Antonio Terracciano KW - Adulthood KW - ELSA KW - Sister studies KW - Subjective age KW - verbal fluency AB - Objectives This study aimed to examine the relation between subjective age and verbal fluency in five large samples of older adults to advance knowledge on the role of subjective age in a complex cognitive function that is an intermediate marker of cognitive impairment and dementia risk. Methods Participants (N > 27,000), aged 32 to 99 years old, predominantly white, were from the Wisconsin Longitudinal Study Graduate (WLSG) and Siblings (WLSS) samples, the Health and Retirement Study (HRS), the Midlife in the United States Study (MIDUS), and the English Longitudinal Study of Ageing (ELSA). They provided complete data on subjective age, demographic factors and verbal fluency. Estimates from each sample were combined in a meta-analysis. Results Across each of the five samples and in the meta-analysis, an older subjective age was related to lower performance on the verbal fluency task. This association was independent of chronological age and was not moderated by age, sex, nor education. The difference in fluency between individuals with an older and younger subjective age ranged from d= .09 to d= .37 across the five samples. Conclusions This study found replicable evidence for an association between an older subjective age and lower verbal fluency, extending knowledge about an intermediate marker of cognitive function. VL - 97 ER - TY - JOUR T1 - A cross-sectional study of self-rated health among older adults: a comparison of China and the United States. JF - BMJ Open Y1 - 2019 A1 - Xu, Dongjuan A1 - Arling, Greg A1 - Wang, Kefang KW - CHARLS KW - Cross-National KW - Self-reported health KW - Sister studies AB -

OBJECTIVES: We used nationally representative samples of China and the US older population to investigate (1) whether factors influencing self-rated health among older Chinese were similar to those among older Americans; and (2) whether there was a significant cross-national difference in self-rated health between China and the USA after controlling those available influencing factors.

DESIGN: A cross-sectional study. Data came from the 2014 Health and Retirement Study and China Health and Retirement Longitudinal Study conducted from 2014 to 2015.

PARTICIPANTS: Our final sample size totaled 8905 older adults in the USA and 4442 older adults in China.

OUTCOME: The response variable was self-rated health. Ordered logistic regression models were conducted to investigate factors influencing self-rated health among older adults.

RESULTS: More than three-fourths (78%) of older adults in China reported fair or poor health status, while almost 74% of older adults in the USA reported excellent, very good or good health status. In the overall ordered logistic regression model, when controlling statistically for sociodemographics, family structure, functional limitations, cognition, chronic conditions, mental health and health-related behaviours, the Chinese survey respondents were much more likely to rate their health as being poorer than the US respondents. The odds of having better versus poorer health was almost five times greater in American older adults than those in China (OR=4.88, 95% CI 4.06 to 5.86). Older adults in China living alone rated their health better than those living with spouse/partner; however, no significant difference was found between these two living arrangements in older Americans. In contrast, older adults in the USA living with others rated their health worse compared with those living with spouse/partner. In addition, older adults who had more activities of daily living limitations, poorer self-reported memory, worse mental health and chronic health conditions had lower self-rated health in both countries.

CONCLUSIONS: We found a striking difference in self-rated health between China and the USA even after controlling for measures of disease, functional status and other influencing factors. Relative to their American counterparts, Chinese elders were much more likely to report worse health.

VL - 9 IS - 7 U1 - http://www.ncbi.nlm.nih.gov/pubmed/31371288?dopt=Abstract ER - TY - JOUR T1 - Economic development and gender inequality in cognition: a comparison of China and India, and of SAGE and the HRS sister studies. JF - Journal of Economics of Ageing Y1 - 2014 A1 - David R Weir A1 - Margaret Lay A1 - Kenneth M. Langa KW - CHARLS KW - Economics KW - Gender Differences KW - LASI KW - Older Adults KW - SAGE KW - Sister studies AB -

This paper examines cognition measures by age and gender from two types of studies in China and India. It finds that despite some notable differences in samples and measures, a general strong association of cognition in older ages with education emerges as a potential explanation for gender gaps and cohort differences. Female disadvantage in cognition is greater in India, both before and after controlling for education. The process of rural-urban migration draws more cognitively able women to cities in China but not in India. The advent of modern longitudinal studies of aging in these developing countries holds great promise for future work.

VL - 4 ER -