Anja Leist

Social Media Use of Older Adults: A Mini-Review

Background: Maintaining social relationships has been defined as a core element of aging well. With a considerable amount of older adults living alone, social media provides the possibility to engage in meaningful social contact, e.g. by joining online social networks and online discussion forums. Objective: The review encompasses current knowledge of prerequisites in social media use of older adults such as functional capacity, information and communications technology-related knowledge, and favorable attitudes towards social media. Then, the potential of social media use for clinical practice and possible negative consequences are outlined. Method: Literature on social media use from a gerontological perspective was reviewed in July and August 2012. Results: Online communities are suitable for providing and receiving social support when confronted with a difficult life situation, regardless of geographical location or time. From a practitioners perspective, social media can be used to advance health-related knowledge such as information on prevention, diagnosis, and treatment of specific conditions and disorders. Further positive consequences have been shown to be overcoming loneliness, relieving stress, and raising feelings of control and self-efficacy. Possible negative consequences could be misuse of personal data as well as the distribution and uncritical adoption of potentially harmful information via online communities. Discussion: The potential of social media in clinical practice is reflected in a wide range of intervention possibilities for older adults. However, with the rise of social media, new threats emerge for older adults as well.

Socioeconomic hierarchy and health gradient in Europe: the role of income inequality and of social origins

BackgroundHealth inequalities reflect multidimensional inequality (income, education, and other indicators of socioeconomic position) and vary across countries and welfare regimes. To which extent there is intergenerational transmission of health via parental socioeconomic status has rarely been investigated in comparative perspective. The study sought to explore if different measures of stratification produce the same health gradient and to which extent health gradients of income and of social origins vary with level of living and income inequality.MethodsA total of 299,770 observations were available from 18 countries assessed in EU-SILC 2005 and 2011 data, which contain information on social origins. Income inequality (Gini) and level of living were calculated from EU-SILC. Logit rank transformation provided normalized inequalities and distributions of income and social origins up to the extremes of the distribution and was used to investigate net comparable health gradients in detail. Multilevel random-slope models were run to post-estimate best linear unbiased predictors (BLUPs) and related standard deviations of residual intercepts (median health) and slopes (income-health gradients) per country and survey year.ResultsHealth gradients varied across different measures of stratification, with origins and income producing significant slopes after controls. Income inequality was associated with worse average health, but income inequality and steepness of the health gradient were only marginally associated.ConclusionsLinear health gradients suggest gains in health per rank of income and of origins even at the very extremes of the distribution. Intergenerational transmission of status gains in importance in countries with higher income inequality. Countries differ in the association of income inequality and income-related health gradient, and low income inequality may mask health problems of vulnerable individuals with low status. Not only income inequality, but other country characteristics such as familial orientation play a considerable role in explaining steepness of the health gradient.

Testing persistence of cohort effects in the epidemiology of suicide: an age-period-cohort hysteresis model

Birth cohort effects in suicide rates are well established, but to date there is no methodological approach or framework to test the temporal stability of these effects. We use the APC-Detrended (APCD) model to robustly estimate intensity of cohort effects identifying non-linear trends (or ‘detrended’ fluctuations) in suicide rates. The new APC-Hysteresis (APCH) model tests temporal stability of cohort effects. Analysing suicide rates in 25 WHO countries (periods 1970–74 to 2005–09; ages 20–24 to 70–79) with the APCD method, we find that country-specific birth cohort membership plays an important role in suicide rates. Among 25 countries, we detect 12 nations that show deep contrasts among cohort-specific suicide rates including Italy, Australia and the United States. The APCH method shows that cohort fluctuations are not stable across the life course but decline in Spain, France and Australia, whereas they remain stable in Italy, the United Kingdom and the Netherlands. We discuss the Spanish case with elevated suicide mortality of cohorts born 1965–1975 which declines with age, and the opposite case of the United States, where the identified cohort effects of those born around 1960 increase smoothly, but statistically significant across the life course.

Social, Behavioral, and Contextual Influences on Cognitive Function and Decline over the Life Course

Maintaining cognitive function is a prerequisite for living autonomously in older age and it is highly desirable to postpone cognitive decline for as long as possible. In order to understand how cognitive function is shaped across the life course, it is necessary to focus on life course influences on cognitive aging. The chapter gives a selective review of current knowledge on life course influences on later-life cognitive function with a particular focus on the most recent developments in research on cognitive reserve between 2008 and 2013. First, the theoretical framework of cognitive reserve and life course epidemiology is introduced. Then, an overview is given on life course influences that have been shown to shape later cognitive function, with a focus on important factors of social and behavioral nature, such as education, work environment, and social and physical activities. New research on contextual factors, such as neighborhood socioeconomic status, schooling laws, and retirement policies is then presented. The chapter ends with prospects for further research.

Technology and Aging: Inhibiting and Facilitating Factors in ICT Use

Extending a literature review, the paper gives an overview of inhibiting and facilitating factors associated with the use of information and communications technology (ICT) of older adults. The paper takes the position that there is no prototypical “elderly user” but that there is a wide heterogeneity of personal characteristics such as cognitive and motivational states and experiences in old age. Dependent upon various characteristics of the elderly user as well as the context of application, development and implementation of ICT should follow the desideratum of a differential technology implementation taking an integrative approach by reconciling individual and social as well as socio-political approaches.

V2me: Evaluating the first steps in mobile friendship coaching

Life events, such as retirement or being widowed, can change the social circle of older people considerably. It may be difficult to find new social contacts when one has never got used to, or perhaps even never learnt, to seek and maintain those contacts. Loneliness has many negative effects for well-being, including depression and even cardiovascular disease. The Ambient Assisted Living Joint Programme AAL-JP research project V2me seeks to find a solution for alleviating loneliness by means of easy-to-use technology including touch screen devices. The idea is to use a virtual coach for encouraging users to take an active role in contacting people and teaching them how to initiate and maintain meaningful and enduring relations. The first step, in the process of creating the complete virtual coach-assisted system for preventing loneliness, is to create a proto type and use the feedback from older users for developing the system. In this paper we discuss the results of the first pilot and what steps need to be taken next.

Economic Downturns, Retirement and Long-Term Cognitive Function Among Older Americans

Objective Workers approaching retirement may be particularly vulnerable to economic downturns. This study assesses whether exposure to economic downturns around retirement age leads to poorer cognitive function in later life. Method Longitudinal data for 13,577 individuals in the Health and Retirement Study were linked to unemployment rates in state of residence. Random- and fixed-effect models were used to examine whether downturns at 55-64 years of age were associated with cognitive functioning levels and decline at ≥65 years, measured by the Wechsler Adult Intelligence Scale-Revised. Results Longer exposure to downturns at 55-64 years of age was associated with lower levels of cognitive function at ≥65 years. Compared to individuals experiencing only up to 1 year in a downturn at 55-64 years of age, individuals experiencing two downturns at these ages had 0.09 point (95% Confidence Interval [CI, -0.17, -0.02]) lower cognitive functioning scores at ≥65 years (3 years: b = -0.17, 95%CI [-0.29, -0.06]; 4 years: b = -0.14, 95%CI [-0.25, -0.02]; ≥5 years: b = -0.22, 95%CI [-0.38, -0.06]). Downturns at 55-64 years of age were not associated with rates of cognitive decline. Discussion Exposure to downturns around retirement is associated with a long-lasting decline in cognitive function in later life. Policies mitigating the impact of downturns on older workers may help to maintain cognitive function in later life.

The Role of Nutrition and Literacy on the Cognitive Functioning of Elderly Poor Individuals

ABSTRACT Maintaining cognitive function is a prerequisite of living independently, which is a highly valued component in older individuals’ well-being. In this article we assess the role of early-life and later-life nutritional status, education, and literacy on the cognitive functioning of older adults living in poverty in Peru. We exploit the baseline sample of the Peruvian noncontributory pension program Pension 65 and find that current nutritional status and literacy are strongly associated with cognitive functioning for poor older adults. In a context of rising popularity of noncontributory pension programs around the world, our study intends to contribute to the discussion of designing accompanying measures to the pension transfer, such as adult literacy programs and monitoring of adequate nutrition of older adults.

Social Inequalities in Dementia Care, Cure, and Research

To the Editor: The World Health Organization’s Executive Board discussed the revised Global Action Plan on the Public Health Response to Dementia at the end of January 2017, with recommendations that the World Health Assembly adopt the plan the following May. That was a major step toward concerted worldwide efforts to address dementia care, cure, and research. With its inclusive nature, the plan aims to improve all countries’ standards regarding dementia; it is thus most welcome, because there are deficits even in the most-advanced countries. Two crosscutting principles of the plan target potential social inequalities in dementia. The first advocates “universal health and social care coverage for dementia” and equitable access to all relevant care services, regardless of financial resources. The second principle supports equity, stressing that all public health responses should support gender equity and vulnerable people “specific to each national context.” These principles are important and well founded, but they may not fully address the staggering ubiquity of social inequalities in dementia care. The drastic educational differences in cognitive function, decline, and dementia incidence are well known; differences in intelligence that selects into education and the neuroprotective effects of education that increase cognitive reserve are commonly cited as explanations for these differences. Without considering such educational differences in this letter, social inequalities in dementia can be found in virtually all fields of cure, care, and research. Early access to diagnostic services and to antidementia medication is desirable—even if there is no cure. Likewise, the prescription of antipsychotic drugs may be undesirable because such drugs have “important and potentially serious side effects” and should be prescribed only with caution and close monitoring. There are social inequalities in dementia incidence between racial and ethnic groups, and there are also inequalities in research, care, and treatment. Ethnic minorities access diagnostic services later in life; after being diagnosed, they are less likely to receive antidementia medication, undergo research trials, or receive 24-hour care. Disparities according to sex (with higher prevalence of dementia in women) are to a large extent attributable to the greater longevity of women, although this may not be the full explanation. Disparities according to sex are also evident in access to research because men are more likely to be recruited for dementia studies. Individual and neighborhood socioeconomic differences play a large role in social inequalities in dementia care; having a lower income decreases the chances of receiving counseling and increases the likelihood of receiving antipsychotic drugs after diagnosis of dementia. In England, living in areas with higher deprivation decreases the likelihood of being prescribed antidementia drugs, and living in rural areas increases the probability of receiving antipsychotic drugs. What are the implications of those social inequalities in dementia cure, care, and research? In contrast to the principle of equity stated in many national dementia plans, substantial numbers of people living with dementia do not receive optimal medical treatment or care; they lack the opportunity to participate in—and therefore benefit from —research studies. These inequalities may also extend to imbalanced access to risk-reduction interventions despite a priori different needs of risk reduction. In economic terms, persisting inequalities suggest that research funding may be targeting already more-advantaged groups. Medical and care expenses are probably not being equitably allocated to those in need. The magnitude of social inequalities in dementia— even in the most-advanced countries—suggests that only concerted efforts made by different players can improve the situation. It may be helpful to draw from 2 decades of experience in the field of heart disease; there, similar to dementia, inequalities in heart disease may be found in all relevant areas of diagnosis, treatment, prevention, and care, with women being systematically, seriously disadvantaged. Strong efforts from funders, healthcare providers, and policy-makers became necessary to address those social inequalities, but the efforts remarkably improved the situation for women with heart disease, although several complexities related to differences according to sex in presentation, risk factors, and response to treatment of heart disease remain to be clarified. Growing worldwide research on social inequalities is also targeting people with dementia. The evidence from such research needs to be translated into rigorous policy responses in a timely manner. Firm efforts by all parties involved in mitigating social inequalities in dementia will be needed to advance toward more-equitable access to care and treatment for all individuals living with dementia.

Increases in well-being after transition to retirement for unemployed. Catching up with formerly employed persons.

ABSTRACT This paper examines the extent to which wellbeing levels change in the transition to retirement depending on transitioning from being employed, unemployed or economically inactive. Whereas transitioning from employment to unemployment has been found to cause a decrease in subjective wellbeing with more time spent in unemployment, it is not clear how transitioning from unemployment to retirement affects wellbeing levels. We use the Survey of Health, Ageing and Retirement in Europe to monitor the life satisfaction of respondents who retire in between two waves. We portray wellbeing scores before and after retirement and then identify the change in life satisfaction during the retirement transition using a First Difference model. Results indicate that being unemployed before retirement is associated with an increase in life satisfaction, but presents mainly a catching-up effect compared to employed persons transitioning to retirement. These results are still significant if we control for selection into unemployment and country differences. Retirement from labour market inactivity does not lead to significant changes in wellbeing. As the wellbeing of unemployed persons recovers after transitioning to retirement, especially the currently unemployed population should be supported to prevent detrimental consequences of economically unfavourable conditions and lower wellbeing.