Carin Lennartsson

Childhood Living Conditions, Socioeconomic Position in Adulthood, and Cognition in Later Life: Exploring the Associations

OBJECTIVES This study examined the association between childhood living conditions, socioeconomic position in adulthood, and cognition in later life. Two questions were addressed: Is there an association between childhood living conditions and late-life cognition, and if so, is the association modified or mediated by adult socioeconomic position? METHODS Nationally representative data of the Swedish population aged 77 years and older were obtained from the 1992 and 2002 Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD). Cognition was assessed with an abbreviated version of the Mini-Mental State Examination scale. Childhood living conditions were assessed by self-reports of childhood living conditions. RESULTS The results showed independent associations between conflicts in the household during childhood, fathers social class, education, own social class in adulthood, and cognition in later life. Exposure to conflicts during childhood, having a father classified as a manual worker, low education, and/or being classified as a manual worker in adulthood was associated with lower levels of cognition in old age. There seemed to be no modifying effect of adult socioeconomic position on the association between childhood conditions and cognition in later life. DISCUSSION This suggests the importance of childhood living conditions in maintaining cognitive function even in late life.

Baseline leisure time activity and cognition more than two decades later

Many studies of the relation between factors earlier in life and late‐life cognition have a short follow‐up time, often less than 10 years. Since cognitive decline can be present up to 20 years prior to dementia it is difficult to distinguish the direction of the relationships without a long follow‐up. We analyzed the association between different types of leisure time activity at baseline and cognition more than 20 years later. A wide range of activities was included—political, mental, socio‐cultural, social, physical, and organizational activities.

Getting by with a little help: The importance of various types of social support for health problems

Aims: Our understanding of the relative importance of various types of social support is still limited. This study examines the overall and relative importance of various types of social support for health problems in a general population. The support resources focused on differ in character and represent companionship and emotional, instrumental, and informational types of social support. The health problems are depression, circulatory problems, and self-rated general health. Methods: The logistic regression analyses are based on a Swedish nationally representative sample of 5,053 adults, aged 18—75, interviewed in the Level of Living Survey in 2000. Panel data from the earlier interview wave in 1991 were also used. Results: The number of support resources was associated with all the health problems studied. The availability of economic support was important relative to the other support resources (or of similar importance), irrespective of marital status, social class, and own economic situation. The associations hold when earlier health status was controlled for. Having someone to talk to about personal problems and having someone for company were relevant, especially the latter. This support resource demonstrated an association with all health problems, which remains when the other support resources and earlier health status are taken into consideration. Conclusions: In the Swedish population, the number of support resources was linked to health problems, indicating the usefulness of a diverse resource pool. The multidimensional approach revealed that economic support, company, and, to a more limited extent, the opportunity to discuss personal problems were most important.

Financial transfers between generations in Sweden

This study has examined the flow of financial transfers between generations in Sweden, measured as financial support in the form of relatively large money transactions or gifts over 12 months. Two questions are considered: is there a net downward flow in the Swedish welfare state and, if so, are there differences according to gender and social class? The questions were tested using data from two linked and nationally representative large-scale surveys. The results show that almost all inter-generational transfers are downward, from older to younger generations. Unlike earlier studies of inter-generational transfers, the analysis focuses on inequality, and the results reveal clear class and income gradients. Both giving and receiving were more common among people in the higher social strata. A gender gradient among unmarried (single) recipients was also found, whereby unmarried women more often received financial support than unmarried men. The paper concludes with a discussion of the implications of the results for social stratification and inequality. From a static or cross-sectional perspective, the results suggest that financial transfers are neutral or even equality promoting, but a dynamic or lifecourse interpretation suggests that financial transfers transmit or even reinforce class inequalities over generations.

Predictors of loneliness among older women and men in Sweden: A national longitudinal study

Objectives: Longitudinal research on loneliness in old age has rarely considered loneliness separately for men and women, despite gender differences in life experiences. The objective of this study was to examine the extent to which older women and men (70+) report feelings of loneliness with a focus on: (a) changes in reported loneliness as people age, and (b) which factors predict loneliness. Method: Data from the 2004 and 2011 waves of SWEOLD, a longitudinal national survey, was used (n = 587). The prediction of loneliness in 2011 by variables measured in 2004 and 2004–2011 variable change scores was examined in three logistic regression models: total sample, women and men. Variables in the models included: gender, age, education, mobility problems, depression, widowhood and social contacts. Results: Older people moved into and out of frequent loneliness over time, although there was a general increase in loneliness with age. Loneliness at baseline, depression increment and recent widowhood were significant predictors of loneliness in all three multivariable models. Widowhood, depression, mobility problems and mobility reduction predicted loneliness uniquely in the model for women; while low level of social contacts and social contact reduction predicted loneliness uniquely in the model for men. Conclusion: This study challenges the notion that feelings of loneliness in old age are stable. It also identifies important gender differences in prevalence and predictors of loneliness. Knowledge about such differences is crucial for the development of effective policy and interventions to combat loneliness in later life.

Data Resource Profile: The Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD)

As the number and proportion of very old people in the population increase, there is a need for improved knowledge about their health and living conditions. The SWEOLD interview surveys are based on random samples of the population aged 77+years. The low non-response rates, the inclusion of institutionalized persons and the use of proxy informants for people unable to be interviewed directly ensure a representative portrayal of this age group in Sweden. SWEOLD began in 1992 and has been repeated in 2002, 2004 and 2011. The survey is based on another national survey, the Swedish Level of Living Survey (LNU), started in 1968 with 10-year follow-up waves. This longitudinal design provides additional data collected when SWEOLD participants were in middle age and early old age. The SWEOLD interviews cover a wide range of areas including health and health behaviour, work history, family, leisure activities and use of health and social care services. Socio-economic factors include education, previous occupation and available cash margin. Health indicators include symptoms, diseases, mobility and activities of daily living (ADL). In addition to self-reported data, the interview includes objective tests of lung function, physical function, grip strength and cognition. The data have been linked to register data, for example for income and mortality follow-ups. Data are available to the scientific community on request. More information about the study, data access rules and how to apply for data are available at the website (www.sweold.se).

Sampling and non-response bias on health-outcomes in surveys of the oldest old

Surveys of the oldest old population are associated with several design issues. Place of residence and possible physical or cognitive impairments make it difficult to maintain a representative study population. Based on a Swedish nationally representative survey among individuals 77+, the present study analyze the potential bias of not using proxy interviews and excluding the institutionalized part of the population in surveys of the oldest old. The results show that compared to directly interviewed people living at home, institutionalized and proxy interviewed individuals were older, less educated and more likely to be female. They had more problems with health, mobility and ADL, and a significantly increased mortality risk. If the study had excluded the institutionalized part of the population and/or failed to use proxy interviews, the result would have been severely biased and resulted in underestimated prevalence rates for ADL, physical mobility and psychologic problems. This could not be compensated for weighting the data by age and sex. The results from this study imply that accurate population estimates require a representative study population, in which all individuals are included regardless of their living conditions, health status, and cognitive ability.

Time-for-Money Exchanges Between Older and Younger Generations in Swedish Families

Despite the maturation of welfare states, family solidarity continues to be strong and a growing body of research has shown that substantial financial transfers are passed from older to younger generations within the family. At the same time, family solidarity in terms of instrumental and social support is found to be mutual. This study examines eventual reciprocity in time-for-money exchanges, by combining two large-scale Swedish representative longitudinal studies. It analyzes how earlier social contacts (time) are related to financial transfers (money) and to what extent social class and gender differentials are visible. The findings indicate that parents provide economic transfers if they have more frequent social contact with any of their children, and that these time investments pay off for children who were of higher social class origins. In contrast, no support for gender-specific patterns is found. In conclusion, family solidarity seems to have different bases in different social strata.

Social mobility, geographical proximity and intergenerational family contact in Sweden

ABSTRACT This study examined intergenerational family contact. Three questions were considered: Is there a relationship between parents class, childs class and family contact? Can class-related differences in family contact be explained by differences in geographical distance between parent and child? Is intergenerational family contact affected by childrens social mobility? The questions were explored using data from a nationally-representative level of living survey. The results from logistic regressions showed that parents class as well as the childs class were associated with intergenerational geographical distance and family contact more often than once a week. Those in or retired from non-manual occupations were less likely than manual workers to live close and to have family contact more than once a week. We found no evidence that a change in class position, upward nor downward, had any effect on family contacts. Rather, class-stable non-manual families socialise less frequently than other families, even when they live relatively close. The results therefore suggest that familial class-cohesiveness is a stronger determinant of inter-generational family contacts than social mobility. Future research should address the complex connection between social mobility and other forms of relations and transfers between generations.

Live long and prosper? Childhood living conditions, marital status, social class in adulthood and mortality during mid-life: A cohort study

Aims: The aim of the present study was to investigate the impact of childhood living conditions, marital status, and social class in adulthood on the risk of mortality during mid-life. Two questions were addressed: Is there an effect of childhood living conditions on mortality risk during mid-life and if so, is the effect mediated or modified by social class and/or marital status in adulthood? Methods: A nationally representative, Swedish, level of living survey from 1968 was used as baseline. The study included those aged 25—69 at baseline (n = 4082). Social conditions in childhood and adulthood were assessed using self-reports. These individuals were then followed for 39 years using registry data on mortality. Results: The results showed associations between childhood living conditions, marital status, social class in adulthood and mortality during mid life. Social class and familial conditions during childhood as well as marital status and social class in adulthood all contributed to the risk of mortality during mid-life. Individuals whose father’s were manual workers, who grew up in broken homes, who were unmarried, and/or were manual workers in adulthood had an increased risk of mortality during mid life. The effects of childhood conditions were, in part, both mediated and modified by social class in adulthood. Conclusions: The findings of this study suggest that there are structural, social conditions experienced at different stages of the life course that affect the risk of mortality during mid-life.