Peter Eibich

Understanding the effect of retirement on health: Mechanisms and heterogeneity.

This paper investigates the mechanisms behind the health effects of retirement. Using a Regression Discontinuity Design to exploit financial incentives in the German pension system for identification, I find that retirement improves subjective health status and mental health, while also reducing outpatient care utilization. I explore a wide range of health behaviors, time use, and effect heterogeneity as potential mechanisms. Relief from work-related stress and strain, increased sleep duration as well as more frequent physical exercise seem to be key mechanisms through which retirement affects health.

Secular changes in late-life cognition and well-being: Towards a long bright future with a short brisk ending?

How sociocultural contexts shape individual functioning is of prime interest for psychological inquiry. Secular increases favoring later-born cohorts in fluid intelligence measures are widely documented for young adults. In the current study, we quantified such trends in old age using data from highly comparable participants living in a narrowly defined geographical area and examined whether these trends would generalize to quality-of-life indicators. To do so, we compared data obtained 20 years apart in the Berlin Aging Study (in 1990-1993) and the Berlin Aging Study II (in 2013-2014), applied a case-matched control design (per cohort, n = 161, Mage = 75), quantified sample selection using a nationally representative sample as the reference, and controlled for number of physical diseases. The later cohort performed better on the fluid intelligence measure (d = .85) and reported higher morale, less negative affect, and more positive affect (ds > .39) than the earlier cohort. We concluded that secular advances have resulted in better cognitive performance and perceived quality of life among older adults and discuss when and how advantages of later cohorts reach their limits.

Exercise at Different Ages and Appendicular Lean Mass and Strength in Later Life: Results From the Berlin Aging Study II

BACKGROUNDnExcessive loss of muscle mass in advanced age is a major risk factor for decreased physical ability and falls. Physical activity and exercise training are typically recommended to maintain muscle mass and prevent weakness. How exercise in different stages of life relates to muscle mass, grip strength, and risk for weakness in later life is not well understood.nnnMETHODSnBaseline data on 891 participants at least 60 years old from the Berlin Aging Study II (BASE-II) were analyzed. Linear and logistic regressions of self-reported exercise in early adulthood, old age, or both on appendicular lean mass (ALM), grip strength, and a risk indicator for weakness (ALM/ body mass index cutoff) were calculated. In addition, treatment bounds are analyzed to address potential confounding using a method proposed by Oster.nnnRESULTSnAnalyses indicate that for men only, continuous exercise is significantly associated with higher muscle mass (SD = 0.24, p < .001), grip strength (SD = 0.18, p < .05), and lower risk for clinically relevant low muscle mass (odds ratio = 0.36, p < .01). Exercise in early adulthood alone is not significantly associated with muscle mass or strength. No significant associations were observed for women.nnnCONCLUSIONSnThe results of the current study underscore the importance of health programs to promote physical activity with a focus on young adults, a group known to be affected from environmentally associated decline of physical activity, and to promote the continuation of physical exercise from early adulthood into later life in general.

Associations between Neighborhood Characteristics, Well-Being and Health Vary over the Life Course.

Background: Neighborhood characteristics are important determinants of individual health and well-being. For example, characteristics such as noise and pollution affect health directly, while other characteristics affect health and well-being by either providing resources (e.g. social capital in the neighborhood), which individuals can use to cope with health problems, or limiting the use thereof (e.g. crime). This also suggests that there might be age differentials in the impact of these characteristics, since individuals at different stages of life might need different resources. However, there is a lack of empirical evidence on age differentials in associations between well-being, health, and neighborhood characteristics. Objective: This paper studies associations between a wide range of neighborhood characteristics with the health and well-being of residents of the greater Berlin area. In particular, we focus on differences in the effects between younger (aged 20-35) and older (aged 60+) residents. Methods: We used data from the Berlin Aging Study II (312 younger and 993 older residents of the Berlin metropolitan area in Germany). We used survey data on health and well-being, combined these with subjective perceptions of the neighborhood, and geo-referenced indicators on the neighborhood, e.g. amenities (public transport, physicians, and hospitals). Results: The results show that access to public transportation is associated with better outcomes on all measures of health and well-being, and social support is associated with higher life satisfaction and better mental health. There are considerable differences between both age groups: while the associations between access to public transport and health and well-being are similar for both age groups, neighborhood social capital shows stronger associations for older residents. However, the difference is not always statistically significant. Conclusion: Having access to services is associated with better health and well-being regardless of age. Local policy makers should focus on lowering barriers to mobility in order to improve the health and well-being of the population. Since the social capital of a neighborhood is associated with better health and well-being among older residents, investments that increase social capital (e.g. community centers) might be warranted in neighborhoods with higher shares of older residents.

Cohort Differences in Psychosocial Function over 20 Years: Current Older Adults Feel Less Lonely and Less Dependent on External Circumstances.

Background: Lifespan psychological and life course sociological perspectives indicate that individual development is shaped by social and historical circumstances. Increases in fluid cognitive performance over the last century are well documented and researchers have begun examining historical trends in personality and subjective well-being in old age. Relatively less is known about secular changes in other key components of psychosocial function among older adults. Objective: In the present study, we examined cohort differences in key components of psychosocial function, including subjective age, control beliefs, and perceived social integration, as indicated by loneliness and availability of very close others. Methods: We compared data obtained 20 years apart in the Berlin Aging Study (in 1990-1993) and the Berlin Aging Study II (in 2013-2014) and identified case-matched cohort groups based on age, gender, cohort-normed education, and marital or partner status (n = 153 in each cohort, mean age = 75 years). In follow-up analyses, we controlled for having lived in former East versus West Germany, physical diseases, cohort-normed household income, cognitive performance, and the presence of a religious affiliation. Results: Consistently across analyses, we found that, relative to the earlier-born BASE cohort (year of birth: mean = 1916; SD = 3.38 years; range = 1901-1922), participants in the BASE-II sample (year of birth: mean = 1939; SD = 3.22 years; range = 1925-1949) reported lower levels of external control beliefs (d = -1.01) and loneliness (d = -0.63). Cohorts did not differ in subjective age, availability of very close others, and internal control beliefs. Conclusion: Taken together, our findings suggest that some aspects of psychosocial function of older adults have improved across the two recent decades. We discuss the possible role of sociocultural factors that might have led to the observed set of cohort differences.

In search of features that constitute an "enriched environment" in humans: Associations between geographical properties and brain structure

Enriched environments elicit brain plasticity in animals. In humans it is unclear which environment is enriching. Living in a city has been associated with increased amygdala activity in a stress paradigm, and being brought up in a city with increased pregenual anterior cingulatexa0cortex (pACC) activity. We set out to identify geographical characteristics that constitute an enriched environment affecting the human brain. We used structural equation modelling on 341 older adults to establish three latent brain factors (amygdala, pACC and dorsolateral prefrontal cortex (DLPFC)) to test the effects of forest, urban green, water and wasteland around the home address. Our results reveal a significant positive association between the coverage of forest and amygdala integrity. We conclude that forests may have salutogenic effects on the integrity of the amygdala. Since cross-sectional data does not allow causal inference it could also be that individuals with high structural integrity choose to live closer to forest.

The Socio-Economic Module of the Berlin Aging Study II (SOEP-BASE): Description, Structure, and Questionnaire

The Berlin Aging Study II (BASE-II) is a multidisciplinary study that allows for the investigation of how a multitude of health status factors as well as many other social and economic outcomes interplay. The sample consists of 1,600 participants aged 60 to 80, and 600 participants aged 20 to 35. The socio-economic part of BASE-II, the so called SOEP-BASE, is conducted by the SOEP Group at the DIW Berlin. The surveyed socio-economic variables are fully comparable with the variables of the long running German Socio-Economic Panel Study (SOEP), which increases the analytical power of BASE-II. The socio-economic data collected on the individual and on the household level are enriched with geo-referenced context data (neighbourhood data) in order to disentangle the interplay between individual, societal and regional determinants on individuals health status and other outcome variables. Furthermore, as the BASE-II study is based on a convenience sample, the SOEP Group at the DIW provides weights for the BASE-II dataset that correct for selectivity bias.

Genome-wide study identifies 611 loci associated with risk tolerance and risky behaviors

Humans vary substantially in their willingness to take risks. In a combined sample of over one million individuals, we conducted genome-wide association studies (GWAS) of general risk tolerance, adventurousness, and risky behaviors in the driving, drinking, smoking, and sexual domains. We identified 611 approximately independent genetic loci associated with at least one of our phenotypes, including 124 with general risk tolerance. We report evidence of substantial shared genetic influences across general risk tolerance and risky behaviors: 72 of the 124 general risk tolerance loci contain a lead SNP for at least one of our other GWAS, and general risk tolerance is moderately to strongly genetically correlated ( to 0.50) with a range of risky behaviors. Bioinformatics analyses imply that genes near general-risk-tolerance-associated SNPs are highly expressed in brain tissues and point to a role for glutamatergic and GABAergic neurotransmission. We find no evidence of enrichment for genes previously hypothesized to relate to risk tolerance.Humans vary substantially in their willingness to take risks. In a combined sample of over one million individuals, we conducted genome-wide association studies (GWAS) of general risk tolerance, adventurousness, and risky behaviors in the driving, drinking, smoking, and sexual domains. We identified 611 approximately independent genetic loci associated with at least one of our phenotypes, including 124 with general risk tolerance. We report evidence of substantial shared genetic influences across general risk tolerance and risky behaviors: 72 of the 124 general risk tolerance loci contain a lead SNP for at least one of our other GWAS, and general risk tolerance is moderately to strongly genetically correlated (|rˆ g | ~ 0.25 to 0.50) with a range of risky behaviors. Bioinformatics analyses imply that genes near general-risk-tolerance-associated SNPs are highly expressed in brain tissues and point to a role for glutamatergic and GABAergic neurotransmission. We find no evidence of enrichment for genes previously hypothesized to relate to risk tolerance.

Historical trends in modifiable indicators of cardiovascular health and self-rated health among older adults: Cohort differences over 20 years between the Berlin Aging Study (BASE) and the Berlin Aging Study II (BASE-II)

Background The last decades have seen great advances in the understanding, treatment, and prevention of cardiovascular disease (CVD). Although mortality rates due to CVD have declined significantly in the last decades, the burden of CVD is still high, particularly in older adults. This raises the question whether contemporary populations of older adults are experiencing better or worse objective as well as subjective health than earlier-born cohorts. The aim of this study was to examine differences in modifiable indicators of cardiovascular health (CVH), comparing data obtained 20 years apart in the Berlin Aging Study (BASE, 1990–93) and the Berlin Aging Study II (BASE-II, 2009–2014). Methods Serial cross-sectional analysis of 242 propensity-score-matched participants of BASE (born 1907–1922) and BASE-II (born 1925–1942). Body mass index (BMI), blood pressure, total cholesterol, glycated hemoglobin (HbA1c), diet, smoking and physical activity were operationalized according to the “Life’s simple 7“(LS7) criteria of the American Heart Association. Results 121 matched pairs were identified based on age, sex, and education. In the later-born BASE-II sample, the mean LS7 score was significantly higher than in the earlier-born sample (7.8±1.8 vs. 6.4±2.1, p<0.001), indicating better CVH. In detail, diet, physical activity, smoking, cholesterol, and HbA1c were more favorable, whereas blood pressure was significantly higher in individuals from the later-born cohort. BMI did not differ significantly between the two matched samples. Notably, despite better CVH, later-born individuals (BASE-II) reported lower self-rated health, presumably because of higher health expectations. Conclusions Overall, cardiovascular health was significantly better in the later-born cohort, but several notable exceptions exist.

Associations between preoperative Oxford hip and knee scores and costs and quality of life of patients undergoing primary total joint replacement in the NHS England: an observational study

Objectives To assess how costs and quality of life (measured by EuroQoL-5 Dimensions (EQ-5D)) before and after total hip replacement (THR) and total knee replacement (TKR) vary with age, gender and preoperative Oxford hip score (OHS) and Oxford knee score (OKS). Design Regression analyses using prospectively collected data from clinical trials, cohort studies and administrative data bases. Setting UK secondary care. Participants Men and women undergoing primary THR or TKR. The Hospital Episode Statistics data linked to patient-reported outcome measures included 602u2009176 patients undergoing hip or knee replacement who were followed up for up to 6u2009years. The Knee Arthroplasty Trial included 2217 patients undergoing TKR who were followed up for 12u2009years. The Clinical Outcomes in Arthroplasty Study cohort included 806 patients undergoing THR and 484 patients undergoing TKR who were observed for 1u2009year. Outcome measures EQ-5D-3L quality of life before and after surgery, costs of primary arthroplasty, costs of revision arthroplasty and the costs of hospital readmissions and ambulatory costs in the year before and up to 12u2009years after joint replacement. Results Average postoperative utility for patients at the 5th percentile of the OHS/OKS distribution was 0.61/0.5 for THR/TKR and 0.89/0.85 for patients at the 95th percentile. The difference between postoperative and preoperative EQ-5D utility was highest for patients with preoperative OHS/OKS lower than 10. However, postoperative EQ-5D utility was higher than preoperative utility for all patients with OHS≤46u2009and those with OKS≤44. In contrast, costs were generally higher for patients with low preoperative OHS/OKS than those with high OHS/OKS. For example, costs of hospital readmissions within 12u2009months after primary THR/TKR were £740/£888 for patients at the 5th percentile compared with £314/£404 at the 95th percentile of the OHS/OKS distribution. Conclusions Our findings suggest that costs and quality of life associated with total joint replacement vary systematically with preoperative symptoms measured by OHS/OKS.