309 research outputs found
Understanding Health Deterioration and the Dynamic Relationship between Physical Ability and Cognition among a Cohort of Danish Nonagenarians
Full text linkThis study aims to determine how demographics, socioeconomic characteristics, and lifestyle affect physical and cognitive health transitions among nonagenarians, whether these transitions follow the same patterns, and how each dimension affects the transitions of the other. We applied a multistate model for panel data to 2262 individuals over a 2-year follow-up period from the 1905 Danish Cohort survey. Within two years from baseline, the transition probability from good to bad physical health—ability to stand up from a chair—was higher than dying directly (29% vs. 25%), while this was not observed for cognition (24% vs. 27%) evaluated with Mini-Mental State Examination—a score lower than 24 indicates poor cognitive health. Probability of dying either from bad physical or cognitive health condition was 50%. Health transitions were associated with sex, education, living alone, body mass index, and physical activity. Physical and cognitive indicators were associated with deterioration of cognitive and physical status, respectively, and with survivorship from a bad health condition. We conclude that physical and cognitive health deteriorated differently among nonagenarians, even if they were related to similar sociodemographic and lifestyle characteristics and resulted dynamically related with each other
Gender and educational inequalities in disability-free life expectancy among older adults living in Italian regions
Full text linkBACKGROUND Italy’s life expectancy at age 65 is one of the highest in Europe, but its disability-free life expectancy (DFLE) is not so high. To understand this diverging pattern of longevity and health it is essential to consider indicators accounting for both mortality and morbidity, and to analyse the gender, social, and geographical inequities characterising them. OBJECTIVE The aim is to quantify the gender, social, and geographical inequalities in DFLE among Italian older adults and analyse the age-specific contribution of mortality and morbidity to those inequalities. METHODS This study draws on census-linked mortality data and disability prevalence for the years 2012–2014. DFLE at age 65 in Italian regions is omputed by gender and educational attainment using the Sullivan method. Age-specific mortality–morbidity contributions to the gender and educational gaps in DFLE are calculated sing the stepwise ecomposition method. RESULTS Although at the national level older women and men share similar DFLE, these estimates hide important geographical and social nequalities. Women’s health disadvantage completely outweighs their life expectancy advantage, resulting in lower DFLE. Educational inequalities in health are far more dramatic than those in mortality and the disadvantage in DFLE accumulates over education and region of residence. CONCLUSIONS In Italy notable differences in DFLE are found between genders nd between educational groups, suggesting the need for better health policies aimed at reducing inequalities
Who felt lonely during the COVID-19 pandemic among European older adults?
No full textFeelings of loneliness are not very widespread among European older adults (aged 50 years and over) according to SHARE data. And, surprisingly enough, according to the analysis of Omar Paccagnella, Veronica Cassarà, Maria Iannario, and Cosmo Strozza, the COVID-19 pandemic did not affect these feelings very much: those whose self-reported status worsened broadly match those who reported an improvement
Who felt lonely during the COVID-19 pandemic among European older adults?
No full textFeelings of loneliness are not very widespread among European older adults (aged 50 years and over) according to SHARE data. And, surprisingly enough, according to the analysis of Omar Paccagnella, Veronica Cassarà, Maria Iannario, and Cosmo Strozza, the COVID-19 pandemic did not affect these feelings very much: those whose self-reported status worsened broadly match those who reported an improvement
Who felt lonely during the COVID-19 pandemic among European older adults?
No full textFeelings of loneliness are not very widespread among European older adults (aged 50 years and over) according to SHARE data. And, surprisingly enough, according to the analysis of Omar Paccagnella, Veronica Cassarà, Maria Iannario, and Cosmo Strozza, the COVID-19 pandemic did not affect these feelings very much: those whose self-reported status worsened broadly match those who reported an improvement
Understanding health dynamics among the oldest-old
Full text linkIn most developed countries, the proportion of oldest-old has increased during the last decades as a consequence of the decline in old-age mortality. An increasing number of oldest-old people will pose challenges for the health-care and economic systems of modern societies but it could be transformed into an opportunity from a social and economic perspective if those people succeed in aging healthily. Evaluating the health condition of the oldest-old is not straightforward as, especially for people in this stage of life, health requires to be analyzed by simultaneously considering multiple dimensions of health. For instance, health-care needs may be the result of a complex system of diseases, syndromes or other characteristics that is not satisfactorily described by a single aspect of health. Considering health holistically, by jointly analyzing several health measures, helps identifying health profiles that would allow to a better evaluation of the needs and a more efficient use of the resources. On the other hand, analyzing single objective health measures has the advantage of deepening the existing knowledge on the dynamic relationships between major health aspects, their deterioration and which factors are related to this process. The increasing presence of oldest-old people in modern societies implies a growing need of statistical information and indicators capable of monitoring the health conditions of those individuals. Over the last years researchers have tried to overcome the problem of scarce data availability on the health of the oldest-old by conducting specific surveys to reach those (not anymore) exceptionally old individuals to better understand the characteristics and dynamics of health among long-lived individuals. Self-rated health (SRH) is the most widely used indicator for assessing the general health status of a person: nowadays its related question is often included in general surveys and it has been harmonized to allow international comparisons. Understanding the mechanism that underlies the process of self-assessment of health is of great interest. It has been investigated both at the general population level and specifically on elderly individuals, however research on the oldest-old is still lacking. No matter which health dimension is analyzed, the socioeconomic status is always the first factor considered to explain health differences. Socioeconomic inequalities in health are well-known among the general population and the elderly. However, there is growing evidence that a socioeconomic gradient in mortality persists also at very old ages suggesting the need for further research to verify whether socioeconomic differences in health persist among the oldest-old. The aim of this PhD thesis is to contribute at partly filling the gaps in oldest-old research by investigating (a) the health conditions in which people reach very old ages especially if considering health holistically; (b) the dynamic relationship between two major health aspects such as physical ability and cognition, their deterioration and which factors are related to this process; (c) the mechanism underlying the self-assessment of health; and (d) whether socio-economic health inequalities persist among nonagenarians. Each of the first three research questions (a, b and c) corresponds to a chapter of the thesis while the forth one (d) is investigated across all of them. Different data sources were used in the PhD thesis. Data from the Mugello Study were used to answer research questions (a), (c) and (d) and data from the 1905 Danish Cohort Study were used to answer research questions (b) and (d). Each of the research questions were addressed by performing the most appropriate methods to address specific issues. Considering health holistically, by analyzing several health dimensions, allowed us to identify heath profiles that are expected to have different health-care needs. Moreover, individuals with certain demographic and socioeconomic characteristics were more likely to be characterized by one or another health profile. Analyzing the deterioration of specific dimensions of health, as physical ability and cognition, resulted in finding a dynamic relationship between two important aspects of health. Their deterioration process does not follow the same path, even though the socioeconomic and lifestyle factors related to both measures are similar. Self-rated health among the oldest-old seems to have a similar hidden structure compared to the one of elderly people. Functional and emotional health play an important role, while socioeconomic characteristics only affect the process of self-assessment of health indirectly via the functional component. Overall, socioeconomic inequalities in health persist among the oldest-old independently on the way health is measured. More studies on the health conditions of oldest-old people, a growing segment of the population in developed country, are necessary to shed lights on many important aspects of health and the health-related factors. In a context of resources that are becoming scarcer and scarcer, this could help policy makers to drive their interventions to the most stringent issues and face them on time to adopt better strategies to cope with the challenges posed by the greater presence of oldest-old in the societies
Le adozioni nel Lazio nell’anno del COVID (2020)
No full textNel corso del 2020 è stato avviato un processo di raccolta sistematica delle principali informazioni relative alle diverse fasi del percorso di adozione. I risultati sono stati illustrati in un rapporto interno che in questa sede viene ripreso nelle sue parti essenziali. Si tratta della descrizione di quanto successo nel 2020 avvalendosi delle informazioni individuali raccolte in modo sistematico dalle dieci ASL della regione. Nel paragrafo seguente (par. 2) i dati del 2020 sulle coppie che hanno partecipato al Gruppo di Orientamento Adozione (GOA), su quelle che hanno fatto domanda di adozione e sui minori dati in affidamento preadottivo (per semplicità adozioni) vengono confrontati con le statistiche dei due anni precedenti per segnalare l’impatto della pandemia da Covid-19 sui numeri delle attività svolte e dei risultati raggiunti, proponendo tra l’altro una lettura degli eventi (incontri GOA, domande di adozione e adozioni) dell’ultimo anno anche per mese di accadimento. Nel paragrafo successivo (par. 3) vengono esaminate le informazioni sulle coppie che hanno partecipato agli incontri GOA in termini di rilevanza sulla popolazione delle ASL e per caratteristiche demografiche dei componenti della coppia (età dei coniugi e differenze di età), segnalando i casi in cui si è arrivati alla domanda di adozione nello stesso anno degli incontri preliminari. Il quarto paragrafo è dedicato proprio alle richieste di adozione presentate nel 2020 distinguendo tra prime domande e rinnovi, tipo di disponibilità (adozione nazionale, internazionale o entrambe) e caratteristiche demografiche dei coniugi. Il paragrafo seguente (par. 5) si concentra sui minori collocati provvisoriamente in famiglia nell’anno considerato per esaminare le loro principali caratteristiche e alcune caratteristiche dei genitori adottivi. Nelle conclusioni vengono proposte sintetiche indicazioni sui limiti del materiale statistico disponibile e sulle strategie da seguire per arricchire il quadro informativo disponibile
COVID-19 exacerbated inequalities in life expectancy in Denmark
No full textSocial inequalities in mortality expanded during the COVID-19 pandemic in Denmark. Cosmo Strozza, Serena Vigezzi, Julia Callaway, and José Manuel Aburto quantified life expectancy changes in 2020 and 2021 and underlying causes of death. COVID-19, as well as other causes, contributed to these changes
COVID-19 exacerbated inequalities in life expectancy in Denmark
No full textSocial inequalities in mortality expanded during the COVID-19 pandemic in Denmark. Cosmo Strozza, Serena Vigezzi, Julia Callaway, and José Manuel Aburto quantified life expectancy changes in 2020 and 2021 and underlying causes of death. COVID-19, as well as other causes, contributed to these changes
Ageing and diversity:Inequalities in longevity and health in low-mortality countries
Full text linkBACKGROUND Longevity and old age are two aspects of the same phenomenon, representing a major concern for modern societies. There is universal consensus among scholars about the need for new frameworks and measures to define older people in a more effective and dynamic way. OBJECTIVE The aim of this paper is to compute prospective old-age thresholds (POATs) in six countries characterised by disparate progress in survival. To outline possible strategies to counter population ageing, the paper also examines trends in POAT and disability-free POAT (DF-POAT) in Italy by gender, geographical area, and education. DATA AND METHODS To compute the POAT, we use life tables from the Human Mortality Database (HMD) and the Italian National Institute of Statistics, Istat. In addition, to compute the DF-POAT, data on mortality and health by geographical area and education were retrieved from Istat. RESULTS During the period 1950–2020 the POAT advanced everywhere, albeit in different rhythms by country, gender, and period. However, great differences in POAT and DFPOAT have emerged, depending on place of residence, education, and health. CONCLUSIONS The POAT changes the evaluation of population ageing and could reduce the alarm caused by measures based on static chronological old-age thresholds. Using Italy as a case study, we show that overcoming geographical and social inequalities would counteract the population ageing process. CONTRIBUTION The paper highlights how individual and population ageing is a relative concept, as acknowledged by James W. Vaupel in his studies where he explores the equivalence between ages based on mortality risks.</p
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