Professor James Nazroo

Unprecedented internal migration to urban areas has happened in China over the last few decades.

Cataract surgery and age-related cognitive decline: A 13-year follow-up of the English Longitudinal Study of Ageing

Let’s talk about sex – what do older men and women say about their sexual relations and sexual activities? A qualitative analysis of ELSA Wave 6 data

Older adults’ experiences of sexual difficulties: qualitative findings from the English Longitudinal Study on Ageing

Class and health inequality in later life: patterns, mechanisms and implications for policy

OBJECTIVES: Visual impairment is the leading cause of age-related disability, but the social patterning of loss of vision in older people has received little attention. This study's objective was to assess the association between social position and onset of visual impairment, to empirically evidence health inequalities in later life. METHOD: Visual impairment was measured in 2 ways: self-reporting fair vision or worse (moderate) and self-reporting poor vision or blindness (severe). Correspondingly, 2 samples were drawn from the English Longitudinal Study on Ageing (ELSA). First, 7,483 respondents who had good vision or better at Wave 1; second, 8,487 respondents who had fair vision or better at Wave 1. Survival techniques were used. RESULTS: Cox proportional hazards models showed wealth and subjective social status (SSS) were significant risk factors associated with the onset of visual impairment. The risk of onset of moderate visual impairment was significantly higher for the lowest and second lowest wealth quintiles, whereas the risk of onset of severe visual impairment was significantly higher for the lowest, second, and even middle wealth quintiles, compared with the highest wealth quintile. Independently, lower SSS was associated with increased risk of onset of visual impairment (both measures), particularly so for those placing themselves on the lowest rungs of the social ladder. DISCUSSION: The high costs of visual impairment are disproportionately felt by the worst off elderly. Both low wealth and low SSS significantly increase the risk of onset of visual impairment.

Visual impairment becomes more prevalent with age. Rather than a uniform decline in vision with age, the strength and direction of change varies between people. This study applies an analytical method that posits multiple trajectories in eyesight, allowing for a more specific description of developmental course of this health outcome and its relationship with social position. The analysis uses the responses of 2956 respondents, aged 60 years and over, followed over 8 years (five observations) as part of the English longitudinal study of ageing. At each observation respondents self-reported their general vision. Optimal matching (sequence analysis), hierarchical clustering, and multinomial logistic regression were used to describe the sequential data, produce a typology of vision trajectories, and examine the socio-demographic characteristics associated with different trajectories. Eight distinctive clusters of trajectories were identified. The probability of reporting different types of vision trajectory varies with a change in age; however, the magnitude of the age effect is associated with social position. Visual impairment in older people is an increasingly relevant area for policy focus, with the rapid growth and diversity of the older population. Identifying factors underpinning the patterning of changes in visual function is essential for developing evidence-based policy, which both meets the needs of those most at risk and increases cost-effectiveness of public health interventions.

The English Longitudinal Study of Ageing (ELSA) (Steptoe et al. 2013a) is a multidis- ciplinary panel study that collects a comprehensive array of measures on a representative sample of men and woman aged 50 and over who are living in England. Repeated measures covering health, economics, psychology, lifestyle, and social connections are collected from the same individuals over time, allowing researchers to study the dynamics of the aging process.

he consequences of self-reported vision change in later-life: evidence from the English Longitudinal Study of Ageing

In 2012/2013 the English Longitudinal Study of Ageing (ELSA) included a comprehensive Sexual Relationships and Activities Questionnaire (SRA-Q). A total of 7,079 men and women mainly aged 50 to >90, primarily heterosexual and in a coupled relationship, completed the SRA-Q, answering a series of questions about their attitudes to sexual relationships, their own sexual activities, problems and concerns with sexual functioning, and quality of intimate relationships. The questions aimed to gain insights into the ways in which sexual relations and activities related to health, wellbeing and other lifestyle factors change as people grow older. The primary mode of data collection was a tick box response to a series of questions. However, at the end of the questionnaire an open comment box was provided, which asked respondents whether there was anything else that they would like to say; 1,084 respondents provided additional information and these comments created a unique qualitative data-set. The analysis of the data then illustrated how people's health, relationships, experiences and perceptions of ageing, along with sexual satisfaction, impact on sexual relationships and activities.

The influence of early life, accumulation and social mobility on wellbeing in later life in the U.S. and England is investigated. Using cross-sectional data from the Health and Retirement Study (HRS) and the English Longitudinal Study of Ageing (ELSA), we estimate multivariate regressions of hedonic and eudemonic measures of wellbeing on these life course mechanisms, controlling for age, gender, ethnic background, partnership status, health and wealth. On the level of the life course mechanisms, there is mixed evidence regarding the critical impact of early life, strong evidence for an association between accumulation and eudemonic wellbeing and a moderate negative effect of downward social mobility. While the relation between hedonic wellbeing and life course mechanisms is unclear or in a different direction than anticipated, eudemonic wellbeing is clearly related to accumulation and mobility in both countries and to early life in the U.S. On the societal level, the major observation is that the life course has a larger influence in the U.S. than in England.

BACKGROUND: Frailty is a state of increased vulnerability to poor resolution of homeostasis after a stressor event, which increases the risk of adverse outcomes including falls, disability and death. The underlying pathophysiological pathways of frailty are not known but the hypothalamic-pituitary-adrenal axis and heightened chronic systemic inflammation appear to be major contributors.

This paper deals with the relationship between family formation and employment in older cohorts of the English population born between 1916 and 1957. Based on retrospective life history data of the English Longitudinal Study of Ageing (ELSA) and using sequence and cluster analyses, we explore three dimensions in particular: employment, marital status, and having children, and the extent to which individuals’ life course trajectories on these three dimensions vary across cohorts, gender, and level of education. While the majority of men followed a trajectory of marriage and family formation with a (relatively) continuous career, the family-work trajectories of women varied noticeably from one cohort to the next, including increased labour market participation combined with fewer and shorter breaks from work to care for children. While the current perception is that the so-called ‘baby boomer’ generation born soon after World War Two was path-breaking in terms of life course innovations, our findings are not compatible with the assumption of a single cohort being particularly pioneering.

The benefits of engagement with social activities on health and wellbeing are widely reported by gerontologists. Less is known, however, about what drives withdrawal from and re-engagement with social activities in later life. This is an important area of research which has direct implications for public policies that aim to ensure equitable outcomes among older adults. Much of the existing literature supports continuity theory which assumes people will not alter their level of social engagement as they age or after life-changing events. This paper uses data from the English Longitudinal Study of Ageing over an eight-year period (2002–2010) to determine the effect of short-term changes in marital, employment and health status over an initial four-year period on the dynamics of social detachment over the following four years. We control for underlying socio-economic disadvantages built up during the lifecourse and find that these effects, including poor education, wealth and health, are the most important determinants of persistent detachment from social activities as well as movement into and out of social detachment. The effects are consistent in men and women. The effects of short-term changes in marital and employment status have little effect on social detachment. Recent deterioration in health, however, predicted movement into social detachment, which implies the relationship between health and social detachment is reciprocal.

Abstract OBJECTIVES: We examine the associations between different patterns of sexual behavior and function and three indicators of subjective well-being (SWB) covering eudemonic, evaluative, and affective well-being in a representative sample of partnered older people. METHOD: Using data from a Sexual Relationships and Activities Questionnaire (SRA-Q) in Wave 6 of the English Longitudinal Study of Ageing, latent class analysis identified groups characterized by distinctive patterns of sexual behavior and function and then examined their link to SWB. Eudemonic SWB was measured using a revised 15-item version of the CASP-19, evaluative SWB using the Satisfaction With Life Scale, and affective SWB using the 8-item version of the Centre for Epidemiologic Studies-Depression scale. RESULTS: Sexual behavior and function was best described by six classes among men and five classes among women. These ranged from high sexual desire, frequent partnered sexual activities, and few sexual problems (Class 1) to low sexual desire, infrequent/no sexual activity, and problems with sexual function (Class 5([women])/6([men])). Men and women who reported either infrequent/no sexual activity, or were sexually active but reported sexual problems, generally had lower SWB than those individuals identified in Class 1. Poorer SWB in men was more strongly associated with sexual function difficulties, whereas in women desire and frequency of partnered activities appeared more important in relation to SWB. DISCUSSION: Within the context of a partnered relationship continuing sexual desire, activity and functioning are associated with higher SWB, with distinctive patterns for women and men

Comparison of hypertension healthcare outcomes among older people in the USA and England