Ageing

OBJECTIVE: Frailty and pre-frailty are two common conditions in the older people, but whether these conditions could predict depression is still limited to a few longitudinal studies. In this paper, we aimed to investigate whether frailty and pre-frailty are associated with an increased risk of depression in a prospective cohort of community-dwelling older people.

The prevalence and dynamics of social care receipt

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.

Physical activity trajectories of frailty among older adults: evidence from the English Longitudinal Study of Ageing

BACKGROUND: Frail older adults are heavy users of health and social care. In order to reduce the costs associated with frailty in older age groups, safe and cost-effective strategies are required that will reduce the incidence and severity of frailty.

Personality and risk of frailty: the English Longitudinal Study of Ageing

Social isolation and loneliness: prospective associations with functional status in older adults

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.

Due to an expected increase of people in need of care, sound knowledge about health effects of informal care provision is becoming more and more important. Theoretically, there might be positive as well as negative health effects due to caregiving to relatives. Moreover, we suppose that such health effects differ by national context - since care is differently organized in Europe - and depend on the social setting in which the care relationship takes place. Using data from the Survey of Health, Ageing and Retirement (SHARE, waves 1, 2, 3, and 5) and from the English Longitudinal Study of Ageing (ELSA, waves 2-5) we examined the connection between informal caregiving and self-perceived as well as mental health in a country comparative perspective. Taking advantage of the longitudinal structure of the data, pooled ordinary least squares (OLS) and fixed-effects models (FEM) were estimated. Our results show distinct differences in the relationship between reported health and the provision of informal care depending on whether individuals give care to someone inside or outside the household. Caregivers inside the household reported worse health, caregivers from outside the household reported better health than non-caregivers. We find that this correlation is largely due to selection into caregiving: people in worse health took up care inside while people in better health took up care outside the household. However, in most countries people who started caregiving inside the household experienced a decline in their mental health. This suggests that caregiving inside the household results in psychological stress irrespective of the type of welfare state. The results regarding self-perceived health and caregiving outside the household are less distinct. All in all our results show that health consequences of caregiving vary not only between different welfare regimes but also between countries of similar welfare state types.

Recent evidence suggests that low vitamin D concentrations are associated with increased levels of inflammatory markers. However, there are limited studies investigating associations between vitamin D levels and inflammatory markers in the general population and much of this evidence in older adults is inconclusive. Therefore, this study investigates the cross-sectional association of serum 25-hydroxyvitamin D (25(OH)D) levels with inflammatory markers in 5870 older English adults from wave 6 (2012-2013) of the English Longitudinal Study of Ageing (ELSA). ELSA is a large prospective observational study of community-dwelling people aged 50 years and over in England. Serum 25(OH)D levels, C-reactive protein (CRP) levels, plasma fibrinogen levels, white blood cell count (WBC), age, season of blood collection, waist circumference, total non-pension household wealth, measures of health and health behaviours that included depression, number of cardiovascular, non-cardiovascular conditions and difficulties in activities of daily living, smoking, and physical activity were measured. There was a significant negative association between low 25(OH)D levels (≤30 nmol/l) and CRP (OR 1·23, 95 % CI 1·00, 1·51) and WBC (OR 1·35, 95 % CI 1·13, 1·60) that remained after adjustment for a wide range of covariates of clinical significance. However, for fibrinogen, the association did not remain significant when waist circumference was entered in the final model. Our findings showed that 25(OH)D levels were associated with two out the three inflammatory markers investigated. The independent and inverse association between serum 25(OH)D levels and inflammation suggests a potential anti-inflammatory role for vitamin D in older English individuals from the general population.

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.

Cross-sectional analyses of adiposity and sleep duration in younger adults suggest that increased adiposity is associated with shorter sleep. Prospective studies have yielded mixed findings, and the direction of this association in older adults is unclear. We examined the cross-sectional and potential bi-directional, prospective associations between adiposity and sleep duration (covariates included demographics, health behaviours, and health problems) in 5,015 respondents from the English Longitudinal Study of Ageing (ELSA), at baseline and follow-up. Following adjustment for covariates, we observed no significant cross-sectional relationship between body mass index (BMI) and sleep duration [(unstandardized) B = -0.28 minutes, (95% Confidence Intervals (CI) = -0.012; 0.002), p = 0.190], or waist circumference (WC) and sleep duration [(unstandardized) B = -0.10 minutes, (95% CI = -0.004; 0.001), p = 0.270]. Prospectively, both baseline BMI [B = -0.42 minutes, (95% CI = -0.013; -0.002), p = 0.013] and WC [B = -0.18 minutes, (95% CI = -0.005; -0.000), p = 0.016] were associated with decreased sleep duration at follow-up, independently of covariates. There was, however, no association between baseline sleep duration and change in BMI or WC (p > 0.05). In older adults, our findings suggested that greater adiposity is associated with decreases in sleep duration over time; however the effect was very small.

Physical inactivity in relation to self-rated eyesight: cross-sectional analysis from the English Longitudinal Study of Ageing.

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

Informal caregiving transitions, subjective wellbeing and depressed mood: Findings from the English Longitudinal Study of Ageing

BACKGROUND: Since our knowledge of the associations between socioeconomic position (SEP) over the life course and inflammatory and metabolic markers, which are excellent predictors of cardiovascular disease, remains limited, we examined the association between social mobility over the life course and these markers at older ages.

BACKGROUND: we aimed to develop and validate a population-representative 10-year mortality risk index for older adults in England.

This report explores the relationship between disability and poverty among the older population. It emphasises the additional living costs that disabled people face, and the importance of taking disability costs into account when making poverty assessments in the older population. The report considers alternative directions of reform for the system of public support for older people with disabilities, and casts doubt on some of the suggestions that have been made for improving the targeting of public support for older disabled people.