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  • 1.
    Baranowska-Rataj, Anna
    et al.
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Abramowska-Kmon, Anita
    Institute of Statistics and Demography, Warsaw School of Economics, Warsaw, Poland.
    Number of Children and Social Contacts among Older People: the Moderating Role of Filial Norms and Social Policies2019In: European Journal of Ageing, ISSN 1613-9372, E-ISSN 1613-9380, Vol. 16, p. 95-107Article in journal (Refereed)
    Abstract [en]

    Social contacts offer opportunities for provision of emotional and instrumental support that enhance well-being throughout the life course, and the importance of these contacts is especially evident at advanced ages. In this paper, we take a cross-country comparative perspective to examine the association between the number of children and the frequency of social contacts among older people. Using data from the European Quality of Life Survey, we employ multilevel models with cross-level interactions between the number of children and macro-level indicators of filial norms and social policies supporting older people. Our results suggest that older adults with children are more likely than older adults without children to have frequent social interactions, but that the number of children does not affect social contact frequency. The magnitude of the association between having children and social contact frequency varies across European societies. The social contact frequency gap between older adults with children and older adults without children is larger in more familialistic countries with strong filial norms. Our results do not confirm that having children affects social contact frequency less in countries where the state provides more support for older people.

  • 2.
    Fischl, Caroline
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy. Department of Rehabilitation, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
    Lindelöf, Nina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Lindgren, Helena
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.
    Older adults’ perceptions of contexts surrounding their social participation in a digitalized society: an exploration in rural communities in Northern Sweden2020In: European Journal of Ageing, ISSN 1613-9372, E-ISSN 1613-9380Article in journal (Refereed)
    Abstract [en]

    Social participation and digital engagement can contribute to health and well-being among older adultsBecause of older adults’ decline in abilities, coupled withcomplex technology and its perceived insufficient relevance to daily life, there is a need to create and tailor social opportunities and services that are supported by digital technologies for older adults to continue participating in society. Thus, it becomes relevant to explore older adults’ perceptions about contexts surrounding their social participation in a digital society. This exploration used a qualitative research design with focus group interviews and qualitative content analysis. Eighteen older adults, aged 66-81 years, from rural communities in Northern Sweden, participated in this study. The analysis resulted in three categories: Experiencing conditions for social participation in a state of flux, Perceiving drawbacks of urbanization on social participation, Welcoming digital technology that facilitates daily and community living.These categories were encapsulated in the theme –The juxtaposition of narrowing offline social networks and expanding digital opportunities for social participation. The findings suggested that co-creating usable digitalized services and facilitating satisfactory use of digital technologies could support older adults’ social participation through activities that they find relevant in their lives, and subsequently, might enable them to live longer at home.

  • 3.
    Genbäck, Minna
    et al.
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics.
    Ng, Nawi
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Stanghellini, Elena
    de Luna, Xavier
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics.
    Predictors of decline in self-reported health: addressing non-ignorable dropout in longitudinal studies of ageing2018In: European Journal of Ageing, ISSN 1613-9372, E-ISSN 1613-9380, Vol. 15, no 2, p. 211-220Article in journal (Refereed)
    Abstract [en]

    Predictors of decline in health in older populations have been investigated in multiple studies before. Most longitudinal studies of aging, however, assume that dropout at follow-up is ignorable (missing at random) given a set of observed characteristics at baseline. The objective of this study was to address non-ignorable dropout in investigating predictors of declining self-reported health (SRH) in older populations (50 years or older) in Sweden, the Netherlands, and Italy. We used the SHARE panel survey, and since only 2895 out of the original 5657 participants in the survey 2004 were followed up in 2013, we studied whether the results were sensitive to the expectation that those dropping out have a higher proportion of decliners in SRH. We found that older age and a greater number of chronic diseases were positively associated with a decline in self-reported health in the three countries studies here. Maximum grip strength was associated with decline in self-reported health in Sweden and Italy, and self-reported limitations in normal activities due to health problems were associated with decline in self-reported health in Sweden. These results were not sensitive to non-ignorable dropout. On the other hand, although obesity was associated with decline in a complete case analysis, this result was not confirmed when performing a sensitivity analysis to non-ignorable dropout. The findings, thereby, contribute to the literature in understanding the robustness of longitudinal study results to non-ignorable dropout while considering three different population samples in Europe.

  • 4.
    Halleröd, Björn
    et al.
    University of Gothenburg, Dept Sociology & Work Life Science.
    Örestig, Johan
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Stattin, Mikael
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Leaving the labour market: the impact of exit routes from employment to retirement on health and wellbeing in old age2013In: European Journal of Ageing, ISSN 1613-9372, E-ISSN 1613-9380, Vol. 10, no 1, p. 25-35Article in journal (Refereed)
    Abstract [en]

    The study analyses whether and to what degree specific routes into retirement affect older people, i.e. the relationship between heterogeneous exit patterns and post-retirement health and wellbeing. We used longitudinal data from two points in time; data related to t 0 were collected in 1993, 1994, 1995 and 1996 and data related to t 1 were collected in 2002 and 2003 (N = 589). We focused on older people (55+ at t 1) who were employed at t 0 and retired at t 1. We used confirmative factor analysis to identify identical measures of health and wellbeing at both t 0 and t 1. Hence, we were able to control for pre-retirement health and wellbeing when evaluating the effects of different exit routes. These routes were defined as dependence on incomes from sickness benefit, disability pension, part-time pension, unemployment insurance and active labour market programmes. Our initial structural equation model showed a clear relation between exit routes and post-retirement wellbeing. People who prior to retirement were pushed into social benefit programmes related to health and unemployment were significantly worse off as retirees, especially those with health-related benefits. However, these relationships disappeared once pre-retirement wellbeing was added to the model. Our main conclusion is that post-retirement wellbeing first and foremost is a consequence of accumulation of advantages and disadvantages during the life course. Both labour market exit routes and post-retirement wellbeing can be seen as outcomes of this process. There are no independent effects of the retirement process. Judging from our findings, there is no reason to believe that involvement in social security programmes allowing early retirement on health grounds has any additional negative consequences for health and wellbeing.

  • 5.
    Kvist, Elin
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Changing social organizations of care: a comparison of European policy reforms encouraging paid domestic work2012In: European Journal of Ageing, ISSN 1613-9372, E-ISSN 1613-9380, Vol. 9, no 2, p. 111-117Article in journal (Refereed)
    Abstract [en]

    In many European countries different types of policy reforms intending to encourage growth in the domestic service sector have been introduced. The methods and reforms differ but mainly the reforms intend to stimulate growth of a ‘new’ legal labour market sector within private households. This potential growth sector in combination with insufficient or declining welfare states, inclining female labour market participation and ageing populations could be viewed as explanatory factors to the increased demand for domestic services. A growing amount of those performing paid domestic work in European homes are migrant women with or without papers. The aim of this article is to create a model that enables comparisons of these reforms, with a special focus on changing social organizations of care for elders, children and other dependent persons. Included in the analysis are Euro- pean countries that have introduced wide domestic service policy reforms as measurement to encourage growth in the domestic service sector, i.e. Austria, Belgium, Denmark, Finland, France, Germany and Sweden. 

  • 6.
    Näsman, Marina
    et al.
    Åbo Akademi University.
    Niklasson, Johan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Nygård, Mikael
    Åbo Akademi University.
    Olofsson, Birgitta
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lövheim, Hugo
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Nyqvist, Fredrika
    Åbo Akademi University.
    Risk factors for a decrease in high morale in very old peopleover a 5‑year period: data from two Nordic countries2019In: European Journal of Ageing, ISSN 1613-9372, E-ISSN 1613-9380Article in journal (Refereed)
    Abstract [en]

    High morale could be considered to be an essential part of aging well and increased knowledge of how to prevent a decreasein high morale in very old age could have important implications for policy, and social and health care development. Theobjective was to identify social and health-related risk factors for a decrease in morale over 5 years in very old peopleamong those with high morale at baseline. The study is based on data derived from the Umeå85+/GERDA study conductedin Northern Sweden and Western Finland. The final sample consisted of 174 individuals who were 85 years and older atbaseline and who had completed the follow-up 5 years later. Morale was measured with The Philadelphia Geriatric CenterMorale Scale (PGCMS). A set of social and health-related variables were used to test which factors were associated with adecrease in morale over 5 years. Linear regression was used for the multivariable analyses. The sample had a mean changeof − 1.3 (SD = 2.5) in PGCMS scores from T1 to T2. The results from the regression analyses showed that development ofdepressive disorders, increased feelings of loneliness and the death of a child during the follow-up period were associatedwith a decrease in morale. The results from our study indicate that preventing the development of depressive disorders andincreasing loneliness are key factors in preventing a decrease in high morale. Additionally, very old people who have recentlylost an adult child should receive adequate psychosocial support

  • 7.
    Zingmark, Magnus
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR). Community Care Administration, Municipality of Östersund, 83182 Östersund, Sweden.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    Norström, Fredrik
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Sahlén, Klas-Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Medicine, Department of Nursing.
    Lindholm, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Cost effectiveness of an intervention focused on reducing bathing disability2017In: European Journal of Ageing, ISSN 1613-9372, E-ISSN 1613-9380, Vol. 14, no 3, p. 233-241Article in journal (Refereed)
    Abstract [en]

    The onset of bathing disability among older people is critical for a decline in functioning and has implications for both the individuals’ quality of life and societal costs. The aim of this study was to evaluate longterm cost effectiveness of an intervention targeting bathing disability among older people. For hypothetical cohorts of community-dwelling older people with bathing disability, transitions between states of dependency and death were modelled over 8 years including societal costs. A five-state Markov model based on states of dependency was used to evaluate Quality-adjusted life years (QALYs) and costs from a societal perspective. An intervention group was compared with a no intervention control group. The intervention focused on promoting safe and independent performance of bathing-related tasks. The intervention effect, based on previously published trials, was applied in the model as a 1.4 increased probability of recovery during the first year. Over the full follow-up period, the intervention resulted in QALY gains and reduced societal cost. After 8 years, the intervention resulted in 0.052 QALYs gained and reduced societal costs by €2410 per person. In comparison to the intervention cost, the intervention effect was a more important factor for the magnitude of QALY gains and long-term societal costs. The intervention cost had only minor impact on societal costs. The conclusion was that an intervention targeting bathing disability among older people presents a cost-effective use of resources and leads to both QALY gains and reduced societal costs over 8 years.

  • 8.
    Zingmark, Magnus
    et al.
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health. Health and Social Care Administration, Municipality of Östersund, 83182 Östersund, Sweden.
    Norström, Fredrik
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Lindholm, Lars
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Dahlin-Ivanoff, Synneve
    Göteborgs universitet.
    Gustafsson, Susanne
    Göteborgs universitet.
    Modelling long-term cost-effectiveness of health promotion for community-dwelling older people2019In: European Journal of Ageing, ISSN 1613-9372, E-ISSN 1613-9380, Vol. 16, no 4, p. 395-404Article in journal (Refereed)
    Abstract [en]

    The effectiveness of health promotion for community-dwelling older people is well documented; however, there is a general lack of health economic evaluations. The aim of the present study was to evaluate long-term cost-effectiveness over 4 years of two health promoting interventions: senior meetings and a preventive home visit, for community-dwelling older people in relation to no intervention. We applied a Markov model including five states defined in relation to level of dependency of home help and place of residency. The model included transitions between dependency states, scores for quality of life and societal costs for each state, intervention costs and intervention effects for two formats of health promoting interventions. For each intervention and a no-intervention control group, we calculated the accumulated quality-adjusted life years (QALYs) and societal costs over 4 years. Sensitivity analyses included higher intervention costs, lower intervention effects and additional intervention costs and effects related to booster sessions. The results of all analyses indicated that health promotion implemented for community-dwelling older people in the format of senior meetings or a preventive home visit was cost-effective. Both interventions lead to QALY gains and reduce societal costs at any follow-up over 4 years, and thus, resources can be used to implement other interventions. The most important factor for the magnitude of QALY gains and cost savings was the intervention effect. Yearly booster sessions implemented for those persons who maintained their level of functioning extended the intervention effects adding additional QALYs and further reducing societal costs.

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