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Explaining the impact of poverty on old-age frailty in Europe: material, psychosocial and behavioural factors.

ABSTRACT: Previous research found poverty to be associated with adverse health outcomes among older adults but the factors that translate low economic resources into poor physical health are not well understood. The goal of this analysis was to assess the impact of material, psychosocial, and behavioural factors as well as education in explaining the poverty-health link.In total, 28 360 observations from 11 390 community-dwelling respondents (65+) in the Survey of Health, Ageing and Retirement in Europe (2004-13, 10 countries) were analysed. Multilevel growth curve models were used to assess the impact of combined income and asset poverty risk on old-age frailty (frailty index) and associated pathway variables.In total, 61.8% of the variation of poverty risk on frailty level was explained by direct and indirect effects. Results stress the role of material and particularly psychosocial factors such as perceived control and social isolation, whereas the role of health behaviour was negligible.We suggest to strengthen social policy and public health efforts in order to fight poverty and its deleterious health effects from early age on as well as to broaden the scope of interventions with regard to psychosocial factors.

SUBMITTER: Stolz E

PROVIDER: S-EPMC5881693 | biostudies-literature | 2017 Dec

REPOSITORIES: biostudies-literature

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Explaining the impact of poverty on old-age frailty in Europe: material, psychosocial and behavioural factors.

Stolz Erwin E Mayerl Hannes H Waxenegger Anja A Freidl Wolfgang W

European journal of public health 20171201 6

<h4>Background</h4>Previous research found poverty to be associated with adverse health outcomes among older adults but the factors that translate low economic resources into poor physical health are not well understood. The goal of this analysis was to assess the impact of material, psychosocial, and behavioural factors as well as education in explaining the poverty-health link.<h4>Methods</h4>In total, 28 360 observations from 11 390 community-dwelling respondents (65+) in the Survey of Health ...[more]

PMID: 29020312

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Project description:CONTEXT:Many assume that having poor physical health in old age lowers life satisfaction, but in fact there are large differences in life satisfaction among older people who experience disability. OBJECTIVE:To investigate whether psychosocial factors modify the negative association between disability and life satisfaction in older people and whether these differ across the life course. DESIGN:Cross sectional study. SETTING:66,561 community-dwelling Survey of Health, Ageing, and Retirement in Europe (SHARE) participants aged 50-106 with a mean age of 67.8 ± 9.9 (SD) years from 17 European countries and Israel. METHODS:Psychosocial factors included depression (EURO-D scale), perceived loneliness, having a spouse, having children, contact with children, and participation in social activities. Disability was assessed by limitations in (Instrumental) Activities of Daily Living ((I)ADL) and life satisfaction by Cantril's ladder. We also ran the analyses with the Control Autonomy Self-realization Pleasure (CASP-12) Index, a normative measure of quality of life. We used multiple linear regressions to estimate associations and proportion of variance explained. RESULTS:The variance in life satisfaction that could be attributed uniquely to ADL and IADL disability was 0.17% and 0.33% respectively (both p < 0.001). The impact of (I)ADL disabilities on life satisfaction was strongest at age 50 and gradually decreased with increasing age (p trend < 0.001). Mental health explained more variance; 5.75% for depressive symptoms and 2.50% for loneliness and for social resources this ranged from 0.09% to 0.47% (all p < 0.001). While disability has a negative effect on life satisfaction, the effect was not stronger in older persons who were depressed, neither in those who felt lonely nor in those without social resources. Similar outcomes were found when using CASP-12 as the explained variable. CONCLUSION:The impact of (I)ADL disabilities on life satisfaction in community-dwelling older people decreases with age. These associations are not affected by psychosocial factors and these patterns cannot be explained by people changing their norms and values.

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Explaining the impact of poverty on old-age frailty in Europe: material, psychosocial and behavioural factors.

Publications

Explaining the impact of poverty on old-age frailty in Europe: material, psychosocial and behavioural factors.

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