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Is migration in later life good for wellbeing? A longitudinal study of ageing and selectivity of internal migration.

ABSTRACT: Migration scholarship has recently paid attention to lifecourse and non-economic effects of moving house. Yet consideration of the effects of internal migration in later life has been relatively neglected despite their implications for social and spatial inequalities. Thus we address two questions: how trajectories of wellbeing in later life vary for movers and non-movers, and how the event of moving affects wellbeing. In both cases we distinguish between "voluntary" and "involuntary" movers. We use 10 years (2002-2012) of the English Longitudinal Study of Ageing (ELSA) to analyse trends in wellbeing for age cohorts and to examine how wellbeing changes through the event of moving. The Control, Autonomy, Selfrealisation and Pleasure (CASP-19) measure of wellbeing is used. We find that, after controls for demographic and socio-economic characteristics, involuntary movers have lower levels of wellbeing than stayers or voluntary movers; and involuntary movers experience a stabilisation in the decline in wellbeing following migration which is not seen for voluntary movers. So, migration in later life is good for wellbeing, maintaining advantageous wellbeing trajectories for voluntary movers and improving wellbeing trajectories for involuntary movers. These findings imply a rich potential of ELSA and similar longitudinal datasets for examining residential mobility; the need for ageing inequalities studies to take more account of residential mobility; the need for internal migration scholarship to pay greater attention to reason for move; and for policy to consider the potentially beneficial effects of residential mobility in later life, particularly for those in adverse circumstances.

SUBMITTER: Finney N

PROVIDER: S-EPMC6282955 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:ObjectivesMany central nervous system (CNS) medications are considered potentially inappropriate for prescribing in older people; however, these medications are common in polypharmacy (≥5 medicines) regimens. This paper aims to determine the prevalence of CNS drug classes commonly taken by older people. Furthermore, this paper aims to determine whether polypharmacy and other factors, previously found to be associated with overall polypharmacy, are associated with the most common CNS drug classes.DesignCross-sectional study.SettingEnglish Longitudinal Study of Ageing (wave 6).Participants7730 participants (≥50 years).Main outcome measuresAdjusted Odds Ratios (OR) and 95% confidence intervals (CI) for CNS drug classes.Results31% of the sample were currently taking ≥5 medications (polypharmacy), of whom 58% (n=1362/2356) were taking CNS medicines as part of their regimen. The most common CNS drug classes in polypharmacy regimens were non-opioid analgesics, opioid analgesics, tricyclic and related antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) (34.6%, 13.2%, 10.9% and 10.4%, respectively). Compared with people currently taking 1-4 prescribed medicines, polypharmacy was associated with adjusted ORs of 5.71 (95% CI: 4.29 to 7.61, p<0.01) for opioid analgesics, 3.80 (95% CI: 3.25 to 4.44, p<0.01) for non-opioid analgesics, 3.11 (95% CI: 2.43 to 3.98, p<0.01) for TCAs and 2.30 (95% CI: 1.83 to 2.89, p<0.01) for SSRIs. Lower wealth was also associated with the aforementioned CNS drug classes.ConclusionOpioid and non-opioid analgesics were the most prevalent classes of CNS medicines in this study. Polypharmacy is strongly associated with the aforementioned classes of analgesics. Polypharmacy is also associated with TCAs and SSRIs, although to a lesser extent than for analgesics. For all CNS medicine classes, polypharmacy may need to be considered in relation to reducing the risk of potential adverse events. After adjustment, lower wealth is associated particularly with analgesics, highlighting that socioeconomic factors may play a role in the prescribing of CNS medicines. These findings provide a baseline for future research into this area.

Project description:BackgroundHaving a network of close relationships may reduce the risk of developing dementia. However, social exchange theory suggests that social interaction entails both rewards and costs. The effects of quality of close social relationships in later life on the risk of developing dementia are not well understood.ObjectiveTo investigate the effects of positive and negative experiences of social support within key relationships (spouse or partner, children, other immediate family, and friends) on the risk of developing dementia in later life.MethodsWe analyzed 10-year follow up data (2003/4 to 2012/13) in a cohort of 10,055 dementia free (at baseline) core participants aged 50 years and over from the English Longitudinal Study of Ageing (ELSA). Incidence of dementia was identified from participant or informant reported physician diagnosed dementia or overall score of informant-completed IQCODE questionnaire. Effects of positive and negative experiences of social support measured at baseline on risk of developing dementia were investigated using proportional hazards regression accommodating interval censoring of time-to-dementia.ResultsThere were 340 (3.4%) incident dementia cases during the follow-up. Positive social support from children significantly reduced the risk of dementia (hazard ratio, HR?=?0.83, p?=?0.042, 95% CI: 0.69 to 0.99). Negative support from other immediate family (HR?=?1.26, p?=?0.011, CI: 1.05 to 1.50); combined negative scores from spouse and children (HR?=?1.23, p?=?0.046, CI: 1.004 to 1.51); spouse, children, and other family (HR?=?1.27, p?=?0.021, CI?=?1.04 to 1.56); other family & friends (HR?=?1.25, p?=?0.033, CI: 1.02 to 1.55); and the overall negative scores (HR?=?1.31, p?=?0.019, CI: 1.05 to 1.64) all were significantly associated with increased risk of dementia.ConclusionPositive social support from children is associated with reduced risk of developing dementia whereas experiences of negative social support from children and other immediate family increase the risk. Further research is needed to better understand the causal mechanisms that drive these associations.

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Is migration in later life good for wellbeing? A longitudinal study of ageing and selectivity of internal migration.

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