S2.7 Health trends in various life stages in The Netherlands: 25 years Longitudinal Aging Study Amsterdam
Wednesday 16:45-18:00 S2.7 Meeting room 3
Health trends in various life stages in the Netherlands: 25 years Longitudinal Aging Study Amsterdam
Chair: Maaike Van der Noordt
Discussant: Marja Jylhä
The Longitudinal Aging Study Amsterdam (LASA) exists 25 years. LASA is a continuing Dutch nation-wide population-based cohort study on predictors and consequences of changes in cognitive, social, emotional and physical functioning with ageing. The first LASA cohort, selected in 1992/1993, consists of 3,107 older adults aged 55-85 who were interviewed face-to-face every three years up until 2015/2016. New cohorts of older adults aged 55-65 were added in 2002/2003 (N=1,001) and in 2012/2013 (N=1,023), all with the same follow-up schedule. This dataset offers the unique opportunity to investigate health trends across different cohorts of older adults over a period of 25 years. In this symposium, these health trends will be presented in various life stages: around the retirement age, in late life and at the end of life. These trends provide insight in the effects of changes in society such as the extension of working lives, improved healthcare and lifestyle deterioration. Opportunities and challenges of trend studies will be discussed, as well as implications for further research and policy.
S2.7.1 Changes in the association between working conditions and pre- and post-
retirement health over a 20-year period
Maaike van der Noordt, Theo G. van Tilburg, Suzan van der Pas, Bram Wouterse, Dorly J.H. Deeg
VU University, Amsterdam, The Netherlands
Background: In Western societies, older workers are required to prolong their working lives in order to limit pension costs. Working more years in an occupation with unfavourable working conditions may have negative effects on health. In this study, we examined the association between favourable and unfavourable working conditions and pre- and post-retirement health. Furthermore, we investigated whether this association has changed over a period of 20 years. Methods: Baseline measurements in 1992/1993, 2002/2003 and 2012/2013 and 3-year follow-up of LASA were used. We included respondents aged 55-65 years with a paid job at baseline and no job at follow-up (N=370). GEE-analyses were performed with working conditions as main determinant and health as outcome. Working conditions concerned physical and cognitive demands, and psychosocial resources. Health domains examined were self-rated health, functional limitations and mental health. Results: The association between working conditions and health has changed. Pre- to post-retirement self-rated and mental health trajectories remained the same for workers exposed to favourable working conditions, but for workers exposed to unfavourable working conditions in physical and psychosocial respect post-retirement self-rated and mental health deteriorated. Furthermore, the number of functional limitations increased for all workers in the more recent cohorts but in the third cohort this number increased more for workers exposed to high physical demands. Conclusions: The results of this study indicate that the health gap between retirees exposed to favourable and unfavourable working conditions in physical and psychosocial respect has increased since workers are required to extend their working lives, in disadvantage of the latter.
S2.7.2 Trends in functioning among older adults in the Netherlands
Erik J. Timmermans, Emiel O. Hoogendijk, Dorly J.H. Deeg, Martijn Huisman
VU University, Amsterdam, The Netherlands
Background: Trends in functioning among older adults at the population-level shape the context in which long-term health care policy should take place. This study examined trends in multiple indicators of functioning among Dutch older adults across a period of 20 years. Methods: Data from the Longitudinal Aging Study Amsterdam were used. A total of 10,010 observations of 3,733 older adults aged 64-84 across 7 measurement waves (1992-2012) were included. Furthermore, a total of 931 observations of 603 people aged 85-94 across 4 waves (2001-2012) were included. At each wave, 8 indicators of functioning were measured: multimorbidity, severe functional limitations, depression, anxiety, cognitive impairment, physical inactivity, loneliness, and social isolation. In addition, a sum score (range: 0-8) of these indicators was calculated, with a score of >5 indicating Multiple Problems (MP). Trends in functioning were assessed using Generalised Estimating Equation analysis. Results: In the 64-84-year olds, the prevalence rate of most indicators decreased (i.e., severe functional limitations, cognitive impairment, physical inactivity, and loneliness) or remained stable (i.e., depression, anxiety, and social isolation) over time. In this age group, however, the prevalence rate of multimorbidity increased over time (OR=1.06, 95% CI=1.05-1.07). In the 85-94-year-olds, the prevalence rate of each indicator remained stable over time, except that severe functional limitations increased (OR=1.09, 95% CI=1.03-1.14). In both age groups, the prevalence rate of MP remained stable over time. Conclusions: During the period of observation, there was an increasing trend in the prevalence of multimorbidity and severe functional limitation among 64-84-year-olds and 85-94-year-olds, respectively.
S2.7.3 Non-linear changes in fatality of specific chronic diseases during 1993-2013 in the
Dorly J.H. Deeg, Maaike van der Noordt, Emiel Hoogendijk, Martijn Huisman
VU University, Amsterdam, The Netherlands
Background. To study 20-year trends in mortality for specific chronic diseases at older ages in the Netherlands. Methods. In the nationally representative Longitudinal Aging Study Amsterdam, 4.6-year mortality during each of six subsequent time intervals was studied for six essentially fatal diseases, selecting ages 64-84 at each interval. Generalised Estimating Equations with adjustment for age and sex were used to assess 20-year trends in mortality over time. Results. From 1993-97 to 2009-13, mortality declined linearly from 20% to 13%. However, the mortality associated with each of the six chronic diseases showed different trends. A linear decline in fatality was observed for diabetes (OR from 3.05, CI=2.23-4.17, down to 1.66, CI=1.11-2.46, p(trend)=0.009). Declines were also observed for heart disease, peripheral artery disease, and chronic obstructive pulmonary disease between 1993-97 and 2006-10. However, for these diseases mortality was significantly higher during 2009-2013, with ORs actually higher in 2009-13 than in 1993-97 (ORs 1.97, 3.07, and 2.20 versus 1.52, 2.30, and 1.45). Stroke and cancer showed no change in associated mortality. Conclusions. The differential change in mortality associated with chronic diseases needs further study. These findings highlight the importance of long time series that enable the detection of non-linear trends.
S2.7.4 The lethality of frailty in older adults: Results from a trend study (1995-
Emiel O. Hoogendijk, Dorly J.H. Deeg,Martijn Huisman
VU University, Amsterdam, The NetherlandsBackground: Frailty is an important predictor of mortality in older adult, but not much is known about cohort and period changes in the frailty-mortality relationship. The aim of the current study was to investigate trends in the relationship between frailty and mortality across a period of 21 years. Methods: Data from 1995 to 2016 were used from the Longitudinal Aging Study Amsterdam. A total of 7,742 observations of 2,874 respondents aged 64-85 years across 6 measurement waves were included. Frailty was measured with a 32-item frailty index (FI), with a cut-off of 0.25 to indicate frailty. The outcome measure was 4-year mortality. Trends in frailty and its association with 4-year mortality were assessed using Generalised Estimating Equation (GEE) analysis. Results: The GEE analyses showed that the 4-year mortality rate declined between 1995 and 2016. In the same observation period, levels of frailty slightly increased. Across all measurement waves, frailty was associated with 4-year mortality (OR = 2.57, 95% CI = 2.03-3.25). The OR increased in more recent measurement waves. However, there was no statistically significant interaction effect between frailty and time on 4-year mortality, indicating that the association between frailty and mortality remained the same during the period of observation. Conclusions: Between 1995 and 2016, the lethality of frailty in older adults did not change, as there was a stable trend in the frailty-mortality relationship