OBJECTIVES: Socioeconomic status impacts emotional health outcomes, but a lifecourse approach is necessary to understand the timing of these effects. The current analyses examined the impact of financial strain in childhood and adulthood on longitudinal changes in three measures of emotional health: depressive symptoms, loneliness, and anxiety.

METHOD: Data were from 1596 adults from the Swedish Twin Registry, aged 45 to 98 at intake (mean = 72.6) who participated in up to 9 waves over 25 years. Measures of financial strain (FS) included questions about how well finances met family needs. Latent growth curve models (LGCM) were used to estimate the impact of childhood and adult FS on changes in emotional health.

RESULTS: Results indicated that both childhood and adult FS independently influenced trajectories of emotional health in mid to late adulthood. For all 3 emotional health variables, both childhood and adult FS were associated with the LGCM intercept and childhood FS was associated with linear change with age. Interaction effects of childhood and adult FS were found for the LGCM intercept for loneliness, only.

CONCLUSION: Results corroborate the accumulation of risk models, with effects of both childhood and adult FS on emotional health, and possible social mobility effects for loneliness.

PURPOSE OF THE RESEARCH: Stress has a clear impact on health and function. Yet, little is known about how different stressors (factors that cause stress) in various contexts throughout the life course impact cognitive and physical aging. The study aimed to investigate if different types of stressors predicted cognitive and physical impairment in late life. The role of social support and internal locus of control was also investigated.

MATERIAL AND METHODS: Two individually linked studies of Swedish nationally representative samples provided longitudinal data over 21 years, including retrospective childhood data (n = 1086). Indicators of work and financial stressors were assessed at late midlife (M=62 years) and financial stressors at early late life (M=70). Social support and internal locus of control were assessed at the mean ages of 62 and 70 years. Physical and cognitive impairment were assessed at late life (M=83). Path analyses were conducted with maximum likelihood estimation and adjusted for smoking, age, sex, educational attainment, and follow-up period.

RESULTS: Work stressors were associated with physical and cognitive impairment directly. Work stressors were also associated with financial stressors, which, in turn, were associated with physical impairment. Childhood conflicts were associated with less social support, and less social support was associated with worse cognitive aging. Internal locus of control was not associated with cognitive and physical impairment.

CONCLUSIONS: This study confirms that stressors earlier in life predict cognitive and physical aging, but that different types of stressors have different paths to impact impairment in late life.

BACKGROUND: Financial stress is an important source of chronic stress and has been associated with cognitive and physical impairments. The goal of this study was to investigate whether financial stress is associated with cognitive and physical impairment and their combination, the role of potential modifiable factors and potential sex differences.

METHODS: The Cardiovascular Risk Factors, Aging, and Dementia population-based cohort study from Finland was used (n = 1497) (baseline data collected 1972-1987, mean age 50 years). Two late-life re-examinations (mean total follow-up 21 years). Midlife financial stress was measured using two questions on financial situation. Cognitive functioning was based on six cognitive domains. Physical impairment was self-reported, including activities of daily living and mobility. Potential mediation factors investigated were smoking, alcohol, physical activity, cohabitant status, non-manual work, and sleep disturbances. Sex differences were investigated. We used path analyses with full information maximum likelihood estimation.

RESULTS: Midlife financial stress was associated with worse cognitive functioning, physical impairment and their combination. Smoking and sleep disturbances mediated the associations between financial stress, physical impairment, and combined impairments. For men: Among smokers financial stress was associated with worse cognitive functioning; alcohol interacted with financial stress on combined impairments; cohabitation and non-manual work mediated associations to worse cognitive functioning. Among women, sleep disturbances moderated the association to worse cognitive functioning.

CONCLUSIONS: Midlife financial stress is associated with late-life impairments, and lifestyle/sociodemographic factors may modify these associations. Sex differences were observed. Interventions promoting healthier lifestyle and psychosocial factors may buffer against the deleterious role of financial stress.

Objectives

This scoping review presents an overview of the available research on symptoms, comorbidities, and associated challenges among older adults with ADHD.

Method

The literature study followed Arksey and O'Malley's five-stage framework. The search was conducted in ProQuest Central, Scopus, PsycInfo, CINAHL, and PubMed. Articles were included if they were peer-reviewed, ethically approved primary studies, written in the English language, concerning ADHD, and including people 60 years of age and older.

Results

The review included 17 articles. Symptoms of ADHD persist throughout life. Older adults with ADHD experience similar core symptoms as younger individuals, but their manifestation and intensity may differ. The most common comorbidity found was mental illness, for example depression and anxiety. ADHD in older adults is linked to several challenges, such as difficulty with relationships and social isolation.

Conclusion

Older adults with ADHD face various symptoms, comorbidities, and challenges that affect their quality of life. Age-related changes can amplify ADHD symptoms and increase the perceived burden of illness. More research is needed to understand the complex relationship between these factors and enable tailored interventions to improve their quality of life and well-being.

Aims: There is substantial evidence that previous working conditions influence post-retirement health, yet little is known about previous working conditions' association with old-age dependency. We examined job strain, hazardous and physical demands across working life, in relation to the risk of entering old-age dependency of care.

Methods: Individually linked nationwide Swedish registers were used to identify people aged 70+ who were not receiving long-term care (residential care or homecare) at baseline (January 2014). Register information on job titles between the years 1970 and 2010 was linked with a job exposure matrix of working conditions. Random effects growth curve models were used to calculate intra-individual trajectories of working conditions. Cox regression models with age as the timescale (adjusted for living situation, educational attainment, country of birth, and sex) were conducted to estimate hazard ratios for entering old-age dependency during the 24 months of follow-up (n = 931,819).

Results: Having initial adverse working conditions followed by an accumulation throughout working life encompassed the highest risk of entering old-age dependency across the categories (job strain: HR 1.23, 95% CI 1.19-1.27; physical demands: HR 1.36, 95% CI 1.31-1.40, and hazardous work: HR 1.35, 95% CI 1.30-1.40). Initially high physical demands or hazardous work followed by a stable trajectory, or initially low-level physical demand or hazardous work followed by an accumulation throughout working life also encompassed a higher risk of dependency.

Conclusions: A history of adverse working conditions increased the risk of old-age dependency. Reducing the accumulation of adverse working conditions across the working life may contribute to postponing old-age dependency.

OBJECTIVES: To examine life-course models by investigating the roles of childhood and adult socioeconomic position (SEP) in longitudinal changes in a functional aging index.

METHOD: Up to eight waves of testing, covering 25 years, were available from the Swedish Adoption/Twin Study of Aging: N = 654, intake age = 50-82. A two-slope latent growth curve model was applied to the data, and the impact of including childhood and adult SEP as covariates of the intercept (at age 70) and slopes (before and after age 70) was tested.

RESULTS: Both childhood and adult SEP contributed to the best-fitting model. Childhood SEP was significantly associated with intercept and Slope 1 (before age 70) of the latent growth curve model (p < .05). Association of adult SEP with Slope 2 (after age 70) trended toward significance (p < .10). There was a significant interaction effect of childhood and adult SEP on the intercept (p < .05). As a result, intercept at age 70 was highest and change after age 70 was fastest for those whose SEP decreased from childhood to adulthood.

CONCLUSIONS: Both childhood and adult SEP impact change in functional abilities with age, supporting both critical period and social mobility models. The social environment is modifiable by policies at local, national, and international levels, and these policies need to recognize that early social disadvantage can have long-lasting health impacts.

Symptoms of dementia change over time, resulting in complex situations that can negatively impact the person with dementia, as well as their relatives, and create challenges for staff members. Behavioral and Psychological Symptoms of Dementia (BPSD), such as delusions, hallucinations, agitation, depression, anxiety, apathy, irritability, aberrant motor behavior, and sleep disturbances, occur in approximately 90% of older people with dementia. The purpose of the study was to identify potential barriers and facilitators prior to introducing a web-based digital tool, the Daily-BPSD. Daily-BPSD is going to be used by staff members for daily registrations of severity levels of BPSD for persons with dementia in nursing home care in Sweden. Qualitative data collection was conducted in co-production with previous users of a similar digital tool in disability care (n = 11) and future users in dementia care (n = 32). The participants were assistant nurses, care managers, nurses, occupational therapists, and relatives. The responses highlight the importance of an accessible and time-effective registration procedure, a manageable number of variables and registrations occasions per day, and ensuring that the same information does not need to be documented in different systems. The findings will be used to tailor Daily-BPSD and adequately prepare staff members for large-scale data collection in the next step of the research project. Daily-BPSD could provide an extended foundation of knowledge of the person with BPSD, which could be used to provide more person-centered and appropriate care.

Objectives

Mental health problems are a major concern in the older population in Sweden, as is the growing number of older adults aging alone in their homes and in need of informal care. Using a linked lives perspective, this study explored if older parents' mental health is related to their children's dual burden of informal caregiving and job strain.

Methods

Data from a nationally representative Swedish survey, SWEOLD, were used. Mental health problems in older age (mean age 88) were measured with self-reported 'mild' or 'severe' anxiety and depressive symptoms. A primary caregiving adult child was linked to each older parent, and this child's occupation was matched with a job exposure matrix to assess job strain. Logistic regression analyses were conducted with an analytic sample of 334.

Results

After adjusting for covariates, caregiving children's lower job control and greater job strain were each associated with mental health problems in their older parents (OR 2.52, p = 0.008 and OR 2.56, p = 0.044, respectively). No association was found between caregiving children's job demands and their older parents' mental health (OR 1.08, p = 0.799).

Conclusion

In line with the linked lives perspective, results highlight that the work-life balance of informal caregiving adult children may play a role in their older parent's mental health.

Financial stress is an important source of chronic stress and has been associated with cognitive and physical impairments. This study investigates whether midlife financial stress is associated with the combination of cognitive and physical impairment, the role of potentially modifiable factors, and sex differences.

Methods: The Cardiovascular Risk Factors, Aging, and Dementia population-based cohort study from Finland was used (n=1497) (baseline collected 1972-1987, mean age 50 years). There were two late-life re-examinations (mean total follow-up 25 years). Midlife financial stress was measured using two questions on financial situation. Cognitive impairment was based on six cognitive domains. Physical impairment was self-reported. Potential modifying factors investigated were smoking, alcohol, physical activity, cohabiting/not, non-manual work, and sleep disturbances. Sex differences were investigated. We used path analyses with full information maximum likelihood estimation.

Results: Among women and men, midlife financial stress associated with cognitive impairment, physical impairment and their combination. Smoking and sleep disturbances mediated associations between financial stress, physical impairment, and combined impairments. Among men: manual/non-manual work mediated the association to cognitive impairments; cohabitation mediated to cognitive impairment; financial stress was associated with cognitive impairment only among smokers and stress had a stronger association to physical and combined impairments among non-drinkers. Among women, sleep seems to have role in the association between financial stress and cognitive impairment.

Conclusions: Midlife financial stress associates with late-life impairments, and lifestyle/sociodemographic factors may modify these associations. Sex differences were observed. Interventions promoting healthier lifestyle and psychosocial factors may buffer against the deleterious role of financial stress.

Background

Psychosocial working conditions are associated with cognitive and physical impairments. The aim of this study was to investigate the associations between mid-late life psychosocial working conditions and the combination of physical and cognitive impairment among older adults, and the potential sex differences in these associations.

Methods

Data were derived from two Swedish nationally representative surveys (n = 839; follow-up: 20–24 years). Multinomial and binary logistic regressions assessed the associations between work stressors (job demand-control model), and a combination of cognitive and physical impairment.

Results

Low control jobs were significantly associated with higher odds of cognitive (OR: 1.41, CI: 1.15–1.72) and physical impairment (OR: 1.23, CI: 1.02–1.47), and cognitive and physical impairment combined (OR: 1.50, CI: 1.19–1.89). Passive jobs (low control, low demand) were associated with higher odds of cognitive impairment (OR: 1.57, CI: 1.12–2.20), and combined cognitive and physical impairment (OR: 1.59, CI: 1.07–2.36). Active jobs (high control, high demand) were associated with lower odds of cognitive impairment (OR: 0.48, CI: 0.29–0.80). Sex-stratified analyses showed stronger associations among men; passive jobs were associated with both cognitive (OR: 2.18, CI: 1.31–3.63) and physical impairment (OR: 1.78, CI: 1.13–2.81), while low strain jobs were associated with less physical impairment (OR: 0.55, CI: 0.33-0.89). No significant associations between work stressors and impairment were found for women.

Conclusions

These results highlight the importance of psychosocial working conditions for late-life physical and cognitive impairment, especially among men. Jobs characterised by low control and low demands are associated with higher risk for impairments.