Exploring determinants of flourishing: a comprehensive network analysis of retirees in Taiwan.

BACKGROUND: Human flourishing is an emerging concept, extending beyond the conventional boundaries of subjective well-being and evolving into a comprehensive capture of the diverse dimensions of human life within complex societal structures. Therefore, moving away from traditional approaches centered on the single latent construct, this study aims to explore the multiple aspects of human flourishing and the intricate interplay of their contributing factors. METHODS: Data were collected from the Health and Living Environments Survey of Taiwanese Retirees during 2023 (valid sample n = 1,111). Human flourishing was measured using the Secure Flourish Index developed by Harvard University, which includes 12 indicators: (1) life satisfaction, (2) happiness, (3) mental health, (4) physical health, (5) meaning in life, (6) sense of purpose, (7) promoting good, (8) delaying gratification, (9) content relationships, (10) satisfying relationships, (11) financial stability, and (12) material stability. A mixed graphical network analysis was employed to analyze the related determinants, divided into four groups: (a) sociodemographic factors, (b) physical functions and health status, (c) social and family engagement, and (d) community environmental characteristics as nodes. RESULTS: We analyzed 31 variables and identified 133 nonzero edges out of 465 potential connections in the comprehensive network. Results showed that happiness and promoting good were the two most critical indicators influencing retirees' overall flourishing. Different flourishing indicators were also associated with various influential factors. For instance, personal characteristics, especially gender and education, emerged as central factors. Family caregiving negatively affected happiness and financial stability, whereas social engagement was positively associated with life satisfaction and meaning in life. Employment status had mixed effects, negatively associated with life satisfaction but positively associated with mental health. Community environments, such as a sense of community and neighborhood safety, generally enhanced flourishing. However, the accessibility of neighborhood resources was paradoxically associated with material stability, pointing to the complexity of environmental factors in human flourishing. CONCLUSION: This study provides a comprehensive network analysis that reveals intricate connections between personal, behavioral, and environmental factors, offering profound insights for targeted interventions to foster human flourishing.

How do patients perceive the retirement of their general practitioner? A qualitative interview study in France.

OBJECTIVES: The perspective of general practitioners' (GPs) on retirement and the factors influencing their attitude towards retirement have been previously investigated. However, while the number of GPs has been declining for many years in France, leading to the emergence of medical deserts, the impact on their patients remains to be explored. The aim of this study was to understand patients' perceptions of their GP's retirement. DESIGN: A semistructured interview-based qualitative study was conducted, using Interpretative Phenomenological Analysis. SETTING: Interviews were conducted in two general practices located in Essonne, Ile-de-France, France, between January and April 2014. PARTICIPANTS: Thirteen women and five men, aged 21-94 years, were included in this study. Exclusion criteria were the non-declaration of the physician as the declared doctor and being under 18 years of age. RESULTS: The GP-patient relationship is a link that is built up over time, over the course of several consultations. Patients choose their GP based on qualities or skills they value. In this way, the physician chosen is unique for their patients; this choice reflects a certain loyalty to their physician. The interaction with the family sphere reinforces this relationship through the multiple links created during care. When a GP retires, this link is broken. Patients' reactions can range from indifference to real grief. CONCLUSION: This study confirms the importance of the link between the GPs and their patients and highlights the need to prepare patients for their GP's retirement.

Physical activity dynamically moderates the impact of multimorbidity on the trajectory of healthy aging over sixteen years.

BACKGROUND: Research examining the healthy aging trajectory of retired older adults with multimorbidity is limited, leaving uncertainties regarding the optimal physical activity (PA) intensity and frequency necessary to sustain healthy aging during retirement. METHODS: Our study investigated the moderating effects of PA on the healthy aging trajectories of retired older adults living with multimorbidity in the United States (US). We utilized data from 1,238 retired individuals aged 50 to 102 who contributed 11,142 observations over 16 years from the Health and Retirement Study (HRS). We employed mixed effects modeling to assess the impact of various classes of multimorbidity on this group and examine how different PA, PA intensities, and PA frequencies influence the disability, physical, and cognitive functioning domains of healthy aging. RESULTS: The results reveal that while outcomes differed significantly, retired older adults in the US attained healthy aging at baseline. However, their ability to maintain healthy aging declined over time, with multimorbidity, especially musculoskeletal and neurological conditions, accelerating this decline. Fortunately, PA, especially light to moderate intensities, is associated with improving healthy aging and moderating the impact of multimorbidity on the disability and cognitive functioning domains of healthy aging. However, the specific moderating effects of PA depend on its frequency, intensity, and chronic conditions. CONCLUSIONS: The significant variability in healthy aging attainment among retired older adults underlies the need to consider these differences when addressing healthy aging issues in the US. Accounting for these variations would aid in evaluating the potential impact of future interventions and contribute to achieving health equity. Fortunately, our dynamic findings facilitate this objective by identifying specific frequencies and intensities of PA tailored to different aspects of multimorbidity and healthy aging. This highlights PA, especially light-to-moderate intensity, as an essential, cost-effective, and amenable strategy for alleviating the impact of multimorbidity on healthy aging.

Mental health status and influencing factors of retired teachers.

Introduction: The wellbeing of retired teachers is often easily overlooked. This study aims to explore the mental health status and influencing factors of retired teachers. Method: From October to December 2022, a convenient sampling survey was conducted on retired teachers using the Symptom Checklist 90 (SCL-90), mainly using the χ2-test and logistic regression analysis. Results: A sampling survey was conducted on 353 retired teachers, with an overall positive detection rate of 16.1%. The five factors with the highest positive detection rate were found to be obsessive-compulsive disorder (30.3%), interpersonal sensitivity (21.5%), paranoia (20.1%), anxiety (19.3%), and others (19.3%). The detection rates for the five factors, namely psychosis, depression, hostility, terror, and somatization, are all below 19%. The data on sex (χ2 = 4.626, P = 0.043), professional title (χ2 = 17.670, P = 0.003), income (χ2 = 9.960, P = 0.041), life satisfaction (χ2 = 27.348, P = 0.000), family relationships (χ2 = 51.451, P = 0.000), and physical health status (χ2 = 50.361, P = 0.000) show that the difference in mental health among retired teachers is statistically significant. The multivariate binary logistic regression analysis revealed that family relationships, life satisfaction, and physical health were important factors leading to mental health problems among retired teachers. Discussion: Retired teachers should cultivate a wide range of interests and hobbies, engage in regular physical exercise, develop healthy living habits, foster a positive family atmosphere, establish harmonious family relationships, promote community cultural construction, strengthen psychological intervention, and prevent psychological diseases.

[Alcohol addiction and old age : state of the art]. / Alcoolodépendance et transition vers l'âge avancé : état des lieux.

The age of retirement until old age are driving on same important changes for physical health, mental health and decreasing social or working environment. The prevalence of alcohol addiction increases in this age group and is often underestimated by caregivers. Retirement is given as a risk factor to develop an alcohol addiction (late onset). It's also a worsening factor, when an alcohol addiction is already present (early onset). The consequences on physical health, mental health and psychosocial problems requires plural skills and coordination between the different stakeholders in the health, social and family sectors in order to find need- adapted solutions and treatments.

La phase de transition entre 55 ans et l'âge avancé amène de nombreux changements pour les personnes concernées, que ce soit au niveau psychique, physique ou socioprofessionnel. Dans le contexte du vieillissement de la population, les prises en charge des personnes souffrant de problèmes d'alcoolodépendance dans cette tranche d'âge prennent plus d'importance et sont souvent sous-estimées. Le passage à la retraite constitue un facteur de risque de développement d'une alcoolodépendance et un facteur d'aggravation quand celle-ci est déjà installée. L'intrication des problèmes (addictologiques, psychiques, somatiques, psychosociaux) exige des compétences plurielles et une coordination entre les différents intervenants des domaines de la santé, du social et de l'entourage familial afin de trouver des solutions adaptées aux besoins de la personne concernée.

Views of aging and mental health - The role of informal care provision: Longitudinal findings of the health and retirement study in the US.

BACKGROUND: Informal care is a common form of social support, which can vary greatly in its intensity. While views of aging have shown to be relevant to mental health before, we aim to analyze whether the association between views of aging and depressive symptoms is influenced by the provision of informal care and its intensity. METHODS: Data of six waves of the Health and Retirement Study in the United States was used. The sample includes up to 41,058 observations pooled over six waves of community-dwelling adults aged ≥50 years. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CESD) and attitudes towards own aging (ATOA) with the Philadelphia Geriatric Center Morale Scale (higher score indicates positive attitudes); informal caregiving (no/yes) and caregiving intensity (moderate, intense) were surveyed. Adjusted fixed effects regression analysis with robust standard errors, and with caregiving as moderator variable were calculated. RESULTS: Informal caregiving did not interact with ATOA. However, transitioning into intense caregiving significantly moderated the association between ATOA and depressive symptoms. Lower depressive symptoms were associated with better ATOA and this association was significantly stronger in the intense caregiving condition than in the non-caregiving condition. No significant interaction effects were found between any form of caregiving and subjective age. LIMITATIONS: The possibility of reciprocal effects cannot be excluded. CONCLUSION: Internalized ageism and depressive symptoms are more strongly related among caregivers who provide intense care. Thus, interventions to reduce internalized ageism could be helpful in particular among this vulnerable group of informal caregivers.

Bridge Employment or Encore Career? Examining Predictors That Distinguish Later-Life Career Transitions.

OBJECTIVES: Bridge employment and encore careers are 2 prevalent retirement pathways that have different goals and outcomes. Yet, "changing jobs in later life" is the shared prequel that blurs the distinction between them in empirical studies. This study proposes a set of criteria-voluntariness of career transition and the duration of work in the posttransition job-to distinguish various retirement pathways and investigates the predictors that distinguish the workers' choice of these pathways. METHODS: I conducted multinomial logistic regression to examine the predictors that distinguish between bridge employment, encore career, and direct workforce exit using the longitudinal sample of respondents with full-time career jobs in the Health and Retirement Study 1992-2020 (HRS, N = 2,038). To examine the predictors that distinguish between bridge employment and encore careers, I conducted logistic regression on the subsample of respondents who chose either bridge employment or encore careers (n = 927). RESULTS: The results show that the accumulated human capital from career jobs, physical and mental health conditions before leaving career jobs, and self-identified retirement status when transitioning to new jobs distinguish the workers' choices of taking on different retirement pathways. DISCUSSION: Maintaining the labor force participation of older workers is an important human resource agenda for policymakers. This study suggests that increasing the number of quality jobs for older workers would promote bridge employment and encore careers by raising the benefits of making career transitions as well as improving older workers' health.

Does work after retirement affect health-related quality of life: Evidence from a propensity score matching study in China.

AIM: Extending working life is considered as an important initiative to respond to the population aging and pension payment dilemma. This study aimed to investigate whether work after retirement is related to improved health-related quality of life. METHODS: We used two waves of data from the China Health and Retirement Longitudinal Study in 2011 and 2018. Work after retirement was ascertained based on self-reported retirement and work status, and health-related quality of life (HRQOL) was measured with the three-level EuroQol five-dimensions. The impact of work after retirement on HRQOL was analyzed using the propensity score matching with difference-in-difference approach. RESULTS: A total of 1043 retirees were included. The results showed that work after retirement was associated with significant improvement in HRQOL among retirees (ß = 0.072, P < 0.001). Heterogeneity analyses did not show specificity on sex (P for sex interaction >0.05), but older-aged retirees seemed more sensitive to the benefits of work after retirement on HRQOL than their younger-aged counterparts (≥65 years: ß = 0.167, P < 0.001 vs <65 years: ß = -0.047, P > 0.05; P for age interaction = 0.010). CONCLUSIONS: Work after retirement shows a positive impact on HRQOL among community-dwelling adults in China. Policy-makers should take the health of retirees into account when implementing policies related to delayed retirement, and reduce health inequity. Geriatr Gerontol Int 2024; 24: 722-729.

Work and Retirement Among Women: The Health and Employment After Fifty Study.

BACKGROUND: Women increasingly work beyond age 50+ but their occupational health is under-researched. AIMS: To investigate what jobs older contemporary women do, when they exit their jobs and what factors predict job exit. METHODS: Data came from the Health and Employment After Fifty cohort, which recruited women aged 50-64 at baseline in 2013-14 and has followed them up annually collecting: demographic, lifestyle and work information. Exits from employment were mapped longitudinally over five follow-ups. Time-to-first event Cox regression analyses were used to identify risk factors for job exit. RESULTS: At baseline, 4436 women participated, 64% of whom were working. The proportions of women working at 50-54, 55-60 and over 60 years were 86%, 79% and 38%, respectively. Amongst all women, after adjustment for age, managing comfortably financially and not coping with the mental demands of the job were associated with exit. Risk factors for job exit differed in the age bands: 50-54; 55-59 and >60 years, reflecting socio-economic status, markers of health (musculoskeletal pain and poor self-rated health) and work factors (under-appreciation, job dissatisfaction, temporary/permanent contracts, coping with work's physical demands). CONCLUSIONS: Factors contributing to exit from work among older women differ by age group, after controlling for perceived financial position, age and mental demands of the job. A number of work characteristics predict job exit and suggest that employers can play an important role in supporting women to continue working until older ages. Identification and treatment of musculoskeletal pain could also enable work amongst older women.

Trajectory of intrinsic capacity among community-dwelling older adults in China: The China health and retirement longitudinal study.

BACKGROUNDS: Intrinsic capacity (IC), the sum of individual mental and physical capabilities, as well as living environment and behavior, jointly determine the functional ability of older adults, shifting the focus from disease to function. At the population level, IC in older adults is associated with adverse health outcomes, such as disability, falls, and death. At the individual level, IC changes dynamically. However, studies on the longitudinal IC trajectory and the factors influencing IC deterioration are limited. We aimed to analyze the IC trajectory and explore the risk factors for IC deterioration in Chinese older adults. METHODS: Data were obtained from the baseline (2011-2012) and 4-year follow-up (2015) CHARLS surveys, including 1906 people aged 60 years and older. IC comprises six dimensions: locomotion, vitality, hearing, vision, cognition, and psychology. IC trajectory was categorized into three groups: improved, maintained, and deteriorated. Logistic regression analysis was used to analyze factors influencing the trajectory of IC deterioration. RESULTS: After 4 years, 32.1 % had deteriorated, 38.5 % remained stable, and 29.4 % had improved. Age, low level of education, widowed were independently associated with IC deterioration. CONCLUSIONS: Dynamic IC monitoring supports the development of individualized intervention policies to delay or prevent IC deterioration.

Quality of life in retired workers with past exposure to asbestos.

BACKGROUND: Asbestos causes cancer and non-cancerous lung and pleural diseases and can also have a negative psychological impact but little is known about its effect on health-related quality of life. OBJECTIVES: The aim of this study is to describe the health-related quality of life (HRQoL) of retired men with a history of occupational exposure to asbestos and examine factors linked with low HRQoL. METHODS: Retired male workers of the French Asbestos-Related Disease Cohort (ARDCO) completed self-questionnaires that included SF-36v2 and HAD scales, questions about their perception of asbestos (perceived dangers and level of exposure, expectations to fall ill, or knowing someone who is) and their respiratory symptoms. Asbestos exposure was assessed by industrial hygienists. A perceived risk score was created using factorial analysis. Multivariable regressions were performed for all SF-36 subscales. RESULTS: A total of 1266 of 2075 questionnaires (61%) were returned complete and included in analysis. After adjustment for potential confounders, an increase in perceived risk score resulted in a decrease in physical component summary score (PCS), up to 10.7 points (p = 0.048) and in mental component summary score (MCS) (p = 0.044). Presence of respiratory symptoms was also associated with significantly decreased PCS and MCS (p < 0.001). Poor HRQoL was linked to higher perceived risk score with p ≤ 0.01 for all SF-36 dimensions. Asbestos exposure assessed by an expert was not associated with any outcome. CONCLUSIONS: All dimensions of HRQoL appear to be affected by the perceived risk of incurring asbestos-related disease and respiratory symptoms.

Health-related quality of life and its relationship with time use, role participation and perceived social support among retirees in Klang Valley and Malacca.

INTRODUCTION: With increased life expectancy among older adults in Malaysia, there is an increasing number of years of living after retirement. The role and lifestyle changes can significantly affect time use and participation in everyday life, influencing individuals' quality of life (QoL) and wellbeing. However, limited research has examined the healthrelated QoL and its relationship with time use, role participation and perceived social support among retirees in Malaysia. MATERIALS AND METHODS: In this cross-sectional study, we used the Malay versions of EuroQol 5 Dimensional (EQ-5D- 3L, Time Use Diary, Role Checklist Version 3 (RCv3) and Multidimensional Scale of Perceived Social Support (MSPSS) questionnaires among 362 purposively selected Malaysian retirees aged 55 and older. Regression analysis was employed to identify the predictor of health-related QoL using the Statistical Package for Social Sciences (SPSS) version 26. RESULTS: The results indicate a weak positive association between all determinants (time use, role participation, perceived social support) and health-related QoL among retirees. Only time use and role participation significantly influenced the health-related QoL of retirees. Our findings reveal no direct and substantial relationship between perceived social support and health-related QoL among Malaysian retirees. CONCLUSION: The results suggest active role involvement and effective time management can improve retirees' healthrelated QoL.

The mediating effect of depressive symptoms on the association between childhood friendship and physical function in middle-aged and older adults: Evidence from the China Health and Retirement Longitudinal Study (CHARLS).

BACKGROUND: This study examines the extent to which depressive symptoms mediate the link between childhood friendship (CF) and physical function among middle-aged and older adults in China. METHODS: China Health and Retirement Longitudinal Study (CHARLS) data were used; specifically, CHARLS life history survey (conducted from June 1-December 31, 2014) and follow-up health survey (conducted from July 1-September 30, 2015) data were used. The Sobel test, Bootstrap test and multivariable logistic regression were performed to examine the mediating role of depressive symptoms (measured by the 10-item Center for Epidemiologic Studies Depression Scale) in the association between CF (measured by a standardized retrospective questionnaire) and physical function, which was measured by basic activities of daily living (BADL) disability, instrumental activities of daily living (IADL) disability, and grip strength. RESULTS: A total of 12,170 participants aged 45 years or older were included in this cross-sectional study. After controlling for covariates, low-quality CF was associated with an increased prevalence of BADL disability (OR = 1.18; 95 % CI = 1.05-1.32), IADL disability (OR = 1.25; 95 % CI = 1.12-1.40), and low grip strength (OR = 1.21; 95 % CI = 1.09-1.34). The proportion of the mediating effect of depressive symptoms was 48 % for CF and BADL, 40 % for CF and IADL, and 11 % for CF and grip strength. Depressive symptoms and worse CF have a joint effect on BADL disability (OR = 3.30; 95 % CI = 2.82-3.85), IADL disability (OR = 3.52; 95 % CI = 3.03-4.09), and low grip strength (OR = 1.65; 95 % CI = 1.43-1.92). LIMITATIONS: Not all potential confounding factors (such as childhood behavioural problems, genetic factors, and memory function) were measured in the analysis, and there may have been recall bias in the retrospective collection of CF data. CONCLUSIONS: Individuals with high-quality CF were more likely to have a decreased prevalence of impaired physical function in later life. Depressive symptoms acted as a mediator associated with the development of CF.

The longitudinal association between physical health and depressive symptoms over eight years: Evidence from the health and retirement study.

BACKGROUND: The bidirectional relationship between physical health (PH) and depressive symptoms (DS) remains unclear. METHODS: Data were extracted from the Health and Retirement Study in the United States. PH was measured with a composite of chronic diseases, functional limitations and difficulties in basic and instrumental activities of daily living, and DS with a modified Center for Epidemiological Studies of Depression. Latent growth curve models (LGCM) were employed to examine how the change in PH or DS affected their mutual trajectories in later life. In addition, multilevel models were utilized. RESULTS: There were 6144 participants included, with an average age of 69.82 ± 6.85 years at baseline, of whom 3686 (59.99 %) were women. PH scores increased from 5.65 in 2010 to 7.72 in 2018, while depression scores increased from 1.14 to 1.31. LGCM results showed that the initial levels of PH and DS were associated (ß = 0.558, P < .001), and the initial level of PH could predict the trajectory of DS (ß = 0.089, P < .001). Likewise, the initial level of DS was also related to initial PH (ß = -0.563, P < .001) but couldn't predict the trajectory of PH. Furthermore, the slopes of PH and DS were predicted bidirectionally by each other. Two-level logistic models further demonstrated the bidirectional association between PH and DS. CONCLUSION: There was a bidirectional association between physical health and depressive symptoms, which highlights the necessity of comprehensive health management for older adults with poor physical health or depression symptoms.

Association of the Type of Public Pension With Mental Health Among South Korean Older Adults: Longitudinal Observational Study.

BACKGROUND: As income and health are closely related, retirement is considered undesirable for health. Many studies have shown the association between pension and health, but no research has considered the association between contribution-based public pensions or their types and health. OBJECTIVE: This study investigates the association between the type of contributory public pension and depressive symptoms among older adults. METHODS: We analyzed the data of 4541 older adults who participated in the South Korea Welfare Panel Study (2014-2020). Depressive symptoms were measured using the 11-item Center for Epidemiologic Studies Depression scale. Public pensions in South Korea are classified into specific corporate pensions and national pensions. For subgroup analyses, pensioners were categorized according to the amount of pension received and the proportion of public pension over gross income. Analyses using generalized estimating equations were conducted for longitudinal data. RESULTS: Individuals receiving public pension, regardless of the pension type, demonstrated significantly decreased depressive symptoms (national pension: ß=-.734; P<.001; specific corporate pension: ß=-.775; P=.02). For both pension types, the higher the amount of benefits, the lower were the depression scores. However, this association was absent for those who received the smaller amount among the specific corporate pensioners. In low-income households, the decrease in the depressive symptoms based on the amount of public pension benefits was greater (fourth quartile of national pension: ß=-1.472; P<.001; second and third quartiles of specific corporate pension: ß=-3.646; P<.001). CONCLUSIONS: Our study shows that contributory public pension is significantly associated with lower depressive symptoms, and this association is prominent in low-income households. Thus, contributory public pensions may be good income sources for improving the mental health of older adults after retirement.

Impact of caregiving on mental, self-rated, and physical health: evidence from the China health and retirement longitudinal study.

OBJECTIVES: Given the escalating demand for care services, understanding the impact of informal caregiving, providing unpaid care for family members, on own health is essential. This study longitudinally analyzed the association of caregiving (and different caregiver types) with mental, physical, and self-rated health. Urban-rural, gender, and employment heterogeneity were further investigated. METHOD: Based on three-wave data (2011, 2013, and 2018) from the China Health and Retirement Longitudinal Study, we used growth curve models to assess the impact of informal caregiving (providing care to family members) and caregiver types (caregivers to grandchildren, parents, spouses, or multiple family members) on three health outcomes (depressive symptoms, self-rated health, and activities of daily living limitations). RESULTS: Our study included 13,377 individuals. Results showed a negative correlation of caregiving with mental, physical, and self-rated health. Compared to noncaregivers, spousal caregivers and multiple caregivers were both associated with worsening mental, self-rated, and physical health. In contrast, adult child caregivers were only negatively associated with mental health, and grandparent caregiving did not significantly affect any health outcomes. Further heterogeneity analysis showed that gender did not moderate the relationship between caregiving and health, whereas the negative association between caregiving and health was more pronounced among the rural population and those employed in agriculture. DISCUSSION: Findings from the present study suggest that caregiving is detrimental to health, and recommend considering caregiver type when examining caregiving and health. These findings have vital implications for policymakers in addressing the challenges of structuring and implementing a sustainable informal care system.

Determinants of social loneliness among older adults in job retirement and the role of emotional expressivity.

OBJECTIVES: The study examined the possibility that a mediating role of positive and negative emotional expressivity may contribute to understanding the associations between social loneliness and its previously identified predictors (i.e. health, age, sex, and social living situation). METHOD: Self-reported assessments were collected from community-dwelling Swedish residents (aged 65 and above) in job retirement. Structural equation modeling with manifest variables was applied to cross-sectional data (N = 601) to analyze two competing models; one main-effect regression model, examining the predictive effect of emotional expressivity (along with health and sociodemographics) on social loneliness, and one mediation model, examining the mediating effect of emotional expressivity (using the bootstrapping technique provided in Mplus). RESULTS: The results indicated that the mediation model fit the data considerably better than the main-effect regression model (Δχ2 [Δdf = 8] = 72.69, p < 0.00001), and demonstrated a good fit on its own, with CFI = 0.986 and RMSEA = 0.030. This suggests that emotional expressivity contributes to the understanding of the connection between social loneliness and its previously identified predictors. CONCLUSION: Recognizing the significance of emotional expressivity has the potential to enhance our understanding of loneliness in older adults, both in theory and in practice.

"I'm more than my sport": Exploring the dynamic processes of identity change in athletic retirement.

Retirement is one of the most impactful career transitions athletes face. Researchers recognise the role that athletic identity plays in this, but analysis of identity content and change processes is limited. Addressing this gap, we conducted a qualitative study exploring the experience of identity change in 21 competitive and successful elite athletes who had retired from sport. All participated in a one-session psychoeducational program that explored the challenges of transitioning out of sport before being interviewed about their understanding of identity in sport, and their experiences negotiating identity loss and change in retirement. Using reflexive thematic analysis, we identified three themes: (i) the role of identity and self-categorizations in shaping sport performance, (ii) adjusting to identity loss (with subthemes indicating that this experience varied depending on the extent to which a person had multiple or exclusive identities), and (iii) attempts to remoor identity in the transition (with subthemes of searching for a new identity and actively repurposing identity). We interpret these themes through the lens of the Social Identity Model of Identity Change and show that this provides a framework for extending our understanding the complexities of identity change associated with retirement from elite sport.

The network structures of depressive and insomnia symptoms among cancer patients using propensity score matching: Findings from the Health and Retirement Study (HRS).

OBJECTIVE: Both depression and insomnia are found to be more prevalent in cancer patients compared to the general population. This study compared the network structures of depression and insomnia among cancer patients versus cancer-free participants (controls hereafter). METHOD: The 8-item Center for Epidemiological Studies Depression Scale (CESD-8) and the 4-item Jenkins Sleep Scale (JSS-4) were used to measure depressive and insomnia symptoms, respectively. Propensity score matching (PSM) was used to construct the control group using data from the Health and Retirement Study (HRS). In total, a sample consisting of 2216 cancer patients and 2216 controls was constructed. Central (influential) and bridge symptoms were estimated using the expected influence (EI) and bridge expected influence (bridge EI), respectively. Network stability was assessed using the case-dropping bootstrap method. RESULT: The prevalence of depression (CESD-8 total score ≥ 4) in cancer patients was significantly higher compared to the control group (28.56 % vs. 24.73 %; P = 0.004). Cancer patients also had more severe depressive symptoms relative to controls, but there was no significant group difference for insomnia symptoms. The network structures of depressive and insomnia symptoms were comparable between cancer patients and controls. "Felt sadness" (EI: 6.866 in cancer patients; EI: 5.861 in controls), "Felt unhappy" (EI: 6.371 in cancer patients; EI: 5.720 in controls) and "Felt depressed" (EI: 6.003 in cancer patients; EI: 5.880 in controls) emerged as the key central symptoms, and "Felt tired in morning" (bridge EI: 1.870 in cancer patients; EI: 1.266 in controls) and "Everything was an effort" (bridge EI: 1.046 in cancer patients; EI: 0.921 in controls) were the key bridge symptoms across both groups. CONCLUSION: Although cancer patients had more frequent and severe depressive symptoms compared to controls, no significant difference was observed in the network structure or strength of the depressive and insomnia symptoms. Consequently, psychosocial interventions for treating depression and insomnia in the general population could be equally applicable for cancer patients who experience depression and insomnia.