Trends in working conditions and health across three cohorts of older workers in 1993, 2003 and 2013: a cross-sequential study.

BACKGROUND: Over the past decades, the number of older workers has increased tremendously. This study examines trends from 1993 to 2013 in physical, cognitive and psychological functioning among three successive cohorts of Dutch older workers. The contribution of the changes in physical and psychosocial work demands and psychosocial work resources to change in functioning is examined. Insight in health of the older working population, and in potential explanatory variables, is relevant in order to reach sustainable employability. METHODS: Data from three cohorts (observations in 1993, 2003 and 2013) of the Longitudinal Aging Study Amsterdam (LASA) were used. Individuals aged 55-65 with a paid job were included (N = 1307). Physical functioning was measured using the Timed Chair Stand Test, cognitive functioning by a Coding Task and psychological functioning by the positive affect scale from the CES-D. Working conditions were deduced from a general population job exposure matrix. Linear and logistic regression analyses were performed. RESULTS: From 1993 to 2013, time needed to perform the Timed Chair Stand Test increased with 1.3 s (95%CI = 0.89-1.71), to a mean of 11.5 s. Coding Task scores increased with 1.7 points (95%CI = 0.81-2.59), to a mean of 31 points. The proportion of workers with low positive affect increased non-significantly from 15 to 20% (p = 0.088). Only the improvement in cognitive functioning was associated with the change in working conditions. The observed decrease of physically demanding jobs and increase of jobs with higher psychosocial resources explained 8% of the improvement. CONCLUSIONS: Changes in working conditions may not contribute to improved physical and psychological functioning, but do contribute to improved cognitive functioning to some extent. Further adjustment of physical work demands and psychosocial work resources may help to reach sustainable employability of older workers.

Gender differences in the relation between depression and social support in later life.

BACKGROUND: Prevalence of depression is twice as high in women as in men, also in older adults. Lack of social support is a risk factor for late-life depression. The relation between depression and social support may be different for men and women. METHODS: Data from the Longitudinal Aging Study Amsterdam were used to investigate gender differences in the relation between social support and depression in a population-based sample aged 55-85 years, with n = 2,823 at baseline and using the 13-year follow-up data on onset of depression. RESULTS: Respondents without a partner in the household, with a small network, and with low emotional support were more often depressed, with men showing higher rates of depression than women. A high need for affiliation was associated with depression in women but not in men. Lack of a partner in the household and having a small network predicted onset of depression in men but not in women. In respondents with high affiliation need and low social support, depression rates were higher, with men being more often depressed than women. CONCLUSIONS: Low social support and a high need for affiliation were related to depression in later life, with men being more vulnerable for depression than women. Considering the serious consequences of depression, especially in older people, it is important to identify the persons with low social support and a high need for affiliation, and to help them to increase their social support or to adjust their needs.

[Loneliness and self-management abilities in the visually impaired elderly]. / Eenzaamheid en zelfmanagementvaardigheden bij visueel beperkte ouderen.

OBJECTIVES: To describe the degree of loneliness among the visually impaired elderly and to make a comparison with a matched reference group of the normally sighted elderly. In addition, we examined self-management abilities (SMAs) as determinants of loneliness among the visually impaired elderly. METHODS: In a cross-sectional study, 173 visually impaired elderly persons completed telephone interviews. Loneliness and SMAs were assessed with the Loneliness Scale of De Jong Gierveld and the SMAS-30, respectively. RESULTS: The prevalence of loneliness among the visually impaired elderly was higher compared to the reference group (50% vs 29%; p < .001). Multivariate hierarchical regression analysis showed that the SMA self-efficacy, partner status, and self-esteem were determinants of loneliness. Severity and duration of visual impairment had no effect on loneliness. DISCUSSION: The relationship between SMAs (i.e., self-efficacy) and loneliness is promising, since SMAs can be learned through training. Consequently, self-management training may reduce feelings of loneliness. An adapted version of this paper was published in Journal of Aging and Health, doi: 10.1177/0898264311399758.

Increased risk of mortality associated with social isolation in older men: only when feeling lonely? Results from the Amsterdam Study of the Elderly (AMSTEL).

BACKGROUND: Loneliness has a significant influence on both physical and mental health. Few studies have investigated the possible associations of loneliness with mortality risk, impact on men and women and whether this impact concerns the situation of being alone (social isolation), experiencing loneliness (feeling lonely) or both. The current study investigated whether social isolation and feelings of loneliness in older men and women were associated with increased mortality risk, controlling for depression and other potentially confounding factors. METHOD: In our prospective cohort study of 4004 older persons aged 65-84 years with a 10-year follow-up of mortality data a Cox proportional hazard regression analysis was used to test whether social isolation factors and feelings of loneliness predicted an increased risk of mortality, controlling for psychiatric disorders and medical conditions, cognitive functioning, functional status and sociodemographic factors. RESULTS: At 10 years follow-up, significantly more men than women with feelings of loneliness at baseline had died. After adjustment for explanatory variables including social isolation, the mortality hazard ratio for feelings of loneliness was 1.30 [95% confidence interval (CI) 1.04-1.63] in men and 1.04 (95% CI 0.90-1.24) in women. No higher risk of mortality was found for social isolation. CONCLUSIONS: Feelings of loneliness rather than social isolation factors were found to be a major risk factor for increasing mortality in older men. Developing a better understanding of the nature of this association may help us to improve quality of life and longevity, especially in older men.

[Loneliness interventions among older adults: sense or nonsense?]. / Zin en onzin van eenzaamheidsinterventies bij ouderen.

This article focuses on the most important findings of a unique evaluation study of loneliness interventions among older adults. Eighteen interventions have recently been carried out and closely monitored in various parts of the Netherlands. In ten of these interventions the number of participants was sufficiently large to quantitatively determine the effect of the intervention on loneliness. It does not appear to be easy to overcome loneliness: no more than two of the ten interventions resulted in a reduction in loneliness among participants that may be attributed to the intervention. Two other interventions may have had a preventive effect: whereas loneliness increased among members of the control group, it remained more or less constant over time among participants. The effect measurements were followed by process evaluations in an effort to gain insight into the possible reasons why feelings of loneliness were not alleviated among participants in the case of most of the interventions. This resulted in a number of lessons for the future, which may be used as a checklist when designing new interventions projects.

[Reference standards for the loneliness scale]. / Cesuurbepaling van de eenzaamheidsschaal.

This article focuses on the cutting scores for the measurement of loneliness on the Loneliness Scale. A cutting score is used to distinguish the lonely from the not lonely. Data have been analyzed relating to interviews with 3,823 respondents (54-89 years old) who live independently. Use has been made of the individuals' self-assessed level of loneliness. More than would be the case with arbitrary cutting scores, this is in keeping with the individuals' own perception. The figures show that 68% of the elderly persons in the Netherlands are not lonely, 28% are moderately lonely, and 4% are quite lonely. Previous research used a lower cutting score and, consequently, observed that much more people are lonely.

[Gerotranscendence as a life cycle perspective: an initial empirical approach among the elderly in The Netherlands]. / Gerotranscendentie als levensperspectief: een eerste empirische benadering bij ouderen in Nederland.

Gerotranscendence has been defined as a shift in meta-perspective, from a materialistic and rationalistic perspective to a more cosmic and transcendent one that accompanies the process of aging. The present study describes scale characteristics of the Dutch translation of Tornstam's gerotranscendence scale, using data from a sample among adults aged 56-76 years (N = 556). Two subscales evolve from scale analysis, similar to those found by Tornstam: cosmic transcendence and egotranscendence. Scores on both subscales are higher for the older old, as well as for the unmarried; divorced or widowed respondents who suffer from physical impairments. Scale scores are also higher for respondents with depressive complaints. On the subscale cosmic transcendence Roman Catholics have higher scores than Protestants and non-church members. On the subscale ego-transcendence well educated respondents and those with few social contacts have higher scores than persons with less education and those with many contacts. The strength of the associations is modest and the variance explained is small. The findings warrant further research into the question whether gerotranscendence adds to competence in later life.

[Living arrangements and social networks of elders. A selection of findings from a NESTOR-Study]. / Leefvormen en sociale netwerken van ouderen. Een selectie van bevindingen uit een NESTOR-Studie.

This article presents an overview of the design and results of the NESTOR survey 'Living Arrangements and Social Networks of Older Adults', an empirical study, started in 1992, among a representative sample of 4495 people, aged 55-89, selected from the population registers of 11 municipalities in the Netherlands. Questions were asked about living arrangements, the composition and functions of social networks, and important transitions in the marital, parental and occupational careers. The results indicated a wide diversity in living arrangements and social networks, a diversity which is particularly visible among the young old. They not only have larger networks, but are also more likely to live alone, to be divorced and to participate in shared housing arrangements. The networks vary considerably in size, from 0 to more than 40 important relationships. The decrease in network size with age appears to be directly related to specific life events such as widowhood, physical handicaps, residential moves etc. About 2/3 of the relationships are family relationships: parents, children (in law), grandchildren (in law), brothers and sisters (in law), uncles and aunts. Older people tend to be in touch at least once a month with the majority of close family members. The intensity of supportive exchanges (giving and receiving instrumental and emotional support in the twelve relationships with the highest levels of contact) is moderate, however mostly in balance. Only the very old receive somewhat more instrumental support and give considerably less than the 'young-old'. We studied the shift in balance between giving and receiving over a period of 12 months among a small proportion of the sample, checking a central hypothesis of exchange theory. In some cases a new balance evolves. In others the relationship continues to exist for a number of reasons, despite the imbalance. Early life experiences appear to be important for later life outcomes. Those who experienced the divorce of their parents before the age of 15 or those whose parents lived apart permanently (e.g. unmarried mothers) have a smaller social network and feel more lonely. Marital history has an impact on patterns of informal and formal care. E.g., those respondents without a partner who have children are less likely to use formal care than those who are childless. Among divorced elderly the use of formal care not only varies between men and women but also differs according to the marriage in which the children are born, first or second marriage. Occupational history is strongly related to the income level of older women living alone.

Religious involvement and depression in older Dutch citizens.

It has been suggested that religiosity helps prevent depression in older people. This study examines the association between religious involvement and depression in older Dutch citizens and focuses on models of the mechanism in which religious involvement has an impact on other factors related to depression. The subjects were 2,817 older adults aged 55-85 years living in the community who participated in the Longitudinal Aging Study Amsterdam. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). Religious involvement was assessed using items on frequency of church attendance and strength of church affiliation. Further data were collected on physical health, size of social network, social support, sense of mastery and self-esteem. As in North American studies, religious involvement appeared to be inversely associated with depression, both on symptom and syndrome levels. Controlling for sociodemographics, physical impairment and network support did not substantially affect this association, particularly among subjects aged 75-85 years. The inverse association between religious involvement and depression was not selectively more pronounced among older people with physical impairments. However, the association appeared to be most specific for subjects with a small social network and those with a low sense of mastery.