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Sharifi M, Nodehi D, Bazgir B. Physical activity and psychological adjustment among retirees: a systematic review. BMC Public Health 2023; 23:194. [PMID: 36709282 PMCID: PMC9884422 DOI: 10.1186/s12889-023-15080-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 01/18/2023] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Health-related behaviors may change after retirement and induce changes in the mental health. This systematic review aimed to investigate the nature of changes in physical activity and leisure activities, as well as the relationship between physical activity, leisure, and psychological adjustment among retirees. METHODS Search of papers was done in three electronic databases of PubMed, ISI Web of Science, and Scopus without constraints on time, geographical regions, or languages in February 2022. The papers that had examined the relationship between physical activity and adjustment among retirees using observational design (cross-sectional or longitudinal) were included in the present study. To evaluate the methodological quality of cross-sectional studies, Joanna Briggs Institute (JBI) Critical Appraisal Checklist, and for longitudinal studies, Newcastle-Ottawa Scale (NOS) were used. RESULTS The search results identified 1458 records. Twenty-six papers were included in this review based on the inclusion and exclusion criteria. The findings of most of these studies indicated a significant positive correlation between physical activity, leisure, and psychological adjustment in retirees. Retirees were mostly engaged in passive leisure activities such as reading, watching TV and movies, and less engaged in physical activities, sport, or physical exercise. General organized assessment of the total physical activity among retirees was not possible. CONCLUSIONS Based on the study findings, it can be stated that there is a positive correlation between physical activity, leisure, and the retirees' adjustment. Usage of the same and valid measurement method specific to old age and retirement period can be useful in more precise assessment of physical activity and its association with adjustment among retirees.
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Affiliation(s)
- Mehdi Sharifi
- grid.411521.20000 0000 9975 294XExercise Physiology Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Davud Nodehi
- grid.411521.20000 0000 9975 294XBehavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Behzad Bazgir
- Exercise Physiology Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.
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Van der Elst MCJ, Schoenmakers B, Verté D, De Donder L, De Witte N, Dury S, Fret B, Luyten J, Schols JMGA, Kempen GIJM, De Lepeleire J. The relation between age of retirement and frailty in later life? A cross-sectional study in Flemish older adults. Arch Gerontol Geriatr 2021; 96:104473. [PMID: 34246958 DOI: 10.1016/j.archger.2021.104473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 06/22/2021] [Accepted: 06/25/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Policymakers in several European countries, concerned about the sustainability of their pension system, have raised the statutory retirement age. While several studies investigated the effect of retirement on health, the relationship between retirement and frailty is neglected. Notwithstanding, frailty is associated with adverse outcomes. OBJECTIVE The aim of this study was to examine the relationship between age of retirement and frailty in later life. METHODS Data of the Belgian Ageing Studies, a cross-sectional research project was used. The present study includes N=12659 participants (>60y) in 83 Flemish municipalities. To address reverse causality, only participants not retired because of health-related reasons were included. The Comprehensive Frailty Assessment Instrument, a multidimensional frailty scale with four domains (physical, psychological, social and environmental) was used to operationalize frailty. Univariate general linear regression analyses (GLM) were performed for scores on the total frailty scale and the four subdomains separately. The analysis was done for men and women separately, since both groups have different labor trajectories. RESULTS The present study found a negative association between age of retirement and physical frailty for both men and women in later life, and total frailty for men, although the differences were small. No evidence was found for a relation between age of retirement and the other subdomains of frailty. CONCLUSIONS The results suggest that age of retirement is not a clinically relevant predictor for frailty in later life. Differences within and between subpopulations (e.g., profession) can shed a new light on this relation.
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Affiliation(s)
- Michael C J Van der Elst
- Care and Public Health Research Institute, Department of Health Services Research, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; Department of Public Health and Primary Care, University of Leuven, Kapucijnenvoer 33 bus 7001 B-3000 Leuven, Belgium.
| | - Birgitte Schoenmakers
- Department of Public Health and Primary Care, University of Leuven, Kapucijnenvoer 33 bus 7001 B-3000 Leuven, Belgium.
| | - Dominique Verté
- Department of Educational Sciences, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussels, Belgium.
| | - Liesbeth De Donder
- Department of Educational Sciences, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussels, Belgium.
| | - Nico De Witte
- Department of Educational Sciences, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussels, Belgium; Faculty of Education, Health and Social Work, University College Ghent, Gent, Belgium.
| | - Sarah Dury
- Department of Educational Sciences, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussels, Belgium.
| | - Bram Fret
- Department of Educational Sciences, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussels, Belgium.
| | - Jeroen Luyten
- Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, University of Leuven, Kapucijnenvoer 35 bus 7001 B-3000 Leuven, Belgium.
| | - Jos M G A Schols
- Care and Public Health Research Institute, Department of Health Services Research, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; Care and Public Health Research Institute, Department of Family Medicine, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
| | - Gertrudis I J M Kempen
- Care and Public Health Research Institute, Department of Health Services Research, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
| | - Jan De Lepeleire
- Department of Public Health and Primary Care, University of Leuven, Kapucijnenvoer 33 bus 7001 B-3000 Leuven, Belgium.
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Xue B, Head J, McMunn A. The Impact of Retirement on Cardiovascular Disease and Its Risk Factors: A Systematic Review of Longitudinal Studies. THE GERONTOLOGIST 2020; 60:e367-e377. [PMID: 31091304 PMCID: PMC7362617 DOI: 10.1093/geront/gnz062] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Indexed: 12/29/2022] Open
Abstract
Background and Objectives People are now spending longer in retirement than ever before and retirement has been found to influence health. This study systematically reviewed the impact of retirement on cardiovascular disease (CVD) and its risk factors (metabolic risk factors, blood biomarkers, physical activity, smoking, drinking, and diet). Research Design and Methods Longitudinal studies published in Medline, Embase, Social Science Citation Index, PsycINFO, and Social Policy and Practice were searched. No language restrictions were applied if there was an English abstract. Eighty-two longitudinal studies were included after critical appraisals. Results Studies in the United States often found no significant effect of retirement on CVD, while studies in European countries, except France, showed a detrimental effect of retirement on CVD. Results from the United States and several European countries consistently show that retirement increase adiposity measures among those retired from physically demanding jobs. For diabetes and hypertension, five out of nine studies suggest no effect of retirement. Retirement has been repeatedly linked to increasing leisure-time physical activity but may reduce work- and transport-related physical activity in turn. Most studies showed that retirement either decreased smoking or had no effect on smoking. The evidence did not show a clear conclusion on drinking. Only a few studies have assessed the impact on diet and blood biomarkers. Discussion and Implications Effect of retirement varies according to the health outcomes studied and country of the study population. Policy concerning extending the retirement age needs to focus on ensuring they are suited to the individual.
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Affiliation(s)
| | - Jenny Head
- Department of Epidemiology and Public Health, University College London, UK
| | - Anne McMunn
- Department of Epidemiology and Public Health, University College London, UK
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Hagberg L, Lundqvist S, Lindholm L. What is the time cost of exercise? Cost of time spent on exercise in a primary health care intervention to increase physical activity. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2020; 18:14. [PMID: 32206041 PMCID: PMC7079439 DOI: 10.1186/s12962-020-00209-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 03/12/2020] [Indexed: 11/21/2022] Open
Abstract
Background In health care interventions aimed at increased physical activity, the individual’s time spent on exercise is a substantial input. Time costs should therefore be considered in cost-effectiveness analyses. The aim of this study was to estimate the cost of time spent on exercise among 333 primary health care patients with metabolic risk factors receiving physical activity on prescription. Methods Based on a theoretical framework, a yardstick was constructed with experience of work (representing claim of salary as compensation) as the lower anchor-point, and experience of leisure activity forgone due to extended exercise time (no claim) as the higher anchor-point. Using this yardstick experience of exercise can be valued. Another yardstick was constructed with experience of cleaning at home in combination with willingness to pay for cleaning as the lowest anchor-point. Results The estimated costs of exercise time were between 14 and 37% of net wages, with physical activity level being the most important factor in determining the cost. Among sedentary individuals, the time cost was 21–51% of net wages while among individuals performing regular exercise it was 2–10%. When estimating the cost of time spent on exercise in a cost-effectiveness analysis, experience of exercise, work, leisure activity forgone, and cleaning at home (or other household work that may be relevant to purchase) should be measured. The individual’s willingness to pay for cleaning at home and their net salary should also be measured. Conclusions When using a single valuation of cost of time spent on exercise in health care interventions, for employed participants 15–30% of net salary should be used. Among unemployed individuals, lower cost estimation should be applied. Better precision in cost estimations can be achieved if participants are stratified by physical activity levels. Trial registration The study was conducted as a survey of existing clinical physical activity on prescription work, and was approved by the Regional Ethical Review Board in Gothenburg, Sweden (ref: 678-14)
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Affiliation(s)
- Lars Hagberg
- 1Centre for Health Care Science, Faculty of Medicine and Health, Örebro University, P.O.Box 1324, 701 13 Örebro, Sweden
| | - Stefan Lundqvist
- 2Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Centrum för Fysisk Aktivitet Göteborg, Svangatan 2B, Region Västra Götaland, 416 68 Göteborg, Sweden
| | - Lars Lindholm
- 4Unit of Epidemiology and Global Health, Umeå University, 901 87 Umeå, Sweden
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Kjær T, Højgaard B, Gyrd-Hansen D. Physical exercise versus shorter life expectancy? An investigation into preferences for physical activity using a stated preference approach. Health Policy 2019; 123:790-796. [PMID: 31200947 DOI: 10.1016/j.healthpol.2019.05.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 03/18/2019] [Accepted: 05/21/2019] [Indexed: 10/26/2022]
Abstract
The positive life-prolonging effect of physical activity is often used as a promotion argument to motivate people to change their behaviour. Yet the decision of investing in health by exercising depends not only on the potential health effect but also on the costs of physical activity including time costs and the individual's (dis)utility of performing physical activity. The objective of this study was to investigate the trade-off between costs and benefits of engaging in physical activity. A web-based stated preference experiment was conducted to elicit individual preferences for physical activity among a representative sample of the Danish population, 18-60 years of age, categorised as moderately physically active or physically inactive. The results of the study suggest that perceived negative quality of life impact of physical activity is an important predictor of the choice of not attending physical activity, and hence should be acknowledged as a barrier to engaging in physical activity. Furthermore, we find time costs to have a significant impact on stated uptake. For individuals categorised as moderately active, the marginal health effect of physical activity is significant but minor. For inactive individuals, this effect is insignificant suggesting that information on long-term health effects does not work as motivation for engaging in exercise for this group. Instead, focus should be on reducing the perceived disutility of physical activity.
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Affiliation(s)
- Trine Kjær
- DaCHE - Danish Center for Health Economic Research, Department of Public Health, University of Southern Denmark, Winsløwsvej 9b, 1., 5230 Odense M, Denmark.
| | - Betina Højgaard
- VIVE, Danish Institute of Applied Social Science, Herluf Trolles Gade 11, 1052 København K, Denmark.
| | - Dorte Gyrd-Hansen
- DaCHE - Danish Center for Health Economic Research, Department of Public Health, University of Southern Denmark, Winsløwsvej 9b, 1., 5230 Odense M, Denmark.
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Forbes H, Fichera E, Rogers A, Sutton M. The Effects of Exercise and Relaxation on Health and Wellbeing. HEALTH ECONOMICS 2017; 26:e67-e80. [PMID: 28276112 PMCID: PMC5811789 DOI: 10.1002/hec.3477] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 10/24/2016] [Accepted: 12/05/2016] [Indexed: 06/06/2023]
Abstract
Better management by individuals of their long-term conditions is promoted to improve health and reduce healthcare expenditure. However, there is limited evidence on the determinants and consequences of self-management activity. We investigate the determinants of two forms of self-management, exercise and relaxation, and their impact on the health and wellbeing of 3472 individuals with long-term health conditions over a 1-year period. We use simultaneous recursive trivariate models to estimate the effects of these two inputs on three health and wellbeing outcomes: the EuroQol five-dimensional (EQ-5D) score, self-assessed health and happiness. We reflect the opportunity cost of time and knowledge with employment status and education and find that employment reduces relaxation and education increases exercise. We find that neither exercise nor relaxation affects the EuroQol five-dimensional score, but exercise increases self-assessed health and relaxation increases happiness. Our findings show that individuals tailor their self-management activities to their economic constraints, with effects on different aspects of their utility. Interventions to encourage self-management should take account of heterogeneous effects and constraints. © 2017 The Authors. Health Economics Published by John Wiley & Sons, Ltd.
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Affiliation(s)
- Hannah Forbes
- Manchester Centre for Health EconomicsUniversity of ManchesterManchesterUK
| | - Eleonora Fichera
- Manchester Centre for Health EconomicsUniversity of ManchesterManchesterUK
| | - Anne Rogers
- NIHR CLAHRC Wessex, Faculty of Health SciencesUniversity of SouthamptonSouthamptonUK
| | - Matt Sutton
- Manchester Centre for Health EconomicsUniversity of ManchesterManchesterUK
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Ojala B, Nygård CH, Huhtala H, Nikkari ST. Effects of a nine-month occupational intervention on health-related quality of life. Scand J Public Health 2017; 45:452-458. [DOI: 10.1177/1403494817695912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study was to evaluate the effectiveness of vocationally outpatient oriented rehabilitation on an intervention group, compared with a control group that did not take part in the intervention. The groups were compared for health-related quality of life (HRQoL) by the quantitative indicator RAND 36. Data were obtained by a self-report at baseline and at nine months follow-up. Differences between base-line and follow-up were analyzed within group and between the groups. The study population consisted of 751 municipal employees aged between 26 and 64 years; an intervention with 463 women and 115 men ( n = 578), and a control group with 138 women and 35 men ( n = 173). In this study we focused on those who had answered to all questions in RAND 36, thus 581 remained. Of these, 388 were in the intervention group (mean age 49.0 years) and 110 in the control group (mean age 48.4 years). Intervention was based on cognitive behavioral therapy. Participants in the 9-month outpatient intervention group showed statistically significant increase in all eight RAND 36 areas. Most improvement was seen in the psychosocial functioning index ( p = 0.002). Although there were no statistically significant changes in RAND 36 components in the control group, difference in changes between groups were seen in energy and fatigue ( p < 0.001), social functioning ( p = 0.032) and general health perceptions 0.027 in favor of the intervention group. The results suggest that a cognitive behavioral intervention as an early rehabilitation program is effective in increasing employees’ quality of life, as measured by RAND 36.
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Affiliation(s)
- Birgitta Ojala
- Faculty of Social Sciences,University of Tampere, Finland
- Tullinkulma Occupational Health Unit, Tampere, Finland
| | | | - Heini Huhtala
- Faculty of Social Sciences,University of Tampere, Finland
| | - Seppo T. Nikkari
- Tullinkulma Occupational Health Unit, Tampere, Finland
- Faculty of Medicine and Life Sciences and FIMLAB Laboratories, University of Tampere, Finland
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