Does retirement trigger depressive symptoms? A systematic review and meta-analysis

Association between retirement age and depressive symptoms among Korean retirees: Results from Korean Retirement and Income Panel Study

BACKGROUND

The effective age of retirement in South Korea is higher than the average of Organization for Economic Co-operation and Development (OECD) countries. Early retirement in Asia may affect mental health differently compared to western countries. Thus, we examined the association between retirement age and depressive symptoms among South Korean retirees.

METHODS

We used data from the 2011, 2013, 2015, 2017, and 2019 Korean Retirement and Income Panel Study, including a total of 2998, 3152, 3203, 3154, and 3055 participants, respectively. We excluded those younger than 50 years, non-retirees, those without information on the Center for Epidemiological Studies-Depression (CES-D) scale, and those with other missing values. We used a generalized estimating equation model to identify the association between retirement age and depressive symptoms measured using the CES-D.

RESULTS

Participants who retired at age < 50 years had significantly higher CES-D scores (β = 1.764, P = 0.0003) compared to those who retired at age ≥ 70 years. The negative effects of early retirement on depressive symptoms were greater among male participants, heads of households, young involuntary retirees, those who retired within the past 20 years, and those who had no difficulties in activities of daily living.

LIMITATIONS

Since we evaluated the association between retirement age and depressive symptoms in one direction, there is a possibility of reverse causality.

CONCLUSION

Our findings highlight the importance of managing depressive symptoms in early retirees, especially young involuntary retirees and those burdened with family care.

Paradox of life after work: A systematic review and meta-analysis on retirement anxiety and life satisfaction

Retirement is a pivotal life transition that often changes routines, identity, and objectives. With increasing life expectancies and evolving societal norms, examining the interplay between retirement anxiety and life satisfaction is vital. This study delves into this relationship, recognising the complexities of retirement. A systematic review and meta-analysis followed PRISMA guidelines. Research from 2003 to 2023 was sourced from databases like CINAHL, PubMed/Medline, PsycINFO, ERIC, and Google Scholar, focusing on diverse methodologies and outcomes related to retirement registered in Prospero database (CRD42023427949). The quality assessment used an eight-criterion risk of bias scale, and analyses included qualitative and quantitative approaches, such as random-effects meta-analysis and moderator analyses. After reviewing 19 studies with varied geographical and demographic scopes, a mixed relationship between retirement and life satisfaction emerged: 32% of studies reported a positive relationship, 47% were negative, and 21% found no significant correlation. Meta-analysis indicated high heterogeneity and non-significant mean effect size, suggesting no consistent impact of retirement on life satisfaction. Moderator analyses highlighted the influence of measurement tools on outcomes. The findings reveal a complex interplay between retirement anxiety and life satisfaction, stressing the need for holistic retirement policies that encompass mental health, social integration, and adaptability, focusing on cultural sensitivity. Challenges include potential biases in data sources, methodological diversity, the scarcity of longitudinal studies, and difficulties in addressing recent societal shifts, like the COVID-19 pandemic. Variability in measurement tools and possible publication bias may have also influenced results. This study contributes to understanding retirement, emphasising the relationship between retirement anxiety and life satisfaction. It advocates for ongoing, detailed, culturally informed research to grasp retirement's multifaceted aspects fully.

Health and labor market effects of an unanticipated rise in retirement age. Evidence from the 2012 Italian pension reform

As retirement ages increase around the world, not all workers may be equally able to extend their working lives. In this article, we examine the health and labor market effects of an Italian pension reform that suddenly increased the normal retirement age up to 7 years for women and up to 2 years for men. To do this, we use linked labor and healthcare administrative data, jointly with survey data and difference-in-difference methods. Our results show that the reform was effective in postponing retirement among both genders, as pension claiming dropped substantially for older workers. However, there were also side effects as the reform significantly pushed previously employed men and women into unemployment and disability pension. Among women only, the reform also increased sick leave and hospitalizations related to mental health and injuries. These effects were driven by women with previously low health status, suggesting that undifferentiated and abrupt increases in pension age might harm more vulnerable workers. Coherently with the milder tightening of retirement age experienced by men, labor market responses were smaller in size, and they did not suffer any significant health effects.

Who are the superheroes? A cross-sectional study on the determinants of good health among Italian older adults

BACKGROUND

People who reach old age enjoying good physical and mental health can be defined as (health) "superheroes", given their relatively low impact on healthcare expenditure and the desirable model they represent.

AIM

To evaluate prevalence and possible determinants of being "physical superheroes" (i.e., free from the ten major chronic conditions, plus obesity), "mental superheroes" (i.e., free from major mental symptoms), and "superheroes" (i.e., both mental and physical superheroes).

METHODS

A telephone-based cross-sectional study (LOST in Lombardia) was conducted in November 2020 (i.e., during the COVID-19 pandemic) on a representative sample of 4,400 adults aged ≥ 65 years from Lombardy region, northern Italy. All participants provided both current data and data referring to one year before.

RESULTS

Mental and physical superheroes were 59.0% and 17.6%, respectively. Superheroes were 12.8% overall, 15.1% among men, and 11.1% among women; 20.2% among individuals aged 65-69 years, 11.3% among 70-74, 10.0% among 75-79, and 8.3% among ≥ 80 years. Multivariable analysis showed that female sex, higher age, disadvantaged socio-economic status, and physical inactivity (p for trend < 0.001) were inversely related to being superheroes. People not smoking (adjusted odds ratio, aOR = 1.40), alcohol abstainers (aOR = 1.30), and those free from feelings of hopelessness (aOR = 5.92) more frequently met the definition of superheroes. During COVID-19 pandemic, the proportion of superheroes decreased by 16.3%.

CONCLUSIONS

Differences in the older adults' health status are largely attributable to their lifestyles but are also likely due to gender, educational, and socio-economic disparities, which should be properly addressed by public health policies.

Grandparenting during pandemic times: pros and cons for mental health

BACKGROUND

The COVID-19 pandemic and associated lockdown measures posed an unprecedented challenge to the crucial role of grandparenting in family-oriented cultures, such as Italy. Reduced contact with grandchildren during this period potentially threatened grandparents' mental health and well-being.

METHODS

We analysed data from the LOckdown and lifeSTyles in Lombardia cross-sectional study conducted in November 2020. The study included a representative sample of 4400 older adults from Lombardy, Italy, of which 1289 provided childcare to their grandchildren.

RESULTS

A decrease in self-reported grandparenting was associated with an increased likelihood of experiencing depressive symptoms among grandparents (OR 1.50, 95% CI 1.01-2.24). Conversely, an increase in grandparenting was linked to poorer sleep quality (OR 11.67, 95% CI 5.88-23.17) and reduced sleep quantity (OR 2.53, 95% CI 1.45-4.41).

CONCLUSIONS

Despite the barriers posed by the pandemic, grandparenting played a beneficial role in maintaining the mental health and well-being of older adults. However, it is crucial to recognise specific vulnerabilities, such as gender, feelings of hopelessness and overcrowding, which can have detrimental effects during and beyond emergency situations. Careful attention to these factors is essential for developing targeted support systems and interventions aimed at safeguarding the mental health of older adults and enhancing their resilience in crises.

Health and inclusive labour force participation

The future of work is rapidly changing, with higher flexibility of the labour market and increasing informal employment in many countries worldwide. There is also an increased pressure to extend working careers until older age. We introduce the concept of working life expectancy as a useful metric, capturing the expected numer of years in paid employment across the working age individuals, in particular among different groups. We describe factors that determine working life expectancy. Macro-level factors focus on the socioeconomic and political context that influences labour force participation, primarily policies and legislation in specific countries. At the meso level, employment contracts and working conditions are important. The micro level shows that individual characteristics, such as education, gender, and age, influence working careers. There are three important groups with a disadvantaged position in the labour market-workers with chronic diseases, workers with impairing disabilities, and workers aged 50 years or more. Within each of these disadvantaged groups, macro-level, meso-level, and micro-level factors that influence entering and exiting paid employment are discussed. To assure that paid employment is available for everyone of working age and that work contributes to better health, specific challenges need to be addressed at the macro, meso, and micro levels. To reach inclusive labour force participation, national policies, company practices, and workplace improvements need to be aligned to ensure safe and healthy workplaces that contribute to the health and wellbeing of workers and their communities.

Depressive symptoms and their severity in a sample with lymphedema: a case-control investigation

Objectives

Depression is a condition that can be associated with other illnesses, especially chronic illnesses. Lower limb lymphedema is a chronic, disabling condition that can affect the quality of life and be related to psychological and psychosocial factors that interfere with people's lives. This study aims to characterize and analyze the depressive symptoms and their severity reported by people with lower limb lymphedema and compare them with a matched group without lymphedema.

Methods

A case-control study was carried out (n = 80) with participants divided into a case group (40 people with lower limb lymphedema) and a control group (40 people without lower limb lymphedema). Both groups were anthropometrically, sociodemographically, and clinically characterized. In the case group, a characterization of lymphedema was performed. Participants completed the Beck Depression Inventory-II.

Results

Individuals with lower limb lymphedema have higher BDI-II scores than the matched group without lymphedema. Somatic depressive symptoms were, in general, the most reported and the ones with the highest scores. The depressive symptoms most reported by the case group were tiredness or fatigue, loss of energy, and changes in sleeping. Tiredness or fatigue, loss of energy, and loss of interest in sex were the most severe depressive symptoms reported by individuals with lower limb lymphedema.

Conclusion

Considering the apparent tendency to depression, greater attention should be given to the mental health of people with lower limb lymphedema.

Social exclusion in people with diabetes: cross-sectional and longitudinal results from the German Ageing Survey (DEAS)

As social exclusion can be linked to worse health and overall reduced quality of life, we describe social exclusion in people with diabetes and assess whether diabetes can be considered as a risk factor for social exclusion. We analyzed two waves (2014, 2017, N = 6604) from a survey of community-dwelling people aged > 40 using linear regression, group comparison and generalized estimating equations to explore the association between diabetes, social exclusion, socioeconomic, physical and psychosocial variables. In the entire cohort, diabetes was cross-sectionally associated with social exclusion after adjusting for covariates (p = 0.001). In people with diabetes, social exclusion was further associated with self-esteem (p < 0.001), loneliness (p =  < 0.001), income (p = 0.017), depression (p = 0.001), physical diseases (p = 0.04), and network size (p = 0.043). Longitudinal data revealed that higher levels of social exclusion were already present before the diagnosis of diabetes, and future social exclusion was predicted by self-esteem, loneliness, depression, and income, but not by diabetes (p = .221). We conclude that diabetes is not a driver of social exclusion. Instead, both seem to co-occur as a consequence of health-related and psychosocial variables.

Transition to retirement impact on smoking habit: results from a longitudinal analysis within the Survey of Health, Ageing and Retirement in Europe (SHARE) project

BACKGROUND

In an ageing society, retirement impacts on behavioural risk factors and health outcomes should be carefully assessed. Scant evidence exists from longitudinal studies on the short- and long-term consequences of the transition to retirement on smoking habit.

METHODS

We conducted a longitudinal study based on the Survey of Health, Ageing and Retirement in Europe (SHARE) data from 27 European countries plus Israel collected in 2004-2020. To estimate relative risks (RR) and corresponding 95% confidence intervals (CI) for smoking status and intensity at seven time periods before and after retirement, we fitted adjusted generalised estimating equation (GEE) models for repeated measures.

RESULTS

We selected a cohort of 8998 individuals employed at baseline and retired at follow-up (median follow-up time: 9 years; maximum: 16 years). As compared to the year of retirement, the RR of smoking was 1.59 (95% CI 1.44-1.76) at 10 years or more before retirement, 1.35 (95% CI 1.25-1.46) from 5 to 9 years before retirement, and 1.18 (95% CI 1.10-1.27) from 1 to 4 years before retirement. Smoking steadily decreased after retirement, being 0.94 (95% CI 0.87-1.01) from 1 to 4 years after retirement, 0.76 (95% CI 0.69-0.84) from 5 to 9 years, and 0.58 (95% CI 0.46-0.74) 10 years or more after retirement. In smokers, the estimated number of cigarettes smoked/day decreased from about 27 cigarettes/day at 10 years or more before retirement to 9 cigarettes/day at 10 years or more after retirement (p trend < 0.001).

CONCLUSION

Longitudinal data suggest that lifestyles might favourably change with retirement. Further studies are needed to direct healthy ageing promotion policies better.

The Social Determinants of Mental Illness: A Rapid Review of Systematic Reviews

Previous research agendas have prioritised the role of biological determinants in mental illness aetiology. This is of particular concern, as endorsing biological determinants has been shown to promote negative attitudes towards people with mental illness. The aim of this review was to provide an overview of high-quality evidence of the social determinants of mental illness. A rapid review of systematic reviews was conducted. Five databases were searched: Embase, Medline, Academic Search Complete, CINAHL Plus, and PsycINFO. Systematic reviews or meta-analyses that described any social determinant of mental illness, were published in peer-review journals in English, and focussed on human participants were included. The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines were applied for the selection procedure. Thirty-seven systematic reviews were deemed eligible for review and narrative synthesis. Determinants identified included conflict, violence and maltreatment, life events and experiences, racism and discrimination, culture and migration, social interaction and support, structural policies and inequality, financial factors, employment factors, housing and living conditions, and demographic factors. We recommend that mental health nurses ensure adequate support be provided to those affected by the evidenced social determinants of mental illness.

Changes in mortality of Polish residents in the early and late old age due to main causes of death from 2000 to 2019

Purpose

The aim of the study was to assess mortality trends in Poland between 2000 and 2019 in the early and late old age population (65-74 years and over 75 years).

Methods

The work used data on all deaths of Polish residents aged over 65 years (N = 5,496,970). The analysis included the five most common major groups of causes of death: diseases of the circulatory system, malignant neoplasms, diseases of the respiratory system, diseases of the digestive system and external causes of mortality. The analysis of time trends has been carried out with the use of joinpoint models. The Annual Percentage Change (APC) for each segments of broken lines, the Average Annual Percentage Change (AAPC) for the whole study period (95% CI), and standardized death rates (SDRs) were calculated.

Results

The percentage of deaths due to diseases of the circulatory system decreased in all the studied subgroups. Among malignant neoplasms, lung and bronchus cancers accounted for the largest percentage of deaths, for which the SDRs among men decreased, while those among women increased. In the early old age, the SDR value increased from 67.8 to 76.3 (AAPC = 0.6%, p > 0.05), while in the late old age group it increased from 112.1 to 155.2 (AAPC = 1.8%, p < 0.05). Among men, there was an upward trend for prostate cancer (AAPC = 0.4% in the early old age group and AAPC = 0.6% in the late old age group, p > 0.05) and a downward trend for stomach cancer (AAPC -3.2 and -2.7%, respectively, p < 0.05). Stomach cancer also showed a decreasing trend among women (AAPC -3.2 and -3.6%, p < 0.05). SDRs due to influenza and pneumonia were increasing. Increasing trends in mortality due to diseases of the digestive system in women and men in the early old age group have been observed in recent years, due to alcoholic liver disease. Among the external causes of mortality in the late old age group, the most common ones were falls.

Conclusions

It is necessary to conduct further research that will allow to diagnose risk and health problems of the elderly subpopulation in order to meet the health burden of the aging society.

Physical activity and psychological adjustment among retirees: a systematic review

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.

What factors predict outcome from an inpatient multidisciplinary chronic pain service? A prospective cohort study

Objective To identify baseline factors associated with outcomes from an inpatient multidisciplinary pain management program (PMP) located in a bicultural area of Aotearoa New Zealand. Methods A prospective cohort study was undertaken involving 164 people with chronic pain who attended the PMP. Demographic, clinical, and psychosocial measures were obtained at baseline, whereas clinical and psychosocial outcome measures were also obtained at program discharge and 3-month follow up (N  = 100). Multivariate analyses were used to determine baseline demographic variables that were associated with outcomes at discharge and follow up. Results Being male and working full-time were associated with poorer outcomes in select measures at discharge. At the 3-month follow up, Māori ethnicity, working full-time, being retired or unemployed, or having chronic widespread pain were associated with poorer outcomes for some measures, whereas those with rheumatoid arthritis had greater self-efficacy. Conclusions Sex, ethnicity, employment status, and patient condition impact clinical outcomes from the program and in the time from discharge to follow up. Program content and/or delivery should be altered to promote more equitable outcomes for all patients in the long term.

Impact of residing in neighborhoods of high social participation on health of retired workers: A multilevel analysis using nationwide longitudinal data in Japan

Retirement is a key determinant of health among middle-aged and older adults. Social participation (SP) has a favorable impact on health outcomes. Combining these two issues, we examined how neighborhood-level SP may affect the health outcomes of retired workers. We used 94,661 longitudinal observations of 13,185 full-time workers aged 50–59 years in 2005 from a nationwide 14-wave survey conducted in Japan from 2005 to 2018. First, we computed neighborhood SP using an econometric method. We then conducted multilevel analysis to examine how neighborhood SP, retirement, and their interaction affected the probabilities of SP, poor self-rated health (SRH), problems in activities of daily living (ADL), and psychological distress (SD). The estimation results showed that retirement in a high-SP neighborhood reduced the probabilities of poor SRH, ADL problems, and SD by 1.1 (95% confidence interval [CI]:0.5–1.7), 0.9 (95% CI:0.0–1.8), and 2.1 (95% CI:0.6–3.7) percentage points, respectively. These effects were substantial in magnitude, considering that the prevalence of poor SRH, ADL problems, and SD were 3.7%, 7.4%, and 18.5%, respectively, among retired men. In contrast, such interaction effects between retirement and neighborhood SP were not observed among the women. The results suggest that policy measures to encourage SP at the neighborhood level should be developed to help individuals enjoy a healthier life in retirement.

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Interaction between neighborhood social participation and retirement was examined.

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High neighborhood social participation enhanced health of retired workers.

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Impact of neighborhood social participation was observed mainly among men.

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Policy measures to encourage neighborhood social participation should be developed.

Is periodontal disease a risk indicator for urogenital cancer? A systematic review and meta-analysis of cohort studies

Objectives

The objective of the present work was to conduct a systematic review and meta-analysis to assess the association between periodontal disease (PD) and urogenital cancer (UC) risk.

Materials and methods

An electronic search in PubMed, EMBASE, the Cochrane Library, and Web of Science was conducted using MeSH terms to identify cohort studies published before May 17, 2022. Cohort studies examining the association between PD and UC risk were included. We used a random-effects model to summarize the effect sizes with 95% confidence intervals (CIs) of the included studies with PD as the indicator and UC as the outcome.

Results

Eleven cohort studies met the inclusion criteria. Our results suggest that PD patients increases the risk of UC by 1.24-fold (hazard ratio (HR), 1.24; 95% CI, 1.17-1.31; I², 22.4%). The strength of the sensitivity analysis and cumulative meta-analysis confirmed the reliability of the results.

Conclusion

We found that PD is a potential risk factor for UC. Our results indicate that along with the decrease in the incidence of PD,PD treatment may help prevent UC. We hope that our study will raise awareness of periodontal health, thereby reducing the incidence of UC.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/, identifier CRD42021244405.

On the Necessity of a Geriatric Oral Health Care Transition Model: Towards an Inclusive and Resource-Oriented Transition Process

People in need of care also require support within the framework of structured dental care in their different life situations. Nowadays, deteriorations in oral health tend to be noticed by chance, usually when complaints or pain are present. Information on dental care is also lost when life situations change. An older person may rely on family members having oral health skills. This competence is often not available, and a lot of oral health is lost. When someone, e.g., a dentist, physician, caregiver, or family member notices a dental care gap, a structured transition to ensure oral health should be established. The dental gap can be detected by, e.g., the occurrence of bad breath in a conversation with the relatives, as well as in the absence of previously regular sessions with the dental hygienist. The aim of the article is to present a model for a structured geriatric oral health care transition. Due to non-existing literature on this topic, a literature review was not possible. Therefore, a geriatric oral health care transition model (GOHCT) on the basis of the experiences and opinions of an expert panel was developed. The GOHCT model on the one hand creates the political, economic, and legal conditions for a transition process as a basis in a population-relevant approach within the framework of a transition arena with the representatives of various organizations. On the other hand, the tasks in the patient-centered approach of the transition stakeholders, e.g., patient, dentist, caregivers and relatives, and the transition manager in the transition process and the subsequent quality assurance are shown.