Retirement, Pensions, and Depressive Symptoms Among Older Adults in China, England, Mexico, and the United States

Education, gender, and frequent pain among middle-aged and older adults in the United States, England, China, and India

ABSTRACT

Using cross-sectional data from the United States, England, China, and India, we examined the relationship between education and frequent pain, alongside the modification role of gender in this relationship. We further examined patterns of 3 pain dimensions among participants who reported frequent pain, including pain severity, interference with daily activities, and medication use (these pain dimension questions were not administered in all countries). Our analytical sample included 92,204 participants aged 50 years and above. We found a high prevalence of frequent pain across the 4 countries ranging from 28% to 41%. Probit models showed that higher education was associated with lower risk of pain (United States: -0.26, 95% CI: -0.33, -0.19; England: -0.32, 95% CI: -0.39, -0.25; China: -0.33, 95% CI -0.41, -0.26; India: -0.18, 95% CI -0.21, -0.15). Notably, in China and India, the negative association between higher education and frequent pain was less pronounced among women compared with men, which was not observed in the United States or England. Further analysis showed that individuals with higher education experiencing frequent pain reported less severity, fewer daily activity interferences, and less medication use compared with those with lower education. In the United States, these associations were stronger among women. Our findings highlight the prevalent pain among middle-aged and older adults in these 4 countries and emphasize the potentially protective role of higher education on frequent pain, with nuanced gender differences across different settings. This underscores the need for tailored strategies considering educational and gender differences to improve pain management and awareness.

Psychosocial Well-Being Differences Between the Young Old, Old-Old, and Oldest Old: A Global Comparison

OBJECTIVES

We investigate global differences in psychosocial well-being between older adult age groups.

METHODS

Using multinomial logistic regression, we analyzed 2018 data (n = 93,663) from 9 countries/regions in the Health and Retirement Study international family of studies to compare age group differences in depression, loneliness, and happiness.

RESULTS

Compared to the young old, the old-old reported more depression in Southern Europe, while the oldest old had higher risk in India and Southern Europe but lower risk in the United States. The old-old reported less loneliness in the United States but more in Southern Europe, while the oldest old had greater risk in Southern Europe. The old-old reported less happiness in Korea, while the oldest old had lower reports in Korea but higher reports in the United States.

DISCUSSION

The psychosocial well-being of the oldest old is exceptionally good in the United States but exceptionally poor in Southern Europe.

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: β=-.734; P<.001; specific corporate pension: β=-.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: β=-1.472; P<.001; second and third quartiles of specific corporate pension: β=-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.

The effect of retirement on physical and mental health in China: a nonparametric fuzzy regression discontinuity study

BACKGROUND

With the rapid aging of the domestic population, China has a strong incentive to increase the statutory retirement age. How retirement affects the health of the elderly is crucial to this policymaking. The health consequences of retirement have been debated greatly. This study aims to investigate the effects of retirement on physical and mental health among Chinese elderly people.

METHODS

The data we use in this study comes from four waves (2011, 2013, 2015, and 2018) of the Harmonized China Health and Retirement Longitudinal Study (Harmonized CHARLS), a prospective cohort. We use the nonparametric fuzzy regression discontinuity design to estimate the effects of retirement on physical and mental health. We test the robustness of our results with respect to different bandwidths, kernel functions, and polynomial orders. We also explore the heterogeneity across gender and education.

RESULTS

Results show that retirement has an insignificant effect on a series of physical and mental health outcomes, with and without adjusting several sociodemographic variables. Heterogeneity exists regarding gender and education. Although stratified analyses indicate that the transition from working to retirement leaves minimal effects on males and females, the effects go in the opposite direction. This finding holds for low-educated and high-educated groups for health outcomes including depression and cognitive function. Most of the results are stable with respect to different bandwidths, kernel functions, and polynomial orders.

CONCLUSIONS

Our results suggest that it is possible to delay the statutory retirement age in China as retirement has insignificant effects on physical and mental health. However, further research is needed to assess the long-term effect of retirement on health.

Depressive symptoms and receipt of pensions: a cross-sectional analysis of the ELSI-Brazil study

OBJECTIVE

To investigate association between depressive symptoms and receipt of retirement pensions or other pensions in the Brazilian population aged 50 years or older.

METHOD

This was a cross-sectional study with participants from the baseline (2015-2016) of the Longitudinal Study of the Health of Elderly Brazilians. Depressive symptoms were measured by the eight-item Center for Epidemiologic Studies Depression Scale. Prevalence ratios (PR) were obtained by Poisson regression.

RESULTS

Among the total 8,469 participants, 33.9% (95%CI 32.8;34.9) reported depressive symptoms and 52.8% (95%CI 51.8;53.9) of the participants received a retirement or other pension. Prevalence of depressive symptoms was lower among participants receiving a retirement or other pension (PR = 0.79; 95%CI 0.73;0.86). Association remained significant after adjustments for sociodemographic and health indicators (PR = 0.84; 95%CI 0.76;0.92).

CONCLUSION

Participants who receive retirement or other pensions are less likely to report depressive symptoms.

MAIN RESULTS

Prevalence of depressive symptoms was 33.9% in the population studied and, after adjusted analysis, it remained statistically lower among participants who received retirement or other pensions.

IMPLICATIONS FOR SERVICES

Prevalence of depressive symptoms was higher in individuals who do not receive retirement or other pensions, which demands attention from health services in caring for this public in vulnerable situations regarding social security.

PERSPECTIVES

Carrying out longitudinal studies capable of assessing the temporality of association between receiving retirement or other pensions and the mental health of the elderly, thus contributing to better knowledge about the social determinants of mental health.

Exploring the reciprocal relationship between activities of daily living disability and depressive symptoms among middle-aged and older Chinese people: a four-wave, cross-lagged model

BACKGROUND

Early studies have shown a relationship between activities of daily living (ADL) disability and depressive symptoms in older people. However, discussions on the direction of this relationship are insufficient. The study's objective was to assess the reciprocal relationship between ADL disability and depressive symptoms among middle-aged and older Chinese people.

METHOD

Data was collected in four waves of a nationwide survey, the China Health and Retirement Longitudinal Study (CHARLS), which was carried out in 2011, 2013, 2015, and 2018. In total, this study included 4,124 participants aged ≥ 45 years at baseline. A summing score of the eleven items for basic activities of daily living (BADL) and instrumental activities of daily living (IADL) was calculated to indicate the degree of ADL disability. The 10-item Centre for Epidemiological Studies Depression Scale (CESD-10) was adopted to measure depressive symptoms. The reciprocal relationship between ADL disability and depressive symptoms was tested by cross-lagged models.

RESULT

At baseline, 911 (22.1%) participants were classified as having difficulties with ADL, and the prevalence of depressive symptoms was 34.4% (1,418). Among middle-aged and older people in China, there was a significant reciprocal and longitudinal relationship between ADL disability and depressive symptoms. People who had difficulty with ADL faced a higher risk of depressive symptoms, and those who suffered from depressive symptoms were accompanied by an increase in ADL disability in the following years. The subgroup analysis on age also showed that ADL disability was reciprocally and longitudinally related to depressive symptoms. However, only women showed similar results in the subgroup analysis on gender.

CONCLUSION

This study shows that ADL disability is bi-directionally related to depressive symptoms in middle-aged and older Chinese people over time. The results suggest we should identify ADL disability and bad psychological conditions in time to prevent subsequent mutual damage among middle-aged and older Chinese people, a vulnerable group rising in the future.

Long-term effects of childhood adversity on the subjective well-being of older adults in urban China: the mediating effect of elder abuse

Adverse childhood experiences (ACEs) have negative impacts on individuals' subjective well-being (SWB) in later life. This article investigates the relationships between the ACEs and SWB of Chinese older adults and examines how elder abuse victimization mediates the pathways in these relationships.

We used retrospective cross-sectional survey data collected in Beijing, China, in 2019. The study sample consists of 1002 older adults aged 65 years and over. The survey measured individual types, number, and various categories of ACEs of older adults and their elder abuse victimization experiences, along with their SWB (i.e. depression and life satisfaction). We tested the potential mediating role of elder abuse victimization in the relationships between ACEs and SWB.

After controlling for socio-demographic factors and self-rated health, the results suggest a full mediating effect of elder abuse on the relationship between both several individual types and multiple categories of ACEs (i.e. childhood victimization, the family's economic difficulties, and a family member's episodes of illness) and depression, in addition to a partial mediating effect of elder abuse between number of ACEs and depression. A full mediating effect of elder abuse was found in regard to the relationship between a family's economic difficulties and life satisfaction.

This study provides evidence for a long-term impact of ACEs on the SWB of older adults in China. In analyzing and understanding elder abuse victimization as a pathway linking ACEs and SWB, we stress the importance of the prevention of interpersonal violence across the life course.

Supplemental data for this article is available online at https://doi.org/10.1080/13607863.2022.2040427 .

Perceived Housing in Relation to Retirement and Relocation: A Qualitative Interview Study among Older Adults

As people age the home environment becomes increasingly important. Retirement commonly leads to spending more time in one's home, and relocating from your own home in older age could be associated with reduced health or wellbeing. The relationship between home and person is complex and perceived aspects of one's housing such as social, emotional and cognitive ties are considered important factors for health and wellbeing. However, little is known about how perceived aspects of the home change in relation to retirement and relocation. This paper used Situational Analysis to explore, via situational mapping, how community dwelling older adults (aged 60-75) perceived their housing situation in relation to retirement and relocation. The results suggest complex relations between relocation/retirement and perceived housing, and between different aspects of perceived housing. Furthermore, the results suggest that the relationship between life transitions and perceived housing can be seen as bi-directional, where different life transitions affect aspects of perceived housing, and that perceived housing affects (decisions for) relocation. The results suggest complex relations between retirement and relocation, as well as other life transitions, and perceived aspects of one's housing. It is important to consider these interactions to understand factors that affect health and wellbeing in older adults.

The role of internet use in the relationship between occupational status and depression

BACKGROUND

The emerging information and communications technology (ICT) and society 5.0 have integrated digital innovation and imaginative creativity to solve social problems and create social value in an aging society. Especially in China, the penetration rate of internet use has become more prominent. Nevertheless, the role of internet use in the relationship between occupational status and depression remains unknown. The purpose of this study was to estimate how internet use moderates the relationship between occupational status and depression in a sample of older adults in China.

METHODS

A cross-sectional design was used to assess the relationship between occupational status, internet use and depression. This study employed data from the Chinese General Social Survey (CGSS) conducted in 2017. The full sample size of this study is 2,403. OLS regression was adopted to explore the correlation between occupational status and depression and the moderating role of internet use. Meanwhile, a heterogeneity analysis based on residence registration was implemented to explore the difference between rural and urban sample groups.

RESULTS

The findings suggested that higher occupational status was related to lower depression level. By playing an inhibitory moderating role between the association of occupational status and depression, internet use and occupational status formed a substituting effect. Meanwhile, the above moderating effect was only significant in urban group and insignificant in rural group. Besides, being male and having higher social class were significantly and negatively correlated with depression.

CONCLUSION

This study began with the theory of social stratification and social mobility, added the theory of social capital, constructed an analytical framework of regulatory effect, put forward two basic assumptions, selected measurement indicators taking into account Chinese cultural factors, and conducted empirical tests using authoritative statistical software and national representative data, providing a new theoretical contribution to our understanding of the impact of occupational status and depression in developing countries.

Emotion regulation and the late positive potential (LPP) in older adults

Emotion regulation (ER) processes in older adults may be important for successful aging. Neural correlates of ER processes have been examined using event-related brain potentials (ERPs), such as the late-positive potential (LPP) during cognitive reappraisal paradigms. The current study sought to extend this research by examining the LPP from an ER task in a sample of 47 community-dwelling older adults between the ages of 60 and 84 years, scoring either high on emotional well-being (as measured by habitual ER use and resiliency; high WB group, n = 20) or low on emotional well-being (as measured by habitual ER use, resiliency, and depression; low WB group, n = 27). Participants viewed unpleasant and neutral images and were instructed to simply react to the images or reappraise their emotional response. Both pre- and post-instruction LPP amplitudes were scored, in addition to self-reported ratings of negative emotion collected during the task. We found greater LPP amplitude to emotionally salient compared to neutral stimuli, reduced LPP amplitude following instructions to reappraise emotional response to stimuli across groups, and a blunted LPP overall for individuals with higher depressive symptoms. Additionally, we demonstrated that older adults with low emotional well-being were less successful at reappraisal according to self-reported ratings of negative emotion, although this was not reflected in the LPP. Collectively, these data suggest that laboratory-based ER tasks might be used to understand abnormal ER use-though the LPP may be more sensitive to depression than individual differences in ER ability.

Work after retirement affects elderly mental health and behaviors in Addis Ababa

This study aimed to determine the impact of being without a job post-retirement on mental health (depression, life satisfaction) and behaviors (alcohol and cigarette). A cross-sectional study was conducted on 330 Ethiopians aged 60-69. Compared to workers, retirees without a job reported higher depression, lower life satisfaction, and hazardous drinking (d = .49, .39 and φ = .65, respectively). Hierarchical multiple regression analyses indicated that being without a job post-retirement was associated with depression and life dissatisfaction. Thus, greater emphasis has to be given to improve the mental health and behaviors of retired elderly.

Basic psychological need satisfaction across the retirement transition: Changes and longitudinal associations with depressive symptoms

Drawing on self-determination theory, the present study examined how satisfaction of the basic psychological needs (autonomy, competence, and relatedness) changes across the retirement transition and how need satisfaction was related to depressive symptoms across the retirement transition. Participants (N = 2655) were drawn from the HEalth, Ageing and Retirement Transitions in Sweden (HEARTS) study. Latent growth curve modeling showed that autonomy need satisfaction increased across the retirement transition, whereas competence and relatedness remained relatively stable. Higher need satisfaction was related to less depressive symptoms at baseline, however, pre-retirement need satisfaction was not a statistically significant predictor of subsequent changes in depressive symptoms (or vice versa) across the retirement transition. At the within-person level, higher than usual need satisfaction at a specific time point was related to less than usual depressive symptoms. Need satisfaction may be an important factor to consider across the retirement transition and need satisfying activities prior, during, and after the transition may ease peoples’ adjustment to retirement.