1
|
Axon DR, Agu U. Correlation of Positive Psychological Health among US Adults (Aged ≥ 50 Years) with Pain and Documented Opioid Treatment. Behav Sci (Basel) 2023; 14:27. [PMID: 38247679 PMCID: PMC10813132 DOI: 10.3390/bs14010027] [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: 11/28/2023] [Revised: 12/18/2023] [Accepted: 12/23/2023] [Indexed: 01/23/2024] Open
Abstract
In this study, we aimed to identify the factors correlated with positive psychological health among United States older adults (≥50 years) with pain and documented opioid treatment. This retrospective cross-sectional study utilized a nationally representative dataset (Medical Expenditure Panel Survey). A multivariable logistic regression model was developed to assess the correlation of positive psychological health in the eligible population. The logistic regression model showed having excellent/very good/good (versus fair/poor) perceived health (adjusted odds ratio [AOR] = 9.062; 95% confidence interval [CI] = 5.383, 15.254) had a statistically significant correlation with positive psychological health among the eligible population. This finding offers important insights for clinicians and policymakers to consider when formulating approaches to better manage the psychological health of United States older adults with pain and documented opioid treatment.
Collapse
Affiliation(s)
- David R. Axon
- Department of Pharmacy Practice and Science, College of Pharmacy, The University of Arizona, 1295 North Martin Avenue, P.O. Box 210202, Tucson, AZ 85721, USA;
- Center for Health Outcomes & Pharmacoeconomic Research (HOPE Center), College of Pharmacy, The University of Arizona, 1295 North Martin Avenue, P.O. Box 210202, Tucson, AZ 85721, USA
| | - Uche Agu
- Department of Pharmacy Practice and Science, College of Pharmacy, The University of Arizona, 1295 North Martin Avenue, P.O. Box 210202, Tucson, AZ 85721, USA;
| |
Collapse
|
2
|
Fujii K, Lee S, Katayama O, Makino K, Harada K, Tomida K, Morikawa M, Yamaguchi R, Nishijima C, Misu Y, Shimada H. Difference in employment status and onset of disability among Japanese community-dwelling older adults: a prospective cohort study. Int Arch Occup Environ Health 2023; 96:1225-1234. [PMID: 37486376 DOI: 10.1007/s00420-023-02000-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 07/12/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVE This prospective cohort study investigates the relationship between the onset of disability and employment status. METHODS We investigated 3,741 community-dwelling adults aged 70 or older, who participated in a population-based cohort study in Japan. Their onset of disability was monitored monthly using the long-term care insurance certification registration system, for five years from baseline. Based on an employment status questionnaire, we categorized participants into three groups: (1) employee, (2) self-employed, and (3) not working. Covariates included demographic information, medical history, number of medications, educational level, living alone, social group engagement, smoking status, walking speed, instrumental activities of daily living, global cognitive function, and depressive symptoms. Missing values were managed using multiple imputation. Cox proportional hazard models were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for incident disability risk by employment status. RESULTS The disability incidence rates were 15.3/1,000 (95% CIs: 10.7-22.0) person-years among employees, and 33.0/1000 (95% CIs: 24.4-44.6) and 39.6/1000 (95% CIs: 36.5-43.0) person-years among self-employed and non-working participants, respectively. The adjusted HRs for the onset of disability among non-working and self-employed participants were 1.69 (95% CIs: 1.16-2.46, p = 0.007) and 1.63 (95% CIs: 1.01-2.62, p = 0.044) compared with employees, respectively. Similar results were found among men. Among women, disability onset was not associated with employment status. CONCLUSIONS Older adults' risk of disability onset differed according to their employment status. Older employees had a lower risk of disability onset than those not working or self-employed.
Collapse
Affiliation(s)
- Kazuya Fujii
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu, Aichi, 474-8511, Japan.
| | - Sangyoon Lee
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu, Aichi, 474-8511, Japan
| | - Osamu Katayama
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu, Aichi, 474-8511, Japan
- Japan Society for the Promotion of Science, Chiyoda-Ku, Tokyo, Japan
| | - Keitaro Makino
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu, Aichi, 474-8511, Japan
- Japan Society for the Promotion of Science, Chiyoda-Ku, Tokyo, Japan
| | - Kenji Harada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu, Aichi, 474-8511, Japan
| | - Kouki Tomida
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu, Aichi, 474-8511, Japan
| | - Masanori Morikawa
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu, Aichi, 474-8511, Japan
| | - Ryo Yamaguchi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu, Aichi, 474-8511, Japan
| | - Chiharu Nishijima
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu, Aichi, 474-8511, Japan
| | - Yuka Misu
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu, Aichi, 474-8511, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu, Aichi, 474-8511, Japan
| |
Collapse
|
3
|
Morrish N, Mujica-Mota R, Medina-Lara A. Understanding the effect of loneliness on unemployment: propensity score matching. BMC Public Health 2022; 22:740. [PMID: 35477427 PMCID: PMC9045886 DOI: 10.1186/s12889-022-13107-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 03/24/2022] [Indexed: 01/19/2023] Open
Abstract
Background Loneliness and unemployment are each detrimental to health and well-being. Recent evidence suggests a potential bidirectional relationship between loneliness and unemployment in working age individuals. As most existing research focuses on the outcomes of unemployment, this paper seeks to understand the impact of loneliness on unemployment, potential interaction with physical health, and assess bidirectionality in the working age population. Methods This study utilised data from waves 9 (2017–19) and 10 (2018–2020) of the Understanding Society UK Household Longitudinal Study. Nearest-neighbour probit propensity score matching with at least one match was used to infer causality by mimicking randomisation. Analysis was conducted in three steps: propensity score estimation; matching; and stratification. Propensity scores were estimated controlling for age, gender, ethnicity, education, marital status, household composition, number of own children in household and region. Findings were confirmed in panel data random effect models, and heterogeneous treatment effects assessed by the matching-smoothing method. Results Experience of loneliness in at least one wave increased the probability of being unemployed in wave 10 by 17.5 [95%CI: 14.8, 20.2] percentage points. Subgroup analysis revealed a greater effect from sustained than transitory loneliness. Further exploratory analysis identified a positive average treatment effect, of smaller magnitude, for unemployment on loneliness suggesting bidirectionality in the relationship. The impact of loneliness on unemployment was further exacerbated by interaction with physical health. Conclusions This is the first study to directly consider the potentially bidirectional relationship between loneliness and unemployment through analysis of longitudinal data from a representative sample of the working age population. Findings reinforce the need for greater recognition of wider societal impacts of loneliness. Given the persisting and potentially scarring effects of both loneliness and unemployment on health and the economy, prevention of both experiences is key. Decreased loneliness could mitigate unemployment, and employment abate loneliness, which may in turn relate positively to other factors including health and quality of life. Thus, particular attention should be paid to loneliness with additional support from employers and government to improve health and well-being. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13107-x.
Collapse
Affiliation(s)
- N Morrish
- Health Economics Group, Institute of Health Research, University of Exeter Medical School, University of Exeter, Exeter, UK.
| | - R Mujica-Mota
- Academic Unit of Health Economics, School of Medicine, University of Leeds, Leeds, UK
| | - A Medina-Lara
- Health Economics Group, Institute of Health Research, University of Exeter Medical School, University of Exeter, Exeter, UK
| |
Collapse
|
4
|
Madhavan A, Bajaj G, Bajaj PD, D'Souza DF. Cognitive abilities among employed and unemployed middle-aged women – A systematic review. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.101042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
5
|
Wolfova K, Kucera M, Cermakova P. Risk and protective factors of neurocognitive disorders in older adults in Central and Eastern Europe: A systematic review of population-based studies. PLoS One 2021; 16:e0260549. [PMID: 34847191 PMCID: PMC8631612 DOI: 10.1371/journal.pone.0260549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 11/11/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND A wide range of potentially modifiable risk factors, indicating that the onset of neurocognitive disorders can be delayed or prevented, have been identified. The region of Central and Eastern Europe has cultural, political and economic specifics that may influence the occurrence of risk factors and their link to the cognitive health of the population. OBJECTIVE We aimed to systematically review population-based studies from Central and Eastern Europe to gather evidence on risk and protective factors for neurocognitive disorders. METHODS We searched the electronic databases PubMed, Cochrane Database of Systematic Reviews, PsycINFO, Web of Science, and Embase. The search was performed on 26th of February 2020 and repeated at the end of the review process on 20th May 2021. RESULTS We included 25 papers in a narrative synthesis of the evidence describing cardiovascular risk factors (n = 7), social factors (n = 5), oxidative stress (n = 2), vitamins (n = 2), genetic factors (n = 2) and other areas (n = 7). We found that there was a good body of evidence on the association between neurocognitive disorders and the history of cardiovascular disease while there were gaps in research of genetic and social risk factors. CONCLUSION We conclude that the epidemiological evidence from this region is insufficient and population-based prospectively followed cohorts should be established to allow the development of preventive strategies at national levels.
Collapse
Affiliation(s)
- Katrin Wolfova
- Department of Psychiatry and Medical Psychology, Third Faculty of Medicine, Charles University, Prague, Czech Republic
- National Institute of Mental Health, Klecany, Czech Republic
- Department of Epidemiology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Matej Kucera
- National Institute of Mental Health, Klecany, Czech Republic
- Department of Epidemiology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Pavla Cermakova
- National Institute of Mental Health, Klecany, Czech Republic
- Department of Epidemiology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| |
Collapse
|
6
|
Socio-economic and demographic patterns of mental health complaints among the employed adults in Estonia. PLoS One 2021; 16:e0258827. [PMID: 34695142 PMCID: PMC8544841 DOI: 10.1371/journal.pone.0258827] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 10/07/2021] [Indexed: 11/19/2022] Open
Abstract
Background Mental health problems follow a distinct socio-economic gradient and contribute to the health inequalities. The study aims to analyse the socio-economic and demographic factors of self-reported mental health complaints (stress, depressiveness, overtiredness, suicidal thoughts) among employed adult population in Estonia. Methods Data on 4041 employed respondents (2064 men and 1977 women) aged 20–64 years from nationally representative health surveys from years 2016 and 2018 in Estonia were used for the study. Dependent variables included self-reported stress, depressiveness, overtiredness, and suicidal thoughts. Descriptive statistics and both log-binomial and Poisson regression analysis were used to describe the socio-economic and demographic variations in these mental health complaints. Results More than half of the respondents had either stress, depressiveness, overtiredness or suicidal thoughts with 25% reporting two or more of mental health complaints. Lower personal income was associated with higher rates of all mental health complaints (stress, depressiveness, overtiredness, and suicidal thoughts) among employed adults in Estonia. Additionally, lower education was associated with higher prevalence of depressiveness and lower job skills predicted higher prevalence of suicidal thoughts. Higher prevalence ratios for depressiveness and overtiredness were found for women compared to men whereas Estonians had higher prevalence ratios for stress and suicidal thoughts compared to non-Estonians. All mental health complaints were more frequently reported at younger ages (compared to 50-64-year olds) and by not married or cohabiting respondents. Conclusion High prevalence of mental health complaints and their socio-economic and demographic patterning refer to considerable inequalities in mental health among employed adults. Policy actions targeting especially younger adults and those with financial difficulties are needed to address these early manifestations of mental health problems.
Collapse
|
7
|
Morrish N, Medina-Lara A. Does unemployment lead to greater levels of loneliness? A systematic review. Soc Sci Med 2021; 287:114339. [PMID: 34455335 PMCID: PMC8505794 DOI: 10.1016/j.socscimed.2021.114339] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 08/19/2021] [Accepted: 08/23/2021] [Indexed: 01/10/2023]
Abstract
There is evidence that loneliness and unemployment each have a negative impact on public health. Both are experienced across the life course and are of increasing concern in light of the COVID-19 pandemic. This review seeks to examine the strength and direction of the relationship between loneliness and unemployment in working age individuals, and in particular the potential for a self-reinforcing cycle with combined healthcare outcomes. A systematic search was undertaken in Medline, PubMed, PsycINFO, Embase and EconLit from inception to December 2020. PRISMA reporting guidelines were followed throughout this review, study quality was assessed using the Joanna Briggs Institute checklist and results were summarised in a narrative synthesis. English language studies evaluating the relationship between loneliness and unemployment in higher income western countries were included. Thirty-seven studies were identified; 30 cross-sectional and 7 longitudinal. Loneliness was measured by a direct question or loneliness scale while unemployment was self-reported or retrieved from a national register. A positive association between unemployment and increased loneliness was observed across all studies. Thus, across the life-course a clear yet complex relationship exists between unemployment and greater experience of loneliness. The magnitude of this relationship increases with the severity of loneliness and appears to peak at age 30–34 and 50–59. Logistic regression provided the greatest consistency at statistical significance revealing at least a 40% increase in the likelihood of reporting loneliness when unemployed. Recent longitudinal studies identified in this review found higher levels of loneliness following job loss, but also that loneliness was predictive of unemployment suggesting potential bi-directionality in the relationship. This bi-directionality may create a multiplier effect between loneliness and unemployment to form a self-reinforcing relationship and greater health concerns for those most at risk. Thus, review findings suggest the need for cross-sector awareness and intervention to tackle both loneliness and unemployment. Unemployment is related to feeling lonely. Stronger association of unemployment with severe experience of loneliness. Greatest connection between loneliness and unemployment at age 30–34 and 50-59. Potential for a bi-directional relationship between loneliness and unemployment. Greater understanding is needed in the face of COVID-19 recovery.
Collapse
Affiliation(s)
- N Morrish
- Health Economics Group, Institute of Health Research, University of Exeter Medical School, University of Exeter, Exeter, UK.
| | - A Medina-Lara
- Health Economics Group, Institute of Health Research, University of Exeter Medical School, University of Exeter, Exeter, UK
| |
Collapse
|
8
|
Xue B, Pai M, Luo M. Working beyond SPA and the trajectories of cognitive and mental health of UK pensioners: Do gender, choice, and occupational status matter? Eur J Ageing 2021; 19:423-436. [PMID: 36052194 PMCID: PMC9424372 DOI: 10.1007/s10433-021-00644-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2021] [Indexed: 11/01/2022] Open
Abstract
AbstractWe assessed the association between work status beyond state pension age (SPA) and the long-term trajectories of cognitive and mental health for men and women separately, and the extent to which this relationship is conditioned by their occupational status and whether the choice to retire or continue working is voluntary or involuntary. Data are pensioners (aged between SPA and SPA + 9) from the English Longitudinal Study of Ageing waves 4 (2008/09) through 9 (2018/19). The analytic sample includes 959 men and 1217 women when considering cognitive outcomes and 1131 men and 1434 women when evaluating depression. Findings based on growth curve models reveal that, compared to women who retired at SPA and without any particular reason, their peers who retired due to frailing health reported a more precipitous decline in memory over time (coefficient = −0.10). However, analysis stratified by occupation shows that this association between ill-health retirement and long-term memory decline was concentrated among older women of the highest occupational status. We also found that men who retired or worked past SPA voluntarily reported a better baseline verbal fluency and were less likely to report depression over time (coefficient for work = 0.80; coefficient for retired = 0.87). Women who worked past SPA voluntarily were less likely to report depression at baseline (OR = 0.53). Policies that extend work life should offer older people more personal control over decision surrounding retirement.
Collapse
|
9
|
Bevilacqua G, D'Angelo S, Ntani G, Syddall HE, Harris EC, Linaker C, Stevens M, Cooper C, Walker-Bone K. Older working adults in the HEAF study are more likely to report loneliness after two years of follow-up if they have negative perceptions of their work quality. BMC Public Health 2021; 21:574. [PMID: 33757464 PMCID: PMC7988922 DOI: 10.1186/s12889-021-10610-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 03/09/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Loneliness is an important public health issue associated with mortality and morbidity. Often researched amongst older people, less is known about risk factors for loneliness among adults aged 50-64 years who are in work. We investigated (a) if exit from the workforce increases the odds of loneliness; (b) whether adverse psychosocial work factors are associated with increased odds of loneliness over 2 years of follow-up; and (c) whether the association is stronger among subjects still working compared with those who have exited the workforce. METHODS Data came from the Health and Employment After Fifty (HEAF) study, a large population cohort who provided questionnaire information about work and health at baseline and 2 annual follow-ups. Logistic regression was used to explore the association between psychosocial risk factors and loneliness at follow-up 2, with adjustment for loneliness at baseline, sex, age, self-rated health, living alone, and mental health diagnosis. RESULTS Of the initial 8134 participants, 4521 were working at baseline and provided data for this analysis. Of those, 507 (11.2%) were defined as lonely at 2 years' follow-up. Exiting the workforce was not significantly associated with loneliness (OR = 1.1, 95%CI: 0.7-1.7). However, negative psychosocial work factors predicted loneliness at follow-up. After mutual adjustment, lack of choice at work (OR: 1.5, 95%CI: 1.1-1.9), often lying awake worrying about work (OR: 1.4, 95%CI: 1.0-1.9) and perceived not coping with physical demands of the job (OR: 1.3, 95%CI: 1.0-1.7) were independent predictors, with associations robust to adjustment for demographic factors and health. Associations were only slightly altered when we restricted the sample to those who remained in work until the end of follow-up. CONCLUSIONS Loneliness amongst middle-aged working adults is not predicted by permanent work exit but is predicted by individuals' perceptions about their work. Provision of good-quality work, matched to the capacity of the older worker, could prevent loneliness.
Collapse
Affiliation(s)
- Gregorio Bevilacqua
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
| | - Stefania D'Angelo
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
| | - Georgia Ntani
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, England
| | - Holly Emma Syddall
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
| | - Elizabeth Clare Harris
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, England
| | - Cathy Linaker
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, England
| | - Martin Stevens
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, England
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, England
| | - Karen Walker-Bone
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK.
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, England.
| |
Collapse
|