The patients’ perspective on access to and use of Personal Health Records

Scientific Conference (2020)

We present the patients' perspective regarding the use of Personal Health Records, and give insights on patients' characteristics, such as socioeconomic and behavioural factors, that are associated with ... [more ▼]

We present the patients' perspective regarding the use of Personal Health Records, and give insights on patients' characteristics, such as socioeconomic and behavioural factors, that are associated with the access to and use of Personal Health Records. The findings come from the INTERREG APPS project that investigated preferences for and intention to use Personal Health Records in four cross-border regions, in Lorraine/France, Luxembourg, Rhineland-Palatinate and Saarland/Germany, and Wallonia/Belgium. [less ▲]

Partnership transitions and cognitive functioning among the European 50+

Scientific Conference (2020)

Changes in neighborhood-level socioeconomic disadvantage and older Americans’ cognitive functioning

in Innovation in Aging (2020), 4(S1), 483

Prevalence of memory impairment 2000-2015 in Sao Paolo, Brazil

in Alzheimer's and Dementia: the Journal of the Alzheimer's Association (2020), 16

Background: Decreases in prevalence of memory impairment and dementia over the last two decades have been observed in different countries for cohorts entering older age. We sought to explore the changes ... [more ▼]

Background: Decreases in prevalence of memory impairment and dementia over the last two decades have been observed in different countries for cohorts entering older age. We sought to explore the changes in prevalence of cognitive impairment across four waves of the Health, Welfare and Aging survey (SABE) with data collected in Sao Paolo, Brazil, in 2000, 2006, 2010, and 2015. Method: Mini Mental State Exam (MMSE) scores and covariate values were available for 5,191 respondents (62.4% female) aged 60 to 99 across four waves. Cognitive impairment was defined as having <=12 points on a 19-point abbreviated version of the MMSE. Age group, educational attainment (no formal schooling, primary, secondary, post-secondary), self-reported heart disease, stroke, diabetes, hypertension, and BMI (<18.5, 18.5-24.9, 25-29.9, 30+) were adjusted for. Result: In more recent waves, prevalence of cognitive impairment was higher for respondents aged 60-64 years (9.0% in 2015 vs. 4.6% in 2000), 65-69 years (9.7% in 2015 vs. 5.8% in 2006) and 70-74 years (13.9% in 2015 vs. 5.8% in 2006). Between 2015 and 2000, respondents were increasingly more likely to report some formal education (90.8% vs. 75.3%), secondary (17.6% vs. 7.3%) or postsecondary education (11.4% vs. 4.3%). Respondents were increasingly more likely to report hypertension (66.5% vs. 54.2%), diabetes (28.7% vs. 17.8%), and be overweight/obese (74.1% vs. 58.9%). In age-adjusted logistic regressions, respondents in 2015 were more likely to show cognitive impairment compared to 2000 (OR 1.84, CI 1.20-2.82). Conclusion: SABE respondents showed higher prevalence of cognitive impairment in 2015 compared to respondents of the same age in earlier waves, but differences disappeared after adjusting for chronic disease burden and educational attainment. [less ▲]

Health inequalities in the first six months of the COVID-19 pandemic

in Mein, Georg; Pause, Johannes (Eds.) Self and Society in the Corona Crisis. Perspectives from the Humanities and Social Sciences (2020)

WYLD Special Symposium: Technological Innovations in Dementia Diagnosis and Care

Scientific Conference (2019, October)

Researchers and entrepreneurs present technological innovations in dementia diagnosis and care, particularly through the use of wearables, apps, and novel data analysis techniques. These innovations ... [more ▼]

Researchers and entrepreneurs present technological innovations in dementia diagnosis and care, particularly through the use of wearables, apps, and novel data analysis techniques. These innovations address complex challenges of differential dementia diagnosis and ensuring high-quality and safe home and formal care. [less ▲]

Gender inequalities across the life course: A societal perspective on gender differences in dementia

Scientific Conference (2019, October)

Introduction. Women are at increased risk of developing dementia, which can only partly be explained with differences in longevity, sex biology, or differences in detection/diagnosis. A promising approach ... [more ▼]

Introduction. Women are at increased risk of developing dementia, which can only partly be explained with differences in longevity, sex biology, or differences in detection/diagnosis. A promising approach at the population level is the systematic investigation of life course conditions for men and women across countries and cohorts in order to detect if schooling or work opportunities differ by gender. In the cognitive reserve framework, education and work reflect opportunities for cognitively stimulating activities, which increase cognitive reserve across the life course, and which could delay cognitive decline and the diagnosis of dementia. Method. We develop a framework for systematizing gender inequalities across different life stages and life domains, with a focus on systematic disadvantages for women that could be relevant barriers to cognitive reserve development. For the empirical analysis, we gather individual information and performance on cognitive tests from several harmonized cross-national aging surveys, i.e. the U.S. Health and Retirement Study and sister studies (SHARE, ELSA, SAGE), separated by cohort. Historical figures on gender inequalities for countries and cohorts, and their relevant timings in the life course of the older respondents, e.g. during schooling, were gathered from different sources, and merged with the individual-level data. Results. The new framework leads to testable hypotheses in both the Western and global context regarding life-course socialization and schooling and work opportunities that have been different for men and women. We will present preliminary evidence of how female (dis)advantages on different cognitive tests – memory, executive functioning – are mirroring societal gender inequalities. Discussion. We need to better understand how different life-course opportunities for men and women can create gender differences in dementia at old ages in order to identify individuals at risk today and improve conditions for future generations. [less ▲]

Epidemiology of and inequalities in ageing

Presentation (2019, June 05)

Social and behavioral factors in cognitive aging: Applying the causal inference framework in observational studies

Scientific Conference (2019, May 25)

Rationale: There is an urgent need to better understand how to maintain cognitive functioning at older ages with lifestyle interventions, given that there is currently no medical cure available to prevent ... [more ▼]

Rationale: There is an urgent need to better understand how to maintain cognitive functioning at older ages with lifestyle interventions, given that there is currently no medical cure available to prevent, halt or reverse the progression of cognitive decline and dementia. However, in current models, it is still not well established which social and behavioral modifiable factors (e.g. education, BMI, physical activity, sleep, depression) matter most at which ages, and which behavioral profiles are most protective against cognitive decline. In the last years, advances in the fields of causal inference have equipped epidemiology and social sciences with methods and models to approach causal questions in observational studies. Method: The presentation will give an overview of the causal inference framework to investigate the value of behavior changes in cognitive aging. Motivated by conflicting recent publications if physical activity should or should not be recommended to reduce individual risk of cognitive decline, we emulate a target trial where sedentary people are followed over the course of the Survey of Health, Ageing and Retirement in Europe (SHARE) and compare their cognitive development depending on initiating or not physical activity at a later measurement. Extended inclusion/exclusion criteria, and concepts of incident versus prevalent users and multiple eligibility are introduced. Discussion: The causal inference framework applied to observational studies is able to guide study design to reconcile conflicting evidence from intervention and observational studies. Investigations under the new framework have fewer ethical considerations compared to intervention research and, considering the need to follow up individuals over several decades, are considerably more cost-effective. Limitations are discussed. [less ▲]

A Bourdieusian approach to class‐related inequalities: the role of capitals and capital structure in the utilisation of healthcare services in later life

in Sociology of Health and Illness (2019)

This paper draws on Bourdieu's theory of economic, social and cultural capital to understand the relative effect of the volume and the composition of these capitals on healthcare service use in later life ... [more ▼]

This paper draws on Bourdieu's theory of economic, social and cultural capital to understand the relative effect of the volume and the composition of these capitals on healthcare service use in later life. Based on data from the fifth wave of the Survey of Health, Aging, and Retirement in Europe (n = 64,840), we first look at the contribution of each capital in the use of three healthcare services (general practitioner, dentist and hospital). Using cluster analysis, we then mobilise Bourdieu's concept of habitus to explain how the unequal distribution of material and non‐material capitals acquired in childhood lead to different levels of health and hospital care utilisation in later life. After controlling for demographic and health insurance variables, our results show that economic capital has the strongest individual association among the three capitals. However, the results of a cluster analysis used to distinguish between capital structures show that those with high non‐material capital and low material capital have higher levels of primary healthcare utilisation, and in turn lower levels of hospital use. Bourdieu's approach sheds light on the importance of capitals in all forms and structures to understand the class‐related mechanisms that contribute to different levels of healthcare use. [less ▲]