Luxembourg

in Immergut, E.; Anderson, K.; Devitt, C. (Eds.) et al Health politics in Europe: A handbook (2021)

Symposium: Contextual and life-course determinants of later-life cognitive functioning and dementia

Scientific Conference (2021, June)

Inequalities by gender, socioeconomic background, and cognitive functioning later in life.

Presentation (2021, May)

Returns to Educational and Occupational Attainment in Cognitive Performance for Middle-Aged South Korean Men and Women

in Gerontology and Geriatric Medicine (2021), 7

Background: Gender differences in late middle-age cognitive performance may be explained by differences in educational or occupational attainment rates, or gender-patterned returns of similar education ... [more ▼]

Background: Gender differences in late middle-age cognitive performance may be explained by differences in educational or occupational attainment rates, or gender-patterned returns of similar education and occupation to cognitive reserve. We tested these competing hypotheses in the historically highly gender unequal context of South Korea. Methods: Data came from the 2006 wave of the Korean Longitudinal Study of Aging. We included adults aged 45–65 years. Using quantile regression decompositions, we decomposed cognitive performance differences across quantiles into differences due to rates of educational and occupational attainment and differences due to divergent returns to those characteristics. Results: Gender-based cognitive performance differences across deciles were driven by differences in rates of educational and occupational attainment, while the returns to these characteristics were similar for both genders. Conclusions: Findings suggest that educational and occupational characteristics contribute to cognitive performance similarly in men and women, but discordant rates of these characteristics contribute to performance gaps. [less ▲]

Socioeconomic and behavioural factors associated with access to and use of Personal Health Records

in BMC Medical Informatics and Decision Making (2021), 21

Background: Access to and use of digital technology are more common among people of higher socioeconomic status. These differences might be due to lack of interest, not having physical access or having ... [more ▼]

Background: Access to and use of digital technology are more common among people of higher socioeconomic status. These differences might be due to lack of interest, not having physical access or having lower intentions to use this technology. By integrating the digital divide approach and the User Acceptance of Information Technology (UTAUT) model, this study aims to further our understanding of socioeconomic factors and the mechanisms linked to different stages in the use of Personal Health Records (PHR): desire, intentions and physical access to PHR. Methods: A cross-sectional online and in-person survey was undertaken in the areas of Lorraine (France), Luxembourg, Rhineland-Palatinate and Saarland (Germany), and Wallonia (Belgium). Exploratory factor analysis was performed to group items derived from the UTAUT model. We applied linear and logistic regressions controlling for country-level heterogeneity, health and demographic factors. Results: A total of 829 individuals aged over 18 completed the questionnaire. Socioeconomic inequalities were present in the access to and use of PHR. Education and income played a significant role in individuals' desire to access their PHR. Being older than 65 years, and migrant, were negatively associated with desire to access PHR. An income gradient was found in having a physical access to PHR, while for the subgroup of respondents who expressed desire to have access, higher educational level was positively associated with intentions to regularly use PHR. In fully adjusted model testing the contribution of UTAUT-derived factors, individuals who perceived PHRs to be useful and had the necessary digital skills were more inclined to use their PHR regularly. Social influence, support and lack of anxiety in using technology were strong predictors of regular PHR use. Conclusion: The findings highlight the importance of considering all stages in PHR use: desire to access, physical access and intention to regularly use PHRs, while paying special attention to migrants and people with lower socioeconomic backgrounds who may feel financial constraints and are not able to exploit the potential of PHRs. As PHR use is expected to come with health benefits, facilitating access and regular use for those less inclined could reduce health inequalities and advance health equity. [less ▲]

Detecting the ‘Black Hole’ of age-period excess mortality in 25 countries: Age-period-cohort residual analysis

in Bell, Andrew (Ed.) Age, Period, and Cohort Effects (2021)

In a time of worldwide availability of annual age-specific mortality data, we lack basic tools for detecting and graphing, from a comparative perspective, fine-grained deviations from mortality trends. We ... [more ▼]

In a time of worldwide availability of annual age-specific mortality data, we lack basic tools for detecting and graphing, from a comparative perspective, fine-grained deviations from mortality trends. We provide a new age-period-cohort-based methodology, combining information from age-period (AP) and APC-Detrended (APCD) analyses to detect all-cause mortality increases. Plotting the resulting AP coefficients and APCD residuals in equilateral Lexis diagrams, mortality patterns can easily be distinguished as age, period, or cohort trends and fluctuations. We highlight abnormalities as interactions of age and period (‘Black Holes’). We then investigate the ‘Black Holes’ of mortality of young-adult cohorts in the early 1990s in Spain, other southern European countries, and the U.S., in emphasizing their simultaneously occurring mortality crises. Additional analyses with WHO mortality data and epidemiological evidence from other studies show that these mortality increases likely result from lack of treatment and inadequate public health responses to the beginnings of the HIV/AIDS epidemic. We discuss other possible applications of the new method. [less ▲]

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

Scientific Conference (2020, October 29)

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 ▲]

Programme Démence Prévention (pdp ): A Nation-Wide Programme for Dementia Prevention in Luxembourg

Poster (2020, April)

Objectives: To implement a multi-year nation-wide programme, by the means of a personalised lifestyle intervention, to prevent or to delay cognitive decline that can contribute to development of dementia ... [more ▼]

Objectives: To implement a multi-year nation-wide programme, by the means of a personalised lifestyle intervention, to prevent or to delay cognitive decline that can contribute to development of dementia in Luxembourg. Methods: Participants with mild cognitive impairment, referred to the programme by their treating physician, undergo an extensive cognitive evaluation by a neuropsychologist on relevant neuropsychological domains as well as a structured dementia risk factor assessment. Based on these assessments, individualised lifestyle interventions are offered by diverse national partners involved in the programme, thus filling a gap of not yet reimbursed services in the Luxemburgish healthcare system. After the personalised lifestyle interventions, each participant will undergo a neuropsychological follow-up in order to re-evaluate his/her health status in terms of cognition. Results: We established a participant-centred national network by presenting the programme on many outreach events and efficient stakeholder communication. The network raises the awareness of dementia prevention in the Luxembourgish population, fosters interdisciplinary communication between individual medical and non-medical healthcare professionals and allows for a successful recruitment of the target population. Moreover, we collect information about adherence to the suggested lifestyle changes, as well as the effectiveness of our interventions in reducing risk factors contributing to the onset of dementia. Conclusions: We provide evidence for the feasibility of the implementation of a nation-wide dementia prevention programme including diverse partners offering personalised lifestyle interventions, which are easily transferrable to other countries. Future results from this programme may also help to integrate prevention interventions into the regular healthcare system. [less ▲]

How to actively protect against dementia. Epidemiological evidence from Luxembourg

Presentation (2020, February)

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 ▲]