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 ▲]

Who is going to pay the price of Covid-19? Reflections about an unequal Brazil

in International Journal for Equity in Health (2020), 19

Being a World Young Leader in Dementia: Between academic brilliance and acts of kindness. Blog post

E-print/Working paper (2020)

The blog post describes my journey from being selected as an 'Emerging Leader in Dementia' in 2014/15 by the UK Science and Innovation Network to helping to form, with other emerging leaders, a truly ... [more ▼]

The blog post describes my journey from being selected as an 'Emerging Leader in Dementia' in 2014/15 by the UK Science and Innovation Network to helping to form, with other emerging leaders, a truly global network of World Young Leaders in Dementia, now spanning 400+ members in 29+ countries, and aiming to facilitate careers of young professionals in the field of dementia. [less ▲]

Using cohort data to emulate lifestyle interventions: Long-term beneficial effects of initiating physical activity on cognitive decline and dementia

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

Background: Intervention studies have shown beneficial short-term effects of physical activity on cognitive decline and reduced risk of dementia. However, randomized controlled trial data of lifestyle ... [more ▼]

Background: Intervention studies have shown beneficial short-term effects of physical activity on cognitive decline and reduced risk of dementia. However, randomized controlled trial data of lifestyle interventions over long time spans are not available due to lack of resources, feasibility or ethical reasons. Drawing from the principles of emulating a ‘target trial’, which apply design principles of randomized trials to the analysis of observational data, cohort data of a large European survey were analyzed to understand the long-term effects of physical activity changes. Method: Biennial assessments of the economic, social, and health situation of respondents aged 50 and older came from the Survey of Health, Ageing and Retirement in Europe (2004-2017). Cognitive functioning (immediate recall, delayed recall, and verbal fluency) and self-reported diagnosis of dementia were assessed at each follow-up. The target trial included sedentary respondents at t1 who, at follow-up (t2), stayed sedentary (“control group”) or newly reported vigorous physical activity more often than once a week (initiators, “treatment group”). Inclusion and exclusion criteria were implemented as close as possible to those of the FINGER trial. Inverse-probability weighting accounted for the probability of initiating physical activity with a large set of predictor variables. Selecting respondents aged 50-85 years old who met the target trial inclusion and exclusion criteria, assessments of cognitive functioning and self-reported diagnosis of dementia were available for 8,781 respondents at t3 (on average 3.02 years later), 3,858 respondents at t4 (5.84 years), and 2,304 respondents at t5 (7.72 years). A total of 304 respondents reported a diagnosis of dementia. Result: Initiators of vigorous physical activity had higher cognitive functioning at two follow-ups compared to non-initiators (t3: “average treatment effect on the treated”, ATET=0.059, CI: 0.028, 0.090), which remained significant after implementing inclusion and exclusion criteria. Initiators had lower risk of dementia compared to non-initiators at all three follow-ups (t3: ATET=-0.009, CI: -0.015, -0.005, relative risk decrease -46.7%), remaining significant after implementing inclusion and exclusion criteria. Conclusion: Emulating a target trial showed long-term benefits of initiating physical activity for cognitive functioning and dementia risk. Multidomain interventions related to nutrition, social, cognitive activities etc. can be similarly emulated. [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)

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

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

Examining gender differentials in the association of low control work with cognitive performance in older workers

in European Journal of Public Health (2020)

Background: Limited workplace control, an important dimension of job strain, can reduce occupational opportunities for problem solving and learning. Women may have fewer professional resources to mitigate ... [more ▼]

Background: Limited workplace control, an important dimension of job strain, can reduce occupational opportunities for problem solving and learning. Women may have fewer professional resources to mitigate effects of low control, while conversely, gender-role norms may moderate the influence of occupational psychosocial risk factors. We therefore examined if the links between control and cognitive function were similarly gendered. Methods: This observational, longitudinal study included respondents of the Survey of Health, Ageing and Retirement in Europe who were aged 50-64 years at entry, employed, and provided at least two measurements of control and cognition (n=6,697). Relationships between control and cognition, quantified with standardised scores from verbal fluency, immediate and delayed word recall tests, were explored using linear fixed-effect and random-effect models with gender interactions. Results: Consistent trends of improved verbal fluency performance with high control were evident across analyses, equal to producing around three-quarters of a word more under high control conditions, with an effect size roughly equal to 0.1 standard deviation units (fully adjusted models, range 0.077-0.104 SD), although associations with recall tests were inconsistent. We did not find evidence of clear gender differences in control–cognition relationships for any of the cognitive domains. Conclusions: The cognitive health of older European workers may benefit from improved workplace control irrespective of gender. Possible sources of bias that could explain the lack of gender differences are discussed, particularly gender differences in labour force participation, response behaviour in job control ratings, and implications of gender-role norms on the importance of occupational risk factors. [less ▲]

Are certain racial groups really at greater risk of type 2 diabetes? A mediation analysis of income inequality and diabetes incidence in the United States

Scientific Conference (2019, November 20)