Depression and anxiety are the most common psychiatric conditions in late life. Despite their prevalence, we know relatively little about their unique manifestation in older adults. And, Although the most common intervention for late-life depression and anxiety continues to be medication, research on psychosocial interventions for late-life depression and anxiety has burgeoned in the past several years. Unfortunately, this growing body of intervention research has yet to be widely translated into improved systems of care for late-life depression. This article is one step toward synthesizing the knowledge in this growing area of research. The review of literature presents the conclusions of several meta-analyses that have reviewed psychosocial interventions for late-life depression and anxiety. In addition, intervention studies concerning the effectiveness of cognitive behavioral therapy, interpersonal therapy, reminiscence therapy, and alternative therapies with depressed and/or anxious older adults are reviewed. A brief description of various approaches to psychosocial intervention with anxious and/or depressed older adults is also presented.

Depression and anxiety.

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Recursive Methods In Economic Dynamics

Older wealthholders spend down assets much more slowly than predicted by classic life-cycle models. This paper introduces health-dependent utility into a model in which preferences for bequests, expenditures when in need of long-term care (LTC), and ordinary consumption combine with health and longevity uncertainty to explain saving behavior. To sharply identify motives, it develops strategic survey questions (SSQs) that elicit stated preferences. The model is estimated using these SSQs and wealth data from the Vanguard Research Initiative. A robust finding is that the desire to self-insure against long-term-care risk explains a substantial fraction of the wealthholding of older Americans.

Long-Term-Care Utility and Late-in-Life Saving

In this paper, we review the existing empirical evidence on how individuals respond to the incentives created by a net wealth tax. Variation in the overall magnitude of behavioural responses is substantial: estimates of the elasticity of taxable wealth vary by a factor of 800. We explore three key reasons for this variation: tax design, context and methodology. We then discuss what is known about the importance of individual margins of response and how these interact with policy choices. Finally, we use our analysis to systematically narrow down and reconcile the range of elasticity estimates. We argue that a well-designed wealth tax would reduce the tax base by 7–17 per cent if levied at a tax rate of 1 per cent.

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Behavioural responses to a wealth tax

This paper studies how households respond to severe health shocks and the insurance role of spousal labor supply. In the empirical part of the paper, we provide new evidence on individuals' labor supply responses to spousal health and mortality shocks. Analyzing administrative data on over 500,000 Danish households in which a spouse dies, we find that survivors immediately increase their labor supply and that this effect is entirely driven by those who experience significant income losses due to the shock. Notably, widows – who experience large income losses when their husbands die – increase their labor force participation by more than 11%, while widowers – who are significantly more financially stable – decrease their labor supply. In contrast, studying over 70,000 households in which a spouse experiences a severe health shock but survives – for whom income losses are well-insured in our setting – we find no economically significant spousal labor supply responses, suggesting adequate insurance coverage for morbidity (vs. mortality) shocks. In the theoretical part of the paper, we develop a method for welfare analysis of social insurance using only spousal labor supply responses. In particular, we show that the labor supply responses of spouses fully identify the welfare gains from insuring households against health and mortality shocks. Our findings imply large welfare gains from transfers to survivors and identify efficient ways for targeting government transfers.Institutional subscribers to the NBER working paper series, and residents of developing countries may download this paper without additional charge at www.nber.org.

Household Responses to Severe Health Shocks and the Design of Social Insurance

This paper analyzes the inter-vivos transfers and bequest decisions of about 700,000 individuals during a period when the decision-maker receives negative news about future life expectancy. The event that produces the news is a negative health outcome. In line with models of dynastic utility maximization, increases in expected mortality increase the likelihood of transferring wealth to the next generation along both the intensive and the extensive margins. The size of the inter-vivos transfer and the bequest are positively related to the wealth of the parent and the severity of the diagnosis--irrespective of diagnosis-specific demand for informal care.

Intergenerational Altruism: Estimates Based on News About Expected Mortality

We examine the portfolio choices of 70,000 couples following a cancer diagnosis, including choices made in the event the diagnosed partner ends up dying. A matched sample of comparable couples is assembled using an approach that minimizes the likelihood that lifestyle factors differ between the treatment and control group. We find that a cancer diagnosis leads to lower financial risk-taking both in the form of participation in the stock market and a risky share of the financial portfolio. Widowhood decreases stock market participation by a factor of ten relative to non-fatal cancers. The effect depends on the relative importance of the deceased’s human capital. There is no link between prior experience with cancer and current portfolio choice.

Cancer and Portfolio Choice: Evidence from Norwegian Register Data

We construct a parsimonious set of equity factors by sorting stocks according to the sociodemographic characteristics of the individual investors who own them. The analysis uses administrative data on the stockholdings of Norwegian investors in 1997-2018. Consistent with financial theory, a mature-minus-young factor, a high wealth-minus-low wealth factor, and the market factor price stock returns. Our three factors span size, value, investment, profitability, and momentum, and perform well in out-of-sample bootstrap tests. The tilts of investor portfolios toward the new factors are driven by wealth, indebtedness, macroeconomic exposure, age, gender, education, and investment experience. Our results are consistent with hedging and sentiment jointly driving portfolio decisions and equity premia.

What Do the Portfolios of Individual Investors Reveal About the Cross-Section of Equity Returns?

This paper infers the importance of bequest motives using a unique panel of 45,000 households obtained from merging administrative data on individual cancer diagnoses with income, wealth, and family linkages. Identification comes from comparing the wealth trajectories of individuals diagnosed with cancer today to those of individuals diagnosed with cancer three years later. Estimates show that family structures are crucial for individual responses to mortality shocks. For couples, changes in life expectancy have no impact on consumption and saving choices. In contrast, widowed individuals respond to mortality shocks by decreasing their wealth by 30% to 50%. A major part of this decrease in wealth can be accounted for by an increase in their children’s wealth. Structural estimation indicates a bequest parameter equivalent to about 3 to 6 years of annual consumption expenditures of the decedent. Overall, the results provide empirical support for dynastic models of overlapping generations ( Barro, 1974; Becker and Tomes , 1979). JEL Classifications: D1, D14, D31, E21, I12 ∗I am indebted to the researchers at Oslo University Hospital for all their guidance and assistance on medical issues and to Espen Henriksen for constant support and long discussions during this project. I am grateful to my committee, Kjetil Storesletten, Pierre Collin-Dufresne, and Thore Johnsen for their comprehensive comments. Special thanks also go Samuli Knüpfer for valuable discussions and advice. I thank the participants at the 2017 EFA Annual Meeting, the CEPR Network Event on Household Finance 2016, the 2016 Annual Meeting of the Society for Economic Dynamics, the 2016 European Winter Meeting in the Econometric Society, the EFMA 2016 Annual Meeting, the Young Scholars Nordic Finance Workshop 2016, and seminars at the BI Norwegian Business School and Norwegian School of Economics (NHH). I have also benefited from the comments and discussions of Bernard Dumas, Trond Døskeland, Paul Ehling, Alessandro Graniero, Burton Hollifield, Markku Kaustia, Patrick Konermann, Alexander Michaelides (discussant), Søren Leth-Petersen, Lars Lochstoer, Magne Mogstad, Kasper Nielsen, Désirée-Jessica Pély (discussant), Elias Rantapuska (discussant) and Erik Sørensen. This paper was previously circulated under the title "What Can Shocks to Life Expectancy Reveal About Bequest Motives?" †Department of Finance, BI Norwegian Business School. Email: jens.s.kvarner@bi.no

How Large are Bequest Motives

We study the impact of loan-to-value regulation on supply and demand for unregulated debt that is used for home acquisition. In our setting, part of the dwelling price is in the form of pre-existing debt exempt from the regulation. Variations in the latter prior to the LTV regulation generated exogenous variation in the regulatory requirements across buildings. We find that households, especially constrained ones, start paying more for dwellings financed with more unregulated debt. Our estimates reveal a willingness to pay for alternative home financing of about 250 percent above the prevailing mortgage rate. In the longer run, the supply of unregulated debt increases by almost 50 percent. We corroborate our findings by aggregating evidence from 13 countries.

Jens Kvaerner

Papers

Intergenerational Altruism: Estimates Based on News About Expected Mortality

Cancer and Portfolio Choice: Evidence from Norwegian Register Data

What Do the Portfolios of Individual Investors Reveal About the Cross-Section of Equity Returns?

How Large are Bequest Motives

Inefficient Regulation: Mortgages versus Total Credit