Showing papers in "European Journal of Ageing in 2005"

European patterns of intergenerational financial and time transfers

Abstract: The ageing of the European population is expected to strongly influence both the structure of family relations and the pattern of private transfers between generations. Using data from the Survey of Health, Ageing and Retirement in Europe conducted from the perspective of adults aged 50 and above in ten European countries, we provide an analysis of financial and time transfers, either given or received. Our results show that cash gifts mainly flow to the younger generations, while time transfers are directed both upwards and downwards. When comparing the countries, we find some remarkable similarity in the pattern of transfers, although there are inter-country differences. These differences sometimes follow the expected north-south European gradient, but not always. The results suggest that the social and demographic transformations currently taking place in Europe often have contradictory and paradoxical effects upon the nature of intergenerational exchanges.

A new comprehensive and international view on ageing: introducing the 'Survey of Health, Ageing and Retirement in Europe'.

Abstract: This paper introduces the ‘Survey of Health, Ageing and Retirement in Europe’ (SHARE) to researchers on ageing. SHARE provides an infrastructure to help researchers better understand the individual and population ageing process: where we are, where we are heading to, and how we can influence the quality of life as we age, both as individuals and as societies. The baseline wave in 2004 provides data on the life circumstances of some 27,000 persons aged 50 and over in 11 European countries, ranging from Scandinavia across Western and Central Europe to the Mediterranean. SHARE has made great efforts to deliver truly comparable data, so we can reliably study how differences in cultures, living conditions and policy approaches shape the life of Europeans just before and after retirement. The paper first describes the SHARE data. In order to demonstrate its value, it then presents highlights from the three main research areas covered by SHARE, namely economics, sociology, and health.

Social exclusion of older people in deprived urban communities of England

Abstract: Addressing the causes and consequences of social exclusion represents a key theme in European social policy, reflecting growing awareness of the social costs which arise when individuals, families and communities become cut off from wider society Conceptually, however, social exclusion remains underexplored in gerontology The article suggests that exclusion represents a useful means of exploring the situation of older people in different environmental settings Social exclusion in old age is conceptualised as a multi-dimensional phenomenon comprising of: exclusion from material resources; exclusion from social relations; exclusion from civic activities; exclusion from basic services; and neighbourhood exclusion Drawing on a survey of 600 people aged 60 and over in deprived neighbourhoods of three English cities, the article develops indicators to represent each dimension of exclusion and seeks to assess the nature of social exclusion faced by older people in deprived neighbourhoods Results reveal a considerable proportion of older people experiencing social exclusion in at least one form The sample fell into three categories: 33% were not excluded on any of the five domains; 31% experienced exclusion on a single domain; 36% were vulnerable to the cumulative impact of multiple forms of exclusion Multiple social exclusion was significantly correlated with respondents’ ethnic origin, educational status, housing tenure, perceived health status and quality of life It is concluded that social exclusion represents a useful means of depicting disadvantage experienced by older people living in deprived urban neighbourhoods, and that it would be useful to extend the analysis to other types of residential setting

Intergenerational solidarity and the family–welfare state balance

Abstract: The article addresses the strength and character of intergenerational family solidarity under different family cultures and welfare state regimes in order to answer the following two questions: (1) Is intergenerational solidarity stronger under the more collectivist southern family tradition than under the more individualist northern tradition? (2) Is more generous access to social care services a risk or a resource for family care? These questions are explored with data from the OASIS project, a comparative study among the urban populations aged 25+ (n=6,106) in Norway, England, Germany, Spain, and Israel. The findings indicate that the welfare state has not crowded out the family in elder care, but has rather helped the generations establish more independent relationships. Intergenerational solidarity is substantial in both the northern and southern welfare state regimes, and seems to vary in character more than in strength.

Social engagement and health outcomes among older people: introduction to a special section.

Abstract: Active social engagement has been shown to be associated with better health and health outcomes across a number of studies (Berkman and Syme 1979; House et al. 1982; Kaplan et al. 1988; Bygren et al. 1996; Glass et al. 1999; Bassuk et al. 1999; Wang et al. 2002; Mendes de Leon et al. 2003). However, the research studies over the last few decades have used different definitions and measures of social engagement, and the terminology used to define and measure social engagement has not been wholly consistent (Andersson 1998; Bennett 2002). Some studies on social engagement have considered social participation (Bygren et al. 1996; Glass et al. 1999), i.e. the involvement in actual activities which have a social element, other studies have examined social networks, i.e. the number of contacts with friends and relatives and membership of groups and organisations (Bowling and Browne 1991; Seeman et al. 1996; Unger et al. 1999), and yet others have focused on social support, i.e. the level of instrumental and emotional help available to an individual (e.g. Everard et al. 2000). Although the distinction between these different types of social engagement is apparent in the literature, there are clear overlaps between these types of social engagement across studies (e.g. Everard et al. 2000). For example, while attending church services is an activity which often has a social element, it can also stimulate contact with close friends. The overlap is also reflected in studies which have examined two or more of these types of engagement in combination—for example, Mendes de Leon et al. (2003) examined the effects of both participation in social activity and social networks on disability. In this special section on social engagement in older people, the studies focus on social participation, and in this Introduction we review research which has examined the relationship between this aspect of social engagement and health. While this review includes studies which have examined social participation and the other types of social engagement, it excludes those studies focusing only on social networks and/or social support, without reference to actual participation in social activities. The research to date has considered social engagement in relation to an increasingly varied series of health outcome measures, including mortality (Berkman and Syme 1979; House et al. 1982; Kaplan et al. 1988; Bygren et al. 1996; Glass et al. 1999), disability (Mendes de Leon et al. 2003), cognitive functioning (Aartsen et al. 2002), cognitive decline (Bassuk et al. 1999) and the risk of dementia (Fratiglioni et al. 2000; Wang et al. 2002). This special section reports new research concerning the relationship between social participation and physical health. Likewise, in this review we concentrate on research which has examined the impact of social participation on physical health outcomes.

A European perspective on quality of life in old age

Abstract: This article focuses on the scientific study of quality of life in old age and summarises, on the one hand, what we know and, on the other, what further research is needed It consists of three main parts, with an extended introduction charting the recent evolution of a European perspective on ageing First of all, it emphasises the amorphous, multidimensional and complex nature of quality of life and the high level of inconsistency between scientists in their approach to this subject Secondly, the article summarises the main areas of consensus about quality of life in old age—its dynamic multifaceted nature, the combination of life course and immediate influences, the similarities and differences in the factors determining quality of life between younger and older people, the most common associations with quality of life and the likely variations between groups, and the powerful role of subjective self-assessment Thirdly, the main research priorities and gaps in knowledge are outlined, together with the key methodological issues which must be tackled if comparative, interdisciplinary research on quality of life is to develop further The main sources for the article are two European Framework Programme projects—the one a small five-country comparison and the other a large multidimensional project which, among other things, has been developing recommendations for research on quality of life in old age and included an extensive literature review on this topic The article also draws on the recently completed UK Growing Older Programme of research on extending quality of life

Social participation and survival at older ages: is the effect driven by activity content or context?

Abstract: This study tested the hypothesis that time spent on social activities (i.e., in direct interaction with others) and time spent in social contexts (i.e., while others are present) is associated with survival in persons aged 70 and older. An observational study with mortality follow-ups was carried out in the former West Berlin, Germany (Berlin Aging Study). The sample was stratified by age and sex, and consisted of 473 persons aged 70 to 103 years. Social activity and social context measures were assessed in 1990–1993 by structured interviews in the participants’ homes. Cox regression was used to model survival from time of interview. The main outcome measure was survival on 1 August 2003. Time spent on social activities was revealed as a predictor of survival only in analyses that did not control for confounding factors. In contrast, time spent in context “with friends” was significantly related to increased survival (relative risk=0.76, 95% confidence interval 0.59 to 0.99) even after several confounding factors were controlled for. This study suggests that time spent with friends affords a survival advantage among older adults, above and beyond the effects of other leisure activities. Future research on social participation and survival may benefit from an examination of the interaction between activity content and social context.

How to understand and improve older people’s self-management of wellbeing

Abstract: This paper addresses the question of how older people can be supported to actively self-manage their own process of ageing such that overall wellbeing is achieved and maintained for as long as possible. Starting from a resource-based approach, a new theory of self-management of wellbeing (SMW theory) is proposed, and it is shown how it can be used as a basis for the design of self-management interventions for ageing successfully. The main aspects of the theory, i.e. six key self-management abilities and the core dimensions of wellbeing, are presented as well as the theory-based 'blueprint' for the design of interventions. Empirical results of two intervention studies are briefly presented and show that the SMW theory may be a useful tool for the design and evaluation of interventions for successful ageing.

Self-rated health among older adults: a cross-national comparison

Abstract: Self-rated health (SRH) may have different implications in various social and cultural settings. However, few studies are available concerning SRH among older persons across countries. The aim of this study was to analyse whether there are cross-national differences in the association between status characteristics, several diseases common among older persons, activities of daily living (ADL), and SRH. The study base was the Comparison of Longitudinal European Studies on Aging (CLESA), which includes data from six population-based studies on aging conducted in Finland, Israel, Italy, The Netherlands, Spain and Sweden. The study population comprised 5,629 persons, with participants from all countries except Italy. Logistic regression analyses were used to assess the relationship between status characteristics, health conditions, ADL and SRH. To examine whether the association among status characteristics, health conditions, ADL and outcome differed across the CLESA countries, interaction terms defined as "variable*country" were considered separately for each variable. Regression analyses revealed that sex, education, lifetime occupation, heart disease and respiratory disease were differently distributed across countries. Among homogeneous factors, marital status (OR=1.21), hypertension (OR=1.41), stroke (OR=1.67), diabetes (OR=2.15), cancer (OR=1.47), musculoskeletal diseases (OR=2.44), and ADL (OR=2.72) turned out to be significantly associated with fair or poor SRH. The results indicate that there are differences in self-ratings of health across countries. These differences cannot be explained entirely by status characteristics, self-reported diseases or functional ability. However, an important finding was that in all countries most of the indicators of medical and functional health were homogeneously associated with SRH.

Who retires early and why? Determinants of early retirement pension among Danish employees 57–62 years

Abstract: The aim of this study was to identify demographic characteristics and occupational determinants of transition from employment to voluntary early retirement pension (ERP). A questionnaire-based survey among 365 employees in Denmark 57–62 years was performed in 2000, with a register-based follow-up 4 years later. Early retirement was associated with increasing age, and lower socioeconomic position. There were weak associations between gender and ERP. Low skill discretion, high conflict in work and two measures of uncomfortable work positions significantly increased the risk of ERP. The study shows that more than half of the eligible population makes use of voluntary ERP, and further indicates a potential for reducing the amount of older employees utilizing this labour market exit option through reducing certain physical and psychosocial exposures in the work environment, independent of age, gender, and socioeconomic position.

Ageing and person–environment fit in different urban neighbourhoods

Abstract: Based on the “complementary-congruence model” of person–environment fit, this study focuses on housing in old age as an interaction between housing needs and housing conditions in urban settings. The research aims are (1) to establish a set of housing-related person–environment (p–e) fit indices based on the relationship between environmental needs and existing conditions in different physical and social domains, and to describe housing among elders aged 51–80 years and in different urban districts with these indices; the study distinguishes between basic, higher-order and social needs relating to housing; (2) to explain outdoor place attachment as an indicator for quality of life in different urban districts with a set of predictors including these person–environment fit indices. Data were drawn from telephone-based interviews with 365 older adults (51–80 years) who were questioned about individual housing needs and housing conditions. Results revealed higher p–e fit scores in the domains of higher-order and social housing needs and conditions in the districts which were considered to be more pleasant but had poor access to the city and to public transportation. By contrast, age was more important in explaining differences in the domain of basic housing needs and conditions with higher p–e fit scores among older participants. In explaining outdoor place attachment, the fit between basic and social housing needs and conditions was important, but the higher-order fit did not play a role.

Social Engagement as a Longitudinal Predictor of Objective and Subjective Health

Abstract: The study aimed to investigate whether social engagement predicted longitudinally objective and subjective physical health. Measures of social engagement, subjective and objective health were taken at three points in time, 4 years apart (T1, T2, T3). Three questions were examined: does social engagement at T1 predict objective/subjective health at T2, does social engagement at T2 predict objective/subjective health at T3, and does social engagement at T1 predict objective/subjective health at T3? Participants were 359 adults aged 65 and over. A fully cross-lagged structural equation model was examined. Social engagement at T1 was found to significantly predict subjective health at T2. However, social engagement at T1 did not significantly predict subjective health at T3, nor was subjective health at T3 predicted by social engagement at T2. Social engagement never significantly predicted objective health. Unexpectedly, objective health at T2 predicted social engagement at T3. Finally, post-hoc analyses suggest that age has a greater influence on social engagement at T2 than at T1. Social engagement is a useful predictor of subjective physical health. However, objective health was not predicted by social engagement—indeed, the converse was the case. It is suggested that the relationship between social engagement and subjective health is mediated by psychosocial factors which may not be present in the social engagement–objective health relationship. In conclusion, the results reflect the complex interplay of objective and subjective health and social engagement as people age.

Grandparents use of new communication technologies in a European perspective.

Abstract: This study examined the pattern of use of different forms of contact between grandparents and grandchildren, and especially the use of new technologies (SMS, e-mail) and factors affecting this. Questionnaire data are reported from 408 grandparents in the UK, Spain, Finland and Estonia, regarding contacts with grandchildren mostly in the 10–15-year age range. Face-to-face contact remained the most frequent mean, followed closely by landline telephone; there was moderate use of mobile phones, and many used letters/cards occasionally; and a minority used SMS and e-mails (about one-half to one-third of those with mobile phones, and networked computers, respectively). When contacting grandchildren, most grandparents accumulate different forms of contact, but others compensate some forms of contact. There were no differences by age of grandparent, but grandmothers made more use of e-mail than grandfathers, as did more highly educated grandparents and those with older grandchildren. Implications for use of Information and Communication Technology by older people are discussed.

Rural and urban perspectives on growing old: developing a new research agenda.

Abstract: Urban and rural themes have played an important part in European gerontological research. This paper analyses current issues in the field of urban and rural studies as applied to understanding old age. Both dimensions are being affected by population movements of different kinds, driven to a significant degree by globalisation in its various forms. The paper summarises trends underpinning rural and urban living and evidence regarding the impact of change in these areas on daily life in old age. The article considers a number of research agendas which would advance rural and urban studies of ageing, these combining developments in geography and urban studies with those in critical gerontology. The paper argues that a revitalised rural and urban gerontology will bring forward major new themes and issues for social gerontology in the 21st century.

Cohort- and age-related decline in elder's life satisfaction: is there really a paradox?

Abstract: Absence of age-related decline in elder's life satisfaction (LS), found in several studies from the last quarter of the twentieth century, has been labelled a "paradox", as it contrasts with increasing psycho-social and health risks in old age. To explain these findings, the present study was based on the hypothesis of a cohort effect on the LS of those born in the first half of the twentieth century, which might have overlayed and thus obscured the age-related decline in cross-sectional studies. In addition, it was hypothesized that the age-related decline in LS accelerates over the old age period such that the "paradox" would not hold for old-old subjects. Longitudinal analysis was conducted by means of multilevel mixed models, using data from the German Socio-Economic Panel. Analyzing single-item measures of LS from 16 panel waves (1984-1999), the findings confirm both hypotheses. For the young-old, cohort- and age-related decline was found with about equal decrements in LS per year of birth or age, neutralizing age-group differences in cross-sectional comparisons. For the old-old, the age-related decline appeared accelerated, outnumbering the cohort effect.

Disability and social ties: comparative findings of the CLESA study

Abstract: The associations between prevalence, incidence and recovery from activities of daily living (ADL) disability and social ties among community-dwelling persons over 65 in Finland, The Netherlands and Spain are examined. Data were harmonized in the CLESA study. The baseline sample was composed of 3,648 subjects between 65 and 85 years old, living in Finland, The Netherlands and Spain. Disability in four activities of daily living was determined at baseline and at follow-up. Social participation, number of family ties and presence of friends were added to obtain a social ties index. Logistic regressions were fitted to the prevalence, incidence and recovery data to estimate the associations between disability and social ties, adjusting for education, co-morbidity and self-rated health. The modifying effects of country, age and sex were tested in all models. For every country, the social ties index, having friends and social participation were negatively associated with ADL disability prevalence. ADL incidence was negatively related to the number of family ties, with a stronger relationship in Spain than in The Netherlands or Finland. ADL recovery was associated with the social ties index. No age or gender differences in these associations were found. Social ties appear to generate a beneficial effect on the maintenance and restoration of ADL function. While social ties play an important role in maintaining and restoring function in all three countries, family ties appear to generate a stronger effect on protection from disability incidence than does social participation, and the strength of this effect varies by culture.

Predictors of cognitive complaints in older adults: a mixture regression approach

Abstract: The present paper examined four hypotheses regarding the nature of cognitive complaints in older adults. Analyzing data from 607 participants (mean age=62.9 years, SD=0.92 years, 59–65 years), we tested the influence of actual cognitive test performance, negative age stereotypes, depressive symptoms, neuroticism, and conscientiousness on cognitive complaints. Bivariate correlations confirmed relations of all hypothesized predictors with cognitive complaints. However, considering all predictors simultaneously in an OLS regression analysis, particularly depressive symptoms and neuroticism were revealed as accounting for large proportions of variance in cognitive complaints. Utilizing mixture regression analyses, evidence for distinct subgroups was obtained in which cognitive complaints were explained by different predictor patterns.

The relationship between rural community type and attachment to place for older people living in North Wales, UK

Abstract: This paper explores the relationship between rural community type and attachment to place for 387 older people aged 70 and over. Six rural settlements in North Wales are characterised according to certain statistics (e.g. age structure, in-migration, strength of local culture, and multiple deprivation) to provide distinct community profiles. It is hypothesised that community type is characterised by particular types of attachment, which are dependent on life course trajectories and changes or stability in the environment. Using a sevenfold classification of attachment to place, the paper tests seven hypotheses. The results support four of the seven hypotheses. Older people living in a retirement destination are more likely to report aesthetic qualities and the appropriateness of the environment. People living in native areas with a strong culture and local language are more likely to note the importance of historical attachment and social integration into the community. Three hypotheses are rejected: older people living in a retirement destination are not less likely to report social support, or a historical perspective in attachment to place, and older people living in areas with high levels of multiple deprivation are not more likely to encounter relocation restraints than are others. Overall, the findings suggest that the taxonomy of attachment to place provides a flexible framework for differentiation by community. The paper concludes that communities are not merely settings—they play a significant role in self-identity and are a vital source of emotional and experiential meaning for the inhabitant.

Discrepancies between personal income and neighbourhood status: effects on physical and mental health

Abstract: During their life course, older persons' income level may become discrepant with the socio-economic status of their neighbourhood. This study examines whether and how such discrepancies affect older persons' physical and mental health. Using baseline data from the Longitudinal Aging Study Amsterdam, 2,540 non-institutionalised persons aged 55-85 years were classified based on self-reported income and neighbourhood status. Two categories defined discrepancies: discrepant-low (DL, low income in high-status neighbourhood), and discrepant-high (DH, high income in low-status neighbourhood). Both categories were compared with the same reference category: matched-high (MH, high personal and high neighbourhood income status). A range of health indicators were examined, as well as mediating effects of neighbourhood and individual characteristics. Among the 504 persons who reported a high income, 16% lived in a low-status neighbourhood (DH). Conversely, among the 757 persons living in a high-status neighbourhood, 24% had a low income (DL). The DL category mainly lived in rural areas, and the DH category predominantly in large cities. The data show discrepant income effects (DL vs. MH) on physical and cognitive ability, self-rated health, and loneliness, and discrepant neighbourhood effects (DH vs. MH) on physical and cognitive ability, depressive symptoms, and loneliness. Personal income effects were partly mediated by other personal characteristics, and neighbourhood effects were fully mediated by socio-economic neighbourhood characteristics as well as by older persons' perceptions of their neighbourhood and their income. It is concluded that discrepancies between personal income and neighbourhood status, accrued throughout the life course, are associated with poor health.

Social capital, health, and care home residence among older adults: a secondary analysis of the Health Survey for England 2000.

Abstract: This secondary analysis of the Health Survey for England 2000 aimed to investigate whether individual-level social capital is associated with care home residence and with function, mental health, and self-assessed health in older adults. Older adults in both care home and community residential settings were included. Two indicators of social capital, perceived social support and group participation, were considered for both care home and community-dwelling respondents. Amongst community dwellers, trust in others was considered as a third indicator. Functional impairment, psychiatric morbidity, and self-assessed health were used as indicators of health. Multivariable modelling was undertaken using logistic or ordinal logistic regression. The results show that severe lack of social support was associated with over twice the odds of care home residence, with increased odds of psychiatric morbidity in both care home and community settings, and with more severe functional impairment and worse self-assessed health in the community but not in care homes. Participation in more groups was associated with lower odds of functional impairment in both settings, and with lower odds of psychiatric morbidity and better self-assessed health among community but not among care home respondents. High levels of trust were associated with lower severity of functional impairment, reduced odds of psychiatric morbidity, and better self-assessed health. It is concluded that individual-level social capital was associated with care home residence and with indicators of physical, mental and self-assessed health. These associations differed between community and care home settings, and were generally stronger in the community.

The effect of frailty on residential/nursing home admission in the Netherlands independent of chronic diseases and functional limitations.

Abstract: The aim of this study was to determine the effect of frailty on the risk of residential/nursing home admission independently of chronic diseases and functional limitations. Frailty consists of multisystem decline and is considered to be a consequence of changes in neuromuscular, endocrine and immune system functioning that occur as people age. Frailty is a combination of multiple impairments in functioning that might lead to functional limitations and disability but it is not clear whether frailty has an independent effect on residential/nursing home admission. Data were used from the Longitudinal Aging Study Amsterdam. The respondents participated at both T 1 (1992/1993) and T 2 (1995/1996), lived independently at T 2, and were aged 65 and over (n=1,503). Nine frailty markers were assessed at two cycles (T 1 and T 2). The frailty markers were defined in two ways: low functioning at T 2 (static frailty); and change in functioning between T 1 and T 2 (dynamic frailty). The outcome variable was residential/nursing home admission between T 2 and T 4 (2001/2002). Cox proportional hazard analyses were used adjusting for chronic diseases, functional limitations, care received, partner status, income, age and sex. Static (RR 1.93, 95%CI 1.36–2.74) and dynamic frailty (RR 1.69, 95%CI 1.19–2.39) were associated with institutionalization in both men and women independently of the effect of chronic diseases and functional limitations. Additional analyses of the total number of both sets of frailty markers present revealed an increased risk of institutionalization when the number increased. In conclusion, frailty is associated with institutionalization, independently of the effect of chronic diseases and functional limitations.

Social engagement and health and social care use and medication use among older people

Abstract: Social engagement has been associated with improved health outcomes in older people, although the precise mechanisms by which this is mediated are not clear. The aim of this study was to examine the relationship between social engagement and health and social care use and medication use in older people. Data were derived from the 1985, 1989 and 1993 waves of the Nottingham Longitudinal Study of Activity and Ageing, a nationally representative sample of people aged 65 and over. Logistic regression models were used to determine whether social engagement predicted cross-sectional and longitudinal health and social care use and medication use. People with higher social engagement were significantly less likely to have seen their family doctor, the district nurse or home help services, and to be taking two or more medications cross-sectionally. This relationship was independent of demographic factors, physical and mental health and physical activity for contact with the district nurse or home help services. Higher social engagement was associated with reduced contact with home help services after 4 years, independent of demographic factors, physical and mental health, and with reduced medication use after 4 years in unadjusted models. Higher social engagement was associated with increased contact with home help services after 8 years, when controlling for demographic factors, physical and mental health and physical activity. Higher social engagement may help to reduce cross-sectional health and social care service and medication use but further research is required to understand the benefits of social engagement and medium- and long-term service/medication use.

Aging parents and their middle-aged children: demographic and psychosocial challenges

Abstract: The aim of this paper is to investigate the impact of an extended lifespan of parents on middle-aged women and men from a demographic, sociological and psychological perspective. Based on Swiss data, three main research questions are investigated and discussed in three different sections: (a) How far has the common lifespan of children and parents been extended and how does it affect kinship structures? (b) How accurate is the term of “sandwich generation” in this context? (c) Which are the psychological concomitants—in terms of filial maturity—of being reinvolved with one’s old parents in mid-life? The demographic analyses illustrate a considerable extension of common lifespan of children and parents. Combined with low fertility rates this results in rapidly increasing parent-support ratios. A sociological approach analysing the concept of “sandwich generation” indicates that, for women, a new kind of double burden (professional work and family care) is more widespread than being ‘sandwiched’ between the youngest and the oldest generation. Finally, in the third section, results are reported from a longitudinal study of middle-aged persons living in different social contexts (such as living or not living with a partner and/or children) on the intrapsychic concomitants of becoming reinvolved with one’s parents. The response patterns reveal a considerable intergenerational ambivalence. Although the possibility to help old parents depends heavily on living context and is a question of available resources, the willingness to help is also closely related to psychological variables such as attachment.

The relation between attachment and intergenerational support.

Abstract: This study investigated the relation between the internal representation of attachment and the perception of the actual exchange of intergenerational support within 100 dyads of adult daughters and their elderly mothers in Germany. Results showed relations between the daughters’ preoccupation and avoidance with their perception of receiving emotional support from their parents and providing instrumental support to them. No relations were found between the mothers’ attachment and the support they provided to the daughters. These results are discussed with respect to different conditions for emotional and instrumental support of adult daughters and their elderly mothers, and a relationship specific approach to attachment.

Disability-free life expectancy of older French people: gender and education differentials from the PAQUID cohort.

Abstract: In countries with low mortality rates, the quality of the years of life is more important to consider than total life expectancy (TLE). Disability-free life expectancy (DFLE) is one of the most relevant indicators of health and the quality of life. This paper aims to estimate TLE and DFLE with four levels of severity of disability and to explore gender and educational differences in older French people. In this cohort study, four levels of disability severity were distinguished, disability being evaluated for mobility, instrumental and basic activities of daily living. For each level, TLE and DFLE were calculated using multi-state models from transition probabilities. From the population of two areas of South West France 3,777 subjects were randomly selected from the electoral rolls. At the baseline, they were aged 65 years and over, living in the community and were interviewed 6 times over the 10-year follow-up. At age 65, women lived longer than men (4.5 extra years), but shorter fully independent lives (−2.2 years). They also lived longer in each of the three degrees of disability (+4.2 years with moderate or severe disability). The higher educated lived longer (1.3 extra years at age 65), with the additional years free of disability. Regardless of age, gender and education, there appeared to be a 1-year incompressible time spent with severe disability. To conclude, these are the first health expectancies based on the longitudinal data for France. Whilst most of the studies were based on cross-sectional data, this paper gives a more realistic indicator of the health and socio-economic inequalities in France in the 1990 s.

Future demand for formal long-term care in Sweden.

Abstract: Ageing population will have a significant effect on demand for human resources in health care and social care for the older people. Here we are presenting, using different scenarios, how projected demographic development may influence the demand for formal long-term care (LTC) for the people older than 65 years in Sweden 2000–2030. Our method uses information on utilisation of current services per gender and age group, demographic projections of number of older people per gender and age group and assumptions on health status changes per gender and age group. Our assumptions on health status changes were based on estimates from Swedish National Survey of Living Conditions, covering 32,502 observations during the period 1975–1999. The assumption that trends in severe ill-health in Sweden between 1975 and 1999 will continue (meaning expected improvements in age/gender-specific health and functional ability among the older people) results in the projected increase in the demand by year 2030 being almost halved, compared with an estimate that is based on unchanged age/gender-specific health and functional ability. The assessment of future demand for LTC for the people older than 65 years should involve extrapolations based on expected changes in health status, as well as the question how decreasing mortality incorporated into population forecasts is to be associated with future trends on severe morbidity/disability.

Ageing in rural areas of East and West Germany: increasing similarities and remaining differences

Abstract: Since unification in 1990, living conditions in Germany’s “New Lander” have slowly converged to the conditions in the “Old Lander”. One can assume, however, that West–East differences persist more strongly in remote rural areas neglected by economic development. Therefore, this paper aims to investigate and compare the living conditions of older adults in rural areas in East and West Germany with respect to personal and environmental resources which are important preconditions for autonomy and well-being in old age. These conditions were examined in a survey conducted in urban and rural regions of five European countries in 2000. The German rural study was carried out in the districts of Jerichow (Saxony-Anhalt) and Vogelsberg (Hesse), and included 762 men and women aged 55 years or older, randomly chosen in villages of at most 5,000 inhabitants. East–West comparison showed both similarities and differences. Similarities arose in human conditions such as subjective health, parenthood and network variety, and in environmental conditions such as home-ownership, attachment to one’s home, length of residence in the same neighbourhood, and satisfaction with mobility options. Differences were found in socio-demographic conditions (e.g. education, income, household composition), basic neighbourhood features, and patterns of social and leisure activities. Regression analysis showed the differing impact of single predictor variables on life satisfaction in the East and West: satisfaction with financial situation and functional health contributes far more to older people’s life satisfaction in the West German rural area, whereas mobility-related aspects affect elders’ life satisfaction more strongly in the East German countryside. The findings reflect, on the one hand, continuing structural East–West differences and, on the other, diverging socio-cultural habits.