Aim: High blood pressure (BP) is a key contributor to the burden of disease. This study aimed to assess: a) educational differences across the entire BP distribution, and b) educational differences in the trajectories of BP across the adult life course. Method: Longitudinal data from the Stockholm Diabetes Prevention Program was analysed using quantile regression and linear mixed effects models. Models were adjusted for age, sex, lifestyle, and BP medication. Results: Lower educational level was associated with higher systolic BP (SBP) at all follow-up periods. Age and sex adjusted mean SBP was 2.49 (95% confidence interval (CI) 1.10, 3.87), 3.95 (95% CI 2.45, 5.45) and 2.61 (95% CI 1.09, 4.13) mmHg higher for people with pre-secondary education compared with post-secondary at baseline, 10 years and 20 years follow-up, respectively. Quantile regressions revealed that the inequalities could be observed across the entire BP continuum. Longitudinally analysed, people with pre-secondary education had 3.01 (95% CI 1.91–4.11) mmHg higher SBP than those with post-secondary education, age and sex adjusted. No significant convergence or divergence of the educational gaps in SBP was observed. Educational differences remained even after adjusting for lifestyle and BP medication. Conclusions: These results imply that public health interventions should aim to bring about distributional shifts in blood pressure, rather than exclusively focusing on hypertensive people, if they are to effectively minimize the educational disparities in blood pressure and its consequences.

Background  Individuals receiving geriatric care are often frail and afflicted with multiple chronic conditions demanding care from several medical disciplines, and from several different care providing units across the health systems.

Objective  To explore the six-month service utilization and direct costs attributed to individuals receiving geriatric inpatient care.

Methods  Health care utilization– in terms of inpatient care, outpatient visits with different health care professions– and social care utilization– in terms of social services, and stay at residential care facility (RCF)– were quantified based on registry data, for a cohort admitted to geriatric inpatient care in Stockholm, Sweden during 2016.

Results  On average, individuals admitted to geriatric inpatient care in Stockholm had 12.8 inpatient care days, 32.1 visits in outpatient care, 432 h of home care and 28.8 days of staying at RCF, during the first six months after discharge. This amounted to an average cost of 722 thousand Swedish kronor (SEK), € 64 900, in 2023 monetary value. Costs were on average 37% attributable to inpatient care including the initial inpatient stay, 12% to outpatient visits, 38% to social services at home, and 13% to stay at residential care facility (whereof 11% short-term, 89% long-term). Total costs differed significantly between groups based on function, age and main diagnosis.

Conclusion  Costs of care for individuals treated at geriatric department are substantial. The variation of cost is also significant; higher age and lower function were associated with higher health care and social care costs. Major cost buckets were inpatient health care (region-financed) and social care at home (municipality-financed).

Objective: This study describes how subjective frequency of contact with friends changes over the lifespan, whether it has increased across cohorts, and if later-born cohorts maintain this contact into older ages.

Methods: Cross-sectional data from individuals aged 15–97 collected between 1968 and 2021 were used to create an age pattern, analyse changes within age groups, and compare self-reported age trajectories of frequent contact with friends across birth cohorts.

Results: Reported frequency of contact with friends follows a clear age pattern: decreasing from young adulthood, plateauing in midlife, and decreasing again in older age. Later-born cohorts are more likely to report frequent contact with friends, but this difference converges in older age. There is no strong evidence that later-born cohorts maintain frequent contact with friends into old age, though upcoming cohorts may show changes in this trend.

Discussion: As life expectancy and overall health in older age improve, understanding the role of contact with friends in supporting well-being becomes increasingly important. The convergence of the frequency of contact with friends across cohorts in older age could lead to unmet expectations of social contact in upcoming cohorts. Therefore, continued research and proactive measures to support social interactions throughout the ageing process could enhance social connectedness in ageing populations.

Loneliness has consistently been found to be associated with an increased probability of depressive symptoms among older adults. Yet, the relationship is complex, and it remains unclear whether loneliness is a cause of depressive symptomatology. The aim of this study is to investigate the possible causal effect of loneliness on subsequent depressive symptoms among older adults (65+) in Europe. We analyzed two waves of observational data (2015–2017) from the Study of Health, Aging, and Retirement in Europe (SHARE) (n = 6808) and attempted to identify a causal effect of loneliness on depressive symptomatology by accounting for confounding by potential unmeasured factors using an endogenous treatment-effect model. The results showed a substantial positive association between loneliness in 2015 and depressive symptoms in 2017 in the sample. However, there was no support for the hypothesis that loneliness in 2015 was a cause of depressive symptoms in 2017. Additionally, there was no evidence of unmeasured factors confounding the relationship. Thus, loneliness may not be a cause of depressive symptoms among older adults in the short term. These findings suggest that there might be other reasons why lonely individuals are at an increased risk of depressive symptoms. Therefore, a shift in focus when aiming to reduce depressive symptoms among lonely older adults may be warranted.

Purpose: Hip fractures significantly impact health-related quality of life (HRQoL) in older adults. This study aimed to investigate and quantify changes in different domains of HRQoL following a hip fracture and to identify factors associated with maintaining HRQoL (resilience). Methods: The study included a cohort of 2,529 individuals aged 65 + who experienced their first hip fracture between 2016 and 2020. HRQoL was assessed using the EQ5D-5L tool both prior to and 4 months after the fracture. Resilience was defined as maintaining or improving pre-fracture EQ5D levels at follow-up. Associations between sociodemographic characteristics, acute conditions, medical factors, and resilience in specific EQ5D domains—Mobility, Usual Activities, Self-Care, Pain/Discomfort, and Anxiety/Depression—were analyzed using regression models. Results: Sixty-nine percent were women and the mean age was 82.6 years. A decline was observed across all EQ5D domains and in the global EQ5D index following a hip fracture. The proportion of patients exhibiting resilience varied by domain, ranging from 36 to 77%, with Mobility being the most adversely affected and Anxiety/Depression the least affected. Factors associated with resilience differed by domain. Mobility, Usual Activities, and Self-Care followed a similar pattern, while Pain/Discomfort and Anxiety/Depression showed distinct patterns. Notably, the absence of fall-risk-increasing medications was the only factor consistently associated with resilience across all domains. Conclusions: While hip fractures generally lead to declines in HRQoL, a significant proportion of patients demonstrate resilience within 4 months post-fracture. Patterns of resilience vary across EQ5D domains, with physical functions being most impacted and mental health the least.

Background  The objective of this study is to estimate the prevalence of self-reported hearing difficulties, vision difficulties and combined vision and hearing difficulties in a Swedish adult population that varies according to migration status, sex, age, disability measured by ADL and IADL and educational attainment level.

Methods  The study utilised data from the Survey of Health, Ageing and Retirement in Europe, which consisted of 2257 individuals aged 60 and above that were interviewed in Sweden in the 2019/2020, SHARE wave 8. To determine the prevalence of sensory difficulties (hearing, vision and dual-sensory difficulties) among various subgroups of the population, a multinomial logistic regression was used. The results of these analyses are presented in terms of predicted probabilities.

Results  The study findings indicate that foreign-born older adults experience a lower prevalence of visual difficulties (6.2% [3.3–11.5] in comparison to their Swedish-born counterparts. Moreover, older adults with higher levels of education tend to report a lower prevalence of sensory difficulties overall. Furthermore, sex differences are apparent, with males reporting a higher prevalence of hearing difficulties (18.9% [15.5–22.8] vs. 12.8% [10.7–15.3]) and females reporting a higher prevalence of vision difficulties (12.7% [10.7–15.1] vs. 8.5%[6.8–10.5]).

Conclusion  The findings highlight disparities in the prevalence and type of perceived sensory difficulties experienced by older adults, by factors such as age, sex, education and migration status. It is important to consider these demographic factors in healthcare planning and interventions aimed at mitigating sensory difficulties in the older population.

Aims: To explore the relationships between adult offspring’s socioeconomic resources and the development of stroke and survival after stroke among older adults in Denmark and Sweden.

Methods: The study included 1,464,740 Swedes and 835,488 Danes who had turned 65 years old between 2000 and 2015. Multivariable Cox proportional hazard regression models were used to analyse incident stroke and survival after stroke until 2020.

Results: Lower level of offspring’s education, occupation and income were associated with higher hazards of stroke among both men and women in Sweden and Denmark. Associations with offspring’s education, occupation and income were most consistent for death after the acute phase and for educational level. From one to five years after stroke and compared with a high educational level of offspring, low and medium educational level were associated with 1.34 (95% confidence interval (CI): 1.11; 1.62) and 1.18 (95% CI: 1.10; 1.27) as well as 1.26 (95% CI: 1.06; 1.48) and 1.14 (1.07; 1.21) times higher hazard of death in Swedish women and men, respectively. The corresponding estimates in the Danish population were 1.36 (1.20; 1.53) and 1.10 (1.01; 1.20) for women and 1.23 (95% CI: 1.11; 1.32) and 1.13 (95% CI: 1.05; 1.21) for men.

Conclusions: Adult offspring socioeconomic resources are, independently of how we measure them and of individual socioeconomic characteristics, associated with development of stroke in old age in both Denmark and Sweden. The relationships between offspring socioeconomic resources and death after stroke are present especially after the acute phase and most pronounced for educational level as a measure of offspring socioeconomic resources.

Background  This study explores recent cohort trends in cognitive performance among older Europeans from 2007 to 2017, addressing three key questions: (1) Did cognitive performance improve universally and across the performance distribution during this period? (2) Did these improvements occur across educational levels and for both men and women? (3) Can established risk factors explain these performance gains?

Methods  Using data from the Survey of Health, Ageing and Retirement in Europe (SHARE) across 12 European countries, we assessed immediate recall, delayed recall, and verbal fluency in individuals aged 60 to 94 in both 2007 and 2017 (n = 32 773). Differences between the two time points were estimated with linear mixed effects regression models and quantile regression.

Results  Cognitive performance improved in all age groups, across educational levels, and for both men and women between 2007 and 2017. Notably, improvements were more pronounced at the upper end of the performance distribution for delayed recall and verbal fluency. Education explained approximately 20% of the observed improvements. Risk factors did not explain the observed improvements.

Conclusions  European cohorts of both younger-old and older adults continue to exhibit improvements in cognitive performance. Variation in the size of the cohort improvements across the performance distributions in delayed recall and in verbal fluency may contribute to growing inequalities in cognitive outcomes. Future research should further investigate the potential heterogeneity in cognitive performance gains.

Purpose: We aim to investigate systematic differences in reporting spousal care between caregivers and cared-for persons and their possible effects for the analysis of care regimes and correlation of care with health. Materials and methods: Using information on care provided/received from the Survey on Health, Ageing and Retirement in Europe (SHARE), we estimate the prevalence of spousal care and discordance between caregivers and cared-for persons in the reporting of care among caregiving dyads. Multinomial regressions are used to estimate systematic differences in reporting spousal care. We then use multivariable logistic regressions to assess the association between discordance in reporting informal care and carer's self-rated health (SRH) and depression using the EURO-D scale. Results: Only 53.9 % of dyads report care that is confirmed by both spouses. Multinomial regressions show that agreement on care being provided/received is more common when women are caregivers, while men are likely to underreport when providing or receiving personal care. Prevalence of spousal care across care regimes is sensitive to who reports care. There is no effect on the association of care with SRH regardless of who identifies the carer, while the magnitude and statistical significance of the association between depression symptoms and care varies according to the choice of respondent. Conclusions: Informal care may be understated across Europe when relying solely on carer self-identification through description of tasks in surveys. From a policy standpoint, relying on self-identification of carers to access support or social benefits may potentially reduce the take-up of such benefits or support.

Background: The objective of this study is to explore the bidirectional, longitudinal associations between self-reported sensory functions (hearing/vision) and cognitive functioning among older adults in Sweden and Denmark during the period 2004–2017.

Methods: The study is based on data from The Survey of Health, Ageing and Retirement in Europe and consists of 3164 persons aged 60 to 93 years. Within-person associations between sensory and cognitive functions were estimated using random intercept cross-lagged panel models.

Results: The results indicated that cognitive and sensory functions were associated within their respective domains over time. The results on the bidirectional associations between sensory functions and cognition over time showed weak and statistically non-significant estimates.

Conclusion: Our study showed no clear evidence for cross-lagged effects between sensory functions and cognitive functioning. Important to note, however, is that using longitudinal data to estimate change within persons is a demanding statistical test and various factors may have contributed to the absence of conclusive evidence in our study. We discuss several of these factors.