Suchergebnisse

W ostatnich dekadach różne aspekty sprawowania opieki przez nieformalnych opiekunów rodzinnych nad starszymi członkami rodziny stały się przedmiotem wzrastającego zainteresowania ze strony badaczy. Obserwowane zmiany w strukturze i zasadach funkcjonowania współczesnej rodziny skłaniają do postawienia pytania o jej odpowiedzialność za sprawowanie opieki nad starszymi współmałżonkami, rodzicami i dziadkami. Szczególną uwagę zwracano na konsekwencje zdrowotne i psychospołeczne wynikające z negatywnych, stresujących doświadczeń związanych z trajektorią pełnienia tej roli. Zmianie uległy także koncepcje teoretyczne poświęcone zapewnieniu rodzinnej opieki – klasyczny model solidarności międzypokoleniowej został zastąpiony modelem ambiwalencji, który w ostatnim czasie został wyparty przez nowy model, koncentrujący się na znaczeniu indywidualnej decyzji o dokonaniu wyboru wejścia w rolę opiekuna rodzinnego, niezależnie od presji społecznej wynikającej z kulturowych norm i zobowiązań. Na podstawie przeglądu literatury przeanalizowano demograficzne i psychospołeczne uwarunkowania decyzji przyjęcia roli opiekuna rodzinnego i przedstawiono wyniki przeprowadzonego sondażu. Pytanie, czy pełnienie roli opiekuna rodzinnego jest wpisane w przyszły scenariusz życia osób niesprawujących aktualnie tej funkcji, zadane zostało 213 respondentom w wieku 35–65 lat. Uzyskane wyniki wskazują, że mniej niż połowa badanych rozważa przyjęcie w razie potrzeby takiej roli – przy czym wejście w przyszłości w rolę opiekuna było istotnie zależne od poczucia przynależności i więzi wewnątrzrodzinnych, ukształtowanych we wcześniejszych etapach życia rodziny. Istotne statystycznie różnice w planach życiowych dotyczących opieki odnotowano w zależności od wieku (częściej planowały takie działania osoby młodsze i aktywne zawodowo), natomiast nie potwierdzono istotnych różnic w zależności od płci badanych. Badani wyrażający gotowość przyjęcia roli opiekuna wiązali swoje przyszłe zadania z okazywaniem wsparcia emocjonalnego i spędzaniem czasu z osobą starszą, natomiast trudy codziennej instrumentalnej pomocy nie były przez nich w pełni brane pod uwagę.

Self-rated health (SRH) is an important indicator of healthy aging, and intergenerational relationships are key factors in that process. However, little is known about the association between these aspects over time. Thus, the study aimed to verify the effect of intergenerational family relationships on SRH among the Polish population aged 50 and over. The results covered data from 930 older adults who participated in a panel survey performed in two waves (COURAGE in Europe – 2011; COURAGEPOLFUS – 2015/2016). Face-to-face interviews were conducted in the respondents' homes using a structured questionnaire. SRH was measured by a single-item scale. Intergenerational relationships were assessed by frequency of face-to-face contact, the strength of social ties, and perceived social support. The presence of conflicts was also verified. The results showed that in 2011, around 31% of people aged 50+ indicated somewhat weak relationships with children or grandchildren; after four years, strengthening (weakening) of the relationships was observed among 16% (13%) of the population. Differences in the SRH during the follow-up were not statistically significant. There were also no significant differences in SRH between those for whom the weakening of intergenerational relationships, strengthening of solidarity, or no such changes were observed. The cross-lagged model showed that the relationships between solidarity and SRH were significant only on the cross-sectional level.

Background: Every research project faces challenges regarding how to achieve its goals in a timely and effective manner. The purpose of this paper is to present a project evaluation methodology gathered during the implementation of the Participation to Healthy Workplaces and Inclusive Strategies in the Work Sector (the EU PATHWAYS Project). The PATHWAYS project involved multiple countries and multi-cultural aspects of re/integrating chronically ill patients into labor markets in different countries. This paper describes key project's evaluation issues including: (1) purposes, (2) advisability, (3) tools, (4) implementation, and (5) possible benefits and presents the advantages of a continuous monitoring. Methods: Project evaluation tool to assess structure and resources, process, management and communication, achievements, and outcomes. The project used a mixed evaluation approach and included Strengths (S), Weaknesses (W), Opportunities (O), and Threats (SWOT) analysis. Results: A methodology for longitudinal EU projects' evaluation is described. The evaluation process allowed to highlight strengths and weaknesses and highlighted good coordination and communication between project partners as well as some key issues such as: the need for a shared glossary covering areas investigated by the project, problematic issues related to the involvement of stakeholders from outside the project, and issues with timing. Numerical SWOT analysis showed improvement in project performance over time. The proportion of participating project partners in the evaluation varied from 100% to 83.3%. Conclusions: There is a need for the implementation of a structured evaluation process in multidisciplinary projects involving different stakeholders in diverse socio-environmental and political conditions. Based on the PATHWAYS experience, a clear monitoring methodology is suggested as essential in every multidisciplinary research projects.

Background: The public health policy agenda oriented towards healthy ageing becomes the highest priority for the European countries. The article discusses the healthy ageing concept and its possible determinants with an aim to identify behavioral patterns related to healthy ageing in selected European countries. Methods: The healthy ageing is assessed based on a composite indicator of self-assessed health, functional capabilities and life meaningfulness. The logistic regression models are used to assess the impact of the healthy lifestyle index, psycho-social index and socio-economic status on the probability of healthy ageing (i.e. being healthy at older age). The lifestyle and psychosocial indexes are created as a sum of behaviors that might be important for healthy ageing. Models are analyzed for three age groups of older people: 60-67, 68-79 and 80+ as well as for three groups of countries representing Western, Southern and Central-Eastern Europe. Results: The lifestyle index covering vigorous and moderate physical activity, consumption of vegetables and fruits, regular consumption of meals and adequate consumption of liquids is positively related to healthy ageing, increasing the likelihood of being healthy at older age with each of the items specified in the index. The score of the index is found to be significantly higher (on average by 1 point for men and 1.1 for women) for individuals ageing healthily. The psychosocial index covering employment, outdoor social participation, indoor activities and life satisfaction is also found to be significantly related to health increasing the likelihood of healthy ageing with each point of the index score. There is an educational gradient in healthy ageing in the population below the age of 68 and in Southern and Central-Eastern European countries. In Western European countries, income is positively related to healthy ageing for females. Conclusions: Stimulation physical activity and adequate nutrition are crucial domains for a well-defined public health policy oriented towards healthy ageing. The psychosocial elements related to social participation, engagement, networking and life satisfaction are also found to be health beneficial.

It is widely recognized that social networks and loneliness have effects on health. The present study assesses the differential association that the components of the social network and the subjective perception of loneliness have with health, and analyzes whether this association is different across different countries. Methods: A total of 10 800 adults were interviewed in Finland, Poland and Spain. Loneliness was assessed by means of the 3-item UCLA Loneliness Scale. Individuals' social networks were measured by asking about the number of members in the network, how often they had contacts with these members, and whether they had a close relationship. The differential association of loneliness and the components of the social network with health was assessed by means of hierarchical linear regression models, controlling for relevant covariates. Results: In all three countries, loneliness was the variable most strongly correlated with health after controlling for depression, age, and other covariates. Loneliness contributed more strongly to health than any component of the social network. The relationship between loneliness and health was stronger in Finland (|β| = 0.25) than in Poland (|β| = 0.16) and Spain (|β| = 0.18). Frequency of contact was the only component of the social network that was moderately correlated with health. Conclusions: Loneliness has a stronger association with health than the components of the social network. This association is similar in three different European countries with different socioeconomic and health characteristics and welfare systems. The importance of evaluating and screening feelings of loneliness in individuals with health problems should be taken into account. Further studies are needed in order to be able to confirm the associations found in the present study and infer causality ; The research leading to these results has received funding from the European Community's Seventh Framework Programme (FP7/2007-2013) under grant agreement number 223071 (COURAGE in Europe), from the European Commission Horizon 2020 under grant number 635316 (ATHLOS), from the Instituto de Salud Carlos III-FIS research grant numbers PS09/00295, PS09/01845, PI12/01490 and PI13/00059, and from the Spanish Ministry of Science and Innovation ACI-Promociona (ACI2009-1010). Projects PI12/01490 and PI13/00059 have been co-funded by the European Union European Regional Development Fund (ERDF) "A Way to Build Europe". Laura Rico is supported by the programme "Contratos predoctorales para Formación de Personal Investigador, FPI-UAM", Universidad Autónoma de Madrid, Spain. Marta Miret is grateful to the Spanish Ministry of Economy and Competitiveness for the postdoctoral fellowship (FPDI-2013-15793). Beatriz Olaya is part of the Sara Borrell postdoctoral programme (reference no. CD12/00429) supported by the Instituto de Salud Carlos III, Spain

The increasing prevalence of chronic diseases among the European working age population, as well as the implications for the individual and societal level, underline the need for policy guidelines targeting the effective inclusion of persons with chronic diseases in the workplace. The aim of the present paper was to explore the perspectives of European and National-level stakeholders on existing strategies for work re-integration of persons with chronic diseases, and to provide policy guidelines. A highly-structured interview protocol was distributed to 58 National level stakeholders (policy makers, professionals and employers) from seven European countries. Additionally, 20 European organizations concerned with health-related issues and employment completed an online survey. The findings reveal that employment-related challenges remain largely unaddressed. Both national and European stakeholders considered the existing legislative frameworks inadequate and appraised the co-ordination for the implementation of employment re-integration policies as ineffective. Policies targeting at work re-integration of persons with chronic diseases at European and national level should focus on consistent cooperation among all key stakeholders, awareness raising to staff and management, dissemination of effective strategies, developing research and evaluation standards and establishing monitoring systems on inclusive labour markets. ; The current study was part of the PATHWAYS project. The PATHWAYS project has received funding from the European Union's Health Programme (2014–2020) Grant agreement n. 663474. ; publishedVersion

The increasing prevalence of chronic diseases among the European working age population, as well as the implications for the individual and societal level, underline the need for policy guidelines targeting the effective inclusion of persons with chronic diseases in the workplace. The aim of the present paper was to explore the perspectives of European and National-level stakeholders on existing strategies for work re-integration of persons with chronic diseases, and to provide policy guidelines. A highly-structured interview protocol was distributed to 58 National level stakeholders (policy makers, professionals and employers) from seven European countries. Additionally, 20 European organizations concerned with health-related issues and employment completed an online survey. The findings reveal that employment-related challenges remain largely unaddressed. Both national and European stakeholders considered the existing legislative frameworks inadequate and appraised the co-ordination for the implementation of employment re-integration policies as ineffective. Policies targeting at work re-integration of persons with chronic diseases at European and national level should focus on consistent cooperation among all key stakeholders, awareness raising to staff and management, dissemination of effective strategies, developing research and evaluation standards and establishing monitoring systems on inclusive labour markets.

BACKGROUND: Continuous population aging has raised international policy interest in promoting active aging (AA). AA theoretical models have been defined from a biomedical or a psychosocial perspective. These models may be expanded including components suggested by lay individuals. This paper aims to study the correlates of AA in three European countries, namely, Spain, Poland, and Finland using four different definitions of AA. METHODS: The EU COURAGE in Europe project was a cross-sectional general adult population survey conducted in a representative sample of the noninstitutionalized population of Finland, Poland, and Spain. Participants (10,800) lived in the community. This analysis focuses on individuals aged 50 years old and over (7,987). Four definitions (two biomedical, one psychosocial, and a complete definition including biomedical, psychosocial, and external variables) of AA were analyzed. RESULTS: Differences in AA were found for country, age, education, and occupation. Finland scored consistently the highest in AA followed by Spain and Poland. Younger age was associated with higher AA. Higher education and occupation was associated with AA. Being married or cohabiting was associated with better AA compared to being widowed or separated in most definitions. Gender and urbanicity were not associated with AA, with few exceptions. Men scored higher in AA only in Spain, whereas there was no gender association in the other two countries. Being widowed was only associated with lower AA in Poland and not being married was associated with lower AA in Poland and Finland but not Spain. CONCLUSIONS: Associations with education, marital status, and occupation suggest that these factors are the most important components of AA. These association patterns, however, seem to vary across the three countries. Actions to promote AA in these countries may be addressed at reducing inequalities in occupation and education or directly tackling the components of AA lacking in each country.

BACKGROUND: Continuous population aging has raised international policy interest in promoting active aging (AA). AA theoretical models have been defined from a biomedical or a psychosocial perspective. These models may be expanded including components suggested by lay individuals. This paper aims to study the correlates of AA in three European countries, namely, Spain, Poland, and Finland using four different definitions of AA. METHODS: The EU COURAGE in Europe project was a cross-sectional general adult population survey conducted in a representative sample of the noninstitutionalized population of Finland, Poland, and Spain. Participants (10,800) lived in the community. This analysis focuses on individuals aged 50 years old and over (7,987). Four definitions (two biomedical, one psychosocial, and a complete definition including biomedical, psychosocial, and external variables) of AA were analyzed. RESULTS: Differences in AA were found for country, age, education, and occupation. Finland scored consistently the highest in AA followed by Spain and Poland. Younger age was associated with higher AA. Higher education and occupation was associated with AA. Being married or cohabiting was associated with better AA compared to being widowed or separated in most definitions. Gender and urbanicity were not associated with AA, with few exceptions. Men scored higher in AA only in Spain, whereas there was no gender association in the other two countries. Being widowed was only associated with lower AA in Poland and not being married was associated with lower AA in Poland and Finland but not Spain./nCONCLUSIONS: Associations with education, marital status, and occupation suggest that these factors are the most important components of AA. These association patterns, however, seem to vary across the three countries. Actions to promote AA in these countries may be addressed at reducing inequalities in occupation and education or directly tackling the components of AA lacking in each country. ; The research leading to these results has received funding from the European Community's Seventh Framework Programme (FP7/2007-2013) under grant agreement number 223071 (COURAGE in Europe), from the Instituto de Salud Carlos III-FIS research grant number PS09/01845 and PS09/00295 and from the Spanish Ministry of Science and Innovation ACI-Promociona (ACI2009-1010). The study was supported by the Centro de Investigación Biomédica Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III and Recercaixa 2011. J.P. is grateful to the Instituto de Salud Carlos III for a predoctoral grant (PFIS)

Background: Pain is a common symptom, often associated with neurological and musculoskeletal conditions, and experienced especially by females and by older people. The aims of this study are to evaluate the temporal variations of pain rates among general populations for the period 1991-2015 and to project 10-year pain rates. Methods: We used the harmonized dataset of ATHLOS project, which included 660,028 valid observations in the period 1990-2015 and we applied Bayesian age-period-cohort modeling to perform projections up to 2025. The harmonized Pain variable covers the content "self-reported pain experienced at the time of the interview", with a dichotomous (yes or no) modality. Results: Pain rates were higher among females, older subjects, in recent periods, and among observations referred to cohorts of subjects born between the 20s and the 60s. The 10-year projections indicate a noteworthy increase in pain rates in both genders and particularly among subjects aged 66 or over, for whom a 10-20% increase in pain rate is foreseen; among females only, a 10-15% increase in pain rates is foreseen for those aged 36-50. Conclusions: Projected increase in pain rates will require specific interventions by health and welfare systems, as pain is responsible for limited quality of subjective well-being, reduced employment rates and hampered work performance. Worksite and lifestyle interventions will therefore be needed to limit the impact of projected higher pain rates. ; The ATHLOS project (Ageing Trajectories of Health: Longitudinal Opportunities and Synergies) has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No 635316.

Background: Pain is a common symptom, often associated with neurological and musculoskeletal conditions, and experienced especially by females and by older people, and with increasing trends in general populations. Different risk factors for pain have been identified, but generally from studies with limited samples and a limited number of candidate predictors. The aim of this study is to evaluate the predictors of pain from a large set of variables and respondents. Methods: We used part of the harmonized dataset of ATHLOS project, selecting studies and waves with a longitudinal course, and in which pain was absent at baseline and with no missing at follow-up. Predictors were selected based on missing distribution and univariable association with pain, and were selected from the following domains: Socio-demographic and economic characteristics, Lifestyle and health behaviours, Health status and functional limitations, Diseases, Physical measures, Cognition, personality and other psychological measures, and Social environment. Hierarchical logistic regression models were then applied to identify significant predictors. Results: A total of 13,545 subjects were included of whom 5348 (39.5%) developed pain between baseline and the average 5.2 years' follow-up. Baseline risk factors for pain were female gender (OR 1.34), engaging in vigorous exercise (OR 2.51), being obese (OR 1.36) and suffering from the loss of a close person (OR 1.88) whereas follow-up risk factors were low energy levels/fatigue (1.93), difficulties with walking (1.69), self-rated health referred as poor (OR 2.20) or average to moderate (OR 1.57) and presence of sleep problems (1.80). Conclusions: Our results showed that 39.5% of respondents developed pain over a five-year follow-up period, that there are proximal and distal risk factors for pain, and that part of them are directly modifiable. Actions aimed at improving sleep, reducing weight among obese people and treating fatigue would positively impact on pain onset, and avoiding vigorous exercise should be advised to people aged 60 or over, in particular if female or obese. ; The ATHLOS project (Ageing Trajectories of Health: Longitudinal Opportunities and Synergies) has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No 635316

We investigated the relation between alcohol drinking and healthy ageing by meansof a validated health status metric, using individual data from the Ageing Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) project. For the purposes of this study, the ATHLOS harmonised dataset, which includes information from individuals aged 65+ in 38 countries, was analysed (n = 135,440). Alcohol drinking was reflected by means of three harmonised variables: alcohol drinking frequency, current and past alcohol drinker. A set of 41 self-reported health items and measured tests were used to generate a specific health metric. In the harmonised dataset, the prevalence of current drinking was 47.5% while of past drinking was 26.5%. In the pooled sample, current alcohol drinking was positively associated with better health status among older adults ((b-coef (95% CI): 1.32(0.45 to 2.19)) and past alcohol drinking was inversely related (b-coef (95% CI): −0.83 (−1.51 to −0.16)) with health status. Often alcohol consumption appeared to be beneficial only for females in all super-regions except Africa, both age group categories (65–80 years old and 80+), both age group categories, as well as among all the financial status categories (all p < 0.05). Regional analysis pictured diverse patterns in the association for current and past alcohol drinkers. Our results report the need for specific alcohol intake recommendations among older adults that will help them maintain a better health status throughout the ageing process. ; This work was supported by the five-year Ageing Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) project. The ATHLOS project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No 635316. The ATHLOS project researchers are grateful for data contribution and funding in the following studies: (A) The 10/66 study (10/66): The 10/66 study is supported by theWellcome Trust (GR066133/ GR080002), the European Research Council (340755), US Alzheimer's Association, WHO, FONDACIT (Venezuela) and the Puerto Rico State Government, and the Medical Research Council (MR/K021907/1 to A.M.P.). The authors gratefully acknowledge the work of the 10/66 Dementia Research Group who provided data for this paper; (B) The Australian Longitudinal Study of Ageing (ALSA): The ALSA study was supported by grants from the South Australian Health Commission, the Australian Rotary Health Research Fund, the US National Institute on Aging (Grant No. AG 08523–02), theO ce for the Ageing (SA), Elderly Citizens Homes (SA), the National Health and Medical Research Council (NH&MRC 22922), the Premiers Science Research Fund (SA) and the Australian Research Council (DP0879152; DP130100428). The authors gratefully acknowledge the work of the project team at the Flinders Centre for Ageing Studies, Flinders University who provided data for this paper; (C) The ATTICA study: The ATTICA study is supported by research grants from the Hellenic Cardiology Society (HCS2002) and the Hellenic Atherosclerosis Society (HAS2003). The authors gratefully acknowledge the work of the project team at the Harokopio University who provided data for this paper; (D) The China Health and Retirement Longitudinal Study (CHARLS): The CHARLS study has received critical support from Peking University, the National Natural Science Foundation of China, the Behavioral and Social Research Division of the National Institute on Aging and the World Bank. The authors gratefully acknowledge the work of the project team at the Peking University who provided data for this paper; (E) Collaborative Research on Ageing (COURAGE) in Europe: The COURAGE study was supported by the European Community's Seventh Framework Programme (FP7/2007–2013) under grant agreement number 223071 (COURAGE in Europe). Data from Spain were also collected with support from the Instituto de Salud Carlos III-FIS research grants number PS09/00295, PS09/01845, PI12/01490, PI13/00059, PI16/00218 and PI16/01073; the Spanish Ministry of Science and Innovation ACI-Promociona (ACI2009–1010); the European Regional Development Fund (ERDF) 'AWay to Build Europe' grant numbers PI12/01490 and PI13/00059; and by the Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III. Data from Poland were collected with support from the Polish Ministry for Science and Higher Education grant for an international co-financed project (number 1277/7PR/UE/2009/7, 2009–2012) and Jagiellonian University Medical College grant for project COURAGE-POLFUS (K/ZDS/005241). The authors gratefully acknowledge the work of COURAGE researchers who provided data for this paper; (F) The Seniors-ENRICA: The Seniors-ENRICA cohort was funded by an unconditional grant from Sanofi-Aventis, the Ministry of Health of Spain, FIS grant 12/1166 (State Secretary for R+D and FEDER-FSE) and the Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III. The authors gratefully acknowledge the work of the project team at the Universidad Autónoma de Madrid who provided data for this paper; (G) The English Longitudinal Study of Ageing (ELSA): ELSA is supported by the U.S. National Institute of Aging, the National Centre for Social Research, the University College London (UCL) and the Institute for Fiscal Studies. The authors gratefully acknowledge the UK Data Service and UCL who provided data for this paper; (H) The Health, Alcohol and Psychosocial factors In Eastern Europe (HAPIEE) study: The HAPIEE study was supported by theWellcome Trust (grant numbers WT064947, WT081081), the US National Institute of Aging (grant number 1RO1AG23522) and the MacArthur Foundation Initiative on Social Upheaval and Health. The authors gratefully acknowledge the work of the project teams at University College London, the National Institute of Public Health in Prague, the Jagiellonian University Medical College in Krakow and the Kaunas University of Medicine who provided data for this paper; (I) The Health 2000/2011 study: The authors gratefully acknowledge the National Institute for Health and Welfare in Finland who provided data for this paper; (J) Health and Retirement Study (HRS): The HRS study is supported by the National Institute on Aging (grant number NIA U01AG009740) and the Social Security Administration, and is conducted by the University of Michigan. The authors gratefully acknowledge the University of Michigan who provided data for this paper; (K) The Japanese Study of Aging and Retirement (JSTAR): The JSTAR is conducted by the Research Institute of Economy, Trade and Industry (RIETI), the Hitotsubashi University, and the University of Tokyo. The authors gratefully acknowledge the RIETI who provided data for this paper; (L) The Korean Longitudinal Study of Ageing (KLOSA): The KLOSA study is funded by the Korea Employment Information Service (KEIS) and was supported by the Korea Labor Institute's KLOSA Team. The authors gratefully acknowledge the KEIS who provided data for this paper; (M) The Mexican Health and Aging Study (MHAS): The MHAS study is partly sponsored by the National Institutes of Health/National Institute on Aging (grant number NIH R01AG018016) and the INEGI in Mexico. The authors gratefully acknowledge the MHAS team who provided data for this paper retrieved from www.MHASweb.org: (N) The Study on Global Ageing and Adult Health (SAGE): The SAGE study is funded by the U.S. National Institute on Aging and has received financial support through Interagency Agreements (OGHA 04034785; YA1323-08-CN-0020; Y1-AG-1005–01) and Grants (R01-AG034479; IR21-AG034263-0182). The authors gratefully acknowledge theWorld Health Organizationwho provided data for this paper; (O) The Survey of Health, Ageing and Retirement in Europe (SHARE): The SHARE study is funded by the European Commission through FP5 (QLK6-CT-2001–00360), FP6 (SHARE-I3: RII-CT-2006–062193, COMPARE: CIT5-CT-2005–028857, SHARELIFE: CIT4-CT-2006–028812) and FP7 (SHARE-PREP: N 211909, SHARE-LEAP: N 227822, SHARE M4: N 261982). Additional funding from the German Ministry of Education and Research, the Max Planck Society for the Advancement of Science, the U.S. National Institute on Aging (U01_AG09740-13S2, P01_AG005842, P01_AG08291, P30_AG12815, R21_AG025169, Y1-AG-4553–01, IAG_BSR06-11, OGHA_04-064, HHSN271201300071C) and from various national funding sources is gratefully acknowledged (see www.share-project.org); (P) The Irish Longitudinal study on Ageing (TILDA): The authors gratefully acknowledge the Trinity College Dublin and the Irish Social Science Data Archive (www.ucd.ie/issda) who provided data for this paper; (Q) The Uppsala Birth Cohort Multigenerational Study (UBCOS): The UBCoS study has received funding from the Swedish Research Council for Health, Working Life and Welfare (FORTE; 2006–1518 and 2013–1084) and from the Swedish Research Council (VR; 2013–5104 and 2013–5474). The authors gratefully acknowledge the Centre for Health Equity Studies at the Stockholm University and Karolinska Institutet's team who provided data for this paper. Additionally, Stefanos Tyrovolas was supported by the Foundation for Education and European Culture, the Miguel Servet programme (reference CP18/00006), and the Fondos Europeos de Desarrollo Regional. Also, Alberto Raggi is supported by a grant from the Italian Ministry of Health (Ricerca Corrente, Fondazione Istituto Neurologico C. Besta, Linea 4—Outcome Research: dagli Indicatori alle Raccomandazioni Cliniche. The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. The authors had access to the data in the study and had final responsibility for the decision to submit for publication.