The effect of income and wealth on the onset of health deficit accumulation in older adults in Europe – results from the SHARE study
The effect of income and wealth on the onset of health deficit accumulation in older adults in Europe – results from the SHARE study
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收入和财富对欧洲老年人健康赤字积累的影响——来自 SHARE 研究的结果
DOI：
10.1055/s-0037-1605645
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Strobl
中科院分区：
文献类型：
--
作者：
Stephan;Strobl
方法：数据来自SHARE（欧洲健康、老龄化和退休调查）研究，包括来自10个欧洲国家的50岁及以上成年人的人群样本，他们参加了2004/05、2006/07、2010/11和2012/13年的至少三次调查。从50个健康缺陷构建了缺陷累积指数（DAI，范围0-1）。DA发作定义为在初始值≤ 0.08之后的至少两次连续测量中DAI值> 0.08。家庭年总收入的定义是所有家庭成员以欧元为单位的自我报告收入的总和，除以家庭规模的平方根，并根据具体国家的贫困线进行二分法。财富是以净资产（所有金融和真实的资产减去债务的总和）的三分位数来衡量的，并根据购买力平价汇率进行了调整。使用有向无环图识别调整集。我们采用了随机效应模型的时间到事件的数据与国家作为groupvariable.Results：6,765名参与者（6061岁，48%的妇女）谁最初在DA发作的风险，1,659（25%）随后经历了DA发作。发病时的中位年龄为81岁，范围为75岁（德国）至85岁（瑞士、荷兰、丹麦）。财富最低三分位数的个体出现DA早期发作的风险显著增加（HR：1.38，95% CI [1.14; 1.67]）。低于贫困线的收入没有显着影响（HR：1.17，95%CI [0.27; 5.19]）。结论：欧洲人群不同的中位年龄在DA发作。个人财富资源，而不是收入似乎预测早期DA发作。
Methods:Data originates from the SHARE (Survey of Health, Aging and Retirement in Europe) study and includes a population sample of adults aged 50 years and older from ten European countries who participated in at least three out of the 2004/05, 2006/07, 2010/11 and 2012/13 waves. A Deficit Accumulation Index (DAI, range 0–1) was constructed from 50 health deficits. DA onset was defined as having DAI values> 0.08 in at least two consecutive measurements following an initial value≤ 0.08. Gross total annual household income was defined as the sum of all household members' self-reported incomes in euro, divided by the square root of the household size and dichotomized according to the country-specific poverty threshold. Wealth was measured in tertiles of net worth (sum of all financial and real assets minus debts) in euro adjusted for purchasing power parity exchange rates. The adjustment set was identified using directed acyclic graphs. We applied a random effect model for time-to-event data with country as group variable.Results:Out of 6,765 participants (Ø 61 years, 48% women) who were initially at risk of DA onset, 1,659 (25%) subsequently experienced a DA onset. Median age at onset was 81 years, ranging from 75 years (Germany) to 85 years (Switzerland, Netherlands, Denmark). Individuals in the lowest wealth tertile had a significantly increased risk for earlier DA onset (HR: 1.38, 95% CI [1.14; 1.67]). Income below the poverty threshold showed no significant effect (HR: 1.17, 95% CI [0.27; 5.19]).Conclusions:European populations differ regarding their median age at DA onset. Individual wealth resources rather than income seemed to predict earlier DA onset.