Search

Background: Studies revealed unidirectional associations between frailty and medication‐related problems (MRPs) among older adults. Less is known about the association between frailty and the risk of MRPs. We aimed to assess the bi‐directional association between frailty and the risk of MRPs in community‐dwelling older adults in five European countries. Methods: Participants were 1785 older adults in the population‐based Urban Health Centres Europe project. Repeated assessments were collected at baseline and one‐year follow‐up, including frailty, the risk of MRPs, and covariates. Linear regression analyses were conducted to examine the unidirectional associations. A cross‐lagged panel modeling was used to assess bi‐directional associations. Results: The unidirectional association between frailty at baseline and the risk of MRPs at follow‐up remained statistically significant after adjusting for covariates (β = 0.10, 95%CI:0.08, 0.13). The association between the risk of MRPs at baseline and frailty at follow‐up shows similar trends. The bi‐directional association was comparable with reported unidirectional associations, with a stronger effect from frailty at baseline to the risk of MRPs at follow‐up than reversed path (Wald test for comparing lagged effects: p < 0.05). Conclusion: This longitudinal study suggests that a cycle may exist where older adults with higher frailty levels are more likely to have a higher risk of MRPs, which in turn contributes to developing a higher level of frailty. Further research is needed to validate our findings and explore underlying pathways. [ABSTRACT FROM AUTHOR]

Background: The prevalence of obesity has risen in recent decades and reached epidemic proportions worldwide. The proportion of those living with obesity is also increasing in nursing homes. This could impact the nursing care required, equipment and facilities provided, and morbidity in these settings. Limited evidence exists on clinical consequences of obesity in nursing home residents and their care. Objective: Therefore, the aim was to examine the rate and associated factors of obesity (BMI ≥30; class I (BMI 30.0–34.9 kg/m2), class II (BMI 35.0–39.9 kg/m2), and class III (BMI >40.0 kg/m2)) amongst older nursing home residents in European countries. Methods: We analysed data from 21,836 people who reside in nursing homes in Austria, the Netherlands, and the United Kingdom. They participated in the "International Prevalence Measurement of Care Quality", a cross sectional study between 2016 and 2019, where trained nurses interviewed the residents, reviewed care records, and conducted clinical examinations. A tested and standardised questionnaire comprised questions on demographic data, measured BMI, medical diagnosis according to ICD‐10, and care dependency. Descriptive and logistic regression analyses were performed. Results: Obesity rates were highest in Austria (17.1%) and lowest in the UK (13.0%) (p =.006). Residents with obesity were younger and less likely to be care dependent or living with dementia and had more often diabetes mellitus, endocrine, metabolic, and skin diseases compared to residents without obesity (p <.05). Most obese residents had obesity class I. Therefore, two subgroups were built (class I vs. class II + III). Residents with obesity class II + III were more frequently care dependent for mobility, getting dressed and undressed, and personal hygiene compared to residents with class I (p <.05). Conclusions: This study identified several factors that are associated with obesity amongst older nursing home residents in selected European countries. Implications for practice: The division into obesity classes is important for planning targeted care according to the individual needs of nursing home residents. [ABSTRACT FROM AUTHOR]

Many researchers and practitioners consider ethnic segregation in neighbourhoods or schools detrimental to migrants' acculturation in host societies. Empirically, however, segregation is a 'mixed bag' and its effects depend crucially on the investigated acculturation domain (e.g., negative for language skills, positive for well‐being). As most prior studies have focused on a restricted spectrum of acculturation, a comprehensive assessment within one single study is needed to establish comparability across different acculturation domains. Among over 8000 immigrant‐background students from four countries, we investigated the association of classroom segregation, defined as opportunities for contact with natives and other migrants, with a broad spectrum of acculturation (academic, attitude‐related, identity‐related, social, health‐related, and psychological criteria). Some findings were consistent (e.g., academic acculturation), some were contrary to prior research (e.g., social acculturation). In sum, our results shed light on the 'mixed bag' of segregation and contribute to the understanding of a crucial social issue. [ABSTRACT FROM AUTHOR]

Abstract: The aim of this article is to shed light on the nexus between occupational pensions (OPs) and the financialization of pensions in Europe. In particular, we address the following questions: Has the recent evolution of OPs contributed to the financialization of pension policy? Is the nexus between OPs and financialization the result of the increased influence of financial markets in the pension field? Or of a more complex interaction of state, market, and social actors? By comparing Italy, the Netherlands and the United Kingdom, we show financialization is a broad process that affects the three countries, but it has followed three different paths. In Italy, financialization is spreading through individual pension schemes rather than OPs. The Dutch collective OPs are still a central part of the pension systems, but are increasingly influenced by the financial markets. In the United Kingdom, employer‐led OPs are in the hands of the financial services industry. This proves that financialization is a powerful trend, but has to deal with domestic socioeconomic institutions (a country's political economies and pensions institutions) that shape actors' strategies and reforms. Financial actors have an increased role in pension politics, but are involved in complex interactions with the state, employers, and trade unions. [ABSTRACT FROM AUTHOR]

Aims We formally estimate future smoking-attributable mortality up to 2050 for the total national populations of England & Wales, Denmark and the Netherlands, providing an update and extension of the descriptive smoking-epidemic model. Methods We used smoking prevalence and population-level lung cancer mortality data for England & Wales, Denmark and the Netherlands, covering the period 1950-2009. To estimate the future smoking-attributable mortality fraction ( SAF) we: (i) project lung cancer mortality by extrapolating age-period-cohort trends, using the observed convergence of smoking prevalence and similarities in past lung cancer mortality between men and women as input; and (ii) add other causes of death attributable to smoking by applying a simplified version of the indirect Peto- Lopez method to the projected lung cancer mortality. Findings The SAF for men in 2009 was 19% (44 872 deaths) in England & Wales, 22% (5861 deaths) in Denmark and 25% (16 385 deaths) in the Netherlands. In our projections, these fractions decline to 6, 12 and 14%, respectively, in 2050. The SAF for women peaked at 14% (38 883 deaths) in 2008 in England & Wales, and is expected to peak in 2028 in Denmark (22%) and in 2033 in the Netherlands (23%). By 2050, a decline to 9, 17 and 19%, respectively, is foreseen. Different indirect estimation methods of the SAF in 2050 yield a range of 1-8% ( England & Wales), 8-13% ( Denmark) and 11-16% (the Netherlands) for men, and 7-16, 12-26 and 13-31% for women. Conclusions From northern European data we project that smoking-attributable mortality will remain important for the future, especially for women. Whereas substantial differences between countries remain, the age-specific evolution of smoking-attributable mortality remains similar across countries and between sexes. [ABSTRACT FROM AUTHOR]