Pet ownership and psychosocial outcomes among the oldest old in Germany during the Covid-19 pandemic. Findings based on the nationally representative "Old Age in Germany (D80+)".

OBJECTIVES: To examine the association between pet ownership and psychosocial outcomes among the oldest old in Germany during the Covid-19 pandemic. METHODS/DESIGN: Data from the "Old Age in Germany (D80+)" study were used, a large, nationwide representative study covering both individuals living at home and individuals in nursing homes aged 80 years and above (n = 2867 individuals). The telephone interviews were conducted from May to October 2021. Established tools (e.g., "Short Form of the Depression in Old Age Scale", DIA-S4) were used to quantify the outcomes. Five groups were generated: (1) no pet ownership, (2) having at least one dog (but no other pets), (3) having at least one cat (but no other pets), (4) having at least one other pet (but neither dogs nor cats), (5) having at least two different types of pets (in any combination). RESULTS: Multiple linear regressions showed that compared to individuals without a pet, individuals having at least one dog had significantly lower loneliness levels (ß = -0.21, p < 0.01). In the fully-adjusted models, other forms of pet ownership were not significantly associated with the outcomes examined. CONCLUSION: Particularly living with a dog was associated with lower loneliness among the oldest old people in Germany. If living with a dog is in line with the preferences and attitudes of the very old, this could be a strategy for reducing loneliness in this age group.

Age-specific risk factors of depression among the oldest-old - evidence from the multicenter AgeCoDe-AgeQualiDe study.

Purpose: The present study aimed to investigate age-group-specific incidence rates and risk factors for depressive symptoms in the highest age groups. Methods: Data were derived from a prospective multicenter cohort study conducted in primary care - the AgeCoDe/AgeQualiDe study. In total, 2,436 patients 75 years and older were followed from baseline to ninth follow-up. To assess depressive symptoms, the short version of the Geriatric Depression Scale (GDS-15, cutoff score 6) was used. Age-specific competing risk regressions were performed to analyze risk factors for incident depressive symptoms in different age groups (75 to 79, 80 to 84, 85+ years), taking into account the accumulated mortality. Results: The age-specific incidence rate of depression was 33 (95% CI 29-38), 46 (95% CI 40-52) and 63 (95% CI 45-87) per 1,000 person years for the initial age groups 75 to 79, 80 to 84 and 85+ years, respectively. In competing risk regression models, female sex, mobility as well as vision impairment, and subjective cognitive decline (SCD) were found to be risk factors for incident depression for age group 75 to 79, female sex, single/separated marital status, mobility as well as hearing impairment, and SCD for age group 80 to 84, and mobility impairment for age group 85+. Conclusion: Depressive symptoms in latest life are common and the incidence increases with increasing age. Modifiable and differing risk factors across the highest age groups open up the possibility of specifically tailored prevention concepts.

Validation of the German version of the 25-item hikikomori questionnaire 25.

OBJECTIVES: The 25-item Hikikomori Questionnaire (HQ-25) is an instrument developed to measure a condition characterized by extreme social withdrawal that was first described in Japan. This study aimed to translate the HQ-25 into German and validate the German version (HQ-25-G). METHODS: Translation was conducted according to established guidelines. Validation was based on data from a quota sample of individuals living in Germany, ranging from 18 to 74 years old (representing the distribution of age, sex and federal state, n = 5000). Data collection occurred during August and September 2023. We tested reliability, construct validity and concurrent validity. Moreover, HQ-25 scores for key sociodemographic group were reported. RESULTS: Internal reliability for the HQ-25-G was excellent (Cronbach's alpha = 0.93). We confirmed the original three-factor model. Moreover, higher hikikomori levels were significantly associated with more depressive symptoms (r = 0.50), more anxiety symptoms (r = 0.45), higher loneliness levels (r = 0.56), higher levels of objective social isolation (r = -0.47), higher levels of perceived social isolation (r = 0.59) and a higher preference for solitude (r = 0.45). CONCLUSIONS: In a large population-based sample (including younger adults, middle-aged adults and older adults), the HQ-25-G version proves to be a psychometrically robust instrument, which is useful for further exploring the phenomenon of hikikomori within the German-speaking population.

Views of aging and mental health - The role of informal care provision: Longitudinal findings of the health and retirement study in the US.

BACKGROUND: Informal care is a common form of social support, which can vary greatly in its intensity. While views of aging have shown to be relevant to mental health before, we aim to analyze whether the association between views of aging and depressive symptoms is influenced by the provision of informal care and its intensity. METHODS: Data of six waves of the Health and Retirement Study in the United States was used. The sample includes up to 41,058 observations pooled over six waves of community-dwelling adults aged ≥50 years. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CESD) and attitudes towards own aging (ATOA) with the Philadelphia Geriatric Center Morale Scale (higher score indicates positive attitudes); informal caregiving (no/yes) and caregiving intensity (moderate, intense) were surveyed. Adjusted fixed effects regression analysis with robust standard errors, and with caregiving as moderator variable were calculated. RESULTS: Informal caregiving did not interact with ATOA. However, transitioning into intense caregiving significantly moderated the association between ATOA and depressive symptoms. Lower depressive symptoms were associated with better ATOA and this association was significantly stronger in the intense caregiving condition than in the non-caregiving condition. No significant interaction effects were found between any form of caregiving and subjective age. LIMITATIONS: The possibility of reciprocal effects cannot be excluded. CONCLUSION: Internalized ageism and depressive symptoms are more strongly related among caregivers who provide intense care. Thus, interventions to reduce internalized ageism could be helpful in particular among this vulnerable group of informal caregivers.

German population norms of the preference to solitude scale and its correlates.

AIM: Our first aim was to present norm values for the Preference for Solitude Scale by sex, age, and other sociodemographic groups. Our second aim was to evaluate the correlates of preference for solitude. METHODS: Data were collected in August/September 2023 from a sample of individuals (N = 5000) living in Germany aged 18 to 74 years (ensuring representativeness in terms of sex, age group and federal state for the German general adult population). The established and valid Preference for Solitude Scale (range 0 to 12, with higher values reflecting a stronger preference for solitude) was used to quantify the preference for solitude. Norm values were provided by sex and age groups. Multiple linear regressions were used to examine the correlates of preference for solitude. RESULTS: Average preference for solitude score was 7.6 (SD = 3.0; 0 to 12). The average score was 7.3 (SD = 3.0) among males and 7.9 (SD = 2.9) among females. Regressions showed that a stronger preference for solitude was associated with being female (ß = .51, p < .001), being older (e.g., being 40 to 49 years compared to 18 to 29 years, ß = .85, p < .001), being single (e.g., divorced compared to being single, ß = -.78, p < .01), higher level of education (secondary education compared to primary education, ß = .43, p < .01), never been a smoker (e.g., daily smoker compared to never smokers, ß = -.61, p < .001), absence of alcohol consumption (e.g., drinking once a week compared to never drinking, ß = -1.09, p < .001), no sports activity (e.g., 2-4 hours per week compared to no sports activity, ß = -.60, p < .001), poorer self-rated health (ß = .28, p < .001) and more depressive symptoms (ß = .05, p < .001). Sex-stratified regressions yielded similar results. CONCLUSION: Norm values provided in this study can be used as a benchmark for comparison with other countries and can guide further research dealing with preferences for solitude. We demonstrated the importance of several sociodemographic factors (e.g., marital status), lifestyle-related factors (e.g., sports activity), and health-related factors (e.g., depressive symptoms) for the preference for solitude. Such knowledge about the correlates of preference for solitude may help to characterize them. This is essential to ensure a good balance between social interaction and being alone. This is important because preference for solitude is associated with poor self-rated health and depression, but also with healthy behaviors such as abstaining from smoking and drinking.

Prevalence and factors associated with probable depression among the oldest old during the Covid-19 pandemic: evidence from the large, nationally representative 'Old Age in Germany (D80+)' study.

BACKGROUND: To date, most studies examining the prevalence and determinants of depression among individuals aged 80 and over have used geographically limited samples that are not generalisable to the wider population. Thus, our aim was to identify the prevalence and the factors associated with probable depression among the oldest old in Germany based on nationally representative data. METHODS: Data were taken from the nationally representative 'Old Age in Germany (D80+)' study (n = 8386; November 2020 to April 2021) covering both community-dwelling and institutionalised individuals aged 80 and over. The Short Form of the Depression in Old Age Scale was used to quantify probable depression. RESULTS: Probable depression was found in 40.7% (95% CI: 39.5% to 42.0%) of the sample; 31.3% were men (95% CI: 29.7% to 32.9%) and 46.6% women (95% CI: 44.9% to 48.3%). The odds of probable depression were positively associated with being female (odds ratio (OR): 1.55, 95% CI: 1.30 to 1.84), being divorced (compared to being married, OR: 1.33, 95% CI: 1.01 to 1.76), being widowed (OR: 1.14, 95% CI: 1.00 to 1.30), having a low education (e.g., medium education compared to low education, OR: 0.86, 95% CI: 0.74 to 0.99), living in an institutionalised setting (OR: 2.36, 95% CI: 1.84 to 3.02), living in East Germany (OR: 1.21, 95% CI, 1.05 to 1.39), not having German citizenship (German citizenship compared to other citizenship, OR: 0.55, 95% CI: 0.31 to 0.95), poor self-rated health (OR: 0.31, 95% CI: 0.28 to 0.34), and the number of chronic conditions (OR: 1.12, 95% CI: 1.09 to 1.14). CONCLUSION: About four out of 10 individuals aged 80 and over in Germany had probable depression, underlining the importance of this challenge. Knowledge of specific risk factors for this age group may assist in addressing older adults at risk of probable depression.

Factors associated with institutionalization among the oldest old: Results based on the nationally representative study 'old age in Germany (D80+)'.

OBJECTIVES: To examine the factors associated with institutionalization among individuals aged 80 years and over in Germany (total sample and stratified by sex). METHODS/DESIGN: We used data from the nationally representative 'Old Age in Germany (D80+)' (analytic sample: n = 9572 individuals), including individuals aged 80 years and over in Germany. Institutionalization (private living vs. institutionalization) served as an outcome measure. For the written interview, data collection took place from November 2020 to April 2021. Multiple logistic regressions of the overall sample (also stratified by sex) were applied. RESULTS: In the analytic sample, 10.2% (95% CI: 9.2%-11.3%) of the participants were institutionalized. The odds of being institutionalized were positively associated with being female (OR: 2.02, 95% CI: 1.08 to 3.80), being 90 years and over (compared to 80-84 years, OR: 1.67, 95% CI: 1.17 to 2.40), not being married (e.g., being single compared to being married: OR: 14.06, 95% CI: 6.73 to 29.37), higher education (e.g., high education compared to low education: OR: 1.88, 95% CI: 1.25 to 2.84), more favorable self-rated health (OR: 1.32, 95% CI: 1.07 to 1.62) and greater functional impairment (OR: 15.34, 95% CI: 11.91 to 19.74). Sex-stratified regressions were also conducted, mostly yielding similar results. CONCLUSION: Our study highlighted the role of several sociodemographic factors (particularly marital status, e.g., being single) and functional impairment for the risk of institutionalization among the oldest old in Germany. This study confirms findings in studies in younger samples that functional decline is the main factor associated with institutionalization. As functional decline may be modifiable, efforts to maintain functional abilities may be important. This knowledge is important for relevant groups (such as clinicians and policy-makers) because it may guide early intervention and prevention efforts, can help allocate healthcare resources effectively and shape policies to support independent living. Further insights using longitudinal data is recommended.

Perceived ageism and psychosocial outcomes during the COVID-19 pandemic.

BACKGROUND: In light of the existing knowledge gap in this research area (particularly based on representative samples and research conducted during the pandemic), the objective of this study was to explore the association between perceived ageism and psychosocial outcomes (i.e., in terms of life satisfaction, loneliness, social isolation, aging satisfaction and depressive symptoms) among middle-aged and older adults during the COVID-19 pandemic based on nationally representative data. METHODS: We used data from the nationally representative German Ageing Survey, which covers community-dwelling middle-aged and older individuals aged 40 years or over. Specifically, wave 7 of the German Ageing Survey (conducted from November 2020 to March 2021) was analyzed, consisting of a sample of 4,167 individuals with an average age of 68.7 years (SD: 10.1 years; ranging from 46 to 98 years). Established instruments were employed to measure psychosocial outcomes. RESULTS: Regressions showed that the presence of perceived ageism was significantly associated with unfavorable psychometric outcomes (i.e., higher loneliness: ß = 0.29, p < 0.001; higher perceived social isolation: ß = 0.32, p < 0.001; more depressive symptoms: ß = 2.68, p < 0.001; lower life satisfaction: ß=-0.28, p < 0.001; higher negative affect: ß = 0.21, p < 0.001; lower aging satisfaction: ß=-0.19, p < 0.001), except for positive affect (ß=-0.06, p = 0.10). Stratified by age group (i.e., individuals 40 to 64 years; individuals aged 65 years and over, see Tables 3 and 4), comparable results were obtained in terms of significance. CONCLUSIONS: Perceived ageism was associated with unfavorable psychosocial outcomes. This knowledge can help reduce vulnerability to negative psychosocial factors in people in the middle and later years of life.

Chronic loneliness and chronic social isolation among older adults: a study protocol for a systematic review, meta-analysis and meta-regression.

INTRODUCTION: There are around 20 studies identifying the prevalence of chronic loneliness and chronic social isolation in older adults. However, there is an absence of a systematic review, meta-analysis and meta-regression that consolidates the available observational studies. Therefore, our objective was to address this knowledge gap. Here, we present the study protocol for this upcoming work. Such knowledge can help in addressing older individuals at risk for chronic loneliness and chronic social isolation. METHODS AND ANALYSIS: Established electronic databases will be searched. Observational studies reporting the prevalence of chronic loneliness and chronic social isolation among individuals aged 60 years and over will be included. Disease-specific samples will be excluded. The focus of data extraction will be on methods, sample characteristics and key findings. The Joanna Briggs Institute (JBI) standardised critical appraisal instrument for prevalence studies will be used for assessing the quality of the studies. Two reviewers will be responsible for carrying out the study selection, data extraction and assessment of study quality. The results will be presented through the use of figures, tables, narrative summaries and a meta-analysis and meta-regression. ETHICS AND DISSEMINATION: No primary data will be collected. Thus, there is no need for approval from an ethics committee. We intend to share our results through publication in a peer-reviewed journal.

Cost-Effectiveness of Treatments for Musculoskeletal Conditions Offered by Physiotherapists: A Systematic Review of Trial-Based Evaluations.

BACKGROUND: Musculoskeletal conditions are a leading contributor to disability worldwide. The treatment of these conditions accounts for 7% of health care costs in Germany and is often provided by physiotherapists. Yet, an overview of the cost-effectiveness of treatments for musculoskeletal conditions offered by physiotherapists is missing. This review aims to provide an overview of full economic evaluations of interventions for musculoskeletal conditions offered by physiotherapists. METHODS: We systematically searched for publications in Medline, EconLit, and NHS-EED. Title and abstracts, followed by full texts were screened independently by two authors. We included trial-based full economic evaluations of physiotherapeutic interventions for patients with musculoskeletal conditions and allowed any control group. We extracted participants' information, the setting, the intervention, and details on the economic analyses. We evaluated the quality of the included articles with the Consensus on Health Economic Criteria checklist. RESULTS: We identified 5141 eligible publications and included 83 articles. The articles were based on 78 clinical trials. They addressed conditions of the spine (n = 39), the upper limb (n = 8), the lower limb (n = 30), and some other conditions (n = 6). The most investigated conditions were low back pain (n = 25) and knee and hip osteoarthritis (n = 16). The articles involved 69 comparisons between physiotherapeutic interventions (in which we defined primary interventions) and 81 comparisons in which only one intervention was offered by a physiotherapist. Physiotherapeutic interventions compared to those provided by other health professionals were cheaper and more effective in 43% (18/42) of the comparisons. Ten percent (4/42) of the interventions were dominated. The overall quality of the articles was high. However, the description of delivered interventions varied widely and often lacked details. This limited fair treatment comparisons. CONCLUSIONS: High-quality evidence was found for physiotherapeutic interventions to be cost-effective, but the result depends on the patient group, intervention, and control arm. Treatments of knee and back conditions were primarily investigated, highlighting a need for physiotherapeutic cost-effectiveness analyses of less often investigated joints and conditions. The documentation of provided interventions needs improvement to enable clinicians and stakeholders to fairly compare interventions and ultimately adopt cost-effective treatments.

Social Activities and Risk of Dementia in Community-Dwelling Older People: Gender-Specific Findings From a Prospective Cohort Study.

OBJECTIVES: This study examines the gender-specific associations between a wide range of social activities and dementia risk. METHODS: A prospective cohort study was conducted involving community-dwelling older Australians (≥70 years) without significant cognitive impairment at enrolment. During the first year of enrolment, we assessed 25 self-reported social activities covering various aspects, including support from relatives and friends, community participation, social interactions with surroundings, and loneliness. Dementia diagnosis followed DSM-IV criteria, adjudicated by an international expert panel. To estimate hazard ratios (HR) and 95% confidence intervals (CI) for associations between social activities and dementia, we performed Cox proportional hazards models, adjusting for age, educational attainment, baseline global cognition, and depressive symptoms. RESULTS: Among 9,936 participants who completed all social activity questionnaires (median [IQR] age: 73.4 [71.6-77.1] years; 47.4% men), dementia was diagnosed in 3.8% of men (n = 181/4,705) and 2.6% of women (n = 138/5,231) over a median 6.4 years (IQR: 5.3-7.6, range: 0.2-10.1) follow-up. Gender-specific relationships emerged: caregiving for a person with illness/disability in women (HR: 0.65, 95% CI: 0.42-0.99), and having ≥9 relatives feeling close to call for help in men (HR: 0.56, 95% CI: 0.33-0.96; reference <9 relatives) were associated with reduced dementia risk. Unexpectedly, in women, having ≥5 friends with whom they felt comfortable discussing private matters were associated with a greater dementia risk (HR: 1.69, 95% CI: 1.10-2.59; reference ≤2 friends). Imputed models further identified that babysitting/childminding was associated with lower dementia risk in men (HR: 0.75, 95% CI: 0.56-0.99). No other social activities showed significant associations with dementia. DISCUSSION: This study provides evidence of social activities influencing dementia risk. Further investigations are required to uncover the mechanisms driving these observed relationships.

Determinants of Telemedicine Service Use Among Middle-Aged and Older Adults in Germany During the COVID-19 Pandemic: Cross-Sectional Survey Study.

Background: The occurrence of the COVID-19 pandemic demanded fast changes in the delivery of health care. As a result, significant growth in the use of telemedicine services occurred. Research, especially from nationally representative German samples, is needed to better understand determinants of telemedicine use. Objective: The purpose of this study was to identify determinants of telemedicine service use among middle-aged and older adults during the COVID-19 pandemic in Germany. Methods: Cross-sectional, nationally representative data were taken from the German sample of the Survey of Health, Ageing and Retirement in Europe (SHARE). The German Corona Survey 2 (n=2039), which was conducted between June and August 2021, was used for this study. Reporting experience with remote medical consultations during the COVID-19 pandemic served as the outcome measure. Associations with socioeconomic, psychological, social, health-related, and COVID-19-related determinants were examined using multiple Firth logistic regressions. Results: Psychological factors including feeling nervous, anxious, or on edge (odds ratio [OR] 1.61, 95% CI 1.04-2.50; P=.03), feeling sad or depressed (OR 1.62, 95% CI 1.05-2.51; P=.03) and feelings of loneliness (OR 1.66, 95% CI 1.07-2.58; P=.02) were positively associated with telemedicine use. Moreover, forgoing medical treatment because of being afraid of being infected by SARS-CoV-2 (OR 1.81, 95% CI 1.10-2.97; P=.02) and describing limitations because of a health problem as severe were positively associated with the outcome (OR 2.11, 95% CI 1.12-4.00; P=.02). Socioeconomic and social factors were not significantly associated with telemedicine use in our sample. Conclusions: Middle-aged and older individuals in Germany seem to use telemedicine services according to psychological needs and health limitations. Especially when psychological symptoms are experienced, telemedicine seems to be a promising service option in this age group. Future research is needed to confirm these initial findings in postpandemic circumstances.

Meeting the WHO Physical Activity Guidelines is Associated With Lower Odds of Depression in Older Adults: Potential Psychosomatic Mechanisms.

OBJECTIVES: Limited data exist on the association between physical activity (PA) and depression in older adults from low- and middle-income countries (LMICs). In this study, we examine the association between meeting the World Health Organization (WHO) PA guidelines and depression in adults aged ≥50 years in Ghana and investigate the psychosomatic factors explaining this association. METHODS: Cross-sectional data from the Aging, Health, Psychological Well-being, and Health-seeking Behavior Study in Ghana (2016-18) were analyzed. Depression was assessed with the Center for Epidemiological Studies Depression Scale (CES-D-10). PA was assessed using the International Physical Activity Questionnaire Short Form (IPAQ-SF). Multivariable logistic regression and Hayes PROCESS macro with bootstrapping mediation analyses were performed to evaluate the hypothesized associations. RESULTS: The study included 1201 individuals (mean [SD] age 66.1 [11.9] years; 63.3% women). The prevalence of meeting PA guidelines and depression was 36.7% and 29.5%, respectively. Meeting the WHO-recommended PA guidelines was associated with a 16% lower rate of developing depression even after adjusting for potential confounders (OR = 0.84, p <0.001). This association was much stronger among men and those aged 50-64 years. Loneliness, social isolation, sleep problems, functional limitations, and pain characteristics largely mediated the association of PA with depression. CONCLUSIONS: PA was negatively associated with depression among older adults in Ghana, and psychosocial and physical factors partially explained the association. The promotion of PA in old age may aid in the prevention of depression, especially in men and those aged 50-64 years. Longitudinal data may confirm our findings.

Factors associated with loneliness among individuals aged 80 years and over: Findings derived from the nationally representative "Old Age in Germany (D80+)" study.

OBJECTIVES: To clarify the factors associated with loneliness in individuals aged 80 years and older in Germany (also stratified by sex). METHODS: Data from the nationally representative "Old Age in Germany (D80+)" were employed. The analytic sample equaled 10,031 individuals. The D80+ study included community-dwelling and institutionalized individuals ≥ 80 years in Germany. Multiple linear regressions were used (with sociodemographic and health-related explanatory factors). The collection of data occurred between November 2020 and April 2021 (written questionnaire). RESULTS: Higher loneliness was significantly associated with not being married (e.g., widowed compared to being married, ß=0.37, p<.001), being institutionalized (ß=0.33, p<.001), low education (high education compared to low education, ß=-0.07, p<.01), a higher number of chronic conditions (ß=0.02, p<.001), poor self-rated health (ß=-0.19, p<.001) and greater functional impairment (ß=0.15, p<.001). Sex-stratified regressions produced comparable results. However, low education was only associated with higher loneliness among men, but not women (with significant interaction: education x sex). CONCLUSION: Several sociodemographic and health-related factors can contribute to loneliness among the oldest old in Germany, with sex-specific associations between education and loneliness. Overall, such knowledge can aid to address individuals with higher loneliness levels.

Personality and the use of cancer screenings - Results of the German National Cohort.

Objective: To determine the association between personality characteristics and use of different cancer screenings. Methods: We used data from the German National Cohort (NAKO; mean age was 53.0 years (SD: 9.2 years)) - a population-based cohort study. A total of 132,298 individuals were included in the analyses. As outcome measures, we used (self-reported): stool examination for blood (haemoccult test, early detection of bowel cancer), colonoscopy (screening for colorectal cancer), skin examination for moles (early detection of skin cancer), breast palpation by a doctor (early detection of breast cancer), x-ray examination of the breast ("mammography", early detection of breast cancer), cervical smear test, finger examination of the rectum (early detection of prostate cancer), and blood test for prostate cancer (determination of Prostate-Specific Antigen level). The established Big Five Inventory-SOEP was used to quantify personality factors. It was adjusted for several covariates based on the Andersen model. Unadjusted and adjusted multiple logistic regressions were computed. Results: A higher probability of having a skin examination for moles, for example, was associated with a higher conscientiousness (OR: 1.07, p < 0.001), higher extraversion (OR: 1.03, p < 0.001), higher agreeableness (OR: 1.02, p < 0.001), lower openness to experience (OR: 0.98, p < 0.001) and higher neuroticism (OR: 1.07, p < 0.001) among the total sample. Depending on the outcome used, the associations slightly varied. Conclusions: Particularly higher levels of extraversion, neuroticism and conscientiousness are associated with the use of different cancer screenings. Such knowledge may help to better understand non-participation in cancer screening examinations from a psychological perspective.

How do individuals rate their health compared to others? findings based on a nationally representative sample in Germany.

BACKGROUND: The aim of this study is to explore the determinants of health comparisons (i.e., how individuals rate their health compared to other individuals in their age bracket) in the general adult population (total sample and in different age groups). METHODS: Data were used from the general adult population in Germany (wave 46, n = 3,876 individuals; November 2021 to January 2022), based on the GESIS panel, which is a probability-based mixed-mode panel. Health comparisons were used as outcome measure. Socioeconomic, lifestyle-related and health-related determinants were included in regression analysis. Robustness checks were conducted. RESULTS: Regressions showed that more favorable health comparisons were associated with being male (among individuals up to 39 years), higher age (among the total sample), higher education (among the total sample and individuals up to 39 years), higher income (among the total sample and individuals aged 40 to 64 years), not "being married, and living together with a spouse" (among the total sample), never eating meat (among the total sample, individuals up to 39 years and particularly individuals aged 40 to 64 years), drinking alcohol (among the total sample, individuals aged 40 to 64 years and individuals aged 65 years and over), a higher frequency of sports activities (all groups) and a higher satisfaction with health (also in all groups). CONCLUSION: In addition to the evident link between health satisfaction and health comparisons, regression analysis revealed that certain socioeconomic factors, such as a higher income level, along with positive lifestyle-related factors - especially among middle-aged individuals - were significantly associated with more positive health comparisons. This knowledge is required in order to support individuals at risk for negative health comparisons. This is important because negative health comparisons can contribute to poor well-being and poor health outcomes.

Pain: its prevalence and correlates among the oldest old.

BACKGROUND: There is very limited knowledge regarding pain among the oldest old. AIMS: To investigate the prevalence and correlates of pain among the oldest old. METHODS: Data were taken from the "Survey on quality of life and subjective well-being of the very old in North Rhine-Westphalia (NRW80+)", including individuals living in North Rhine-Westphalia aged 80 years and over. Pain was categorized as no pain, moderate pain and severe pain. Its prevalence was stratified by sex, age groups, marital status, place of residence and education. A multinomial logistic regression analysis was conducted. RESULTS: 28.50% of the participants reported no pain, 45.06% moderate pain and 26.44% severe pain. Regressions showed that being 85 years or older and a better self-rated health status decreased the likelihood of moderate pain. Being 85-89 years old, being male, highly educated and a better self-rated health status decreased the likelihood of severe pain. The likelihood of moderate and severe pain increased with a higher number of chronic diseases. DISCUSSION: Study findings showed a high prevalence of pain in the oldest old living in North Rhine-Westphalia, Germany. The likelihood of having moderate or severe pain was reduced among those who were older and presented with a better self-rated health but increased with a growing number of comorbidities. Severe pain was less likely among men and those with a higher education. CONCLUSION: This cross-sectional representative study adds first evidence of prevalence and correlations of pain among the oldest old. Longitudinal studies are required to further explore the determinants of pain in this age group.