Jiménez Laura J, Dutton Daniel J
Department of Community Health and Epidemiology, Faculty of Medicine, Centre for Clinical Research, Dalhousie University, Halifax, Nova Scotia, Canada.
Can J Public Health. 2024 Dec;115(6):903-912. doi: 10.17269/s41997-024-00875-9. Epub 2024 Apr 22.
Statistically model the likelihood of changes in the activities of daily living (ADLs) over time for three groups of older adults: those on a pension at all time periods, those never on a pension, and those who transition onto a public pension.
Our study used data from the Canadian Longitudinal Study on Aging (CLSA), a large national survey. We used data from baseline (2010-2015) and the first follow-up wave (2015-2018). We used logistic regression to model the likelihood of ADL changes in males and females by pension receipt status, controlling for several potential confounders and allowing for the impact of public pensions to be modified by baseline income.
The magnitudes of the estimates indicated that those who transition to a public pension are less likely to report ADL degradation and more likely to report ADL improvement compared to those with no public pension. In the lowest baseline income group, those who transitioned onto a pension at follow-up had a 15% (male) or 11% (female) lower likelihood of reporting degraded ADL scores compared to those not receiving a pension at follow-up. Those who transitioned onto a pension in the lowest income group were more likely to report an improved ADL score at follow-up.
Our results could provide evidence for the potential health benefits of more comprehensive guaranteed annual income programs beyond the pension program. The penalty of being low-income was mitigated by the stability of the pension income in terms of ADL improvement or degradation.
对三组老年人日常生活活动(ADL)随时间变化的可能性进行统计建模,这三组老年人分别是:在所有时间段都领取养老金的人、从未领取过养老金的人以及开始领取公共养老金的人。
我们的研究使用了来自加拿大老龄化纵向研究(CLSA)的数据,这是一项大型的全国性调查。我们使用了基线(2010 - 2015年)和首次随访期(2015 - 2018年)的数据。我们使用逻辑回归对按养老金领取状况划分的男性和女性ADL变化的可能性进行建模,控制了几个潜在的混杂因素,并考虑了公共养老金的影响因基线收入而有所不同。
估计值的大小表明,与没有公共养老金的人相比,开始领取公共养老金的人报告ADL恶化的可能性较小,而报告ADL改善的可能性较大。在基线收入最低的组中,随访时开始领取养老金的人报告ADL得分恶化的可能性比随访时未领取养老金的人低15%(男性)或11%(女性)。在最低收入组中开始领取养老金的人在随访时更有可能报告ADL得分有所改善。
我们的结果可以为除养老金计划之外更全面的有保障的年度收入计划的潜在健康益处提供证据。就ADL的改善或恶化而言,养老金收入的稳定性减轻了低收入带来的不利影响。