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婚姻和健康状况变化作为后续负面财富冲击的风险因素:1995 - 2020年美国基于人群的纵向研究

Changes in marital and health status as risk factors for a subsequent negative wealth shock: A population-based longitudinal study in the United States, 1995-2020.

作者信息

Cho Tsai-Chin, Yu Xuexin, Adar Sara D, Choi HwaJung, Langa Kenneth M, Kobayashi Lindsay C

机构信息

Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA; Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor, MI, USA.

Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.

出版信息

Soc Sci Med. 2025 Apr;371:117905. doi: 10.1016/j.socscimed.2025.117905. Epub 2025 Mar 7.

Abstract

OBJECTIVES

A negative wealth shock, defined as a loss of ≥75% in equivalized household total wealth over a short period, may cause adverse health outcomes for older adults. The individual-level risk factors for experiencing a negative wealth shock in later adulthood are unclear.

METHODS

Data were from 25,072 adults aged ≥55 in the longitudinal, population-based US Health and Retirement Study from 1995 to 2020 (n = 123,651 observations across all study respondents). We performed multivariable-adjusted Poisson mixed effects models to examine the association of each of the four risk factors, 1) separation from or loss of a spouse/partner; 2) transition from better to worse self-reported general health; 3) transition from low to high depressive symptoms; and 4) transition from normal cognition to cognitive impairment without dementia (CIND) or dementia, with the subsequent experience of a negative wealth shock in mid-to-later life.

RESULTS

All four risk factors increased the likelihood of newly experiencing a negative wealth shock: separation from or loss of a spouse/partner (incidence rate ratio (IRR) = 1.59; 95% CI: 1.41, 1.78), transition from excellent/good to fair/poor self-reported general health (IRR = 1.14; 95% CI: 1.06, 1.23), transition from low to high depressive symptoms (IRR = 1.10; 95% CI: 1.02, 1.19), and transition from normal to CIND or dementia (IRR = 1.14; 95% CI: 1.06, 1.22).

DISCUSSION

This long-timespan, population-based study suggests that adverse changes in marital or health status in mid-to-later life may signal risks for a future negative wealth shock. Public policy interventions to support aging adults at risk of a negative wealth shock may be warranted.

摘要

目的

负财富冲击被定义为在短时间内家庭等价总资产损失≥75%,这可能会给老年人带来不良健康后果。成年后期经历负财富冲击的个体层面风险因素尚不清楚。

方法

数据来自1995年至2020年美国基于人群的纵向健康与退休研究中25,072名年龄≥55岁的成年人(所有研究受访者共有123,651次观察)。我们进行了多变量调整的泊松混合效应模型,以检验四个风险因素中的每一个与中年及老年后期随后经历负财富冲击之间的关联,这四个风险因素分别为:1)与配偶/伴侣分居或失去配偶/伴侣;2)自我报告的总体健康状况从较好转变为较差;3)抑郁症状从低水平转变为高水平;4)从正常认知转变为无痴呆的认知障碍(CIND)或痴呆。

结果

所有四个风险因素均增加了新经历负财富冲击的可能性:与配偶/伴侣分居或失去配偶/伴侣(发病率比(IRR)=1.59;95%置信区间:1.41, 1.78),自我报告的总体健康状况从优秀/良好转变为一般/较差(IRR =1.14;95%置信区间:1.06, 1.23),抑郁症状从低水平转变为高水平(IRR =1.10;95%置信区间:1.02, 1.19),以及从正常转变为CIND或痴呆(IRR =1.14;95%置信区间:1.06, 1.22)。

讨论

这项基于人群的长期研究表明,中年及老年后期婚姻或健康状况的不利变化可能预示着未来负财富冲击的风险。可能有必要采取公共政策干预措施来支持有负财富冲击风险的老年人。

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本文引用的文献

1
Healthcare on the brink: navigating the challenges of an aging society in the United States.
NPJ Aging. 2024 Apr 6;10(1):22. doi: 10.1038/s41514-024-00148-2.
2
Food Security and Health Outcomes following Gray Divorce.
Nutrients. 2024 Feb 24;16(5):633. doi: 10.3390/nu16050633.
3
Changes in Care Use and Financial Status Associated With Dementia in Older Adults.
JAMA Intern Med. 2023 Dec 1;183(12):1315-1323. doi: 10.1001/jamainternmed.2023.5482.
4
Declines in Wealth Among US Older Adults at Risk of Dementia.
JAMA Neurol. 2023 Nov 1;80(11):1250-1252. doi: 10.1001/jamaneurol.2023.3216.
6
Economic Well-Being And Health: The Role Of Income Support Programs In Promoting Health And Advancing Health Equity.
Health Aff (Millwood). 2022 Dec;41(12):1700-1706. doi: 10.1377/hlthaff.2022.00846.
7
Association of Stroke and Cerebrovascular Pathologies With Scam Susceptibility in Older Adults.
JAMA Neurol. 2023 Jan 1;80(1):49-57. doi: 10.1001/jamaneurol.2022.3711.
8
Management of Financial Assets by Older Adults With and Without Dementia or Other Cognitive Impairments.
JAMA Netw Open. 2022 Sep 1;5(9):e2231436. doi: 10.1001/jamanetworkopen.2022.31436.
9
Time cannot heal all wounds: Wealth trajectories of divorcees and the married.
J Marriage Fam. 2022 Apr;84(2):592-611. doi: 10.1111/jomf.12824. Epub 2022 Jan 29.
10
Assessment of Mortality Disparities by Wealth Relative to Other Measures of Socioeconomic Status Among US Adults.
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