@article {11593,
	title = {A multidimensional measure of polypharmacy for older adults using the Health and Retirement Study.},
	journal = {Scientific Reports},
	volume = {11},
	year = {2021},
	pages = {8783},
	abstract = {<p>Polypharmacy is commonly defined based on the number of medications taken concurrently using standard cut-offs, but several studies have highlighted the need for a multidimensional assessment. We developed a multidimensional measure of polypharmacy and compared with standard cut-offs. Data were extracted for 2141 respondents of the 2007 Prescription Drug Survey, a sub-study of the Health Retirement Study. Latent classes were identified based on multiple indicators of polypharmacy, including quantity, temporality and risk profile. A four-class model was selected based on fit statistics and clinical interpretability: {\textquoteright}High risk, long-term{\textquoteright} (Class 1), {\textquoteright}Low risk, long-term{\textquoteright} (Class 2), {\textquoteright}High risk, short-term{\textquoteright} (Class 3), and {\textquoteright}High risk for drug interactions, medium-term, regular{\textquoteright} (Class 4). Classes differed regarding sex, cohabitation, disability and multimorbidity. Participants in the {\textquoteright}low risk{\textquoteright} class tended to be male, cohabitating, and reported fewer health conditions, compared to {\textquoteright}high risk{\textquoteright} classes. Polypharmacy classes were compared to standard cut-offs (5+ or 9+ medications) in terms of overlap and mortality risk. The three {\textquoteright}high risk{\textquoteright} classes overlapped with the groups concurrently taking 5+ and 9+ medications per month. However, the multidimensional measure further differentiated individuals in terms of risk profile and temporality of medication taking, thus offering a richer assessment of polypharmacy.</p>},
	keywords = {Diseases, Health Care, Medical research, Risk Factors},
	issn = {2045-2322},
	doi = {10.1038/s41598-021-86331-x},
	author = {Carr, Ewan and Federman, Alex and Dzahini, Olubanke and Dobson, Richard J and Bendayan, Rebecca}
}
@article {9602,
	title = {Occupational and educational inequalities in exit from employment at older ages: evidence from seven prospective cohorts},
	journal = {Occupational and Environmental Medicine},
	volume = {75},
	year = {2018},
	month = {Dec-05-2018},
	pages = {369 - 377},
	abstract = {Objectives

Past studies have identified socioeconomic inequalities in the timing and route of labour market exit at older ages. However, few studies have compared these trends cross-nationally and existing evidence focuses on specific institutional outcomes (such as disability pension and sickness absence) in Nordic countries. We examined differences by education level and occupational grade in the risks of work exit and health-related work exit.

Methods

Prospective longitudinal data were drawn from seven studies (n=99 164). Participants were in paid work at least once around age 50. Labour market exit was derived based on reductions in working hours, changes in self-reported employment status or from administrative records. Health-related exit was ascertained by receipt of health-related benefit or pension or from the reported reason for stopping work. Cox regression models were estimated for each study, adjusted for baseline self-rated health and birth cohort.

Results

There were 50 003 work exits during follow-up, of which an average of 14\% (range 2-32\%) were health related. Low level education and low occupational grade were associated with increased risks of health-related exit in most studies. Low level education and occupational grade were also associated with an increased risk of any exit from work, although with less consistency across studies.

Conclusions

Workers with low socioeconomic position have an increased risk of health-related exit from employment. Policies that extend working life may disadvantage such workers disproportionally, especially where institutional support for those exiting due to poor health is minimal.},
	keywords = {Education, Employment and Labor Force, Europe, Health Disparities, Work},
	issn = {1351-0711},
	doi = {10.1136/oemed-2017-10461910.1136/oemed-2017-104619.supp1},
	url = {http://oem.bmj.com/content/75/5/369},
	author = {Carr, Ewan and Fleischmann, Maria and Goldberg, Marcel and Kuh, Diana and Murray, Emily T and Stafford, Mai and Stansfeld, Stephen and Vahtera, Jussi and Xue, Baowen and Zaninotto, Paola and Zins, Marie and Head, Jenny}
}
