BackgroundInternational comparisons of disease prevalence have been useful in understanding what proportion of disease might be preventable and in informing potential policy interventions in different cultural and economic contexts. Using newly available, harmonized data from 20 countries, we compare disability and morbidity of older adults between the ages of 55 and 74.MethodsThe Gateway to Global Aging Data, a data and information portal, provides access to easy-to-use individual-level longitudinal data from 10 surveys covering over 30 countries. Exploiting harmonized measures available from the Gateway, we descriptively examine how disability and morbidity differ across countries.ResultsSignificant cross-country differences are observed for several health indicators. Comparing countries with the highest and lowest prevalence rates, we observe that hypertension rates vary twofold and stroke rates vary threefold, while disability and arthritis rates vary more than fivefold. Among women, higher gross domestic product and life expectancy are related to lower diabetes, heart disease, and better functioning. Among men, national indicators of economic conditions are not significantly associated with reported disease prevalence.ConclusionsWe document substantial heterogeneity in disability and morbidity across countries, separately for men and women and after controlling for population age composition and education. Rich data from various surveys across the world offers remarkable opportunities for cross-country analyses, calling for further investigation of what drives observed differences. The Gateway to Global Aging Data provides easy-to-use harmonized data files and tools to facilitate this type of research.

It has been suggested that depression is a polygenic trait, arising from the influences of multiple loci with small individual effects. The aim of this study is to generate a polygenic risk score (PRS) to examine the association between genetic variation and depressive symptoms. Our analytic sample included N=10,091 participants ages 50+ from the Health and Retirement Study (HRS). Depressive symptoms were measured by CESD scores assessed on up to nine occasions across 18 years. We conducted a genome-wide association analysis for a discovery set (n=7,000) and used the top 11 single nucleotide polymorphisms, all with P<10−05 to generate a weighted PRS for our replication sample (n=3,091). Results showed the PRS was significantly associated with mean CESD score in the replication sample (β=.08, P=.002). The R2-change for the inclusion of the PRS was .003. Using a multinomial logistic regression model we also examined the association between genetic risk and chronicity of high (4+) CESD scores. We found that a one standard deviation increase in PRS was associated with a 36% increase in the odds of having chronically high CESD scores relative to never having had high CESD scores. Our findings are consistent with depression being a polygenic trait and suggest that the cumulative influence of multiple variants increase an individual’s susceptibility for chronically experiencing high levels of depressive symptoms.

Objectives The Gateway to Global Aging Data (Gateway; g2aging.org) is a data and information platform developed to facilitate cross-country analyses on aging, especially those using the international family of Health and Retirement studies. We provide a brief introduction to the Gateway to Global Aging Data, discussing its potential for cross-national comparisons of family, social environment, and healthy aging. Methods We summarize the survey metadata, study characteristics, and harmonized data available from the Gateway, describing the population represented in each study. We portray cohort characteristics and key measures of health and social environment from 37 countries in North America, Europe, and Asia using harmonized data. Results Significant cross-country heterogeneity was observed in many measures of family, social environment, and healthy aging indicators. For example, there was a three-fold difference in co-residence with children, ranging from 14% in Sweden to over 46% in Spain and Korea in 2014. From 2002-2014, the difference between informal care receipt in individuals of low and high wealth decreased by 6% in the US and remained unchanged in England. The percentage of individuals aged 50-59 living alone in 2012 varied fifteen-fold, from a low of 2% in China to a high of 30% in Mexico. Discussion By partnering with nationally representative studies around the globe, the Gateway to Global Aging Data facilitates comparative research on aging through the provision of easy-to-use harmonized data files and other valuable tools.

Background Inequality in gender varies across social contexts, which may influence the health of both men and women. Based on theories of gender as a social system, we examine whether systematic gender inequality at the macro-level influences health of men and women. Method Using harmonized panel data from the Gateway to Global Aging Data in 23 high- and middle-income countries (N = 168 873), we estimate disability prevalence and incidence for men and women ages 55–89 (2000–2016). Within each country or geographic region, we also investigate gender differences in age gradients of the probability of disability onset. We, then, pool data from all countries and test the hypothesis that gender inequality increases the probability of disability onset. Results We found substantial cross-country variation in disability incidence rates, and this variation is greater for women than for men. Among ages 65–69, disability incidence rates ranged from 0.4 to 5.0 for men and from 0.5 to 9.4 for women. Our within-country analysis showed significant gender differences in age gradients of the probability of disability onset in the United States, Korea, Southern Europe, Mexico, and China, but not in Northern, Central, and Eastern Europe, England, and Israel. Testing hypothesized effects of gender inequality, we find that gender inequality is significantly associated with the probability of disability onset for women, but not for men. Conclusions Macro-level societal gender inequality is significantly associated with the probability of disability onset for women. Reducing and eliminating gender inequality is crucial to achieving good health for women.