This study aimed to examine the association between motor dysfunction and mental well-being in later life using multicohort data and explore moderation by the country-level factors.
This cross-country study used data from four large cohorts: JSTAR (Japanese Study of Aging and Retirement), ELSA (English Longitudinal Study of Ageing), HRS (Health Retirement Study), and SHARE (Survey of Health, Ageing and Retirement in Europe). Four waves, collected over six years, were included from each cohort. We included 69,257 individuals (225,522 observations) aged 50-75 years at baseline across 15 countries, including Japan, England, the United States, and Europe. Motor function was assessed at each time point based on a 10-item self-repot about mobility, upper-limb, and gross motor function (0-10 points, higher scores indicating greater limitations). Four aspects of mental well-being were measured, self-reported health, depressive symptoms, happiness, and life satisfaction, which were standardized across countries and converted to score ranges of 0-100. We performed fixed-effects analyses on each country to automatically control for time-invariant covariates and adjust for important time-varying demographic and socioeconomic factors and health status to examine the association between motor dysfunction and mental well-being. Then, results were pooled by meta-analysis to obtain an overall effect (i.e., a pooled coefficient). Finally, meta-regression analyses were conducted to examine whether the relationship between motor dysfunction and mental well-being was moderated by country-level factors (such as GDP, income inequality, and social expenditure).
Independent of confounders, having motor dysfunction was associated with poorer self-reported health (pooled coefficient = -3.11; 95% CI=-3.59, -2.62), higher levels of depressive symptoms (pooled coefficient = 2.83; 95% CI = 2.53, 3.12), and lower levels of happiness (pooled coefficient = -0.70; 95% CI = -0.94, -0.45) and life satisfaction (pooled coefficient = -1.11; 95% CI = -1.46, -0.76). However, the relationships showed some heterogeneity across countries. Meta-regression analysis suggested that greater country-level income inequality increased the impact of motor dysfunction on mental well-being, whereas higher social expenditure on older adults alleviated the impact.
This study showed that, across 15 countries, a decline in motor function impaired mental well-being in later life. However, some heterogeneity in the impact of motor dysfunction on well-being was also observed across countries, and the country-level economic equality and social spending for older adults may moderate this impact.
The findings highlight the importance of prevention and rehabilitation of motor dysfunction to ensure the mental well-being of older adults across countries. Moreover, improving the environment through economic and social insurance policies may help enhance the well-being of older adults with motor dysfunction.
Motor function
Well-being
