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Biopsychosocial Factors In Oral And Systemic Diseases: A Scoping Review, Abby L. J. Hensel, Kathryn Nicholson, Kelly K Anderson, Noha A. Gomaa

Dentistry Publications

BACKGROUND: The association between chronic oral diseases and other major systemic health conditions, commonly referred to as the oral-systemic health connection, has been previously studied with several underlying common risk factors and pathways linking both groups of diseases. Psychosocial factors contribute to an increased susceptibility to chronic oral and non-oral diseases. The aim of this review is to summarize the current state of knowledge on the role of psychosocial stress in chronic oral and systemic diseases.

METHODS: A search strategy was built and a literature search was conducted using four databases (CINAHL, Embase, Medline, PsycINFO). A combination of search terms …

Social Capital Associates With Better Cognitive Health, Oral Health And Epigenetic Age Deceleration: Findings From The Canadian Longitudinal Study On Aging., Aileen Liang, Noha Gomaa

Department of Medicine Publications

Background: Social exposures are linked to an array of health outcomes, especially around aging. In this study, we examined the association of social capital, defined as social relationships and networks, with clinical and biological outcomes including cognitive health, oral inflammation, and epigenetic aging. Methods: We used data from the Canadian Longitudinal Study on Aging (CLSA) (n =1,479; aged 45–85 years), categorizing social capital as structural and cognitive capital. Oral inflammation was determined as the presence of gum bleeding. Epigenetic aging was computed as the difference between chronological age and DNA methylation age. We constructed multivariable regression models adjusted for covariates …

Age- And Sex-Specific Differences In Sympathetic Vascular Transduction And Neuro-Hemodynamic Balance In Humans., Andrew W D'Souza, Sarah L Hissen, Kazumasa Manabe, Ryosuke Takeda, Takuro Washio, Geoff B Coombs, Belinda Sanchez, Qi Fu, Kevin Shoemaker

Kinesiology Publications

Bursts of muscle sympathetic nerve activity (MSNA) and the ensuing vasoconstriction are pivotal determinants of beat-by-beat blood pressure regulation. Although age and sex impact blood pressure regulation, how these factors affect the central and peripheral arcs of the baroreflex remains unclear. In 27 young (25[3] years) males (YM; n=14) and females (YF; n=13) and 23 older (71[5] years) males (OM; n=11) and females (OF; n=12) femoral artery blood flow, blood pressure and MSNA were recorded for 10 minutes of supine rest. Sympathetic baroreflex sensitivity (i.e., central arc) was quantified as the relationship between diastolic blood pressure …

Hypophosphorylated Prb Knock-In Mice Exhibit Hallmarks Of Aging And Vitamin C-Preventable Diabetes, Zhe Jiang, Huiqin Li, Stephanie A. Schroer, Veronique Voisin, Young Jun Ju, Marek Pacal, Natalie Erdmann, Wei Shi, Philip E.D. Chung, Tao Deng, Nien Jung Chen, Giovanni Ciavarra, Alessandro Datti, Tak W. Mak, Lea Harrington, Frederick A. Dick, Gary D. Bader, Rod Bremner, Minna Woo, Eldad Zacksenhaus

Paediatrics Publications

Despite extensive analysis of pRB phosphorylation in vitro, how this modification influences development and homeostasis in vivo is unclear. Here, we show that homozygous Rb∆K4 and Rb∆K7 knock-in mice, in which either four or all seven phosphorylation sites in the C-terminal region of pRb, respectively, have been abolished by Ser/Thr-to-Ala substitutions, undergo normal embryogenesis and early development, notwithstanding suppressed phosphorylation of additional upstream sites. Whereas Rb∆K4 mice exhibit telomere attrition but no other abnormalities, Rb∆K7 mice are smaller and display additional hallmarks of premature aging including infertility, kyphosis, and diabetes, indicating an accumulative effect of blocking pRb phosphorylation. Diabetes in …

Cortical Responses To The Amplitude Envelopes Of Sounds Change With Age, Vanessa C. Irsik, Ala Almanaseer, Ingrid S. Johnsrude, Björn Herrmann

Brain and Mind Institute Researchers' Publications

Many older listeners have difficulty understanding speech in noise, when cues to speech-sound identity are less redundant. The amplitude envelope of speech fluctuates dramatically over time, and features such as the rate of amplitude change at onsets (attack) and offsets (decay), signal critical information about the identity of speech sounds. Aging is also thought to be accompanied by increases in cortical excitability, which may differentially alter sensitivity to envelope dynamics. Here, we recorded electroencephalography in younger and older human adults (of both sexes) to investigate how aging affects neural synchronization to 4 Hz amplitude-modulated noises with different envelope shapes (ramped: …

Development Of A Standardized Histopathology Scoring System Using Machine Learning Algorithms For Intervertebral Disc Degeneration In The Mouse Model—An Ors Spine Section Initiative, Itzel Paola Melgoza, Srish S. Chenna, Steven Tessier, Yejia Zhang, Simon Y. Tang, Takashi Ohnishi, Emanuel José Novais, Geoffrey J. Kerr, Sarthak Mohanty, Vivian Tam, Wilson C.W. Chan, Chao Ming Zhou, Ying Zhang, Victor Y. Leung, Angela K. Brice, Cheryle A. Séguin, Danny Chan, Nam Vo, Makarand V. Risbud, Chitra L. Dahia

Paediatrics Publications

Mice have been increasingly used as preclinical model to elucidate mechanisms and test therapeutics for treating intervertebral disc degeneration (IDD). Several intervertebral disc (IVD) histological scoring systems have been proposed, but none exists that reliably quantitate mouse disc pathologies. Here, we report a new robust quantitative mouse IVD histopathological scoring system developed by building consensus from the spine community analyses of previous scoring systems and features noted on different mouse models of IDD. The new scoring system analyzes 14 key histopathological features from nucleus pulposus (NP), annulus fibrosus (AF), endplate (EP), and AF/NP/EP interface regions. Each feature is categorized and …

The Benefits Of High-Intensity Interval Training On Cognition And Blood Pressure In Older Adults With Hypertension And Subjective Cognitive Decline: Results From The Heart & Mind Study, Narlon C. Boa Sorte Silva, Andrea F.M. Petrella, Nathan Christopher, Catherine F.S. Marriott, Dawn P. Gill, Adrian M. Owen, Robert J. Petrella

Brain and Mind Institute Researchers' Publications

Background: The impact of exercise on cognition in older adults with hypertension and subjective cognitive decline (SCD) is unclear. Objectives: We determined the influence of high-intensity interval training (HIIT) combined with mind-motor training on cognition and systolic blood pressure (BP) in older adults with hypertension and SCD. Methods: We randomized 128 community-dwelling older adults [age mean (SD): 71.1 (6.7), 47.7% females] with history of hypertension and SCD to either HIIT or a moderate-intensity continuous training (MCT) group. Both groups received 15 min of mind-motor training followed by 45 min of either HIIT or MCT. Participants exercised in total 60 min/day, …

Cognition Across The Lifespan: Investigating Age, Sex, And Other Sociodemographic Influences, Emily S. Nichols, Conor J. Wild, Adrian M. Owen, Andrea Soddu

Brain and Mind Institute Researchers' Publications

Maintaining cognitive health across the lifespan has been the focus of a multi-billion-dollar industry. In order to guide treatment and interventions, a clear understanding of the way that proficiency in different cognitive domains develops and declines in both sexes across the lifespan is necessary. Additionally, there are sex differences in a range of other factors, including psychiatric illnesses such as anxiety, depression, and substance use, that are also known to affect cognition, although the scale of this interaction is unknown. Our objective was to assess differences in cognitive function across the lifespan in men and women in a large, representative …

The Process Of Creating And Disseminating Exercise Programs By Physical Therapists For Older Adults With Chronic Back Pain, Melissa E. Hay, Denise M. Connelly

Physical Therapy Publications

Objective: The purpose of this study was to enhance the understanding of the process that physical therapists undertake when creating and disseminating exercise programs for older adults with chronic backpain. Methods: Constructivist grounded theory methodology was used as an accessible mode of researching pragmatic clinical practices. Physical therapists from outpatient, ambulatory care clinic settings participated in in-depth, individual interviews (n = 9) and in-clinic observations (n = 5). Data collection and analysis were iterative processes. Codes were generated based on recurrent themes, and constant comparative analysis was used to compare data. Analysis and data collection were concluded when theoretical sufficiency …

Lactate Dehydrogenase Expression Modulates Longevity And Neurodegeneration In Drosophila Melanogaster, Dani M. Long, Ariel Frame, Patrick N. Reardon, Robert C. Cumming, David A. Hendrix, Doris Kretzschmar, Jadwiga M. Giebultowicz

Paediatrics Publications

Lactate dehydrogenase (LDH) catalyzes the conversion of glycolysis-derived pyruvate to lactate. Lactate has been shown to play key roles in brain energetics and memory formation. However, lactate levels are elevated in aging and Alzheimer's disease patients, and it is not clear whether lactate plays protective or detrimental roles in these contexts. Here we show that Ldh transcript levels are elevated and cycle with diurnal rhythm in the heads of aged flies and this is associated with increased LDH protein, enzyme activity, and lactate concentrations. To understand the biological significance of increased Ldh gene expression, we genetically manipulated Ldh levels in …

Bilingualism Affords No General Cognitive Advantages: A Population Study Of Executive Function In 11,000 People, Emily S. Nichols, Conor J. Wild, Bobby Stojanoski, Michael E. Battista, Adrian M. Owen

Brain and Mind Institute Researchers' Publications

Whether acquiring a second language affords any general advantages to executive function has been a matter of fierce scientific debate for decades. If being bilingual does have benefits over and above the broader social, employment, and lifestyle gains that are available to speakers of a second language, then it should manifest as a cognitive advantage in the general population of bilinguals. We assessed 11,041 participants on a broad battery of 12 executive tasks whose functional and neural properties have been well described. Bilinguals showed an advantage over monolinguals on only one test (whereas monolinguals performed better on four tests), and …

Thirty-Five Years Of Computerized Cognitive Assessment Of Aging — Where Are We Now?, Avital Sternin, Alistair Burns, Adrian M. Owen

Brain and Mind Institute Researchers' Publications

Over the past 35 years, the proliferation of technology and the advent of the internet have resulted in many reliable and easy to administer batteries for assessing cognitive function. These approaches have great potential for affecting how the health care system monitors and screens for cognitive changes in the aging population. Here, we review these new technologies with a specific emphasis on what they offer over and above traditional ‘paper-and-pencil’ approaches to assessing cognitive function. Key advantages include fully automated administration and scoring, the interpretation of individual scores within the context of thousands of normative data points, the inclusion of …

Emergence Of Human Immunoprofiling In Health And Disease, Bhagirath Singh

Microbiology & Immunology Publications

The human immune system is critical for maintaining health and providing protection from infectious diseases and cancer. Major advances in our understanding of the immune system have largely emerged from studies using animal models such as mice. However, this mouse-centric research has also limited our ability to comprehend the human immune system and how it changes with age and disease state. The fact that we have yet to define what constitutes a normal human immune system has hampered our ability to diagnose, treat, and prevent many human diseases. Immunoprofiling that measures the frequency of human immune cells based upon their …

Moderating Effect Of Cortical Thickness On Bold Signal Variability Age-Related Changes, Daiana R. Pur, Roy A. Eagleson, Anik De Ribaupierre, Nathalie Mella, Sandrine De Ribaupierre

Brain and Mind Institute Researchers' Publications

© Copyright © 2019 Pur, Eagleson, de Ribaupierre, Mella and de Ribaupierre. The time course of neuroanatomical structural and functional measures across the lifespan is commonly reported in association with aging. Blood oxygen-level dependent signal variability, estimated using the standard deviation of the signal, or “BOLDSD,” is an emerging metric of variability in neural processing, and has been shown to be positively correlated with cognitive flexibility. Generally, BOLDSD is reported to decrease with aging, and is thought to reflect age-related cognitive decline. Additionally, it is well established that normative aging is associated with structural changes in brain regions, and that …

Initiating Participatory Action Research With Older Adults: Lessons Learned Through Reflexivity*, Colleen E. Mcgrath

Occupational Therapy Publications

Participatory action research (PAR) is well suited to research that aims to address social exclusion and inclusion in older age. Illustrations of and reflections on PAR with older adults are scarce, particularly the initiation stage, which sets the stage for the cyclical participatory action that follows. In this article, we describe the initiation of a PAR project with older adults and reflect on the alignment of this process with key participatory principles and fit within typical research structures. Findings point to the tensions between developing relationships over time and time-sensitive calls for funding, how traditional conceptions of research can influence …

Longitudinal Alzheimer's Degeneration Reflects The Spatial Topography Of Cholinergic Basal Forebrain Projections, Taylor W. Schmitz, Marieke Mur, Meghmik Aghourian, Marc Andre Bedard, R. Nathan Spreng

Brain and Mind Institute Researchers' Publications

© 2018 The Author(s) The cholinergic neurons of the basal forebrain (BF) provide virtually all of the brain's cortical and amygdalar cholinergic input. They are particularly vulnerable to neuropathology in early Alzheimer's disease (AD) and may trigger the emergence of neuropathology in their cortico-amygdalar projection system through cholinergic denervation and trans-synaptic spreading of misfolded proteins. We examined whether longitudinal degeneration within the BF can explain longitudinal cortico-amygdalar degeneration in older human adults with abnormal cerebrospinal fluid biomarkers of AD neuropathology. We focused on two BF subregions, which are known to innervate cortico-amygdalar regions via two distinct macroscopic cholinergic projections. To …

Cognitive Changes Following Multiple-Modality Exercise And Mind-Motor Training In Older Adults With Subjective Cognitive Complaints: The M4 Study, Narlon Cassio Boa Sorte Silva, Dawn P. Gill, Adrian M. Owen, Teresa Liu-Ambrose, Vladimir Hachinski, Ryosuke Shigematsu, Robert Petrella

Lifestyle Research Team

Background

We investigated the effects of multiple-modality exercise with additional mind-motor training on cognition in community-dwelling older adults with subjective cognitive complaints.

Methods

Participants (n = 127, mean age 67.5 [7.3] years, 71% women) were randomized to receive 45 minutes of multiple-modality exercise with additional 15 minutes of either mind-motor training (M4, n = 63) or control (balance, range of motion and breathing exercises [M2, n = 64]). In total, both groups exercised 60 minutes/day, 3 days/week, for 24 weeks. Standardized global cognitive functioning (GCF), concentration, reasoning, planning, and memory were assessed at 24 weeks and after a 28-week no-contact …

Cognitive Changes Following Multiple-Modality Exercise And Mind-Motor Training In Older Adults With Subjective Cognitive Complaints: The M4 Study, Narlon Cassio Boa Sorte Silva, Dawn P. Gill, Adrian M. Owen, Teresa Liu-Ambrose, Vladimir Hachinski, Ryosuke Shigematsu, Robert Petrella

Lifestyle Research Team

Background

We investigated the effects of multiple-modality exercise with additional mind-motor training on cognition in community-dwelling older adults with subjective cognitive complaints.

Methods

Participants (n = 127, mean age 67.5 [7.3] years, 71% women) were randomized to receive 45 minutes of multiple-modality exercise with additional 15 minutes of either mind-motor training (M4, n = 63) or control (balance, range of motion and breathing exercises [M2, n = 64]). In total, both groups exercised 60 minutes/day, 3 days/week, for 24 weeks. Standardized global cognitive functioning (GCF), concentration, reasoning, planning, and memory were assessed at 24 weeks and after a 28-week no-contact …

The Impact Of Blood Pressure Dipping Status On Cognition, Mobility And Cardiovascular Health In Older Adults Following An Exercise Program, Narlon Cassio Boa Sorte Silva, Michael A. Greagory, Dawn P. Gill, Cheri L. Mcgowan, Robert Petrella

Lifestyle Research Team

Objectives: To determine whether a dual-task gait and aerobic exercise intervention differentially impacted older adults with normal blood pressure (BP) dipping status (dippers) compared to those with nondipping status (nondippers).

Methods: This study was a secondary analysis involving participants (mean age = 70.3 years, 61% women) who attended a laboratory-based exercise intervention over a 6-month period (40 min/day and 3 days/week). Participants were assessed in measures of cognition, mobility, and cardiovascular health at baseline, 3, 6, and 12 months (after a 6-month no-contact follow-up).

Results: We observed improvements in cognition in both groups at 6 and 12 months, although no …

Osteoarthritis, Cerebrovascular Dysfunction And The Common Denominator Of Inflammation: A Narrative Review, B. K. Al-Khazraji, C. T. Appleton, F. Beier, T. B. Birmingham, J. K. Shoemaker

Physiology and Pharmacology Publications

© 2018 The Author(s) Objective: Population-based cohort studies suggest an association between osteoarthritis (OA) and cerebrovascular disease, yet the mechanisms underlying vascular comorbidities in OA remain unclear. The purpose of this narrative review is to discuss the literature examining inflammation in OA with a focus on physiological mechanisms, and whether overlapping mechanisms exist in cerebrovascular dysfunction. Method: A literature search was conducted in PubMed using combinations of search terms: osteoarthritis, cerebrovascular (disease/dysfunction/risk), cardiovascular (disease/dysfunction/risk), aging/ageing, inflammation, inflammatory mediators, cytokine, c-reactive protein, interleukin, advanced glycation end-products, metabolic syndrome, reactive oxidative species, cognitive impairment, (vascular-related) dementia, small cerebral vessel disease, endothelial function, …

Aging Affects Adaptation To Sound-Level Statistics In Human Auditory Cortex, Björn Herrmann, Burkhard Maess, Ingrid S. Johnsrude

Brain and Mind Institute Researchers' Publications

Optimal perception requires efficient and adaptive neural processing of sensory input. Neurons in nonhuman mammals adapt to the statistical properties of acoustic feature distributions such that they become sensitive to sounds that are most likely to occur in the environment. However, whether human auditory responses adapt to stimulus statistical distributions and how aging affects adaptation to stimulus statistics is unknown. We used MEG to study how exposure to different distributions of sound levels affects adaptation in auditory cortex of younger (mean: 25 years; n=19) and older (mean: 64 years; n=20) adults (male and female). Participants passively listened to two sound-level …

Reading As A Lifeline Among Aging Readers, Paulette Rothbauer, Nicole Dalmer

FIMS Publications

No abstract provided.

Adolescent Cannabinoid Exposure Induces A Persistent Sub-Cortical Hyper-Dopaminergic State And Associated Molecular Adaptations In The Prefrontal Cortex., Justine Renard, Laura G Rosen, Michael Loureiro, Cleusa De Oliveira, Susanne Schmid, Walter J Rushlow, Steven R Laviolette

Brain and Mind Institute Researchers' Publications

Considerable evidence suggests that adolescent exposure to delta-9-tetrahydrocanabinol (THC), the psychoactive component in marijuana, increases the risk of developing schizophrenia-related symptoms in early adulthood. In the present study, we used a combination of behavioral and molecular analyses with in vivo neuronal electrophysiology to compare the long-term effects of adolescent versus adulthood THC exposure in rats. We report that adolescent, but not adult, THC exposure induces long-term neuropsychiatric-like phenotypes similar to those observed in clinical populations. Thus, adolescent THC exposure induced behavioral abnormalities resembling positive and negative schizophrenia-related endophenotypes and a state of neuronal hyperactivity in the mesocorticolimbic dopamine (DA) pathway. …

Impact Of Age On Cerebrovascular Dilation Versus Reactivity To Hypercapnia., Nicole S Coverdale, Mark B Badrov, J Kevin Shoemaker

Kinesiology Publications

This study quantified the effect of age on cerebrovascular reactivity and cerebrovascular conductance while accounting for differences in grey matter volume in younger (YA: n = 12; 24 ± 4 years, six females) and older adults (OA: n = 10; 66 ± 7 years; five females). Cerebral blood flow velocity (CBFV; transcranial Doppler) in the middle cerebral artery (MCA), MCA cross-sectional area (CSA), intracranial volumes (magnetic resonance imaging), and mean arterial pressure (MAP; Finometer), were measured under normocapnic and hypercapnic (6% carbon dioxide) conditions. Cerebral blood flow (CBF) was quantified from CBFV and MCA CSA and normalized to grey matter …

Vacht Overexpression Increases Acetylcholine At The Synaptic Cleft And Accelerates Aging Of Neuromuscular Junctions, Satoshi Sugita, Leland L. Fleming, Caleb Wood, Sydney K. Vaughan, Matheus P. S. M. Gomes, Wallace Camargo, Ligia A. Naves, Vania F. Prado, Marco A. M. Prado, Cristina Guatimosim, Gregorio Valdez

Anatomy and Cell Biology Publications

Background: Cholinergic dysfunction occurs during aging and in a variety of diseases, including amyotrophic lateral sclerosis (ALS). However, it remains unknown whether changes in cholinergic transmission contributes to age-and disease-related degeneration of the motor system. Here we investigated the effect of moderately increasing levels of synaptic acetylcholine (ACh) on the neuromuscular junction (NMJ), muscle fibers, and motor neurons during development and aging and in a mouse model for amyotrophic lateral sclerosis (ALS). Methods: Chat-ChR2-EYFP (VAChTHyp) mice containing multiple copies of the vesicular acetylcholine transporter (VAChT), mutant superoxide dismutase 1 (SOD1G93A), and Chat-IRES-Cre and tdTomato transgenic mice were used in this …

Effects Of Aging And Coronary Artery Disease On Sympathetic Neural Recruitment Strategies During End-Inspiratory And End-Expiratory Apnea, Mark B. Badrov, Sophie Lalande, T Dylan Olver, Neville Suskin, J Kevin Shoemaker

Kinesiology Publications

In response to acute physiological stress, the sympathetic nervous system modifies neural outflow through increased firing frequency of lower-threshold axons, recruitment of latent subpopulations of higher-threshold axons, and/or acute modifications of synaptic delays. Aging and coronary artery disease (CAD) often modify efferent muscle sympathetic nerve activity (MSNA). Therefore, we investigated whether CAD (n = 14; 61 ± 10 yr) and/or healthy aging without CAD (OH; n = 14; 59 ± 9 yr) modified these recruitment strategies that normally are observed in young healthy (YH; n = 14; 25 ± 3 yr) individuals. MSNA (microneurography) was measured at baseline and during …

Hip Fracture Types In Canadian Men And Women Change Differently With Age: A Population-Level Analysis, Richard G. Crilly, Marita Kloseck, Selam Mequanint

Bone and Joint Institute

© the authors, publisher and licensee Libertas Academica Limited. Background: We have previously reported a gender difference in the occurrence of hip fracture type with age in our local population. In the current report, we have explored this phenomenon in a Canadian population using five years of data from a national administrative database. We have com-pared community-dwelling and institutionalized individuals to determine if frailty is important and has a differential effect on the type of hip fracture experienced.Methods: Hospitalization records from 2005 to 2009, in which the most responsible diagnosis, that is the diagnosis causing the admission to hospital, was …

Enriching Or Discouraging? Competing Pictures Of Aging And Paid Work In Later Life, Rebecca Casey, Ellie Berger

Population Change and Lifecourse Strategic Knowledge Cluster Discussion Paper Series/ Un Réseau stratégique de connaissances Changements de population et parcours de vie Document de travail

The picture and experience of work and retirement are continuously changing in Canada and will likely continue to change into the future with the aging of the population. There are two pictures of work in older age presented in the literature: a positive and enriching picture and a picture that highlights the challenges facing some older workers. The positive and enriching picture focuses on the experiences of older individuals who are able to continue working if they want to work and are able to work; those who continue working because they are motivated by work rather than pay or new …

Category Learning In Older Adulthood: A Study Of The Shepard, Hovland, And Jenkins (1961) Tasks., Rahel Rabi, John Paul Minda

Brain and Mind Institute Researchers' Publications

Shepard, Hovland, and Jenkins (1961) examined the categorization abilities of younger adults using tasks involving single-dimensional rule learning, disjunctive rule learning, and family resemblance learning. The current study examined category learning in older adults using this well-known category set. Older adults, like younger adults, found category tasks with a single relevant dimension the easiest to learn. In contrast to younger adults, older adults found complex disjunctive rule-based categories harder to learn than family resemblance based categories. Disjunctive rule-based category learning appeared to be the most difficult for older adults to learn because this category set placed the heaviest demands on …

Living And Working Longer In An Aging Society: Toward Increasing Inequalities?, Yves Carrière, Jacques Légaré, Mélanie Léger St-Cyr, Chloé Ronteix, Viorela Diaconu

Population Change and Lifecourse Strategic Knowledge Cluster Discussion Paper Series/ Un Réseau stratégique de connaissances Changements de population et parcours de vie Document de travail

Population ageing raises questions about the sustainability of the public pillars of the retirement income system and about inter-generational equity. In response to this, a number of countries have raised the normal retirement age in an attempt to reduce projected future expenditures on their state pension system. In this context, private savings and later retirement represent the best ways of avoiding a major fall in living standards when retiring. Increased life expectancy at age 65 appears to justify this policy trend. But there are substantial differences in life expectancy and healthy life expectancy between people of different socio-economic status, and …