Effects of retirement on cognitive function: A gender and international perspecive

Background: As the global population is ageing, studying cognitive impairments including dementia, one of the leading causes of disability in old age worldwide, is of fundamental importance to public health. As a major transition in older age, a focus on the complex impacts of the duration, timing, and voluntariness of retirement on health is important for policy changes in the future. Longer retirement periods, as well as leaving the workforce early, have been associated with poorer health, including reduced cognitive functioning. These associations are hypothesized to differ based on gender, as well as on pre-retirement educational and occupational experiences, and on post-retirement social factors and health conditions. Methods: A cross-sectional study is conducted to determine the relationship between duration and timing of retirement and cognitive function, using data from the five sites of International Mobility in Aging Study (IMIAS). Cognitive function is assessed using the Leganes Cognitive Test (LCT) scores in 2012. Data are analyzed using multiple linear regressions. Analyses are also done by site/region separately (Canada, Latin America, and Albania). Robustness checks are done with an analysis of cognitive change from 2012 to 2014, the effect of voluntariness of retirement on cognitive function. An instrumental variable (IV) approach is also applied to the cross-sectional and longitudinal analyses as a robustness check to address the potential endogeneity of the retirement variable. Results: Descriptive statistics highlight differences between men and women, as well as between sites. In linear regression analysis, there was no relationship between timing or duration of retirement and cognitive function in 2012, when adjusting for site/region. There was no association between retirement characteristics and cognitive function in site/region/stratified analyses. In IV analysis, longer retirement and on time or late retirement was associated with lower cognitive function among men. In IV analysis, there is no relationship between retirement characteristics and cognitive function among women. Conclusions: While results of the thesis suggest a negative effect of retirement on cognitive function, especially among men, the relationship remains uncertain. A lack of power results in the inability to draw conclusions for site/region-specific analysis and site-adjusted analysis in both linear and IV regressions.

Multivariate Techniques in Biomechanical Analysis

This work outlines the theoretical advantages of multivariate methods in biomechanical data, validates the proposed methods and outlines new clinical findings relating to knee osteoarthritis that were made possible by this approach. New techniques were based on existing multivariate approaches, Partial Least Squares (PLS) and Non-negative Matrix Factorization (NMF) and validated using existing data sets. The new techniques developed, PCA-PLS-LDA (Principal Component Analysis – Partial Least Squares – Linear Discriminant Analysis), PCA-PLS-MLR (Principal Component Analysis – Partial Least Squares –Multiple Linear Regression) and Waveform Similarity (based on NMF) were developed to address the challenging characteristics of biomechanical data, variability and correlation. As a result, these new structure-seeking technique revealed new clinical findings. The first new clinical finding relates to the relationship between pain, radiographic severity and mechanics. Simultaneous analysis of pain and radiographic severity outcomes, a first in biomechanics, revealed that the knee adduction moment’s relationship to radiographic features is mediated by pain in subjects with moderate osteoarthritis. The second clinical finding was quantifying the importance of neuromuscular patterns in brace effectiveness for patients with knee osteoarthritis. I found that brace effectiveness was more related to the patient’s unbraced neuromuscular patterns than it was to mechanics, and that these neuromuscular patterns were more complicated than simply increased overall muscle activity, as previously thought.

Estimation of Sample Size and Power For Quantile Regression

Quantile regression (QR) was first introduced by Roger Koenker and Gilbert Bassett in 1978. It is robust to outliers which affect least squares estimator on a large scale in linear regression. Instead of modeling mean of the response, QR provides an alternative way to model the relationship between quantiles of the response and covariates. Therefore, QR can be widely used to solve problems in econometrics, environmental sciences and health sciences. Sample size is an important factor in the planning stage of experimental design and observational studies. In ordinary linear regression, sample size may be determined based on either precision analysis or power analysis with closed form formulas. There are also methods that calculate sample size based on precision analysis for QR like C.Jennen-Steinmetz and S.Wellek (2005). A method to estimate sample size for QR based on power analysis was proposed by Shao and Wang (2009). In this paper, a new method is proposed to calculate sample size based on power analysis under hypothesis test of covariate effects. Even though error distribution assumption is not necessary for QR analysis itself, researchers have to make assumptions of error distribution and covariate structure in the planning stage of a study to obtain a reasonable estimate of sample size. In this project, both parametric and nonparametric methods are provided to estimate error distribution. Since the method proposed can be implemented in R, user is able to choose either parametric distribution or nonparametric kernel density estimation for error distribution. User also needs to specify the covariate structure and effect size to carry out sample size and power calculation. The performance of the method proposed is further evaluated using numerical simulation. The results suggest that the sample sizes obtained from our method provide empirical powers that are closed to the nominal power level, for example, 80%.