Abstract
This study assesses the prevalence and trends of depression in the European population aged 50 years and older between 2004 and 2022 in different geographical regions. We retrieved and pooled data from waves 1, 2, and 4-9 of the Survey of Health, Aging and Retirement in Europe (SHARE) conducted between 2004 and 2022. The 12-item EURO-D scale was used as a continuous marker of depression risk. Twenty-eight countries were classified into five geographical regions (Eastern, Western, Southern and Northern Europe, and Israel) as defined by the United Nations. A total of 375 693 observations corresponding to 146 888 participants (weighted mean age 65.8 years [SE = 0.2], 54.2% women) were included in the study. In 2022, the overall prevalence of self-reported depression in Europe was 28.3% (95% CI, 27.0-29.7). From 2004 to 2022, the prevalence of self-reported depression in Europe decreased significantly by 5.9% (95% CI, −8.1 to −3.8). In particular, in Southern Europe, the prevalence of depression decreased significantly by 8.8% (95% CI, −12.3 to −5.2). No significant differences were observed in the other geographic regions. These findings highlight the need to develop depression screening and prevention strategies focused on countries with higher prevalence and identified associated factors.
This article is part of a Special Collection on Cross-National Gerontology.
Keywords: mental health, risk factors, health surveys, public health, multinational studies, aging population
Introduction
Depression, a common mental disorder, has become one of the greatest public health challenges worldwide, affecting an estimated 280 million people, according to the World Health Organization.1 Depression is a chronic condition that often interferes with normal mental and physical functioning and may manifest differently in different people, but often includes lack of energy, low mood, sadness, sleeplessness, and a lack of enjoyment of life.2 This disorder not only impairs the quality of life of those suffering from it, but can also lead to serious consequences such as suicide.3 In middle-aged and older adults, depression has been shown to increase the risk of all-cause and cardiovascular mortality.4,5 In addition, it is a leading cause of the global burden of disease in terms of disability-adjusted life years, years lived with disability, and years of life lost.6,7
While the number of depression cases worldwide increased by about 50% between 1990 and 2017,8 most European countries have experienced a decrease in the burden of depressive symptoms between 2006 and 2014, according to a study using the European Social Survey, which covers 18 European countries.9 These findings are consistent with a study based on the Global Burden of Disease 2019 (GBD) database, which found that the age-standardized prevalence rate of major depressive disorder, a type of depression, also followed a downward trend between 1990 and 2019.10 However, the burden of the disease remains high worldwide, particularly among women, the older adults, and populations in regions with a low socio-economic development.10 Although prior to 2020 some studies observed an overall decline in depression burden,9-11 the onset of the COVID-19 pandemic and its economic and social consequences led to an increase in the prevalence of major depression compared to pre-pandemic levels.12,13 Later, in 2022, following the effectiveness and high coverage of vaccination14 many European countries began to lift their states of emergency and minimize restrictions. Nevertheless, only a few investigations have assessed national trends in depression until years after the first waves of the pandemic.15,16 Therefore, updated information is crucial to continuously monitor trends in development of this public health problem.
Importantly, pre-pandemic studies have found differences in the prevalence of depression between countries in Europe.17,18 Moreover, European countries differ markedly in terms of social support, socio-economic status, health, and psychological abuse among older adults.19 A 2015 cross-sectional study of older adults found that both the prevalence of depression by gender and the magnitude of the gender gap were low in northern Europe and quite high in the south, setting a precedent for the importance of studying the behavior of this phenomenon among different geographic regions.20 However, to date there are no prospective studies contrasting trends in depression in different geographic regions of Europe, as well as the risk of depression by age and sex in each geographic region. Cross-country comparisons are therefore increasingly necessary, especially in the case of older adults, as comparisons across geographical areas can provide relevant information to inform effective mental health interventions and policies that address the specific needs of each community.
The objective of the present study is to assess the prevalence and trends of depression in the European population between 2004 and 2022 in different geographical regions, as well as differences by sex and age. Prevalence was chosen over incidence because it provides a complete snapshot of the current burden of depression in the population. This information is essential for formulating public health policy and allocating resources, identifying trends, and evaluating the effectiveness of existing mental health strategies. As depression in older adults often presents as a recurrent or chronic condition, prevalence captures both new and ongoing cases, highlighting the overall impact of depression in this population and the need for targeted prevention and treatment strategies.
Methods
Study design and sample
We retrieved and pooled data from waves 1, 2, and 4-9 of the Survey of Health, Aging and Retirement in Europe (SHARE) conducted between 2004 and 2022. Wave 3 was discarded as it did not contain data on depression. Specifically, the ninth wave of the SHARE was conducted between October 2021 and September 2022.
The Survey of Health, Aging and Retirement in Europe is based on a multistage stratified sampling design, in which the participating countries are divided into different strata according to geographical areas, and municipalities or postal codes within these strata serve as primary sampling units (PSUs).21 Data are collected through computer-assisted in-home interviews every 2 years in each SHARE wave. SHARE uses ex-ante harmonized interviews, and new respondents have been added in each wave to compensate for losses. The SHARE target population consists of all persons aged 50 years and older at the time of sample collection who have their usual place of residence in the respective SHARE country. In SHARE, individuals are excluded from the baseline or refreshment samples if they are incarcerated, hospitalized, or out of the country during the entire survey period, do not speak the language(s) of the country, or have moved to an unknown address. Current partners living in the same household, regardless of age, are interviewed at all waves. Ethical approval was obtained from the SHARE Project and written informed consent was obtained.
From an eligible sample of 611 373 observations, we discarded those duplicated (n = 32 119), those aged younger than 50 years (n = 126 635), and those with no data on depression (n = 76 926)—leaving a final sample size of 375 693 observations corresponding to 146 888 individuals for the present study. The reporting of this study followed the guidelines of the Observational Routinely collected health Data Statement.22
Depression
The 12-item EURO-D scale was used to follow participants throughout the study to identify existing depressive symptoms. The scale consists of 12 items assessing depression, pessimism, suicidality, guilt, sleep, interest, irritability, appetite, fatigue, concentration, pleasure, and tearfulness.23 The 12-item EURO-D scale has been previously described and validated. The scale has a possible range of 0-12. An optimal cut-off of ≥4 depressive symptoms, which has been identified as clinically significant depression, was used for the purposes of this study.23,24
Covariates
Data were collected on the age and sex of the participants. In addition, 28 countries were categorized into a geographical region variable, with 5 categories (Eastern, Western, Southern and Northern Europe, and Israel) according to the United Nations definition.25
Statistical analysis
Statistical analyses were conducted during May 2024 using Stata software version 18.0. Survey analysis procedures were used to account for calibrated cross-sectional individual weights for each survey and the complex sampling design of SHARE.
To ensure national representativeness, all analyses accounted for the weights and the complex survey design of SHARE. Specifically, we used calibrated individual cross-sectional weights provided for each survey round. These weights were derived through a multi-step process involving initial sampling weights (each respondent was assigned a weight based on their probability of selection determined by the survey’s stratified sampling design), adjustment for nonresponse (nonresponse bias was corrected by adjusting weights using response propensity models that included demographic and socio-economic variables), and calibration to population benchmark (the weights were further calibrated to align with external population data, such as age, sex, and regional distributions, obtained from Eurostat and other national statistics sources). The calibrated weights were incorporated into all models using the svyset command in Stata, which also accounted for PSUs and strata. This approach allowed for valid variance estimation and robust population-level inferences.
The crude weighted prevalence and 95% CIs of depression were estimated by survey year and geographical region. The overall crude linear trends on depression were examined using multilevel Tobit regression models across geographical regions. These models were used to estimate regression coefficients and 95% CIs for annual change. This approach was chosen to address the hierarchical structure of the data, with repeated observations nested within individuals, and the limited nature of depression scores (0-12), which may result in floor effects. P values for trends were calculated using the survey year as a continuous variable, whereas absolute differences in the estimated prevalence of depression were estimated by comparing the 2022 survey with the baseline survey of each geographical region. In addition, crude trends on depression were visually illustrated.
To examine the relationship between depression and predictors (sex and age), we employed a multilevel logistic regression model. This model accounted for correlated observations within individuals and included random intercepts to account for within-group variability. Odds ratios (ORs) and 95% CIs were calculated to estimate associations, both overall and stratified by geographic region.
Additionally, to address possible differences in population demographics (eg, age and sex), age-standardized prevalence rates of depression were calculated. Prevalence rates were calculated for each region and sex, along with their respective 95% CIs. All statistical tests were two-sided, and statistical significance was set at P < .05.
Results
A total of 375 693 observations corresponding to 146 888 participants (weighted mean age 65.8 years [SE = 0.2], 54.2% women) were included in the study. The weighted sample size per interview year ranged from 497 049 (2009) to 11 100 000 000 (2022). Table 1 shows the unweighted sample sizes from the 2022 survey for each geographical region and sex. Table S1 shows participants by year of interview and country.
Table 1.
Sample size for depression in the European population aged 50 years and older by geographical region, Survey of Health, Aging and Retirement in Europe 2022.
| Overall | Western Europe | Northern Europe | Southern Europe | Eastern Europe | Israel | |
|---|---|---|---|---|---|---|
| No. of participants (unweighted %) | 35 493 | 14 804(28.5) | 5397(10.4) | 8759(16.9) | 22 362(43.1) | 613(1.2) |
| Weighted N | 111 052 118 | 37 468 985 | 2 354 304 | 40 833 864 | 28 396 027 | 2 010 043 |
| Sexa | ||||||
| Female | 29 711(57.2) | 8290 (56.0) | 2928(54.3) | 4978(56.8) | 13 152(58.8) | 363(59.2) |
| Male | 22 224(42.8) | 6514(44.0) | 2469(45.8) | 3781(43.2) | 9210(41.2) | 250(40.8) |
Percentage of sex by geographical region.
Table 2 displays the crude weighted prevalence of depression from 2004 to 2022 overall and for geographical regions. Initial assessment set in 2005 for Israel and 2006 for Eastern Europe (ie, the initial survey for these geographical regions). Overall, the prevalence of depression decreased significantly by 5.9% (95% CI = −8.1 to −3.8). In particular, in Southern Europe, the prevalence of depression decreased significantly by 8.8% (95% CI, −12.3 to −5.2). No significant differences were observed in Northern Europe (4.8%, 95% CI, −1.5 to 11.0), Western Europe (−0.8%, 95% CI, −3.4 to 1.9), Eastern Europe (1.6%, 95% CI, −3.5 to 6.6), and Israel (−5.1%, 95% CI, −18.1 to 7.8).
Table 2.
Crude weighted trends among the European population aged 50 years and older across survey years and geographical region, Survey of Health, Aging and Retirement in Europe 2004-2022.a,b
| 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 | 2012 | 2013 | 2014 | 2015 | 2016 | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall | 34.2(32.5-36.0) | 31.7(29.7-33.7) | 31.3(29.5-33.1) | 31.3(29.4-33.3) | NO | 31.3(26.5-36.1) | 32.4(28.4-36.4) | 33.1(31.8-34.4) | NO | 31.7(30.4-33.0) | NO | 31.4(30.1-32.6) | NO |
| Western Europe | 30.6(28.6-32.6) | 31.6(29.5-33.6) | 31.1(29.0-33.2) | 25.4(22.9-27.8) | NO | NO | NO | 31.0(29.5-32.5) | NO | 30.7(29.3-32.1) | NO | 32.8(30.9-34.7) | NO |
| Northern Europe | 19.4(13.6-25.1) | NO | 14.6(8.2-21.1) | 21.5(17.6-25.4) | NO | NO | NO | 19.1(12.7-25.4) | NO | 23.6(17.8-29.3) | NO | 18.7(13.2-24.3) | NO |
| Southern Europe | 35.8(33.5-38.1) | NO | 33.4(27.9-38.8) | 33.3(30.9-35.8) | NO | NO | NO | 34.1(32.2-36.1) | NO | 33.3(31.5-35.2) | NO | 31.4(29.6-33.2) | NO |
| Eastern Europe | NO | NO | 26.9(22.3-31.5) | 23.3(19.7-26.9) | NO | NO | NO | 32.6(30.1-35.0) | NO | 25.5(23.3-27.6) | NO | 29.5(26.1-33.0) | NO |
| Israel | NO | 35.6(30.0-41.1) | 36.4(32.3-40.5) | NO | NO | 31.3(26.5-36.1) | 32.4(28.4-36.4) | NO | NO | 20.9(17.5-24.2) | NO | 26.6(21.5-31.8) | NO |
| 2017 | 2018 | 2019 | 2020 | 2021 | 2022 | β (95% CI) c | P for trend c | 2022 vs.2004 survey, Difference (95 % CI) d | |||||
| Overall | 34.9(33.1-36.7) | NO | 31.6(28.7-34.5) | 29.1(27.5-30.8) | 32.0(29.4-34.6) | 28.3(27.0-29.7) | −.018(−0.025 to 0.010) | P < .001 | −5.9(−8.1 to −3.8) | ||||
| Western Europe | 31.5(29.1-33.8) | NO | 31.4(28.7-34.1) | 28.4(26.1-30.7) | 33.9(29.8-38.0) | 29.8(27.9-31.7) | −.001(−0.009 to 0.007) | P = .858 | −0.8(−3.4 to 1.9) | ||||
| Northern Europe | 18.1(11.4-24.7) | NO | 22.7(19.0-26.4) | 24.3(19.3-29.3) | 20.9(7.0-34.7) | 24.1(21.4-26.9) | .030(0.010-0.049) | P < .005 | 4.8(−1.5 to 11.0) | ||||
| Southern Europe | 38.4(35.8-41.1) | NO | 30.9(25.8-36.0) | 27.4(23.7-31.1) | 32.8(28.4-37.3) | 27.0(24.3-29.7) | −.032(−0.046 to −0.018) | P < .001 | −8.8(−12.3 to −5.2) | ||||
| Eastern Europe | 19.5(14.8-24.1) | NO | 35.0(30.0-40.0) | 31.4(29.0-33.8) | 27.9(24.4-31.5) | 28.4(26.4-30.5) | −.002(−0.019 to 0.016) | P = .838 | 1.6(−3.5 to 6.6) | ||||
| Israel | NO | NO | 33.3(22.5-44.1) | 42.6(31.0-54.2) | NO | 30.4(18.7-42.2) | .002(−0.045 to 0.049) | P = .936 | −5.1(−18.1 to 7.8) | ||||
Prevalence of depression, weighted % (95% CI).
Sample sizes for individual cells ranges from 572 to 27922.
All estimates accounts for the weights and complex survey design of the Survey of Health, Aging and Retirement in Europe to be nationally representative.
The estimate β, 95% CI, and P-value for trend are calculated with multi-level Tobit regression that includes the year of each Survey of Health, Aging and Retirement in Europe as a continuous variable. The estimate β can be interpreted as the average annual percentage point change of the depression score (Euro-D), which ranges from 0 to 12.
Initial assessment set in 2005 for Israel and 2006 for Eastern Europe (ie, the initial survey for these geographical regions).
In 2022, the prevalence of depression is as follows: Europe overall, 28.3% (95% CI, 27.0-29.7); Western Europe, 29.8% (95% CI, 27.9-31.7); Northern Europe, 24.1% (95% CI, 21.4-26.9); Southern Europe, 27.0% (95% CI, 24.3-29.7); Eastern Europe, 28.4% (95% CI, 26.4-30.5); and Israel, 30.4% (95% CI, 18.7-42.2) (Table 2).
According to the multilevel Tobit regression model (Table 2), the overall depression score showed a statistically significant annual decrease (β = −.018, 95% CI, −0.025 to −0.010, P < .001). When stratified by region, a significant annual decrease in depression scores was observed in Southern Europe (β = −.032; 95% CI, −0.046 to −0.018; P < .001), whereas Northern Europe showed a significant annual increase (β = .030; 95% CI, 0.010 to 0.049; P < .005). No significant trends were observed in Western Europe, Eastern Europe, or Israel.
Figure 1 shows the crude weighted trends in the prevalence of depression across geographic regions during the period examined. In all survey years except 2013, respondents from Northern Europe showed the lowest levels of depression. In most follow-up years, respondents from Southern Europe showed the highest levels of depression. Trends for Israel showed the greatest fluctuations. In particular, during the COVID-19 period (ie, 2020 to 2021), an increase in depressive symptoms was observed in Northern Europe, Southern Europe, and Western Europe, which decreased in the following period (ie, 2021 to 2022).
Figure 1.
Crude weighted trends of depression among European adults aged 50 years and over, 2004-2022, by geographical region (prevalence and 95% CIs).a aAll estimates accounted for the weights and complex survey design of the Survey of Health, Ageing and Retirement in Europe to be nationally representative. Error bars indicate 95% CIs.
Table 3 shows weighted ORs of depression in adults aged 50 years and older among different European geographical regions according to sex and age. Compared with men, women were more likely to have experienced depression in all geographical regions (Overall, OR = 2.42, 95% CI, 2.31-2.53; Western Europe, OR = 2.24, 95% CI, 2.07-2.41; Northern Europe, OR = 2.30, 95% CI, 1.84-2.87; Southern Europe, OR = 2.68, 95% CI, 2.49-2.88; Eastern Europe, OR = 2.06, 95% CI, 1.89-2.25; and Israel, OR = 2.07, 95% CI, 1.58-2.72). Each year of age also increased the odds for depression overall and in each geographical region.
Table 3.
Weighted multilevel logistic regression models for depression among European aged 50 years and over by geographical region, Survey of Health, Aging and Retirement in Europe 2004-2022.a
| Odds ratio (95% CI) | ||||||
|---|---|---|---|---|---|---|
| Overall | Western Europe | Northern Europe | Southern Europe | Eastern Europe | Israel | |
| No. | 375 693 | 139328 | 45003 | 75035 | 106049 | 10278 |
| Weighted N | 613641894 | 193968156 | 6314825 | 308501307 | 94229092 | 10628514 |
| Ageb | 1.03(1.03-1.03) | 1.01(1.01-1.02) | 1.02(1.01-1.03) | 1.04(1.04-1.04) | 1.03(1.03-1.04) | 1.03(1.01-1.05) |
| Sexc | ||||||
| Male | 1(reference) | 1(reference) | 1(reference) | 1(reference) | 1(reference) | 1(reference) |
| Female | 2.42(2.31-2.53) | 2.24(2.07-2.41) | 2.30(1.84-2.87) | 2.68(2.49-2.88) | 2.06(1.89-2.25) | 2.07(1.58-2.72) |
All estimates accounted for the weights and complex survey design of the Survey of Health, Aging and Retirement in Europe.
The odds ratios (ORs) in this row represent the change in odds expected from a 1-year increase in age within this geographical region.
For sex, the ORs represent the change in odds expected in each category in relation to the reference group.
Figures S1 and S2 present the prevalence of depression standardized by age and stratified by geographic region and sex, with 95% CIs, over the study period. Age-standardized prevalence rates of depression were higher than the main estimates. In addition, the age-adjusted prevalence of depression was consistently higher in women than in men in all regions analyzed. Age-adjusted trends revealed that Southern Europe had a high but declining prevalence, while Northern Europe had consistently low and stable levels.
Discussion
In this representative sample of the European population, depression showed an overall downward trend between 2004 and 2022, especially in Southern Europe. However, the prevalence of depression in general remained critically high at over 28.3%. Women were more likely to have experienced depression in all geographic regions compared to men. In addition, each year of age also increased the likelihood of depression overall and in each geographic region. Importantly, our study provides up-to-date data on the prevalence of depression across geographical regions in Europe, which is crucial for developing effective mental health interventions and policies that address the specific needs of each community. This is particularly relevant, as previous studies have estimated that early prevention of depression can reduce its incidence by 20%-25% in high-income countries,26 justifying the implementation of preventive measures.
Our findings on trends in depression in the general European population are consistent with pre-pandemic studies indicating a decline in the burden of depression both in Europe9 and globally.11 For example, two studies based on the GBD 2019 database found a decreasing trend in the incidence11 and in the age-standardized prevalence rate of depressive disorders between 1990 and 2019.10 However, the burden of depressive disorders remained high. Our results estimate a prevalence of more than 28.3% in the European population of older adults. Our finding is similar to that reported in a recent meta-analysis, which estimated an overall prevalence of depression in older adults of 28.4%, including reports published between 2000 and 2021.27
While there was a downward trend in depression in Southern Europe and an upward trend in Northern Europe, it is worth noting that in most years of follow-up, Southern European respondents had the highest levels of depression and Northern European respondents had the lowest. In general, economic crises, which have hit southern European countries most severely, are strongly associated with an increase in the prevalence of depression due to factors such as unemployment and economic insecurity,28 which may partly explain why levels of depression are higher in Southern Europe. In addition, in the early months of the pandemic, southern European countries, such as Italy and Spain, experienced some of the most severe and rapid outbreaks of COVID-19 on the continent,29 resulting in significant pressure on health systems and prolonged containment measures. In this regard, although during the COVID-19 period (ie, from 2020 to 2021) an increase in depression was observed in Northern Europe, Southern Europe, and Western Europe, the prevalence of depression decreased in the following period (ie, from 2021 to 2022).
The higher prevalence of depression in women compared to men is one of the widely documented findings in the mental health literature, also in older people.20,30 These differences can be explained by biological, psychological, and social factors.31-33 For example, genetic vulnerability and neurophysiological differences at the brain level could increase women’s predisposition to depression.31 Also, fluctuations in estrogen levels may affect neurotransmitter systems, such as serotonin, that control mood.31 Sex hormones play a role in the control of inflammation in the central nervous system and may influence the functioning of the hypothalamic–pituitary–adrenal axis, which increases the likelihood of depression.34 In addition, psychosocial elements such as role pressure, social support, gender-based socialization, the way they cope with difficulties, and their position in society may contribute to women experiencing more depressive symptoms.31,35
In this context, previous longitudinal studies have provided useful evidence for developing strategies to prevent or manage mental health in older adults. For example, integrating strategies to address loneliness, foster resilience, and promote an active social life may be key to reducing the risk of increased depressive symptoms.36 Similarly, having greater muscle strength may serve as a preventive factor for depression in older adults.37 Thus, exercise also appears to play a key role in reducing depression by decreasing systemic inflammation and enhancing neuroplasticity and neuroendocrine and oxidative stress responses.38-40 According to our results, one in three older adults in Europe has depression; therefore, it is relevant to further increase efforts to reduce the prevalence of depression by implementing effective mental health interventions and policies that address the specific needs of each community.
The decline in the prevalence of depression in southern Europe may be related to improvements in mental health systems, greater public awareness, and mental health programmes that have reduced stigma and improved access to treatment.41 In contrast, the increase observed in Northern Europe may reflect increased detection and diagnosis of depression, as well as social factors such as an aging population and economic pressures. In this context, mental health policies, access to services, and social changes could play a key role in regional trends in depression in Europe. On the other hand, a greater fluctuation in the prevalence of depression was observed in Israel over the years, which could be related to factors such as political instability or social changes in Israel during the period studied, which could have affected the mental health of the population and contributed to these fluctuations. For example, periods of conflict or significant economic changes could have had an impact on psychological well-being, which would be reflected in the observed fluctuations in the prevalence of depression.42
Importantly, age-adjusted models highlight the significant impact of age differences on the prevalence of depression, providing more comparable estimates across regions. In addition, older women emerge as a priority group for interventions, especially in regions with high adjusted prevalences such as Eastern and Southern Europe. These regional and gender variations underline the need to design specific and culturally tailored mental health policies.
Strengths and limitations
Significantly, this is the first research to delve into temporal trends in depressive symptoms across different geographic regions in Europe, spanning a wide 18-year interval and with a representative sample across multiple nations. We pooled data from 8 waves of the SHARE survey and accounted for specific weights and survey designs for this study. The main limitation of the current study is that symptoms of depression were self-reported by participants, which can lead to a recall and misclassification bias, although the questionnaire is consistent across survey weights and it has been previously validated. Also, the set of countries that participated in each wave of SHARE is slightly different, which may have partially influenced our results. Nevertheless, we accounted for specific weights and survey design that has probably compensated for this issue; this procedure strengthens our estimates and compensates for not-participating countries of each geographical region. Finally, since our data is mostly representative from the European Union, the generalizability to populations of other countries outside this geographical area should be made with caution.
Conclusion
Over a span of 18 years, the prevalence of self-reported depression among adults aged 50 years and older decreased overall in the European population, especially in Southern Europe. However, the prevalence of depression in the European population remains high. These findings highlight the need to develop depression screening and prevention strategies focused on countries with higher prevalence and identified associated factors. Future intervention strategies are needed to promote better mental health among older adults.
Supplementary material
Supplementary material is available at the American Journal of Epidemiology online.
Supplementary Material
Contributor Information
Rodrigo Núñez-Cortés, Department of Physical Therapy, Faculty of Medicine, University of Chile, 8380453 Santiago, Chile; Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain.
Joaquín Calatayud, Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain.
Lars Louis Andersen, National Research Centre for the Working Environment, Copenhagen, Denmark.
Jorge Hugo Villafañe, Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain; Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain.
Luis Suso-Martí, Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain.
Rubén López-Bueno, Department of Health Sciences, Public University of Navarra, 31006 Pamplona, Spain.
Funding
R.L.-B. is supported by the European Union—Next Generation EU. The SHARE data collection has been funded by the European Commission through FP5 (QLK6-CT-2001-00360), FP6 (SHARE-I3: RII-CT-2006-062193, COMPARE: CIT5-CT-2005-028857, SHARELIFE: CIT4-CT-2006-028812), FP7 (SHARE-PREP: GA N°211909, SHARE-LEAP: GA N°227822, SHARE M4: GA N°261982, DASISH: GA N°283646), Horizon 2020 (SHARE-DEV3: GA N°676536, SHARE-COHESION: GA N°870628, SERISS: GA N°654221, SSHOC: GA N°823782) and by DG Employment, Social Affairs & Inclusion. Additional funding from the German Ministry of Education and Research, the Max Planck Society for the Advancement of Science, the US National Institute on Aging (U01_AG09740-13S2, P01_AG005842, P01_AG08291, P30_AG12815, R21_AG025169, Y1-AG-4553-01, IAG_BSR06-11, OGHA_04-064, HHSN271201300071C) and from various national funding sources is gratefully acknowledged (see www.share-project.org).
Conflict of interest
The authors declare no conflicts of interest.
Data availability
Data can be accessed through application to the SHARE database.
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Supplementary Materials
Data Availability Statement
Data can be accessed through application to the SHARE database.