Vegard Fykse Skirbekk

• Bowen, Catherine E.; Halse, Bjørn Atle Sundsback; Seterelv, Siri Schøyen; Selbæk, Geir; Langballe, Ellen Melbye & Skirbekk, Vegard Fykse (2026). Most older long-term care residents in Oslo have documented do-not-resuscitate status: a cross-sectional study. Resuscitation. ISSN 0300-9572. 229, p. 111344–111344. doi: 10.1016/j.resuscitation.2026.111344. Full text in Research Archive Show summary

  With population aging, understanding the frequency and distribution of decisions to attempt or withhold cardiopulmonary resuscitation (CPR) in long-term care populations is increasingly important. In Oslo, CPR status, that is, an advance decision about whether CPR should or should not be attempted, is systematically assessed and documented for all long-term care residents. Comprehensive register data therefore provide a unique opportunity to assess advance CPR decisions at the population level. We obtained cross-sectional data on the documented CPR status of nearly all persons aged 50+ years admitted to public or private long-term care facilities in Oslo between 2018 and 2023 (N = 7860). We examined the proportion of long-term care residents with documented positive CPR status (CPR should be attempted) and used multivariable logistic regression to analyze the associations between documented positive CPR status and age, sex, marital status, primary contact (e.g., son, daughter, spouse, professional), functional limitations, institutional relocations, duration of stay, and year of admission. We found that 9.2% of long-term care residents had documented positive CPR status. Documented positive CPR status was related to younger age, fewer limitations, shorter duration of stay, and fewer relocations. Compared with residents first admitted in 2018, documented positive CPR status was less likely among those first admitted between 2019 and 2022, but not among those first admitted in 2023. There was no evidence that documented positive CPR status was related to sex, marital status, primary contact. Our findings provide population-level evidence on documented CPR status in long-term care and highlight the need for future research on how such decisions are made.

• Bowen, Catherine E.; Pędziwiatr, Konrad; Stonawski, Marcin Jan & Skirbekk, Vegard Fykse (2026). Muslim religious leaders’ views of climate change: An international survey. PLOS ONE. 21(8). doi: 10.1371/journal.pone.0353201. Full text in Research Archive
• Akaliyski, Plamen Ivanov; Bowen, Catherine E.; Gehrig, Stefan & Skirbekk, Vegard Fykse (2026). Demographic processes constrain global growth in gender egalitarianism. PNAS Nexus. 5(5). doi: 10.1093/pnasnexus/pgag133. Full text in Research Archive
• Spoorenberg, Thomas & Skirbekk, Vegard Fykse (2026). The ratio of births observed to births needed: An indicator to assess demographic sustainability. Demographic Research. ISSN 1435-9871. 54, p. 973–986. doi: 10.4054/DemRes.2026.54.30. Full text in Research Archive
• Zotcheva, Ekaterina; Strand, Bjørn Heine; Sunde, Anita Lenora; Deckers, Kay; Aarsland, Dag & Ashton, Nicholas J. [Show all 12 contributors for this article] (2026). Associations of Anthropometry Measures Across 35 Years With Late-Life Plasma P-tau217 and Dementia. Neurology. ISSN 0028-3878. 106(12). doi: 10.1212/wnl.0000000000218093. Full text in Research Archive
• Schubert, Henrik Alexander; Skirbekk, Vegard Fykse & Nisén, Jessica (2026). Secularization and low fertility: How declining church membership changes couples’ childbearing. Social Science Research. ISSN 0049-089X. 137. doi: 10.1016/j.ssresearch.2026.103371. Full text in Research Archive
• Schubert, Henrik Alexander; Spoorenberg, Thomas; Dudel, Christian & Skirbekk, Vegard Fykse (2026). Masculinization of populations reverses sex differences in fertility. Proceedings of the National Academy of Sciences of the United States of America (PNAS). ISSN 0027-8424. 123(17). doi: 10.1073/pnas.2533317123. Full text in Research Archive
• Singh, Anjali; Rahut, Dil Bahadur; Sonobe, Tetsushi & Skirbekk, Vegard Fykse (2026). Family structure, orphanhood, and adolescent sexual debut and motherhood: evidence from Africa and Asia. Journal of Population Research. ISSN 1443-2447. 43(1). doi: 10.1007/s12546-025-09409-7. Full text in Research Archive
• Wolfova, K.; Strand, Bjørn Heine; Weiss, J.; Kearns, P. Brennan; Yitayew, Teferi Mekonnen & Stern, Y. [Show all 9 contributors for this article] (2026). Reproductive history and cognitive health among older Norwegian females and males: the population-based HUNT Study. Journal of Psychiatric Research. ISSN 0022-3956. 194, p. 187–187. doi: 10.1016/j.jpsychires.2026.01.001. Full text in Research Archive
• Balachandran, Arun; Pei, Heming; Shi, Yifan; Beard, John R.; Caspi, Avshalom & Cohen, Alan A. [Show all 16 contributors for this article] (2025). Pace of Aging analysis of healthspan and lifespan in older adults in the US and UK. Nature Aging. 5(6), p. 1132–1142. doi: 10.1038/s43587-025-00866-6. Full text in Research Archive
• Atalell, Kendalem Asmare; Pereira, Gavin Francis; Duko, Bereket; Nyadanu, Sylvester Dodzi; Skirbekk, Vegard Fykse & Tessema, Gizachew A. (2025). Developmental vulnerability in children from culturally and linguistically diverse backgrounds in Western Australia: a population-based study. World Journal of Pediatrics. ISSN 1708-8569. 21(7), p. 744–754. doi: 10.1007/s12519-025-00936-0. Full text in Research Archive
• Compans, Marie Caroline; Beaujouan, Eva & Skirbekk, Vegard Fykse (2025). Time to birth for spontaneous and ART births among infertile groups. BMC Women's Health. 25, p. 1–9. doi: 10.1186/s12905-025-04016-3. Full text in Research Archive Show summary

  Background Childbearing postponement in high-income countries has likely led to an increase in the incidence of age-related infertility. While assisted reproductive technologies (ART) can help some individuals to become parents, this often takes time. However, we know little about how long it takes individuals with infertility problems to achieve a live birth, whether they use ART or not, and how this has changed over time. Method We use retrospective information from the HUNT study, which provides rare information on the age at first conception attempt among people who have ever experienced infertility issues. These data are linked to the Norwegian Medical Birth Registry (NMBR), which allows tracking the timing of live births and whether they result from ART. We control for several maternal and paternal characteristics and distinguish between the late 1980–1990s (1987–99) and the 2000–2010s (2000–19). Cox models were fitted to samples of 863 mothers and 590 fathers. Results The average time from the start of conception attempt to spontaneous births is three years, and to ART births is five years. ART births occurred faster when pregnancy attempts were initiated in 2000–19 rather than 1987–99 (coeff = 0.536, [0.198; 0.873] for women, coeff = 0.487, [0.072; 0.902] for men), and when men and women tried to conceive for the first time at age 35–39 (coeff = 1.215, [0.260; 2.171] for women, coeff = 1.005, [0.275; 1.735] for men). This was not the case for spontaneous births. Conclusions While assisted reproductive technologies enable individuals facing infertility issues to achieve a live birth, they require more time to succeed. However, since the 2000s, time to ART births has decreased, with the shortest observed among those initiating conception attempts in their late thirties. Despite the fact that age remains a significant negative factor associated with the declining occurrence of births, these findings may reflect shifts in the profile of fertility clinic patients, faster care-seeking processes, and improvements in ART efficiency.

• Skirbekk, Vegard Fykse & Spoorenberg, Thomas (2025). Bringing mortality back into our understanding of fertility change: revisiting the onset of fertility transitions using net reproduction measures. Journal of Population Research. ISSN 1443-2447. 42(4). doi: 10.1007/s12546-025-09394-x. Full text in Research Archive
• Tamnes, Christian K.; Bekkhus, Mona; Eilertsen, Maja; Nes, Ragnhild Bang; Prydz, Monica Beer & Ystrom, Eivind [Show all 63 contributors for this article] (2025). The nature of the relation between mental well-being and ill-being. Nature Human Behaviour. 9(12), p. 2431–2440. doi: 10.1038/s41562-025-02319-x. Full text in Research Archive
• Skirbekk, Vegard Fykse; Bratsberg, Bernt Magne; Page, Christian Magnus & Kristjansson, Dana (2025). The Overlooked Legacy: Genetic Contributions of the Childless. Twin Research and Human Genetics. ISSN 1832-4274. 28(3), p. 234–240. doi: 10.1017/thg.2025.25. Full text in Research Archive Show summary

  Abstract Childless individuals have historically faced stigma with assumptions that they lack an interest in future generations because they do not directly contribute to genetic lineage. Individuals share approximately half of their genes with siblings, 12.5% with first cousins, and 6.25% with first cousins’ children. Norwegian census data (2005−2023), reflecting similar trends to the US, UK, and other European countries, indicates a moderate difference in the number of siblings (Parents: 2.03 [women and men]; Childless: 1.88 [women], 1.94 [men]) and nieces/nephews (Parents: 3.99 [women], 4.03 [men]; Childless: 3.32 [women], 3.42 [men]) for 514,777 women and 532,834 men, respectively. By linking four generations through grandmothers, both childless and childbearing women had a slightly higher number of biological extended family members (Parents: 9.63 cousins with 15.79 children; Childless: 8.66 cousins with 12.22 children). Linking four generations for men, numbers were similar: Parents: 9.68 cousins with 15.91 children, Childless: 8.83 cousins with 12.44 children. Based on the average number of children who are parents, the childless have an average genetic fitness that is 49% of that for parents for the next generation. Both parents and childless individuals have a stake in future generations through their biological extended family.

• Ellingjord-Dale, Merete; Strand, Bjørn Heine; Skirbekk, Vegard Fykse; Bratsberg, Bernt Magne; Yitayew, Teferi Mekonnen & Zotcheva, Ekaterina [Show all 10 contributors for this article] (2025). Potentially modifiable risk factors for dementia in Norway (HUNT4 70+): a retrospective cohort study. The Lancet Healthy Longevity. 6(12), p. 100802–100802. doi: 10.1016/j.lanhl.2025.100802. Full text in Research Archive Show summary

  Background The 2024 Lancet Commission report on dementia identified 14 modifiable dementia risk factors. The Norwegian HUNT study uniquely includes data collection of all 14 risk factors in the same individuals throughout adulthood, as well as a study-specific dementia diagnosis. We aimed to evaluate the potential for dementia prevention associated with these 14 risk factors, along with three additional sociodemographic risk factors in this retrospective cohort. Methods This retrospective cohort study included data on participants with study-specific diagnosis from the HUNT4 70+ study (2017–19) and was linked with national administrative registries (1960–2018) and earlier HUNT surveys (1984–2008) with data on dementia risk factors at ages 35–92 years. Inverse probability weighting was applied to account for non-response. Logistic regression estimated dementia risk associated with exposure to less education in early adult life (age <45 years), hearing loss, high LDL cholesterol, depression, traumatic brain injury, physical inactivity, diabetes, smoking, hypertension, obesity, excessive alcohol use in midlife (age 45–65 years), and social isolation, air pollution, and vision loss in late life (age >65 years). Midlife occupational physical activity and marital and employment status were added to the Lancet model. The potential for dementia prevention was assessed using population attributable fraction (PAF). Findings Between Sept 1, 2017, and Feb 28, 2019, 19 403 individuals were invited to participate and 9745 participants (1525 with dementia, 8220 without dementia) were included. 4445 (45·6%) of 9745 participants were male and 5300 (54·4%) were female. The total PAF for the 14 Lancet risk factors was 50·9% (95% CI 37·7–61·4). Including family-related and work-related risk factors increased the PAF to 54·9% (42·3–64·7; p<0·0001). When these factors were added for women, the total PAF increased from 48·0% (95% CI 29·4–61·7) to 52·2% (34·2–65·3; p=0·0090), whereas no significant change was observed in men (56·2% [95% CI 35·5–70·2] to 56·7 [95% CI 36·1–70·6]; p=0·71).

• Yitayew, Teferi Mekonnen; Kristjansson, Dana; Bratsberg, Bernt Magne; Kohler, Hans-Peter; Selbæk, Geir & Larsen, Frode Kibsgaard [Show all 12 contributors for this article] (2025). Changes in survival probabilities and mortality risks among population living with Down syndrome born 1967–2018: a Norwegian registry-based study. BMC Public Health. 25. doi: 10.1186/s12889-025-25326-z. Full text in Research Archive
• Blekesaune, Morten & Skirbekk, Vegard Fykse (2025). Is Religiosity Related to the Risk of Technology-Induced Job Loss? Nordic Journal of Religion and Society. ISSN 0809-7291. 38(2), p. 59–74. doi: 10.18261/njrs.38.2.1. Full text in Research Archive Show summary

  This study tests a hypothesis that religious individuals are less likely than non-religious individuals to work in occupations associated with a risk of technology-induced job loss due to a general tendency towards risk aversion as well as lower prioritization given to material rewards. It combines data on religiosity from a Norwegian large-scale health survey (HUNT4, 2017‒2019) with assessments of the risks of technology-induced job loss, as indicated by a Routine Task Intensity (RTI) index collected from the O*NET Database, at the level of 358 occupations. Our findings show that religious individuals are less likely to work in occupations at risk of technology-induced job loss. Additionally, religious individuals tend to have lower incomes from work even at similar levels of education. The gap in occupational risks between religious and non-religious individuals is larger among men than women, and it holds across various types of religious activity, age groups, and levels of education.

• Blekesaune, Morten & Skirbekk, Vegard Fykse (2025). Frail parents and adult children’s life-satisfaction: a longitudinal analysis of Norwegian data. European Journal of Ageing. ISSN 1613-9372. 22. doi: 10.1007/s10433-025-00883-9. Full text in Research Archive Show summary

  Earlier research has found that adult children’s caregiving for older parents is associated with a decline in life satisfaction. However, other research indicates that emotional stress in adult children might be related to the declining health and frailty of their older parents rather than caregiving per se. Hence, there is a possibility that the first set of findings (declining life satisfaction when giving care) reflects factors not specified in statistical models rather than the care provided by adult children. This study tests this possibility by investigating changes in life satisfaction among 3,094 adult children from panel data in Norway that includes multiple indicators of health and care needs in older parents, together with data on who is providing care. Declining life satisfaction was observed among daughters but not among sons, and these changes were driven by the frailty and care needs of their parents rather than caregiving per se. The findings indicate that it is not caregiving that affects life satisfaction but the circumstances leading to caregiving. In these situations, adult daughters may struggle with sources of distress beyond providing support and care. Further research should investigate these relationships in countries with different distributions of care between families and public care institutions.

• Bratsberg, Bernt Magne; Harris, Jennifer Ruth; Skirbekk, Vegard Fykse; Stern, Yaakov; Håberg, Asta & Selbæk, Geir [Show all 8 contributors for this article] (2025). Occupational social interaction is associated with reduced dementia risk: The Trøndelag Health Study (HUNT). Psychology and Aging. ISSN 0882-7974. 41(1), p. 12–24. doi: 10.1037/pag0000940. Full text in Research Archive Show summary

  Lifetime social engagement could build cognitive reserve and lower the risk of dementia through compensatory effects on brain health. We aimed to investigate whether social interaction at work is protective of later-life cognitive impairment. Data from 9,248 participants of the population-based Norwegian HUNT4 70+ Study (2017-2019), with cognitive assessments at or after age 70, were linked retrospectively to longitudinal registry-based employment information spanning ages 30-65 years. An occupational social interaction score was computed using occupational characteristics from the O*NET database. Multinomial logistic regression was used to estimate the associations between occupational social interaction and dementia and mild cognitive impairment (MCI), while linear regression was used to model the association with cognition using the Montreal Cognitive Assessment (MoCA). The models were subsequently adjusted for confounding variables age, sex, education, and apolipoprotein E-ε4 genotype, as well as for midlife family, health, and lifestyle-related variables collected from national registries and earlier Trøndelag Health Study waves. Higher occupational social interaction was associated with reduced risks of dementia and MCI, and better MoCA performance. Adjusted for confounding from age, sex, education, and apolipoprotein E-ε4, each standard deviation higher occupational social interaction score was associated with a relative risk ratio of 0.89 for dementia (p = .003), 0.88 for MCI (p < .001), and a 0.31-point higher MoCA score (p < .001). Our findings highlight the importance of occupational social interaction in preserving and promoting cognitive health in later life

• Skirbekk, Vegard Fykse; Tamnes, Christian K.; Juliusson, Pétur Benedikt; Jugessur, Astanand & Soest, Tilmann von (2025). Diverging trends in the age of social and biological transitions to adulthood. Advances in Life Course Research. ISSN 1569-4909. 65. doi: 10.1016/j.alcr.2025.100690. Full text in Research Archive
• Zotcheva, Ekaterina; Strand, Bjørn Heine; Skirbekk, Vegard Fykse; Deckers, Kay; Krokstad, Steinar & Livingston, Gill [Show all 8 contributors for this article] (2025). Sex differences in body mass index and waist circumference trajectories and dementia risk: the HUNT4 70+ study. GeroScience. ISSN 2509-2715. doi: 10.1007/s11357-025-01660-3. Full text in Research Archive Show summary

  We examined associations between body mass index (BMI), waist circumference (WC), and dementia risk, and differences in BMI and WC trajectories before dementia diagnosis. We included 9,739 participants (54% women) aged 70+ from the Trøndelag Health Study (HUNT4 70+). BMI was measured four times (1984–2019) and WC three times (1995–2019). Dementia diagnoses were clinically assessed at HUNT4 70+ . Women and men with dementia had higher midlife BMI and WC than those without dementia. These differences diminished closer to diagnosis, especially in women. Midlife obesity in both sexes and midlife overweight, high WC, and overweight/obesity with high WC in men were linked to higher dementia risk. Lower dementia risk was observed with late-life overweight for both sexes, late-life high WC in women, late-life overweight/obesity with normal WC in men or high WC in women. Adiposity measures and their changes influence dementia risk differently in women and men.

• Yitayew, Teferi Mekonnen; Skirbekk, Vegard Fykse; Håberg, Asta; Engdahl, Bo Lars; Zotcheva, Ekaterina & Jugessur, Astanand [Show all 18 contributors for this article] (2025). Mediators of educational differences in dementia risk later in life: evidence from the HUNT study. BMC Public Health. 25, p. 1–12. doi: 10.1186/s12889-025-22592-9. Full text in Research Archive Show summary

  Despite a well-known inverse association between education and dementia risk, the mediating mechanisms are not well understood. We explored how lifestyle and health risk factors across the life-course mediate the relationship between education and dementia among adults aged 70 + years. We included 7,655 participants with dementia diagnoses and education information, using a historical cohort design linking prospective exposure data across the life course from the HUNT4 70 + Study with registry data from Statistics Norway and earlier HUNT surveys. We conducted causal mediation analysis to assess the mediating roles of occupational characteristics, lifestyle factors (smoking, physical inactivity), and health risk factors (obesity, hypertension, diabetes, hearing impairment, cardiovascular diseases, LDL cholesterol, depression, anxiety) assessed during early, middle, and late adulthood in the relationship between education and dementia in later life. Participants with lower education were more likely to have dementia with odds ratios of 1.99, 1.88, 1.83 for the model’s accounting exposure to mediators during early, middle, and late adulthood, respectively. These associations were partially mediated by the joint effect of health and lifestyle risk factors from early through late adulthood (mediated 11.55–19.50%). Health risk factors from early to late adulthood jointly mediated 6.85–13.06% of the effect of low education on dementia risk later in life. Additionally, lifestyle factors during middle and late adulthood jointly mediated 4.11–4.96% of the total effect of low education on dementia risk later in life. Educational differences in dementia risk can partly mediated by lifestyle and health factors across the life course. These findings suggest potential targets to address varying dementia risks linked to education levels.

• Reme, Bjørn-Atle; Røgeberg, Ole; Wörn, Jonathan; Bratsberg, Bernt Magne & Skirbekk, Vegard Fykse (2025). The distribution of technology induced job loss: Evidence from a population-wide study in Norway. PLOS ONE. 20(4). doi: 10.1371/journal.pone.0321072. Full text in Research Archive
• Kjeldgaard, Helena Kames; Omsland, Tone Kristin; Skirbekk, Vegard Fykse; O’Flaherty, Martin; Meyer, Haakon Eduard & Holvik, Kristin (2025). Forecasting the burden of hip fracture in Norway towards 2050 by educational level: The Norwegian Epidemiologic Osteoporosis Studies (NOREPOS). Scandinavian Journal of Public Health. ISSN 1403-4948. doi: 10.1177/14034948251325760. Full text in Research Archive Show summary

  Aims: Hip fracture burden is expected to increase due to the ageing population. Given that hip fracture incidence differs by educational attainment, and that a shift in the older population’s educational level will manifest itself in coming decades, we investigated future hip fracture trends in Norway and their variation by attained educational level. Methods: Estimated annual hip fracture numbers in the population aged 50+ years in 2020–2050 were based on information from the Norwegian Epidemiologic Osteoporosis Studies hip fracture database and official population projections from Statistics Norway. Projected educational attainment was obtained from the Wittgenstein Centre for Demography and Global Human Capital. We explored two scenarios: first, assuming that the observed 2019 rates remain constant until 2050, and second, assuming a continuing rate of decline corresponding to that observed during 1999–2019. Results: The projections showed that the annual number of hip fractures will increase by 91% in women and 131% in men given constant sex- and age-specific rates, and by 27% in women and 66% in men given declining rates. The majority of hip fractures are expected in the group with secondary education, however, the numbers will increase steeply in people with tertiary education due to the temporal shift in educational attainment. Conclusions: The annual number of hip fractures may double by 2050, placing high demands on the healthcare services. The majority of hip fractures are projected to occur in people with secondary and tertiary education. It is vital to intensify preventive efforts, not least in the high-risk populations.

• Skirbekk, Vegard Fykse; Blekesaune, Morten & Sunde, Hans Fredrik (2025). Personality and fertility dynamics in Norway across four decades – Findings from the HUNT survey. Personality and Individual Differences. ISSN 0191-8869. 233. doi: 10.1016/j.paid.2024.112862. Full text in Research Archive Show summary

  In recent years, Western countries have seen unprecedented fertility declines; increasing childlessness, lower fertility levels and a shift in the timing of fertility to increasingly older ages. The reasons behind these changes in reproductive patterns have been insufficiently understood. In an era emphasizing individual autonomy and personal choice in family planning, personality traits could play a significant role in shaping family formation and fertility patterns. To explore this we use personality measures from the Trøndelag Health Study (HUNT) combined with birth records from the Norwegian Population Registry (N = 27,585). We investigated how extraversion and neuroticism related to three measures of fertility (age of a first child, number of children and childlessness) across four decades. Our study finds that extraversion was associated with an earlier age at first birth and a greater number of children ever born. Neuroticism was associated with an earlier age at first birth but fewer children ever born. Associations were generally stronger for men. Extraversion showed no clear time trends, whereas neuroticism has generally become more strongly associated with fertility in younger cohorts.

• Mekonnen, Teferi; Skirbekk, Vegard; Zotcheva, Ekaterina; Engdahl, Bo; Bratsberg, Bernt & Jugessur, Astanand [Show all 19 contributors for this article] (2025). Number of children and dementia risk: a causal mediation analysis using data from the HUNT study linked with national registries in Norway. BMC Neurology. 25(1). doi: 10.1186/s12883-025-04044-4. Full text in Research Archive Show summary

  Background: Childlessness, as well as having a high number of children, has been reported to be associated with an elevated risk of dementia compared to having 2–3 children. The mechanisms underlying these relationships are not well understood and may be mediated by different midlife risk factors. We examined the mediating role of various factors on the relationship between the number of children and dementia risk. These factors include socioeconomic factors (e.g., occupational complexity), psychosocial (e.g.., social activities, loneliness, life satisfaction), lifestyle (e.g., smoking, physical inactivity, alcohol intake), and chronic diseases (e.g., obesity, diabetes, depression, hearing impairment and hypertension). Methods: Using a historic cohort design, we included 9,745 participants born between 1931–48, with a mean age of 78.2 (SD = 6.4) years at the time of cognitive testing in the HUNT4 70 + sub-study (2017–2019). Further measures were obtained through data linkage between information from Statistics Norway and the HUNT1(1984–86), and HUNT2 (1995–97) Surveys. Causal mediation analyses using an inverse odd weighting approach were conducted to decompose the total effect of the number of children (0, 1, or 4 + children vs. 2–3) on the risk of dementia at age 70 + years into direct and indirect effects with mediators assessed at a mean age of 50.7 (SD = 6.4) years. The analyses were adjusted for age, sex, marital status at age 25 years, educational status, and religion assessed during HUNT3 (2006–2008). Results: Overall, 15.7% were diagnosed with dementia. The proportions with dementia by the number of children were 22.3% among those with no children, 21.4% for those with one child, 13% for those with 2–3 children (specifically, 12.6% for those with 2 children and 13.4% for those with 3 children), and 19.9% for those with 4 + children. Compared to the reference group of individuals with 2–3 children, the dementia risk was higher among the groups with no children (relative risk (RR): 1.30, 95% confidence interval (CI) (1.12, 1.51)), those with one child (RR: 1.30, 95% CI (1.14, 1.47)) and those with 4 + children (RR: 1.12, 95% CI (1.01, 1.24)). The elevated risks of dementia were not mediated by the socioeconomic, psychosocial, lifestyle, or chronic diseases related factors that we tested. Sex-stratified analysis showed higher dementia risk for men without children and women with one or 4 + children compared to those with 2–3 children, with similar patterns across sexes. None of the mediators contributed to mediation in either group. None of the mediators appeared to contribute through mediation in either group. Conclusions: Our findings suggest that the number of children—specifically being childless, having one child, or having four or more children—may influence the risk of dementia. These relationships were not mediated by psychosocial, lifestyle, and socioeconomic factors, or markers of chronic diseases in adulthood considered in this study.

• Edwin, Trine Holt; Håberg, Asta; Zotcheva, Ekaterina; Bratsberg, Bernt Magne; Jugessur, Astanand & Engdahl, Bo Lars [Show all 16 contributors for this article] (2024). Trajectories of Occupational Cognitive Demands and Risk of Mild Cognitive Impairment and Dementia in Later Life The HUNT4 70+ Study. Neurology. ISSN 0028-3878. 102(9). doi: 10.1212/WNL.0000000000209353. Full text in Research Archive
• Wolfova, Katrin; Frycova, Barbora; Seblova, Dominika; Tom, Sarah E.; Skirbekk, Vegard Fykse & Kearns, Pavla Brennan (2024). Sex differences in cognitive decline among middle-aged and older adults: a cohort study in Europe. Age and Ageing. ISSN 0002-0729. 53(4), p. 1–10. doi: 10.1093/ageing/afae078. Full text in Research Archive Show summary

  Objectives Previous studies on sex differences in cognitive decline provide inconsistent findings, with many European countries being underrepresented. We determined the association between sex and cognitive decline in a sample of Europeans and explored differences across birth cohorts and regions. Methods Participants 50+ years old enrolled in the Survey of Health, Ageing and Retirement in Europe had their cognition measured by tests of immediate recall, delayed recall and verbal fluency biennially up to 17 years of follow-up (median 6, interquartile range 3–9 years). We used linear mixed-effects models to assess the relationship between sex and the rate of cognitive decline, adjusting for sociodemographic and health-related characteristics. Results Of 66,670 participants (mean baseline age 63.5 ± standard deviation 9.4), 55% were female. Males and females had similar rates of decline in the whole sample in immediate recall (beta for interaction sex × time B = 0.002, 95% CI -0.001 to 0.006), delayed recall (B = 0.000, 95% CI −0.004 to 0.004), and verbal fluency (B = 0.008, 95% CI −0.005 to 0.020). Females born before World War II had a faster rate of decline in immediate recall and delayed recall compared to males, while females born during or after World War II had a slower rate of decline in immediate recall. Females in Central and Eastern Europe had a slower rate of cognitive decline in delayed recall compared to males. Discussion Our study does not provide strong evidence of sex differences in cognitive decline among older Europeans. However, we identified heterogeneity across birth cohorts and regions.

• Strand, Bjørn Heine; Håberg, Asta; Eyjólfsdóttir, Harpa Sif; Kok, Almar; Skirbekk, Vegard Fykse & Huxhold, Oliver [Show all 11 contributors for this article] (2024). Spousal bereavement and its effects on later life physical and cognitive capability: the Tromsø study. GeroScience. ISSN 2509-2715. 46(6), p. 6055–6069. doi: 10.1007/s11357-024-01150-y. Full text in Research Archive Show summary

  Spousal bereavement is associated with health declines and increased mortality risk, but its specific impact on physical and cognitive capabilities is less studied. A historical cohort study design was applied including married Tromsø study participants (N=5739) aged 50–70 years with baseline self-reported overall health and health-related factors and measured capability (grip strength, finger tapping, digit symbol coding, and short-term recall) at follow-up. Participants had data from Tromsø4 (1994–1995) and Tromsø5 (2001), or Tromsø6 (2007–2008) and Tromsø7 (2015–2016). Propensity score matching, adjusted for baseline confounders (and baseline capability in a subset), was used to investigate whether spousal bereavement was associated with poorer subsequent capability. Spousal bereavement occurred for 6.2% on average 3.7 years (SD 2.0) before the capability assessment. There were no significant bereavement effects on subsequent grip strength, immediate recall, or finger-tapping speed. Without adjustment for baseline digit symbol coding test performance, there was a negative significant effect on the digit symbol coding test (ATT −1.33; 95% confidence interval −2.57, −0.10), but when baseline digit symbol coding test performance was taken into account in a smaller subsample, using the same set of matching confounders, there was no longer any association (in the subsample ATT changed from −1.29 (95% CI −3.38, 0.80) to −0.04 (95% CI −1.83, 1.75). The results in our study suggest that spousal bereavement does not have long-term effects on the intrinsic capacity components physical or cognition capability to a notable degree.

• Spoorenberg, Thomas; Carlsen, Ellen Øen; Flatø, Martin; Stonawski, Marcin Jan & Skirbekk, Vegard Fykse (2024). The Global Adolescent Fertility Decline is Counteracted by Increasing Teen Births in Sub-Saharan Africa. Studies in family planning. ISSN 0039-3665. 55(3), p. 229–245. doi: 10.1111/sifp.12273. Full text in Research Archive
• Halkjelsvik, Torleif & Skirbekk, Vegard Fykse (2024). Concurrent decline in teenage fertility rate and binge drinking? An observational study across 45 nations. Drug and Alcohol Review. ISSN 0959-5236. 43(6), p. 1451–1460. doi: 10.1111/dar.13867. Full text in Research Archive
• Bratsberg, Bernt Magne; Fjell, Anders Martin; Røgeberg, Ole; Skirbekk, Vegard Fykse & Walhovd, Kristine B (2024). Differences in cognitive function at 18 y of age explain the association between low education and early dementia risk. Proceedings of the National Academy of Sciences of the United States of America (PNAS). ISSN 0027-8424. 121(41). doi: 10.1073/pnas.2412017121. Full text in Research Archive Show summary

  Major initiatives attempt to prevent dementia by targeting modifiable risk factors. Low education is frequently pointed to, due to its relationship with dementia. Impact of education is difficult to assess, however, because of associations with multiple other factors, requiring large population-representative samples to tease the relationships apart. We studied 207,814 Norwegian men born between 1950 and 1959 who underwent compulsory cognitive testing during military conscription as young adults, to systematically test associations of education, cognition, and other important factors. Participants were grouped into five education levels and seven cognitive levels. A total of 1,521 were diagnosed with dementia between ages 60 and 69 y. While having compulsory education only was associated with increased risk (Hazard ratio [HR] = 1.37, CI: 1.17 to 1.60), this association was markedly attenuated when controlling for cognitive test scores (HR = 1.08, CI: 0.91 to 1.28). In contrast, low cognitive score was associated with double risk of later diagnosis, even when controlling for education (HR = 2.00, CI: 1.65 to 2.42). This relationship survived controlling for early-life socioeconomic status and replicated within pairs of brothers. This suggests that genetic and environmental factors shared within families, e.g., common genetics, parental education, socioeconomic status, or other shared experiences, cannot account for the association. Rather, independent, nonfamilial factors are more important. In contrast, within-family factors accounted for the relationship between low education and diagnosis risk. In conclusion, implementing measures to increase cognitive function in childhood and adolescence appears to be a more promising strategy for reducing dementia burden.

• Methi, Fredrik; Nes, Ragnhild Bang; Skirbekk, Vegard Fykse & Hansen, Thomas (2024). The double-edged sword of becoming a caregiver: dynamic impact on four dimensions of well-being in Norway. BMC Psychology. 12(1), p. 1–14. doi: 10.1186/s40359-024-01623-x. Full text in Research Archive Show summary

  Background Becoming a caregiver can be a transformative journey with profound, multifaceted implications for well-being. However, existing research predominantly emphasizes the negative aspects of caregiving, paying less attention to the positive sides. This study aims to explore the impact of transitioning into a caregiving role on various well-being indicators, such as negative hedonic, positive hedonic, eudaimonic, and social well-being. Methods We use Norwegian panel data (2019–2021) and employ a combination of nearest-neighbour matching and a difference-in-differences approach to analyse well-being trajectories among new caregivers (n = 304) and non-caregivers (n = 7822). We assess ten items capturing the dimensions of negative hedonic (anxiousness, sadness, and worriedness), positive hedonic (happiness and life satisfaction), eudaimonic (contributing to others’ happiness, engagement, and meaning), and social (strong social relations and loneliness) well-being. Results Our results show a general increase in negative hedonic well-being and a decline in positive hedonic well-being for new caregivers. These impacts are larger for caregivers providing daily care, compared to those providing weekly and monthly care, and for those providing care inside rather than outside their own household. We observe only minor differences regarding gender and age. Interestingly, we also notice neutral or beneficial changes for eudaimonic aspects of well-being; of note, caregivers generally experience an increased sense of contributing to others’ happiness. Conclusion Our study reveals that adopting a caregiving role often leads to significant psychosocial challenges, especially in intensive caregiving situations. However, it also uncovers potential positive influences on eudaimonic aspects of well-being. Future research should explore underlying explanatory mechanisms, to inform strategies that enhance caregivers’ well-being.

• Zotcheva, Ekaterina; Strand, Bjørn Heine; Bowen, Catherine E; Bratsberg, Bernt Magne; Jugessur, Astanand & Engdahl, Bo Lars [Show all 16 contributors for this article] (2023). Retirement age and disability status as pathways to later-life cognitive impairment: Evidence from the Norwegian HUNT Study linked with Norwegian population registers. International Journal of Geriatric Psychiatry. ISSN 0885-6230. 38(7), p. 1–10. doi: 10.1002/gps.5967. Full text in Research Archive Show summary

  Background Research shows that retirement age is associated with later-life cognition but has not sufficiently distinguished between retirement pathways. We examined how retirement age was associated with later-life dementia and mild cognitive impairment (MCI) for people who retired via the disability pathway (received a disability pension prior to old-age pension eligibility) and those who retired via the standard pathway. Methods The study sample comprised 7210 participants from the Norwegian Trøndelag Health Study (HUNT4 70+, 2017–2019) who had worked for at least one year in 1967–2019, worked until age 55+, and retired before HUNT4. Dementia and MCI were clinically assessed in HUNT4 70+ when participants were aged 69–85 years. Historical data on participants' retirement age and pathway were retrieved from population registers. We used multinomial regression to assess the dementia/MCI risk for women and men retiring via the disability pathway, or early (<67 years), on-time (age 67, old-age pension eligibility) or late (age 68+) via the standard pathway. Results In our study sample, 9.5% had dementia, 35.3% had MCI, and 28.1% retired via the disability pathway. The disability retirement group had an elevated risk of dementia compared to the on-time standard retirement group (relative risk ratio [RRR]: 1.64, 95% CI 1.14–2.37 for women, 1.70, 95% CI 1.17–2.48 for men). MCI risk was lower among men who retired late versus on-time (RRR, 0.76, 95% CI 0.61–0.95). Conclusion Disability retirees should be monitored more closely, and preventive policies should be considered to minimize the dementia risk observed among this group of retirees.

• Skirbekk, Vegard Fykse (2023). Low, but not too low, fertility can represent a positive development. Vienna Yearbook of Population Research. ISSN 1728-4414. 21, p. 81–92. doi: 10.1553/P-CMBB-HHEG. Full text in Research Archive
• Medford, Anthony; Skirbekk, Vegard Fykse & Strand, Bjørn Heine (2023). Trends in ages at death of Norwegian centenarians: the 1870–1904 birth cohorts. Scandinavian Journal of Public Health. ISSN 1403-4948. doi: 10.1177/14034948231206529. Full text in Research Archive
• Hansen, Thomas; Hynek, Kamila Angelika; McMunn, Anne; Nes, Ragnhild Bang; Skirbekk, Vegard Fykse & Vollrath, Margarete E. [Show all 7 contributors for this article] (2023). Emerging costs in a “hidden” workforce: The longitudinal psychosocial effects of caregiving during the COVID-19 pandemic among Norwegian adults. Scandinavian Journal of Psychology. ISSN 0036-5564. p. 1–10. doi: 10.1111/sjop.12986. Full text in Research Archive Show summary

  During COVID-19 many informal caregivers experienced increased caregiving load while access to formal and informal support systems and coping resources decreased. Little is known about the psychosocial costs of these challenges for an essential yet vulnerable and “hidden” frontline workforce. This study explores and compares changes in psychosocial well-being (psychological well-being, psychological ill-being, and loneliness) before and across up to three stages of the COVID-19 pandemic among caregivers and non-caregivers. We also examine predictors of psychosocial well-being among caregivers during the peak of the pandemic. We use longitudinal data collected online in the Norwegian Counties Public Health Survey (age: 18–92) in four counties and up to four data points (n = 14,881). Caregivers are those who provide care unpaid, continuous (≥ monthly across all time points) help to someone with health problems. Findings show that levels of psychosocial well-being first remained stable but later, during the peak stages of the pandemic, dropped markedly. Caregivers (13–15% of the samples) report lower psychosocial well-being than non-caregivers both before and during the pandemic. Caregivers seem especially vulnerable in terms of ill-being, and during the peak of the pandemic caregivers report higher net levels of worry (OR = 1.22, p < 0.01) and anxiety (OR = 1.23, p < 0.01) than non-caregivers. As expected, impacts are graver for caregivers who provide more intensive care and those reporting health problems or poor access to social support. Our study findings are valuable information for interventions to support caregivers during this and future pandemics.

• Wörn, Jonathan; Reme, Bjørn-Atle & Skirbekk, Vegard Fykse (2023). Job loss and psychological distress during the COVID-19 pandemic: a national prospective cohort study. BMC Public Health. 23(1), p. 1–6. doi: 10.1186/s12889-023-16303-5. Full text in Research Archive
• Langballe, Ellen Melbye; Skirbekk, Vegard Fykse & Strand, Bjørn Heine (2023). Subjective age and the association with intrinsic capacity, functional ability, and health among older adults in Norway. European Journal of Ageing. ISSN 1613-9372. 20(4), p. 1–10. doi: 10.1007/s10433-023-00753-2. Full text in Research Archive Show summary

  This study investigates the relationships between subjective age, intrinsic capacity, functional ability and health among Norwegians aged 60 years and older. The Norwegian Survey of Health and Ageing (NORSE) is a population-based, cross-sectional study of home-dwelling individuals aged 60–96 years in the former county of Oppland. Age- and sex-adjusted regression models were used to investigate the gap between subjective and chronological age and this gap’s association with self-reported and objectively measured intrinsic capacity (covering all six sub domains defined by WHO), health, and functional ability among 817 NORSE participants. The results show most participants felt younger than their chronological age (86.5%), while relatively few felt the same as their chronological age (8.3%) or older (5.2%). The mean subjective age was 13.8 years lower than mean chronological age. Participants with incontinence, poor vision, or poor hearing felt 3.1 [95% confidence interval (CI) (0.6, 5.5)], 2.9 [95% CI (0.2, 5.6)], and 2.9 [95% CI (0.3, 5.5)] years older, respectively, than participants without those conditions, whereas none of the following factors—anxiety, depression, chronic disease, Short Physical Performance Battery score, grip strength, cognition, or frailty—significantly had an impact on the gap. In line with prior research, this study finds that feeling considerably younger than one’s chronological age is common at older ages. However, those with poor hearing, poor vision, and incontinence felt less young compared to those not having these conditions. These relationships may exert undesirable effects on vitality and autonomy, which are considered key factors of intrinsic capacity and healthy ageing.

• Bratsberg, Bernt Magne; Røgeberg, Ole & Skirbekk, Vegard Fykse (2023). The Relevance of Cognition in the Context of Population Aging. In Bloom, David E.; Sousa-Poza, Alfonso & Sunde, Uwe (Ed.), The Routledge Handbook of the Economics of Ageing. Routledge. ISSN 9780367713324. Full text in Research Archive
• Zotcheva, Ekaterina; Bratsberg, Bernt Magne; Strand, Bjørn Heine; Jugessur, Astanand; Engdahl, Bo Lars & Bowen, Catherine [Show all 17 contributors for this article] (2023). Trajectories of occupational physical activity and risk of later-life mild cognitive impairment and dementia: the HUNT4 70+ study. The Lancet Regional Health - Europe. 34. doi: 10.1016/j.lanepe.2023.100721. Full text in Research Archive Show summary

  High levels of occupational physical activity (PA) have been linked to an increased risk of dementia. We assessed the association of trajectories of occupational PA at ages 33–65 with risk of dementia and mild cognitive impairment (MCI) at ages 70+. Methods We included 7005 participants (49.8% were women, 3488/7005) from the HUNT4 70+ Study. Group-based trajectory modelling was used to identify four trajectories of occupational PA based on national registry data from 1960 to 2014: stable low (30.9%, 2162/7005), increasing then decreasing (8.9%, 625/7005), stable intermediate (25.1%, 1755/7005), and stable high (35.2%, 2463/7005). Dementia and MCI were clinically assessed in 2017–2019. We performed adjusted multinomial regression to estimate relative risk ratios (RRR) with 95% confidence intervals (CI) for dementia and MCI. Findings 902 participants were diagnosed with dementia and 2407 were diagnosed with MCI. Absolute unadjusted risks for dementia and MCI were 8.8% (95% CI: 7.6–10.0) and 27.4% (25.5–29.3), respectively, for those with a stable low PA trajectory, 8.2% (6.0–10.4) and 33.3% (29.6–37.0) for those with increasing, then decreasing PA; while they were 16.0% (14.3–17.7) and 35% (32.8–37.2) for those with stable intermediate, and 15.4% (14.0–16.8) and 40.2% (38.3–42.1) for those with stable high PA trajectories. In the adjusted model, participants with a stable high trajectory had a higher risk of dementia (RRR 1.34, 1.04–1.73) and MCI (1.80, 1.54–2.11), whereas participants with a stable intermediate trajectory had a higher risk of MCI (1.36, 1.15–1.61) compared to the stable low trajectory. While not statistically significant, participants with increasing then decreasing occupational PA had a 24% lower risk of dementia and 18% higher risk of MCI than the stable low PA group. Interpretation Consistently working in an occupation with intermediate or high occupational PA was linked to an increased risk of cognitive impairment, indicating the importance of developing strategies for individuals in physically demanding occupations to prevent cognitive impairment.

• Chang, Milan; Michelet, Mona; Skirbekk, Vegard Fykse; Langballe, Ellen Melbye; Hopstock, Laila Arnesdatter & Sund, Erik Reidar [Show all 8 contributors for this article] (2023). Trends in the use of home care services among Norwegians 70+ and projections towards 2050: The HUNT study 1995–2017. Scandinavian Journal of Caring Sciences. ISSN 0283-9318. 37(3), p. 752–765. doi: 10.1111/scs.13158. Full text in Research Archive Show summary

  Life expectancy (LE) is increasing worldwide, while there is lack of information on how this affects older individuals' use of formal home care services. Aim We aimed to decompose LE into years with and without home care services and estimate projected number of users towards 2050 in Norway for people 70 years or older. Methods This study is based on a sample of 25,536 participants aged 70 years and older in the Trøndelag Health Study (HUNT) survey 2 (1995–1997), 3 (2006–2008), or 4 (2017–2019) linked with national data on mortality. Prevalence of home care services was standardised to the Norwegian population by age and sex. The Sullivan method was used to estimate expected years with and without home help services and nursing services for the years 1995, 2006 and 2016. Data from HUNT4 and Statistics Norway were used to estimate projected use of these services between 2020 and 2050. Results During 1995–2017, the use of home help services decreased from 22.6% to 6.2% (p < 0.001), and from 6.4% to 5.5% (p = 0.004) for home nursing services. Adjusted for age and sex, the use of home help services decreased significantly over time (p < 0.001), while home nursing services were stable (p = 0.69). LE at age 70 increased from 11.9 to 15.3 years in men (p < 0.05) during 1995–2017, and from 14.7 to 17.1 in women (p < 0.05). In the same period, the expected years receiving home help decreased from 2.6 to 1.1 in men (p < 0.05), and from 4.4 to 2.1 in women (p < 0.05). The expected years receiving home nursing increased from 0.6 to 0.9 in men (p < 0.05), and from 1.3 to 1.7 in women (p < 0.05). Projected numbers of people 70+ in Norway in need of either of these services were estimated to rise from 64,000 in 2020 to 160,000 in 2050. Conclusion While overall life expectancy increased, the expected years receiving home help have decreased and home nursing slightly increased among the Norwegian population aged 70 years and older during 1995–2017. However, the substantial increase in the projected number of older adults using home care services in the future is an alert for the current health care planners.

• Hynek, Kamila Angelika; Gotehus, Aslaug; Methi, Fredrik; Nes, Ragnhild Bang; Skirbekk, Vegard Fykse & Hansen, Thomas (2023). Caregiving + Migrant Background = Double Jeopardy? Associations between Caregiving and Physical and Psychological Health According to Migrant Backgrounds in Norway. International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 20(10). doi: 10.3390/ijerph20105800. Full text in Research Archive Show summary

  Informal caregiving can have detrimental consequences for physical and psychological health, but the impacts are highly heterogenous. A largely ignored question is whether these impacts differ with migrant backgrounds, and whether caregiving and a migrant background combine to create double jeopardy. We explored these questions using large-scale data that allows stratification by sex, regional background, and types (inside vs. outside of household) of caregivers. We used cross-sectional 2021 data collected from two Norwegian counties as part of the Norwegian Counties Public Health Survey (N = 133,705, RR = 43%, age 18+). The outcomes include subjective health, mental health, and subjective well-being. The findings show that both caregiving, especially in-household caregiving, and a migrant background relate to lower physical–psychological health. In bivariate analysis, non-Western caregivers, women particularly, reported poorer mental health and subjective well-being (but not physical health) than other caregiver groups. After controlling for background characteristics, however, no interaction exists between caregiver status and migrant background status. Although the evidence does not suggest double jeopardy for migrant caregivers, caution is warranted due to the likely underrepresentation of the most vulnerable caregivers of migrant backgrounds. Continued surveillance of caregiver burden and distress among people of migrant backgrounds is critical to develop successful preventive and supportive intervention strategies for this group, yet this aim hinges on a more inclusive representation of minorities in future surveys.

• Mogi, Ryohei; Esteve, Albert & Skirbekk, Vegard Fykse (2022). The Decline of Spanish Fertility: The Role of Religion. European Journal of Population. ISSN 0168-6577. 38, p. 1333–1346. doi: 10.1007/s10680-022-09644-1. Full text in Research Archive
• Kolk, Martin & Skirbekk, Vegard Fykse (2022). Fading family lines- women and men without children, grandchildren and great-grandchildren in 19th, 20th and 21st Century Northern Sweden. Advances in Life Course Research. ISSN 1569-4909. 53. doi: 10.1016/j.alcr.2022.100481. Full text in Research Archive
• Blekesaune, Morten & Skirbekk, Vegard Fykse (2022). Does forming a nuclear family increase religiosity? Longitudinal evidence from the British Household Panel Survey. European Sociological Review. ISSN 0266-7215. 39(4), p. 663–675. doi: 10.1093/esr/jcac060. Full text in Research Archive Show summary

  This study investigates how far the nuclear family—in terms of entering cohabitation and marriage and having a first and second child—affects religious salience, religious attendance, and activity in religious organizations. Previous research has shown that religious individuals are more likely to marry, and have higher fertility, than non-religious individuals. Less is known about how far the nuclear family also affects religiosity. This study presents longitudinal evidence on how religious factors change within the life-course of individuals after entering cohabitation or marriage and after having a first or second child in up to 14 waves of the British Household Panel Survey collected between 1991 and 2009. The comparison between longitudinal and cross-sectional results indicates how far religious factors affect family formation processes. All religious factors investigated (salience, attendance, activity) increased when people became parents, as well as when they married, but not when they started to cohabit. Most of these effects are long-lasting and they hold across age, gender and cohort groups.

• Reme, Bjørn-Atle; Wörn, Jonathan & Skirbekk, Vegard Fykse (2022). Longitudinal evidence on the development of socioeconomic inequalities in mental health due to the COVID-19 pandemic in Norway. Scientific Reports. 12(1). doi: 10.1038/s41598-022-06616-7. Full text in Research Archive
• Wolfova, Katrin; Wu, Di; Weiss, Jordan; Cermakova, Pavla; Kohler, Hans-Peter & Skirbekk, Vegard Fykse [Show all 9 contributors for this article] (2022). Sons and parental cognition in mid-life and older adulthood. Journal of Psychiatric Research. ISSN 0022-3956. 156, p. 284–290. doi: 10.1016/j.jpsychires.2022.10.026. Full text in Research Archive
• Tyrovolas, Stefanos; Stergachis, Andy; Krish, Varsha Sarah; Chang, Angela Y.; Skirbekk, Vegard Fykse & Dieleman, Joseph L. [Show all 50 contributors for this article] (2022). Global, regional, and national burden of diseases and injuries for adults 70 years and older: systematic analysis for the Global Burden of Disease 2019 Study. The BMJ. 376(8329). doi: 10.1136/bmj-2021-068208. Full text in Research Archive Show summary

  Objectives To use data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) to estimate mortality and disability trends for the population aged ≥70 and evaluate patterns in causes of death, disability, and risk factors. Design Systematic analysis. Setting Participants were aged ≥70 from 204 countries and territories, 1990-2019. Main outcomes measures Years of life lost, years lived with disability, disability adjusted life years, life expectancy at age 70 (LE-70), healthy life expectancy at age 70 (HALE-70), proportion of years in ill health at age 70 (PYIH-70), risk factors, and data coverage index were estimated based on standardised GBD methods. Results Globally the population of older adults has increased since 1990 and all cause death rates have decreased for men and women. However, mortality rates due to falls increased between 1990 and 2019. The probability of death among people aged 70-90 decreased, mainly because of reductions in non-communicable diseases. Globally disability burden was largely driven by functional decline, vision and hearing loss, and symptoms of pain. LE-70 and HALE-70 showed continuous increases since 1990 globally, with certain regional disparities. Globally higher LE-70 resulted in higher HALE-70 and slightly increased PYIH-70. Sociodemographic and healthcare access and quality indices were positively correlated with HALE-70 and LE-70. For high exposure risk factors, data coverage was moderate, while limited data were available for various dietary, environmental or occupational, and metabolic risks. Conclusions Life expectancy at age 70 has continued to rise globally, mostly because of decreases in chronic diseases. Adults aged ≥70 living in high income countries and regions with better healthcare access and quality were found to experience the highest life expectancy and healthy life expectancy. Disability burden, however, remained constant, suggesting the need to enhance public health and intervention programmes to improve wellbeing among older adults.

• Skirbekk, Vegard Fykse; Dieleman, Joseph L.; Stonawski, Marcin; Fejkiel, Krystian; Tyrovolas, Stefanos & Chang, Angela Y. (2022). The health-adjusted dependency ratio as a new global measure of the burden of ageing: a population-based study. The Lancet Healthy Longevity. 3(5), p. 332–338. doi: 10.1016/S2666-7568(22)00075-7. Full text in Research Archive
• Jørgensen, Astrid Ytrehus; Aarhus, Lisa; Engdahl, Bo Lars; Bratsberg, Bernt Magne; Skirbekk, Vegard Fykse & Mehlum, Ingrid Sivesind (2022). Hearing loss, sick leave, and disability pension. Findings from the HUNT follow-up study. BMC Public Health. 22(1). doi: 10.1186/s12889-022-13760-2. Full text in Research Archive Show summary

  Background Evidence on the association between hearing loss and sick leave or disability pension is to a great extent based on few cross-sectional studies and remains unclear. We aim to assess the associations in a long-term follow-up population study. Methods We used baseline data from a large population-based hearing study in Norway, the HUNT Hearing study (1996–1998). The sample included 21 754 adults (48.5% men, mean age at baseline 36.6 years). We used register data on sick leave and disability pension (1996–2011). Cox regression was used to assess the association between hearing loss at baseline (Pure tone average/PTA 0.5–4 kHz > 20 dB) and time to first physician-certified sick leave episode, as well as time to first disability pension payment. Results Hearing loss at baseline (yes/no) was weakly associated with time to first physician-certified sick leave episode: Hazard ratio (HR) 1.2 (95% confidence interval (CI) 1.1–1.3). Restricting the exposed group to people with both hearing loss and tinnitus, the HR was slightly increased: 1.3 (95% CI 1.1–1.6). Hearing loss in 1996–1998 was also associated with time to first received disability pension: HR 1.5 (95% CI 1.3–1.8). Stronger associations were found for disabling hearing loss (PTA > 35). Restricting the exposure to hearing loss and tinnitus, the HR was increased: 2.0 (95% CI 1.4–2.8). Conclusions This large population-based cohort study indicates that hearing loss is associated with increased risk of receiving disability pension, especially among younger adults and low educated workers. Hearing loss was weakly associated with sick leave.

• Bonsang, Eric & Skirbekk, Vegard Fykse (2022). Does Childbearing Affect Cognitive Health in Later Life? Evidence From an Instrumental Variable Approach. Demography. ISSN 0070-3370. 59(3), p. 975–994. doi: 10.1215/00703370-9930490. Full text in Research Archive
• Peri-Rotem, Nitzan & Skirbekk, Vegard Fykse (2022). Religiosity, Sex Frequency, and Sexual Satisfaction in Britain: Evidence from the Third National Survey of Sexual Attitudes and Lifestyles (Natsal). Journal of Sex Research. ISSN 0022-4499. 60(1), p. 13–35. doi: 10.1080/00224499.2022.2108745. Full text in Research Archive Show summary

  Previous studies on the relationship between religiosity and sexual behavior have yielded mixed results, partly due to variations by gender and marital status. Furthermore, less is known about this relationship in relatively secularized societies, as in the case of Britain. In this study, we used data from the third British National Survey of Sexual Attitudes and Lifestyles (Natsal-3) to explore the link between religiosity (11% of men and 16% of women stated that religion and religious beliefs were very important to them) and sex frequency and satisfaction among men and women in different types of relationships. Women and men who saw religion as more important in their lives reported having less sex on average, though this was mainly driven by the significantly lower sex frequency among non-cohabiting religious individuals compared to their less religious peers. At the same time, religiosity was linked with overall higher levels of sex life satisfaction. This relationship appeared to be largely mediated by attitudes on the appropriate context for sexual intercourse. These findings highlight the importance of sociocultural norms in shaping sexual behavior and sexual satisfaction.

• Saarela, Jan; Hardy, Melissa & Skirbekk, Vegard Fykse (2022). Childlessness Among Heterosexual Partnered Individuals: Register-Based Evidence from the Finnish Cohorts Born 1952-1966. Journal of Comparative Family Studies. ISSN 0047-2328. 53(2), p. 189–215. doi: 10.3138/jcfs.53.2.030. Full text in Research Archive Show summary

  Finland has been a demographic forerunner in terms of the adoption of new family forms as well as family friendly social policies. Childlessness has nevertheless grown and, is high compared to many other countries. A large and increasing share of all persons who live in unions are childless. Using population-register data for the cohorts born 1952–1966, we study persons who were partnered at age 45 (n = 44,321). The aim is to analyse how marital status and union duration, together with socioeconomic characteristics of the ego and the partner, relate to the probability of being childless at 45. Logistic regression models are estimated separately for women and men, using a 10-year retrospective window. We find for both men and women, the strongest marker for being a parent by age 45 is whether they are married and had lived with the same partner for at least ten years. Shorter union durations and cohabitations are associated with a several-fold increase in the likelihood of being childless. Socioeconomic characteristics are relevant as well, but notably less important in terms of estimated effect sizes. Future research on this topic should tentatively be concerned with how childlessness relates to transitions into, from, and across unions.

• Skirbekk, Vegard Fykse; Bowen, Catherine E; Håberg, Asta; Jugessur, Astanand; Engdahl, Bo Lars & Bratsberg, Bernt Magne [Show all 15 contributors for this article] (2022). Marital Histories and Associations With Later-Life Dementia and Mild Cognitive Impairment Risk in the HUNT4 70+ Study in Norway. Journal of Aging and Health. ISSN 0898-2643. 35(7-8), p. 543–555. doi: 10.1177/08982643221131926. Full text in Research Archive Show summary

  Objectives: Earlier studies suggest that being married in later life protects against dementia, and that being single in old age increases the risk of dementia. In this study, we examine midlife marital status trajectories and their association with dementia and mild cognitive impairment (MCI) at ages 70 plus using a large population based sample from Norway. Methods: Based on a general population sample linked to population registries (N = 8706), we used multinomial logistic regression to examine the associations between six types of marital trajectories (unmarried, continuously divorced, intermittently divorced, widowed, continuously married, intermittently married) between age 44 and 68 years from national registries and a clinical dementia or a MCI diagnosis after age 70. We estimated relative risk ratios (RRR) and used mediation analyses adjusting for education, number of children, smoking, hypertension, obesity, physical inactivity, diabetes, mental distress, and having no close friends in midlife. Inverse probability weighting and multiple imputations were applied. The population attributable fraction was estimated to assess the potential reduction in dementia cases due to marital histories. Results: Overall, 11.6% of the participants were diagnosed with dementia and 35.3% with MCI. Dementia prevalence was lowest among the continuously married (11.2%). Adjusting for confounders, the risk of dementia was higher for the unmarried (RRR = 1.73; 95% CI: 1.24, 2.40), continuously divorced (RRR = 1.66; 95% CI: 1.14, 2.43), and intermittently divorced (RRR = 1.50; 95% CI: 1.09, 2.06) compared to the continuously married. In general, marital trajectory was less associated with MCI than with dementia. In the counterfactual scenario, where all participants had the same risk of receiving a dementia diagnosis as the continuously married group, there would be 6.0% fewer dementia cases. Discussion: Our data confirm that staying married in midlife is associated with a lower risk of dementia and that divorced people account for a substantial share of dementia cases.

• Skirbekk, Vegard Fykse; Bonsang, Eric & Engdahl, Bo Lars (2022). Childhood hearing impairment and fertility in Norway. Scientific Reports. 12(402). doi: 10.1038/s41598-021-04195-7. Full text in Research Archive
• Orlov, Sergey; Rovenskaya, Elena; Cantele, Matthew; Stonawski, Marcin & Skirbekk, Vegard (2021). Modeling Social Status and Fertility Decisions Under Differential Mortality, Dynamic Economic Problems with Regime Switches. Springer. ISSN 9783030545765. p. 1–25. doi: 10.1007/978-3-030-54576-5_5. Full text in Research Archive
• Strand, Bjørn Heine; Skirbekk, Vegard Fykse; Langballe, Ellen Melbye; Bergh, Sverre; Landmark, Brynjar Fowels & Wangensteen, Sigrid [Show all 8 contributors for this article] (2021). Cohort profile: Norwegian survey of health and ageing (NORSE). BMC Public Health. 21, p. 1–7. doi: 10.1186/s12889-021-12294-3. Full text in Research Archive Show summary

  Purpose The Norwegian Survey of Health and Ageing (NORSE) was set up to provide internationally comparable data on ageing in Norway, which includes measured intrinsic capacity and cognitive function. Participants NORSE is a population-based health examination study of seniors aged 60+ from the 1921–1958 birth cohorts in the former Norwegian county of Oppland, interviewed and examined during 2017–19 (N = 957, 16% response rate). NORSE is to some extent based on the SHARE-questionnaire (share-project.org), which includes work-related information, self-assessed and retrospective health, and expectations on longevity, quality of life, volunteering activities, consumption, and financial arrangements. In addition, several objective measures of intrinsic and cognitive capacity are included in NORSE. Findings to date A shorter preferred life expectancy (PLE) was found to be associated with the prospects of a life with dementia and chronic pain. Motivation for retirement was found to be related to work-life experience and health. Social media was mostly used in the younger age groups and there was a tendency towards more use in the higher educational groups. NORSE incorporates questions on religion, and older women tend to have a higher degree of religiosity (proxied as self-assessed religiosity) than men in their 80s, but more similar (and lower levels) among those in their 60s. Future plans NORSE participants have allowed their data to be linked to National registry data and midlife health examination studies and thereby provide a longitudinal design as well as information on disability status, socioeconomic status, household and marital status, support to/from children and parents, and pension status.

• Hansen, Thomas; Nilsen, Thomas Sevenius; Knapstad, Marit; Skirbekk, Vegard Fykse; Skogen, Jens Christoffer & Vedaa, Øystein [Show all 7 contributors for this article] (2021). Covid-fatigued? A longitudinal study of Norwegian older adults’ psychosocial well-being before and during early and later stages of the COVID-19 pandemic. European Journal of Ageing. ISSN 1613-9372. p. 1–11. doi: 10.1007/s10433-021-00648-0. Full text in Research Archive Show summary

  As the pandemic continues, many older adults are facing prolonged isolation and stress while having less access to traditional ways of coping. There is widespread concern that the situation is increasingly taking its toll on older adults’ psychological and social well-being. We use linear mixed models to examine psychosocial impacts and predictors thereof among older Norwegians in early and later stages of the pandemic. Longitudinal data were collected online in the Norwegian Counties Public Health Survey right before the pandemic and in June and November–December 2020 in two counties (baseline n = 4,104; age 65–92). Outcomes include loneliness (single item, UCLA3), psychological ill-being (worried, anxious, depressed), and psychological well-being (satisfied, engaged, happy). From before to three months into the pandemic men’s psychosocial well-being remained stable, whereas women’s slightly declined. Five months later we observe broad and substantial declines in psychosocial well-being. These impacts disproportionately affect women (all outcomes) and single and older individuals (loneliness only) and are not moderated by educational level, urbanicity, or whether self or partner are reported “at risk” due to health problems. Pre-pandemic low social support and high psychological distress predict relatively improved psychosocial well-being. Older Norwegians seemed to manage the pandemic’s early stage without clear psychosocial impacts. However, we observe notably compromised well-being during the second wave of COVID-19 in late 2020. Lessons learned about the nature and distribution of the psychosocial impacts of prolonged health-threats and social distancing provide valuable knowledge for intervention design during this and future pandemics.

• Storeng, Siri Høivik; Øverland, Simon Nygaard; Skirbekk, Vegard; Hopstock, Laila Arnesdatter; Sund, Erik Reidar & Krokstad, Steinar [Show all 7 contributors for this article] (2021). Trends in Disability-Free Life Expectancy (DFLE) from 1995 to 2017 in the older Norwegian population by sex and education: The HUNT Study. Scandinavian Journal of Public Health. ISSN 1403-4948. doi: 10.1177/14034948211011796. Full text in Research Archive Show summary

  Aim: Understanding whether increasing Life Expectancy (LE) translates to improved health and function among older adults is essential, but results are inconclusive. We aimed to estimate trends in Disability-Free Life Expectancy (DFLE) in the older Norwegian population by sex and education from 1995 to 2017. Method: National life table data were combined with cross-sectional data on functional ability for 70+ year-olds from the population-based Trøndelag Health Surveys 2-4 (1995–1997, 2006–2008 and 2017–2019) (n=24,733). Self-reported functional ability was assessed on a graded scale by a combination of Instrumental Activities of Daily Living (IADL) such as paying bills, going out or shopping (mild disability) and Personal Activities of Daily Living (PADL) such as washing, dressing or eating (severe disability). LE, DFLE, Mild-Disability LE and Severe-Disability LE at age 70 were estimated by the Sullivan method. Results: From 1995 to 2017 DFLE at age 70 increased from 8.4 to 13.0 years in women, and from 8.0 to 12.1 years in men. DFLE increased in the basic and high educational groups, but more so in the high educational group among men. Educational inequalities in years spent with disability however, remained low. Conclusions: From the mid-1990s and over the past three decades both LE and DFLE at 70 years increased in the older Norwegian population, for both men and women, and across basic and high educational levels. Educational inequalities in DFLE increased, especially in men, but years spent with disability were similar across the three decades.

• Skirbekk, Vegard Fykse; Langballe, Ellen Melbye & Strand, Bjørn Heine (2021). Preferred life expectancy and the association with hypothetical adverse life scenarios among Norwegians aged 60+. Age and Ageing. ISSN 0002-0729. 50(6), p. 2012–2018. doi: 10.1093/ageing/afab113. Full text in Research Archive Show summary

  Background: how long older individuals prefer to live given hypothetical adverse changes in health and living conditions has been insufficiently studied. Objectives: the objective of this study is to investigate the relationship between six adverse health and living conditions and preferred life expectancy (PLE) after the age of 60 years. Design: cross-sectional face-to-face interviews. Setting: population-based sample. Participants: 825 community dwellers aged 60 years and older in Norway. Methods: logistic regression models were used to analyse PLE, measured with a single question: ‘If you could choose freely, until what age would you wish to live?’ The impact on PLE of several hypothetical scenarios, such as being diagnosed with dementia, spousal death, becoming a burden, poverty, loneliness and chronic pain was analysed by age, sex, education, marital status, cognitive function, self-reported loneliness and chronic pain. Results: average PLE was 91.4 years (95% CI 90.9, 92.0), and there was no difference between men and women, but those at older ages had higher PLE than those at younger ages. The scenarios that had the strongest negative effects on PLE were dementia, followed by chronic pain, being a burden to society, loneliness, poverty and losing one’s spouse. PLE among singles was not affected by the prospect of feeling lonely. The higher educated had lower PLE for dementia and chronic pain. Conclusion: among Norwegians 60+, the desire to live into advanced ages is significantly reduced by hypothetical adverse life scenarios, with the strongest effect caused by dementia and chronic pain

• Ward, Joseph L.; Azzopardi, Peter S.; Francis, Kate Louise; Santelli, John S.; Skirbekk, Vegard Fykse & Sawyer, Susan M. [Show all 51 contributors for this article] (2021). Global, regional, and national mortality among young people aged 10–24 years, 1950–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet. ISSN 0140-6736. 398(10311), p. 1593–1618. doi: 10.1016/S0140-6736(21)01546-4. Full text in Research Archive Show summary

  Background Documentation of patterns and long-term trends in mortality in young people, which reflect huge changes in demographic and social determinants of adolescent health, enables identification of global investment priorities for this age group. We aimed to analyse data on the number of deaths, years of life lost, and mortality rates by sex and age group in people aged 10–24 years in 204 countries and territories from 1950 to 2019 by use of estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Methods We report trends in estimated total numbers of deaths and mortality rate per 100 000 population in young people aged 10–24 years by age group (10–14 years, 15–19 years, and 20–24 years) and sex in 204 countries and territories between 1950 and 2019 for all causes, and between 1980 and 2019 by cause of death. We analyse variation in outcomes by region, age group, and sex, and compare annual rate of change in mortality in young people aged 10–24 years with that in children aged 0–9 years from 1990 to 2019. We then analyse the association between mortality in people aged 10–24 years and socioeconomic development using the GBD Socio-demographic Index (SDI), a composite measure based on average national educational attainment in people older than 15 years, total fertility rate in people younger than 25 years, and income per capita. We assess the association between SDI and all-cause mortality in 2019, and analyse the ratio of observed to expected mortality by SDI using the most recent available data release (2017). Findings In 2019 there were 1·49 million deaths (95% uncertainty interval 1·39–1·59) worldwide in people aged 10–24 years, of which 61% occurred in males. 32·7% of all adolescent deaths were due to transport injuries, unintentional injuries, or interpersonal violence and conflict; 32·1% were due to communicable, nutritional, or maternal causes; 27·0% were due to non-communicable diseases; and 8·2% were due to self-harm. Since 1950, deaths in this age group decreased by 30·0% in females and 15·3% in males, and sex-based differences in mortality rate have widened in most regions of the world. Geographical variation has also increased, particularly in people aged 10–14 years. Since 1980, communicable and maternal causes of death have decreased sharply as a proportion of total deaths in most GBD super-regions, but remain some of the most common causes in sub-Saharan Africa and south Asia, where more than half of all adolescent deaths occur. Annual percentage decrease in all-cause mortality rate since 1990 in adolescents aged 15–19 years was 1·3% in males and 1·6% in females, almost half that of males aged 1–4 years (2·4%), and around a third less than in females aged 1–4 years (2·5%). The proportion of global deaths in people aged 0–24 years that occurred in people aged 10–24 years more than doubled between 1950 and 2019, from 9·5% to 21·6%. Interpretation Variation in adolescent mortality between countries and by sex is widening, driven by poor progress in reducing deaths in males and older adolescents. Improving global adolescent mortality will require action to address the specific vulnerabilities of this age group, which are being overlooked. Furthermore, indirect effects of the COVID-19 pandemic are likely to jeopardise efforts to improve health outcomes including mortality in young people aged 10–24 years. There is an urgent need to respond to the changing global burden of adolescent mortality, address inequities where they occur, and improve the availability and quality of primary mortality data in this age group.

• Bratsberg, Bernt; Røgeberg, Ole & Skirbekk, Vegard Fykse (2021). Technology-induced job loss risk, disability and all-cause mortality in Norway. Occupational and Environmental Medicine. ISSN 1351-0711. 79(1), p. 32–37. doi: 10.1136/oemed-2021-107598. Full text in Research Archive Show summary

  Background Ongoing shifts in economic structure from automation and globalisation can affect employment and mortality, yet these relations are not well described. Objective We assess whether long-term employment and health outcomes relate systematically to structural change in the labour market, using the occupational Routine Task Intensity (RTI) score as indicator of exposure is to risks of outsourcing and technology-induced job loss. Methods Using a cohort design and administrative data with national population coverage, we categorise all Norwegian employees in 2003 by the RTI score of their occupation and examine how this score correlates with employment and health outcomes measured in 2018 and 2019. The study sample counts 416 003 men and 376 413 women aged 33–52 in 2003. Results The occupational RTI score at baseline is robustly associated with long-term employment, disability and mortality outcomes. Raw correlations are reduced after adjustment for potential confounders, but associations remain substantial in models controlling for individual covariates and in sibling comparisons. Working in an occupation with RTI score 1 SD above the mean in 2003 is associated with a raised probability of being deceased in 2019 of 0.24 percentage points (95% CI: 0.18 to 0.30) for men and 0.13 percentage points (95% CI: 0.02 to 0.24) for women, corresponding to raised mortality rates of 6.7% and 5.5%. Conclusions Individuals in occupations characterised by high routine intensity are less likely to remain employed in the long term, and have higher rates of disability and mortality.

• Bourne, Rupert RA; Steinmetz, Jaimie D; Flaxman, Seth; Briant, Paul Svitil; Taylor, Hugh R & Resnikoff, Serge [Show all 50 contributors for this article] (2020). Trends in prevalence of blindness and distance and near vision impairment over 30 years: an analysis for the Global Burden of Disease Study. The Lancet Global Health. ISSN 2572-116X. 9(2), p. e130–e143. doi: 10.1016/S2214-109X(20)30425-3. Full text in Research Archive Show summary

  Background To contribute to the WHO initiative, VISION 2020: The Right to Sight, an assessment of global vision impairment in 2020 and temporal change is needed. We aimed to extensively update estimates of global vision loss burden, presenting estimates for 2020, temporal change over three decades between 1990–2020, and forecasts for 2050. Methods We did a systematic review and meta-analysis of population-based surveys of eye disease from January, 1980, to October, 2018. Only studies with samples representative of the population and with clearly defined visual acuity testing protocols were included. We fitted hierarchical models to estimate 2020 prevalence (with 95% uncertainty intervals [UIs]) of mild vision impairment (presenting visual acuity ≥6/18 and <6/12), moderate and severe vision impairment (<6/18 to 3/60), and blindness (<3/60 or less than 10° visual field around central fixation); and vision impairment from uncorrected presbyopia (presenting near vision <N6 or <N8 at 40 cm where best-corrected distance visual acuity is ≥6/12). We forecast estimates of vision loss up to 2050. Findings In 2020, an estimated 43·3 million (95% UI 37·6–48·4) people were blind, of whom 23·9 million (55%; 20·8–26·8) were estimated to be female. We estimated 295 million (267–325) people to have moderate and severe vision impairment, of whom 163 million (55%; 147–179) were female; 258 million (233–285) to have mild vision impairment, of whom 142 million (55%; 128–157) were female; and 510 million (371–667) to have visual impairment from uncorrected presbyopia, of whom 280 million (55%; 205–365) were female. Globally, between 1990 and 2020, among adults aged 50 years or older, age-standardised prevalence of blindness decreased by 28·5% (–29·4 to –27·7) and prevalence of mild vision impairment decreased slightly (–0·3%, –0·8 to –0·2), whereas prevalence of moderate and severe vision impairment increased slightly (2·5%, 1·9 to 3·2; insufficient data were available to calculate this statistic for vision impairment from uncorrected presbyopia). In this period, the number of people who were blind increased by 50·6% (47·8 to 53·4) and the number with moderate and severe vision impairment increased by 91·7% (87·6 to 95·8). By 2050, we predict 61·0 million (52·9 to 69·3) people will be blind, 474 million (428 to 518) will have moderate and severe vision impairment, 360 million (322 to 400) will have mild vision impairment, and 866 million (629 to 1150) will have uncorrected presbyopia.

• Bratsberg, Bernt; Røgeberg, Ole Jørgen & Skirbekk, Vegard (2020). Fathers of children conceived using ART have higher cognitive ability scores than fathers of naturally conceived children. Human Reproduction. ISSN 0268-1161. 35(6), p. 1461–1468. doi: 10.1093/humrep/deaa119. Full text in Research Archive
• Skirbekk, Vegard; Sherbinin, Alex de; Adamo, Susana B.; Navarro, Jose & Chai-Onn, Tricia (2020). Religious Affiliation and Environmental Challenges in the 21st Century. Journal of Religion and Demography. ISSN 2589-7411. 7(2), p. 238–271. doi: 10.1163/2589742X-12347110. Full text in Research Archive

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• Skirbekk, Vegard Fykse (2022). Decline and Prosper! Palgrave Macmillan. ISBN 9783030916107. doi: 10.1007/978-3-030-91611-4. Full text in Research Archive

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• Hart, Rannveig Kaldager & Skirbekk, Vegard Fykse (2026). Fødselstall under press. [Internet]. Tendens. Full text in Research Archive Show summary

  Norge får stadig færre barn. En ny utredning viser at årsakene handler om mer enn familiepolitikk.

• Skirbekk, Vegard Fykse (2026). The role of mortality in fertility transition studies. Full text in Research Archive Show summary

  Many of those concerned about overpopulation are encouraged by trends showing declining births per woman (TFR). However, a recent study by Skirbekk and Spoorenberg shows that taking declining death rates into account, net reproduction and hence the population growth rate have peaked later than typically reported. Most striking, in seven African countries, fertility transitions have yet to even begin.

• Skirbekk, Vegard Fykse (2026). Globalt mannsoverskudd gir historisk skifte i fruktbarhet. [Journal]. Aftenposten.no. Full text in Research Archive Show summary

  Norskledet studie viser at for første gang i historien er menn mindre fruktbare enn kvinner. – Litt overraskende, sier forsker.

• Skirbekk, Vegard Fykse (2026). IUSSP Debate: "When Populations Shrink: Should States Encourage Births or Adapt?". Full text in Research Archive
• Skirbekk, Vegard Fykse & Rørtveit, Guri (2026). The Future of Fertility and the Health of Men. Full text in Research Archive Show summary

  A chat with a Norwegian demographer and the director general of the Norwegian Institute of Public Health

• Skirbekk, Vegard Fykse & Spoorenberg, Thomas (2026). Fertility postponement is not a universal correlate of fertility decline - N-IUSSP. Full text in Research Archive
• Dierker, Philipp & Skirbekk, Vegard Fykse (2026). Grandparenthood related to reduced risk of gray divorce: evidence from 15 countries. MPIDR Working Paper. doi: 10.4054/mpidr-wp-2026-015. Full text in Research Archive
• Skirbekk, Vegard Fykse (2026). Kvinner får nå i gjennomsnitt flere barn enn menn - FHI. Full text in Research Archive Show summary

  Menn har tradisjonelt hatt flere barn enn kvinner fordi det har vært færre menn enn kvinner i reproduktiv alder. Fra og med 2024 har dette snudd globalt – og menn forventes å ha relativt færre barn enn kvinner i lang tid framover.

• Skirbekk, Vegard Fykse & Håberg, Asta (2025). 4.C. Scientific session: How modern family and work life influence dementia risk – The REFAWOR project. European Journal of Public Health. ISSN 1101-1262. 35(Supplement_4), p. iv84–iv85. doi: 10.1093/eurpub/ckaf161.205. Full text in Research Archive Show summary

  Abstract   In the Changing Lives Changing Brians project (REFAWOR), which is supported by a NIH R01 grant 2020-26, we study life-course effects of family and work in adulthood for risk of Alzheimer's disease and related dementias (ADRD) in older adults by exploiting the Norwegian Trøndelag Health Study (HUNT), a large ongoing prospective population level study that includes cohorts born 1900-1960, including more than 11700 participants aged 70+ years, combined with Norwegian national registry data. The project is led by Columbia University in New York, together with UPEnn and The Norwegian Institute of Public Health and includes 22 researchers from US and Europe. Family patterns have fundamentally changed in Western countries in the second half of the 20th century, with more childlessness, partnership disruptions, cohabitation and patchwork-families. The cognitive reserve theory posits that individuals accrue cognitive abilities throughout their lives, offering a buffer against cognitive decline. Factors such as education, engaging occupations, and participation in stimulating activities contribute to building cognitive reserve. With a global surge in the aging population, understanding modifiable risk factors for cognitive decline gains prominence. This workshop investigates the cognitive reserve theory using Norwegian population-based data, features four presenters and a summary by the chairs. The workshop topic is relevant for the EPH Conference and international audience as it addresses social determinants of dementia - a highly prevalent non-communicable chronic disease of growing importance. First, Dr Zothcheva investigates how physical and cognitive demands at the workplace are associated with the risk of dementia. Secondly, Strand, and Mekonnen delve into the effects of lifetime employment, number of children and marital histories on risk of mild cognitive impairment and dementia. Thirdly, Mekonnen gives an overview of the mediation pathways linking education and dementia, before Ellingjord-Dale informs of the potential for prevention by addressing factors related to lifestyle, family and work. Finally, our chairs open up for questions from the audience, they sum up the findings and inform them of our plans in the REFAWOR project. Since its first publication in 2022, results from REFAWOR have been published in highly ranked journals such as the Lancet regional health Europe and Neurology and received attention from media worldwide by outlets such as the Guardian, CNN and Daily mail. In this workshop, new and published results from the project will be presented and synthesized, and these presentations contribute valuable insights into the multifaceted dynamics of cognitive reserve and its implications for aging well. Key messages • Modern family, education and work life influence dementia risk, and mediating factors related to lifestyle and health factors across the life-course matter. • Addressing modifiable risk factors and factors related to marital and occupational status could potentially prevent more than half of all dementia.

• Engeland, Jeanette; Langballe, Ellen Melbye; Strand, Bjørn Heine & Skirbekk, Vegard Fykse (2025). Life Satisfaction in Older Age among people with disabilities in early-to-mid adulthood. doi: https:/helsinkifi-my.sharepoint.com/:w:/g/personal/lomulomu_ad_helsinki_fi/EaJtILWO_OVKsaloDULkjU8BOvWpLZolLx-oAgqRb52g7A?e=u4o32A. Full text in Research Archive Show summary

  Background: The global population is ageing, and the prevalence of disabilities is on the rise. There is limited knowledge about the long-term effects of disabilities experienced in early-to-mid adulthood on life satisfaction in older age. Understanding these long-term effects is crucial for improving both public health policies and interventions aimed at enhancing the quality of life for older adults. Methods: The analysis includes 21,481 participants from the Trøndelag Health Study (HUNT), who were between 20 and 49 years old during the first wave of the study (1984–1986) and between 53 and 84 years old during the follow-up in the fourth study wave (2017–2019). A total of 3,244 participants (15.1%) reported having a disability. Ordinary Least Squares (OLS) regression was chosen to estimate the relationship between disability in early-to-mid adulthood and life satisfaction in older age. The analysis was adjusted for potential confounding factors including age, gender, education level, employment status, and living situation (whether living alone or not). Results: Participants with disabilities in early-to-mid adulthood reported significantly lower life satisfaction in older age compared to those without disabilities. The strongest negative association was found for individuals with mental health conditions and people with more than one disability. Education did not have a significant effect on life satisfaction in older age. However, participants who were currently employed reported higher life satisfaction, as did those who lived with someone. Conclusions: The study highlights the critical need for global public health policies that provide sustained support to individuals with disabilities across their lifespan. Addressing the inequalities faced by aging populations with disabilities is essential to improving life satisfaction and reducing the long-term impact of early-life disability on well-being.

• Langballe, Ellen Melbye; Holvik, Kristin; Håberg, Asta; Skirbekk, Vegard Fykse; Syse, Astri & Strand, Bjørn Heine (2025). Does increased life expectancy translate to more years of health capacity to work? European Journal of Public Health. ISSN 1101-1262. 35(Suppl.4). doi: 10.1093/eurpub/ckaf161.108. Full text in Research Archive
• Holvik, Kristin; Langballe, Ellen Melbye; Håberg, Asta; Skirbekk, Vegard Fykse; Syse, Astri & Strand, Bjørn Heine (2025). Health capacity to work among older adults in different occupational groups. Norsk Epidemiologi, Supplement. ISSN 0803-4206. 33(Suppl.1), p. 81–81. doi: https:/www.ntnu.no/ojs/index.php/norepid/index. Full text in Research Archive
• Ellen, Jakobsen, Siw & Skirbekk, Vegard Fykse (2025). Det er ikke tilfeldig hvem som blir 100 år gammel. [Journal]. Forskning.no. doi: https:/folkehelse.sharepoint.com/:x:/r/sites/1035/_layouts/15/Doc.aspx?sourcedoc=%7B6F7F640E-D714-43A5-BF19-3BFD6CE2736A%7D&file=CeFH%20Media%202025.xlsx&action=default&mobileredirect=true&CID=07C0AC4F-F804-4E42-BF95-388A462DAB5C&wdLOR=c6CB981AC-8E96-41DA-8B3B-72FAF1E9F6B8. Full text in Research Archive
• Skirbekk, Vegard Fykse (2025). A radical proposal: put the EU's counter-tariffs on US social media apps. Full text in Research Archive
• Gideon, Lewis-Kraus, & Skirbekk, Vegard Fykse (2025). The End of Children: Birth rates are crashing around the world. Should we be worried? [Journal]. The New Yorker. doi: https:/www.newyorker.com/magazine/2025/03/03/the-population-implosion. Full text in Research Archive
• Skirbekk, Vegard Fykse; Halse, Bjørn Atle Sundsback; Seterelv, Siri Schøyen; Selbæk, Geir & Langballe, Ellen Melbye (2025). Cardiopulmonary resuscitation status among long-term care residents in Norway. medRxiv. doi: 10.1101/2025.01.15.25320634. Full text in Research Archive Show summary

  Abstract Objectives Norwegian health authorities require all long-term care institutions to determine and record whether residents should have cardiopulmonary resuscitation (CPR) administered in the case of an emergency. There is a need to better understand variation in CPR-status using population level data to obtain accurate estimates and to understand how it differs by cultural and socioeconomic status. Design Population register based assessments. Setting and Participants This study investigate the proportions of CPR+ and CPR- 2 . by age, gender, marital status, primary contact and care needs in a sample that include all residents in long-term care facilities in Oslo aged 50 years or older ( N = 11,948) during the period 1 st of January 2018 to 31 st of December 2023. Everyone in the dataset had CPR status. Methods Descriptive population-level assessment of health care residents’ registry data and logistic regression analyses. Results The proportion of residents who were CPR+ was slightly below one third (31.4%), with significantly more women (33,2%) than men (27.9%). CPR+ decreased with age (45.9% for those aged 50–66 years, 27.4% for those aged 85-89 years) but rose again for the oldest age group (33.0%, aged 90+). Compared to unmarried individuals and widows or widowers, the proportion of married long-term care residents with CPR+ was lower. Those who had no primary contact or more distant ones (e.g., a lawyer) were more likely to be CPR+. The CPR+ was slightly higher among individuals with comprehensive care needs. However, the differences were only significant for CPR+ among those with comprehensive care needs compared to those with moderate care needs when adjusted for age, gender, and primary contact. Conclusions and Implications Only one third of long-term care residents in Norway are registered as CPR+. Particularly women and those at younger ages and the oldest old were more likely to be CPR+. The low proportions of CPR+ residents across major segments of Norway’s institutionalized population as well as gender and age distribution will hopefully spark debates about CPR practices.

• Skirbekk, Vegard Fykse (2024). The Low Fertility Fallacy: Why Panic About Birthrates Is Overblown. [Journal]. Foreign Affairs. doi: https:/www.foreignaffairs.com/united-states/low-fertility-fallacy. Full text in Research Archive
• Kjeldgaard, Helena Kames; Omsland, Tone Kristin; Skirbekk, Vegard Fykse; O'Flaherty, Martin; Meyer, Haakon Eduard & Holvik, Kristin (2024). Forecasting the burden of hip fracture in Norway towards 2050 by educational level. The Norwegian Epidemiologic Osteoporosis Studies (NOREPOS). Norsk Epidemiologi, Supplement. ISSN 0803-4206. 32, p. 21–21. Full text in Research Archive
• Tungodden, Kayla Marie; Fadum, Elin Anita; Malmø-Lund, Anna; Engeland, Jeanette; Jansen, Eirik & Skirbekk, Vegard Fykse [Show all 8 contributors for this article] (2024). Forsvarets arkiver som kunnskapsressurs - digitalisering og transkribering av militære helsedata. Norsk arkivforum. ISSN 0800-3106. doi: 10.18261/naf.30.1.4. Full text in Research Archive
• Langballe, Ellen Melbye; Skirbekk, Vegard Fykse & Strand, Bjørn Heine (2023). Correction: Subjective age and the association with intrinsic capacity, functional ability, and health among older adults in Norway (European Journal of Ageing, (2023), 20, 1, (4), 10.1007/s10433-023-00753-2). European Journal of Ageing. ISSN 1613-9372. 20(1). doi: 10.1007/s10433-023-00757-y. Full text in Research Archive
• Wolfova, Katrin; Wu, Di; Weiss, Jordan; Cermakova, Pavla; Kohler, Hans-Peter & Skirbekk, Vegard Fykse [Show all 9 contributors for this article] (2023). Corrigendum to “Sons and parental cognition in mid-life and older adulthood” [J. Psychiatr. Res. 156 (2022) 284–290, (S0022395622005696), (10.1016/j.jpsychires.2022.10.026)]. Journal of Psychiatric Research. ISSN 0022-3956. 160, p. 8–8. doi: 10.1016/j.jpsychires.2023.01.048. Full text in Research Archive
• Zotcheva, Ekaterina; Strand, Bjørn Heine; Håberg, Asta; Selbæk, Geir; Bratsberg, Bernt Magne & Skirbekk, Vegard Fykse (2022). Sex-specific associations of occupational physical demands and dementia risk: the HUNT Study. Full text in Research Archive
• Skirbekk, Vegard Fykse (2022). Elon Musk Is Totally Wrong About Population Collapse. [Journal]. Wired Magazine. Full text in Research Archive
• Skirbekk, Vegard Fykse (2022). Centre talk: Why has fertility more than halved? Full text in Research Archive
• Skirbekk, Vegard Fykse (2022). Social and biological drivers of low fertility. Full text in Research Archive
• Skirbekk, Vegard Fykse (2022). Over halvparten av oss kan bli uten etterkommere. [Internet]. forskning.no. Full text in Research Archive
• Skirbekk, Vegard Fykse (2022). What will a population of 8 billion people mean for us and the planet? [Journal]. New Scientist. Full text in Research Archive
• Skirbekk, Vegard Fykse (2022). Vegard Skirbekk on why we should embrace low fertility rates. [Journal]. The Economist. Full text in Research Archive
• Skirbekk, Vegard Fykse (2022). Understanding the Global Transition to Low Fertility. Full text in Research Archive
• Strand, Bjørn Heine; Sund, Erik Reidar; Hopstock, Laila Arnesdatter; Storeng, Siri Høivik; Skirbekk, Vegard Fykse & Krokstad, Steinar (2021). Gode nyheter fra FHI: Vi lever ikke bare lenger. Vi får også flere år med god helse. Full text in Research Archive
• Stanaway, Jeffrey D.; Afshin, Ashkan; Gakidou, Emmanuela; Lim, Stephen S.; Abate, Degu & Abate, Kalkidan Hassen [Show all 1,040 contributors for this article] (2019). Erratum: Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017 (The Lancet (2018) 392(10159) (1923–1994), (S0140673618322256), (10.1016/S0140-6736(18)32225-6)). The Lancet. ISSN 0140-6736. 393(10190), p. e44–e44. doi: 10.1016/S0140-6736(19)31429-1. Full text in Research Archive
• Tyagi, Rishabh; Skirbekk, Vegard Fykse; Gugushvili, Alexi; Dudel, Christian & Myrskylä, Mikko (2025). The Disparate Effects of Employment Uncertainty on Life Course Outcomes. Universitetet i Oslo. Full text in Research Archive Show summary

  Job loss and unemployment have long-lasting effects on individuals' career trajectories, as well as other life course outcomes. This doctoral thesis is based on four empirical studies in Germany, Norway, and India. The first study in the German context shows that experiencing involuntary job loss for men increases the risk of partnership dissolution by almost 65% within three years of the job loss. However, men with egalitarian gender attitudes (who perform a relatively higher share of housework and childcare among other men) did not experience an increased risk of partnership dissolution following job loss. The second and third studies examine the impact of employment uncertainty due to workplace closures on first and second birth outcomes in the Norwegian context. The first study at the individual level shows that experiencing a workplace closure does not affect men’s birth outcomes, while for women, there is a negative anticipation effect on birth outcomes before closure happens, and a positive effect on birth outcomes after workplace closure. The experience of workplace closure does not affect the total number of children at age 49 for either men or women. The third study takes a couple's perspective and finds that the Female partner’s job loss negatively influences couples’ decisions to become parents, while the male partner's job loss negatively influences the couple’s decisions to have second children. The negative effects of job loss are more pronounced for low-income couples. The fourth article finds a positive association between adult children's unemployment and their parents' risk of depression in the Indian context. Parents with high levels of social participation did not experience an increased risk of depression associated with their adult children's unemployment. Parents living in low or medium-income inequality states also experience a weaker association of children's unemployment with their own depression risk. This doctoral thesis demonstrates that employment uncertainty due to job loss and unemployment affects partnership dissolution risk, reproductive decisions, and mental health outcomes of their family, too. The extent to which these life course outcomes are affected is also shaped by the individual, regional and welfare characteristics.

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