Extreme wealth loss and subsequent mental well-being among adults aged ≥50 years: a multicohort study

The association of extreme wealth loss with subsequent mental well-being in later life, as well as whether this association varies across countries with different levels of economic development, remains unclear.

Our study included 23,817 participants, of which 3282 were from the China Health and Retirement Longitudinal Study (2011-2018), 11,838 from the Health and Retirement Study (2008-2019), and 8697 from the Mexican Health and Aging Study (2012-2019). Extreme wealth loss in our study is defined as a net wealth decline of 75% or more between the first two waves. Mixed-effects linear regression models were employed to examine the associations.

In the fully adjusted models, extreme wealth loss was associated with higher depressive symptoms (odds ratio (OR) = 1.3; 95% confidence interval (CI) = 1.2-1.4 for China, OR = 1.3; 95% CI = 1.2-1.3 for USA, and OR = 1.1; 95% CI = 1.0-1.1) for Mexico); lower life satisfaction (OR = 0.8; 95% CI = 0.7-0.9) for China, OR = 0.8; 95% CI = 0.7-0.8) for USA, OR = 0.9; 95% CI = 0.9-1.0 for Mexico) and worse self-reported health (OR = 0.9; 95% CI = 0.8-0.9 for China, OR = 0.9; 95% CI = 0.8-0.9 for USA, OR = 1.0; 95% CI = 0.9-1.1 for Mexico). Predicted standardised scores showed that the negative association between extreme wealth loss and mental well-being remained unchanged over time in China and Mexico. In the USA, we observed a significant interaction between exposure groups and follow-up time.

Public health policy formulation should target populations experiencing significant wealth loss and provide them with stable economic security to effectively enhance mental health outcomes.