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

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